HDAC inhibitors in liver cancer: which route to take?
Authors: Kiesslich T, Neureiter D PMID: 30991854 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - April 19, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Pneumococcal vaccination in celiac disease.
Authors: Casella G, Ingravalle F, Abbate G, Monti C, Bonetti F, Bassotti G, Mansueto P, Villanacci V, Carroccio A Abstract INTRODUCTION: Celiac disease (CD) is an immune-mediated disorder associated with gluten exposure in genetically predisposed subjects. Areas covered: Infectious disease is one of the causes of morbidity and mortality in CD patients. Invasive streptococcus pneumoniae (pneumococcus) is a particularly dangerous morbid condition in both the general population and celiac patients. Pneumococcal vaccination is the most effective means for its prevention. Expert opinion: In CD, evaluation of spleen func...
Source: Expert Review of Gastroenterology and Hepatology - April 17, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Neo-adjuvant therapy for pancreatic cancer: hope for the future.
Authors: Borazanci E, Sckolnik S, Amini A Abstract INTRODUCTION: In 2018, pancreatic ductal adenocarcinoma (PDAC) was the 3rd highest cause cancer related death in the United States. Worldwide estimates in 2018 indicate 458,918 cases diagnosed with 432,242 deaths. Standard therapy for decades for localized PDAC has been to pursue surgical resection for localized disease. For the individuals who are diagnosed with localized PDAC and undergo surgical resection, historical survival has been reported to be around 24 months. While recent advancements in the use of multiagent systemic therapy has allowed for greater surv...
Source: Expert Review of Gastroenterology and Hepatology - April 14, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

A current overview of corticosteroid use in active ulcerative colitis.
Authors: Salice M, Rizzello F, Calabrese C, Calandrini L, Gionchetti P Abstract INTRODUCTION: Ulcerative colitis (UC) is a chronic inflammatory condition that causes continuous mucosal inflammation of the colon. New biological drugs have been developed in order to avoid colectomy, but corticosteroids still play a crucial role in management of active UC. Areas covered: We reviewed the current literature about the importance of corticosteroid use in the treatment of ulcerative colitis. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current prac...
Source: Expert Review of Gastroenterology and Hepatology - April 7, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

A systemic review of 139 reported cases of acute esophageal necrosis: an increasingly well recognized life-threatening condition.
CONCLUSIONS: Patients with acute esophageal necrosis can have a favorable outcome if treated appropriately. PMID: 30933549 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - April 3, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Gut microbiota: Implications for radiotherapy response and radiotherapy-induced mucositis.
Authors: Al-Qadami G, Van Sebille Y, Le H, Bowen J Abstract INTRODUCTION: Radiotherapy is a mainstay of solid tumor management but can be associated with unacceptable levels of off-target tissue toxicity which impact treatment outcomes and patients' quality of life. Tumour response to radiotherapy and the frequency and severity of radiotherapy-induced toxicities, especially mucositis, varies among patients. Gut microbiota has been found to modulate both the efficacy and toxicity of some types of cancer chemotherapies and immunotherapies but has yet to be investigated thoroughly in the setting of radiotherapy. Area ...
Source: Expert Review of Gastroenterology and Hepatology - March 27, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in HIV infection: a metabolic approach of an infectious disease.
Authors: Coronel-Castillo CE, Qi X, Contreras-Carmona J, Ramirez-Perez OL, Mendez-Sanchez N Abstract INTRODUCTION: With the successes of antiretroviral therapy, patients infected with human immunodeficiency virus (HIV) living longer. Regarding this, the common diseases of HIV population (i.e., opportunistic infections) are now losing ground in front of metabolic alterations. This phenomenon is related to the delay in progression to acquired immune deficiency syndrome (AIDS), making it so that patients live in a chronic inflammatory state which, combined with other mechanisms such infectious ones, cause metabolic di...
Source: Expert Review of Gastroenterology and Hepatology - March 25, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Follow up on atopy and the gastrointestinal tract - a review of a common association 2018.
