Selective Use of Liver Transplantation for Severe Alcohol-Associated Hepatitis.
Authors: Ayyala-Somayajula D, Han H, Terrault NA Abstract Introduction: Severe alcohol-associated hepatitis (sAH) portends high morbidity and mortality and there are no effective therapies for those ineligible or unresponsive to corticosteroids. Early liver transplantation (LT), defined as transplant without a mandated period of sobriety, for sAH, is being increasingly considered as a rescue therapy.Areas covered: PubMed and manual searches were combined and last performed on October 28th 2019. Key search terms were "alcoholic hepatitis", "abstinence", "alcohol relapse", and "live...
Source: Expert Review of Gastroenterology and Hepatology - February 22, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Anemia and iron deficiency in Crohn's disease.
Authors: Yue Ying C, Jun S, Yu Fan W, Hua RZ Abstract Introduction: Anemia is a common extraintestinal complication of Crohn's disease (CD) mainly caused by iron deficiency and, affects the quality of life of CD patients. In recent years, the etiology and pathology of iron-deficiency anemia (IDA) and anemia of chronic diseases have been elucidated. However, common biochemical parameters of iron status for the assessment of patients with anemia and CD are insufficient. Thus, novel iron indices are required for accurate assessment in CD patients with IDA. Oral iron supplementation as IDA treatment is common and assoc...
Source: Expert Review of Gastroenterology and Hepatology - February 22, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The role of a plant-based diet in the pathogenesis, etiology and management of the Inflammatory Bowel Diseases.
Authors: Grosse CS, Christophersen CT, Devine A, Lawrance IC Abstract Introduction: Inflammatory Bowel Disease (IBD) carries a significant burden on an individual's quality-of-life and on the healthcare system. The majority of patients use dietary modifications to manage their symptoms, despite limited research to support these changes. There is emerging data that a plant-based diet will be of benefit to IBD patients.Areas covered: A literature review on the pathogenesis and potential benefits of dietary management of IBD.Expert opinion: A Westernized diet has been associated with IBD risk and relapse; hence a plan...
Source: Expert Review of Gastroenterology and Hepatology - February 22, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Comparison of efficacy of pharmacological therapies for gastric endoscopic submucosal dissection-induced ulcers: a systematic review and network meta-analysis.
Conclusion: P-CAB may prevent delayed bleeding, but not significantly. MP agents have potential to heal post-ESD ulcers. The results of this study will help in the selection of treatment options for patients with iatrogenic ulcers. PMID: 32063071 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 19, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Sarcopenia in Non-alcoholic Fatty Liver Disease: New challenges for clinical practice.
Authors: El Sherif O, Dhaliwal A, Newsome PN, Armstrong M Abstract Introduction: Sarcopenia is increasingly recognised in patients with non-alcoholic liver disease (NAFLD). Initially recognised as a consequence of advanced liver disease, there is now emerging evidence that sarcopenia may be a novel risk factor for the development of NAFLD, with a role in fibrosis and disease progression.Areas covered: This review examines the epidemiology, pathogenesis and complex interplay between NAFLD and sarcopenia. Furthermore, the authors discuss the challenges with diagnosis of sarcopenia in the clinic and the evidence-based...
Source: Expert Review of Gastroenterology and Hepatology - February 19, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Fibro-indices versus liver stiffness for prediction of significant fibrosis in hepatitis B virus-infected Egyptian patients; a single-center experience.
Conclusion: FIB4, APRI, and GUCI scores are acceptable, noninvasive, and cheap simple indices that can be helpful on treatment follow-up of fibrosis regression in the setting of low socioeconomic conditions compared to the relatively expensive fibroscan modality. PMID: 32031424 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 9, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Progress in the serology-based diagnosis and management of adult celiac disease.
Authors: Penny HA, Raju SA, Sanders DS Abstract INTRODUCTION: This review provides a comprehensive overview of the development and application of serological tests used routinely in clinical practice for the diagnosis and management of adult coeliac disease.Areas covered: We summarise existing scientific literature related to anti-endomyseal, anti-tissue transglutaminase and anti-deamidated gliadin peptide antibodies and detail the current and potential future applications of these tests in the diagnosis and management of adult coeliac disease.Expert opinion: Current serological tests in coeliac disease have some o...
