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 24, 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 24, 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 20, 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 20, 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 16, 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 16, 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 16, 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 14, 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 14, 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 14, 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 14, 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 14, 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 14, 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 14, 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

Copyright
Elsevier (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 8, 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 - May 8, 2020 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Source Type: research

Gastroenterology Clinics of North America
Modern Approaches for Evaluation and Treatment of GI Motility Disorders (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 8, 2020 Category: Gastroenterology Source Type: research

Hepatitis A
virus (HAV) is a positive-strand RNA virus that is transmitted feco-orally through person-to-person contact. Outbreaks are often linked to poor sanitation, overcrowding, or food and water contamination. Infection is often asymptomatic in children, but adults present with jaundice, abdominal pain, hepatitis, and hyperbilirubinemia. Diagnosis is through detection of immunoglobulin M antibodies against HAV, and treatment is supportive. Vaccination is the mainstay of prevention and should be given before exposure whenever possible. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - March 29, 2020 Category: Gastroenterology Authors: Ameer Abutaleb, Shyam Kottilil Source Type: research

Hepatitis B
This article highlights key developments in antiviral/immunomodulatory therapy, the rationale for these approaches, and possible therapeutic regimens. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - March 29, 2020 Category: Gastroenterology Authors: Elias Spyrou, Coleman I. Smith, Marc G. Ghany Source Type: research

Progress Toward Hepatitis C Virus Elimination
The World Health Organization has called for the elimination of hepatitis C virus (HCV) as a public health threat by 2030. Highly effective direct-acting antiviral agents provide the therapeutic tools required for elimination. In the absence of a vaccine, HCV elimination will require enhanced primary prevention and an increase in the proportions of people diagnosed and treated. Given that globally only 20% of people with chronic HCV are diagnosed, and around 5% have initiated HCV treatment, the task ahead is enormous. But, global public health needs optimism, and countries currently on track for HCV elimination provide a p...
Source: Gastroenterology Clinics of North America - March 29, 2020 Category: Gastroenterology Authors: Marianne Martinello, Sahar Bajis, Gregory J. Dore Source Type: research

Hepatitis C
Chronic hepatitis C virus infection remains a national and global public health burden and is associated with significant morbidity and mortality. Oral direct-acting antiviral combination regimens have excellent tolerability and efficacy with rates exceeding 90%. Sustained virologic response is associated with significant improvements in clinical outcomes. However, translation of sustained virologic response rates from trials to community settings has been poor with interferon-based regimens. We review and summarize key datasets from major real-world observational cohort studies. We review preliminary data from oral generi...
Source: Gastroenterology Clinics of North America - March 29, 2020 Category: Gastroenterology Authors: Ashley N. Tran, Joseph K. Lim Source Type: research

Hepatitis C
The cure of chronic hepatitis C infection has a major impact on the morbidity and mortality of infected patients. It is now clear that sustained virologic response improves overall survival and significantly reduces the risk of liver failure, fibrosis progression, need of liver transplantation, and incidence of hepatocellular carcinoma. Moreover, hepatitis C eradication improves a broad range of extrahepatic manifestations, such as dermatologic, neoplastic, cardiovascular, and endocrine, and improves quality of life. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - March 29, 2020 Category: Gastroenterology Authors: Humberto C. Gonzalez, Stuart C. Gordon Source Type: research

Extrahepatic Manifestations of Chronic Viral C Hepatitis
Hepatits C virus (HCV) infection has been largely associated with extrahepatic comorbidities such as diseases related to dysregulation of the immune system, neuropsychiatric disorders, and cardiometabolic alterations. These clinical consequences, together with experimental evidence, suggest a potential (in)direct effect of HCV, contributing to the pathogenesis of these diseases. Various studies have reported a positive effect of viral eradication on occurrence and outcomes of extrahepatic diseases. These observations and the availability of safe and effective direct antiviral agents further underline the need to search for...
Source: Gastroenterology Clinics of North America - March 29, 2020 Category: Gastroenterology Authors: Salvatore Petta, Antonio Crax ì Source Type: research

Genetic Risk Factors and Disease Modifiers of Nonalcoholic Steatohepatitis
Nonalcoholic fatty liver disease is strongly associated with obesity and the metabolic syndrome, but genetic factors also contribute to disease susceptibility. Human genetic studies have identified several common genetic variants contributing to nonalcoholic fatty liver disease initiation and progression. These findings have provided new insights into the pathogenesis of nonalcoholic fatty liver disease and opened up new avenues for the development of therapeutic interventions. In this review, we summarize the current state of knowledge about the genetic determinants of nonalcoholic fatty liver disease, focusing on the mos...
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Authors: Julia Kozlitina Source Type: research

Implications of Nonalcoholic Steatohepatitis as the Cause of End-Stage Liver Disease Before and After Liver Transplant
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Nonalcoholic steatohepatitis (NASH) is the clinically aggressive variant of NAFLD and has a propensity for fibrosis progression and cirrhosis. The prevalence of NAFLD and NASH is projected to increase rapidly in the near future and dramatically add to the already substantial health care burden. Cirrhosis and end-stage liver disease resulting from NASH is now the fastest growing indication for liver transplant (LT) in the United States. Patients with NASH cirrhosis have higher prevalence of cardiometabolic diseases. Following LT, rec...
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Authors: Anchalia Chandrakumaran, Mohammad Shadab Siddiqui Source Type: research

