Fistula-associated anal carcinoma in Crohn's disease.
Authors: Yamamoto T, Gustavo Kotze P, Spinelli A, Panaccione R Abstract INTRODUCTION: Fistula-associated anal carcinoma in patients with Crohn's disease (CD) is a rare condition. More recently, this entity has been increasingly reported likely due to increased recognition and the incidence may be greater than once appreciated. There remains a paucity of data regarding the incidence, diagnosis, treatment and outcome of fistula-associated anal carcinoma. Area covered: This review evaluates the clinical features, pathology, treatment and prognosis of fistula-associated anal carcinoma in patients with CD. A strategy fo...
Source: Expert Review of Gastroenterology and Hepatology - July 13, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Helicobacter pylori drug resistance: therapy changes and challenges.
Authors: Flores-Treviño S, Mendoza-Olazarán S, Bocanegra-Ibarias P, Maldonado-Garza HJ, Garza-González E Abstract INTRODUCTION: Helicobacter pylori is a Gram-negative bacterium that causes chronic gastritis, dyspepsia, peptic ulcers and gastric cancer. Over half the world's population is infected with H. pylori, with higher prevalence in developing countries. Areas covered: In this review, current guidelines on H. pylori therapy, such as the Toronto consensus statement, the Maastricht V/Florence consensus report and the American College of Gastroenterology guidelines are compared. Also, we anal...
Source: Expert Review of Gastroenterology and Hepatology - July 8, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The role of the chronic care model in promoting the management of the patient with rare liver disease.
DISCUSSION: Unlike in common chronic conditions e.g. diabetes, there has been limited consideration in the literature of the use of CCM (or its components) for the management of RLD. This may reflect a reluctance of the clinical community to view these diseases as chronic or lack of healthcare policy investment in rare diseases in general. PMID: 29976101 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - July 8, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Pancreas volume in health and disease: a systematic review and meta-analysis.
Authors: DeSouza SV, Singh RG, Yoon HD, Murphy R, Plank LD, Petrov MS Abstract INTRODUCTION: The pancreas plays a central role in metabolism and is involved in the pathogenesis of several diseases. Pancreas volume is a holistic quantitative measure of pancreas size but the clinical relevance of pancreas volumetry is poorly understood. Areas covered: The aim was to systematically review studies in adults that used computed tomography or magnetic resonance imaging to measure pancreas volume in health and disease, to determine normal pancreas volume range, and to quantify changes in pancreas volume that are associated...
Source: Expert Review of Gastroenterology and Hepatology - July 6, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Pregnant women with inflammatory bowel disease: the effects of biologicals on pregnancy, outcome of infants and the developing immune system.
Authors: Wieringa JW, Driessen GJ, van der Woude CJ Abstract INTRODUCTION: Relapse of Inflammatory Bowel Disease (IBD) during conception and pregnancy has been associated with a negative pregnancy outcome. Therefore, it is advised to maintain drugs in order to prevent relapse. The effect of drugs, which cross the placenta, on children who have been exposed during pregnancy will be discussed in this review. Areas covered: A literature search was performed using the following search terms: inflammatory bowel disease, pregnancy, infant, anti-tumor necrosis factor alpha, infliximab, adalimumab, golimumab, certolizumab,...
Source: Expert Review of Gastroenterology and Hepatology - July 6, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Impact of primary tumor side on the outcomes of patients with non-metastatic colon cancer; a patient-level pooled analysis of two clinical trials.
CONCLUSION: Stage II right-sided colon cancer patients have better disease-free survival compared to stage II left-sided colon cancer patients when treated with surgery only. This survival difference disappears if patients were treated with adjuvant fluoropyrimidines. PMID: 29966444 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - July 5, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Hemochromatosis: pathophysiology, evaluation and management of hepatic iron overload with a focus on MRI.