Source: Expert Review of Gastroenterology and Hepatology - February 6, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Motilin: a panoply of communications between the gut, brain, and pancreas.
Authors: Singaram K, Gold-Smith FD, Petrov MS Abstract Introduction: Motilin was first alluded to nearly a century ago. But it remains a rather abstruse peptide, in the shadow of its younger but more lucid 'cousin' ghrelin.Areas covered: The review aimed to bring to the fore multifarious aspects of motilin research with a view to aiding prioritization of future studies on this gastrointestinal peptide.Expert opinion: Growing evidence indicates that rodents (mice, rats, guinea pigs) do not have functional motilin system and, hence, studies in these species are likely to have a minimal translational impact. Both the ...
Source: Expert Review of Gastroenterology and Hepatology - February 1, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Plecanatide for the treatment of constipation-predominant irritable bowel syndrome.
Authors: Miner PB Abstract INTRODUCTION: As an analogue of uroguanylin plecanatide binds to the Guanylate Cyclase-C receptor activating fluid and ion secretion in the small intestine with the same pH-dependent binding kinetics as the natural ligand. Plecanatide has been FDA approved as safe and effective for the indications of Chronic Idiopathic Constipation (CIC) and Irritable Bowel Syndrome with Constipation (IBS-C).Areas Covered: All clinical trial results supporting approval of plecanatide in IBS-C are reported, evaluated and interpreted in the context of the complex pathophysiology of functional diseases and t...
Source: Expert Review of Gastroenterology and Hepatology - January 29, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Hepatitis B-related glomerulonephritis and optimization of treatment.
Authors: Liu Y, Shi C, Fan J, Wang B, Li G Abstract Introduction: Multiple studies have revealed a strong relationship between the development of nephropathy and hepatitis B virus (HBV) infection. The underlying pathogenesis of hepatitis B-related glomerulonephritis (HBV-GN) involves immune complexes, which can be isolated from kidney tissues. Clearance of HBV antigenemia improves renal impairment and proteinuria in HBV-GN patients.Areas covered: In this review, we present our current understanding of the epidemiology, pathogenesis, pathology, diagnosis, and treatment of HBV-GN. We discuss the advantages and disadv...
Source: Expert Review of Gastroenterology and Hepatology - January 19, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

A Current Clinical Overview of Atrophic Gastritis.
Authors: Annibale B, Esposito G, Lahner E Abstract SUMMARYIntroduction: Atrophic gastritis (AG) is a complex syndrome which arise as consequence of H. pylori infection or in the context of gastric autoimmunity. It often deserves a benign course, but may lead to potentially life-threatening complications: cancer and anaemia. This review aims to address traditional and innovative knowledge on this often under-diagnosed disorder.Areas covered: This review covers clinical presentation, risk factors, diagnosis and management of AG and provides an updated resource for clinicians to get insight in this challenging disorde...
Source: Expert Review of Gastroenterology and Hepatology - January 19, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Fatty liver in pregnancy: a narrative review of two distinct conditions.
Authors: Azzaroli F, Mazzella G, Marchesini G, Brodosi L, Petroni ML Abstract INTRODUCTION: Fatty liver is rather common in pregnancy, occurring in two totally different conditions, i.e, nonalcoholic fatty liver disease (NAFLD) in pregnancy and acute fatty liver of pregnancy (AFLP). The former is a common condition, resulting by chance association because of the epidemics of obesity and the older age of many pregnant women in Western countries; the latter is a rare disease whose pathophysiology is still incompletely understood.Areas covered:We reviewed the evidence-based knowledge on fatty liver in/of pregnancy. Fo...
Source: Expert Review of Gastroenterology and Hepatology - January 15, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Trifluridine/Tipiracil for the Treatment of Metastatic Gastric Cancer.
Authors: Kawazoe A, Shitara K Abstract Introduction: Trifluridine/tipiracil is a novel oral cytotoxic chemotherapy consisting of a thymidine-based nucleoside analog, trifluridine, and a thymidine phosphorylase inhibitor, tipiracil. Trifluridine/tipiracil was approved for the treatment of metastatic colorectal cancer refractory to standard therapies. A phase II trial in Japan demonstrated that this therapy has antitumor activity and is tolerated by patients with advanced gastric cancer (AGC); as a result, the phase III TAGS trial (Trifluridine/Tipiracil Versus Placebo in Patients With Heavily Pretreated Metastatic G...