Authors: Walker MM, Talley NJ, Keely S Abstract INTRODUCTION: Primary atopic disorders can be classified as heritable genetic disorders presenting with deregulated pathogenic allergic effector responses irrespective of sensitization. In the last decade, there are parallel rises in the burden of atopic and gastrointestinal (GI) diseases. Areas covered: There is increasing recognition of an association between atopy and GI disease through immune dysregulation, the microbiome and shared genetic pathways. Since the first article on atopy and the GI tract in 2014 in this journal, many more studies have shed light on the...
Source: Expert Review of Gastroenterology and Hepatology - March 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Methotrexate for inflammatory bowel disease: time for reconsideration.
Authors: Nielsen OH, Ainsworth MA, Steenholdt C PMID: 30895827 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - March 23, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Role of imaging techniques in liver veno-occlusive disease diagnosis: recent advances and literature review.
Authors: Ravaioli F, Colecchia A, Alemanni LV, Vestito A, Dajti E, Marasco G, Sessa M, Pession A, Bonifazi F, Festi D Abstract INTRODUCTION: Veno-occlusive-disease (VOD), known also as sinusoidal-obstruction-syndrome (SOS), is one of the main complications of haematopoietic stem cell transplantation and is related to the treatment with pyrrolizidine alkaloids or other toxic agents (chemotherapy for liver-metastasis). Clinical diagnosis using the recent criteria from the European Society for Blood and Marrow Transplantation, is the reference for VOD/SOS diagnosis. However, increasing evidence suggests the emerg...
Source: Expert Review of Gastroenterology and Hepatology - March 23, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Advancements in the use of manometry and impedance testing for esophageal functional disorders.
Authors: Savarino E, Marabotto E, Bodini G, Furnari M, Della Coletta M, Ghisa M, Barberio B, Frazzoni M, De Bortoli N, Zentilin P, Pellegatta G, Tolone S, Ottonello A, Savarino V Abstract INTRODUCTION: The utilization of high-resolution manometry (HRM) has enhanced our understanding and assessment of esophageal motor disorders. Moreover, the combination of impedance technology with HRM (HRIM) has further improved our knowledge of esophageal physiology and the clinical evaluation of dysmotility, thanks to the addition of accurate measurement of bolus transit. Areas covered. This paper provides an overview of current...
Source: Expert Review of Gastroenterology and Hepatology - March 23, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Circadian rhythms: a regulator of gastrointestinal health and dysfunction.
Authors: Voigt RM, Forsyth CB, Keshavarzian A Abstract INTRODUCTION: Circadian rhythms regulate much of gastrointestinal physiology including cell proliferation, motility, digestion, absorption, and electrolyte balance. Disruption of circadian rhythms can have adverse consequences including the promotion of and/or exacerbation of a wide variety of gastrointestinal disorders and diseases. Areas covered: In this review, we evaluate some of the many functions that are regulated by circadian rhythms and how dysregulation of these functions may contribute to disease. This review also discusses some common gastrointestin...
Source: Expert Review of Gastroenterology and Hepatology - March 17, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Pediatric NAFLD: an overview and recent developments in diagnostics and treatment.
Authors: Draijer L, Benninga M, Koot B Abstract INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children and adults in industrialized countries. Besides liver-related morbidity, NAFLD is also associated with an increased risk of cardiovascular disease, type 2 diabetes and mortality at adult age. However, despite the high prevalence and serious complications, diagnosing and staging of disease remains complicated due to a lack of accurate screening tools and non-invasive methods to detect fibrosis. Areas covered: Recent insights in epidemiology, pathogenesis, diagno...
Source: Expert Review of Gastroenterology and Hepatology - March 17, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

An update on cirrhotic cardiomyopathy.
Authors: Møller S, Danielsen KV, Wiese S, Hove JD, Bendtsen F Abstract INTRODUCTION: Cirrhosis with portal hypertension and related complications are associated with a high mortality. Excess of circulating vasodilatators and cardiodepressive substances lead to a hyperdynamic circulation with changed myocardial structure and function. The entity cirrhotic cardiomyopathy seems to be involved in different aspects of hepatic decompensation, which focuses on new targets of treatment. Areas covered: This review deals with contemporary aspects of cirrhotic cardiomyopathy and the literature search was undertaken by ...