Authors: Golfeyz S, Lewis S, Weisberg IS Abstract INTRODUCTION: Hereditary hemochromatosis (HH) is an autosomal recessive disorder that occurs in approximately 1 in 200-250 individuals. Mutations in the HFE gene leads to excess iron absorption. Excess iron in the form of non-transferrin bound iron (NTBI) causes injury and is readily up-taken by cardiomyocytes, pancreatic islet cells and hepatocytes. Symptoms greatly vary among patients and include fatigue, abdominal pain, arthralgias, impotence, decreased libido, diabetes and heart failure. Untreated hemochromatosis can lead to chronic liver disease, fibrosis, cirr...
Source: Expert Review of Gastroenterology and Hepatology - July 3, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Treating pancreatic cancer: More antioxidants more problems?
Authors: Alexander MS, Cullen JJ PMID: 29956580 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - July 1, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

How to predict response to anti-tumour necrosis factor agents in inflammatory bowel disease.
Authors: Naviglio S, Giuffrida P, Stocco G, Lenti MV, Ventura A, Corazza GR, Di Sabatino A Abstract INTRODUCTION: Anti-tumour necrosis factor (TNF) agents have changed the therapeutic approach to inflammatory bowel disease. However, a considerable proportion of patients either does not primarily respond or lose response to treatment. Despite the longstanding experience in the use of these drugs, still there is the need of identifying possible predictors of efficacy. Areas covered: We critically review the current knowledge on predictors of response to anti-TNF therapy, both those available in clinical practice and ...
Source: Expert Review of Gastroenterology and Hepatology - July 1, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The role of imaging and biopsy in the management and staging of large non-pedunculated rectal polyps.
Authors: Banerjee AK, Longcroft-Wheaton G, Beable R, Conti J, Khan J, Bhandari P Abstract INTRODUCTION: Endoscopic Mucosal resection (EMR) and endoscopic submucosal dissection (ESD) is often used for benign and Sm1 large non-pedunculated rectal polyps (LNPRPs), although other surgical techniques including transanal endoscopic microsurgery (TEMS) and Transanal minimal invasive surgery (TAMIS) remain available. This review covers the role of pre- excisional imaging and selective biopsy of LNPRPs. Areas covered: Polyps between 2-3 cm with favourable features (Paris 1, Kudo III/IV pit patterns, non-- lateral spreading ...
Source: Expert Review of Gastroenterology and Hepatology - June 28, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Updates in the field of autoimmune pancreatitis: a clinical guide.
Authors: de Pretis N, Amodio A, Frulloni L Abstract INTRODUCTION: Autoimmune Pancreatitis (AIP) is a peculiar form of pancreatitis different from all other type of pancreatitis ("one like no one pancreatitis") and characterized by a dramatic response to steroids. AIP can be classified histologically in type 1, included in a larger group of diseases named IgG4-related disease, and type 2. At imaging, AIP may involve all (diffuse form) or only a part (focal form) of the pancreatic gland. Areas covered: In this article, the clinical approach to diagnosis and different therapeutic strategies of this complicat...
Source: Expert Review of Gastroenterology and Hepatology - June 26, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Somatostatin analogue-induced pancreatic exocrine insufficiency in patients with neuroendocrine tumours: results of a prospective observational study.
Conclusion This study demonstrated that PEI occurs at a higher rate than previously reported; clinicians need to diagnose and treat this SSA-related adverse-event which occurs in 1 in 4 patients with Wd-NETs treated with SSAs. PMID: 29923433 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - June 26, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Outcomes and prediction of corticosteroid therapy after successive courses of ulcerative colitis treatments.
Authors: Barreiro-Alonso E, Saro-Gismera C, Sánchez M PMID: 29911903 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - June 19, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Challenges of Surgical Management of Intrahepatic Cholangiocarcinoma.
Authors: Squires MH, Cloyd JM, Dillhoff M, Schmidt C, Pawlik TM PMID: 29911912 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - June 19, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Review of recent efforts to discover biomarkers for early detection, monitoring, prognosis, and prediction of treatment responses of patients with gastric cancer.
