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Artificial Intelligence for Colorectal Polyp Detection and Characterization
AbstractPurpose of reviewTo elucidate the advantages and limitations of existing artificial intelligence technologies for colonoscopy by evaluating the currently available eight prospective studies (two for automated polyp detection and six for automated polyp characterization).Recent findingsAI is expected to mitigate the inherent risk of human error causing a polyp to be missed or mischaracterized by assisting polyp detection and characterization (i.e., pathological prediction). Some of the prospective studies clearly demonstrate the potential for AI to improve adenoma detection rates, which is considered one of the most...
Source: Current Treatment Options in Gastroenterology - March 25, 2020 Category: Gastroenterology Source Type: research

Lactose Intolerance and Milk Protein Allergy
AbstractPurpose of reviewReal or perceived lactose intolerance (LI) and true cow ’s milk allergy (CMA) are common reasons for dairy avoidance but are underdiagnosed and under-treated. Dairy avoidance is associated with nutrient deficiencies and unintended health consequences that disproportionately affect minorities.Recent findingsSurveyed GI physicians report that at least 30% of their patients had LI and 16% had food allergies including CMA. In a 2019 survey, approximately 10.8% of adults have symptoms consistent with a food allergy and CMA was the second most common allergy reported. LI and CMA are more common in ethn...
Source: Current Treatment Options in Gastroenterology - February 19, 2020 Category: Gastroenterology Source Type: research

New Developments in the Diagnosis and Management of Gastroesophageal Reflux
AbstractPurpose of reviewTo examine recent key developments in the pathophysiology, diagnosis, and treatment of gastroesophageal reflux disease (GERD).Recent findingsNewer research has suggested cytokine-mediated inflammation may play a role in the physiology of GERD, implying that the underlying mechanism may not be entirely related to chemical damage due to acid. Aided by novel technologies, diagnostic testing is also moving toward elucidating individual mechanisms and better defining specific GERD phenotypes with the goal of providing directed therapy. This is especially important in current times given the increase in ...
Source: Current Treatment Options in Gastroenterology - February 18, 2020 Category: Gastroenterology Source Type: research

Burden of Gastroduodenal Diseases from the Global Perspective
AbstractPurpose of reviewWe reviewed the recent medical literature to show global burden of gastroduodenal disease, potential strategies, and further perspectives.Recent findingsGastrointestinal and liver diseases are growing health problems, and cause more than 8 million deaths per year worldwide; encompass a range of long-term health conditions, such as digestive cancers, gastroesophageal reflux disease, Helicobacter pylori infection, peptic ulcer disease, liver diseases, inflammatory bowel disease, coeliac disease, and functional gastrointestinal disorders. Scientific knowledge demonstrates that the noncommunicable dise...
Source: Current Treatment Options in Gastroenterology - January 27, 2020 Category: Gastroenterology Source Type: research

The Use of Attachment Devices to Aid in Adenoma Detection
AbstractPurpose of reviewWith the intent of maximizing adenoma detection rate (ADR), different devices and colonoscopic innovations have been introduced over the past few years. There are a variety of attachment devices available for use in colonoscopy, all intended to improve ADR. In this review, we evaluate the evidence surrounding the available attachment devices and their impact on ADR.Recent findingsEndocuff, Endoring, Transparent cap, G-EYE balloon, and Third Eye Retroscope were all included in this review. Three of the devices, Endocuff, Endoring, and transparent hood or cap, have been shown to increase ADR without ...
Source: Current Treatment Options in Gastroenterology - January 26, 2020 Category: Gastroenterology Source Type: research

Molecular Diagnostics and Testing for Pancreatic Cysts
AbstractPurpose of reviewIn current clinical practice, the diagnosis and management of pancreatic cystic lesions (PCLs) are based on guidelines that combine clinical and imaging findings. These guidelines usefully identify a large category of low-risk PCLs that do not require treatment. However, they have limited accuracy for diagnosis of advanced neoplasia in worrisome and high-risk PCLs. Novel molecular markers that can accurately detect advanced neoplasia in PCLs can transform the care of patients with PCLs. We reviewed the recent medical literature on molecular diagnostics of PCLs and summarized molecular biomarkers as...
Source: Current Treatment Options in Gastroenterology - January 26, 2020 Category: Gastroenterology Source Type: research

Chronic Burping and Belching
AbstractAbstractBelching is a physiological event that allows venting of swallowed gastric air. Excessive belching is a common presentation to gastroenterology clinics and could be isolated complains or associated with other gastrointestinal problems.Purpose of this ReviewIt is to describe the presentation, diagnosis, and treatment of belching disordersRecent FindingsThese demonstrate that learned abnormal behaviors in response to unpleasant feeling in the abdomen are the driving causes for excessive belching and addressing these behaviors by speech pathology and cognitive behavior therapy considered as the keystone in its...
Source: Current Treatment Options in Gastroenterology - January 22, 2020 Category: Gastroenterology Source Type: research