Source: Expert Review of Gastroenterology and Hepatology - February 27, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Effect of ω-3 polyunsaturated fatty acids on liver function and inflammatory reaction in patients undergoing hepatectomy: a systematic review and meta-analysis of randomized control trials.
Effect of ω-3 polyunsaturated fatty acids on liver function and inflammatory reaction in patients undergoing hepatectomy: a systematic review and meta-analysis of randomized control trials. Expert Rev Gastroenterol Hepatol. 2019 Feb 07;: Authors: Zhang C, Lin J, Li F, Li Y, Jiang B, Bai H, Zhang J Abstract INTRODUCTION: Several studies have investigated the relationship between ω-3 polyunsaturated fatty acids (PUFAs) administration and liver function and inflammatory reaction in patients undergoing liver resection, but the results remain conflicting and inconclusive. Areas covered: In this ...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Correction.
Authors: PMID: 30791757 [PubMed - in process] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Prucalopride for the treatment of constipation: a view from 2015 and beyond.
Authors: Bassotti G, Usai Satta P, Bellini M Abstract INTRODUCTION: Prucalopride is a prokinetic drug, that has been commercially available in recent years for the treatment of chronically constipated patients. In this update of a previous 2016 article, we reviewed the more recent data supporting its role in the treatment of constipation and constipation-associated conditions. Areas covered: We carried out an extensive literature review on the effects of prucalopride for the years 2012-2018 by means of scientific databases and manual research. More evidence was found on its possible therapeutic role in conditions i...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Emerging treatments for short bowel syndrome in adult patients.
Authors: Billiauws L, Joly F Abstract INTRODUCTION: Short bowel syndrome (SBS) is the major cause of chronic intestinal failure (IF), defined as 'the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth'. Areas covered: Spontaneous intestinal adaptation, including increased hormonal secretion, development of hyperphagia and gut microbiota dysbiosis, occurs 2 years after resection, improving intestinal absorption and decreasing PN dependency. Hormonal treatments...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

A guide to the management of hepatitis E infection during pregnancy.
Authors: Kar P, Sengupta A Abstract INTRODUCTION: Hepatitis E virus (HEV) infection has distinct features, depending upon the genotype and geographical area. HEV genotypes 1 and 2 are endemic to various developing countries causing epidemics of acute viral hepatitis with human to human transmission. On the other hand, HEV genotypes 3 and 4 prevalent in developed countries commonly lead to subclinical infection and are transmitted zoonotically. HEV infection typically causes acute self-limiting illness associated with low morbidity and mortality. Infection with HEV genotype 1 or 2 in pregnancy, especially in the thi...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Updates on vaccinating the inflammatory bowel disease patient.
Authors: Zullow S, Farraye FA Abstract INTRODUCTION: Many of the therapeutic options for patients with inflammatory bowel disease (IBD) suppress the immune system, which increases the risk of certain infections in these patients. Effective vaccines exist and offer protection against a number of infectious diseases. However, data has shown that IBD patients are inadequately vaccinated and, as a result, are at risk of developing certain preventable infections. Furthermore, gastroenterologists' knowledge regarding the appropriate immunizations to administer to their IBD patients is suboptimal. Areas covered: Over the ...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Apoptosis signal-regulating kinase-1 as a therapeutic target in nonalcoholic fatty liver disease.
Authors: Kefala G, Tziomalos K PMID: 30791762 [PubMed - in process] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Unmasking the pathological and therapeutic potential of histone deacetylases for liver cancer.
Authors: Zhao J, Gray SG, Greene CM, Lawless MW Abstract INTRODUCTION: Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer, currently ranking as one of the highest neoplastic-related mortalities in the world. Due to the difficulty in early diagnosis and lack of effective treatment options, the 5-year survival rate of HCC remains extremely low. Histone deacetylation is one of the most important epigenetic mechanisms, regulating cellular events such as differentiation, proliferation and cell cycle. Histone deacetylases (HDACs), the chief mediators of this epigenetic mechanism, are often abe...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Upper gastrointestinal hemorrhage in acute-on-chronic liver failure: prevalence, characteristics, and impact on prognosis.
