Multimodality management, recurrence patterns, and long-term outcome of gastroenteropancreatic neuroendocrine neoplasms: Progress over 17  years
This study highlights the progress in its management over 17  years, outcomes, recurrence patterns, and follow up protocols.MethodsThis retrospective analysis of prospectively maintained database at a single tertiary center included GEP-NEN patients from January 2001  to August 2017. Management protocols were based on European Neuroendocrine Tumor Society guidelines. Recurrences were categorized as follows: localized nodal, regional, distant hepatic, or combined. Patients were divided into cohorts: cohort 1 (2001–2006), cohort 2 (2007–2011), and cohort 3 ( 2012–2017). Survival patterns were...
Source: Indian Journal of Gastroenterology - December 4, 2019 Category: Gastroenterology Source Type: research

All that a physician should know about FODMAPs
AbstractA diet low in poorly absorbed, fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) is now considered as an effective strategy for symptoms control in patients with irritable bowel syndrome (IBS). The low FODMAP diet is administered in three phases, namely restriction of all dietary FODMAPs followed by rechallenge and then reintroduction of specific FODMAPs according to the tolerance of patients. A dietician should be involved in patients in whom a low FODMAP diet is planned. While restricting high FODMAPs, it is pertinent that patients are advised a well-balanced diet and suitable al...
Source: Indian Journal of Gastroenterology - December 4, 2019 Category: Gastroenterology Source Type: research

Mesh migration after hiatal hernia repair
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - November 26, 2019 Category: Gastroenterology Source Type: research

Why differences between New York and New Delhi matter in approach to gastroesophageal reflux disease
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - November 25, 2019 Category: Gastroenterology Source Type: research

Prevalence of thyroid autoimmunity in first-degree relatives of patients with celiac disease
AbstractAimPatients with celiac disease (CeD) are prone to develop other autoimmune diseases such as autoimmune thyroid disease and type 1 diabetes. While 7.5% of first-degree relatives (FDRs) of patients with CeD develop CeD, it is not clear whether FDRs of patients with CeD are at higher risk of developing autoimmune thyroid disease.MethodsIn this prospective case-control study, we recruited 194 FDRs (males 53.1%) of 91 patients with CeD and 140 age-matched healthy controls (males 76.4%). They were screened for CeD using anti-tissue transglutaminase antibodies (anti-tTG Ab) and thyroid disease using a symptom questionnai...
Source: Indian Journal of Gastroenterology - November 8, 2019 Category: Gastroenterology Source Type: research

Corrosive injury of upper gastrointestinal tract by calcium oxide
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - November 6, 2019 Category: Gastroenterology Source Type: research

Antibacterial spectrum of human omentum and differential expression of beta defensins
ConclusionOmentum directly responds to bacterial infection, which may be due to differential expression of hBD1 and hBD2 in human omental tissue. These peptides (hBD1 and hBD2) may be an ideal candidate for novel antibiotic class with a broad-spectrum activity. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - October 23, 2019 Category: Gastroenterology Source Type: research

Immediate and long-term outcome of corrosive ingestion
ConclusionsCI is associated with high immediate and long-term morbidity and mortality. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - October 23, 2019 Category: Gastroenterology Source Type: research

Hepatitis B genotyping: The utility for the clinicians
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - October 15, 2019 Category: Gastroenterology Source Type: research

Efficacy of enteral glutamine supplementation in patients with severe and  predicted severe acute pancreatitis— A randomized controlled trial
AbstractBackgroundIn severe acute pancreatitis (AP), intravenous glutamine has been shown to reduce the rate of complications, hospital stay, and mortality. In the present randomized trial, we aimed to evaluate the effect of enteral glutamine supplementation on clinical outcomes, gut permeability, systemic inflammation, oxidative stress, and plasma glutamine levels in patients with severe and predicted severe AP.MethodsPatients with AP admitted within 72  h of onset of symptoms were included. The primary outcome measure was development of infected pancreatic and peri-pancreatic necrosis and in-hospital morta...
Source: Indian Journal of Gastroenterology - October 14, 2019 Category: Gastroenterology Source Type: research

Optical biopsy in gastroenterology: Focus on confocal laser endomicroscopy
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - October 2, 2019 Category: Gastroenterology Source Type: research

