Ten Questions About Barium Esophagography and Dysphagia
This article addresses 10 questions about barium esophagography and dysphagia that should help gastroenterologists gain a better perspective about the utility of barium studies in this clinical setting. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Marc S. Levine Source Type: research

Computed Tomography and Magnetic Resonance Small Bowel Enterography
This article focuses on CTE and MRE for the evaluation of Crohn disease. The article describes recent efforts to achieve more standardized interpretation of CTE and MRE, summarizes recent research studies investigating the role and impact of CTE and MRE more directly for several different clinical and research issues beyond general diagnostic accuracy, and provides an update on progress in imaging techniques. Also addressed are areas that need further exploration in the future. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Seong Ho Park, Byong Duk Ye, Tae Young Lee, Joel G. Fletcher Source Type: research

Radiologic Assessment of Gastrointestinal Bleeding
Gastrointestinal (GI) bleeding represents a broad differential of disease throughout the GI tract. The proper diagnostic evaluation of patients presenting with symptoms of GI bleeding depends on the overall clinical acuity and suspected source locations. The radiologic assessment of these patients is centered around computed tomography (CT) angiography, CT enterography, conventional angiography, and nuclear scintigraphy. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Gene Kim, Jorge A. Soto, Trevor Morrison Source Type: research

Defecography
Pelvic floor and defecatory dysfunction are common in the female patient population. When combined with physical examination, barium defecography allows for accurate and expanded assessment of the underlying pathology and helps to guide future intervention. Understanding the imaging findings of barium defecography in the spectrum of pathology of the anorectum and pelvic floor allows one to appropriately triage and treat patients presenting with defecatory dysfunction. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Nathan Y. Kim, David H. Kim, Perry J. Pickhardt, Evie H. Carchman, Arnold Wald, Jessica B. Robbins Source Type: research

Imaging in Autoimmune Pancreatitis and Immunoglobulin G4 –Related Disease of the Abdomen
This article describes the imaging findings of AIP and IgG4 disease in the liver, bile ducts, kidneys, and the retroperitoneal regions. The imaging differentiation of AIP from pancreas cancer is discussed. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Kumaresan Sandrasegaran, Christine O. Menias Source Type: research

Percutaneous Biliary Interventions
Biliary drainage is important in the care of patients with benign and malignant biliary obstruction. Careful preprocedure evaluation of high-quality cross-sectional imaging and inventory of symptoms are necessary to determine whether a percutaneous, endoscopic, or surgical approach is most appropriate. High bile duct obstruction is usually best managed percutaneously; a specific duct can be targeted and enteric contamination of isolated ducts can be avoided. Options for percutaneous biliary intervention include external or internal/external biliary drainage, stent placement, biliary stone retrieval, and bile duct biopsy. P...
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Rocio Perez-Johnston, Amy R. Deipolyi, Anne M. Covey Source Type: research

Splenomegaly
An enlarged spleen (splenomegaly) is a common imaging finding and may be related to a broad array of underlying conditions. The multifaceted functions of the spleen make it susceptible to involvement by a variety of pathophysiologic processes. Understanding these conditions and incorporating all relevant clinical and radiologic data allow narrowing the differential diagnosis. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Brett P. Sjoberg, Christine O. Menias, Meghan G. Lubner, Vincent M. Mellnick, Perry J. Pickhardt Source Type: research

MRI of the Nontraumatic Acute Abdomen
Obtaining a specific diagnosis in the nontraumatic acute abdomen can be clinically challenging, because a wide range of disease processes affecting a number of different organ systems may have very similar presentations. Although computed tomography and ultrasound examination are the imaging tests most commonly used to evaluate the acute abdomen, MRI can often offer comparable diagnostic performance, and may be considered when other modalities are equivocal, suboptimal, or contraindicated. In some circumstances, MRI is emerging as an appropriate first-line imaging test. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Bryan Dustin Pooler, Michael D. Repplinger, Scott B. Reeder, Perry J. Pickhardt Source Type: research

PET/MRI for Gastrointestinal Imaging
Positron emission tomography (PET)/computed tomography (CT) with 2-deoxy-2-[18F]fluoro-d-glucose (FDG) has become the standard of care for the initial staging and subsequent treatment response assessment for numerous gastrointestinal malignancies. However, it is often supplemented by magnetic resonance imaging (MRI) for local tumor staging. Hybrid PET/MRI scanners, which acquire PET data and MRI data simultaneously, have the potential to provide accurate whole-body staging in a single examination. Furthermore, to address certain limitations of FDG, many new PET tracers have been developed to probe distinctive aspects of tu...
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Tyler J. Fraum, Daniel R. Ludwig, Thomas A. Hope, Kathryn J. Fowler Source Type: research

