Drug Eluting Versus Covered Metal Stents in Malignant Biliary Strictures—Is There a Clinical Benefit?: A Systematic Review and Meta-Analysis
Conclusion: On the basis of this meta-analysis, DES and SEMS seem to demonstrate comparable clinical outcomes in patients with malignant biliary strictures. Reported adverse events and/or complications were comparable as well. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Pancreatic Insufficiency in Patients Under Sorafenib Treatment for Hepatocellular Carcinoma
Conclusions: We validated the association between MA and PI in 10% of sorafenib-treated patients. Pancreatic enzymes supplementation successfully led to symptomatic recovery. Awareness of this adverse event can help in the management of sorafenib irrespective of cancer type and likely, of other tyrosine kinase inhibitors for HCC patients. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

National Trends and Outcomes of Nonautoimmune Hemolytic Anemia in Alcoholic Liver Disease: Analysis of the Nationwide Inpatient Sample
Goal: The aim of this study was to determine the burden of nonautoimmune hemolytic anemia (NAHA) in hospitalized patients with coexisting alcoholic liver disease (ALD), identify risk factors for NAHA in ALD and describe the hospitalization outcomes. Background: ALD can result in structural and metabolic alterations in the red-blood cell membrane leading to premature destruction of erythrocytes and hemolytic anemia of varying severity. Study: Hospitalized ALD patients with concomitant NAHA were identified in the Nationwide Inpatient Sample database using International Classification of Diseases-9 codes fro...
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Cost-effectiveness of Universal Hepatitis C Screening in Pregnant Women: A Systematic Review
Conclusions: Universally screening pregnant women for HCV was CE in studies that utilized oral DAAs. Most pharmacoeconomic studies failed to incorporate the impact of vertical transmission on infants. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Quantitative Analysis of Intramucosal Mast Cells in Irritable Bowel Syndrome: A Comparison With Inflammatory Bowel Disease in Remission
Conclusions: There is no significant difference in the number of intramucosal mast cells between IBS and IBD that show normal colonic biopsies. In IBS patients, the number of intramucosal mast cell does not correlate with symptoms. The mast cell count (≥20/HPF) is not a reliable criterion for the diagnosis of IBS or for the distinction between patients with IBS and those with IBD in remission. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Clinical Performance of a Novel LIAISON Fecal Calprotectin Assay for Differentiation of Inflammatory Bowel Disease From Irritable Bowel Syndrome
This study was a multicenter, cross-sectional analysis of prospectively collected stool samples from patients 4 years of age or older who presented with gastrointestinal (GI) symptoms and underwent colonoscopy for diagnostic confirmation. IBD was diagnosed based on clinical, endoscopic, and histologic findings. IBS was diagnosed based on Rome III Criteria and negative colonoscopy. Stool samples were extracted and tested on the DiaSorin LIAISON XL using the LIAISON Calprotectin Assay. Results: A total of 240 patients (67% female) were included in the study. In total, 102 patients had IBD (54% ulcerative colitis), 67 ...
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Comparison of the Efficacy of Polaprezinc Plus Proton Pump Inhibitor and Rebamipide Plus Proton Pump Inhibitor Treatments for Endoscopic Submucosal Dissection-induced Ulcers
Conclusion: The polaprezinc plus PPI treatment showed noninferiority to rebamipide plus PPI treatment in the ulcer healing rate at 4 weeks after ESD. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Nonbiopsy Approach for Celiac Disease Is Accurate When Using Exact Duodenal Histomorphometry: Prospective Study in 2 Countries
Goals: To test the accuracy of serology-based criteria for diagnosing celiac disease utilizing quantitative histomorphometry. Background: The revised European pediatric guidelines allow noninvasive celiac disease diagnosis for a subgroup of children. However, in some of the studies on this issue, the positive predictive value (PPV) of serology has remained suboptimal, possibly because of challenges of histopathology as the reference standard. Study: Prospectively enrolled children with transglutaminase 2 antibodies (TGA) above the upper limit of normal (ULN) underwent blood sampling and duodenal biopsy in...
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Pancreatic Fungal Infection in Patients With Necrotizing Pancreatitis: A Systematic Review and Meta-analysis
Conclusions: PFI is common in patients with NP and is associated with increased mortality, intensive care unit admission rate, and length of stay. Further prospective studies are needed to better understand the pathophysiology of PFIs and to determine the role for preemptive therapeutic strategies, such as prophylactic antifungal therapy. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