Authors: Sawaki K, Kanda M, Kodera Y Abstract INTRODUCTION: Gastric cancer (GC) is the leading cause of cancer-related death worldwide. Despite recent advances in diagnosis and therapy, the prognosis of patients with GC is poor. Many patients have inoperable disease upon diagnosis or experience recurrent disease after curative gastrectomy. Unfortunately, tumor markers for GC, such as serum carcinoembryonic antigen and carbohydrate antigen 19-9, lack sufficient sensitivity and specificity. Therefore, effective biomarkers are required to detect early GC and to predict tumor recurrence and chemosensitivity. Areas cove...
Source: Expert Review of Gastroenterology and Hepatology - June 16, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Capsule endoscopy for patients with coeliac disease.
Authors: Chetcuti Zammit S, Sidhu R, Sanders DS Abstract INTRODUCTION: Coeliac disease is an autoimmune mediated condition in response to gluten. A combination of innate and adaptive immune responses results in villous shortening in the small bowel which can be morphologically picked up on capsule endoscopy. Small bowel capsule endoscopy is the only imaging modality that can provide mucosal views of the whole length of the small bowel whilst histology is generally limited to the proximal small bowel. Radiological modalities are not designed to pick up changes in villous morphology. Areas covered: In this review, we...
Source: Expert Review of Gastroenterology and Hepatology - June 12, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

A critical appraisal of advances in the diagnosis of diverticular disease.
Authors: Tursi A Abstract INTRODUCTION: Diverticulosis of the colon is a common condition, and about one fourth of those people develop symptoms, which is called "diverticular disease" (DD). Since there are still some concerns about the diagnosis of diverticular disease, the aim of this review was to analyse current and evolving advances in its diagnosis. Area covered: Analysis of clinical, radiology, laboratory and endoscopic tools to pose a correct diagnosis of DD was performed according to current PubMed literature. Expert commentary: A combination of clinical characteristic of the abdominal pain and f...
Source: Expert Review of Gastroenterology and Hepatology - June 12, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Endoscopic management of primary sclerosing cholangitis.
Authors: Tabibian JH, Baron TH Abstract INTRODUCTION: Primary sclerosing cholangitis (PSC) is a rare but clinically important cholestatic liver disease. Histopathologically and cholangiographically, PSC is characterized by intra- and/or extra-hepatic bile duct inflammation and fibro-obliteration, which ultimately leads to biliary cirrhosis and related sequelae, including development of hepatobiliary and colorectal carcinomata. PSC can be diagnosed at essentially any age and carries a median survival of 15-20 years, regardless of age at diagnosis, and is a foremost risk factor for cholangiocarcinoma. Given the chron...
Source: Expert Review of Gastroenterology and Hepatology - June 9, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Pathophysiology of diverticular disease.
Authors: Schieffer KM, Kline BP, Yochum GS, Koltun WA Abstract INTRODUCTION: Inflammation of diverticula, or outpouchings of the colonic mucosa and submucosa through the muscularis layer, leads to diverticulitis. The development of diverticular disease, encompassing both diverticulosis and diverticulitis, is a result of genetic predisposition, lifestyle, and environmental factors, including the microbiome. Areas covered: Previous reports implicated genetic predisposition, environmental factors, and colonic dysmotility in diverticular disease. Recent studies have associated specific host immune responses and the mic...
Source: Expert Review of Gastroenterology and Hepatology - June 3, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Could endothelial TGF β signaling be a promising new target for liver disease?
Could endothelial TGFβ signaling be a promising new target for liver disease? Expert Rev Gastroenterol Hepatol. 2018 May 25;: Authors: Adams DH, Shepherd EL, Lalor PF PMID: 29799279 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - May 30, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Esophageal achalasia: current diagnosis and treatment.
Authors: Schlottmann F, Patti MG Abstract INTRODUCTION: Esophageal achalasia is a primary esophageal motility disorder of unknown origin, characterized by lack of peristalsis and by incomplete or absent relaxation of the lower esophageal sphincter in response to swallowing. The goal of treatment is to eliminate the functional obstruction at the level of the gastroesophageal junction Areas covered: This comprehensive review will evaluate the current literature, illustrating the diagnostic evaluation and providing an evidence-based treatment algorithm for this disease Expert commentary: Today we have three very effec...
