Gut-Brain Interactions
Anorexia nervosa has poor prognosis and treatment outcomes and is influenced by genetic, metabolic, and psychological factors. Gut microbes interact with gut physiology to influence metabolism and neurobiology, although potential therapeutic benefits remain unknown. Type 1 diabetes is linked to anorexia nervosa through energy dysregulation, which in both disease states is related to the gut microbiota, disordered eating, and genetics. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - June 25, 2019 Category: Gastroenterology Authors: Daria Igudesman, Megan Sweeney, Ian M. Carroll, Elizabeth J. Mayer-Davis, Cynthia M. Bulik Source Type: research

The Human Microbiota and Its Relationship with Allergies
Allergic diseases have been increasing to epidemic proportions during the past century, especially in high-income countries. Recent evidence suggests there might be a link between the allergy epidemic and reduced microbial exposures, resulting from a rapidly evolved modern lifestyle, including changed diets, health and hygiene standards, and daily habits. Recently it has become clear that the microbial communities in our respiratory system and our gut, as well as on our skin, may play a key role in shaping our physiology, and influencing our health. We are only beginning to understand the mechanisms by which the human micr...
Source: Gastroenterology Clinics of North America - June 25, 2019 Category: Gastroenterology Authors: Nanna Fyhrquist Source Type: research

Prescribed Drugs and the Microbiome
The interaction between drug use, the microbiome, and the host is complex and multidimensional. Drugs and the microbiota may be risk factors or protective factors for disease. These interactions may explain interpersonal variations in drug efficacy and toxicity, but also interpersonal variations in microbiota composition and functioning, and potential (long-term) side effects from drugs. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - June 12, 2019 Category: Gastroenterology Authors: Nele Brusselaers Source Type: research

Mood and Microbes
The gut microbiota, acting via the gut-brain axis, modulates key neurobiological systems that are dysregulated in stress-related disorders. Preclinical studies show that the gut microbiota exerts an influence over neuroimmune and neuroendocrine signaling pathways, in addition to epigenetic modification, neurogenesis, and neurotransmission. In humans, preliminary evidence suggests that the gut microbiota profile is altered in depression. The full impact of microbiota-based treatments, at different neurodevelopmental time points, has yet to be fully explored. The integration of the gut microbiota, as a mediator, in the compl...
Source: Gastroenterology Clinics of North America - June 12, 2019 Category: Gastroenterology Authors: John R. Kelly, Veronica O ’ Keane, John F. Cryan, Gerard Clarke, Timothy G. Dinan Source Type: research

The Microbiota and Pancreatic Cancer
Pancreatic cancer is one of the most lethal diseases. In pancreatic cancer development and progression, genetic (gene mutations and activation of oncogenes) and environmental factors (smoking, alcohol consumption, type 2 diabetes mellitus, obesity) play an essential role. Recently, molecular studies revealed that dysbiosis of microbiota also has influence on cancer development. Research indicates that bacteria and viruses can lead to chronic inflammation, antiapoptotic changes, cell survival, and cell invasion. This review presents bacteria and viruses oncogenic for the pancreas. Possible mechanisms of carcinogenic action ...
Source: Gastroenterology Clinics of North America - June 12, 2019 Category: Gastroenterology Authors: Tomasz M. Karpi ński Source Type: research

Effective Use of the Laboratory in the Management of Patients with Inflammatory Bowel Diseases
Inflammatory bowel disease (IBD) comprises a group of chronic, intestinal inflammatory disorders, including ulcerative colitis and Crohn ’s disease. IBD is characterized by periods of relapse and remission. Long-term progressive intestinal inflammation can result in severe and devastating complications, such as intestinal strictures and/or fistulae. Immune suppressive medications with potent side effects are often used to control i nflammation and limit disease activity. Laboratory tests guide various decisions in clinical management of IBD. We discuss tests used to diagnose IBD, assess for relapse or remission, moni...
Source: Gastroenterology Clinics of North America - April 30, 2019 Category: Gastroenterology Authors: M. Nedim Ince, David E. Elliott Source Type: research

Preface
The clinical laboratory plays a critical, central role in the diagnosis, prognosis, and management of patients with gastrointestinal and liver diseases. Progress in understanding disease pathogenesis, improved test methodologies, and identification of clinically relevant biomarkers has made the laboratory's contributions to clinical practice all the more integral to quality patient care. The laboratory's role in promoting personalized medicine is foundational. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 30, 2019 Category: Gastroenterology Authors: Stanley J. Naides Source Type: research

