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Novel Therapies for Inflammatory Bowel Disease
AbstractPurpose of reviewSignificant advances in the discovery of novel therapeutic targets for inflammatory bowel disease address a crucial need for patients refractory to available treatment options. We will review the recent literature and data available for novel therapies for adult patients with Crohn ’s disease (CD) and ulcerative colitis (UC), limited to those currently in phase III trials with a focus on clinical endpoints and safety.Recent findingsEmerging therapeutic agents currently in phase III trials including IL-23 inhibitors (risankizumab, guselkumab, and mirikizumab), JAK inhibitors (filgotinib and upadac...
Source: Current Treatment Options in Gastroenterology - February 25, 2022 Category: Gastroenterology Source Type: research

Diagnostic Approach to Incidentally Detected Pancreatic Cystic Lesions
The objective of this study is to answer few key questions in order to establish the best possible available diagnostic strategy for incidentally discovered pancreatic cystic lesions (PCLs).Recent findingsAdvances in EUS-guided sampling techniques, cross-sectional and intracystic confocal imaging, molecular biomarkers analysis, determination of cyst fluid glucose, and artificial intelligence, appear to be associated with an improved diagnostic accuracy in distinguishing mucinous from non-mucinous PCLs.SummaryThe diagnostic process has the aim of recognizing cysts with malignant potential and identifying those with high-ris...
Source: Current Treatment Options in Gastroenterology - February 23, 2022 Category: Gastroenterology Source Type: research

Polyps of Fundic Glands —a Second Glance
AbstractPurpose of ReviewFundic gland polyps (FGPs) can be a trivial finding or evidence of a significant underlying disorder. The aim of this review is to discuss the clinical characteristics of FGPs and how to recognize features suggestive of familial polyposis syndromes, as well as highlight the most current recommendations on appropriate screening and surveillance when indicated.Recent FindingsThe discovery of a novel polyposis syndrome, gastric adenocarcinoma proximal polyposis syndrome (GAPPS), and the rise in gastric cancer incidence in familial adenomatous polyposis (FAP) patients have buoyed the development of end...
Source: Current Treatment Options in Gastroenterology - February 16, 2022 Category: Gastroenterology Source Type: research

Endoscopy After the COVID-19 Pandemic —What Will Be Different?
AbstractPurpose of ReviewThis paper reviews the latest literature regarding the impact of COVID on endoscopy service provision.Recent FindingsEndoscopy has been shown to be largely safe when appropriate infection prevention and control measures are in place. Endoscopy training and education has been profoundly affected though novel training models to overcome this have been developed. Proper handling of delayed or cancelled procedures is of utmost importance to minimize delays in diagnosis and treatment of diseases such as cancer. Adoption of new technologies such as non-endoscopy alternatives and telehealth may be a viabl...
Source: Current Treatment Options in Gastroenterology - January 26, 2022 Category: Gastroenterology Source Type: research

Expanding Role of Lumen-Apposing Metal Stents in the GI Tract
AbstractPurpose of reviewLumen-apposing metal stents (LAMS) are fully covered self-expandable metal stents specifically designed for the endoscopic drainage of pancreatic fluid collections. Initially utilized for pancreatic fluid collections, LAMS are increasingly being applied for various other indications like endoscopic gastroenterostomy, choledochoduodenostomy, drainage of gall bladder, facilitation of ERCP in surgically altered anatomy, and management of refractory gastrointestinal strictures. The availability of electrocautery-enhanced version has simplified the deployment of LAMS and paved the way for their use in t...
Source: Current Treatment Options in Gastroenterology - January 24, 2022 Category: Gastroenterology Source Type: research

How to Endoscopically Treat Achalasia: to Balloon, Inject, or Incise?
AbstractPurpose of reviewAchalasia is a primary esophageal motility disorder characterized by abnormal peristalsis and impaired relaxation of the esophagogastric junction (EGJ). It is a heterogenous disease with no definitive cure. Endoscopic therapies include botulinum toxin injection (BTI), pneumatic dilation (PD), and peroral endoscopic myotomy (POEM). Recent literature debates which intervention befits which patient population. In this review, we will provide an overview of these endoscopic treatment options and discuss the recent advancements in the domain.Recent findingsPneumatic dilation is often the first treatment...
Source: Current Treatment Options in Gastroenterology - January 14, 2022 Category: Gastroenterology Source Type: research

Correction to: Management of Anticoagulation and Colonoscopy
(Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - December 29, 2021 Category: Gastroenterology Source Type: research

Management of Diverticulitis
This article will provide a review of the recent changes to the management of diverticulitis over the past 5 to 10  years.Recent findingsRecent studies have broadened our understanding of diverticulitis pathogenesis and identified modifiable diet and lifestyle risk factors for the disease. Treatment paradigms for diverticulitis are being reshaped, largely by randomized controlled trials. In select patients, an individualized and less aggressive approach can be considered.SummaryDiverticulitis is an area of active research. Medical and surgical management of diverticulitis continue to evolve. (Source: Current Treatment Opt...
Source: Current Treatment Options in Gastroenterology - December 16, 2021 Category: Gastroenterology Source Type: research