Multidetector Computed Tomography for Retrospective, Noninvasive Staging of Liver Fibrosis
Although not traditionally used to assess hepatic fibrosis, computed tomography (CT) is fast, accessible, robust, and commonly used for abdominal indications. CT metrics are often easily retrospectively obtained without special equipment. Metrics such as liver segmental volume ratio, which quantifies regional hepatic volume changes; splenic volume; and liver surface nodularity scoring show diagnostic performance comparable to elastography techniques for detecting significant and advanced fibrosis. Other emerging CT tools, such as CT texture analysis and fractional extracellular volume, have also shown promise in identifyin...
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Meghan G. Lubner, Perry J. Pickhardt Source Type: research

Role of Imaging in Surveillance and Diagnosis of Hepatocellular Carcinoma
The prognosis for hepatocellular carcinoma (HCC) is dependent on tumor stage at diagnosis, with curative treatment options more available to early-detected HCCs. Professional organizations have produced HCC screening guidelines in at-risk groups, with ultrasound the most commonly used screening tool and increased interest in MRI in specific populations. HCC may be diagnosed by imaging features alone and have been universally incorporated into management guidelines. The radiology community has standardized imaging criteria for HCC with the development of the Liver Imaging Reporting and Data System, which has expanded to inc...
Source: Gastroenterology Clinics of North America - July 6, 2018 Category: Gastroenterology Authors: Mohit Gupta, Helena Gabriel, Frank H. Miller Source Type: research

The Natural History of Colorectal Polyps
For decades, colorectal screening strategies have been largely driven by static features, particularly polyp size. Although cross-sectional features of polyp size, morphology, and location are important determinants of clinical relevance before histology, they lack any dynamic information on polyp growth rates. Computed tomography colonography allows for in  vivo surveillance of colorectal polyps, providing volumetric growth rates that are providing new insights into tumorigenesis. In this article, existing cross-sectional and longitudinal data on colorectal polyps are reviewed, with an emphasis on how these features ...
Source: Gastroenterology Clinics of North America - July 2, 2018 Category: Gastroenterology Authors: Perry J. Pickhardt, Bryan Dustin Pooler, David H. Kim, Cesare Hassan, Kristina A. Matkowskyj, Richard B. Halberg Source Type: research

Rectal MRI for Cancer Staging and Surveillance
MRI is an integral part of the multidisciplinary treatment of rectal adenocarcinoma. Staging MRI is performed to establish TNM stage and assess for prognostic factors, including circumferential resection margin status and presence of extramural vascular invasion. The results of staging MRI determine which patients will undergo preoperative neoadjuvant chemoradiation before resection. Restaging MRI is performed to evaluate for treatment response and may identify patients with no residual visible tumor who are candidates for a “watch and wait” strategy in lieu of resection. In addition, the results of MRI in conj...
Source: Gastroenterology Clinics of North America - July 2, 2018 Category: Gastroenterology Authors: Courtney C. Moreno, Patrick S. Sullivan, Pardeep K. Mittal Source Type: research

Diagnostic Imaging: A Peephole into Many of the Body ’s Dressing Rooms
Diagnostic imaging provides a window in an otherwise cloaked human being. Increasingly, less invasive imaging techniques are replacing direct examination though orifices, regardless of whether natural or manmade. Various imaging techniques can be combined, as in the case of PET/computed tomography or PET/MR, to provide more functional imaging. Today ’s imaging provides a resolution previously only imagined. In other cases, these evolved imaging techniques serve to complement endoscopic views by revealing what lies beyond the tip or walls of the scope, and in some cases, such techniques as endoscopic ultrasound, radio...
Source: Gastroenterology Clinics of North America - July 2, 2018 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Living Donor Liver Transplantation
Living donor liver transplantation (LDLT) has found a place to serve the end-stage liver disease community as the donor safety and recipient suitability has been elucidated. Donor safety is of paramount importance and transplant programs must continue endeavors to maintain the highest possible standards. At the same time, adequacy of grafts based on recipient clinical status via their model for end-stage liver disease (MELD) score and volumetric studies to achieve a GRBWR  >0.8, along with special attention to anatomic tailoring and portal venous flow optimization are necessary for successful transplantation. Techn...
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Authors: Kiara A. Tulla, Hoonbae Jeon Source Type: research