Authors: Zhao H, Zhao R, Hu J, Zhang X, Ma J, Shi Y, Ma W, Sheng J, Li L Abstract BACKGROUND: Upper gastrointestinal hemorrhage (UGH) is a life-threatening complication in patients with cirrhosis; however, data regarding the role of UGH in acute-on-chronic liver failure (ACLF) are limited. METHODS: A prospective, observational cohort study was performed from February 2014 to Mach 2015. RESULTS: UGH was identified in 170 of 492 cirrhotic patients with acute decompensation (AD) at the time of admission. Logistic regression analysis showed that fecal occult blood test positivity was an independent risk factor ...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Efficacy and safety of selective internal radiotherapy versus sorafenib for intermediate-locally advanced hepatocellular carcinoma: a systematic review and meta-analysis.
CONCLUSIONS: In patients with intermediate-locally advanced HCC, SIRT and SOR result in similar survival rates. The improved toxicity profile of SIRT may help when choosing between the two treatments. PMID: 30791765 [PubMed - in process] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Perspectives on the interlinked nature of systemic sclerosis and reflux disease.
Authors: Chwiesko A, Kowal-Bielecka O, Sierakowski S Abstract INTRODUCTION: Systemic sclerosis (SSc) is a multisystem connective tissue disease, characterized by chronic inflammation and vascular changes that result in esophageal smooth muscle atrophy and fibrosis. Subsequent progressive loss of peristalsis in the distal esophagus and loss of lower esophageal sphincter function lead to problems with the protective barrier and exposure of sensitive tissues to the gastroduodenal contents, a disorder called reflux disease. Areas covered: Depending on the range, nature and symptoms of the disease, the term 'reflux dise...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Gut microbiota: novel therapeutic target for nonalcoholic fatty liver disease.
Authors: Suk KT, Kim DJ Abstract INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is one of the most common and increasing liver diseases worldwide with a prevalence of 20-33%. NAFLD may progress to fibrosis, compensated cirrhosis, advanced cirrhosis, or hepatocellular carcinoma. Despite the increasing prevalence of NAFLD, definitive medical treatment has not been established, with the exception of lifestyle modification with exercise. Because of the direct connection via portal vein between the intestines and the liver (gut-gut microbiota-liver axis), gut microbiota and associated dysbiosis have been known a...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

The association between nonalcoholic fatty liver disease and risk of colorectal adenoma and cancer incident and recurrence: a meta-analysis of observational studies.
CONCLUSIONS: The presence and severity of NAFLD are associated with an increased risk of incident CRA/CRC. However, there is insufficient evidence to indicate that NAFLD is associated with an increased risk of recurrent CRA/CRC. PMID: 30791768 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

An overview of walled-off pancreatic necrosis for clinicians.
Authors: Rana SS Abstract INTRODUCTION: Walled of pancreatic necrosis (WOPN) is a new term coined for encapsulated fluid collection developing after acute necrotising pancreatitis (ANP). It is a heterogeneous collection containing varying amount of liquid as well as solid necrotic material. The literature on its natural history as well as appropriate management is gradually expanding thereby improving treatment outcomes of this enigmatic disease. Areas covered: This review discusses currently available literature on etiology, frequency, natural history, and imaging features WOPN. Also, updated treatment options inc...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Optogenetic control of the enteric nervous system and gastrointestinal transit.
Authors: Spencer NJ, Hibberd T, Feng J, Hu H Abstract INTRODUCTION: There are limited effective therapies available for improving gastrointestinal (GI) transit in mammals with intractable or chronic constipation. Current therapeutics to improve GI-transit usually require oral ingestion of therapeutic drugs, such as the serotonin receptor agonist prucalopride. However, most receptors are distributed all over the body and unsurprisingly drugs like prucalopride stimulate multiple organs, often leading to unwanted side effects. There is a desperate need in the community to improve GI-transit selectively without effects...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Safety and tolerability of linaclotide for the treatment of chronic idiopathic constipation and irritable bowel syndrome with constipation: pooled Phase 3 analysis.