Source: Expert Review of Gastroenterology and Hepatology - May 30, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Bacterial translocation in patients with liver cirrhosis: physiology, clinical consequences and practical implications.
Authors: Ponziani FR, Zocco MA, Cerrito L, Gasbarrini A, Pompili M Abstract INTRODUCTION: The gut liver axis is an operative unit that works to protect the human body against potentially harmful substances and microorganisms, maintaining the homeostasis of the immune system. Liver cirrhosis profoundly alters this complex system. The intestine becomes more permeable allowing the translocation of bacteria, bacterial products and fragments into the portal circulation, triggering an abnormal local and systemic inflammatory response and a condition of perpetual immunologic alarm. This immune-inflammatory disorder relate...
Source: Expert Review of Gastroenterology and Hepatology - May 30, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Acute-on-chronic liver failure 2018: a need for (urgent) liver biopsy?
Authors: van Leeuwen DJ, Alves V, Balabaud C, Bhathal PS, Bioulac-Sage P, Colombari R, Crawford JM, Dhillon AP, Ferrell L, Gill R, Guido M, Hytiroglou P, Nakanuma Y, Paradis V, Rautou PE, Sempoux C, Snover DC, Theise ND, Thung SN, Tsui WMS, Quaglia A Abstract INTRODUCTION: "Acute-on-Chronic-Liver Failure (ACLF)" entered hepatology practice by the end of the 20th century. Although we lack precise and universally agreed definitions, acute decompensation of chronic liver disease with jaundice and deranged clotting, multi-organ failure and high, short-term mortality are hallmarks of the syndrome. Timely recog...
Source: Expert Review of Gastroenterology and Hepatology - May 30, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Clinical updates on perianal fistulas in Crohn's disease.
Authors: Rackovsky O, Hirten R, Ungaro R, Colombel JF Abstract INTRODUCTION: Perianal fistulizing disease is an aggressive and debilitating phenotype of Crohn's disease (CD), representing a significant therapeutic challenge. New work has led to advancement in epidemiology and long term outcomes of perianal disease. The range of therapeutic options continues to expand, including new biologic agents, biosimilars, and stem cell therapy. Areas covered: We discuss updates to all aspects of management of perianal disease, with a focus on the last three years of published data. Areas considered include new data on epidemi...
Source: Expert Review of Gastroenterology and Hepatology - May 26, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Characteristics of right-sided colonic neoplasia and colonoscopy barriers limiting their early detection and prognosis: a review of the literature.
Authors: Fischbach W, Elsome R, Amlani B Abstract INTRODUCTION: Colonoscopy provides less protection from colorectal cancer in the right colon than the left. Areas Covered: This review examines patient outcomes and colonoscopy success rates to identify factors that limit the protective effect of colonoscopy in the right colon. The MEDLINE and Embase databases were searched for literature from 2000 onwards, on the long-term outcomes and differences in screening practice between the right and left colon. In total, 12 systematic reviews (including nine meta-analyses) and 44 primary data records were included. Differen...
Source: Expert Review of Gastroenterology and Hepatology - May 23, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Diagnosis of cholangiocarcinoma in primary sclerosing cholangitis.
Authors: Taghavi SA, Eshraghian A, Niknam R, Sivandzadeh GR, Bagheri Lankarani K Abstract INTRODUCTION: Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease of the hepatobiliary system characterized by chronic inflammation, progressive fibrosis, stricture formation and destruction of extrahepatic and intrahepatic bile ducts. Areas covered: The increased incidence of cholangiocarcinoma (CCA) in PSC has been well documented and can be explained by the continuous inflammation in the biliary tree leading to an enhanced dysplasia-carcinoma sequence. Although PSC patients may progress to liver cirrhosis...
Source: Expert Review of Gastroenterology and Hepatology - May 23, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Irritable bowel syndrome and functional dyspepsia: what can epidemiology tell us about etiology?
Authors: Talley NJ, Holtmann G PMID: 29774764 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - May 20, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Statins in liver disease: not only prevention of cardiovascular events.
