Fecal lactoferrin predicts primary non-response to biologic agents in inflammatory bowel disease
Conclusions: In CD and UC patients during induct ion with biologic agents early FL measurements accurately separate clinical responders from those experiencing PNR. The method described here offers several potential advantages over other strategies to assess and manage these patients. (Source: Digestive Diseases)
Source: Digestive Diseases - February 24, 2021 Category: Gastroenterology Source Type: research
Characteristics and Outcomes of Endoscopies Before and During the COVID-19 Pandemic in New York
This study aimed to characterize differences in gastrointestinal endoscopies in the New York metropolitan region before, during, and after the first wave of the pandemic.
Methods
Across three hospitals, we compared demographics, indications, and yield of endoscopies before and after March 16, 2020, the date on which elective procedures were cancelled, as well as a recovery period for five months after they were resumed.
Results
A total of 9,401 procedures before and 332 procedures were performed during the first wave. Females comprised 57% and 44% of patients (p (Source: Digestive Diseases)
Source: Digestive Diseases - February 24, 2021 Category: Gastroenterology Source Type: research
Inflammatory cell numbers in the stomach of Japanese subjects with endoscopically normal mucosa without H. pylori infection
Introduction: Since inflammatory cells, such as lymphocytes and plasma cells, normally inhabit the stomach, the border between normal and mild inflammation is difficult to visually determine using the updated Sydney system scale of gastritis. Additionally, eosinophils in the gastric mucosa must be counted to diagnose eosinophilic gastritis. We aimed to determine the normal number of inflammatory cells in patients with endoscopically normal mucosa and without H. pylori infections.
Methods: We assessed patients aged 20 –79 years, who had undergone upper gastrointestinal endoscopy at Kawasaki Medical School Hospital betwee...
Source: Digestive Diseases - February 18, 2021 Category: Gastroenterology Source Type: research
Management of Chronic Diarrhea in Primary Care: The Gastroenterologists Advice
Background: Chronic diarrhea is defined as more than three bowel movements per day, or loose stools, or stool weight> 200 g/d for at least 4 weeks. Accompanying symptoms may include urgency, abdominal pain or cramps.
Summary: A number of causes have to be considered, including inflammatory, neoplastic, malabsorptive, infective, vascular and functional gastrointestinal diseases. Other causes include food intolerances, side effects of drugs, or postsurgical conditions. Diarrhea may also be symptom of a systemic disease, like diabetes or hyperthyroidism. Special patient groups, like the very elderly and immunocompromised pat...
Source: Digestive Diseases - February 14, 2021 Category: Gastroenterology Source Type: research
Sleep disturbance in Inflammatory Bowel Disease is associated with disease activity and adverse outcome
Conclusion: There is a high prevalence of poor SQ in IBD patients, highlighting the importance of its inclusion in patient reported outcomes. Sleep disturbance seems to have prognostic value in IBD. (Source: Digestive Diseases)
Source: Digestive Diseases - February 14, 2021 Category: Gastroenterology Source Type: research
Efficacy of vonoprazan for refractory reflux esophagitis after esophagectomy
Background: Refractory reflux esophagitis (RRE), unresponsive to conventional proton-pump inhibitors (PPIs) is a complication in esophagectomy with gastric pull-up. Vonoprazan, a novel potassium-competitive acid blocker, has been available in Japan since 2015. Here, we investigated the efficacy of vonoprazan on PPI-resistant RRE after esophagectomy with gastric pull-up.
Methods: This was a single-center retrospective study. We used the revised Los Angeles (r-LA) classification based on the Los Angeles (LA) classification and the modified Los Angeles (m-LA) classification to evaluate abnormal forms of mucosal breaks such ...
Source: Digestive Diseases - February 9, 2021 Category: Gastroenterology Source Type: research
Reflux symptoms – functional and structural diseases
The approach from the general practitioner (GP)
A primary care management strategy of gastroesophageal reflux disease (GERD) should pay attention to the epidemiology, prevalence and distribution of reflux-like symptoms in the community, to the special characteristics of patients presenting for the first time with reflux symptoms in primary care. General practitioners (GPs) encounter daily challenges to make cost-effective differential diagnostic and therapeutic decisions, avoiding needless and costly investigation or referral. They should provide long-term effective control of symptoms and esophageal healing in a personalized, symptom based, patient-centered and evidenc...
