Gastrointestinal Coronavirus disease 2019: epidemiology, clinical features, pathogenesis, prevention and management.
Authors: Simona D, Lorena T, Davide F, Stefano DG, Marcello C, Federico M, Germano O, Luchino C, Giovanni CM, Melis A, Gaya S, Luigi Z, Angelo R Abstract INTRODUCTION: The new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the etiologic agent of coronavirus disease 2019. Some authors reported evidences that patients with SARS-CoV-2 infection could have a direct involvement of the gastrointestinal tract, and in symptomatic cases, gastrointestinal symptoms (diarrhea, nausea/vomiting, abdominal pain) could be very common. Area covered: In this article, we reviewed current published data of the gastroi...
Source: Expert Review of Gastroenterology and Hepatology - September 23, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

New advances in the clinical management of RAS and BRAF mutant colorectal cancer patients.
Authors: Ruffinelli JC, Santos Vivas C, Sanz-Pamplona R, Moreno V Abstract INTRODUCTION: In colorectal carcinogenesis, genetic alterations in RAS and BRAF oncogenes play an important role for cancer initiation and/or progression and represent a key focus in the search for targeted therapies. Despite many years of research and a great amount of studies, until very recently this pathway was considered extremely hard to downregulate to obtain a significant clinical impact in colorectal cancer patients. But better times are coming with the advent of new promising drugs and combinations strategies. AREAS COVERED: In...
Source: Expert Review of Gastroenterology and Hepatology - September 20, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The interrelation between lipid profile in chronic HCV patients and their response to antiviral agents.
Conclusion Higher baseline lipid parameters and their further elevation starting from week six on treatment are good predictors of SVR in HCV patients. Successful HCV therapy with DAAs is associated with a significant increase in lipid parameters. PMID: 32933323 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - September 17, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Prognostic value of vascular endothelial growth factor in both conventional and drug eluting beads transarterial chemoembolization for treatment of unresectable hepatocellular carcinoma in HCV patients.
Authors: Farid K, ElAlfy H, Abo El-Khair SM, Elgamal H, Besheer T, Elmokadem A, Shabana W, Abed S, Elegezy M, El-Khalek AA, El-Morsy A, Negm A, Elsamanoudy AZ, El Deek B, Amer T, El-Bendary M Abstract OBJECTIVES: This work aimed to measure serum vascular endothelial growth factor (VEGF) levels before and after Conventional transarterial chemoembolization (cTACE) versus drug eluting beads (DEB)-TACE and evaluate its efficacy in predicting response to therapy and tumor recurrence. METHODS: 114 patients with unresectable hepatocellular carcinoma complicating hepatitis C virus related cirrhosis were included. They ...
Source: Expert Review of Gastroenterology and Hepatology - September 17, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Developments in research on interstitial Cajal-like cells in the biliary tract.
Authors: Liu Y, Fan Y, Wu S Abstract INTRODUCTION: Interstitial cells of Cajal (ICCs) is a special type of interstitial cells located in the gastrointestinal tract muscles. They are closely related to smooth muscle cells and neurons, participate in gastrointestinal motility and nerve signal transmission, and are pacemaker cells for gastrointestinal electrical activity. Research interest in ICCs has continuously grown since they were first discovered in 1893. Later, researchers discovered that they are also present in other organs, including the biliary tract, urethra, bladder, etc; these cells were named interstiti...
Source: Expert Review of Gastroenterology and Hepatology - September 17, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Recurrence of hepatocellular carcinoma following liver transplantation.
Authors: Hoffman D, Mehta N Abstract Introduction Hepatocellular carcinoma (HCC) is an increasingly common disease with liver transplant (LT) the best long-term therapy for early stage disease. We will review the data for assessing risk and managing recurrence for patients undergoing LT for HCC. Areas Covered In this review, we will provide an overview of methods of patient risk stratification in the post-transplant period, the data around surveillance for HCC recurrence, and the evidence for and against post-LT adjuvant treatment strategies. Finally, we will provide data regarding treatment options for patients wi...
Source: Expert Review of Gastroenterology and Hepatology - September 17, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Functional abdominal pain disorders and asthma: Two disorders, but similar pathophysiology?