Liver Transplant for Cholangiocarcinoma
This article discusses LT following neoadjuvant therapy for CCA and the early data on LT alone for ICC. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Authors: Daniel Zamora-Valdes, Julie K. Heimbach Source Type: research

Immunologic Monitoring to Personalize Immunosuppression After Liver Transplant
Although immunosuppressive drugs have enhanced patient outcomes in transplantation, the liver transplant community has made significant research efforts into the discovery of more accurate and precise methods of posttransplant monitoring and diagnosing. Current research in biomarkers reveals many promising approaches. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Authors: Andrew Zhu, Alexandra Leto, Abraham Shaked, Brendan Keating Source Type: research

Status of Adult Living Donor Liver Transplantation in the United States
This article reviews the Adult-to-Adult Living Donor Liver Transplant Cohort Study (A2ALL). The findings show that the number of adult-to-adult living donor liver transplants is consistently increasing. Living donor liver transplantation has an important benefit for patients with acute liver failure, does not compromise donor safety, and has lower rates of acute cellular rejection in biologically related donor and recipient. The conclusions from the A2ALL consortium have been critical in transplant advancement, supporting increased use to help decrease waitlist death and improve long-term survival of transplant recipients....
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Authors: Samir Abu-Gazala, Kim M. Olthoff Source Type: research

Pancreas Transplantation for Patients with Type 1 and Type 2 Diabetes Mellitus in the United States
This article describes the development and risk factors of pancreas transplantation with or without a kidney graft between 2001 and 2016. Patient survival and graft function improved significantly owing to careful recipient and donor selection, which reduced technical failure and immunologic graft loss rates. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Authors: Angelika C. Gruessner, Rainer W.G. Gruessner Source Type: research

Endoscopic Follow-up of Intestinal Transplant Recipients
This article reviews the endoscopic management and interventions provided for transplant recipients at the University of Illinois Hospital with complications, such as acute rejection, ischemia, bleeding, fistula, post-transplant lymphoproliferative disorder, and gastroparesis. Further research is needed on promising strategies currently used for related diseases to treat and sustain the intestinal graft. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Authors: Robert E. Carroll Source Type: research

Composite and Multivisceral Transplantation
The successful development of multivisceral and composite visceral transplantation is among the milestones in the recent history of human organ transplantation. All types of gastrointestinal transplantation have evolved to be the standard of care for patients with gut failure and complex abdominal pathologic conditions. The outcome has markedly improved over the last 3 decades owing to technical innovation, novel immunosuppression, and better postoperative care. Recent data documented significant improvement in the long-term therapeutic indices of all types of visceral transplantation close to that achieved with thoracic a...
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Authors: Guilherme Costa, Neha Parekh, Mohammed Osman, Sherif Armanyous, Masato Fujiki, Kareem Abu-Elmagd Source Type: research

Transplantation of Abdominal Organs
Transplantation has encompassed many of the greatest recent advances in medicine. Now, all abdominal organs can be transplanted: liver, stomach, intestine, colon, pancreas, although spleen and gallbladder transplantation would not be particularly useful. The ultimate future goal is long-term functioning artificial organs. Transplantation, however, serves as an immediate bridge to that therapy, which is some time away from reality for most organs. Both graft and patient survival have improved dramatically due to advances in surgical technique and experience, immunosuppression and immunologic monitoring, and posttransplant c...
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Gastrointestinal Transplantation
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Authors: Enrico Benedetti, Ivo G. Tzvetanov Source Type: research

Copyright
ELSEVIER (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 5, 2018 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 5, 2018 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Source Type: research

Forthcoming Issues
Gastrointestinal Imaging (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - May 5, 2018 Category: Gastroenterology Source Type: research

Modern Management of Acute Liver Failure
This article summarizes the current management of acute liver failure. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Ruben Khan, Sean Koppe Source Type: research

Intestinal Failure and Rehabilitation
The rendering of proper care for the patient with intestinal failure requires the provider to have a functional understanding of digestion and absorption, nutrient requirements, and intestinal adaptation. Inherent in those concepts is that not only is nutritional absorption compromised, but medication absorption is as well. The principles of the management of home parenteral nutrition must be mastered and then proper and controlled weaning of parenteral nutrition may be commenced by use of dietary and pharmacologic means with appropriate clinical outcome measures followed. This complicated management requires a team experi...
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Alan L. Buchman Source Type: research