Authors: Magan-Fernandez A, Rizzo M, Montalto G, Marchesini G PMID: 29768950 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - May 19, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The role of diet in the management of irritable bowel syndrome: a focus on FODMAPs.
Authors: Dolan R, Chey WD, Eswaran S Abstract INTRODUCTION: Irritable bowel syndrome is a common condition that negatively impacts quality of life and results in significant health care expenditures. The vast majority of IBS patients associate their symptoms with eating. Numerous randomized, controlled trials suggest that restriction of dietary FODMAPs improves overall symptoms, abdominal pain, bloating and quality of life in more than half of IBS sufferers. There is emerging data which suggests that other diets (gluten free, guided elimination diets) might also be of benefit to IBS patients. Areas covered: Compreh...
Source: Expert Review of Gastroenterology and Hepatology - May 17, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Presentation and Prognosis of liver disease in alpha-1 antitrypsin deficiency.
Authors: Townsend S, Newsome P, Turner AM PMID: 29768056 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - May 17, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

An account of the real-life hepatitis C management in a single specialized viral hepatitis treatment centre in Egypt: results of treating 7042 patients with 7 different direct acting antiviral regimens.
CONCLUSIONS: All regimens were highly effective at treating HCV in a real-life setting, apart from SOF/RBV, which was the least effective. A nationwide screening program and enhancing the follow-up of treated patients are the main missing pillars in the Egyptian model. PMID: 29757684 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - May 16, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The current situation and challenges of screening for and treating hepatitis B in sub-Saharan Africa.
Authors: Béguelin C, Fall F, Seydi M, Wandeler G Abstract INTRODUCTION: Hepatitis B virus (HBV) infection is the most important cause of hepatocellular carcinoma in sub-Saharan Africa (SSA). Although the tools to curb the epidemic are known, only a minority of HBV-infected persons are currently diagnosed and treated. Areas covered: We discuss HBV epidemiological trends in SSA, describe important determinants of its natural history, and summarize current knowledge on the continuum of HBV care. Using the results of a systematic review of the literature, we describe the proportion of patients with liver fibrosi...
Source: Expert Review of Gastroenterology and Hepatology - May 10, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Accounting for differences in risk of HCV re-infection by mental health diagnoses.
Authors: Beaulieu T, Barbic SP, Ti L PMID: 29737229 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - May 10, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Is an enzyme supplement for celiac disease finally on the cards?
Authors: König J, Brummer RJ PMID: 29730969 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - May 9, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Is fecal microbiota transplantation a temporary patch for treatment of Clostridium difficile infection or a new frontier of therapeutics?
Authors: Khoruts A PMID: 29667436 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - April 20, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Contrast enhanced ultrasound (CEUS) imaging of solid benign focal liver lesions.
Authors: Dietrich CF, Tana C, Caraiani C, Dong Y Abstract INTRODUCTION: Ultrasound is well accepted worldwide for imaging of the liver. Absences of radiation exposure, low cost and large diffusion are some of the advantages that make this technique the first to be used in the assessment of focal liver lesions (FLL). Areas covered: Contrast enhanced ultrasound (CEUS) has been introduced more than twenty years ago, and its detection rate is comparable to that of contrast enhanced magnetic resonance imaging (CEMRI) and contrast enhanced computed tomography (CECT). In this narrative review, we discuss the main CEUS fea...
Source: Expert Review of Gastroenterology and Hepatology - April 17, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Pediatric Irritable Bowel Syndrome and Other Functional Abdominal Pain Disorders: An Update of Non-Pharmacological Treatments.
Authors: Gupta S, Schaffer G, Saps M Abstract INTRODUCTION: Functional abdominal pain disorders, including irritable bowel syndrome, are common in children and treatment can often be difficult. Pharmacological therapies and complementary treatments are widely used, despite the limited data in pediatrics. Areas covered: This review provides an overview of the available data for the use of diet, probiotics, percutaneous electrical nerve stimulation and psychosocial interventions, including hypnotherapy, yoga, cognitive and behavioral therapy and mind-body interventions for the treatment of functional abdominal pain d...