Authors: Kumari MV, Amarasiri L, Rajindrajith S, Devanarayana NM Abstract Introduction: Functional abdominal pain disorders (FAPDs) and asthma are common ailments affecting both children and adults worldwide. Multiple studies have demonstrated an association between these two disorders. However, the exact reason for this observed association is not apparent. Areas covered: The current review has explored available literature and outlined multiple underlying pathophysiological mechanisms, common to both asthma and FAPDs, as possible reasons for this association. Expert opinion: Smooth muscle dysfunction, hypersensit...
Source: Expert Review of Gastroenterology and Hepatology - September 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Feasibility of telehealth in the management of autoimmune hepatitis before and during the COVID-19 pandemic.
CONCLUSIONS: In this study, we show for the first time that telehealth is a feasible alternative for managing AIH, both under normal circumstances and during the COVID-19 pandemic. PMID: 32909852 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - September 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The vascular endothelial growth factor signaling pathway regulates liver sinusoidal endothelial cells during liver regeneration after partial hepatectomy.
Authors: Lu J, Zhao YL, Zhang XQ, Li LJ Abstract INTRODUCTION: Liver regeneration after partial hepatectomy is a very complex and well-regulated procedure. It utilizes all liver cell types, which are associated with signaling pathways involving growth factors, cytokines, and stimulatory and inhibitory feedback of several growth-related signals. Liver sinusoidal endothelial cells (LSECs) contribute to liver regeneration after partial hepatectomy. Vascular endothelial growth factor (VEGF) has various functions in LSECs. In this review, we summarize the relationship between VEGF and LSECs involving VEGF regulatory act...
Source: Expert Review of Gastroenterology and Hepatology - September 10, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Non-alcoholic fatty liver disease: molecular and cellular interplays of the lipid metabolism in a steatotic liver.
Authors: Ramos LF, Silva CM, Pansa CC, Moraes KC Abstract INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) affects ~25% of world population and cases have increased in recent decades. These anomalies have several etiologies; however, obesity and metabolic dysfunctions are the most relevant causes. Despite being considered a public health problem, no effective therapeutic approach to treat NAFLD is available. For that, a deep understanding of metabolic routes that support hepatic diseases is needed. AREAS COVERED: This review covers aspects of the onset of NAFLD. Thereby, biochemistry routes as well as ce...
Source: Expert Review of Gastroenterology and Hepatology - September 9, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Biomarkers for hepatitis B virus replication an overview and a look to the future.
Authors: Li FC, Li YK, Fan YC Abstract INTRODUCTION: Hepatitis B virus(HBV) infection is a major public health issue but there are no powerful drugs to eradicate the virus. HBV markers including HBsAg, HBcrAg, HBV RNA, HBcAb and HBV DNA are becoming promising biomarkers to reflect the natural phases of chronic HBV infection and predict the outcome of anti-HBV treatment. AREAS COVERED: The authors summarized the biomarkers of HBV replication and presented the current advances of these biomarkers on predicting the outcome of anti-HBV treatment and identifying the progression of chronic HBV infection. EXPERT O...
Source: Expert Review of Gastroenterology and Hepatology - September 7, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Current perspectives on the pathophysiology of metabolic associated fatty liver disease: are macrophages a viable target for therapy?
Authors: Kjær MB, George J, Kazankov K, Grønbæk H Abstract INTRODUCTION: Metabolic associated fatty liver disease (MAFLD) is a new nomenclature for fatty liver replacing non-alcoholic fatty liver disease (NAFLD). MAFLD has emerged as the leading cause of liver-related morbidity and mortality with increasing incidence due to its close association with the global epidemic of obesity and type 2 diabetes mellitus. Macrophages play a key role in MAFLD development and progression of steatohepatitis and fibrosis. Therefore, targeting macrophages may be a new therapeutic approach for MAFLD and MAFLD with...
Source: Expert Review of Gastroenterology and Hepatology - September 6, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Gastroduodenal Tuberculosis: A case series and systematic review of clinical manifestations, diagnosis and management.
We report our experience with five cases of gastroduodenal tuberculosis and present results of a systematic review on gastroduodenal tuberculosis regarding clinical presentation, endoscopic, imaging findings and the diagnostic and therapeutic approach. EXPERT OPINION: The presentation of gastroduodenal tuberculosis is diverse and may include non-specific abdominal pain or dyspepsia like symptoms apart from gastric outlet obstruction. Endoscopy may show presence of growth, ulcer, narrowing or fistula on endoscopy. Endoscopic biopsy, well-biopsy or mucosal resection of an elevated lesion are helpful. On microscopy, granu...