Pediatric Intestinal Transplantation
Pediatric intestinal transplantation has moved from the theoretic to an actual therapy for children with irreversible intestinal failure who are suffering from complications of total parenteral nutrition. Owing to significant advancement in the management of intestinal failure and prevention of parenteral nutrition-related complications that have led to reduction in incidence of parenteral nutrition-associated liver disease and have improved intestinal adaptation, the indications for intestinal transplantation are evolving. Long-term outcomes have improved, but challenges in long-term graft function owing to chronic reject...
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Neslihan Celik, George V. Mazariegos, Kyle Soltys, Jeffrey A. Rudolph, Yanjun Shi, Geoffrey J. Bond, Rakesh Sindhi, Armando Ganoza Source Type: research

Living Donor Intestinal Transplantation
Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intestinal and hepatic failure; the virtual elimination of waiting time may avoid the high mortality experienced by candidates on the deceased waiting list. Potentially, LDIT could be used in highly sensitized recipients to allow the application of de-sensitization protocols. In the case of available identical twins ...
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Ivo G. Tzvetanov, Kiara A. Tulla, Giuseppe D ’Amico, Enrico Benedetti Source Type: research

Robotic Pancreas Transplantation
Obesity is considered a relative contraindication to pancreas transplantation due to an overall increased risk in wound-related complications and surgical site infections. The rationale for performing pancreas transplantation in a minimally invasive fashion is to reduce these risks, which can be associated with inferior patient and graft survival following pancreas transplantation in morbidly obese patients. At the University of Illinois at Chicago, the initial series of robotic-assisted pancreas transplantation in obese patient with type 1 and 2 diabetes has been performed. In this article, surgical technique and world ex...
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Mario Spaggiari, Ivo G. Tzvetanov, Caterina Di Bella, Jose Oberholzer Source Type: research

Adult Intestinal Transplantation
Adult intestinal transplantation differs significantly from pediatric intestinal transplantation. While indications have remained largely consistent since 2000, indications for adults have expanded over the last two decades to include motility disorders and desmoid tumors. Graft type in adult recipients depends on the distinct anatomic characteristics of the adult recipient. Colonic inclusion, while initially speculated to portend unfavorable outcomes due to complex host-bacterial interactions has increased over the past two decades with superior graft survival and improved patient quality of life. Overall, outcomes have s...
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Cal S. Matsumoto, Sukanya Subramanian, Thomas M. Fishbein Source Type: research

Gastrointestinal Transplantation
Organ transplantation plays an important role in the management of patients with end-stage  organ diseases. Solid organ transplantation has experienced a steady development in surgical techniques as well as in immunosuppressive therapy; furthermore, the field has expanded in both volumes and indications. It is both challenging and important for practicing physicians without specific tran splant training to be informed of the progress in the field. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Enrico Benedetti, Ivo G. Tzvetanov Tags: Preface Source Type: research

Modern Management of Acute Liver Failure
This article summarizes the current management of acute liver failure. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Ruben Khan, Sean Koppe Source Type: research

Intestinal Failure and Rehabilitation
The rendering of proper care for the patient with intestinal failure requires the provider to have a functional understanding of digestion and absorption, nutrient requirements, and intestinal adaptation. Inherent in those concepts is that not only is nutritional absorption compromised, but medication absorption is as well. The principles of the management of home parenteral nutrition must be mastered and then proper and controlled weaning of parenteral nutrition may be commenced by use of dietary and pharmacologic means with appropriate clinical outcome measures followed. This complicated management requires a team experi...
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Alan L. Buchman Source Type: research

Pediatric Intestinal Transplantation
Pediatric intestinal transplantation has moved from the theoretic to an actual therapy for children with irreversible intestinal failure who are suffering from complications of total parenteral nutrition. Owing to significant advancement in the management of intestinal failure and prevention of parenteral nutrition-related complications that have led to reduction in incidence of parenteral nutrition-associated liver disease and have improved intestinal adaptation, the indications for intestinal transplantation are evolving. Long-term outcomes have improved, but challenges in long-term graft function owing to chronic reject...
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Neslihan Celik, George V. Mazariegos, Kyle Soltys, Jeffrey A. Rudolph, Yanjun Shi, Geoffrey J. Bond, Rakesh Sindhi, Armando Ganoza Source Type: research

Living Donor Intestinal Transplantation
Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intestinal and hepatic failure; the virtual elimination of waiting time may avoid the high mortality experienced by candidates on the deceased waiting list. Potentially, LDIT could be used in highly sensitized recipients to allow the application of de-sensitization protocols. In the case of available identical twins ...
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Ivo Tzvetanov, Kiara Tulla, Giuseppe D ’Amico, Enrico Benedetti Source Type: research

