Surgical Management of Ulcerative Colitis
This article includes descriptions of technique, management alternatives, and intraoperative and postoperative management of pouch issues. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 27, 2020 Category: Gastroenterology Authors: Michael J. Grieco, Feza H. Remzi Source Type: research

Health Maintenance in Ulcerative Colitis
Ulcerative Colitis (UC) is a complex chronic, immune-mediated inflammatory disorder of the colon. The exact cause of UC is still unknown, but the incidence and prevalence are increasing worldwide. Making the diagnosis of UC can be difficult because there are other disease states that mimic the signs and symptoms with which patients present. Given the complex nature of the disease and heterogeneity of presentation, severity and distribution of disease, and complications associated with inadequately treated disease, it is important to understand the natural history of UC and how to make the initial diagnosis. (Source: Gastro...
Source: Gastroenterology Clinics of North America - October 27, 2020 Category: Gastroenterology Authors: Scott D. Lee Tags: Preface Source Type: research

Ulcerative Colitis
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 27, 2020 Category: Gastroenterology Authors: Scott D. Lee Source Type: research

Copyright
Elsevier (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 27, 2020 Category: Gastroenterology Source Type: research

Contributors
ALAN L. BUCHMAN, MD, MSPH, FACP, FACN, FACG, AGAF (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 27, 2020 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 27, 2020 Category: Gastroenterology Source Type: research

Forthcoming Issues
Nutritional Management of Gastrointestinal Diseases (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 27, 2020 Category: Gastroenterology Source Type: research

Health Maintenance in Patients with Ulcerative Colitis
This article reviews pertinent topics in preventive care for individuals with UC to provide a framework for gastroenterology subspecialists to be able to provide patient-centered care. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 4, 2020 Category: Gastroenterology Authors: Jason Harper Source Type: research

Biologic Therapy for Ulcerative Colitis
Five biologics are approved for the treatment of ulcerative colitis (UC): infliximab, adalimumab, golimumab, vedolizumab, and ustekinumab. These drugs have varying levels of efficacy and are recommended as first-line treatment of moderate to severe UC. There has been only 1 head-to-head trial comparing the efficacy of the biologics, adalimumab and vedolizumab, which has important implications for management. Therapeutic drug monitoring of biologics, especially anti-TNF alpha agents, may improve the long-term efficacy of these agents. The future of treatment may include personalization of medications, based on patient-speci...
Source: Gastroenterology Clinics of North America - September 24, 2020 Category: Gastroenterology Authors: Abhik Bhattacharya, Mark Tomislav Osterman Source Type: research

Mesalamine in the Initial Therapy of Ulcerative Colitis
Inflammatory bowel disease is a chronic disorder of intestinal inflammation and includes Crohn ’s disease and ulcerative colitis. The goal of therapy is to induce and maintain remission, which is achieved with conventional therapies. Mesalamine is considered a first-line therapy for ulcerative colitis. Clinical trials have confirmed its efficacy and safety in patients with mild to moderate ulcerative colitis. Doses of more than 2.4 g/d achieve significantly higher rates of clinical and endoscopic remission, with a decreased risk of relapse. Serious adverse effects are rare, but nonadherence is common. Mesalamine...
Source: Gastroenterology Clinics of North America - September 23, 2020 Category: Gastroenterology Authors: Richa Chibbar, Alan C. Moss Source Type: research

Epidemiology and Pathogenesis of Ulcerative Colitis
Ulcerative colitis (UC) is a complex chronic, immune-mediated inflammatory disorder of the colon. Factors associated with increased risk of UC include diet, particularly Western diet influences in newly industrialized nations, medications, and lifestyle factors that may influence the host ’s microbiome or immune response to antigens. Although much evidence identifying potential genetic and host-related factors is currently available, there are still many unanswered questions. As the global UC incidence and prevalence continues to increase, there are multiple opportunities for conti nued investigation to clarify our u...
Source: Gastroenterology Clinics of North America - September 23, 2020 Category: Gastroenterology Authors: Lillian Du, Christina Ha Source Type: research

