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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

Screening for Barrett ’s Oesophagus: Are We Ready for it?
AbstractPurpose of reviewThe targeted approach adopted for Barrett ’s oesophagus (BO) screening is sub-optimal considering the large proportion of BO cases that are currently missed. We reviewed the literature highlighting recent technological advancements in efforts to counteract this challenge. We also provided insights into strategies that can improve the outc omes from current BO screening practises.Recent findingsThe standard method for BO detection, endoscopy, is invasive and expensive and therefore inappropriate for mass screening. On the other hand, endoscopy is more cost-effective for screening a high-risk popul...
Source: Current Treatment Options in Gastroenterology - March 16, 2021 Category: Gastroenterology Source Type: research

Correction to: Acid Suppressant Therapy: a Step Forward with Potassium-Competitive Acid Blockers
A Correction to this paper has been published: https://doi.org/10.1007/s11938-021-00343-0 (Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - March 11, 2021 Category: Gastroenterology Source Type: research

Diagnosis and Management of Epithelial Precancerous Conditions and Lesions in the Stomach
AbstractPurpose of reviewChronic atrophic gastritis and intestinal metaplasia are associated with higher gastric cancer risk and guidelines recommend endoscopic surveillance, as diagnosis of early gastric neoplasia allows endoscopic resection. This review summarizes the current approach to the diagnosis and surveillance of pre-malignant gastric conditions and endoscopic treatment of early gastric cancer.Recent findingsVirtual chromoendoscopy can diagnose extensive gastric metaplasia with great accuracy compared with histopathology and higher endoscopic staging is a risk factor for gastric cancer. Poorly differentiated and ...
Source: Current Treatment Options in Gastroenterology - March 10, 2021 Category: Gastroenterology Source Type: research

EUS-FNA vs EUS-FNB for Pancreatic Lesions: Which Needle When to Use?
AbstractPurpose of reviewThe aim of this review is to present recent evidence on the different needle designs used for endoscopic ultrasound –guided tissue acquisition and further to discuss adequate use of specific needles in patients with pancreatic lesions.Recent findingsSeveral high-quality studies have recently been published, demonstrating superiority of tissue core needles compared to aspiration needles. Only a few studies have directly compared different core needles, reporting primacy of crown cut designs over side-bevel needles in terms of histology and microcores. As for cystic lesions, novel advancements incl...
Source: Current Treatment Options in Gastroenterology - March 10, 2021 Category: Gastroenterology Source Type: research

Occult Small Bowel Bleeding
AbstractPurpose of reviewThis review sought to summarize the literature available on occult gastrointestinal (GI) bleeding within the small bowel, specifically.Recent findingsMuch of the recent research on this topic focuses on appropriate use of diagnostic modalities, including indications for, diagnostic yield of, and prognosis following capsule endoscopy, CT enteroscopy, and deep enteroscopy.SummaryOverall, occult small bowel bleeding remains a relatively uncommon condition, defined as either positive fecal occult blood testing and/or iron deficiency anemia, without visible GI bleeding and following negative endoscopy. ...
Source: Current Treatment Options in Gastroenterology - March 3, 2021 Category: Gastroenterology Source Type: research

Clinical Management of Oligopolyposis of Unknown Etiology
AbstractPurpose of reviewCancer risk management for adenomatous oligopolyposis (10 –99 colonic adenomas) depends upon whether the oligopolyposis results from a defined hereditary syndrome. Herein, we summarize genetic testing strategies for evaluation of oligopolyposis and outline colonoscopy and extra-colonic surveillance for individuals without a detectable hereditary syndrome , who have a condition referred to as oligopolyposis of unknown etiology (OPUE).Recent findingsMulti-gene panel genetic testing is appropriate for individuals with 10 or more cumulative colonic adenomas, yet a significant proportion of these indi...
Source: Current Treatment Options in Gastroenterology - March 1, 2021 Category: Gastroenterology Source Type: research

How to Measure Detection Rate During Colonoscopy: PDR, ADR, SDR, or All Three?
AbstractPurpose of reviewOur aim was to clarify the respective role and significance of the adenoma detection rate (ADR) among other colonoscopy detection metrics such as the polyp detection rate (PDR) or the serrated polyp detection rate (SDR).Recent findingsPDR is easy to measure, but affected by the resection of hyperplastic lesions in the distal colon, or non-neoplastic colorectal mucosa, and cannot be considered a reliable detection metric. The use of SDR is limited by the heterogeneity of the serrated lesions. In 2021, the ADR remains sole recommended detection metric, inversely correlated to interval colorectal canc...
Source: Current Treatment Options in Gastroenterology - February 25, 2021 Category: Gastroenterology Source Type: research

