MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Current Gastroenterology Reports' source. Wed, 08 Feb 2012 16:28:12 +0100 http://www.medworm.com/index.php?rid=5667927&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft41784umm8x1h427%2F This article reviews the current state of IBD genetics and evolving molecular approaches that may have potential clinical impact. Content Type Journal ArticleCategory Inflammatory Bowel Disease (SB Hanauer, Section Editor)Pages 1-7DOI 10.1007/s11894-012-0248-6Authors Adam V. Weizman, Mount Sinai Hospital Inflammatory Bowel Disease Group, Zane Cohen Centre for Digestive Diseases, University of Toronto, Ontario, CanadaMark S. Silverberg, Mount Sinai Hospital Inflammatory Bowel Disease Group, Zane Cohen Centre for Digestive Diseases, University of Toronto, Ontario, Canada Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5667927 Thu, 02 Feb 2012 18:16:18 +0100 5667927 http://www.medworm.com/index.php?rid=5667928&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa5l1468302237116%2F Abstract  Perianal Crohn’s Disease (CD) is a significant cause of morbidity in CD patients. Accurate identification of perianal involvement requires advanced imaging techniques in addition to physical exam. Treatment of the disease is aimed at improving both the perianal and intestinal manifestations. Proper treatment depends upon the severity of the disease and combines current medical and surgical therapies to maximize response. The ability to improve perianal disease has grown significantly since the introduction of anti-TNF agents which are now a mainstay of treatment along with antibiotics and immunomodulators. New experimental therapies are limited by lack of research to support their use. Content Type Journal ArticleCategory Inflammatory Bowel Disease (SB Hanau... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5667928 Thu, 02 Feb 2012 18:16:16 +0100 5667928 http://www.medworm.com/index.php?rid=5649041&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe728971318166611%2F Abstract  The process of Intraductal papillary mucinous neoplasms (IPMN) follows the adenoma-to-carcinoma sequence. If it progresses to malignancy about 5 years is required. Even though the process is slow IPMN provides the clinician with the opportunity to avoid malignancy if the patient is at risk. The natural history as observed through Kaplan Meier event curves for occurrence of malignancy show the process to malignancy is much faster (50% within 2 years) if pancreatitis-like symptoms are present or if the main pancreatic duct (MPD) is involved. Almost all decisions to resect (95% in our experience) are based on the presence of symptoms or the MPD location. Cyst size is used infrequently. Every patient with an IPMN should always have a planned follow-up and the... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5649041 Wed, 25 Jan 2012 18:05:41 +0100 5649041 http://www.medworm.com/index.php?rid=5515934&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F31104263m28q5065%2F Abstract  Autoimmune hepatitis is a chronic liver disease characterized by elevated aminotransferase levels, autoantibodies, increased γ-globulin or IgG levels and biopsy evidence of interface hepatitis. Recent advances include new practice guidelines that redefine criteria for remission to require complete biochemical and histological normalization on therapy; comparisons between the revised original and simplified diagnostic scoring systems; refined characterization of autoantibodies and their diagnostic performance parameters; proof of the safety and efficacy of combination budesonide and azathioprine therapy for non-cirrhotic patients; scrutiny of overlap syndromes; further analyses of the outcomes of orthotopic liver transplantation and the diagnosis and treatment of ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5515934 Fri, 16 Dec 2011 16:54:21 +0100 5515934 http://www.medworm.com/index.php?rid=5495393&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F164g7646672411l2%2F Abstract  Direct-acting antiviral agents in combination with pegylated interferon (PEG-IFN) and ribavirin (RBV) significantly improve sustained virologic response rate and reduce duration of therapy among both treatment-naïve and treatment-experienced patients with genotype 1 chronic hepatitis C. One of the most important considerations with both boceprevir and telaprevir is the potential development of resistant variants with therapy. Patients with poor intrinsic responsiveness to interferon, and those with incomplete virological suppression on protease inhibitor therapy, appear to be at higher risk for resistance. In this article we will define antiviral resistance and review the data on both in vitro and in vivo resistance to protease inhibitors, concentrating on data o... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5495393 Fri, 09 Dec 2011 17:07:14 +0100 5495393 http://www.medworm.com/index.php?rid=5495394&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fnpn7r85j10057013%2F We describe in this review relevant issues in epidemiology, diagnosis and management of CHC in ESRD, HD and renal transplant recipients. Content Type Journal ArticleCategory Liver (BR Bacon, Section Editor)Pages 1-9DOI 10.1007/s11894-011-0238-0Authors Mohammad A. B. Al-Freah, Institute of Liver Studies, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS United KingdomZeino Zeino, Institute of Liver Studies, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS United KingdomMichael A. Heneghan, Institute of Liver Studies, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS United Kingdom Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterolo... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5495394 Fri, 09 Dec 2011 17:07:12 +0100 5495394 http://www.medworm.com/index.php?rid=5458735&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2626x42222474522%2F Abstract  While many therapeutic agents have been evaluated in Primary Sclerosing Cholangitis (PSC), none have been shown in controlled trials to modify the course of disease. The bile acid ursodeoxycholic acid (UDCA) has been widely used in the treatment of PSC but its use remains controversial. It may have a role in providing chemoprotection against the development of colonic dysplasia/cancer in patients with associated inflammatory bowel disease. The exclusion of IgG4-associated cholangitis, which generally responds to immunosuppressant agents, is essential prior to deciding on an appropriate therapeutic strategy in PSC. In the absence of proven therapeutic agents, treatment strategies are usually aimed at minimizing the complications of the biliary disease. Endoscopic m... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5458735 Mon, 28 Nov 2011 16:58:48 +0100 5458735 http://www.medworm.com/index.php?rid=5458734&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Faw88h56082858m7v%2F Abstract  Non-Alcoholic Fatty Liver Disease (NAFLD) is a common worldwide clinical and major public health problem affecting both adults and children in developed nations. Increased hepatic iron stores are observed in about one-third of adult NAFLD patients. Iron deposition may occur in parenchymal and/or non-parenchymal cells of the reticuloendothelial system (RES). Similar patterns of iron deposition have been associated with increased severity of other chronic liver diseases including HCV infection and dysmetabolic iron overload, suggesting there may be a common mechanism for hepatic iron deposition in these diseases. In NAFLD, iron may potentiate the onset and progression of disease by increasing oxidative stress and altering insulin signaling and lipid metabolism. The ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5458734 Mon, 28 Nov 2011 16:58:48 +0100 5458734 http://www.medworm.com/index.php?rid=5450014&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fgm0p772r72224770%2F Abstract  Vitamin D is now widely recognized to have multiple extraskeletal health functions. The liver is one of the major organs involved in its metabolism. Recent studies have demonstrated a very high prevalence of vitamin D deficiency and insufficiency in patients with chronic liver disease and cirrhosis. There is an emerging interest to explore the relationship between vitamin D deficiency and prevalence and severity of non-alcoholic liver disease and response to antiviral therapy in hepatitis C. In this review, we discuss the current status of our understanding of vitamin D metabolism and vitamin D deficiency in patients with chronic liver disease and cirrhosis. Content Type Journal ArticleCategory Liver (BR Bacon, Section Editor)Pages 1-7DOI 10.1007/s11894-011-02... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5450014 Wed, 23 Nov 2011 17:36:47 +0100 5450014 http://www.medworm.com/index.php?rid=5450013&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9g413hum6430630n%2F Abstract  The HCV genotype will remain an important, independent pre-treatment predictor of virological response. While direct acting antivirals (DAA) will improve in the coming months the rates of virological response in patients with HCV-1, the development of DAAs effective against other HCV genotypes is at an earlier stage. Therefore, Peg-Interferon and Ribavirin will continue to be used in the near future as standard treatment in these patients. In this manuscript, we will discuss highly debated aspects related to non-1 HCV genotypes. First of all, the predictive role of IL28B genetic variation, secondarily specific aspects related to HCV-4. In the final part, we will highlight potential differences between HCV-2 and HCV-3. Indeed, despite the fact that HCV-2 and HCV-3 ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5450013 Wed, 23 Nov 2011 17:36:47 +0100 5450013 http://www.medworm.com/index.php?rid=5441930&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl1826175764k1172%2F This article discusses some of the preliminary data from interferon free studies. Content Type Journal ArticleCategory Liver (BR Bacon, Section Editor)Pages 1-4DOI 10.1007/s11894-011-0229-1Authors Fred Poordad, Hepatology and Liver Transplantation, Cedars-Sinai Medical Center, 8635 W 3rd St, Suite 1060, Los Angeles, CA 90048, USAGrace M. Chee, Hepatology Department, Cedars-Sinai Medical Center, 8631 W 3rd St, Suite 430, Los Angeles, CA 90048, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5441930 Mon, 21 Nov 2011 18:06:07 +0100 5441930 http://www.medworm.com/index.php?rid=5441931&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu4v00hx572454226%2F In conclusion, genotyping of chronic HBV infections can help practicing physicians identify those at risk of disease progression and determine optimal anti-viral therapy. Content Type Journal ArticleCategory Liver (BR Bacon, Section Editor)Pages 1-10DOI 10.1007/s11894-011-0233-5Authors Sudeep Tanwar, Centre for Hepatology, University College London Royal Free Campus, Rowland Hill Street Hampstead, London, NW3 2PF UKGeoffrey Dusheiko, Centre for Hepatology, University College London Royal Free Campus, Rowland Hill Street Hampstead, London, NW3 2PF UK Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5441931 Mon, 21 Nov 2011 18:06:05 +0100 5441931 http://www.medworm.com/index.php?rid=5432342&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq604g832v2781628%2F Abstract  The farnesoid X receptor (FXR) is a nuclear receptor expressed in the liver, small intestine, kidneys, and adrenals. In mouse liver, FXR is bound to thousands of genomic DNA binding sites. Conformational changes induced by bile acid binding to pre-bound FXR leads to increased expression of a variety of genes. These changes lead to decreased intracellular bile acid concentrations through multiple mechanisms including decreased bile acid synthesis from cholesterol, decreased hepatocellular uptake and increased secretion into bile. Activated FXR also modulates the expression of genes responsible for lipid and glucose metabolism. One of the other genes induced by activated FXR is a small heterodimeric partner (SHP), a protein that represses expression of specific gene... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5432342 Fri, 18 Nov 2011 07:01:27 +0100 5432342 http://www.medworm.com/index.php?rid=5423005&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F50075w7872456814%2F Abstract  Acute-on-chronic liver failure (ACLF) is a clinical entity that is well recognized by those who care for patients with cirrhosis, however in spite of this widespread recognition, there remains little consensus with regard to definition and clinical features. While many similarities exist between ACLF and decompensated cirrhosis, there are also key differences, the implications of which are far reaching for both clinicians and patients alike. Among these differences are the possibility of a reversible component, the presence of a defined insult, prognosis, and outcomes associated with ACLF (see Fig. 1). However, for ACLF to have meaningful clinical implications, it first must be defined. If ACLF can be clearly defined and more easily recognized, then clinicians... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5423005 Tue, 15 Nov 2011 16:57:42 +0100 5423005 http://www.medworm.com/index.php?rid=5409427&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F64u4784582622837%2F Abstract  Wilson disease (WD), the autosomal recessively inherited copper overload disorder, remains a diagnostic and therapeutic challenge. In the last decade, direct sequencing of the affected gene ATP7B became commercially available, but interpretation of the results still requires careful attention. Thus, a combination of tests reflecting the disturbed copper metabolism is needed to make the final diagnosis. Because of the low disease frequency, the existing treatment concepts are not based on controlled trails. Here, recent outcome reports of larger cohort studies challenge the recommended therapies and call for individualized treatment strategies. The notion, that certain medical regimens may either be insufficient to upkeep copper homeostasis or may lead to a clinical... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5409427 Mon, 14 Nov 2011 16:53:38 +0100 5409427 http://www.medworm.com/index.php?rid=5324538&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv315213439567107%2F Abstract   Helicobacter pylori infects half of the world’s population and plays a causal role in ulcer disease and gastric cancer. This pathogenic neutralophile uniquely colonizes the acidic gastric milieu through the process of acid acclimation. Acid acclimation is the ability of the organism to maintain periplasmic pH near neutrality in an acidic environment to prevent a fall in cytoplasmic pH in order to maintain viability and growth in acid. Recently, due to an increase in antibiotic resistance, the rate of H. pylori eradication has fallen below 80% generating renewed interest in novel eradication regimens and targets. In this article, we review the gastric biology of H. pylori and acid acclimation, various detection procedures, antibiotic resistance and the role that ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5324538 Thu, 13 Oct 2011 05:44:51 +0100 5324538 http://www.medworm.com/index.php?rid=5251425&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx20w547663567vn9%2F Abstract  Pernicious anemia is a macrocytic anemia due to cobalamin deficiency, which is the result of intrinsic factor deficiency. Pernicious anemia is associated with atrophic body gastritis, whose diagnostic criteria are based on the histologic evidence of gastric body atrophy associated with hypochlorhydria. Serological markers suggesting the presence of oxyntic mucosa damage are increased levels of fasting gastrin and decreased levels of Pepsinogen I. Without the now obsolete Schilling’s test, intrinsic factor deficiency may not be proven, and gastric intrinsic factor output after pentagastric stimulation has been proposed. Intrinsic factor autoantibodies are useful surrogate markers of pernicious anemia. The management of patients with pernicious anemia should focus... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5251425 Fri, 23 Sep 2011 15:50:45 +0100 5251425 http://www.medworm.com/index.php?rid=5238869&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd8425860289k0383%2F Abstract  Ménétrier’s disease is a rare hyperproliferative protein-losing gastropathy of the gastric foveolar epithelium. Most common symptoms include epigastric pain with fullness and vomiting, and generalized peripheral edema with hypoalbuminemia. Radiologically, the wall of the gastric body and fundus is diffusely thickened, often with antral sparing. Giant rugal edematous folds are seen on gastroscopy, and histology of biopsy material shows diffuse foveolar hyperplasia with cystic dilatation of the glandular portion of the gastric mucosa in the absence of significant inflammatory infiltrate. The recent discovery of transforming growth factor α overexpression opens the way of epidermal growth factor receptor blockade with cetuximab as first-line treatment modality i... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5238869 Mon, 19 Sep 2011 13:44:26 +0100 5238869 http://www.medworm.com/index.php?rid=5238868&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw57j4r6126kl3424%2F Abstract  Subepithelial lesions are increasingly being identified with improved endoscopic imaging technologies. Many of these lesions are now recognized as gastrointestinal stromal tumors (GISTs). Recent advances in immunohistochemistry have allowed for reliable differentiation of GISTs from other subepithelial tumors, thereby significantly improving our understanding of these lesions. The wealth of recent information and continual evolution in our understanding of GISTs has exposed some knowledge gaps pertaining to the optimal management of these lesions. In this article, we review the endoscopic management of GISTs as it relates to the identification, diagnosis and management of these lesions based on the best available literature and our own clinical experience to date.... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5238868 Mon, 19 Sep 2011 13:44:26 +0100 5238868 http://www.medworm.com/index.php?rid=5227005&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx220004287r8w406%2F Abstract  Upper gastrointestinal bleeding is the most common gastrointestinal emergency, with peptic ulcer as the most common cause. Appropriate resuscitation followed by early endoscopy for diagnosis and treatment are of major importance in these patients. Endoscopy is recommended within 24 h of presentation. Endoscopic therapy is indicated for patients with high-risk stigmata, in particular those with active bleeding and visible vessels. The role of endoscopic therapy for ulcers with adherent clots remains to be elucidated. Ablative or mechanical therapies are superior to epinephrine injection alone in terms of prevention of rebleeding. The application of an ulcer-covering hemospray is a new promising tool. High dose proton pump inhibitors should be administered intr... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5227005 Wed, 14 Sep 2011 16:09:31 +0100 5227005 http://www.medworm.com/index.php?rid=5163241&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff2473324550486qx%2F Abstract  The small intestine has been difficult to examine by traditional endoscopic and radiologic techniques. Within the past 10 years, advances have led to an explosion of technologies that facilitate examination of the entire small intestine. Wireless video capsule endoscopy, deep enteroscopy using balloon-assisted or spiral techniques, computer tomography (CT) and magnetic resonance (MR) enterography have facilitated the diagnosis, monitoring, and management of patients with small intestinal diseases. These technologies are complementary, each with its advantages and limitations. Capsule endoscopy provides a detailed view of the mucosal surface and has excellent patient acceptance, but does not allow therapeutics. Deep enteroscopy allows careful inspection of the... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5163241 Tue, 16 Aug 2011 06:16:54 +0100 5163241 http://www.medworm.com/index.php?rid=5089066&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F056693m52334337m%2F Abstract  Bile acid malabsorption occurs when there is impaired absorption of bile acids in the terminal ileum, so interrupting the normal enterohepatic circulation. The excess bile acids in the colon cause diarrhea, and treatment with bile acid sequestrants is beneficial. The condition can be diagnosed with difficulty by measuring fecal bile acids, or more easily by retention of selenohomocholyltaurine (SeHCAT), where this is available. Chronic diarrhea caused by primary bile acid diarrhea appears to be common, but is under-recognized where SeHCAT testing is not performed. Measuring excessive bile acid synthesis with 7α-hydroxy-4-cholesten-3-one may be an alternative means of diagnosis. It appears that there is no absorption defect in primary bile acid diarrhea but, inste... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5089066 Fri, 29 Jul 2011 16:01:53 +0100 5089066 http://www.medworm.com/index.php?rid=5089067&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff34788k62r0444t6%2F Abstract  The performance of colon polypectomy has proven to be one of the most impactful services provided by today’s endoscopist. Advancements in instrumentation and endoscopic techniques have been studied intensely by endoscopists over the past decade in order to expand their extent of resection capabilities to large and complex polyps. Much of the research in the past year has focused on the safety and efficacy of performing endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and combined laparascopic-endoscopic resections (CLER). Experts have published case-series, multicenter studies, and even nationwide results on the use of these methods for complex polypectomy. Because of the novelty and increased risk of these procedures, recent research ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5089067 Fri, 29 Jul 2011 16:01:50 +0100 5089067 http://www.medworm.com/index.php?rid=5089069&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F912664614l860756%2F Abstract  Intestinal polyposis syndromes are relatively rare. However, it is important for clinicians to recognize the potential risks of these syndromes. Based on histology, these syndromes can be classified mainly into hamartomatous polyposis syndromes and familial adenomatous polyposis (FAP), which affects mainly the large intestine. This review discusses the clinical manifestations and underlying genetics of the most common small intestinal polyposis syndromes: Peutz-Jeghers syndrome (PJS), juvenile polyposis (JP), PTEN hamartoma tumor syndrome (PHTS), and the small intestinal implications of familial adenomatous polyposis (FAP). Content Type Journal ArticlePages 1-7DOI 10.1007/s11894-011-0218-4Authors Nadir Arber, Integrated Cancer Prevention Center, Tel Aviv Sour... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5089069 Thu, 28 Jul 2011 15:54:10 +0100 5089069 http://www.medworm.com/index.php?rid=5089068&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh51k66757755k83u%2F Content Type Journal ArticlePages 1-4DOI 10.1007/s11894-011-0211-yAuthors Brooks D. Cash, Uniformed Services University of the Health Sciences, 8901 Wisconsin Avenue, Bldg 9, Gastroenterology, Bethesda, MD 20889, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5089068 Thu, 28 Jul 2011 15:54:10 +0100 5089068 http://www.medworm.com/index.php?rid=5080637&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp25n77722638nt0q%2F Abstract  Adverse reactions to foods are extremely common, and generally they are attributed to allergy. However, clinical manifestations of various degrees of severity related to ingestion of foods can arise as a result of a number of disorders, only some of which can be defined as allergic, implying an immune mechanism. Recent epidemiological data in North America showed that the prevalence of food allergy in children has increased. The most common food allergens in the United States include egg, milk, peanut, tree nuts, wheat, crustacean shellfish, and soy. This review examines the various forms of food intolerances (immunoglobulin E [IgE] and non–IgE mediated), including celiac disease and gluten sensitivity. •  Immune mediated reactions can be eit... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5080637 Tue, 26 Jul 2011 15:48:38 +0100 5080637 http://www.medworm.com/index.php?rid=5080638&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx1855758156041w2%2F Abstract  Crohn’s disease (CD) is a chronic inflammatory disorder characterized by focal, asymmetric, transmural inflammation of any part of the luminal gastrointestinal tract of uncertain etiology and an unpredictable course. The available treatment options include aminosalicylates, budesonide and systemic corticosteroids, antibiotics, immunomodulators,methotrexate and anti-TNF agents. This review discusses recent developments in the treatment of CD and provides a comprehensive update on management of patients with CD based on the data from randomized controlled trials. Pique Content Type Journal ArticlePages 1-10DOI 10.1007/s11894-011-0220-xAuthors Anna M. Buchner, Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USAWojciech Blonski, Divi... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5080638 Tue, 26 Jul 2011 15:48:37 +0100 5080638 http://www.medworm.com/index.php?rid=5070524&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1115322167608545%2F Content Type Journal ArticlePages 1-3DOI 10.1007/s11894-011-0212-xAuthors Joseph H. Sellin, Ben Taub Hospital, Houston, TX, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5070524 Mon, 25 Jul 2011 15:44:46 +0100 5070524 http://www.medworm.com/index.php?rid=5070523&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr825435g36l14867%2F Abstract  The treatment options for inflammatory bowel disease have expanded with the introduction of biological therapies. Recently published controlled clinical trials were searched and those that impact the clinical management of ulcerative colitis (UC) are discussed in this review. In the management of mild to moderate UC, mesalamine still remains the first choice of drug. The newly developed once daily formulations have shown equal efficacy to divided doses and possibly portend better compliance owing to a simplified regimen. In outpatients with moderate to severe UC, recent data indicate that infliximab induced and maintained remission leads to decreased colectomy rates and fewer hospitalizations. An alternative anti-tumor necrosis factor (TNF) agent, adalimumab, was ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5070523 Mon, 25 Jul 2011 15:44:46 +0100 5070523 http://www.medworm.com/index.php?rid=5064216&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fyv2m15h362020442%2F Abstract  Exposure to ionizing radiation is associated with an increased risk of cancer. With the growing use of diagnostic imaging studies, there is concern for increasing the risk of radiation associated malignancy of the gastrointestinal tract. The purpose of this review is to summarize the existing literature for risk of gastrointestinal malignancy after ionizing radiation exposure from diagnostic imaging studies. Estimates of organ specific effective doses of radiation vary widely based on the method of measurement and patient factors. Most of the current data are based on calculations of organ effective doses from anthropomorphic phantoms and estimated cancer risk based on radiation exposure from environmental sources. Radiation associated cancer risk is dependent on ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5064216 Thu, 21 Jul 2011 18:10:05 +0100 5064216 http://www.medworm.com/index.php?rid=5064218&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp780056jr8211531%2F Abstract  Transmission of foodborne pathogens remains a growing concern despite increasing public awareness and heightened federal measures to control infection. Over 76 million cases of acute diarrhea secondary to ingestion of contaminated food occur annually in the United States. Fortunately, most are self-limited and resolve without therapy, but up to 6000 deaths occur on an annual basis. Mechanisms of infection include consumption of a preformed toxin, formation of toxin following ingestion, and direct invasion of intestinal epithelial cells by the infecting organism. Diagnosis is most often confirmed through an accurate history, as cultures are often of low yield. Content Type Journal ArticlePages 1-7DOI 10.1007/s11894-011-0209-5Authors John R. Cangemi, Mayo Clin... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5064218 Tue, 19 Jul 2011 23:44:07 +0100 5064218 http://www.medworm.com/index.php?rid=5064217&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy35626021qu61712%2F Abstract  Diarrhea is the most common complaint reported by travelers from industrialized countries visiting developing nations. High-risk areas for travelers’ diarrhea (TD) include South Asia, Sub-Saharan Africa, and Latin America, while moderate-risk areas include Southeast Asia, Middle East, Oceania and the Caribbean. Bacterial pathogens are the major cause of TD. Recent advances in the therapy for diarrhea include a better understanding of the potential benefit of symptomatic and antimicrobial therapy. The mainstay of treatment includes antibacterial therapy with one of three drugs, a fluoroquinolone, rifaximin, or azithromycin. Probiotics have been used in preliminary studies for both treatment and prevention of TD, but more studies are needed with these biologic age... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5064217 Tue, 19 Jul 2011 23:44:07 +0100 5064217 http://www.medworm.com/index.php?rid=5064220&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fng04q6117248w2l8%2F Abstract  Microscopic colitis is a common cause of chronic diarrhea in predominantly older adults. Incidence rates of microscopic colitis (including lymphocytic and collagenous colitis) have increased over time to levels comparable to other forms of inflammatory bowel disease. The possibility of drug-induced microscopic colitis is an important consideration when evaluating these patients, although this concept requires further investigation. There are few controlled treatment trials in microscopic colitis, with much of the data on treatment coming from retrospective studies. In patients with microscopic colitis, a systematic approach to therapy often leads to satisfactory control of symptoms. In this review, we will provide an updated assessment of the epidemiology, diagnos... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5064220 Tue, 19 Jul 2011 23:44:06 +0100 5064220 http://www.medworm.com/index.php?rid=5064219&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fxt71460k8w52t323%2F Abstract  Computed tomographic (CT) colonography is being implemented increasingly in the USA and Europe, and in many centers it has become the radiological technique of choice for imaging the whole colorectum. Although high diagnostic accuracy has been demonstrated in both screening and symptomatic populations, controversy persists regarding implementation, who should interpret the examination, and its cost effectiveness, particularly in the context of primary colorectal cancer screening. Published research in recent years has demonstrated efficacy in a wide range of patient groups, striking technical improvements, and high levels of patient acceptability. New developments continue in the fields of computer aided detection, digital cleansing, and integration into positron ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5064219 Tue, 19 Jul 2011 23:44:06 +0100 5064219 http://www.medworm.com/index.php?rid=5064221&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm0x502661q811k47%2F Abstract  Several hepatobiliary abnormalities have been described in association with inflammatory bowel disease (IBD), including primary sclerosing cholangitis (PSC), small duct PSC, chronic hepatitis, cryptogenic cirrhosis, cholangiocarcinoma, and cholelithiasis. PSC is the most common biliary condition in patients with IBD, with an incidence ranging from 2.5% to 7.5%. PSC usually progresses insidiously and eventually leads to cirrhosis independent of inflammatory bowel disease activity. There is a very high incidence of cholangiocarcinoma and an elevated risk for developing colon cancer in patients with PSC. Medical therapy has not proven successful in slowing disease progression or prolonging survival. Treatment of symptoms due to cholestasis, such as pruritis and steat... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=5064221 Tue, 19 Jul 2011 23:44:03 +0100 5064221 http://www.medworm.com/index.php?rid=4896271&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx4nm77124hg0j460%2F Content Type Journal ArticlePages 1-2DOI 10.1007/s11894-011-0199-3Authors Walter J. Coyle, Division of Gastroenterology and Hepatology, Scripps Clinic Torrey Pines, 10666 N. Torrey Pines Road, N203, LaJolla, CA 92037, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4896271 Mon, 30 May 2011 16:54:53 +0100 4896271 http://www.medworm.com/index.php?rid=4896272&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F244714162ml471g9%2F Abstract  Gastrointestinal dysmotility is commonly noted in the intensive care unit and postoperative settings. Characterized by delayed passage of stool and flatus, nausea, vomiting, and abdominal distention, the condition is associated with nutritional deficiencies, risk of aspiration, and considerable allocation of health care resources. Knowledge of gastrointestinal function in health and illness continues to expand. While the factors that precipitate ileus differ between postoperative and critically ill patients, the two clinical scenarios seem to have similar mechanisms and share many of the same pathophysiologic patterns. By reviewing and comparing the literature on the respective mechanisms and contributing factors generated in these separate clinical settings, a co... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4896272 Fri, 27 May 2011 18:13:25 +0100 4896272 http://www.medworm.com/index.php?rid=4896273&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F67m05364732q2t16%2F Abstract  Protein utilization and requirements in critical illness are much researched and debated topics. The enhanced turnover and catabolism of protein in the setting of critical illness is well described and multifactorial in nature. The need to preserve lean body mass and enhance nitrogen retention in this state to improve immunologic function and reduce morbidity is well described. Debates as to the optimum amount of protein to provide in such states still exist, and a significant amount of research has contributed to our understanding of not only how much protein to supply to these patients, but how best to do so. Small peptide formulations, intact protein formulations, branched chain amino acids, and specialty formulas all exist, and their benefits, drawbacks, and p... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4896273 Mon, 23 May 2011 17:06:06 +0100 4896273 http://www.medworm.com/index.php?rid=4896274&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd03u33117tnq1662%2F Abstract  Acute pancreatitis is a common cause of hospitalization and a major source of morbidity worldwide. When it is severe, and especially when it progresses to include necrosis of the pancreas, the risk of infection rises and mortality increases. Early reports suggested prophylactic antibiotics given in severe pancreatitis prevent infection and death. More recent clinical trials do not support this benefit, and meta-analyses on the topic offer conflicting recommendations. In this article, we evaluate the body of published literature examining the use of antibiotics as a preventive measure in acute pancreatitis. The highest quality, currently available data fail to support prophylactic use of antibiotics, which should be added to treatment regimens only where infection ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4896274 Mon, 23 May 2011 17:06:03 +0100 4896274 http://www.medworm.com/index.php?rid=4854909&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr27x14811124623q%2F Abstract  Suitable and timely early enteral nutrition is paramount to providing optimal patient care for the critically ill. Lipids serve many essential roles throughout the human body, and are important components of most enteral formulations. This paper reviews lipid structure, function, and optimal utility for this macronutrient in enteral feeds. The use of omega–3 fatty acids has become common in critical care formulations, and their clinical efficacy is outlined separately. Available evidence is reviewed, and future directions are discussed. Content Type Journal ArticlePages 1-8DOI 10.1007/s11894-011-0203-yAuthors Craig Munroe, Department of Medicine, Stanford University, Palo Alto, CA, USADavid Frantz, Department of Medicine, Stanford University, Palo Alto, CA,... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4854909 Fri, 20 May 2011 16:05:44 +0100 4854909 http://www.medworm.com/index.php?rid=4854910&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F12k36376j1822844%2F Abstract  Glycemic control in the critically ill patient has remained a controversial issue over the last decade. Several large trials, with widely varying results, have generated significant interest in defining the optimal target for blood-glucose control necessary for improving care while minimizing morbidity. Nutritional support has evolved into an additional area of critical care where appropriate practices have been associated with improved patient outcomes. Carbohydrate provision can impact blood-glucose levels, and the relationship between nutrition and glucose levels has become more complex in the era of improved glycemic control. This review discusses the controversy surrounding intensive-insulin therapy in the intensive care unit and explores the relationship wit... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4854910 Fri, 20 May 2011 16:05:43 +0100 4854910 http://www.medworm.com/index.php?rid=4854911&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F504q8544k4038211%2F Abstract  Historically, physicians have perceived the quality of nutrition training during medical school as inadequate. A literature review suggests that this perception has not significantly changed since the 1950s. Many schools have worked to create clinical nutrition curricula for use during medical school. Interestingly, data suggest that medical students’ perception of the importance of clinical nutrition can decrease during medical school. Recent data support the importance of targeted nutritional therapy to reduce morbidity and mortality, yet the number of physicians interested in nutrition appears to be declining, and fewer hours of nutrition training are occurring in medical school. One possible solution to improve both training and awareness of the problem is t... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4854911 Thu, 19 May 2011 16:33:52 +0100 4854911 http://www.medworm.com/index.php?rid=4854912&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4114n28218277206%2F This article reviews what is known about IBS patients’ expectations and needs. Content Type Journal ArticlePages 1-5DOI 10.1007/s11894-011-0205-9Authors Albena Halpert, Section of Gastroenterology & Hepatology, Boston School of Medicine, 85 East Concord Street, Boston, MA 02118, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4854912 Wed, 18 May 2011 18:20:00 +0100 4854912 http://www.medworm.com/index.php?rid=4854913&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk737n218456178r5%2F Content Type Journal ArticlePages 1-5DOI 10.1007/s11894-011-0200-1Authors Ryan T. Hurt, Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USAStephen A. McClave, Department of Medicine, University of Louisville, Louisville, KY, USANabeel Azeem, Department of Medicine, Mayo Clinic, Rochester, MN, USAShaun E. Cole, Department of Medicine, Mayo Clinic, Rochester, MN, USADavid