Treatment of Ulcerative Colitis with Steroids (in Whom, How Long, What Dose, What Form)
Corticosteroids are a nonspecific immune modulator used in the treatment of ulcerative colitis. Topical and systemic forms of corticosteroids have been shown to be effective in induction of clinical remission and remain first-line therapy for acute severe ulcerative colitis. A large proportion of patients experience adverse effects, however, including some serious adverse effects, including infection and increased mortality. Newer formulations of gut selective corticosteroids have reduced adverse effects associated with steroids. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - September 23, 2020 Category: Gastroenterology Authors: Lauren A. George, Raymond K. Cross Source Type: research

Risk of Colon Cancer and Recommended Surveillance Strategies in Patients with Ulcerative Colitis
This article summarizes key strategies for colonoscopic surveillance, the most widely used and evidence-based method of CRC prevention. As currently constituted and practiced, surveillance examinations every 1 to 3 years with lesion detection and removal using high-definition endoscopic systems with or without pancolonic spray-dye chromoendoscopy is the best method for mitigating the development of CRC morbidity and mortality. For patients with primary sclerosing cholangitis with UC, surveillance should begin at the time of diagnosis and colonoscopy should be performed annually. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - September 23, 2020 Category: Gastroenterology Authors: Wendy Rabbenou, Thomas A. Ullman Source Type: research

Fecal Microbiota Transplantation for Ulcerative Colitis. Are We Ready for Primetime?
“Patients with inflammatory bowel disease, including ulcerative colitis (UC) and Crohn disease, have altered gut microbiomes. The success of fecal microbiota transplantation (FMT) in the treatment of Clostridioides difficile infection, a disease that is also marked by dysbiosis, has spurred resear ch in applying FMT to UC. So far, 3 randomized controlled trials have demonstrated benefit in mild to moderate UC disease course after FMT. However, important questions regarding optimal stool preparation, route, and frequency of administration, as well as characteristics of the stool donor and reci pient still remain.&rdqu...
Source: Gastroenterology Clinics of North America - September 23, 2020 Category: Gastroenterology Authors: Yao-Wen Cheng, Monika Fischer Source Type: research

Ulcerative Colitis: Where We Are and Where We Are Not in 2020
Inflammatory bowel disease (IBD) has 2 general subclasses of disease: Crohn disease and ulcerative colitis, although I have always felt that our diagnostic abilities have been naive in that these are in reality many different diseases: gastroduodenal Crohn is fundamentally different from terminal ileal disease, which differs from isolated colonic disease, not to mention fistulizing disease, and obstructive disease. We are not as yet ready to chuck the term Crohn, perhaps out of deference to the Crohn family. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - September 23, 2020 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Ulcerative Colitis
Ulcerative colitis is an inflammatory condition of the colon. The diagnosis of ulcerative colitis is based on clinical presentation, endoscopic evaluation, and histologic parameters in the absence of demonstrable alternate etiology. The differential diagnosis remains broad, and infection in particular must be considered and excluded. Although laboratory and radiographic findings can aid in the diagnosis of ulcerative colitis, endoscopy remains the gold standard for diagnosis. A correct diagnosis and disease staging are imperative because these factors affect treatment options and prognosis. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - September 22, 2020 Category: Gastroenterology Authors: Tanyaporn Kaenkumchorn, Ghassan Wahbeh Source Type: research

Assessing Severity of Disease in Patients with Ulcerative Colitis
This article reviews the history of severity scoring in UC and provides a concise, clinically oriented approach to assessing disease severity. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - September 22, 2020 Category: Gastroenterology Authors: Baldeep Singh Pabla, David Allen Schwartz Source Type: research

Nonbiologic Immune Suppression in Ulcerative Colitis
This article reviews nonbiologic immunosuppressive agents in the induction and maintenance of remission of ulcerative colitis. Based on meta-analyses and North American guidelines, azathioprine, mercaptopurine, and methotrexate monotherapy are not recommended for induction therapy. Thiopurines are recommended in combination with infliximab. Tofacitinib has been shown to be an effective induction agent. Cyclosporine or tacrolimus are calcineurin inhibitors that can be used as induction therapy. Thiopurine monotherapy is suggested or recommended as maintenance therapy for patients who have achieved steroid-induced remission....
Source: Gastroenterology Clinics of North America - September 18, 2020 Category: Gastroenterology Authors: Val érie Heron, Edward V. Loftus Source Type: research