Management of Familial Adenomatous Polyposis
AbstractPurpose of reviewThis paper reviews important aspects in the management of individuals with familial adenomatous polyposis (FAP).Recent findingsNewly discovered germline pathogenic variants (PVs) beyondAPC are a rare cause of adenomatous polyposis. The decreasing cost of multi-gene panel testing (MGPT) has broadened the use of commercial panels to enhance the genetic diagnosis of adenomatous polyposis in families where the causative germline PV inAPC is not known. We elucidate emerging risks of cancer in FAP particularly gastric cancer and provide best practices to surveillance and cancer prevention in FAP, includi...
Source: Current Treatment Options in Gastroenterology - February 22, 2021 Category: Gastroenterology Source Type: research

Correction to: Updates in Chemoprevention Research for Hereditary Gastrointestinal and Polyposis Syndromes
A Correction to this paper has been published:https://doi.org/10.1007/s11938-021-00332-3 (Source: Current Treatment Options in Gastroenterology)
Source: Current Treatment Options in Gastroenterology - February 8, 2021 Category: Gastroenterology Source Type: research

Progress Toward Improving Outcomes in Patients with Cholangiocarcinoma
AbstractPurpose of reviewTo provide an update on the latest advances in treatment of cholangiocarcinoma.Recent findingsIncidence of cholangiocarcinoma has been increasing over the past decade. A better understanding of the genetic landscape of cholangiocarcinoma and its risk factors resulted in earlier diagnosis and treatment option expansion to targeted therapy with FGFR inhibitors, and liver transplantation for early perihilar cholangiocarcinoma and early intrahepatic cholangiocarcinoma. IDH1/2 inhibition for intrahepatic cholangiocarcinoma is an emerging targeted therapy approach. Data supports benefits of adjuvant ther...
Source: Current Treatment Options in Gastroenterology - January 30, 2021 Category: Gastroenterology Source Type: research

Reproductive Health in IBD Patients
AbstractPurpose of reviewMany patients with inflammatory bowel disease (IBD) are diagnosed in early adulthood, impacting their reproductive health. We discuss the recent data related to fertility, preconception counseling, the safety of IBD medications during pregnancy and lactation, delivery methods, and postpartum care in women with IBD. Additionally, we will review the psychosocial aspects, the effect of IBD, and its treatment on sexual function (SD) and fertility in men. We address the misconceptions around these topics and help the healthcare providers (HCPs) manage these patients appropriately.Recent findingsHCPs pla...
Source: Current Treatment Options in Gastroenterology - January 28, 2021 Category: Gastroenterology Source Type: research

Acid Suppressant Therapy: a Step Forward with Potassium-Competitive Acid Blockers
AbstractPurpose of the reviewThe introduction of H2-receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) into clinical practice has been a real breakthrough in the treatment of acid-related diseases. PPIs are now the standard of care for the treatment of gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD),Helicobacter pylori infection, NSAID-associated gastroduodenal lesions, and upper gastrointestinal bleeding (UGIB). However, despite their effectiveness, PPIs display some intrinsic limitations, which underlie the unmet clinical needs that have been identified over the past decades.Recent findings...
Source: Current Treatment Options in Gastroenterology - January 25, 2021 Category: Gastroenterology Source Type: research

Idiopathic Peptic Ulcer: a Separate Entity or Diagnostic Uncertainty?
AbstractPurpose of the reviewIdiopathic peptic ulcer disease (IPUD) is an ulcer with no identifiable etiology. The major causes of peptic ulceration areHelicobacter pylori infection and ingestion of non-steroidal anti-inflammatory drugs. Is this a truly idiopathic disease or simply a misdiagnosis?Recent findingsThe diagnosis ofH. pylori infection can be missed if patients are taking antibiotics or proton pump inhibitors or when gastrointestinal bleeding occurs. A history of NSAID ingestion is often also overlooked. The proportion of IPUDs has increased over time. IPUDs occur more commonly in older patients and those with c...
Source: Current Treatment Options in Gastroenterology - January 23, 2021 Category: Gastroenterology Source Type: research

Management of Anticoagulation and Colonoscopy
AbstractPurpose of reviewPatients undergoing colonoscopy frequently require antithrombotic therapy for underlying cardiovascular disease. Antithrombotic therapy increases the risk of bleeding during or after colonoscopy, particularly when more invasive procedures are required. However, the risk of thrombosis —with possibly devastating consequences—is increased if antithrombotic agents are held. This review will highlight existing data on the balance of procedural and patient risk factors to guide endoscopists on the management of periprocedural antithrombotic therapy.Recent findingsDiagnostic colonoscopy has long been ...
Source: Current Treatment Options in Gastroenterology - January 16, 2021 Category: Gastroenterology Source Type: research