Source: Expert Review of Gastroenterology and Hepatology - September 6, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Radiation-induced liver disease in the era of SBRT: a review.
Authors: De La Pinta C Abstract INTRODUCTION: Stereotactic Body Radiotherapy (SBRT) in liver tumors allows ablative radiation doses in tumors preserving the liver tissue. However, liver is a parallel organ allowing high doses in a small region to preserve its function. If this is not possible, radio-induced liver toxicity is produced. Radio-induced liver toxicity or radio-induced liver disease (RILD) is the most serious toxicity in liver radiotherapy. AREAS COVERED: In this review, we analyzed published literature on PubMed and MEDLINE. We included papers in English language with information about RILD characte...
Source: Expert Review of Gastroenterology and Hepatology - September 6, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Accreditation of digestive endoscopy services: a method of quality assuring?
Authors: Spinzi G, Milano A, Capelli M Abstract INTRODUCTION: Accreditation is one method of assuring quality, but the evidence base in support of service accreditation is mixed. More recent experiences indicate that accreditation may accelerate improvements. AREAS COVERED: Our aim is focused on endoscopy service accreditation and we conducted a literature search using Medline (via Pubmed) and the Cochrane Center Register of Controlled Trials up to January 2020. EXPERT OPINION: Worldwide numerous centers fail to meet important quality indicators as suggested by international guidelines. Accreditation can pr...
Source: Expert Review of Gastroenterology and Hepatology - September 2, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

COVID-19 in patients with Inflammatory Bowel Disease.
Authors: Anikhindi SA, Kumar A, Arora A Abstract Introduction Coronavirus disease 2019(COVID-19) caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) has rapidly spread world over causing morbidity and mortality in affected patients, especially elderly and those with co-morbidities. Inflammatory Bowel Disease (IBD) patients frequently require immunosuppressive therapy are known to be at risk of opportunistic infections. Areas covered We hereby review the available literature pertaining to COVID-19 in IBD based on published consensus guidelines, expert opinions, case series, registries and reports. ...
Source: Expert Review of Gastroenterology and Hepatology - August 30, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Current perspectives on the safety and efficacy of robot-assisted surgery for gastric cancer.
Authors: Park SH, Hyung WJ Abstract INTRODUCTION: Robotic gastrectomy is performed worldwide as part of the treatment for gastric cancer and is associated with good clinical outcome. This review aims to describe the current issues, debates, and future directions associated with the use of robotic gastrectomy for gastric cancer. AREA COVERED: Here, we review the current evidence surrounding the safety and efficacy of robotic gastrectomy, including our institutional experience. Current issues associated with robotic gastrectomy, including feasibility, perioperative outcomes, and oncological outcomes, are describe...
Source: Expert Review of Gastroenterology and Hepatology - August 28, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Data sharing during COVID-19 pandemic: what to take away.
Authors: Rios RS, Zheng KI, Zheng MH Abstract INTRODUCTION: In light of the viral outbreak of SARS-CoV-2 that monopolized the focus of the scientific community and general public alike for the past 6 months, one of the greatest contributors in the battle against this pandemic was the international sharing of information. Whether regarding the viral genome, incubation periods, method of transmission, symptoms, dangerous behaviors, age groups at risk, all information was valuable, all data was shared as soon as possible. AREAS COVERED: Considering that the most severely impacted group of patients are already suff...
Source: Expert Review of Gastroenterology and Hepatology - August 28, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Evaluation of guidelines for the management of perianal fistulas in crohn's disease.
CONCLUSION: There is much room for improvement in the quality of guidelines for the management of perineal fistulas in Crohn's disease. The recommendations and evidence for guidelines for the management of perineal fistulas in Crohn's disease are quite heterogeneous, and guideline-developers would be well advised to address the above issues during future guideline development. PMID: 32811202 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - August 21, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Non-alcoholic fatty liver disease and sarcopenia: pathophysiological connections and therapeutic implications.
NON-ALCOHOLIC FATTY LIVER DISEASE AND SARCOPENIA: PATHOPHYSIOLOGICAL CONNECTIONS AND THERAPEUTIC IMPLICATIONS. Expert Rev Gastroenterol Hepatol. 2020 Aug 19;: Authors: Fernández-Mincone T, Contreras-Briceño F, Espinosa-Ramírez M, García-Valdés P, López-Fuenzalida A, Riquelme A, Arab JP, Cabrera D, Arrese M, Barrera F Abstract INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is currently one of the most common liver diseases worldwide. Recent data suggest that loss of skeletal muscle mass and function (i.e. sarcopenia) is highly prevalent and frequently o...
