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Intractable Hiccups and Belching: Approach, Evaluation, and Treatment
AbstractPurpose of ReviewHiccups and belching are common physiological phenomena that involve air movement in the upper GI tract. Because of their commonplace and often acute nature, the problem of hiccups and belching is often trivialized. As a result, there is a dearth of high-quality original research on these topics. In this review, we will summarize the current understanding of epidemiological data, pathophysiological mechanisms, and therapeutic modalities of intractable hiccups and belching.Recent FindingsThere has been little advancement in this particular area of gastroenterology beyond case reports and systematic ...
Source: Current Treatment Options in Gastroenterology - July 27, 2023 Category: Gastroenterology Source Type: research

Emerging Medical Therapy in Eosinophilic Esophagitis
This article will highlight the most up-to date literature for emerging medical therapy for this disease.Recent findingsIt is estimated that nearly one-third of patients with eosinophilic esophagitis will not respond to traditional pharmacologic therapies which include proton-pump inhibitors and swallowed topical corticosteroids. The need for more effective therapy has led to an explosion of research for targeted biologic therapies, and there are several promising molecules in the pipeline.SummaryA number of Phase II and III clinical trials are underway and show propitious results for treatment in eosinophilic esophagitis....
Source: Current Treatment Options in Gastroenterology - July 13, 2023 Category: Gastroenterology Source Type: research

Evolving Role of Endoscopic Submucosal Dissection in the Management of Barrett ’s Neoplasia
AbstractPurpose of ReviewWe aim to examine evidence on endoscopic submucosal dissection (ESD) for managing Barrett ’s esophagus related neoplasia by a narrative review.Recent FindingsAvailable studies and meta-analysis indicate ESD has comparable efficacy rates and adverse events as to endoscopic mucosal resection for managing Barrett ’s neoplasia. There is a high rate of en bloc, curative resections for T1a cancers, and early promising data for T1b cancers. However, most data is from expert centers and does not report long-term results. Lesion selection needs to be better defined in future large-scale studies.SummaryT...
Source: Current Treatment Options in Gastroenterology - July 11, 2023 Category: Gastroenterology Source Type: research

How to Improve the Efficacy of Gastric Cancer Screening?
AbstractPurpose of reviewThis review article aims to provide an overview of existing and emerging screening strategies for gastric cancer and discuss potential measures to improve its efficacy in countries with different risk profiles for the disease.Recent findingsRecent developments in endoscopic technology, including image enhancement and computer-guided diagnosis, can improve further early cancer detection in countries with primary endoscopic screening. Moreover, accumulating data on upper endoscopy quality underlines the pivotal role of appropriate examination time and the vital role of premedication (sedation, defoam...
Source: Current Treatment Options in Gastroenterology - July 8, 2023 Category: Gastroenterology Source Type: research

Artificial Intelligence in Colorectal Cancer Screening
Abstract    Purpose of reviewArtificial intelligence (AI) has been shown to be an increasingly powerful tool in the practice of medicine. There is great potential for AI to improve the quality of colorectal cancer screening. We will review recent progress that has been made in this area.Recent findingsThe use of CADe polyp detection has shown potential to increase adenoma detection rate (ADR) and decrease the adenoma miss rate (AMR), while CADx polyp diagnosis has the potential to reduce the need for histopathology, supporting cost-saving strategies like “diagnose and leave” or “resect and discard” during colono...
Source: Current Treatment Options in Gastroenterology - June 28, 2023 Category: Gastroenterology Source Type: research

Nutritional Optimization of Patients Undergoing Liver Transplantation
AbstractPurpose of ReviewMalnutrition is common in patients with cirrhosis and is widely common in those with compensated cirrhosis and remains a significant risk factor for mortality even in those with lower model of end-stage liver disease (MELD) scores. There exists an intricate interplay between frailty, malnutrition, and loss of muscle mass, making nutritional intervention an important part of caring for patients undergoing liver transplant evaluation. This manuscript will review the approach to caring for patients before, during, and after liver transplantation.Recent FindingsMultiple studies have demonstrated that m...
Source: Current Treatment Options in Gastroenterology - June 24, 2023 Category: Gastroenterology Source Type: research

Management of Esophageal Squamous Cell Neoplasia
This article reviews the most recent advances regarding the diagnosis and endoscopic treatment of superficial esophageal squamous cell neoplasia.Recent findingsThe incidence of superficial esophageal squamous cell carcinoma (ESCC) has increased mainly because of improvement in endoscopic detection. It is estimated that high-definition white light endoscopy has low sensitivity for the detection of ESCC. Lugol ’s iodine chromoendoscopy significantly improves the diagnosis, but with a low specificity. Recently, magnifying endoscopic assessment of the intrapapillary capillary loops has been shown to accurately predict the de...
Source: Current Treatment Options in Gastroenterology - June 21, 2023 Category: Gastroenterology Source Type: research

Barrett ’s Esophagus: When to Scope and When to Ablate
AbstractPurpose of reviewBarrett ’s esophagus (BE) is an acquired condition caused by chronic gastroesophageal reflux disease which can progress to esophageal adenocarcinoma (EAC). This paper discusses different sampling approaches, endoscopic surveillance techniques, endoscopic eradication therapies, as well as the future of BE diagnosis and management.Recent findingsAdequate inspection with high-definition white light and chromoendoscopy, as well as adherence to the Seattle biopsy protocol, is recommended for BE surveillance. Chromoendoscopy includes dye-based and electronic techniques, with narrow band imaging now bei...
Source: Current Treatment Options in Gastroenterology - June 8, 2023 Category: Gastroenterology Source Type: research