Robotic Pancreas Transplantation
Obesity is considered a relative contraindication to pancreas transplantation due to an overall increased risk in wound-related complications and surgical site infections. The rationale for performing pancreas transplantation in a minimally invasive fashion is to reduce these risks, which can be associated with inferior patient and graft survival following pancreas transplantation in morbidly obese patients. At the University of Illinois at Chicago, the initial series of robotic-assisted pancreas transplantation in obese patient with type 1 and 2 diabetes has been performed. In this article, surgical technique and world ex...
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Mario Spaggiari, Ivo G. Tzvetanov, Caterina Di Bella, Jose Oberholzer Source Type: research

Adult Intestinal Transplantation
Adult intestinal transplantation differs significantly from pediatric intestinal transplantation. While indications have remained largely consistent since 2000, indications for adults have expanded over the last two decades to include motility disorders and desmoid tumors. Graft type in adult recipients depends on the distinct anatomic characteristics of the adult recipient. Colonic inclusion, while initially speculated to portend unfavorable outcomes due to complex host-bacterial interactions has increased over the past two decades with superior graft survival and improved patient quality of life. Overall, outcomes have s...
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Cal S. Matsumoto, Sukanya Subramanian, Thomas M. Fishbein Source Type: research

Gastrointestinal Transplantation
Organ transplantation plays an important role in the management of patients with end-stage  organ diseases. Solid organ transplantation has experienced a steady development in surgical techniques as well as in immunosuppressive therapy; furthermore, the field has expanded in both volumes and indications. It is both challenging and important for practicing physicians without specific tran splant training to be informed of the progress in the field. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 3, 2018 Category: Gastroenterology Authors: Enrico Benedetti, Ivo G. Tzvetanov Tags: Preface Source Type: research

The Role of Diet in the Treatment of Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a multifaceted illness involving maladaptive shifts in the gut microbiota that affect the enteric nervous and immune systems, mucosal barrier function, the balance of neurotransmitters and hormones, and emotional well-being. There is abundant evidence indicating that certain foods elicit symptoms in IBS. Numerous elimination-type diets have been shown to alleviate symptoms. However, among these, the most controversial is a group of foods called fructo, oligo-, di-, and monosaccharides and polyols (FODMAPs). This paper reviews the role of diet and systematically analyze the literature for t...
Source: Gastroenterology Clinics of North America - January 27, 2018 Category: Gastroenterology Authors: Rajdeep Singh, Ahmed Salem, Julie Nanavati, Gerard E. Mullin Source Type: research

The Need to Reassess Dietary Fiber Requirements in Healthy and Critically Ill Patients
This article provides evidence that current dietary fiber intake levels may be insufficient to maintain colonic mucosal health and defense, and reduce inflammation and cancer risk in otherwise healthy people. Current commercial tube feeds generally overlook the metabolic needs of the colon and may predispose patients to dysbiosis, bacterial overgrowth with pathogens such as Clostridium difficile, and acute colitis. These results raise concern about the wide-scale use of prophylactic antibiotics in the intensive care unit and the use of elemental, fiber-depleted tube feeds. Nutrition support is not complete without the addi...
Source: Gastroenterology Clinics of North America - January 27, 2018 Category: Gastroenterology Authors: Stephen J.D. O ’Keefe Source Type: research

Nutritional Management of Gastrointestinal Disease
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 27, 2018 Category: Gastroenterology Authors: Andrew Ukleja Source Type: research

Copyright
ELSEVIER (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 27, 2018 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 - January 27, 2018 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 27, 2018 Category: Gastroenterology Source Type: research

Forthcoming Issues
Gastrointestinal Transplantation (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 27, 2018 Category: Gastroenterology Source Type: research

Nutritional Management of Gastrointestinal Diseases
It is my great pleasure to introduce you to an issue of Gastroenterology Clinics of North America focused on nutrition. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 27, 2017 Category: Gastroenterology Authors: Andrew Ukleja Tags: Preface Source Type: research

Nutrition and Disease
Nutrition starts and ends in the gastrointestinal tract. Although “nutrition” itself is only directly responsible for “undernutition” (eg, malnutrition) or overnutrition (eg, obesity), it contributes via metabolism to virtually every bodily function and disease process. There are many things in nutrition that are “so obvious,” yet on closer inspection are not actually true, while at the same time there are things that make little sense, but that’s the way it is. “Nutrition” is the culmination of complex interactions between the host, oral nutrient and fluid intake, the ...
Source: Gastroenterology Clinics of North America - December 27, 2017 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research