Source: Expert Review of Gastroenterology and Hepatology - August 21, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Limited Surgery following Neoadjuvant Treatment among Patients with Localized Rectal Cancer; A Population-Based Study.
CONCLUSION: Among patients with localized rectal cancer treated with neoadjuvant radiation, there does not seem to be a difference in cancer-specific survival according to the type of surgery (limited versus radical surgery). PMID: 32791929 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - August 15, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Clinical heterogeneity in patients with Non-Alcoholic Fatty Liver Disease associated Hepatocellular Carcinoma.
Authors: Anastasopoulos NT, Lianos GD, Tatsi V, Karampa A, Goussia A, Glantzounis GK Abstract INTRODUCTION: The indisputable increase in non-Alcoholic Fatty Liver Disease (NAFLD) prevalence, has consequently led to an increase in Hepatocellular Carcinoma (HCC) and liver-related mortality worldwide. Twenty-five percent of the general population present with various degrees of steatosis and most of them are unaware of their disease until its progression to advanced stages The characteristics of patients with HCC, secondary to NAFLD, are older age, large tumours due to late diagnosis, often without cirrhosis and high ...
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Implementing psychological therapies for gastrointestinal disorders in pediatrics.
Authors: Reed B, Buzenski J, van Tilburg MAL Abstract INTRODUCTION: The brain-gut axis refers to complex and reciprocal interactions that impact symptom presentation and disease course within the GI tract. Psychological therapies included in the treatment of functional gastrointestinal disorders (FGIDs) as well as chronic gut disorders including inflammatory bowel disease (IBD) address environmental and psychological factors impacting patients' symptoms and overall functioning. AREAS COVERED: Employing a biopsychosocial approach, this review focuses on the evidence for and implementation of psychological therap...
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Epidemiology and risk factors for eosinophilic esophagitis: lessons for clinicians.
Authors: Arias Á, Lucendo AJ Abstract INTRODUCTION: The rapid expansion in the epidemiology of eosinophilic esophagitis (EoE) is being documented, along with cumulative research assessing environmental exposures associated with EoE and susceptibility due to genetic variants. AREAS COVERED: Incidence rates for EoE of 5-10 new cases per 100,000 inhabitants annually have shown an increase in recent reports of up to 20 in some countries; the highest prevalence being reported for Europe and North America, where EoE now affects more than 1 out of 1,000 people. EoE has been shown to be associated with several d...
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Human Intestinal Parasitic Infection: A Narrative Review on Global Prevalence and Epidemiological Insights on Preventive, Therapeutic and Diagnostic Strategies for Future Perspectives.
Authors: Wong LW, Ong KS, Khoo JR, Goh CBS, Hor JW, Lee SM Abstract INTRODUCTION: Intestinal parasitic infection (IPI) is a global health concern among socioeconomically deprived communities in many developing countries. Many preventative strategies have been deployed to control IPI, however, there is a lack in standards on the techniques used to diagnose and monitor the prevalence of IPI. AREAS COVERED: The present article will review the diseases associated with IPI and discuss the current IPI control strategies such as the water, sanitation, and hygiene (WASH) interventions, community-led total sanitation (C...
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Telemedicine in Gastroenterology in the Wake of COVID-19.
Authors: George LA, Cross RK PMID: 32755288 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Updates in the field of hereditary nonpolyposis colorectal cancer.
Authors: Peltomäki P, Olkinuora A, Nieminen TT Abstract INTRODUCTION: Up to one third of colorectal cancers show familial clustering and 5% are hereditary single-gene disorders. Hereditary non-polyposis colorectal cancer comprises DNA mismatch repair-deficient and -proficient subsets, represented by Lynch syndrome (LS) and familial colorectal cancer type X (FCCTX), respectively. Accurate knowledge of molecular etiology and genotype-phenotype correlations are critical for tailored cancer prevention and treatment. AREAS COVERED: The authors highlight advances in the molecular dissection of hereditary non-pol...
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Transhiatal versus transthoracic surgical approach for Siewert type Ⅱ adenocarcinoma of the esophagogastric junction: a meta-analysis.