Comparison of concomitant therapy versus standard triple-drug therapy for eradication of Helicobacter pylori infection: A prospective open-label randomized controlled trial
ConclusionAlthough the rate of  eradication ofH. pylori infection with   concomitant therapy was higher than that with triple therapy, the rate of concomitant therapy was still less than expected. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - September 14, 2019 Category: Gastroenterology Source Type: research

Is everolimus linked to metabolic syndrome in liver transplant recipients?
ConclusionsOur study demonstrated for the first time that everolimus was independently associated with post-LT MS. Nevertheless, more robust studies are required to confirm these findings. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - September 12, 2019 Category: Gastroenterology Source Type: research

Clinical profile and outcome of primary sclerosing cholangitis: A single-centre experience from western India
ConclusionPSC commonly presents in young age  and rapidly progresses to decompensation. Prevalence of IBD in PSC is lower and the proportion of small-duct PSC is higher than that observed in western populations. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - September 12, 2019 Category: Gastroenterology Source Type: research

Endoscopic submucosal dissection for the treatment of synchronous hypopharyngeal mass and esophageal superficial carcinoma
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - September 6, 2019 Category: Gastroenterology Source Type: research

Per-oral endoscopic myotomy and gastroesophageal reflux: Where do we stand after a decade of “POETRY”?
AbstractPer-oral endoscopic myotomy (POEM) was introduced nearly a decade ago. Since then, the literature on its safety and efficacy has been ever increasing. Initial studies focused solely on the feasibility and efficacy of this procedure in patients with idiopathic achalasia. Subsequent studies analyzed the incidence of gastroesophageal reflux disease (GERD) in addition to the efficacy of POEM. These studies depict a high incidence of GERD after POEM. However, vast majority of these studies lacked a comprehensive evaluation of GERD after POEM. Consequently, it is difficult to provide a true estimate of the incidence of G...
Source: Indian Journal of Gastroenterology - September 2, 2019 Category: Gastroenterology Source Type: research

A man with peri-cecal, calcified mass — disseminated peritoneal adenomucinosis
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - September 2, 2019 Category: Gastroenterology Source Type: research

A study on confocal endomicroscopy in comparison with histopathology for polypoidal lesions of the gastrointestinal tract: A prospective single-centre experience
ConclusionCLE is a useful tool for prediction of histology to assess the polypoidal lesions of the GI tract, and it may avoid polypectomy at least in some patients. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - August 24, 2019 Category: Gastroenterology Source Type: research

Non-endoscopic predictors of esophageal varices in children with chronic liver disease and their utility in resource-constrained countries
AbstractBackgroundAlthough endoscopy is the standard diagnostic screening test to identify esophageal varices in patients with chronic liver disease (CLD), selective endoscopy in patients who are at higher risk of having varices may be cost-effective in a resource-constrained country. The aim of this prospective study was to identify non-endoscopic parameters that may predict the presence of varices, especially high-risk esophageal varices in children with CLD.MethodsFrom January 2016 through March 2018, consecutive children with CLD without a history of variceal bleeding were prospectively included. Esophagogastroduodenos...
Source: Indian Journal of Gastroenterology - August 19, 2019 Category: Gastroenterology Source Type: research

Could quantitative real-time polymerase chain reaction assay serve as an alternative test method to evaluate human epidermal growth factor receptor 2 status of gastric carcinoma in the South Asian setting?
AbstractBackgroundHuman epidermal growth factor receptor 2 (HER2) protein overexpression and/or HER2 gene amplification are/is linked to a dismal outcome of gastric carcinoma (GCa). Immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) are key methods to identify patients for HER2 targeted therapy. Drawbacks of both the  methods warrant novel tests. Hence, we evaluated the value of quantitative real-time polymerase chain reaction (qPCR) as an alternative test method, relative to IHC to detect HER2 status of GCa and to find relationship between these  results with demographic/clinicopatholo...
Source: Indian Journal of Gastroenterology - August 10, 2019 Category: Gastroenterology Source Type: research

Chicago classification for minor peristaltic abnormalities —Much ado about nothing!
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - August 3, 2019 Category: Gastroenterology Source Type: research

Diet and inflammatory bowel disease: The Asian Working Group guidelines
ConclusionsAvailable objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 38 recommendations. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 27, 2019 Category: Gastroenterology Source Type: research

Per-oral endoscopic myotomy with fundoplication: A reproducible procedure
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 26, 2019 Category: Gastroenterology Source Type: research