Source: Digestive Diseases - February 8, 2021 Category: Gastroenterology Source Type: research
Reflux symptoms – functional and structural diseases
The approach from the GI specialist
The GI specialist has an important role to play in the long-term management of gastroesophageal reflux disease (GERD) patients; to secure a proper diagnosis and the selection of best possible therapeutic strategy. Through intensified information and education the implementation of national and international guidelines can be more effectively processed, whereupon a significant improvements in also cost-effectiveness of the current management will be fostered. Regarding the more specific group of GERD patients, as represented by the so called PPI refractory patients, data have now emerged to guide us into the future. Notewor...
Source: Digestive Diseases - February 8, 2021 Category: Gastroenterology Source Type: research
NASH/liver fibrosis prevalence and incidence of non-liver comorbidities among people with NAFLD and incidence of NAFLD by metabolic comorbidites: Lessons from South Korea
Background: NAFLD incidence, NASH prevalence, NAFLD fibrosis prevalence, incidence of metabolic comorbidities, as well as mortality data in the NAFLD population remain limited.
Aims: We used a meta-analytic approach to “stage” NAFLD among the Korean population.
Methods: We searched PubMed, Embase, Cochrane Library, and KoreaMed from inception until June 29, 2019 and calculated pooled estimates via random-effects model.
Results: We screened 1,485 studies and analyzed 191 eligible studies: 179 (3,556,579 partici pants) for NAFLD prevalence and outcome analysis and 32 (1,089,785 participants) for NAFLD incidence analysis...
Source: Digestive Diseases - February 2, 2021 Category: Gastroenterology Source Type: research
Association between the frequency of daily tooth brushing and development of nonalcoholic fatty liver disease
Conclusions:
Frequent tooth brushing was shown to significantly reduce the risk of developing NAFLD. (Source: Digestive Diseases)
Source: Digestive Diseases - February 2, 2021 Category: Gastroenterology Source Type: research
Early kidney dysfunction in non-alcoholic fatty liver disease - is transient elastography useful as a screening method?
Conclusion: Significant liver fibrosis is associated with a significant increased risk of EKD in patients with MAFLD, regardless of other comorbidities. Higher levels of LSM, particularly>6.1kPa, alert for timely identification of EKD and associated comorbidities, as well as their control, in order to prevent the development of CKD in the long term. (Source: Digestive Diseases)
Source: Digestive Diseases - January 27, 2021 Category: Gastroenterology Source Type: research
Outcomes of Radiofrequency ablation vs endoscopic surveillance for Barrett's esophagus with low-grade dysplasia: A systematic review and meta-analysis
CONCLUSIONS:
Based on our meta-analysis, there was a significant reduction in the risk of progression to HGD or EAC among patients with BE-LGD treated with RFA compared with those undergoing endoscopic surveillance. Endoscopic eradication therapy with RFA should be the preferred management approach for BE-LGD (Source: Digestive Diseases)
Source: Digestive Diseases - January 26, 2021 Category: Gastroenterology Source Type: research
Gastroenterologists attitude regarding medical cannabis for IBD in Israel
Conclusion: The use of MC for IBD patients is commonly encountered. Completely different attitudes regarding this treatment were seen. Age above 50 and female physicians generally had a more positive attitude towards the use of MC. Guidelines and clear recommendations are needed. (Source: Digestive Diseases)
Source: Digestive Diseases - January 26, 2021 Category: Gastroenterology Source Type: research
Unusual Biliary Complication following Christmas Eve dinner
We present a case of a fish bone impacted in the papilla of Vater resulting in dyspepsia and mild elevation in liver function tests, that was subsequently treated endoscopically. Fish bones are one of the most commonly encountered of swallowed foreign bodies. However involvement of the biliary tract, such as the one described by us, represents an extremely rare complication of fish bone ingestion. The diagnosis of a foreign body in the biliary tract can be difficult and early endoscopic or surgical extraction may be required to avoid complications such as biliary stone formation, obstructive jaundice, cholangitis or cholec...
Source: Digestive Diseases - January 21, 2021 Category: Gastroenterology Source Type: research
Sleeve gastrectomy is the most common cause of Gastro-esophageal Reflux Disease in comparison with other bariatric operations
Abstract
Introduction
GERD is one of the complications of bariatric operations that might affect the quality of life. We aim to perform a retrospective cohort study to determine the incidence of symptomatic GERD following different types of bariatric surgery and which operations are considered a contraindication of GERD. Besides, we are attempting to identify the risk factors of GERD after bariatric surgery.
Methods
Medical records of 729 patients undergone bariatric operations between January 2010 and June 2019 at Shamir (Assaf Harofeh) Medical Center were reviewed.
Results
There was a significant difference between...
Source: Digestive Diseases - January 12, 2021 Category: Gastroenterology Source Type: research