Source: Expert Review of Gastroenterology and Hepatology - January 12, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Functions of circular RNAs and their potential applications in gastric cancer.
Authors: Ruan Y, Li Z, Shen Y, Li T, Zhang H, Guo J Abstract Introduction: In recent years, circular RNAs (circRNAs) have emerged in the field of RNA research and their biological functions are now being gradually identified. circRNAs are divided into three categories: exonic circular RNAs (ecircRNAs), exon-intron circular RNAs (EIciRNAs), and intronic circular RNAs (ciRNAs). The circular structure of circRNAs confers unique biological characteristics upon them, such as enhanced stability over linear RNAs.Areas covered: circRNAs function to competitively bind with microRNAs (miRNAs) and proteins, participate in pro...
Source: Expert Review of Gastroenterology and Hepatology - January 12, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

An approach to the diagnosis and management of Rome IV functional disorders of chronic constipation.
Authors: Imran A, Whitehead WE, Palsson OS, Törnblom H, Simrén M Abstract Introduction: Chronic constipation is highly prevalent, affecting between 10% and 15% of the population. The Rome IV criteria categorizes disorders of chronic constipation into four subtypes: (a) functional constipation, (b) irritable bowel syndrome with constipation, (c) opioid-induced constipation, and (d) functional defecation disorders, including inadequate defecatory propulsion and dyssynergic defecation. The initial management approach for these disorders is similar, focusing on diet, lifestyle and the use of standard over-t...
Source: Expert Review of Gastroenterology and Hepatology - January 3, 2020 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Is there a role for therapeutic sphingolipids in inflammatory bowel disease?
Authors: Parigi TL, Roda G, Argollo M, Gilardi D, Danese S Abstract Introduction: Inflammatory bowel diseases (IBD), which include Crohn's disease and ulcerative colitis, are lifetime chronic inflammatory disorders. Over the past few decades, new therapeutic approaches, including early and more effective intervention with immunomodulators and biological agents, increased the possibility of a favourable modification of the natural history of IBD. Despite this progress there is still a need to explore new therapeutic options.Area covered: Here, we review the literature about the role of therapeutic sphingolipids in i...
Source: Expert Review of Gastroenterology and Hepatology - December 26, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Diagnosis and management of renal dysfunction in patients with cirrhosis.
Authors: Carrion AF, Radhakrishnan R, Martin P Abstract Introduction:Care of patients with sarcoidosis requires familiarity with its natural history as well as various immunosuppressants employed in its treatment.  We would like to share our approach to management based on our experience and understanding of the relevant literature.Areas covered:Asymptomatic patients with pulmonary sarcoidosis ought to be managed conservatively. Systemic sarcoidosis with burdensome symptoms usually responds to corticosteroids, but one needs to consider the risk of long-term steroid toxicity as well as relapse. Rapidly tapering...
Source: Expert Review of Gastroenterology and Hepatology - December 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Hepatitis C, systemic inflammation and oxidative stress: correlations with metabolic diseases.
Authors: Sevastianos VA, Voulgaris TA, Dourakis SP Abstract Introduction: Hepatitis C chronic infection has long been correlated with numerous systemic diseases, such as diabetes mellitus and hepatic steatosis. Recent studies have also revealed an association with atherosclerosis.Areas Covered: An analysis is presented on the mechanisms through which the hepatitis C viral infection can lead to a systemic increase in pro-inflammatory markers, especially tumor necrosis factor-a and interleukin-6. The immunological imbalance created may, through different mechanisms, act on the metabolic pathways that contribute to th...
Source: Expert Review of Gastroenterology and Hepatology - December 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Metabolomics studies in Gastrointestinal cancer: a systematic review.
Authors: Yu J, Zhao J, Zhang M, Guo J, Liu X, Liu L Abstract Introduction: This systemic review provides an overview of metabolic perturbations and possible mechanisms in gastrointestinal cancer. The authors discuss emerging challenges of technical and clinical application.Areas covered: In this systemic review, the authors summarized the current available results of metabolomic biomarkers linked to GI cancer, and discussed the altered metabolism pathways including carbohydrate metabolism, amino acid metabolism, lipids and nucleotide metabolism. Furthermore, future efforts need to adhere to normalize analysis proce...