Women ’s Health and Ulcerative Colitis
This article reviews topics that affect females with ulcerative colitis, including the impact of disease on the menstrual cycle, fertility, child bearing, sexual health, and recommendations for health care maintenance. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - September 18, 2020 Category: Gastroenterology Authors: Kindra Clark-Snustad, Madalina Butnariu, Anita Afzali Source Type: research

Targeting Treatment of Gastroparesis
Gastroparesis presents with nausea, vomiting, and other upper gut symptoms, and is diagnosed by confirming delayed gastric emptying. A related condition, chronic unexplained nausea and vomiting, has similar symptoms but with normal emptying. Both conditions are managed using therapies with diverse mechanisms of action. Even though prokinetic treatments are proposed to improve gastroparesis by accelerating gastric emptying, there is limited evidence that they provide benefit by virtue of transit stimulating effects. Other tests can delineate alterations in other gut sensorimotor parameters in patients with suspected gastrop...
Source: Gastroenterology Clinics of North America - July 25, 2020 Category: Gastroenterology Authors: William L. Hasler Source Type: research

Modern Approaches for Evaluation and Treatment of GI Motility Disorders
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 25, 2020 Category: Gastroenterology Authors: Henry P. Parkman Source Type: research

Copyright
Elsevier (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 25, 2020 Category: Gastroenterology Source Type: research

Contributors
ALAN L. BUCHMAN, MD, MSPH, FACP, FACN, FACG, AGAF (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 25, 2020 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 25, 2020 Category: Gastroenterology Source Type: research

Forthcoming Issues
Ulcerative Colitis (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 25, 2020 Category: Gastroenterology Source Type: research

Endoscopic and Surgical Treatments for Achalasia
Achalasia is a progressive neurodegenerative disorder characterized by failure of relaxation of the lower esophageal sphincter (LES) and altered motility of the esophagus. The traditional, highly effective, surgical approach to relieve obstruction at the LES includes cardiomyotomy. Fundoplication is added to decrease risk of postoperative reflux. Per oral endoscopic myotomy is a new endoscopic procedure that allows division of the LES via transoral route. It has several advantages including less invasiveness, cosmesis, and tailored approach to the length on the myotomy. However, it is associated with increased rate of post...
Source: Gastroenterology Clinics of North America - June 25, 2020 Category: Gastroenterology Authors: Romulo A. Fajardo, Roman V. Petrov, Charles T. Bakhos, Abbas E. Abbas Source Type: research

Modern Approaches for Evaluation and Treatment of Gastrointestinal Motility Disorders
The time is ripe for this issue of Gastroenterology Clinics of North America on the modern approaches for the evaluation and treatment of gastrointestinal (GI) motility disorders. New developments have taken place in the evaluation of patients with symptoms of GI motility disorders: new equipment and new protocols for their use. How to place these new developments into context in the evaluation and management of patients needs clarification. There are also new pharmacologic and surgical treatments currently available. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - June 23, 2020 Category: Gastroenterology Authors: Henry P. Parkman Tags: Preface Source Type: research

New Advances in Motility of the Digestive Tract
Dr Parkman has assembled a world-renowned group of experts to provide clinical review articles on motility of the digestive tract. Gastrointestinal absorption affects multiple aspects of life: it affects food intake, digestion, absorption, vitamin synthesis, and also clinical symptoms of bloating, pain, diarrhea, and constipation. The intestinal microbiome is also affected. New diagnostic techniques are allowing for greater insight into these problems, although our medical and surgical therapeutic regimen has yet to catch up to these advances. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - June 23, 2020 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Endoscopic and Surgical Treatments for Gastroparesis
Gastroparesis is a complex chronic debilitating condition of gastric motility resulting in the delayed gastric emptying and multiple severe symptoms, which may lead to malnutrition and dehydration. Initial management of patients with gastroparesis focuses on the diet, lifestyle modification and medical therapy. Various endoscopic and surgical interventions are reserved for refractory cases of gastroparesis, not responding to conservative therapy. Pyloric interventions, enteral access tubes, gastric electrical stimulator and gastrectomy have been described in the care of patients with gastroparesis. In this article, the aut...
Source: Gastroenterology Clinics of North America - June 19, 2020 Category: Gastroenterology Authors: Roman V. Petrov, Charles T. Bakhos, Abbas E. Abbas, Zubair Malik, Henry P. Parkman Source Type: research