Recruitment and Retention of Patients for Nonalcoholic Steatohepatitis Clinical Trials
The volume of clinical studies globally in nonalcoholic fatty liver disease has created tremendous competition among sponsors and investigators to identify patients. Patients with nonalcoholic steatohepatitis are often asymptomatic and personally unaware and uneducated about the disease. In addition, many physicians caring for undiagnosed patients are also poorly informed of the disease. This has created a perfect storm of high demand for clinical research participants among a pool of difficult to identify patients with nonalcoholic steatohepatitis. Based on the current data, the current volume of nonalcoholic fatty liver ...
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Authors: Mark H. DeLegge Source Type: research

Burden of Disease due to Nonalcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease (NAFLD) is rapidly becoming the most common liver disease in both Western populations and other parts of the world. This review discusses the prevalence and incidence of NAFLD in various regions around the world. The methodology used to identify the epidemiology and classify the stages of the disease is described. The impact of the disease on individuals, looking at both liver-related and extrahepatic consequences of the disease, is then discussed. Finally, the economic and societal impact of the disease is discussed. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Authors: Mark D. Muthiah, Arun J. Sanyal Source Type: research

Pharmacologic Treatment Strategies for Nonalcoholic Steatohepatitis
This article reviews pharmacologic therapeutics being developed to treat NASH. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Authors: James Philip G. Esteban, Amon Asgharpour Source Type: research

Nonalcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease (NAFLD) is now a leading cause of liver disease seen clinically and a principal contributor to the burden of disease globally. On 1 hand, this has led to an intense effort to better understand the evolving epidemiology, molecular biology, and clinical course of the disease along with development of diagnostic and therapeutic approaches. On the other hand, it requires many different groups involved in health care to remain up-to-date with this rapidly developing field. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Authors: Arun J. Sanyal, Mohammad Shadab Siddiqui Tags: Preface Source Type: research

Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis: The Disease Burden Grows
Now that infectious hepatitis cures exist for most, what are we left with? We are left with an increasingly heavier burden from a condition of fatty liver disease. Is it actually a disease, or is it a condition that is caused by a variety of diseases? Hepatitis C treatment was elusive because of a multitude of mutated viruses. Nonalcoholic fatty liver disease (NAFLD)/ nonalcoholic steatohepatitis (NASH) remains elusive because there are a variety of underlying causes; one may question whether NAFLD/NASH is a disease itself, as prevention and treatment may ultimately depend largely on the causes rather than the phenotype. (...
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Nonalcoholic Fatty Liver Disease
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Authors: Arun J. Sanyal, Mohammad Shadab Siddiqui Source Type: research

Copyright
Elsevier (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - February 5, 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 - February 5, 2020 Category: Gastroenterology Source Type: research

Contents
Erratumix (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Source Type: research

Forthcoming Issues
Infections of Liver and Biliary Systems (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Source Type: research

Erratum
An error was made in the December 2019 (Volume 48, Issue 4, December 2019, Pages 565-574) Gastroenterology Clinics of North America issue. In the article “Nontransplant Surgery for Intestinal Failure,” the author listing Ricardo Colletta, MD, PhD should be listed as Ricard Coletta, MD, PhD. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - February 5, 2020 Category: Gastroenterology Source Type: research

How to Identify the Patient with Nonalcoholic Steatohepatitis Who Will Progress to Cirrhosis
Non-alcoholic fatty liver disease (NAFLD) figures prominently into the clinical hepatology landscape. NAFLD represents a disease spectrum comprising simple steatosis, steatosis with elevated liver enzymes, and non-alcoholic steatohepatitis (NASH), the entity with clear potential for fibrosis progression. Risk factors associated with fibrosis progression in NASH include histologic findings of lobular inflammation and any fibrosis as well as clinical comorbidities that include type 2 diabetes, obesity, and metabolic syndrome. Liver biopsy remains the gold standard in evaluating NASH; however, noninvasive methods are accumula...
Source: Gastroenterology Clinics of North America - December 23, 2019 Category: Gastroenterology Authors: Zachary H. Henry, Curtis K. Argo Source Type: research

Nutrition and Nonalcoholic Fatty Liver Disease
This article reviews roles of key dietary macronutrients and micronutrients in NAFLD pathogenesis and their effects on molecular targets shared with established or emerging pharmacotherapies. Based on current evidence, a recommendation for a dietary framework as part of the comprehensive management strategy for NAFLD is provided. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 23, 2019 Category: Gastroenterology Authors: Manu V. Chakravarthy, Thomas Waddell, Rajarshi Banerjee, Nicola Guess Source Type: research

Similarities and Differences Between Nonalcoholic Steatohepatitis and Other Causes of Cirrhosis
This article discusses in detail the comparison of clinical, genetic, and outcome characteristics between patients with NASH cirrhosis as opposed to alternative causes of chronic liver disease. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 23, 2019 Category: Gastroenterology Authors: Naga Swetha Samji, Rajiv Heda, Alexander J. Kovalic, Sanjaya K. Satapathy Source Type: research