Source: Expert Review of Gastroenterology and Hepatology - December 4, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Clinical utility of pre-endoscopy risk scores in upper gastrointestinal bleeding.
This article aims to address the clinical utility of the various pre-endoscopic risk assessment tools used in AUGIB.Areas covered: The authors undertook a literature review of the current evidence on the pre-endoscopic risk assessment scores. Additional the authors discuss the recently published novel risk assessment scores.Expert opinion: The evidence shows that GBS is the most clinically useful risk assessment score in correctly identifying very low-risk patients suitable for outpatient management. At present, research is ongoing to assess machine learning in the assessment of patients presenting with AUGIB. More researc...
Source: Expert Review of Gastroenterology and Hepatology - December 4, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The progress of non-alcoholic fatty liver disease as the risk of liver metastasis in colorectal cancer.
Authors: Lv Y, Patel N, Zhang HJ Abstract Introduction: The liver is the most common metastatic site of colorectal cancer (CRC), and the long-term survival rate of CRC patients who cannot resect liver metastatic lesions radically is extremely low. Early identification of risk factors for liver metastasis from CRC may be an effective strategy to reduce the incidence of liver metastasis. The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing in parallel with an increasing prevalence of obesity and metabolic syndrome (MS), which has become one of the main causes of chronic liver disease worldwide.Are...
Source: Expert Review of Gastroenterology and Hepatology - November 28, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

An overview of deep learning algorithms and water exchange in colonoscopy in improving adenoma detection.
Authors: Hsieh YH, Leung FW Abstract Introduction: Among the Gastrointestinal (GI) Endoscopy Editorial Board top 10 topics in advances in endoscopy in 2018, water exchange colonoscopy and artificial intelligence were both considered important advances in GI endoscopy. Artificial intelligence holds potential to increase and water exchange significantly increases adenoma detection.Areas covered: The authors searched MEDLINE (1998-2019) using the following medical subject terms and keywords: colonoscopy, adenoma, artificial intelligence, deep learning, computer-assisted detection, and neural networks. Additional relat...
Source: Expert Review of Gastroenterology and Hepatology - November 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Incidence and mortality of renal dysfunction in cirrhotic patients with acute gastrointestinal bleeding: a systematic review and meta-analysis.
This study aimed to explore the incidence and mortality of renal dysfunction in cirrhotic patients with acute GIB.Methods: The PubMed, EMBASE, and Cochrane Library databases were searched. We pooled the incidence and mortality of renal dysfunction in cirrhotic patients using a random-effect model. Odds ratio (OR) with 95% confidence interval (CI) were calculated.Results: Seventeen studies were included. The pooled incidence of renal dysfunction was 21% (95%CI=16%-25%) in cirrhosis with acute GIB. In subgroup analyses, the pooled incidence of renal failure, acute kidney injury (AKI), and renal impairment were 21%, 25%, and ...
Source: Expert Review of Gastroenterology and Hepatology - November 20, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Real life application of FIB-4 & APRI during mass treatment of HCV genotype 4 with directly acting anti-viral agents in Egyptian patients, an observational study.
Real life application of FIB-4 & APRI during mass treatment of HCV genotype 4 with directly acting anti-viral agents in Egyptian patients, an observational study. Expert Rev Gastroenterol Hepatol. 2019 Nov 08;: Authors: Said M, Soliman Z, Daebes H, M El-Nahaas S, El-Serafy M Abstract Background: Non-invasive prediction of significant liver fibrosis and gastro-esophageal varices during mass treatment for HCV is crucialThe aim is to validate the accuracy of FIB-4 & APRI for predicting significant fibrosis in chronic HCV patients during mass treatment with directly acting anti-viral agents (DAAs) ...
Source: Expert Review of Gastroenterology and Hepatology - November 10, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Cyclic Vomiting Syndrome: An Overview for Clinicians.
Authors: Herlihy JD, Reddy S, Shanker A, McCallum R Abstract INTRODUCTION: Cyclic vomiting syndrome (CVS) is an under recognized entity causing significant impact on patient's lifestyle. CVS is characterized by recurrent episodes of abdominal pain, nausea, and vomiting leading to many emergency department presentations prior to diagnosis. Patients often have lengthy delays in starting appropriate therapy leading to significant physical and financial hardship. Most cases of cyclic vomiting syndrome are reversible by managing risk factors and starting on appropriate treatment.Areas covered: This review covers the dia...