Assessing Anorectal Function in Constipation and Fecal Incontinence
This article provides an approach to the assessment of anorectal function. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - June 19, 2020 Category: Gastroenterology Authors: Alice C. Jiang, Ami Panara, Yun Yan, Satish S.C. Rao Source Type: research

Esophageal Evaluation for Patients Undergoing Lung Transplant Evaluation
Lung transplantation is a high-risk, but lifesaving, procedure for patients with end-stage lung disease. Although 1-year survival is high, long-term survival is not nearly as high, due mainly to acute and chronic rejection. Bronchiolitis obliterans syndrome is the most common type of chronic rejection and often leads to poor outcomes. For this reason, esophageal testing in the lung transplant population has become a major issue, and this article discusses the evidence behind esophageal testing, the importance of esophageal dysmotility gastroesophageal reflux disease, both acidic and nonacidic reflux, and aspiration and the...
Source: Gastroenterology Clinics of North America - June 15, 2020 Category: Gastroenterology Authors: Zubair Malik, Kartik Shenoy Source Type: research

Tailoring Endoscopic and Surgical Treatments for Gastroesophageal Reflux Disease
The incidence of gastroesophageal reflux disease (GERD) remains on the rise. Pathophysiology of GERD is multifactorial, revolving around an incompetent esophagogastric junction as an antireflux barrier, with other comorbid conditions contributing to the disease. Proton pump inhibitors remain the most common treatment of GERD. Endoscopic therapy has gained popularity as a less invasive option. The presence of esophageal dysmotility complicates the choice of surgical fundoplication. Most literature demonstrates that fundoplication is safe in the setting of ineffective or weak peristalsis and that postoperative dysphagia cann...
Source: Gastroenterology Clinics of North America - June 15, 2020 Category: Gastroenterology Authors: Charles T. Bakhos, Abbas E. Abbas, Roman V. Petrov Source Type: research

Treating Chronic Abdominal Pain in Patients with Chronic Abdominal Pain and/or Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is probably the most common diagnosis in gastroenterology involving the brain-gut axis. By definition, pain is the most frequent symptom experienced by patients. It is important to understand the biopsychosocial and physiologic aspects of the disease when discussing treatment of IBS. Such therapies as lifestyle modifications, changes in diet, and cognitive behavioral therapy should be used in conjunction with pharmacotherapy rather than pharmacotherapy alone. The pathophysiologic mechanisms are reviewed in this article along with the current treatments available, in the era of growing demand ...
Source: Gastroenterology Clinics of North America - June 15, 2020 Category: Gastroenterology Authors: Lauren Stemboroski, Ron Schey Source Type: research

Enhancing High-Resolution Esophageal Manometry
High-resolution manometry evaluates esophageal motor function using 10 supine water swallows. Superimposing impedance over high-resolution manometry pressure topography assesses the relationship between contraction and bolus propulsion and identifies inadequate clearance. Ancillary techniques and maneuvers augment the standard supine high-resolution manometry evaluation by challenging peristaltic function. Increasing bolus volume (rapid drink challenge) and altering bolus consistency (standardized test meal, solid swallows) enhance identification of esophageal outflow obstruction syndromes. Physiologic maneuvers (multiple ...
Source: Gastroenterology Clinics of North America - June 13, 2020 Category: Gastroenterology Authors: Benjamin D. Rogers, C. Prakash Gyawali Source Type: research

EndoFLIP in the Esophagus
This article summarizes use of FLIP in assessing sphincter function, wall stiffness, and motility to guide treatments. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - June 13, 2020 Category: Gastroenterology Authors: Erica N. Donnan, John E. Pandolfino Source Type: research

Evaluation and Treatment of Patients with Persistent Reflux Symptoms Despite Proton Pump Inhibitor Treatment
This article discusses the mechanisms that might underlie heartburn that does not respond PPIs and an approach to the management of patients with PPI-refractory GERD symptoms. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - June 13, 2020 Category: Gastroenterology Authors: Stuart Jon Spechler Source Type: research

