Current Treatment Options in Gastroenterology 
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This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.Diagnosis and Management of Exocrine Pancreatic Insufficiency
AbstractPurpose of reviewRecent studies have documented that many patients with pancreatic exocrine insufficiency (EPI) are not identified and are not treated with appropriate dosages of pancreatic enzyme replacement therapy. This review will summarize the approach to diagnosis, treatment, and monitoring for treatment effect and complications in patients with exocrine insufficiency.Recent findingsWhile chronic pancreatitis is the most commonly identified cause of EPI, pancreatic cancer and pancreatic surgery are increasingly important. The diagnosis of EPI remains challenging, but fecal elastase is the most clinically usef...
Source: Current Treatment Options in Gastroenterology - July 19, 2018 Category: Gastroenterology Source Type: research
Training in Endoscopy
AbstractPurpose of the reviewProgress towards the goal of high-quality endoscopy across health economies has been founded on high-quality structured training programmes linked to credentialing practice and ongoing performance monitoring. This review appraises the recent literature on training interventions, which may benefit performance and competency acquisition in novice endoscopy trainees.Recent findingsIncreasing data on the learning curves for different endoscopic procedures has highlighted variations in performance amongst trainees. These differences may be dependent on the trainee, trainer and training programme. Ev...
Source: Current Treatment Options in Gastroenterology - July 17, 2018 Category: Gastroenterology Source Type: research
Inflammatory Bowel Disease in the Baby to Baby Boomer: Pediatric and Elderly Onset of IBD
AbstractPurpose of reviewEarly- and late-onset of inflammatory bowel disease (IBD) may perhaps be etiologically distinct and potentially attributed to genetics, environmental or microbial factors. We review disease factors and clinical characteristics, as well as unique management and treatment strategies to consider when caring for the “baby” or “baby boomer” with IBD.Recent findingsAround 25% of cases of initial diagnosis of IBD is made before the age of 18 years old, and another 15–20% made after the age of 60. Crohn’s disease (CD) typically presents as ileocolonic and stricturing or penetrating phenotype ...
Source: Current Treatment Options in Gastroenterology - July 13, 2018 Category: Gastroenterology Source Type: research
Outcomes and Management of the Ileal Pouch-Anal Anastomosis in the Elderly
AbstractPurpose of ReviewIleal pouch-anal anastomosis (IPAA) is the preferred surgical treatment for patients undergoing colectomy to maintain intestinal continuity. Earlier studies have suggested that outcomes are worse in elderly patients who underwent IPAA. However, more recent reports have shown that IPAA outcomes in the elderly are comparable to younger patients. We review the recent medical literature regarding outcomes and treatments for common complications in elderly IPAA patients.Recent FindingsCompared to younger patients, IPAA in the elderly is not associated with increased major surgical complications, but is ...
Source: Current Treatment Options in Gastroenterology - July 12, 2018 Category: Gastroenterology Source Type: research
The Use of Statins in Patients With Chronic Liver Disease and Cirrhosis
AbstractPurpose of reviewStatins are drugs developed to treat hypercholesterolemia. Its use in patients with liver disease has been limited because one of its potential and most feared side effects is hepatotoxicity. However, there is robust evidence that supports the safety of statins in this population in the absence of severe liver dysfunction. In this review, we will summarize the efficacy and safety of statins in cirrhosis.Recent findingsStatins are effective in the treatment of dyslipidemia in patients with liver disease, because of their pleiotropic properties. These properties are independent of their effect on cho...
Source: Current Treatment Options in Gastroenterology - June 1, 2018 Category: Gastroenterology Source Type: research
Esophageal Stenting in Clinical Practice: an Overview
Opinion statementPurpose of reviewEsophageal stents are used in clinical practice for endoscopic treatment of a wide variety of esophageal diseases and conditions. This review provides key principles and a literature update on the utility and limitations of esophageal stenting in clinical practice.Recent findingsIndications for esophageal stenting can be subdivided into two groups. The first group consists of patients with malignant or benign dysphagia, in which an esophageal stent restores luminal patency. In the past years, temporary stent placement has increasingly been used in the therapeutic management of refractory b...
Source: Current Treatment Options in Gastroenterology - June 1, 2018 Category: Gastroenterology Source Type: research
Management of Hepatic Encephalopathy Not Responsive to First-Line Treatments
AbstractPurpose of reviewHepatic encephalopathy (HE) is a neuropsychiatric syndrome that occurs in up to 30% of patients with cirrhosis. HE may be a consequence of pure liver failure, as in patients with fulminant hepatitis, or of the combination of liver failure and portal-systemic shunting, as in patients with liver cirrhosis. Episodes of HE are usually related to precipitating events, such as infections or gastrointestinal bleeding; a minority of cirrhotic patients experienced a chronic HE, refractory to standard medical treatment. The prevention of HE recurrence, after the first episode of HE, could be obtained by the ...
Source: Current Treatment Options in Gastroenterology - June 1, 2018 Category: Gastroenterology Source Type: research
Interaction Between Hepatocellular Carcinoma and Hepatitis C Eradication With Direct-acting Antiviral Therapy
This article reviews the current literature on the interaction between HCC and hepatitis C eradication with DAAs.Recent findingsFollowing publication of the initial observation in 2016, a number of studies have looked at the impact of active HCC on the success of antiviral therapy, as well as that of treatment with DAAs on both the occurrence and recurrence of HCC. The presence of active HCC decreases sustained virologic response (SVR) rates with DAAs. However, SVR rates improve in patients who have achieved complete radiological response or are treated post transplantation. With respect to occurrence of HCC after DAAs, ma...