The Laboratory in Gastroenterology: Use and Abuse
It ’s not just the gastrointestinal/endoscopy lab that’s important in the diagnosis and treatment as well as determining disease course in gastroenterology, it’s the chemistry and physiology laboratory. This laboratory must be effectively and appropriately utilized for the correct indications. As testing has become increasingly sophisticated and individualized, so must our thinking evolve. The emphasis though remains on utilizing the laboratory to make a difference in clinical management; in today’s times it’s not sufficient just to know. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 30, 2019 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Laboratory Monitoring of Gastrointestinal and Hepatobiliary Disease
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 30, 2019 Category: Gastroenterology Authors: Stanley J. Naides Source Type: research

Copyright
Elsevier (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 30, 2019 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 - April 30, 2019 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 30, 2019 Category: Gastroenterology Source Type: research

Gastroenterology Clinics of North America
The Microbiome: Interactions with Organ Systems, Diet, and Genetics (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 30, 2019 Category: Gastroenterology Source Type: research

Gut Microbiome in Health and Disease
The gut microbiome is fundamental to human health and development. Altered microbiomes have been associated with many diseases. However, variation between individuals, environmental effects, and a lack of standardization across studies makes differentiation between health and disease challenging. Large-scale population cohorts in different countries will be required to match disease subjects with healthy controls, whereas standardized, reproducible pipelines for analysis are required to compare findings between studies. Despite this, several conditions have already demonstrated great promise for developing microbiome-based...
Source: Gastroenterology Clinics of North America - April 5, 2019 Category: Gastroenterology Authors: Aonghus Lavelle, Colin Hill Source Type: research

Primary Immunodeficiency and the Gut
This article presents the most common gastrointestinal, hepatic, and pancreatic manifestations of the primary immunodeficiency diseases, including the appropriate laboratory testing, endoscopic evaluation, and recommendations for further management. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 5, 2019 Category: Gastroenterology Authors: David Schwimmer, Sarah Glover Source Type: research

Inborn Errors of Metabolism and the Gastrointestinal Tract
Inborn errors of metabolism (IEMs) are usually recognized by characteristic neurologic and metabolic manifestations and sometimes by dysmorphism. However, IEMs can present with a wide variety of gastrointestinal manifestations, whether as the primary or a minor clinical symptom. Regardless, gastrointestinal and hepatic manifestations of IEMs are important clinical features that can help identify an underlying defect; these disorders should be taken into consideration as part of a patient ’s clinical assessment. It is prudent to include metabolic disorders in the differential diagnosis because in some cases, gastroint...
Source: Gastroenterology Clinics of North America - April 1, 2019 Category: Gastroenterology Authors: Ruben Bonilla Guerrero, Karen M. Kloke, Denise Salazar Source Type: research

Liver Fibrosis Determination
All chronic liver disease can lead to liver fibrosis. Assessment of the severity of liver fibrosis is central to making treatment and management decisions. Liver biopsy, the gold standard for liver fibrosis assessment, is invasive and carries risks of complications and sampling errors. The use of noninvasive elastography-based radiologic methods of liver fibrosis determination is limited to centers that have the capabilities. Laboratory liver fibrosis determinations, both general clinical scoring systems and combination biomarker panels, are accessible to a wider population of clinicians for identifying patients at low ris...
Source: Gastroenterology Clinics of North America - April 1, 2019 Category: Gastroenterology Authors: Michelle Lai, Nezam H. Afdhal Source Type: research

Next Generation of Adeno-Associated Virus Vectors for Gene Therapy for Human Liver Diseases
This article describes advances that have been made and challenges that remain in the optimal use of AAV vectors in human gene therapy applications. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 1, 2019 Category: Gastroenterology Authors: Kenneth I. Berns, Arun Srivastava Source Type: research

Laboratory Diagnosis and Monitoring of Viral Hepatitis
Many microbes, toxins, autoimmune diseases, and neoplastic diseases may cause liver inflammation; however, 5 viruses whose main pathogenesis is liver disease are referred to as hepatitis A, B, C, D, and E viruses. These viruses cause a significant burden of global illness. With the exception of hepatitis A virus, all may cause chronic infection potentially leading to cirrhosis and hepatocellular carcinoma. Excellent serologic and nucleic acid detection methods are available for determining the precise cause and, in some cases, the duration of infection. Diagnostics are critical for identifying individuals needing treatment...
Source: Gastroenterology Clinics of North America - April 1, 2019 Category: Gastroenterology Authors: Kunatum Prasidthrathsint, Jack T. Stapleton Source Type: research