CONCLUSION: These pooled analyses of patients treated for ≤104 weeks confirm linaclotide's overall safety. PMID: 30791771 [PubMed - as supplied by publisher] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Non-invasive assessment of liver fibrosis and prognosis: an update on serum and elastography markers.
Authors: Agbim U, Asrani SK Abstract INTRODUCTION: Non-invasive assessment of fibrosis is increasingly utilized in clinical practice to diagnose hepatic fibrosis. Non-invasive assessment of liver fibrosis relies on biologic and/or physical properties to assess tissue fibrosis. Serum markers estimate fibrosis by incorporating markers reflecting hepatic function (indirect markers) and/or markers measuring extracellular matrix degradation/fibrogenesis (direct markers). Radiology based techniques relay the mechanical properties and stiffness of a tissue, with increased stiffness associated with more advanced fibrosis. ...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Extraintestinal manifestations in inflammatory bowel disease - epidemiology, genetics, and pathogenesis.
Authors: Greuter T, Vavricka SR Abstract INTRODUCTION: Inflammatory bowel disease (IBD) is a chronic inflammatory disorder, primarily of, but not restricted to the gut. Extraintestinal manifestations (EIMs) are frequently observed and involve the joints, eyes, hepatobiliary tract, and skin. Areas covered: In this review, we discuss classical EIM focusing on epidemiology, genetics, and pathogenesis, highlighting recent advances in the understanding of EIM. We further discuss treatment-induced immunological phenomena, which are increasingly recognized and might challenge IBD-treating physicians in the era of biologic...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Oxaliplatin in perioperative chemotherapy for gastric and gastroesophageal junction (GEJ) adenocarcinoma.
Authors: Fritsch R, Hoeppner J Abstract INTRODUCTION: Platinum-based chemotherapy remains standard-of-care for gastric and gastroesophageal junction (GEJ) adenocarcinoma. For locally advanced resectable disease, perioperative treatment with cisplatin-based doublet or triplet chemotherapy regimens had been the predominant approach in Europe and the US, based on pivotal phase III trials including the MAGIC study. Results from more recent landmark studies including the German FLOT4 and the Asian CLASSIC trials have, however, triggered a shift from cisplatin towards oxaliplatin-based chemotherapy protocols in the perio...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Irritable bowel syndrome: a review of the general aspects and the potential role of vitamin D.
Authors: Barbalho SM, Goulart RA, Araújo AC, Guiguer ÉL, Bechara MD Abstract INTRODUCTION: Irritable Bowel Syndrome (IBS) is a bowel disorder leading to symptoms such as abdominal pain, modifications in the motility and bowel habits, distention, bloating, and gas. Vitamin D (VD) may interfere in a plethora of cellular mechanisms, and act directly or indirectly in the regulation of the microbiome, the release of anti-microbial peptides, modulation of the immune system and inflammation processes; which in turn, may positively interfere with the altered gut function. The main purpose of this review was t...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Update on C-reactive protein and fecal calprotectin: are they accurate measures of disease activity in Crohn's disease?
Authors: Ma C, Battat R, Parker CE, Khanna R, Jairath V, Feagan BG Abstract INTRODUCTION: 'Treat-to-target' paradigms in Crohn's disease (CD) directed at suppressing intestinal inflammation require accurate and reliable measures of disease activity. Although endoscopy has traditionally been considered a gold standard, cost, complexity, resource limitations, and invasiveness are important limitations. Hence, substantial interest exists for non-invasive serum and fecal biomarkers, namely C-reactive protein (CRP) and fecal calprotectin (FC), in the diagnosis, monitoring, and treatment of CD. Areas covered: We review t...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

An update on the pathogenesis and clinical management of cirrhosis with refractory ascites.