Source: Expert Review of Gastroenterology and Hepatology - November 10, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Surgical choice of proximal gastric cancer in china :a retrospective study of a 30-year experience from a single center in china.
Conclusion: Considering the survival benefits and preserved function, proximal gastrectomy can be performed safely in stage Ia and Ib gastric cancer (T1N0, T1N1, and T2N0) with an excellent remission rate. Proximal gastrectomy is not recommended for advanced gastric cancer. PMID: 31687853 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - November 9, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Progress in promising anti-fibrotic therapies.
Authors: Santoro R, Mangia A Abstract Introduction: Liver cirrhosis is the most deleterious consequence of chronic liver diseases of different etiologies. Progression of liver diseases to cirrhosis, irrespective of etiology, involves chronic parenchymal injury, persistent activation of inflammatory response, sustained activation of fibrogenesis and wound-healing response. Despite intensive research on antifibrotic drugs, novel therapeutics specifically for liver have not been yet licensed. This review will examine compounds currently under development and key challenges in specific settings as for example that of N...
Source: Expert Review of Gastroenterology and Hepatology - November 9, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Corticosteroid improves liver function but does not curb the clinical progression of hepatitis B virus-related acute-on-chronic pre-liver failure.
This study aimed to evaluate the efficacy of short-term (5 days) and low-dose dexamethasone (5mg/d) toward HBV pre-ACLF.Design and Methods: One hundred twenty-one patients with HBV pre-ACLF were randomly divided into two groups: medical comprehensive treatment (MCT) group and corticosteroid treatment (CT) group. Laboratory measurements at admission and 7 days post-admission were compared between the two groups, respectively. Hospitalization periods and clinical progression were also monitored and compared between the two groups.Results: Higher than normal levels of ALT, AST, TBIL, DBIL, TBA and GLO were observed at 7 days ...
Source: Expert Review of Gastroenterology and Hepatology - November 3, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Microbiota transplant therapy and autism: lessons for the clinic.
Authors: Adams JB, Borody TJ, Kang DW, Khoruts A, Krajmalnik-Brown R, Sadowsky MJ Abstract Introduction: The purpose of this review is to discuss Microbiota Transplant Therapy (MTT), a type of intensive intestinal microbiota transplantation (IMT), for people with autism spectrum disorders (ASD) and chronic gastrointestinal disorders (constipation and/or diarrhea).Areas covered: This paper briefly reviews IMT, gastrointestinal symptoms and gastrointestinal bacteria in children with ASD, and results and lessons learned from intensive MTT for autism.Expert opinion: An open-label study and a two-year follow-up suggests...
Source: Expert Review of Gastroenterology and Hepatology - November 1, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Updates in the management of hepatitis B in children.
Authors: Lai MW, Chang MH Abstract Introduction: Universal infant hepatitis B virus (HBV) vaccination program has reduced HBV infection dramatically in vaccinated young generations. Management of chronically infected children is still challenging concerning high viral load with mostly mild diseases, yet with a nonnegligible proportion of advanced diseases, and long-term effect of antivirals. However, with more potent antivirals approved for pediatric patients, to start antivirals earlier in eligible patients may benefit their outcomes. This review aimed to update the current management of chronic hepatitis B in chi...
Source: Expert Review of Gastroenterology and Hepatology - October 31, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Identification and management of pancreas divisum.
Authors: Gutta A, Fogel E, Sherman S Abstract Introduction: Pancreas divisum is the most common congenital malformation of the pancreas with the majority asymptomatic. The etiological role, pathogenesis, clinical significance and management of pancreas divisum in pancreatic disease has not been clearly defined and our understanding is yet to be fully elucidated.Areas covered: This review describes the role of pancreas divisum in the development of pancreatic disease and the ambiguity related to it. In our attempt to offer clarity, a comprehensive search on PubMed, Ovid, Embase and Cochrane Library from inception to...
Source: Expert Review of Gastroenterology and Hepatology - October 31, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Updates and advancements in the management of hepatocellular carcinoma patients after hepatectomy.