Acupuncture and Related Therapies for the Treatment of Gastrointestinal Diseases
Gastrointestinal diseases are very common worldwide. Patients with gastroesophageal reflux disease, functional dyspepsia, irritable bowel syndrome, and inflammatory bowel diseases frequently recur to complementary medicine, including acupuncture, likely because of the recurrence of symptoms and the sometimes lack of efficacy of conventional treatments. Acupuncture is a medical practice used in Asian country with benefits for thousands years. In the last decades, growing attention has been given to acupuncture also in Western countries and many studies have investigated the role of acupuncture in gastroenterology. This revi...
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

Therapeutic Drug Monitoring for Current and Investigational Inflammatory Bowel Disease Treatments
This article reviews therapeutic drug monitoring (TDM) use for current inflammatory bowel disease (IBD) treatments. IBD comprises Crohn’s disease and ulcerative colitis-chronic gastrointestinal inflammatory disorders. Treatment options for moderate to severe IBD include thiopurines; methotrexate; biologic agents targeting tumor necrosis factor, α4β7 integrin or interleukins 12 and 23; and Janus kinase inhibitors. TDM is recommended to guide treatment decisions for some of these agents. Published literature concerning TDM for IBD treatments was reviewed. S.D.L., R.S., and E.V.L. drew on their clinical exper...
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

COVID-19 in Chronic Liver Disease and Liver Transplantation: A Clinical Review
We present a comprehensive review of the latest literature on preexisting liver diseases and its interrelationship with COVID-19 infection in cirrhosis, hepatocellular carcinoma, nonalcoholic fatty liver disease, autoimmune hepatitis, and viral hepatitis B. As social distancing and telemedicine gain new footing, we synthesize recommendations from 3 major hepatology societies [American Association for the Study of Liver Disease (AASLD), the European Association for the Study of Liver (EASL), and the Asian Pacific Association for the Study of Liver (APASL)] to present the best approaches for caring for patients with liver di...
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

Ulcerative Colitis: A Critical Approach to the Global Research Output Employing Density-equalizing Mapping and Scientometric Methods
Conclusions: Scientometrics proofed to be a useful methodical approach to evaluate quantitative and semiqualitative aspects regarding UC. Also, we conclude that the influence of international cooperations on the scientific progress in the field of UC is constantly progressing. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: ONLINE ARTICLE: Clinical Review Source Type: research

World Gastroenterology Organisation (WGO) News and Events
No abstract available (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - February 12, 2021 Category: Gastroenterology Tags: WGO NEWS Source Type: research