Conclusion In terms of surgery-related and long-term outcomes, the TH approach may be more appropriate for Siewert type Ⅱ adenocarcinoma of EGJ, especially for esophagus invasion ≤4cm. PMID: 32757864 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Endoscopy after surgery in inflammatory bowel disease: Crohn's disease recurrence and pouch surveillance.
Authors: Vespa E, Furfaro F, Allocca M, Fiorino G, Correale C, Gilardi D, Argollo M, Zilli A, Zacharopoulou E, Loy L, Danese S Abstract INTRODUCTION: Crohn's disease (CD) and ulcerative colitis (UC) are immune-mediated disorders characterized by a chronic inflammation, with intermittent exacerbations of symptoms and inflammation. In both diseases, medical treatment has made revolutionary steps forward. Nevertheless, surgery is still required in many cases due to inefficacy of multiple medical therapies. It is not clear whether surgery rates in inflammatory bowel diseases (IBD) are currently decreasing despite all i...
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Treat to target or "treat to clear" in inflammatory bowel diseases: one step further?
Treat to target or "treat to clear" in inflammatory bowel diseases: one step further? Expert Rev Gastroenterol Hepatol. 2020 Aug 07;: Authors: Dal Buono A, Roda G, Argollo M, Zacharopoulou E, Peyrin-Biroulet L, Danese S Abstract INTRODUCTION: Inflammatory bowel diseases (IBD), are chronic and progressive diseases. Long-term complications are demolitive surgery and colon-rectal cancer. A "treat to target" strategy, in which the treatment aims to achieve objective outcomes, has already been introduced in the management of chronic conditions as rheumatic diseases. This approach is emer...
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The clinical application of camrelizumab on advanced hepatocellular carcinoma.
Authors: Chen Z, Lu X, Koral K Abstract INTRODUCTION: Camrelizumab (also known as SHR-1210), a humanised monoclonal antibody against PD-1, has been shown to block the binding of PD-1 to PD-L1 and consequently inhibit the immune escape of tumour cells. Recently, camrelizumab was approved as a second-line drug for previously treated advanced hepatocellular carcinoma in China. AREAS COVERED: In this paper, the chemical properties, mechanism of action, pharmacokinetics, clinical efficacy, safety and tolerability of camrelizumab for the treatment of advanced hepatocellular carcinoma are introduced in detail. The str...
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Unrecognized Anemia After Whipple - Should We Learn from Gastric Bypass?
CONCLUSIONS: All patients remained anemic after pancreatoduodenectomy. This was not linked to chemotherapy. Iron and vitamin B12 supplementation, given in a minority, did not ameliorate the anemia. Future studies should investigate this lack of aid, as nutrient supplementation may be an important change in the standard of care of these patients. PMID: 32772584 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

An overview of interventions for constipation in adults.
Authors: Daniali M, Nikfar S, Abdollahi M Abstract INTRODUCTION: The increasing global prevalence of the symptoms of constipation adversely affects the quality of life (QOL) of symptomatic patients. An acceptable universal definition of constipation does not exist and a detailed history taking form each patient with various complaints including stool consistency, sensing of incomplete evacuation or a manual need to assist evacuation is required. Complexity of obtaining etiologic diagnosis and the wide range of therapeutic options can mislead physicians in choosing correct treatment. AREAS COVERED: This review, ...
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Curcumin therapy for ulcerative colitis remission: systematic review and meta-analysis.
Authors: Goulart RA, Barbalho SM, Rubira CJ, Araújo AC, Lima VM, Buchaim RL, Guiguer EL Abstract INTRODUCTION: Despite significant advances in the study of Ulcerative colitis (UC) management, up to a third of patients may be refractory to conventional therapy, and specialists have considered natural compounds such as curcumin. AREA COVERED: The meta-analyses found in the literature compare the effects of curcumin used in different administration routes or compare patients in remission with patients with active disease. Due to the biases in these studies, we performed a systematic review and meta-analysis...
Source: Expert Review of Gastroenterology and Hepatology - August 13, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

COVID-19 and gastrointestinal symptoms: the dust hasn't settled yet.
Authors: Parigi TL, Vespa E, Pugliese N, Danese S PMID: 32729732 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - August 1, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Perioperative management of ileocecal Crohn's disease in the current era.
Authors: Yamamoto T, Lightner AL, Spinelli A, Kotze PG Abstract INTRODUCTION: The ileocecal region is most commonly involved in patients with Crohn's disease (CD). Area covered: In the management of ileocecal CD, this review discusses the underlying clinical issues with perioperative management and surgical intervention. Expert commentary: Despite advances in medical treatments, surgery is required in a proportion of patients. Preoperative optimization including weaning of corticosteroids, initiation of enteral feeds, venous thromboembolism prophylaxis and smoking cessation may lead to improved postoperative outcom...