Authors: Lu SD, Li L, Liang XM, Chen W, Chen FL, Fan LL, Ahir BK, Zhang WG, Zhong JH Abstract Introduction: The 5-year recurrence rate of hepatocellular carcinoma (HCC) after hepatic resection or local ablation is up to 70%. Adjuvant therapies to prevent HCC recurrence have been reported but are not currently recommended by EASL or AASLD guidelines. This review examined evidence from randomized controlled trials, meta-analyses and systematic reviews on the safety and efficacy of adjuvant therapies and chemotherapies in HCC patients after resection or local ablation. Areas covered: PubMed was searched through June 1...
Source: Expert Review of Gastroenterology and Hepatology - October 30, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

An approach to acute severe ulcerative colitis.
Authors: Sedano R, Quera R, Simian D, Yarur AJ Abstract INTRODUCTION: Despite the introduction of novel therapies and treatment strategies for ulcerative colitis (UC), many patients develop acute, severe episodes, warranting prompt care and aggressive management. There is a significant unmet need to improve outcomes in these patients. Clinicians must be able to identify those that will have worse prognosis and plan an aggressive therapy with an early/proactive adjustments in management if needed. Areas covered: The aim of this review is to evaluate the most recent evidence on the assessment and management of patien...
Source: Expert Review of Gastroenterology and Hepatology - October 30, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

177Lu-DOTATATE for the treatment of gastroenteropancreatic neuroendocrine tumors.
Authors: Das S, Al-Toubah T, El-Haddad G, Strosberg J Abstract INTRODUCTION: 177Lutetium-[DOTA0,Tyr3]octreotate (177Lu-DOTATATE) is a type of peptide receptor radionuclide therapy that garnered FDA approval in January 2018 for the treatment of somatostatin receptor-positive gastroenteropancreatic (GEP) neuroendocrine tumor (NET) patients. The therapy approval was based on findings from the randomized international phase III NETTER-1 trial as well as outcomes data from a large European registry. The mechanism of the drug stems directly from its structure: a somatostatin analog (octreotate) selectively binding to som...
Source: Expert Review of Gastroenterology and Hepatology - October 30, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Inflammatory bowel disease: current and future non-invasive diagnostic techniques in clinical practice.
Authors: Bannaga AS, Farrugia A, Arasradnam RP Abstract Introduction: Inflammatory bowel disease (IBD) is a common disease with significant morbidity. Non-invasive diagnostic techniques are lacking in IBD. Currently, faecal calprotectin is a sensitive marker of gut inflammation however is not specific to Crohn's disease (CD) or ulcerative colitis (UC) alone. Volatile organic compounds (VOCs) were shown to have potential in IBD diagnosis. Areas covered: This systematic review aimed to examine the next-generation diagnosis of IBD in adults and children using VOCs. An in-depth literature-based search of current clinic...
Source: Expert Review of Gastroenterology and Hepatology - October 30, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Inflammatory bowel disease: long-term therapeutic challenges.
Authors: Ashton JJ, Green Z, Kolimarala V, Beattie RM Abstract Introduction- Long-term, sustained, remission is the ultimate goal of contemporary inflammatory bowel disease therapy. Avoiding complications, surgery and malignancy, alongside minimising the side effects of medications are vital. However, the reality of treatment involves patients losing response to therapy, or developing complications requiring cessation of medication. The reasons for this are numerous and include medication and host-related influences. Underpinning the response to medication, long-term outcomes and loss of response are individual aet...
Source: Expert Review of Gastroenterology and Hepatology - October 30, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Inflammatory bowel diseases: interrelationships between dietary vitamin D, exposure to UV radiation and the faecal microbiome.
Authors: Ghaly S, Hart PH, Lawrance IC Abstract Introduction: Environmental factors and an altered faecal microbiome are believed to be central to the pathogenesis of inflammatory bowel diseases (IBD). Vitamin D and ultraviolet radiation (UVR) are environmental factors that are associated by several pathways, including changes to the gastrointestinal microbiome, with the development and course of IBD. Area covered: This review explores the interaction of vitamin D, and UVR, with the intestinal innate and adaptive immune systems, and how they may influence the gut microbiome and the subsequent development, and progr...
Source: Expert Review of Gastroenterology and Hepatology - October 30, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

From circadian clocks to non-alcoholic fatty liver disease.