Endoscopic Diagnosis and Response Evaluation in Patients with Eosinophilic Esophagitis
AbstractPurpose of reviewThe aim of this review is to provide practical guidance for clinicians to support the optimal use of endoscopy in both the diagnosis and the evaluation of treatment response in patients with eosinophilic esophagitis (EoE).Recent findingsThe systematic and high-quality assessment and grading of EoE endoscopic features improves EoE detection. Fibrotic complications of EoE that negatively impact patients ’ symptoms and quality of life can be detected and treated through endoscopy. The correlation between endoscopic features of EoE and histological activity remains challenging. However, assessment of...
Source: Current Treatment Options in Gastroenterology - June 7, 2023 Category: Gastroenterology Source Type: research

The Emerging Role of Endoscopic Ultrasound-Directed Transgastric ERCP (EDGE)
AbstractPurpose of reviewRoux-en-Y gastric bypass (RYGB) is one of the most performed bariatric operations, but it is associated with a high rate of gallstone-related complications. Endoscopic retrograde cholangiopancreatography (ERCP) is the preferred therapeutic modality to treat choledocholithiasis; however, biliary access is compromised due to altered surgical anatomy after RYGB. Endoscopic ultrasound-guided transgastric ERCP (EDGE) is a recent endoscopic procedure developed to overcome this limitation. In this review, we discuss the recent literature surrounding technical and clinical considerations of the EDGE proced...
Source: Current Treatment Options in Gastroenterology - May 16, 2023 Category: Gastroenterology Source Type: research

Endoscopic Treatment of Non-malignant Esophageal Perforation: Time to Go Vacuum?
This article provides a comprehensive review of the endoscopic treatment of non-malignant esophageal perforation (NMEP), highlighting endoscopic vacuum therapy (EVT) and its benefits compared to other therapies based on the available data and in our experience in the management of this condition.Recent findingsThe treatment of NMEP is challenging, often being a life-threatening situation. Historically, the management was always performed surgically, although associated with significant morbidity and mortality. Less invasive approaches such as endoscopic therapies are now preferred for clinically stable patients. There i...
Source: Current Treatment Options in Gastroenterology - May 8, 2023 Category: Gastroenterology Source Type: research

Endobariatrics: a Still Underutilized Weight Loss Tool
AbstractPurpose of reviewBariatric and metabolic endoscopic therapies provide an option for patients seeking clinically significant weight loss with fewer adverse events than conventional bariatric surgery. Our aims are to provide an overview of the current state of primary endoscopic treatment options for weight loss and to emphasize the importance of including these therapies when presenting weight loss options to qualified patients.Recent findingsBariatric endoscopy procedures are associated with a lower adverse event rate when compared to bariatric surgery and result in more weight loss than most existing pharmacothera...
Source: Current Treatment Options in Gastroenterology - May 6, 2023 Category: Gastroenterology Source Type: research

Diet, Deficiencies, and Inflammatory Bowel Diseases: a Comprehensive Review
AbstractPurpose of reviewThe goal of this paper is to discuss the pathophysiology and treatment for common micronutrient deficiencies seen in IBD, and to address current data and recommendations for the role of diets and specific dietary components as therapy for IBD.Recent findingsThe pathophysiology and supplementation recommendations for micronutrient deficiencies in IBD are increasingly well-understood. Given the difficulty in designing placebo-controlled randomized controlled trials (RCTs) on dietary interventions, most data on diet as therapy for IBD currently derive from animal or epidemiology data, which often lack...
Source: Current Treatment Options in Gastroenterology - May 1, 2023 Category: Gastroenterology Source Type: research

Innovations in the Treatment of Gastric Outlet Obstruction: Is This the Era of Endoscopic Ultrasonography-Guided Gastroenterostomy?
AbstractPurpose of review Gastric outlet obstruction is a syndrome that is caused by several benign and malignant diseases. Endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) is a novel treatment that seems to combine the advantages of the two traditional treatments: enteral stent placement (ES) and surgical gastrojejunostomy (SGJ). This review aims to determine the current position of EUS-GE amidst the two traditional treatment options.Recent findingsDifferent approaches can be adopted to facilitate EUS-GE. Direct gastroenterostomy seems to have the shortest procedure time. All methods possess high technical ...
Source: Current Treatment Options in Gastroenterology - April 14, 2023 Category: Gastroenterology Source Type: research

Updates in the Medical and Nutritional Management of Short Gut Syndrome
AbstractPurpose of ReviewIntestinal adaptation is the main treatment goal in short bowel syndrome to control symptoms and improve health-related quality of life. This can be achieved in part through the use of medical therapies as well as parenteral and enteral nutrition, including oral dietary choices. This review will focus on dietary and medical management of short bowel syndrome and offer insights into novel nutritional and pharmacological approaches that may benefit patients.Recent FindingsA balanced oral diet inclusive of whole plant-based foods may be beneficial in short bowel syndrome for reasons including alleviat...
Source: Current Treatment Options in Gastroenterology - April 14, 2023 Category: Gastroenterology Source Type: research