Source: Current Treatment Options in Gastroenterology - June 1, 2018 Category: Gastroenterology Source Type: research
Intensive Care Management of Patients with Cirrhosis
AbstractPurpose of reviewCirrhosis is a major worldwide health problem which results in a high level of morbidity and mortality. Patients with cirrhosis who require intensive care support have high mortality rates of near 50%. The goal of this review is to address the management of common complications of cirrhosis in the ICU.Recent findingsRecent epidemiological studies have shown an increase in hospitalizations due to advanced liver disease with an associated increase in intensive care utilization. Given an increasing burden on the healthcare system, it is imperative that we strive to improve our management cirrhotic pat...
Source: Current Treatment Options in Gastroenterology - June 1, 2018 Category: Gastroenterology Source Type: research
Frailty in Patients With Cirrhosis
AbstractPurpose of reviewThis review gives an overview of the evolving concept of physical frailty in patients with cirrhosis. As well as summarizing the available metrics that have been used to diagnose it, this review also examines the major recent trials that have investigated frailty in patients with cirrhosis. The complex relationship between sarcopenia and frailty is explored, and strategies to optimize frailty, such as including pharmacological and non-pharmacological therapies, are discussed.Recent findingsThough there is heterogeneity between studies on how physical frailty in cirrhosis has been assessed, it is no...
Source: Current Treatment Options in Gastroenterology - June 1, 2018 Category: Gastroenterology Source Type: research
Management of Hepatic Encephalopathy Not Responsive to First-Line Treatments
AbstractPurpose of reviewHepatic encephalopathy (HE) is a neuropsychiatric syndrome that occurs in up to 30% of patients with cirrhosis. HE may be a consequence of pure liver failure, as in patients with fulminant hepatitis, or of the combination of liver failure and portal-systemic shunting, as in patients with liver cirrhosis. Episodes of HE are usually related to precipitating events, such as infections or gastrointestinal bleeding; a minority of cirrhotic patients experienced a chronic HE, refractory to standard medical treatment. The prevention of HE recurrence, after the first episode of HE, could be obtained by the ...
Source: Current Treatment Options in Gastroenterology - April 28, 2018 Category: Gastroenterology Source Type: research
Intensive Care Management of Patients with Cirrhosis
AbstractPurpose of reviewCirrhosis is a major worldwide health problem which results in a high level of morbidity and mortality. Patients with cirrhosis who require intensive care support have high mortality rates of near 50%. The goal of this review is to address the management of common complications of cirrhosis in the ICU.Recent findingsRecent epidemiological studies have shown an increase in hospitalizations due to advanced liver disease with an associated increase in intensive care utilization. Given an increasing burden on the healthcare system, it is imperative that we strive to improve our management cirrhotic pat...
Source: Current Treatment Options in Gastroenterology - April 4, 2018 Category: Gastroenterology Source Type: research
Frailty in Patients With Cirrhosis
AbstractPurpose of reviewThis review gives an overview of the evolving concept of physical frailty in patients with cirrhosis. As well as summarizing the available metrics that have been used to diagnose it, this review also examines the major recent trials that have investigated frailty in patients with cirrhosis. The complex relationship between sarcopenia and frailty is explored, and strategies to optimize frailty, such as including pharmacological and non-pharmacological therapies, are discussed.Recent findingsThough there is heterogeneity between studies on how physical frailty in cirrhosis has been assessed, it is no...
Source: Current Treatment Options in Gastroenterology - March 27, 2018 Category: Gastroenterology Source Type: research
The Use of Statins in Patients With Chronic Liver Disease and Cirrhosis
AbstractPurpose of reviewStatins are drugs developed to treat hypercholesterolemia. Its use in patients with liver disease has been limited because one of its potential and most feared side effects is hepatotoxicity. However, there is robust evidence that supports the safety of statins in this population in the absence of severe liver dysfunction. In this review, we will summarize the efficacy and safety of statins in cirrhosis.Recent findingsStatins are effective in the treatment of dyslipidemia in patients with liver disease, because of their pleiotropic properties. These properties are independent of their effect on cho...
Source: Current Treatment Options in Gastroenterology - March 23, 2018 Category: Gastroenterology Source Type: research
Interaction Between Hepatocellular Carcinoma and Hepatitis C Eradication With Direct-acting Antiviral Therapy
This article reviews the current literature on the interaction between HCC and hepatitis C eradication with DAAs.Recent findingsFollowing publication of the initial observation in 2016, a number of studies have looked at the impact of active HCC on the success of antiviral therapy, as well as that of treatment with DAAs on both the occurrence and recurrence of HCC. The presence of active HCC decreases sustained virologic response (SVR) rates with DAAs. However, SVR rates improve in patients who have achieved complete radiological response or are treated post transplantation. With respect to occurrence of HCC after DAAs, ma...
Source: Current Treatment Options in Gastroenterology - March 22, 2018 Category: Gastroenterology Source Type: research