IgG4-Related Disease with Emphasis on Its Gastrointestinal Manifestation
IgG4-related disease is an immune-mediated fibroinflammatory condition with a diverse spectrum of organ involvement, commonly in the pancreas and bile ducts among other organs such as salivary and lacrimal glands. Classic histopathologic findings are the gold standard for confirmation of diagnosis, although diagnosis remains challenging, as biomarkers to date are neither sufficient nor necessary. Glucocorticoids are the most effective initial treatment, generally having a dramatic response, although limited clinical evidence exists regarding effective maintenance therapy. This review summarizes key GI manifestations of thi...
Source: Gastroenterology Clinics of North America - April 1, 2019 Category: Gastroenterology Authors: Bijal Vashi, Arezou Khosroshahi Source Type: research

Serologic Diagnosis of Celiac Disease
Most patients affected by celiac disease (CD) are asymptomatic or hyposymptomatic and undiagnosed, and are at risk of preventable complications. Therefore, early diagnosis is highly recommended. Multiple diagnostic antibodies are available; the most frequently used is IgA to tissue transglutaminase (IgA-tTg). It may yield false results and, alone, does not address IgA deficiency. Recently, a new generation of anti-neo-epitope tTg check (IgG  + IgA) has become available. It is highly sensitive and specific, covers IgA-deficient patients with CD, reflects intestinal damage, and has predictive potential in the diagn...
Source: Gastroenterology Clinics of North America - April 1, 2019 Category: Gastroenterology Authors: Aaron Lerner, Ajay Ramesh, Torsten Matthias Source Type: research

Celiac Disease
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 31, 2019 Category: Gastroenterology Authors: Benjamin Lebwohl, Peter H.R. Green Source Type: research

Copyright
Elsevier (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 31, 2019 Category: Gastroenterology Source Type: research

Contributors
ALAN L. BUCHMAN, MD, MSPH, FACN, FACG, FACP, AGAF (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 31, 2019 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 31, 2019 Category: Gastroenterology Source Type: research

Forthcoming Issues
Laboratory Monitoring of Gastrointestinal and Hepatobiliary Disease (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 31, 2019 Category: Gastroenterology Source Type: research

Nutritional Considerations of the Gluten-Free Diet
Celiac disease (CD) is an autoimmune-related disease causing inflammation in the small intestine triggered by the ingestion of gluten in the diet. The gluten-free diet (GFD) is the only treatment. Nutritional deficiencies of macronutrients and micronutrients are frequently found in untreated or newly diagnosed CD. A registered dietitian nutritionist is uniquely qualified to educate on the GFD and assess and support nutritional status at diagnosis and long term as well as helping patients with nonresponsive CD. Quality of life is important to address in individuals with CD because the GFD affects all aspects of life. (Sourc...
Source: Gastroenterology Clinics of North America - December 14, 2018 Category: Gastroenterology Authors: Melinda Dennis, Anne R. Lee, Tara McCarthy Source Type: research

Biopsy Diagnosis of Celiac Disease
This article discusses the histopathology and differential diagnosis of celiac disease and provides the pathologist ’s perspective on biopsy adequacy, evaluation, and reporting in light of current knowledge. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 14, 2018 Category: Gastroenterology Authors: Stephen M. Lagana, Govind Bhagat Source Type: research

Capsule Endoscopy and Enteroscopy in Celiac Disease
Celiac disease predominantly involves the proximal small bowel, but villus atrophy can be patchy, spare the duodenum, and be present more distally. Video capsule endoscopy is more sensitive than standard endoscopy to detect villus atrophy, and can define extent of disease, though it cannot obtain biopsies. Duodenal biopsy is the gold standard for diagnosis. Video capsule endoscopy assists in special circumstances when biopsy is not possible, and in equivocal diagnosis. Video capsule endoscopy and enteroscopy are recommended for evaluating complicated celiac disease, especially refractory celiac disease type II. Future deve...
Source: Gastroenterology Clinics of North America - December 14, 2018 Category: Gastroenterology Authors: Suzanne K. Lewis, Carol E. Semrad Source Type: research

Follow-up of Celiac Disease
This article deals with conventional strategies used in order to follow-up patients on treatment and aiming to obtain the best clinical outcome. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 14, 2018 Category: Gastroenterology Authors: Steffen Husby, Julio C. Bai Source Type: research