An in vitro and clinical dose-finding study of antifoaming effects of simethicone during colonoscopy
AbstractSimethicone is an antifoaming agent frequently added to endoscopic rinse solutions but has recently been implicated as a risk factor for transmission of infections due to the formation of simethicone deposits within scope channels. Since the build-up of residue is likely dose-related, the smallest effective dose of simethicone should be used but there are no data available on the effective dose. Thus, we conducted a dose-finding study in an “in vitro bubble model” to determine the appropriate simethicone dose. Six 100-mL test tubes were filled with a 1% (v/v) solution of kitchen detergent (Fairy ®, ...
Source: Indian Journal of Gastroenterology - July 17, 2019 Category: Gastroenterology Source Type: research

Celiac disease in the East and the West: Bridging the gaps between the guidelines and their implementation in daily practice is mandatory
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 17, 2019 Category: Gastroenterology Source Type: research

From clinical practice guideline development to trial registration: A systematic investigation of research pipeline for inflammatory bowel disease
ConclusionThis study used clinical practice guidelines to help determine areas of needed research in  IBD, UC, and Crohn’s disease. By searching trial registries and articles indexed on PubMed, we identified the extent to which studies were being conducted to address research gaps. Of the gaps identified, five recommendations received most of the attention. While most of the significant gaps ha d some recent or ongoing research, our study found several areas where investigation is still needed. Clinical practice guidelines are an effective method to prioritize future research. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 3, 2019 Category: Gastroenterology Source Type: research

An unusual cause of acute-on-chronic liver failure
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 1, 2019 Category: Gastroenterology Source Type: research

Celiac disease: What the Indian pediatricians know about the disease
AbstractTo ascertain the knowledge, awareness, and practices pertaining to celiac disease (CD) among the Indian pediatricians. A survey link containing a questionnaire  was shared through electronic mail using a pediatric database. The survey was kept active for 6 months; all responses received at the end of the survey were analyzed. Two hundred and seventy one pediatricians out of more than 10,000 chose to respond to the survey. Most pediatricians agreed that m ore patients with CD are being diagnosed than earlier. The reasons for higher detection of CD were perceived to be higher index of clinical suspicion by ...
Source: Indian Journal of Gastroenterology - June 28, 2019 Category: Gastroenterology Source Type: research

Clinical and anorectal manometry profile of patients with functional constipation and constipation-predominant irritable bowel syndrome
AbstractBackgroundFunctional constipation (FC) and constipation-predominant irritable bowel syndrome (IBS-C) have significant healthcare impact. Clinical and investigative data of patients with these disorders in Indian population is scarce. We aimed to compare the clinical and anorectal manometric profile of patients with FC and IBS-C.MethodsConsecutive patients with chronic constipation undergoing  anorectal manometry (ARM) and balloon expulsion test (BET) were enrolled. Thirty healthy volunteers served as controls (HC). Functional defecatory disorder (FDD) was diagnosed according to ROME IV criteria if both ARM and...
Source: Indian Journal of Gastroenterology - June 25, 2019 Category: Gastroenterology Source Type: research

Comment on “Lessons learnt from living donor liver transplantation with ABO-incompatibility: A single-center experience from southern India”
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - June 22, 2019 Category: Gastroenterology Source Type: research

Gallstone ileus of upper gastrointestinal tract: A case series
AbstractThree patients with gallstone ileus are presented here. All of them were diagnosed on the basis of clinical presentation, endoscopy, and abdominal ultrasonography (USG) findings. We, therefore, propose that presence of the triad, i.e. cholecystoduodenal fistula on endoscopy, diseased gallbladder on USG, and clinical and radiological features of luminal obstruction should point to the diagnosis of gallstone ileus. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - June 12, 2019 Category: Gastroenterology Source Type: research

Interpretation and implementation of the revised European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines on pediatric celiac disease amongst consultant general pediatricians in Southwest of England
ConclusionsThere is a need for improved understanding of revised CD guidelines amongst consultant general pediatricians especially while using the NBP and requesting HLA-DQ2/DQ8 testing. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - June 10, 2019 Category: Gastroenterology Source Type: research