Reducing Hospitalization in Mild Acute Pancreatitis: Results of Long-term Follow-up
Goals and Background: Acute pancreatitis (AP) is a common emergency department (ED) diagnosis, amounting to enormous costs. Our previous pilot study demonstrated the feasibility of reducing hospitalization using an ED-based observation pathway. In this follow-up study, we hypothesize that the pathway is durable in clinical practice, outside of research supervision, and patients can safely be managed without hospitalization. Study: We reviewed patients prospectively enrolled in the observation pathway after the end of the pilot study. We compared outcomes to patients enrolled in our pilot study and with a histori...
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Alcohol-associated Cirrhosis and Alcoholic Hepatitis Hospitalization Trends in the United States
Goals: The goals of this study were to evaluate trends in hospitalizations and in-hospital mortality among US adults with alcohol-associated cirrhosis and alcoholic hepatitis. Background: Alcohol-associated liver disease contributes to significant liver-related morbidity in the United States, among which inpatient care is a major driver of clinical and economic burden. Methods: Using the 2007-2014 National Inpatient Sample, alcohol-associated cirrhosis and alcoholic hepatitis hospitalizations were identified. Survey-weighted annual hospitalization trends were stratified by sex, race/ethnicity, and age and...
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Association of Gastric Acid Suppression and Sorafenib Efficacy in Advanced Hepatocellular Carcinoma
Conclusions: This single-center experience shows that patients with advanced HCC taking sorafenib and concomitant gastric acid suppression therapy have significantly inferior PFS and OS. This is the first time that this negative interaction has been reported and further prospective validation is warranted. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Nonsurgical Secondary Prophylaxis of Esophageal Variceal Bleeding in Cirrhotic Patients: A Systematic Review and Network Meta-analysis
Conclusions: TIPS was more effective in reducing the incidence of cirrhosis EV rebleeding, rebleeding-related mortality, and overall mortality in cirrhosis. Combined with the above results, TIPS is more likely to be recommended as a secondary prophylaxis intervention for EV in cirrhosis. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Balloon-occluded Retrograde Transvenous Obliteration Versus Transjugular Intrahepatic Portosystemic Shunt for Gastric Varices: A Meta-Analysis
This study aims to compare clinical outcomes of patients who have undergone both procedures for portal hypertensive gastric variceal bleeding. Materials and Methods: We conducted a search of electronic databases from their establishment to April 2019. The goal was to compare the efficacy of BRTO and TIPS in preventing variceal rebleeding and the risk of adverse events such as ascites and hepatic encephalopathy. Predictors of overall survival and rebleeding were also analyzed. Meta-analysis was performed with STATA 15.1. Results: Five randomized controlled trials and retrospective cohort studies were included ...
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Validation of a Novel Fecal Incontinence Scale: The Rapid Assessment Fecal Incontinence Score (RAFIS)
Conclusion: The RAFIS scale is easy to administer and compares well with other validated incontinence instruments. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Novel Orally Administered Recombinant Anti-TNF Alpha Fusion Protein for the Treatment of Ulcerative Colitis: Results From a Phase 2a Clinical Trial
Conclusions: Oral administration of the nonabsorbable OPRX-106 is safe and effective in mild-to-moderate UC, and not associated with immune suppression, while inducing favorable anti-inflammatory immune modulation. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Altered Expression of the Epithelial Mucin MUC1 Accompanies Endoscopic Recurrence of Postoperative Crohn’s Disease
We examined archived neo-terminal ileum biopsies from patients with prior ileocecal resection who had postoperative endoscopic assessment of CD recurrence and given a Rutgeerts ileal recurrence score. Consecutive tissue sections were stained using 2 different anti-MUC1 antibodies, HMPV that recognizes all forms of MUC1 and 4H5 that recognizes only inflammation-associated hypoglycosylated MUC1. Results: A total of 71 postoperative CD patients were evaluated. There was significant increase in MUC1 expression of both glycosylated/normal (P (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Esophagogastric Junction Outflow Obstruction: Are We Missing Anything?
Goals: The authors aimed to compare preperistaltic distal esophageal pressure in patients with esophagogastric junction outflow obstruction (EGJOO) with and without reported dysphagia. Background: Manometric EGJOO is characterized by elevated integral relaxation pressure (>15 mm Hg) without achalasia. The nomenclature inherently implies that it should be associated with impaired food bolus transit and should theoretically present clinically as dysphagia. Study: The authors queried an esophageal functional test database to identify patients diagnosed with EGJOO. They excluded patients who ...
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Application of Artificial Intelligence in Gastrointestinal Endoscopy
Artificial intelligence (AI), also known as computer-aided diagnosis, is a technology that enables machines to process information and functions at or above human level and has great potential in gastrointestinal endoscopy applications. At present, the research on medical image recognition usually adopts the deep-learning algorithm based on the convolutional neural network. AI has been used in gastrointestinal endoscopy including esophagogastroduodenoscopy, capsule endoscopy, colonoscopy, etc. AI can help endoscopic physicians improve the diagnosis rate of various lesions, reduce the rate of missed diagnosis, improve the q...
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