Authors: Ji Y, Elkin K, Yip J, Guan L, Han W, Ding Y Abstract Introduction: The circadian rhythm is an integral regulator of various endocrine processes in the body, including sleep-wake cycles, hormonal regulation, and metabolism. In addition to metabolic, genetic, and environmental factors, a dysregulated circadian rhythm resulting from lifestyle changes has been implicated in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). An accumulating body of evidence also supports strong association between NAFLD and metabolic disorder, the pathogenesis of which is related to periodic fluctuations in hormonal...
Source: Expert Review of Gastroenterology and Hepatology - October 27, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Is 45 the new 50? Controversies in lowering the screening age for colorectal cancer.
Authors: Megna B, Shaukat A PMID: 31623468 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - October 20, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Microbiota and mucosal defense in IBD: an update.
Authors: Stange EF, Schroeder BO Abstract Introduction: Inflammatory bowel diseases (IBD) are on the rise worldwide. This review covers the current concepts of the etiology of Crohn´s disease and ulcerative colitis by focusing on an unbalanced interaction between the intestinal microbiota and the mucosal barrier. Understanding these issues is of paramount importance for the development of targeted therapies aiming at the disease cause. Area covered: Gut microbiota alterations and a dysfunctional intestinal mucosa are associated with IBD. Here we focus on specific defense structures of the mucosal barrier, nam...
Source: Expert Review of Gastroenterology and Hepatology - October 12, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The intestinal tissue homeostasis - the role of extracellular matrix remodelling in inflammatory bowel disease.
Authors: Mortensen JH, Lindholm M, Langholm LL, Kjeldsen J, Bay-Jensen AC, Karsdal MA, Manon-Jensen T Abstract Introduction: Extracellular matrix (ECM) remodelling of the intestinal tissue is important in inflammatory bowel disease (IBD) due to the extensive mucosal remodelling. There are still gaps in our knowledge as to how ECM remodelling is related to intestinal epithelium homeostasis and healing of the intestinal mucosa. Areas covered: The aim of this review is to highlight the importance of the ECM in relation to the pathogenesis of IBD, while addressing basement membrane and interstitial matrix remodelling, ...
Source: Expert Review of Gastroenterology and Hepatology - October 8, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Difficult peroral endoscopic myotomy: definition and management strategies.
Authors: Tan Y, Li C, Yan J, Long L, Huo J, Liu D Abstract Introduction: Peroral endoscopic myotomy (POEM) has been established as an alternative endoscopic method for the treatment of achalasia, and several studies have confirmed its relatively long-term efficacy. Although most of the POEM procedures can be smoothly completed, technical difficulties do arise during the treatment of some patients, which may lead to prolonged procedure duration, increased procedure-related complications, or even aborted POEM. Area covered: In the present review, we provide a comprehensive review of difficult POEM, focusing on its de...
Source: Expert Review of Gastroenterology and Hepatology - October 1, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Imaging in discriminating Intestinal tuberculosis and Crohn's disease: Past, Present and the Future.
Authors: Goyal P, Shah J, Gupta S, Gupta P, Sharma V Abstract Introduction: Intestinal tuberculosis (ITB) and Crohn's disease (CD) have similar clinical presentation, but require different treatment approaches. Despite advances in various endoscopic, imaging, microbiological and histological techniques, the differentiation of these two entities is often difficult. Newer radiological and image acquisition modalities have now become indispensable tools for evaluation of these two diseases. Areas covered: This review summarizes the currently available literature on various radiological investigations to differentiate ...
Source: Expert Review of Gastroenterology and Hepatology - September 30, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Infections and malignancies risks related to TNF- α-blocking agents in pediatric inflammatory bowel diseases.
Infections and malignancies risks related to TNF-α-blocking agents in pediatric inflammatory bowel diseases. Expert Rev Gastroenterol Hepatol. 2019 Sep 06;:1-5 Authors: Alvisi P, Dipasquale V, Barabino A, Martellossi S, Miele E, Lionetti P, Lombardi G, Cucchiara S, Torre G, Romano C Abstract Introduction: Tumor necrosis factor-α (TNF-α)-blocking agents are drugs approved for the treatment of inflammatory bowel diseases (IBDs). Infliximab and adalimumab are approved for the treatment of IBD in the pediatric setting with the improvement of therapeutic management. Biological agents, also...