Enhancing Scintigraphy for Evaluation of Gastric, Small Bowel, and Colonic Motility
This article reviews the latest enhancements in standards and technology for performing gastric emptying and associated small bowel and colon transit scintigraphic studies. It discusses how developments in appropriate use criteria, American Medical Association Current Procedural Terminology coding, and advanced commercial software permit clinicians to obtain more comprehensive physiologic studies of gastric, small bowel, and colon gastrointestinal motility disorders. It shows how gastrointestinal scintigraphy has expanded to permit assessments of global and regional (fundic and antral) gastric motility and how it permits a...
Source: Gastroenterology Clinics of North America - June 13, 2020 Category: Gastroenterology Authors: Alan H. Maurer Source Type: research

Gastric Biopsies in Gastroparesis
The cellular and molecular understanding of human gastroparesis has markedly improved due to studies on full-thickness gastric biopsies. A decrease in the number of interstitial cells of Cajal (ICC) and functional changes in ICC constitutes the hallmark cellular feature of gastroparesis. More recently, in animal models, macrophages have also been identified to play a central role in development of delayed gastric emptying. Activation of macrophages leads to loss of ICC. In human gastroparesis, loss of anti-inflammatory macrophages in gastric muscle has been shown. Deeper molecular characterization using transcriptomics and...
Source: Gastroenterology Clinics of North America - June 13, 2020 Category: Gastroenterology Authors: Lakshmikanth L. Chikkamenahalli, Pankaj J. Pasricha, Gianrico Farrugia, Madhusudan Grover Source Type: research

Small Intestinal Bacterial Overgrowth
Small intestinal bacterial overgrowth (SIBO) is a condition with presentation that can vary from asymptomatic to steatorrhea and malnutrition. Small bowel aspiration and culture is the current gold standard of diagnosis; however, this is invasive and is not without risk to the patient. Breath testing is a noninvasive and less expensive alternative method; however, it lacks diagnostic sensitivity and specificity. Novel diagnostic methods being studied include gas-sensing capsules. The mainstay of treatment is antibiotics; alternative therapies include herbal medications, dietary modifications, and prokinetic agents. Further...
Source: Gastroenterology Clinics of North America - June 13, 2020 Category: Gastroenterology Authors: Brian Ginnebaugh, William D. Chey, Richard Saad Source Type: research

Refractory Constipation
This article reviews clinical testing in patients with refractory constipation, differentiating subtypes of primary chronic idiopathic constipation, and common pitfalls in assessment of refractory chronic constipation. The constipation may also be refractory because of significant associated diseases affecting the colon and resulting in slow transit constipation. The choice of therapy is best guided by the subtype. Management of refractory constipation requires correct diagnosis and individualized treatment, which may rarely include conservative surgery (loop ileostomy). (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - June 13, 2020 Category: Gastroenterology Authors: Michael Camilleri, Justin Brandler Source Type: research

Global Epidemiology of Viral Hepatitis
Viral hepatitis (A, B, C, D, and E) is the leading cause of inflammation of liver tissue (hepatitis). The disease burden associated with hepatitis A and E occurs shortly after infection; it is more severe among adults. With hepatitis A and E, the number of incident cases (new acute infections) is important from a public health perspective. Long-term hepatitis has been shown to cause cirrhosis and hepatocellular carcinoma in patients. The disease burden associated with hepatitis B, C, and D appears 10 to 20  years after infection. Thus, the prevalence of these infections is important from a public health perspective. (...
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Authors: Homie Razavi Source Type: research

Hepatitis Delta
This article explores the epidemiology, natural history, as well as current and potential therapeutic options for hepatitis delta virus infection. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Authors: Julian Hercun, Christopher Koh, Theo Heller Source Type: research