Stylet Slow-pull Versus Standard Suction for Endoscopic Ultrasound-guided Fine-needle Aspiration/Biopsy of Pancreatic Solid Masses: A Meta-Analysis
Conclusions: The authors provide evidence that SP is superior to SS in diagnostic accuracy, low blood contamination, and adequate core tissue acquisition, without reducing adequacy of cellularity or technical success rate. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

The Clinical Utility of Provocative Maneuvers at Esophageal High-resolution Manometry (HRM)
Esophageal high-resolution manometry (HRM) assesses esophageal motor function and is indicated both for evaluation of esophageal symptoms and before antireflux interventions. HRM studies are interpreted and esophageal motor diagnoses made according to the Chicago Classification, version 3.0 algorithm, which is based on ten 5 mL supine water swallows. However, this practice of single liquid swallows performed in the supine position does not reflect typical “real-life” swallowing, and may not reproduce the patient’s presenting symptoms. Therefore, provocative maneuvers at HRM—beyond these 10 st...
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

Evaluation of the Esophagogastric Junction on High Resolution Manometry
The esophagogastric junction (EGJ) is a complex barrier between the thoracic and abdominal luminal gut compartments, comprised primarily of the lower esophageal sphincter (LES) and crural diaphragm. Although closed at rest, the EGJ relaxes to allow antegrade bolus transit and retrograde venting of air. Abnormal relaxation is the hallmark of achalasia spectrum disorders, while increased frequency of transient lower esophageal sphincter relaxations and/or EGJ disruption are seen in gastroesophageal reflux disease. High resolution manometry (HRM) is the modern day gold standard for assessment of EGJ morphology and function, w...
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: ONLINE ARTICLE: Clinical Review Source Type: research

World Gastroenterology Organisation (WGO) News and Events
No abstract available (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - January 9, 2021 Category: Gastroenterology Tags: WGO NEWS Source Type: research

EUS-directed Transgastric Endoscopic Retrograde Cholangiopancreatography (EDGE): The First Learning Curve
No abstract available (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LETTERS TO THE EDITOR Source Type: research

Lean and Nonobese NAFLD/NASH From a Hepatologist’s Point of View
No abstract available (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LETTERS TO THE EDITOR Source Type: research

Older Patients With Hepatocellular Carcinoma Are Less Knowledgeable About Survivorship Issues: Outcomes from a Survey-based Study
Conclusions: In a population of 110 ethnically diverse hepatocellular carcinoma survivors, the authors found older patients had gaps in knowledge of survivorship issues. Particular attention should be paid to older populations during liver cancer treatment. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

High Prevalence of Gastrointestinal Manifestations of COVID-19 Infection in Hospitalized Patients With Cancer
Conclusions: Acute GI symptoms associated with COVID-19 are highly prevalent in hospitalized cancer patients and can occur as a presenting symptom without respiratory symptoms. Symptoms are severe in a small subset of patients. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Low Uptake of Direct-acting Antiviral Therapy Among Hepatitis C Patients With Advanced Liver Disease and Access to Care, 2014-2017
Conclusions: During 4 calendar years of follow-up, one third of patients initiated DAAs. Large fractions of untreated patients had advanced liver disease, died, or were lost to follow-up. Even among patients in integrated health care systems, receipt of DAAs was limited. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