Source: Expert Review of Gastroenterology and Hepatology - August 1, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Single center analysis of therapy and outcomes of Hepatocellular carcinoma in Sub-Saharan Africa.
CONCLUSION: Our study found that antiviral treatment of HBV infection was associated with longer survival in HCC. Furthermore, Sorafenib was beneficial in patients that used this modality of treatment and the NLR was a good prognostic factor in those patients. PMID: 32730120 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - August 1, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The risk factors for delayed bleeding after endoscopic resection of colorectal tumors: a meta-analysis.
This study is the first meta-analysis to investigate risk factors for colorectal delayed bleeding. We found several risk factors contributing to this condition: colorectal tumors located in the proximal colon, a history of antithrombotic drug use, high-grade intraepithelial neoplasia or early cancer, piecemeal resection, intraoperative hemorrhage, no clip placement, and severe submucosal fibrosis. Despite our findings, we also conclude that more high-quality, large-scale clinical randomized controlled studies are needed due to limited retrospective studies at present. Future therapeutic colonoscopies should focus on precis...
Source: Expert Review of Gastroenterology and Hepatology - July 31, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

MAFLD in COVID-19 patients: an insidious enemy.
Authors: Dongiovanni P, Meroni M, Longo M, Fracanzani AL PMID: 32705906 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - July 28, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Is there a causal link between psychological disorders and functional gastrointestinal disorders?
Authors: Koloski N, Holtmann G, Talley N Abstract INTRODUCTION: Psychological distress is associated with functional gastrointestinal disorders (FGIDs) including irritable bowel syndrome (IBS) and functional dyspepsia (FD) but only evidence from prospective longitudinal and treatment studies can indicate whether the link between FGIDs and psychological distress is causal. Emerging evidence suggests underlying biological mechanisms may explain the association of psychological distress with FGIDs. AREAS COVERED: This review critically evaluates whether anxiety and/or depression and FGIDs are causally related incl...
Source: Expert Review of Gastroenterology and Hepatology - July 28, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Non-invasive diagnostic tools for pediatric NAFLD: where are we now?
Authors: Mosca A, Panera N, Crudele A, Alisi A Abstract INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is a leading cause of liver disease in the pediatric population. It is a significant liver complication of obesity that also prominently affects children. Over the past decade, several non-invasive methods have been investigated for replacing liver biopsy to identify which children with NAFLD have nonalcoholic steatohepatitis (NASH) and fibrosis. These methods that aim to differentiate the type and extent of liver damage are based on two main different methodologies: a 'biological' approach centered on the...
Source: Expert Review of Gastroenterology and Hepatology - July 28, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Medical care of liver transplant patients.
Authors: Hoppmann N, Massoud O Abstract INTRODUCTION: Liver transplantation is a life-changing event for patients and survival following transplantation has improved significantly since the first transplantation in 1967. Following liver transplantation, patients face a unique set of healthcare management decisions including transplantation-specific complications, recurrence of primary liver disease, as well as metabolic and malignancy concerns related to immunosuppression. As more patients with liver disease receive transplantation and live longer, understanding and managing these patient will require not only tran...
Source: Expert Review of Gastroenterology and Hepatology - July 22, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

A modern multidisciplinary approach to the treatment of enterocutaneous fistulas in Crohn's disease patients.
Authors: Papa A, Lopetuso LR, Minordi LM, Di Veronica A, Neri M, Rapaccini G, Gasbarrini A, Papa V Abstract INTRODUCTION: Enterocutaneous fistulas (ECFs) is a manifestation of penetrating Crohn's disease (CD) that is challenging to treat and has considerable morbidity and mortality rates. AREAS COVERED: This review aims to explore the practical and updated principles for the optimal treatment of ECFs in CD patients. EXPERT OPINION: Optimal ECF management requires a multidisciplinary approach. Treatment first includes fluid resuscitation and electrolyte rebalancing with control of sepsis by means of antibiot...
Source: Expert Review of Gastroenterology and Hepatology - July 18, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

An insight into primary biliary cholangitis and its recent advances in treatment: semi-synthetic analogs to combat ursodeoxycholic-acid resistance.