Acute upper gastrointestinal bleed: An audit of the causes and outcomes from a tertiary care center in eastern India
ConclusionPortal hypertension remains the commonest cause of UGI bleed in India and carries a higher risk of rebleed and mortality as compared to PUD-related bleed. Post-endoscopy Rockall score is a useful tool for clinicians to assess risk of rebleed. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 28, 2019 Category: Gastroenterology Source Type: research

Comparison of risk scores in upper gastrointestinal bleeding in western India: A prospective analysis
AbstractAimTo study the upper gastrointestinal bleeding (UGIB) characteristics and to validate the Rockall and Glasgow-Blatchford scores (GBS), Progetto Nazionale Emorragica Digestiva (PNED) and albumin, international normalized ratio (INR), mental status, systolic blood pressure, and age>  65 (AIMS65) risk scores in predicting outcomes in patients with UGIB.MethodsThree hundred subjects with hematemesis and/or melena were prospectively enrolled and followed up for 30  days. All patients were assessed by hematological investigations, imaging, and endoscopy and risk scores were calculated.ResultsThe mean age ...
Source: Indian Journal of Gastroenterology - May 24, 2019 Category: Gastroenterology Source Type: research

Prevalence and clinical presentation of cirrhotic cardiomyopathy: A single centre experience from southern India
AbstractBackgroundThere are scanty data from India on the prevalence and clinical profile of cirrhotic cardiomyopathy (CCM).AimTo identify the prevalence and clinical presentation of CCM in patients with liver cirrhosis.MethodsFive hundred and eighty-six patients with liver cirrhosis were recruited based on inclusion criteria and evaluated for cardiac parameters using electrocardiography, 2-dimensional echocardiography, dobutamine stress test and coronary angiography as needed. Baseline demographic data, liver biochemistry, endoscopic and radiological findings were recorded in all the patients. Appropriate statistical anal...
Source: Indian Journal of Gastroenterology - May 21, 2019 Category: Gastroenterology Source Type: research

Antithrombin as a marker of severe acute hepatitis B
In this study, we demonstrate that antithrombin (AT) plasma levels were associated with AHB severity in 161 patients.ResultsNine (6%) patients had severe AHB (i.e. international normalized ratio  [INR] ≥ 1.6 and total bilirubin ≥ 10 mg/dL). Coagulopathy (i.e. INR>  1.2 and/or AT
Source: Indian Journal of Gastroenterology - May 14, 2019 Category: Gastroenterology Source Type: research

Post-infection irritable bowel syndrome in the tropical and subtropical regions: Vibrio cholerae is a new cause of this well-known condition
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 9, 2019 Category: Gastroenterology Source Type: research

Mucosal healing in inflammatory bowel disease: Expanding horizon
AbstractManagement of inflammatory bowel diseases has witnessed paradigm shift from 5-aminosalicylic acid and glucocorticoids to various immunosuppressant and biological agents. Targets of therapy have also been changed drastically from symptomatic improvement to mucosal, histological healing, and recently transmural healing. Mucosal healing is associated with reduced need of steroid therapy, hospitalization, and surgery. However, whether mucosal healing alters the natural history of disease remains to be proven. Though assessment of mucosal healing is traditionally done by endoscopic examination, newer tests like fecal ca...
Source: Indian Journal of Gastroenterology - April 29, 2019 Category: Gastroenterology Source Type: research

Frequency of HLA celiac disease risk alleles and haplotypes in healthy adults in Tamil Nadu
AbstractCeliac disease (CeD) occurs only in individuals who are able to express human leukocyte antigens (HLA) DQ2 or DQ8, and these are expressed in nearly a third of healthy people in the West. As the disease is very uncommon in Tamil Nadu, we evaluated the possibility that the relevant genes are infrequent in this population. Four hundred healthy adults without any gastrointestinal abnormalities were recruited from Vellore district of Tamil Nadu. Genomic DNA was extracted from venous blood and amplified by PCR using the allele-specific primers for the  following alleles—DQA1*0201, 0301, and 0501 and DQB1*02, ...
Source: Indian Journal of Gastroenterology - April 26, 2019 Category: Gastroenterology Source Type: research

A prospective study on incidence, risk factors, and validation of a risk score for post-infection irritable bowel syndrome in coastal eastern India
ConclusionOne fourth of AGE patients developed PI-IBS after 6  months. Factors influencing its development were younger age, long duration of AGE, and abdominal pain. The PI-IBS risk score had good predictive accuracy in our population. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - April 4, 2019 Category: Gastroenterology Source Type: research

