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Acute Bacterial Gastroenteritis
Acute bacterial gastroenteritis is among the most common infections worldwide, with millions of infections annually in the United States. Much of the illness is foodborne, occurring as both sporadic cases and large multistate outbreaks. Pathogen evolution through genetic exchange of virulence traits and antibiotic resistance determinants poses challenges for empiric therapy. Culture-independent diagnostic tests in clinical laboratories afford rapid diagnosis and expanded identification of pathogens. However, cultures remain important to generate sensitivity data and strain archiving for outbreak investigations. Most infect...
Source: Gastroenterology Clinics of North America - April 23, 2021 Category: Gastroenterology Authors: James M. Fleckenstein, F. Matthew Kuhlmann, Alaullah Sheikh Source Type: research

Viral Acute Gastroenteritis in Special Populations
Viral acute gastroenteritis (AGE) is common and afflicts people of all ages. Nonviral causes of AGE are less common. Norovirus is a leading cause of sporadic cases and outbreaks of AGE across all ages. Universal rotavirus vaccination of infants has reduced frequency and severity of rotavirus AGE cases in children and indirectly reduced cases in older adults. Severe illness is more likely in persons at age extremes or with immunocompromising conditions. Viral causes of AGE can lead to protracted diarrheal illness in immunocompromised persons. Nucleic acid amplification tests are changing diagnostic testing algorithms. (Sour...
Source: Gastroenterology Clinics of North America - April 23, 2021 Category: Gastroenterology Authors: Jeffery L. Meier Source Type: research

Acute Cholangitis
This article provides an update on early diagnosis and management of acute cholangitis. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 23, 2021 Category: Gastroenterology Authors: Zhibo An, Annie L. Braseth, Nadav Sahar Source Type: research

Potential Prenatal Origins of Necrotizing Enterocolitis
This article reviews the evidence behind the prenatal risk factors for necrotizing enterocolitis, and discusses how these risk factors may elucidate the pathogenesis of necrotizing enterocolitis and provide insight into prevention and treatment. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 23, 2021 Category: Gastroenterology Authors: Sarah N. Watson, Steven J. McElroy Source Type: research

Post-infection Irritable Bowel Syndrome
Epidemiologic data support that acute gastrointestinal infection is one of the strongest risk factors for development of irritable bowel syndrome (IBS). Risk of post-infection IBS (PI-IBS) seems to be greater with bacterial and protozoal than viral enterocolitis. Younger individuals, women, and those with severe enterocolitis are more likely to develop PI-IBS. Disease mechanisms in animal models and humans involve chronic perturbation of intestinal microbiome, epithelial and neuronal remodeling, and immune activation. These mechanisms can lead to luminal (increased proteolytic activity, altered bile acid composition) and p...
Source: Gastroenterology Clinics of North America - April 23, 2021 Category: Gastroenterology Authors: Antonio Berumen, Adam L. Edwinson, Madhusudan Grover Source Type: research

Small Intestinal Bacterial Overgrowth
The term “small intestinal bacterial overgrowth” (SIBO) has been used to refer to a disorder resulting from the colonization of the small bowel by an increased number of microorganisms or by the presence of bacteria that are not usual constituents of this part of the gastrointestinal tract. Clinical pres entations, often in patients with certain risk factors, can range from a full-blown malabsorption syndrome to such “functional” complaints as bloating and flatulence. SIBO is diagnosed by either culture of a small bowel aspirate or one of several breath tests. Treatment of SIBO entails risk fact or modification, co...
Source: Gastroenterology Clinics of North America - April 23, 2021 Category: Gastroenterology Authors: Daniel Bushyhead, Eamonn M. Quigley Source Type: research

Fungal Infections of the Gastrointestinal Tract
The thinking about fungi has evolved from unusual agents considered contaminants and colonizers to actual pathogens. Fungi are ubiquitous in nature and are found throughout in association with food, soil, mammals, and insects. Fungi have become important pathogens in animals and humans causing infections extending from superficial disease to disseminated infection. Because the gastrointestinal tract is continually exposed to fungi, it is frequently colonized and infected by numerous yeast and other fungi. It is also the origin of many disseminated fungal infections. The increased incidence of fungal infections has led to t...
Source: Gastroenterology Clinics of North America - April 23, 2021 Category: Gastroenterology Authors: Andrew Chao, Jose A. Vazquez Source Type: research