Authors: Neong SF, Adebayo D, Wong F Abstract INTRODUCTION: Ascites commonly complicates cirrhosis, becoming refractory to treatment with diuretics and sodium restriction in approximately 10% of patients. Pathogenesis of refractory ascites (RA) is multifactorial, the common final pathway being renal hypoperfusion and avid sodium retention. Refractory ascites has a negative prognostic implication in the natural history of cirrhosis. Management of RA include sodium restriction and regular large volume paracentesis (LVP) with albumin infusions, preventing paracentesis-induced circulatory dysfunction. In appropriate se...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Nonalcoholic steatohepatitis before and after liver transplant: keeping up with the times.
Authors: Gitto S, Marra F, De Maria N, Bihl F, Villa E, Andreone P, Burra P Abstract INTRODUCTION: In the last years, nonalcoholic steatohepatitis (NASH) has become a leading indication for liver transplant (LT). After transplant, both recurrent and de novo nonalcoholic fatty liver disease (NAFLD) can be commonly diagnosed. However, dedicated surveillance programs for patients with pre- or post-transplant NAFLD are not available. Areas covered: Patients waiting for LT for NASH show specific peculiarities and would deserve targeted stratification of mortality risk. Obesity, hyperlipidemia, and diabetes mellitus can ...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

An update on the evaluation and management of iron deficiency anemia in inflammatory bowel disease.
Authors: Aksan A, Farrag K, Stein J PMID: 30791779 [PubMed - in process] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Follow-up on: optimizing lesion detection in small bowel capsule endoscopy and beyond: from present problems to future solutions.
This study presents the commercially available CE platforms, as well as the advances made in optimizing the diagnostic capabilities of CE. The latter includes recent concept and prototype capsule endoscopes, medical approaches to improve diagnostic yield, and progress in software for enhancing visualization, abnormality detection, and lesion localization. Expert commentary: Currently, moving through the second decade of CE evolution, there are still several open issues and remarkable challenges to overcome. PMID: 30791780 [PubMed - in process] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Cholesterol cholelithiasis: part of a systemic metabolic disease, prone to primary prevention.
Authors: Di Ciaula A, Wang DQ, Portincasa P Abstract INTRODUCTION: Cholesterol gallstone disease have relationships with various conditions linked with insulin resistance, but also with heart disease, atherosclerosis, and cancer. These associations derive from mechanisms active at a local (i.e. gallbladder, bile) and a systemic level and are involved in inflammation, hormones, nuclear receptors, signaling molecules, epigenetic modulation of gene expression, and gut microbiota. Despite advanced knowledge of these pathways, the available therapeutic options for symptomatic gallstone patients remain limited. Therapy i...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Trends in hepatocellular carcinoma due to non-alcoholic fatty liver disease.
Authors: Bertot LC, Adams LA Abstract INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide and is associated with hepatocellular carcinoma (HCC), the most frequent malignant liver tumor. The increasing prevalence of obesity and diabetes is influencing the epidemiology of HCC with the most dramatic increases in NAFLD-related HCC seen in Western countries. Although cirrhosis is the major risk factor for HCC in NAFLD, there is increasing recognition that NAFLD-HCC occurs in the absence of cirrhosis. Areas covered: The epidemiology of NAFLD related HCC and its impac...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Biosimilars for inflammatory bowel disease: how can healthcare professionals help address patients' concerns?
Authors: Gecse KB, Cumming F, D'Haens G Abstract INTRODUCTION: The patent expiration of some biologics used in chronic conditions such as inflammatory bowel disease (IBD) has led to the development of biosimilar monoclonal antibodies. The tailored regulatory approval route for biosimilar development ensures that approved biosimilars show similarity to their originators in terms of efficacy and safety, and avoids unnecessary repetition of clinical trials carried out with the originator product. However, some patients may still have concerns about using biosimilars and it is the responsibility of healthcare professio...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Molecular basis and cellular mechanisms of eosinophilic esophagitis for the clinical practice.