Updates in Clinical, Endoscopic, and Histologic Composite and Co-primary Endpoints for Clinical Trials in Inflammatory Bowel Disease
AbstractPurpose of reviewThe evolution of endpoints used to assess disease activity and treatment efficacy in inflammatory bowel disease (IBD) has accompanied changes in clinical trial methodology and the therapeutic landscape.Recent findingsComposite and co-primary endpoints for patient-reported outcomes (without physician ’s global assessment) and endoscopic improvement (excluding friability) are used to define clinical remission and clinical response in contemporary clinical trials for ulcerative colitis and Crohn’s disease. Histologic-endoscopic mucosal healing has emerged as a therapeutic goal and validated hi sto...
Source: Current Treatment Options in Gastroenterology - November 30, 2021 Category: Gastroenterology Source Type: research

Health Maintenance for Adult Patients with Inflammatory Bowel Disease
AbstractPurpose of reviewThis review serves as a summary of healthcare maintenance items that should be addressed when managing patients with inflammatory bowel disease (IBD). This manuscript discusses vaccine-preventable illnesses, cancer prevention recommendations, and other screenings that are important to gastroenterologists and primary care physicians caring for patients with IBD.Recent findingsPatients with IBD often require immunomodulator agents and/or biologics to induce and maintain disease remission which can increase the risk of developing several infections. Also, subsets of patients with IBD are at an increas...
Source: Current Treatment Options in Gastroenterology - November 22, 2021 Category: Gastroenterology Source Type: research

The Natural History of Inflammatory Bowel Disease
AbstractPurpose of reviewThe evolution of our management armamentarium for inflammatory bowel disease (IBD) has changed the therapeutic goal beyond symptom control and towards altering the disease course. This review article aims to update the natural history of IBD.Recent findingsIn the biologic era, the disease phenotype at the time of IBD diagnosis is generally similar to that of historical reports. More than half of patients with IBD achieved disease remission within 5  years after diagnosis. The rates of hospitalization and surgery and the risk of colorectal cancer have been decreasing over time. IBD did not increase...
Source: Current Treatment Options in Gastroenterology - November 19, 2021 Category: Gastroenterology Source Type: research

Cardiogastroenterology: Management of Elderly Cardiac Patients at Risk of GIB
AbstractPurpose of reviewTo characterize cardiac patients at greatest risk of antithrombotic-related gastrointestinal bleeding (GIB), clarify modifiable risk factors, and summarize best-practice preventive management strategies based on patient characteristics.Recent findingsRecent study findings reinforce risk factors in this patient cohort, including advanced age and a history of bleeding events. Data also highlight the importance of managing polypharmacy, renal impairment, and eradication ofHelicobacter pylori, as well as the utilization of proton pump inhibitors (PPI) for gastroprotection.SummaryThis narrative review w...
Source: Current Treatment Options in Gastroenterology - October 29, 2021 Category: Gastroenterology Source Type: research

Endoscopic Management of Hamartomatous Polyposis Syndromes
AbstractPurpose of reviewTo review the clinical diagnosis, recommended endoscopic surveillance, and endoscopic management of the hamartomatous polyposis syndromes (HPS) including (1) Peutz-Jeghers syndrome (PJS), (2) juvenile polyposis syndrome (JPS), and 3) PTEN hamartomatous syndromes (PHTS).Recent findingsDevice-assisted enteroscopy (DAE) with polypectomy is now first-line treatment for small bowel polyps identified on surveillance with VCE or CT/MRI enterography. The efficacy and safety of DAE has been described in multiple studies of patients with PJS.SummaryEndoscopic management of HPS relies on endoscopic surveillan...
Source: Current Treatment Options in Gastroenterology - September 26, 2021 Category: Gastroenterology Source Type: research

COVID-19 and Effect on Liver Transplant
AbstractPurpose of reviewThe Coronavirus disease-2019 (COVID-19) pandemic has significantly impacted all aspects of liver transplantation. We reviewed the literature regarding COVID-19 clinical outcomes, treatment, and vaccination of liver transplant candidates and recipients.Recent findingsPatients with chronic liver disease, especially with cirrhosis, have higher morbidity and mortality from COVID-19 than patients without liver disease. Increased mortality has not been consistently seen in liver transplant recipients, in whom severe disease is more strongly associated advanced age and medical comorbidities, rather than w...
Source: Current Treatment Options in Gastroenterology - August 16, 2021 Category: Gastroenterology Source Type: research

Pharmacotherapeutic Options for Weight Regain After Bariatric Surgery
We present an overview of these findings.SummaryThis review represents a comprehensive compilation of the recently published data on efficacy of anti-obesity pharmacotherapy in the treatment of weight regain after bariatric surgery for children, adolescents, and adults. (Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - July 16, 2021 Category: Gastroenterology Source Type: research