Source: Expert Review of Gastroenterology and Hepatology - September 8, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Precision medicine for metastatic colorectal cancer: an evolving era.
Authors: Guler I, Askan G, Klostergaard J, Sahin IH Abstract Introduction: Metastatic colorectal cancer (CRC) remains a dilemma for cancer researchers with an increasing incidence in the younger patient population. Until the last decade, limited therapeutic options were available for metastatic CRC patients leading to relatively poor clinical outcomes. Areas covered: With advances in genome sequencing technology and reductions in the cost of next-generation sequencing, molecular profiling has become more accessible for cancer researchers and clinical investigators, which has furthered our understanding of the molec...
Source: Expert Review of Gastroenterology and Hepatology - September 4, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Liver stiffness measurements and FIB-4 are predictors of response to sofosbuvir-based treatment regimens in 7256 chronic HCV patients.
Conclusion: Baseline LS by TE and FIB-4 score may be useful for predicting treatment outcome in the new era of DAAs and could be integrated into pretreatment assessment of chronic HCV patients for better optimization of patient management. PMID: 31418303 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - August 18, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The current knowledge about the therapeutic use of endoscopic sclerotherapy and endoscopic tissue adhesives in variceal bleeding.
Authors: Al-Khazraji A, Curry MP Abstract Introduction: The most recent guidelines vary in their approach to the management of variceal bleeding especially with the use of endoscopic sclerotherapy (ES) and endoscopic tissue adhesive (ETA). This review highlights their clinical use for variceal bleeding from different guidelines perspectives. Areas covered: A comprehensive literature review of three major guidelines including the American Association for the Study of Liver Diseases (AASLD) 2017, United Kingdom (UK) guidelines 2015 and Baveno VI Consensus workshop guidelines in 2015 on the use of ES and ETA in varice...
Source: Expert Review of Gastroenterology and Hepatology - August 9, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Red cell distribution width to platelet ratio for liver fibrosis: A systematic review and meta-analysis of diagnostic accuracy.
Authors: Milas GP, Karageorgiou V, Cholongitas E Abstract Introduction: Red cell distribution width to platelet ratio (RPR) may be a useful marker for the evaluation of liver fibrosis in chronic liver disease (CLD). We sought to investigate its value in fibrosis-related outcomes in a meta-analysis of diagnostic accuracy. Areas covered: We searched MEDLINE (1966-2019), Clinicaltrials.gov (2008-2019), Cochrane Central Register of Controlled Trials (CENTRAL) (1999-2019), Google Scholar (2004-2019) and WHO (International Clinical Trials Register Platform) databases using a structured algorithm. The articles were assess...
Source: Expert Review of Gastroenterology and Hepatology - August 9, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Management of HCV patients in cases of direct-acting antiviral failure.
Authors: Hayes CN, Imamura M, Chayama K Abstract Introduction: Over 70 million people are infected with hepatitis C virus (HCV), increasing the risk of cirrhosis and hepatocellular carcinoma. Areas covered: Since the approval of the first interferon-free direct-acting antiviral (DAA) therapy in 2011, a number of DAAs have been approved, and HCV is now considered curable. Until recently, however, there were no clear guidelines on how to re-treat patients who fail DAA therapy. Current protease inhibitors (PIs) are generally unaffected by earlier resistance-associated variants (RAVs), but many NS5A inhibitors continue...
Source: Expert Review of Gastroenterology and Hepatology - August 9, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Visceral fat is associated with cirrhotic portal vein thrombosis.
Authors: Hernández-Conde M, Llop E, Fernández-Carrillo C, Perelló C, López-Gómez M, Abad J, Martínez-Porras JL, Fernández-Puga N, Calleja JL Abstract Background: Central obesity, due to the accumulation of visceral fat(VF), is one of the main risk factors for venous thrombosis. The aim of this study was to determine if VF may be a risk factor for development of portal vein thrombosis(PVT) in cirrhotic patients. Methods: A total of 214 cirrhotic patients at the outpatient clinic were consecutively included, undergoing an anthropometric evaluation, blood tests and bioi...
Source: Expert Review of Gastroenterology and Hepatology - August 9, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research