This article aims to provide a state-of-the-art update on the pathophysiology of EoE applied to clinical practice, and latest research and developments with potential interest to improve the diagnosis and treatment of patients with EoE are revised. Expert commentary: Preliminary approaches have provided promising results toward incorporating minimally invasive methods for patient diagnosis and monitoring in clinical practice. Early diagnosis and optimized therapies will allow for personalized medicine in EoE. PMID: 30791784 [PubMed - in process] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

To cap/cuff or ring: do distal attachment devices improve the adenoma detection?
Authors: Thayalasekaran S, Alkandari A, Varytimiadis L, Subramaniam S, Coda S, Longcroft-Wheaton G, Bhandari P Abstract INTRODUCTION: Colonoscopy reduces the risk of colorectal cancer, by interrupting the adenoma-carcinoma sequence enabling the detection and removal of adenomas before they turn into colorectal cancer. Colonoscopy has its limitations as adenoma miss rates as high as 25% have been reported. The reasons for missed pathology are complicated and multi-factorial. The recent drive to improve adenoma detection rates has led to a plethora of new technologies. Areas covered: An increasing number of advanced ...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Precision medicine beyond medical oncology: using molecular analysis to guide treatments of colorectal neoplasia.
Authors: Molloy MP, Engel A PMID: 30791786 [PubMed - in process] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Non-alcoholic fatty liver disease and cardiovascular risk: an update.
Authors: Mullish BH, Forlano R, Manousou P, Mikhailidis DP PMID: 30791787 [PubMed - in process] (Source: Expert Review of Gastroenterology and Hepatology)
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Adverse events in IBD therapy: the 2018 update.
Authors: Quezada SM, McLean LP, Cross RK Abstract INTRODUCTION: Crohn's disease and ulcerative colitis affect an increasing number of patients, and utilization of immune suppressant and biologic therapies is also increasing. These agents are linked to adverse events ranging from mild nuisance symptoms to potentially life-threatening complications including infections and malignancies. Areas covered: This review provides an updated discussion on adverse events associated with immunomodulator, anti-TNF-α, anti-integrin, and anti-IL 12/IL-23 antibody therapies. In addition, we review the risk profile of the curr...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Direct acting antivirals failure: cause and retreatment options.
Authors: Parlati L, Pol S Abstract INTRODUCTION: Chronic hepatitis C (HCV) infection is a systemic life-threatening condition that can lead to hepatic and extra-hepatic complications. Sustained virological response (SVR) is associated with a regression of most liver and non-liver manifestations, which reduce mortality. The history of HCV infection therapy radically changed in the last decade, with the introduction of the first generation direct acting antivirals (DAAs). Areas covered: The new regimens, based on the combination of 2 or 3 second-generation DAAs, allow SVR, namely hepatitis C infection cure, in more t...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Cost-utility analysis of second-generation direct-acting antivirals for hepatitis C: a systematic review.
Authors: Puig-Junoy J, Pascual-Argente N, Puig-Codina L, Planellas L, Solozabal M Abstract INTRODUCTION: High prices of second-generation direct-acting antivirals (DAAs) in the treatment of chronic hepatitis C virus (HCV) patients led to reimbursement decisions based on cost per quality-adjusted life year (QALY). Areas covered: We performed a systematic review of cost-utility analyses (CUA) comparing interventions with second-generation DAA therapies with no treatment, and with previous therapies for chronic HCV patients until July 2017. A total of 36 studies were included: 30 studies from the perspective of t...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research

Endoscopic management of complications of acute pancreatitis: an update on the field.
Authors: Aghdassi A, Simon P, Pickartz T, Budde C, Skube ME, Lerch MM Abstract INTRODUCTION: Acute pancreatitis is a frequent, nonmalignant gastrointestinal disorder leading to hospital admission. For its severe form and subsequent complications, minimally invasive and endoscopic procedures are being used increasingly, and are subject to rapid technical advances. Areas covered: Based on a systematic literature search in PubMed, medline, and Web-of-Science, we discuss the currently available treatment strategies for endoscopic therapy of pancreatic pseudocysts, walled-off pancreatic necrosis (WON), and disconnected ...
Source: Expert Review of Gastroenterology and Hepatology - February 24, 2019 Category: Gastroenterology Tags: Expert Rev Gastroenterol Hepatol Source Type: research