Authors: Sahu R, Mishra R, Majee C Abstract INTRODUCTION: Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease which on progression causes cirrhosis; various studies also suggested that several diseases can co-exist in patients. In existing depiction of disease PBC, apart from entire use of ursodeoxycholic acid (UDCA), several patients need to step forward to liver-transplantation or death due to resistance or non-responder with UDCA monotherapy. AREAS COVERED: To overcome this non-respondent treatment, novel bile acid semi synthetic analogs have been identified which shows their potency aga...
Source: Expert Review of Gastroenterology and Hepatology - July 18, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Use of antibiotic prophylaxis is not needed for endoscopic ultrasound-guided fine needle aspiration of pancreatic cysts: a meta-analysis.
CONCLUSIONS: Prophylactic antibiotics do not seem to substantially reduce the risk of infections after endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions and routine use of prophylactic antibiotics should be questioned. PMID: 32674699 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - July 18, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

A comprehensive review of the diagnosis and treatment of Parkinson's disease dysphagia and aspiration.
Authors: Patel B, Legacy J, Hegland KW, Okun MS, Herndon NE Abstract INTRODUCTION: Bulbar dysfunction is common in Parkinson's disease (PD) with more than 80% of affected individuals developing dysphagia during the course of the disease. Symptoms can begin in the preclinical stage and individuals may remain clinically asymptomatic for years. Furthermore, patients may be unaware of swallowing changes, which contributes to the difference between the prevalence of self-reported dysphagia and deficits identified during instrumental evaluations. Dysphagia is underrecognized and contributes to the development of aspirati...
Source: Expert Review of Gastroenterology and Hepatology - July 15, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Understanding the relationship between esophageal motor disorders and reflux disease.
Authors: Ribolsi M, de Carlo G, Balestrieri P, Guarino MPL, Cicala M Abstract INTRODUCTION: The management of gastro-esophageal reflux disease (GERD) patients is often complex as the clinical presentation is heterogeneous and the mechanisms underlying symptoms are multifactorial. In the past decades, investigations conducted with conventional manometry and, above all, the more accurate high resolution manometry (HRM), helped us in exploring the field of esophageal motility and in understanding the link between motor features and GERD pathogenesis. AREAS COVERED: Several studies carried out with conventional man...
Source: Expert Review of Gastroenterology and Hepatology - July 15, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Life on a knife edge: the optimal approach to the management of perforations during endoscopic submucosal dissection (ESD).
This article also highlights the do's and don'ts of various closure devices, focusing particularly on advanced closure methods, the-over-the-scope clips (OTSCs) and endoscopic suturing. EXPERT OPINION: As ESD offers surgery-sparing alternatives to patients, advanced closure techniques allow endoscopists to effectively and promptly manage associated complications, improving the possibility of the widespread implementation of ESD in the US. With continued improvements in OTSCs and endoscopic suturing, ESD will become a stalwart of endoscopic management of malignant and premalignant gastrointestinal lesions. PMID: 326...
Source: Expert Review of Gastroenterology and Hepatology - July 15, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

A 2020 update on liver transplant for hepatocellular carcinoma.
Authors: Finotti M, Vitale A, Volk M, Cillo U Abstract INTRODUCTION: Hepatocellular carcinoma is the most frequent liver tumor and is associated with chronic liver disease in 90% of cases. In selected cases, liver transplantation represents an effective therapy with excellent overall survival. AREA COVERED: Since the introduction of Milan criteria in 1996, numerous alternative selection systems to LT for HCC patients have been proposed. Debate remains about how best to select HCC patients for transplant and how to prioritize them on the waiting list. EXPERT OPINION: The selection of the best scoring system ...
Source: Expert Review of Gastroenterology and Hepatology - July 15, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Liver injury in severe COVID-19 infection: current insights and challenges.
Authors: Ali N, Hossain K Abstract INTRODUCTION: The outbreak of COVID-19 is a serious health threat worldwide. Different degrees of liver injury or liver dysfunctions have been reported in patients with COVID-19 infection. However, currently, it remains unclear to what extent liver diseases should be considered as significant risk factors for the severity and mortality of COVID-19. Moreover, the mechanisms involved in liver injury in severe COVID-19 infection are not yet well understood. AREA COVERED: This review summarizes the current evidence on liver function abnormalities in COVID-19 patients and the effec...
Source: Expert Review of Gastroenterology and Hepatology - July 12, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research