Source: Expert Review of Gastroenterology and Hepatology - April 12, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The role of neutrophil to lymphocyte ratio for the assessment of liver fibrosis and cirrhosis: a systematic review.
Authors: Peng Y, Li Y, He Y, Wei Q, Xie Q, Zhang L, Xia Y, Zhou X, Zhang L, Feng X, Chen K, Chen S, Chen W, Long Q, Chai J Abstract INTRODUCTION: Neutrophil to lymphocyte ratio (NLR) is widely used to assess inflammatory diseases. We performed a systematic review to explore the prognostic role of NLR for the assessment of liver fibrosis and cirrhosis. Areas covered: We searched the PubMed and EMBASE databases for the eligible papers which explored the association between NLR and liver fibrosis/cirrhosis or investigated the prognostic value of NLR in cirrhotic patients. Expert commentary: In accordance with assessme...
Source: Expert Review of Gastroenterology and Hepatology - April 10, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Molecular profiling of pancreatic neuroendocrine tumors (pNETS) and the clinical potential.
Authors: Camilli M, Papadimitrio K, Nogueira A, Incorvaia L, Galvano A, D'Antonio F, Ferri J, Santini D, Silvestris N, Russo A, Peeters M, Rolfo C Abstract INTRODUCTION: Pancreatic neuroendocrine tumors (pNETs) represent a small part of pancreatic neoplasms, and the knowledge about their indolent clinical course remains a subject of investigation. They occur sporadically or as part of familial cancer syndromes and are classified by WHO in 3 categories. There is ongoing research to understand their molecular profiling and leading mutations. Areas covered: The aim of this review is to clarify the overall aspects of t...
Source: Expert Review of Gastroenterology and Hepatology - April 10, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The relationship between obesity and the severity of non-alcoholic fatty liver disease: systematic review and meta-analysis.
Authors: Lu FB, Hu ED, Xu LM, Chen L, Wu JL, Li H, Chen DZ, Chen YP Abstract INTRODUCTION: A number of researches have explored the association between obesity and nonalcoholic fatty liver disease (NAFLD) liver function, histopathology, complications, genetic factors and prognosis, but the results were conflicting and inconclusive. Areas covered: In this meta-analysis, the liver function, histopathology, metabolic complications, patatin-like phospholipase domain-containing protein 3 (PNPLA3) genetic polymorphism and prognosis were compared between non-obese and obese NAFLD. Pubmed, EMBASE, Cochrane databases were s...
Source: Expert Review of Gastroenterology and Hepatology - April 5, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The use of human albumin in patients with cirrhosis: a European survey.
CONCLUSIONS: The present survey indicates that hepatologists across Europe present adherence to international guidelines and highlights the areas where solid scientific data are awaited to achieve a more appropriate HA prescription in patients with decompensated cirrhosis. PMID: 29611452 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - April 5, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Acid suppression in patients treated with endoscopic therapy for the management of gastroesophageal varices: A systematic review and meta-analysis.
CONCLUSION: Acid suppression might be considered in patients undergoing prophylactic EVL for gastroesophageal varices. PMID: 29564926 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - March 26, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Emerging therapeutic biomarkers of autoimmune hepatitis and their impact on current and future management.
Authors: Czaja AJ Abstract INTRODUCTION: Autoimmune hepatitis lacks a quantifiable biomarker that is close to its pathogenic mechanisms and that accurately reflects inflammatory activity, correlates with treatment response, and ensures inactive disease before treatment withdrawal. Areas covered: Micro-ribonucleic acids, programmed death-1 protein and its ligands, macrophage migration inhibitory factor, soluble CD163, B cell activating factor, and metabolite patterns in blood were considered the leading candidates as therapeutic biomarkers after search of PubMed from August 1981 to August 2017 using the search words...
Source: Expert Review of Gastroenterology and Hepatology - March 17, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Conditional survival of patients with hepatocellular carcinoma: results from the Surveillance, Epidemiology, and End Results registry.