The Prevalence of Gastrointestinal Symptoms, Abnormal Liver Function, Digestive System Disease and Liver Disease in COVID-19 Infection: A Systematic Review and Meta-Analysis
Conclusion: The most significant GI symptoms were anorexia and diarrhea. The most significant abnormal liver function was increased ALT. Severe patients were more likely to have GI symptoms and abnormal liver function. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

The Citrullinated and MMP-degraded Vimentin Biomarker (VICM) Predicts Early Response to Anti-TNFα Treatment in Crohn’s Disease
Background: In Crohn’s disease (CD), 10% to 40% of patients do not respond to anti-tumor necrosis factor-α (TNFα) treatment. Currently, there are no biomarkers with adequate sensitivity to separate responders from nonresponders at an early stage. Aim: The aim of this study was to investigated whether early changes in the VICM (citrullinated and matrix metalloproteinase-degraded vimentin) biomarker were associated with response to anti-TNFα treatment in patients with CD. Methods: Serum VICM levels were measured by ELISA in 2 independent cohorts of CD patients (n=42) treated with ant...
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Will They Show? Predictors of Nonattendance for Scheduled Screening Colonoscopies at a Safety Net Hospital
Conclusions: Specific predictors for scheduled screening colonoscopy nonattendance at a safety net hospital can be identified. These findings can be used to tailor community-based interventions to improve colorectal cancer screening rates. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Efficacy and Safety of Monoclonal Antibodies Against Clostridioides difficile Toxins for Prevention of Recurrent Clostridioides difficile Infection: A Systematic Review and Meta-Analysis
Background: Clostridioides difficile infection is one of the most common health care-associated infections. To reduce the recurrent Clostridioides difficile infection (rCDI), monoclonal antibodies against Clostridioides difficile toxin A (actoxumab) and toxin B (bezlotoxumab) were developed. In the present study, we performed a systematic review and meta-analysis to assess their efficacy and safety. Materials and Methods: An electronic database was searched for relevant randomized controlled trials assessing bezlotoxumab and/or actoxumab. Outcomes included rate of rCDI and adverse events including cardiovascular...
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Development and Pilot Testing of Decision Aid for Shared Decision Making in Barrett’s Esophagus With Low-Grade Dysplasia
Conclusions: BE-Choice is a feasible and effective decision aid to promote SDM in the management of BE-LGD. On pilot testing, BE-Choice had promising impact on patient-important outcomes. A larger multicenter trial is needed to confirm our results and promote widespread use of BE-Choice. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research

Psychological Comorbidity and Intervention in Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is associated with significant psychological comorbidities, with associated impacts on patient quality of life, disease course, and health care costs. The present article reviews the latest evidence on the etiology of psychological comorbidities in IBD, with a focus on shared inflammatory pathways. The current state of practice in managing and understanding psychological comorbidities from the perspective of both gastroenterology practice and psychological treatment is reviewed, with a focus on evidence-based treatments shown to be effective in managing depression, anxiety, stress, and impr...
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

Role of Diet in Diarrhea-predominant Irritable Bowel Syndrome
Irritable bowel syndrome (IBS) is a chronic condition characterized by abdominal pain associated with altered bowel habits. Patients with IBS often complain of food-related gastrointestinal symptoms. Specifically, those with diarrhea-predominant IBS report a significantly higher effect on quality on life because of food avoidance compared with those with other IBS subtypes. Physicians and patients often use dietary therapies to mitigate IBS symptoms. In the last 10 years, several dietary interventions such as a gluten-free diet, a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diets h...
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

Is a Fundamental Design Change for Gastrointestinal Endoscopes Required?
Since the first fiberoptic instruments, gastrointestinal endoscopy has shaped the field of gastroenterology and is now a key diagnostic and therapeutic tool. Compared with the initial fiberoptic endoscopes state-of-the-art optical chips (or charge-coupled device technology) allowed a quantum leap in image quality. Despite these advances, gastrointestinal endoscopy is far from being perfect. The diagnostic yield (eg, for adenoma detection rates) is highly operator dependent and there is still the need for sedation or even anesthesia to address discomfort during the procedure. Despite highly standardized cleaning and high-le...
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