Development of an animal model of Helicobacter pylori (Indian strain) infection
AbstractTo develop an animal model for Indian strainHelicobacter pylori (H. pylori) infection. This model will allow one to study many facts ofH. pylori infection in a more controlled manner. Mongolian gerbils were orogastric inoculated with two different Indian strains ofH. pylori at different time points. Animals were sacrificed and looked for the presence of infection up to 52 weeks post-inoculation using a variety of techniques. Simultaneously, serums from these animals were also tested for antibody, and changes in the histopathology of stomach on H&E (hematoxylin and eosin) stains were also noted. Experimental set...
Source: Indian Journal of Gastroenterology - March 25, 2019 Category: Gastroenterology Source Type: research

Impact of calcifications on diagnostic yield of endoscopic ultrasound –guided fine-needle aspiration for pancreatic ductal adenocarcinoma
ConclusionsCCP had a significant impact on the diagnostic yield of EUS-FNA for pancreatic adenocarcinoma. Novel techniques and newer technology that may mitigate the negative effect of calcification on diagnostic yield of EUS-FNA in patients with  CCP. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - March 22, 2019 Category: Gastroenterology Source Type: research

Genotype distribution in relation to viral load in a large cohort of Indian patients with chronic hepatitis C virus infection: A retrospective analysis
AbstractIntroductionHepatitis C virus (HCV) displays high genetic diversity, characterized by regional variations in the prevalence of genotype posing challenges to the development of vaccines and definitive treatment. Very few reports exist on the distribution and frequency change of HCV genotypes in India. In the present retrospective study, we aimed to understand the distribution pattern of HCV genotypes and viral load among HCV-infected patients attending the Asian Institute of Gastroenterology, Hyderabad, India, a tertiary care hospital.MethodsPatients referred to the Hepatology Department from January 2009 to Decembe...
Source: Indian Journal of Gastroenterology - March 22, 2019 Category: Gastroenterology Source Type: research

Long-term outcome of endoscopic variceal band ligation of esophageal varices in patients with chronic liver disease
ConclusionEVL is effective in the long-term for both primary and secondary prophylaxis of esophageal variceal bleeding. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - March 14, 2019 Category: Gastroenterology Source Type: research

The effectiveness of mindfulness meditation in relief of symptoms of depression and quality of life in patients with gastroesophageal reflux disease
In this study, we looked at the effectiveness of mindfulness-based stress reduction (MBSR) in relieving the symptoms of depression and the health-related quality of life of these patients.MethodsA longitudinal, interventional open-label study was carried out on 60 patients with GERD and 60 controls. Zung Self-Rating Depression Scale (ZSDS) was used for assessing depression before and after the intervention. The GERD-Health-Related Quality of Life (GERD-HRQL) questionnaire was used to assess the health-related quality of life and the Freiburg Mindfulness Inventory (FMI) to quantify the amount of mindfulness over the study p...
Source: Indian Journal of Gastroenterology - March 13, 2019 Category: Gastroenterology Source Type: research

Vitamin D deficiency in adult patients with ulcerative colitis: Prevalence and relationship with disease severity, extent, and duration
ConclusionVDD is highly prevalent among patients with UC. Patients with longer disease duration, more severe symptoms, and pancolitis are likely to have lower vitamin D levels. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - March 13, 2019 Category: Gastroenterology Source Type: research

Scoring systems for upper gastrointestinal bleeding: Which one scores better?
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - March 12, 2019 Category: Gastroenterology Source Type: research

Lessons learnt from living donor liver transplantation with ABO-incompatibility: A single-centre experience from southern India
ConclusionsCareful selection of patients and less intense desensitisation protocol are probably important in improving the outcomes in ABOi LDLT. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - March 8, 2019 Category: Gastroenterology Source Type: research

Comparison of various prognostic scores in variceal and non-variceal upper gastrointestinal bleeding: A prospective cohort study
ConclusionThe prognostic scores such as CRS, FRS, GBS, mGBS, and AIMS65 predict the need for hospital-based management, rebleeding, and mortality better among patients with NVUGIB than VUGIB. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - March 4, 2019 Category: Gastroenterology Source Type: research

Dr. Ajay Kumar —President, Indian Society of Gastroenterology 2019–2020
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - February 23, 2019 Category: Gastroenterology Source Type: research