CONCLUSIONS: Conditional survival exhibited an improved prognosis over time. For hepatocellular carcinoma patients who survived for a specific period of time after diagnosis, more dramatic improvements occurred in patients aged 65-74 years, patients with AJCC stage IVB, and patients with a positive/elevated AFP value. PMID: 29543072 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - March 17, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Elucidating the link between collagen and pancreatic cancer: what's next?
Authors: Hamada S, Masamune A PMID: 29495889 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - March 4, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Fecal microbiota transplantation for managing irritable bowel syndrome.
Authors: El-Salhy M, Mazzawi T Abstract INTRODUCTION: Irritable bowel syndrome (IBS) is a widespread gastrointestinal disorder affecting 11.2% of the world adult population. The intestinal microbiome is thought to play a pivotal role in the pathophysiology of IBS. The composition of the fecal microbiome in IBS patients differs from that in healthy individuals, but the exact bacteria species involved in the development of IBS remain to be determined. There is also an imbalance between useful and harmful bacteria (dysbiosis) in the intestinal microbiome in patients with IBS. Consuming prebiotics, probiotics, or synbi...
Source: Expert Review of Gastroenterology and Hepatology - March 3, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The potential of gut microbiota and fecal volatile organic compounds analysis as early diagnostic biomarker for necrotizing enterocolitis and sepsis in preterm infants.
Authors: Berkhout DJC, Niemarkt HJ, de Boer NK, Benninga MA, de Meij TGJ Abstract INTRODUCTION: Although the exact pathophysiological mechanisms of both necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) in preterm infants are yet to be elucidated, evidence is emerging that the gut microbiota plays a key role in their pathophysiology. Areas covered: In this review, initial microbial colonization and factors influencing microbiota composition are discussed. For both NEC and LOS, an overview of studies investigating preclinical alterations in gut microbiota composition and fecal volatile organic compounds (V...
Source: Expert Review of Gastroenterology and Hepatology - March 1, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Esophageal hiatal hernia: Risk, Diagnosis and Management.
Authors: Yu HX, Han CS, Xue JR, Han ZF, Xin H Abstract INTRODUCTION: Esophageal hiatal hernia involves abnormal abdominal entry into thoracic cavity. It is classified based on orientation between esophageal junction and diaphragm. Sliding hiatal hernia (Type-I) comprises the most frequent category, emanating from right crus of diaphragm. Type-II esophageal hernia engages both left and right muscular crura. Type-III and IV additionally include the left crus. Age and increased body mass index are key risk factors, and congenital skeletal aberrations trigger pathogenesis through intestinal malrotations. Familiar manif...
Source: Expert Review of Gastroenterology and Hepatology - February 18, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Clinical management of pediatric achalasia.
Authors: van Lennep M, van Wijk MP, Omari TI, Benninga MA, Singendonk MMJ Abstract INTRODUCTION: Achalasia is a rare esophageal motility disorder. Much of the literature is based on the adult population. In adults, guidance of therapeutic approach by manometric findings has led to improvement in patient outcome. Promising results have been achieved with novel therapies such as PerOral Endoscopic Myotomy (POEM). Areas covered: In this review, we provide an overview of the novel diagnostic and therapeutic tools for achalasia management and in what way they will relate to the future management of pediatric achalasia. ...
Source: Expert Review of Gastroenterology and Hepatology - February 15, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The potential role of statins in treating liver disease.
Authors: Imprialos KP, Stavropoulos K, Doumas M, Skalkou A, Zografou I, Athyros VG Abstract INTRODUCTION: Statins are commonly use for the management of dyslipidemia, worldwide. Various studies have demonstrated that statins offer significant reduction in the risk of cardiovascular morbidity and mortality. However, this class of drugs has been implicated in potential liver toxicity, thus has been considered as a "forbidden-drug" in patients with increased liver enzymes. Areas covered: Studies have shown that statins might offer clinical benefits in the setting of viral hepatitis, progression of cirrhosis,...
Source: Expert Review of Gastroenterology and Hepatology - February 14, 2018 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research