Chronic Hiccups
AbstractPurpose of reviewNearly 4000 patients will be admitted to hospital in the US this year for hiccups. Hiccups are controlled by a complex reflex arc between peripheral receptors and the brainstem. Any disruption along this pathway may produce hiccups. Typically, hiccups resolve spontaneously but in certain pathologies symptoms may persist. Persistent hiccups may be considered a sign of underlying pathology. The most common cause involves GERD.Recent findingsBased on etiologies, studies have shown that first-line therapy should use a proton pump inhibitor (PPI) and involve appropriate gastrointestinal consultation. If...
Source: Current Treatment Options in Gastroenterology - January 22, 2020 Category: Gastroenterology Source Type: research

Artificial Intelligence and Polyp Detection
AbstractPurpose of reviewThis review highlights the history, recent advances, and ongoing challenges of artificial intelligence (AI) technology in colonic polyp detection.Recent findingsHand-crafted AI algorithms have recently given way to convolutional neural networks with the ability to detect polyps in real-time. The first randomized controlled trial comparing an AI system to standard colonoscopy found a 9% increase in adenoma detection rate, but the improvement was restricted to polyps smaller than 10  mm and the results need validation. As this field rapidly evolves, important issues to consider include standardizati...
Source: Current Treatment Options in Gastroenterology - January 20, 2020 Category: Gastroenterology Source Type: research

Multi-Target Stool DNA Testing for Colorectal Cancer Screening: Emerging Learning on Real-world Performance
AbstractPurpose of ReviewMulti-target stool DNA (MT-sDNA) was approved in 2014 for use in screening average-risk patients for colorectal cancer (CRC). Here, we highlight recent literature from post-market studies to provide an update on clinical use and utility not possible from pre-approval studies.Recent FindingsMT-sDNA has been included in major society guidelines as an option for colorectal cancer screening, and has seen exponentially increasing use in clinical practice. MT-sDNA appears to be attracting new patients to CRC screening, and patient adherence to diagnostic colonoscopy after a positive MT-sDNA test is high....
Source: Current Treatment Options in Gastroenterology - January 20, 2020 Category: Gastroenterology Source Type: research

The Effects of Bariatric Surgery and Endoscopic Bariatric Therapies on GERD: An Update
AbstractPurpose of reviewBariatric surgery and endoluminal bariatric therapies (EBTs) form an increasingly utilized therapeutic approach to treat obese patients but may worsen gastroesophageal reflux disease (GERD). In this updated article, we review the evidence on the effects of bariatric procedures on GERD.FindingsRecent evidence implicates sleeve gastrectomy with the highest rates of de novo GERD and Barrett ’s esophagus (BE), whereas malabsorptive-restrictive procedures such as Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) were shown to have significantly lower reported rates. The intraga...
Source: Current Treatment Options in Gastroenterology - January 19, 2020 Category: Gastroenterology Source Type: research

Rumination Syndrome: Recognition and Treatment
AbstractPurpose of reviewThe purpose of this paper is to discuss current diagnostic and treatments of rumination.Rumination is often underdiagnosed or misdiagnosed in adults, especially when symptoms suggest regurgitation rather than vomiting accompanied by re-chewing and re-swallowing and should be included in the differential diagnosis. It is primarily diagnosed clinically by ROME-IV or DSM-5.Recent findingsThat rumination can be re-affirmed by characteristic patterns on objective testing such as high-resolution esophageal manometry and 24-h pH impedance testing. However, although gastroduodenal manometry and EMG are hel...
Source: Current Treatment Options in Gastroenterology - January 19, 2020 Category: Gastroenterology Source Type: research

Minor esophageal functional disorders: are they relevant?
AbstractPurpose of reviewHigh resolution esophageal manometry (HRM) has expanded understanding of esophageal motor function. The Chicago Classification scheme has allowed systematic categorization of the myriad of manometric parameters identified during HRM. Multichannel intraluminal impedance pH has enhanced ambulatory reflux monitoring through complete assessment of esophageal content transit. However, the clinical implications of identified minor esophageal functional disorders remain unclear.Recent findingsEsophagogastric junction outlet obstruction is defined by esophagogastric junction obstruction with preserved peri...
Source: Current Treatment Options in Gastroenterology - January 16, 2020 Category: Gastroenterology Source Type: research

Correction to: An Approach to Obesity Management for Gastroenterologists and Hepatologists
The original article unfortunately contained a mistake. (Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - January 6, 2020 Category: Gastroenterology Source Type: research

Current Endpoints of Clinical Trials in Ulcerative Colitis: Are They Valid?
AbstractNote: This statement is mandatory. Please provide. (Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - January 3, 2020 Category: Gastroenterology Source Type: research