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.Sucrase-Isomaltase Deficiency: Hiding in Plain Sight?
AbstractPurpose of reviewOur review focuses on the various presentations, diagnosis, and treatment of sucrose –isomaltase deficiency (SID), previously thought to be limited to the pediatric population with severe malabsorptive symptoms.Recent findingsAlthough sucrase –isomaltase deficiency is presumed to be a rare disorder, it is likely under recognized and more prevalent than is currently known. Congenital sucrase–isomaltase deficiency usually manifests early in life, but the phenotype may vary depending on the mutation(s) present.SummarySID is characterized by dysfunction of the brush border enzyme, sucrase –isom...
Source: Current Treatment Options in Gastroenterology - July 13, 2021 Category: Gastroenterology Source Type: research
Endoscopic Anti-Reflux Procedures: Ready for Clinical Use?
AbstractPurpose of reviewEndoscopic intervention is one of the therapeutic modalities that are currently available for GERD. Endoscopic treatment for GERD has been recently positioned as an alternative for chronic medical therapy or anti-reflux surgery. Patients who are candidates for these procedures include those with typical symptoms of GERD, low-grade erosive esophagitis (Los Angeles A and B), abnormal esophageal acid exposure if normal endoscopy, small hiatal hernia (< 3 cm), and partial or complete response to PPI treatment. This review will highlight the present and emerging data available about current and new...
Source: Current Treatment Options in Gastroenterology - June 23, 2021 Category: Gastroenterology Source Type: research
The Time to Act Is Now: The Rationale to Start Colorectal Cancer Screening at Age 45
AbstractPurpose of reviewColorectal cancer (CRC) in adults<50 years is referred to as early onset colorectal cancer (EOCRC). Despite a significant reduction in CRC incidence among older adults, the incidence of CRC in adults aged 20 –49 years old has increased by almost 50%.Recent findingsCurrently, nearly half of EOCRCs occur between the ages of 45 and 49 years. Recent data show that the prevalence of advanced colorectal neoplasia in patient ’s aged 45–49 is equivalent to that of patient’s aged 50–54. EOCRC tumors are more often late stage, compared to CRCs in older adults. Models estimating the benefits vers...
Source: Current Treatment Options in Gastroenterology - June 14, 2021 Category: Gastroenterology Source Type: research
Management of Chronic Refractory Oesophageal Strictures
AbstractPurpose of reviewBenign oesophageal strictures are commonly encountered in endoscopy. Although most strictures are successfully treated with endoscopic dilatation, up to 40% of patients may develop refractory strictures which require repeated long-term endoscopic intervention with an adverse impact on their quality of life. This review summarises the current evidence-based treatment options available for these patients including preliminary data on novel interventions for this difficult to treat cohort of patients.Recent findingsOnly one-third of patients with refractory oesophageal strictures are able to escape th...
Source: Current Treatment Options in Gastroenterology - June 11, 2021 Category: Gastroenterology Source Type: research
ACLF and Liver Transplantation
AbstractPurpose of reviewThe prevalence, mechanisms, and outcomes of acute-on-chronic liver failure (ACLF) pretransplant that affect post-transplant results are herein summarized.Recent findingsACLF, defined by organ failures, continues to increase in incidence and now affects almost a quarter of patients before liver transplant. MELD-lactate has emerged as a useful tool to predict inpatient mortality in ACLF patients. ACLF is characterized by bioenergetic failure and increased immunologic response. Specific stool microbiome and serum metabolomic signatures on admission can help predict who is at greatest risk for ACLF pre...
Source: Current Treatment Options in Gastroenterology - June 7, 2021 Category: Gastroenterology Source Type: research
Nutritional Management of Sarcopenia in Chronic Liver Disease
AbstractPurpose of reviewThe progressive loss of muscle mass known as sarcopenia is prevalent in patients with cirrhosis and contributes to morbidity and mortality. This review highlights recent literature on the pathogenesis, diagnosis, and management of sarcopenia in chronic liver disease.Recent findingsMultiple mechanisms contribute to sarcopenia in cirrhosis, including poor nutritional intake, physical inactivity, accelerated starvation state, chronic inflammation, and hormonal and metabolic derangements. Specific nutritional interventions as well as exercise and novel pharmacologic therapies show promise in attenuatin...
Source: Current Treatment Options in Gastroenterology - May 28, 2021 Category: Gastroenterology Source Type: research
Recent Advances in the Artificial Intelligence –Assisted Detection of Esophageal Neoplasia
AbstractPurpose of reviewGiven the poor outcomes associated with esophageal cancer, there is increasing interest in the use of artificial intelligence (AI) for early detection of esophageal neoplasia and its precursors. In this review, we examine the use of AI in the endoscopic detection of Barrett ’s esophagus (BE)-related neoplasia, esophageal adenocarcinoma (EAC), esophageal squamous cell carcinoma (ESCC), and dysplasia. In addition, we summarize the findings, strengths, and limitations of recent studies evaluating the efficacy of AI in the detection of esophageal neoplasia.Recent findingsOver the past decade, AI has ...
Source: Current Treatment Options in Gastroenterology - May 28, 2021 Category: Gastroenterology Source Type: research
Dyspepsia: Treatment Options Directed to Specific Targets
AbstractPurpose of reviewFunctional dyspepsia (FD) is a highly prevalent condition affecting up to 12% of the US population. We reviewed the recent medical literature regarding therapeutic interventions and aimed to identify guidance for the most appropriate/effective treatment in patients presenting with FD.Recent findingsThere are a variety of therapeutic interventions that have recently demonstrated clinical efficacy in placebo-controlled trials and subsequent systematic reviews and meta-analysis. Pharmacologic interventions include acid inhibition, prokinetics, antimicrobial interventions, and central nervous system ac...