Hepatic Manifestations of Nonhepatotropic Infectious Agents Including Severe Acute Respiratory Syndrome Coronavirus-2, Adenovirus, Herpes Simplex Virus, and Coxiella burnetii
Nonhepatotropic viruses such as adenovirus, herpes simplex virus, flaviviruses, filoviruses, and human herpes virus, and bacteria such as Coxiella burnetii, can cause liver injury mimicking acute hepatitis. Most of these organisms cause a self-limited infection. However, in immunocompromised patients, they can cause severe hepatitis or in some cases fulminant hepatic failure requiring an urgent liver transplant. Hepatic dysfunction is also commonly seen in patients with severe acute respiratory syndrome coronavirus-2 infection. Patients with preexisting liver diseases are likely at risk for severe coronavirus disease 2019 ...
Source: Gastroenterology Clinics of North America - April 23, 2021 Category: Gastroenterology Authors: Saeed Ali, Sameer Prakash, Arvind R. Murali Source Type: research

Infectious Gastroenteritis in Transplant Patients
Infectious gastroenteritis is common after transplantation and can lead to increased morbidity and mortality. A wide range of organisms can lead to gastroenteritis in this patient population. Clostridioides difficile, cytomegalovirus, and norovirus are the most common pathogens. Newer diagnostic methods, especially multiplex polymerase chain reaction, have increased the diagnostic yield of infectious etiologies. In this review, we describe the epidemiology and risk factors for common infectious pathogens leading to gastroenteritis. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 23, 2021 Category: Gastroenterology Authors: Lemuel R. Non, Dilek Ince Source Type: research

Intra-abdominal and Anorectal Abscesses
Intra-abdominal and anorectal abscesses are common pathologies seen in both inpatient and outpatient settings. To decrease morbidity and mortality, early diagnosis and treatment are essential. After adequate drainage via a percutaneous or incisional approach, patients need to be monitored for worsening symptoms or recurrence and evaluated for the underlying condition that may have contributed to abscess formation. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - April 23, 2021 Category: Gastroenterology Authors: Dakota T. Thompson, Jennifer E. Hrabe Source Type: research

Gastrointestinal Food Allergies and Intolerances
Adverse reactions to food include immune-mediated food allergies, celiac disease, and nonimmune-mediated food intolerances. Differentiating between these many disorders is important to guide us toward appropriate testing and management. Double-blind placebo-controlled food challenges are the gold standard for food allergy diagnosis but are difficult and time-consuming. In place of this, strong clinical history, other supportive tests, and oral food challenges are helpful. Some commonly available tests for food allergy and intolerances lack sufficient evidence for efficacy. Food intolerance diagnosis is largely based on his...
Source: Gastroenterology Clinics of North America - January 29, 2021 Category: Gastroenterology Authors: Emily Hon, Sandeep K. Gupta Source Type: research

All Things Gluten
Gluten is a common dietary component with a complex protein structure. It forms incomplete products of digestion, which have the potential to mount an immune response in genetically predisposed individuals, resulting in celiac disease. It also has been linked with nonceliac gluten sensitivity and irritable bowel syndrome due to wheat allergy. A gluten-free diet is an effective treatment of these conditions; however, it can lead to micronutrient and mineral deficiencies and a macronutrient imbalance with higher sugar and lipid intake. Recent popularity has led to greater availability, but increasing cost, of commercially av...
Source: Gastroenterology Clinics of North America - January 29, 2021 Category: Gastroenterology Authors: Naueen A. Chaudhry, Chelsea Jacobs, Peter H.R. Green, S. Devi Rampertab Source Type: research

Colorectal Cancer and Diet
This article reviews prior studies involving certain food items and their relation to colorectal cancer, to elucidate whether diet can be a potential intervention. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 29, 2021 Category: Gastroenterology Authors: Elinor Zhou, Samara Rifkin Source Type: research

The Impact of Dietary Patterns and Nutrition in Nonalcoholic Fatty Liver Disease
Nonalcoholic fatty liver disease (NAFLD) has become one of the most common causes of chronic liver disease worldwide. The prevalence of NAFLD has grown proportionally with the rise in obesity, sedentary lifestyle, unhealthy dietary patterns, and metabolic syndrome. Currently, in the absence of approved pharmacologic treatment, the keystone of treatment is lifestyle modification focused on achieving a weight loss of 7% –10%, cardiovascular exercise, and improving insulin sensitivity. The primary aim of this review is to outline the effect of different dietetic approaches against NAFLD and highlight the important micronutr...
Source: Gastroenterology Clinics of North America - January 29, 2021 Category: Gastroenterology Authors: Ahyoung Kim, Arunkumar Krishnan, James P. Hamilton, Tinsay A. Woreta Source Type: research

Nutritional Management of Gastrointestinal Diseases
GASTROENTEROLOGY CLINICS OF NORTH AMERICA (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 29, 2021 Category: Gastroenterology Authors: Gerard E. Mullin, Berkeley N. Limketkai Source Type: research