The Natural Course of Gastroesophageal Reflux Disease: A Critical Appraisal of the Literature
Interpreting natural course studies have been very difficult due to their retrospective design, lack of standardization, reliability of reported mucosal findings, liberal use of antireflux medications and accuracy of chart documentation. Studies provided a wide range of progression rates of patients from nonerosive reflux disease (NERD) to erosive esophagitis (EE). However, direct progression from NERD to Barrett’s esophagus appears to be an uncommon phenomenon. Importantly, progression of NERD patients was commonly reported to low grades of EE, which are currently considered inconclusive of gastroesophageal reflux d...
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: CLINICAL REVIEWS Source Type: research

WGO Guidance for the Care of Patients With COVID-19 and Liver Disease
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the least deadly but most infectious coronavirus strain transmitted from wild animals. It may affect many organ systems. Aim of the current guideline is to delineate the effects of SARS-CoV-2 on the liver. Asymptomatic aminotransferase elevations are common in coronavirus disease 2019 (COVID-19) disease. Its pathogenesis may be multifactorial. It may involve primary liver injury and indirect effects such as “bystander hepatitis,” myositis, toxic liver injury, hypoxia, and preexisting liver disease. Higher aminotransferase elevations, lower albumin,...
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: WGO GUIDELINE Source Type: research

Comparative Analysis of 3-Year Persistence With Vedolizumab Compared With Antibodies Against Tumor Necrosis Factor-Alpha in Patients With Inflammatory Bowel Disease in Germany: Retrospective Analysis of a Large Prescription Database
Aims: The goal of the study was to compare persistence with vedolizumab versus adalimumab, golimumab, and infliximab in biologics-naïve patients with inflammatory bowel disease treated in gastroenterological practices and outpatient clinics in Germany. Methods: Patients aged 18 or older who had initiated a biological therapy (vedolizumab, infliximab, adalimumab, or golimumab) were included in the present study. Prescriptions between July 2014 and March 2017 of the respective biological drug emerging from gastroenterological practices or outpatient clinics in Germany were retrieved from the longitudinal pres...
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: ONLINE ARTICLE: Original Article Source Type: research

World Gastroenterology Organisation (WGO) News and Events
No abstract available (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - December 8, 2020 Category: Gastroenterology Tags: WGO NEWS Source Type: research

Treating Acute Medical Conditions Outside the Hospital: Streamlining Care During a Pandemic
No abstract available (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - October 9, 2020 Category: Gastroenterology Tags: LETTERS TO THE EDITOR Source Type: research

Impact of Tilt-down Positioning Compared With Left Lateral Positioning on Ease of Colonoscope Insertion During Colonoscopy
No abstract available (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - October 9, 2020 Category: Gastroenterology Tags: LETTERS TO THE EDITOR Source Type: research

Inhibitors of the Janus Kinases: A New Oral Treatment Option for Ulcerative Colitis
No abstract available (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - October 9, 2020 Category: Gastroenterology Tags: LETTERS TO THE EDITOR Source Type: research

Regular Statin Use and Incidence of Postendoscopic Retrograde Cholangiopancreatography Pancreatitis
Conclusions: Regular statin use was not shown to be protective against PEP. A further investigation is warranted before this medication is tested in prospective randomized trials. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - October 9, 2020 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research

Improving Communication in Outpatient Consultations in People With Cirrhosis: The Development of a Question Prompt List (QPL)
Conclusions: A QPL, suitable for use in patients with liver cirrhosis attending hepatology outpatient clinics, has been developed and piloted. The QPL seems to be feasible to use and acceptable to patients and clinicians. Further work is needed to evaluate its effectiveness and to determine optimum delivery in clinical practice. (Source: Journal of Clinical Gastroenterology)
Source: Journal of Clinical Gastroenterology - October 9, 2020 Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research