Celiac Disease
The presentation in celiac disease is shifting from the classical malabsorptive presentation to more nonclassical presentations, requiring clinicians to maintain a high level of suspicion for the disease and to be aware of the possible extraintestinal manifestations. The diagnosis of celiac disease is guided by initial screening with serology, followed by confirmation with an upper endoscopy and small intestinal biopsy. In some pediatric cases, biopsy may be avoided. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Isabel A. Hujoel, Norelle R. Reilly, Alberto Rubio-Tapia Source Type: research

Clinical Features and Diagnosis
The presentation in celiac disease is shifting from the classical malabsorptive presentation to more nonclassical presentations, requiring clinicians to maintain a high level of suspicion for the disease and to be aware of the possible extraintestinal manifestations. The diagnosis of celiac disease is guided by initial screening with serology, followed by confirmation with an upper endoscopy and small intestinal biopsy. In some pediatric cases, biopsy may be avoided. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Isabel A. Hujoel, Norelle R. Reilly, Alberto Rubio-Tapia Source Type: research

Epidemiology of Celiac Disease
Celiac disease is a common, chronic inflammatory disorder of the small intestine triggered by exposure to gluten in individuals with certain genetic types. This disorder affects people of any age or gender. Although often thought to be European in origin, it is now global in extent. Presentations are variable, from asymptomatic patients to severe malnutrition. Initial detection usually relies on celiac-specific serology, and confirmation often requires intestinal biopsy. There have been substantial increases in prevalence and incidence over the last 2 decades for reasons that are almost certainly environmental but for whic...
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Jonas F. Ludvigsson, Joseph A. Murray Source Type: research

(Outcome) Measure for (Intervention) Measures
This article reviews various measures of intestinal function and nutrition, patient-reported outcome measures for symptoms and for health-related quality of life, and measures of sickness burden as they apply to intervention studies for celiac disease. A series of case studies is presented to illustrate key considerations in selecting outcome measures for dietary interventions, pharmacologic interventions, and real-world studies. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Prashant Singh, Jocelyn A. Silvester, Daniel Leffler Source Type: research

Celiac Disease in Asia
Celiac disease, once thought to be very uncommon in Asia, is now emerging in many Asian countries. Although the absolute number of patients with celiac disease at present is not very high, this number is expected to increase markedly over the next few years/decades owing to increasing awareness. It is now that the medical community across the Asia should define the extent of the problem and prepare to handle the impending epidemic of celiac disease in Asia. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Govind K. Makharia, Carlo Catassi Source Type: research

The Microbiome in Celiac Disease
The healthy microbiome is necessary for normal immune development in the gut. Alterations in the microbial makeup after a critical window increase the risk of autoimmunity, including celiac disease. Although this dysbiosis has been described in adult and pediatric patients, factors leading to dysbiosis are still being elucidated. Genetics has some role in determining the microbiome makeup of the host, but other factors have yet to be determined. The microbiome remains an important therapeutic target in many autoimmune conditions, including celiac disease, however studies have yet to determine the ideal replacement therapy ...
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Suneeta Krishnareddy Source Type: research

Refractory Celiac Disease
Refractory celiac disease (RCD) refers to persistence of malnutrition and intestinal villous atrophy for more than 1 to 2  years despite strict gluten-free diet in patients with celiac disease. Diagnosis remains difficult and impacts treatment and follow-up. RCD has been subdivided into 2 subgroups according to the normal (RCDI) or abnormal phenotype of intraepithelial lymphocytes (IELs) (RCDII). RCDII is considered a s a low-grade intraepithelial lymphoma and has a poor prognosis due to gastrointestinal and extraintestinal dissemination of the abnormal IELs, and high risk of overt lymphoma. (Source: Gastroenterology ...
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Georgia Malamut, Christophe Cellier Source Type: research

Nondietary Therapies for Celiac Disease
Celiac disease (CD) is an autoimmune enteropathy triggered by gluten. Gluten-free diets can be challenging because of their restrictive nature, inadvertent cross-contaminations, and the high cost of gluten-free food. Novel nondietary therapies are at the preclinical stage, clinical trial phase, or have already been developed for other indications and are now being applied to CD. These therapies include enzymatic gluten degradation, binding and sequestration of gluten, restoration of epithelial tight junction barrier function, inhibition of tissue transglutaminase –mediated potentiation of gliadin oligopeptide immunog...
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Gloria Serena, Ciaran P. Kelly, Alessio Fasano Source Type: research