Source: Current Treatment Options in Gastroenterology - May 27, 2021 Category: Gastroenterology Source Type: research
Strategies to Improve Delivery of Cirrhosis Care
AbstractPurpose of reviewThis review provides an overview of the current state of research around improving healthcare delivery for patients with cirrhosis in the outpatient, inpatient, and transitional care settings.Recent findingsRecent studies have broadly employed changes to the model of care delivery, team composition, and technology to improve cirrhosis care. In the outpatient setting, approaches have included engaging caregivers, patient navigators, and non-physicians and using virtual care, smartphone applications, and wearables. Inpatient care approaches have focused on the role of interdisciplinary teams, educati...
Source: Current Treatment Options in Gastroenterology - May 24, 2021 Category: Gastroenterology Source Type: research
Metabolomics in Advanced Liver Disease
AbstractPurpose of reviewCirrhosis is one of the most important global public health problems. Patients with cirrhosis risk progression to acute-on-chronic liver failure (ACLF), associated with high mortality rates, and development of hepatocellular carcinoma (HCC). Metabolomics could identify urgently required novel biomarkers to improve disease diagnosis, monitor progression, and identify therapies.Recent findingsIn this review, current metabolic studies in decompensated cirrhosis, ACLF, and HCC over the past 3 years are summarised. Over numerous metabolomics studies, in cirrhosis, common alterations in proteins, carbohy...
Source: Current Treatment Options in Gastroenterology - April 25, 2021 Category: Gastroenterology Source Type: research
Prevention of Bleeding After Endoscopic Resection of Colonic Polyps: to Clip or not to Clip
AbstractPurpose of reviewEndoscopic resection of large colonic lesions once thought only amenable to surgery is now standard treatment, but post-procedure bleeding has been common, occurring in 5 –10% of patients. This review summarizes efficacy data on clip closure to reduce bleeding risk, selection of polyps, costs and limitations.Recent findingsRandomized control trials and meta-analysis provide strong evidence for the benefit of prophylactic clip closure to prevent bleeding after endoscopic resection of large ≥ 20-mm proximal polyps, but not for smaller polyps or for large polyps in the distal colon. Clip closure...
Source: Current Treatment Options in Gastroenterology - April 1, 2021 Category: Gastroenterology Source Type: research
Recent Progress in Systemic Therapy for Hepatocellular Cancer (HCC)
AbstractPurpose of reviewThe management of advanced hepatocellular carcinoma (HCC) has drastically changed in the past few years with approval of several first-line and second-line systemic therapies. In this review, we present an overview of the recent progress in the treatment of advanced HCC and discuss future perspectives.Recent findingsThe phase 3 clinical trial IMBRAVE150 has recently shown the combination of an immune checkpoint inhibitor, atezolizumab, with an antiangiogenic agent, bevacizumab, to be superior to sorafenib monotherapy for treatment-naive advanced HCC. Moreover, patients now have multiple options ava...
Source: Current Treatment Options in Gastroenterology - March 31, 2021 Category: Gastroenterology Source Type: research
Serrated Polyposis Syndrome: an Update and Review of the Literature
We present an overview on enhancing the identification of patients with serrated polyps (SPs) and serrated polyposis syndrome (SPS), and provide an update on the prevalence and risk of advanced neoplasia in SPS. We finally share recommendations on the endoscopic management of SPS patients and surveillance of first-degree relatives.Recent findingsDetection of patients with SPS can be enhanced by recognizing the clinical criteria; tracking cumulative lifetime size, number, and location of SPs; and designing automated processes to track those polyps. The clinical criteria for SPS were revised in 2019 and provide a framework t...
Source: Current Treatment Options in Gastroenterology - March 29, 2021 Category: Gastroenterology Source Type: research
Treatment of Micronutrient Deficiencies Pre and Post Bariatric Surgery
AbstractPurpose of reviewThe goal of this article is to review micronutrient deficiencies in patients with obesity. We will describe the absorption of micronutrients and highlight the risk factors that may exist pre- and post-surgery that contribute to the development of micronutrient deficiency states. Furthermore, we will discuss the process involved in detecting, preventing, and treating micronutrient deficiencies.Recent findingsPre-bariatric surgery micronutrient deficiencies are commonly due to intake of a high energy, but low micronutrient diet. Deficiencies frequently include vitamin D, folate, vitamin B12, and iron...
Source: Current Treatment Options in Gastroenterology - March 23, 2021 Category: Gastroenterology Source Type: research
Endoscopic Evaluation of Indeterminate Biliary Strictures: a Review
AbstractPurpose of reviewIndeterminate biliary strictures present a balancing act between the potential morbidity from redundant operations and the risk of missed malignancy and disease progression. This review aims to compare and assess the efficacy of the different diagnostic techniques.Recent findingsUntil today, endoscopic retrograde cholangiopancreatography with tissue sampling was considered the standard for distinguishing benign from malignant biliary strictures. However, it is hampered by a low diagnostic yield.SummaryIndeterminate biliary strictures remain a difficult clinical problem. Invariably, expert evaluatio...
Source: Current Treatment Options in Gastroenterology - March 20, 2021 Category: Gastroenterology Source Type: research