Epstein-Barr Virus and Cytomegalovirus Infections of the Liver
Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections are common and are associated with a variety of liver manifestations. EBV and CMV infections, in immunocompetent hosts, commonly manifest as acute hepatitis, with severity varying from asymptomatic, self-limited icteric hepatitis to acute liver failure. Atypical manifestations, such as cholestasis, chronic hepatitis, precipitation of acute-on-chronic liver failure, and autoimmune hepatitis, are reported with EBV infection, whereas cholestasis, portal vein thrombosis, and Budd-Chiari syndrome are reported with CMV infection. In the setting of liver transplantatio...
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Authors: Chalermrat Bunchorntavakul, K. Rajender Reddy Source Type: research

Fungal and Parasitic Infections of the Liver
Hepatosplenic candidiasis and other fungal infections of the liver are uncommon in healthy individuals; however, high index of suspicion is essential in immunocompromised patients with prolonged fever. Parasitic infections are protozoan or helminthic; their distribution and epidemiology are variable among different world regions. Clonorchiasis, opisthorchiasis, fascioliasis, and ascariasis are helminthic infections that commonly involve the biliary systems. Signs and symptoms of cholangitis require prompt management to relieve biliary obstruction; addition of antihelminthic agents is essential. Parasitic infections are mos...
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Authors: Sirina Ekpanyapong, K. Rajender Reddy Source Type: research

Hepatitis B
Enhancing host immunity by vaccination to prevent hepatitis B virus (HBV) infection remains the most important strategy for global control of hepatitis B. Currently, 187 countries have in place infant hepatitis B vaccination programs. Hepatitis B surface antigen prevalence has decreased to less than 1% in children after successful implementation of universal HBV vaccination in newborns. The incidence of primary liver cancer in children, adolescents, and young adults has drastically decreased to near zero in birth cohorts receiving hepatitis B vaccination. Elimination of chronic hepatitis B by 2030 is not a mission impossib...
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Authors: Chih-Lin Lin, Jia-Horng Kao Source Type: research

Hepatitis E
virus is a common cause of acute hepatitis and acute liver failure in resource-constrained parts of the world. The disease is particularly severe when the infection occurs during pregnancy. In developed countries, human infections occur primarily through zoonotic transmission from animal reservoirs; however, clinical disease is less frequent than in the developing world. The virus strains prevalent in these areas also cause chronic infection in immunocompromised persons, which, if untreated, can progress to cirrhosis; such infection responds well to oral ribavirin. A safe and highly effective recombinant vaccine is availa...
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Authors: Amit Goel, Rakesh Aggarwal Source Type: research

Pyogenic and Amebic Infections of the Liver
Pyogenic liver abscesses are classified by the bacteria that have caused the abscess because this guides treatment and can point to the underlying cause. The most common cause is biliary disease. The diagnosis is made by imaging. Treatment is a combination of antibiotics and percutaneous drainage. Amebic liver abscess is caused by extraintestinal spread of Entamoeba histolytica. E histolytica is spread by fecal-oral transmission and typically colonizes the gastrointestinal tract. It is diagnosed based on imaging and the mainstay of treatment is metronidazole. Only about 15% of cases require percutaneous drainage. The progn...
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Authors: Rebecca Roediger, Mauricio Lisker-Melman Source Type: research

Hepatitis and Other Liver Infections in the New Millennium
Historians may one day be able to explain why one refers to the “heart,” or center of a problem or issue, rather than the “liver” of the issue: an equally important organ, albeit infinitely more complex. As with the heart and other organs, the liver is a target for various infectious organisms. Resultant infections in the liver may give rise to the event ual development of cirrhosis, hepatocellular carcinoma, death, or a need for liver transplantation; as such, viral hepatitis has been a major scourge in gastrointestinal illness. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Infections of the Liver and Biliary System
Infections of the liver and biliary system are not uncommon as most of the infections are viral in nature. Globally, viral hepatitis is a major public health problem, parallels infections such as human immunodeficiency virus (HIV), malaria, and tuberculosis, and is  associated with significant morbidity and mortality. More recent data, alarmingly, project the global mortality from hepatitis B and C to exceed that from tuberculosis, HIV, and malaria by 2040. Rapid advances have been made with hepatitis C virus therapy at a time when the focus has shifted towar d global elimination, although the progress toward this goa...
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Authors: K. Rajender Reddy Tags: Preface Source Type: research

Infections of the Liver and Biliary System
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Authors: K. Rajender Reddy Source Type: research