Nonceliac Wheat Sensitivity
Non-celiac wheat sensitivity (NCWS) is characterized by gastrointestinal and extra-intestinal symptoms following the ingestion of gluten-containing cereals in subjects without celiac disease or wheat allergy. The identity of the molecular triggers in these cereals responsible for the symptoms of NCWS remains to be delineated. Recent research has identified a biological basis for the condition, with the observation of systemic immune activation in response to microbial translocation that appears to be linked to intestinal barrier defects. Ongoing research efforts are aimed at further characterizing the etiology, mechanism, ...
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Umberto Volta, Roberto De Giorgio, Giacomo Caio, Melanie Uhde, Roberto Manfredini, Armin Alaedini Source Type: research

New Developments in Celiac Disease
The world of celiac disease is changing rapidly. From the mid-twentieth century forward, celiac disease was understood as an illness primarily affecting children, exclusively affecting the small intestine, and treated by life-long gluten restriction, with no other therapies on the horizon. In recent years, these aspects of celiac disease have been upended. This issue of Gastroenterology Clinics of North America documents the current state of understanding celiac disease during this time of major change. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Benjamin Lebwohl, Peter H.R. Green Tags: Preface Source Type: research

Celiac Disease, Gluten-Free, and Today ’s Fashionista
First described by the famous ancient Greek physician Aretaeus of Cappadocia, “celiac” and the later-described “gluten-free” have become buzz words during this millennium. Individuals claim they feel much better when consuming a gluten-free diet. Is this gluten sensitivity? Is it a real disease entity? Rigorous studies have begun to investigate this in a scientific ma nor. A famous chef in Chicago once told me a number of years ago when restaurants were forced to come out with gluten-free menus that the same individuals who requested gluten-free meals were the same ones ordering bread pudding for de...
Source: Gastroenterology Clinics of North America - December 13, 2018 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Pediatric Gastroenterology: Not Just Dealing with Little Adults
The practice of pediatric gastroenterology has grown substantially since its first appearance as a subspecialty in the 1960s in Europe and Australia. Yes, North America lagged behind a little, although many advances in the field have been discovered and promoted by clinicians and investigators in North America. Some diseases are limited to children, while others only begin with childhood and may often have different manifestations and associated psychosocial issues that are not apparent in their adult counterparts. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 17, 2018 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Pediatric Gastroenterology
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 17, 2018 Category: Gastroenterology Authors: Robert J. Shulman Source Type: research

Copyright
Elsevier (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 17, 2018 Category: Gastroenterology Source Type: research

Contributors
ALAN L. BUCHMAN, MD, MSPH (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 17, 2018 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 17, 2018 Category: Gastroenterology Source Type: research

Forthcoming Issues
Celiac Disease (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 17, 2018 Category: Gastroenterology Source Type: research

Pediatric Pancreatitis —Molecular Mechanisms and Management
Pediatric pancreatitis is an emerging field with an increasing incidence of disease. Management of pediatric pancreatitis is understudied and, therefore, extrapolated from adult studies (although the etiologies are different). There is evidence that feeding is safe in mild acute pancreatitis in children without increased pain or length of stay. Studies are needed to predict course of the disease, disease severity, and risk of chronic pancreatitis in children. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - October 4, 2018 Category: Gastroenterology Authors: Maisam Abu-El-Haija, Mark E. Lowe Source Type: research

Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract, of which ulcerative colitis and Crohn's disease are the 2 most prevailing entities. Very early onset IBD (VEO-IBD) children diagnosed with IBD under age 6  years. Although the etiology of IBD is mostly unknown, it involves a complex interaction among host genetics, microbiota, environmental factors, and aberrant immune responses. Advances in the understanding of the genetic contribution, which appears to be much more significant in younger children, gives us a useful insight into the pathogenesis and potential future the...
Source: Gastroenterology Clinics of North America - October 4, 2018 Category: Gastroenterology Authors: Eileen Crowley, Aleixo Muise Source Type: research

Food Sensitivities
Food allergies are on the rise, for reasons that are not fully understood. However, there is a tendency to overestimate their frequency, mostly based on parents ’ reports or on the assumption that a positive skin or blood IgE test implies the existence of clinically relevant allergy. It is imperative to base food allergy diagnosis on well-defined criteria, avoiding “alternative” tests that are available to the general public. Non-celiac gluten sensiti vity is a misnomer and should be abandoned in favor of non-celiac wheat intolerance, an entity suffering from lack of biomarkers and still not convincingly ...
Source: Gastroenterology Clinics of North America - October 4, 2018 Category: Gastroenterology Authors: Catherine DeGeeter, Stefano Guandalini Source Type: research