Wetzel, Department of Medicine, Mayo Clinic, Rochester, MN, USASherezade Khambatta, Department of Medicine, Mayo Clinic, Rochester, MN, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4854913 Wed, 18 May 2011 18:19:59 +0100 4854913 http://www.medworm.com/index.php?rid=4806798&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh5j3q4874wu6r207%2F Abstract  Functional gastrointestinal disorders (FGIDs) are common and currently defined by a symptom-based classification with no discernable pathology. In functional dyspepsia (FD), the duodenum is now implicated as a key area where symptoms originate.This is attributed to immune activation with increasing evidence indicating a role for duodenal eosinophilia. In irritable bowel syndrome (IBS), mastocytosis has been documented throughout the small and large intestine. Eosinophils and mast cells are an important link between innate and adaptive immunity, and are important in allergic type TH2 inflammation. Eosinophils may give rise to symptoms due to release of preformed cytokine proteins, which trigger neural excitation, muscle spasm, and pain. The close relationship of ma... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4806798 Fri, 06 May 2011 16:18:36 +0100 4806798 http://www.medworm.com/index.php?rid=4790697&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F742424x47r137q08%2F This article reviews recent data useful in the evaluation, treatment, and prevention of C. difficile infection in these patient groups. Recent publications relating to C. difficile infection in specific immunocompromised conditions are also discussed. Content Type Journal ArticlePages 1-7DOI 10.1007/s11894-011-0196-6Authors Daniel L. Raines, Department of Medicine, Section of Gastroenterology, Louisiana State University Health Sciences Center, 1542 Tulane Avenue Suite 423, New Orleans, LA 70112, USAFred A. Lopez, Department of Medicine, Section of Infectious Disease, Louisiana State University Health Sciences Center, 1542 Tulane Avenue Suite 425, New Orleans, LA 70112, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gast... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4790697 Tue, 03 May 2011 16:03:27 +0100 4790697 http://www.medworm.com/index.php?rid=4783263&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F348r310125260056%2F Abstract  Visceral hypersensitivity is currently considered a key pathophysiological mechanism involved in pain perception in large subgroups of patients with functional gastrointestinal disorders, including irritable bowel syndrome (IBS). In IBS, visceral hypersensitivity has been described in 20%–90% of patients. The contribution of the central nervous system and psychological factors to visceral hypersensitivity in patients with IBS may be significant, although still debated. Peripheral factors have gained increasing attention following the recognition that infectious enteritis may trigger the development of persistent IBS symptoms, and the identification of mucosal immune, neural, endocrine, microbiological, and intestinal permeability abnormalities. Growing evidence ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4783263 Mon, 02 May 2011 15:00:13 +0100 4783263 http://www.medworm.com/index.php?rid=4783262&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb6x51012143g62m5%2F Abstract  Defecatory disorders are a common cause of chronic constipation and should be managed by biofeedback-guided pelvic floor retraining. While anorectal tests are necessary to diagnose defecatory disorders, recent studies highlight the utility of a careful digital rectal examination. While obstetric anal injury can cause fecal incontinence (FI), diarrhea is a more important risk factor for FI among women in the community, who typically develop FI after age 40. Initial management of fecal incontinence should focus on bowel disturbances. Pelvic floor retraining with biofeedback therapy is beneficial for patients who do not respond to bowel management. Sacral nerve stimulation should be considered in patients who do not respond to conservative therapy. Content Type J... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4783262 Mon, 02 May 2011 15:00:13 +0100 4783262 http://www.medworm.com/index.php?rid=4783264&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa06537133430634h%2F Abstract  Nutrition in the intensive care setting is a vital part of patient care, and may even be referred to as “nutritional therapy”. Current nutritional practices have progressed a lot over the past few years, and draw from a large body of accumulating evidence. Yet, as with other trends in critical care, there are a lot of variations in the way nutrition is approached between institutions, as well as between individual physicians. This review attempts to look at some of these differences and provide recommendations based upon the available literature. Content Type Journal ArticlePages 1-7DOI 10.1007/s11894-011-0193-9Authors Jinesh P. Mehta, University of Louisville, 550 S Jackson St., ACB A3R40, Louisville, KY 40202, USABashar Chihada Alhariri, University of L... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4783264 Mon, 02 May 2011 15:00:11 +0100 4783264 http://www.medworm.com/index.php?rid=4726490&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7393wt60m7w615j1%2F Abstract  Congenital diarrheal disorders (CDD) are a group of rare enteropathies related to specific genetic defects. Infants with these disorders have chronic diarrhea, frequently requiring parenteral nutrition support. Etiologies and prognoses are variable. We propose a new classification of CDD into four groups, taking into account the specific etiology and genetic defect: 1) defects in digestion, absorption, and transport of nutrients and electrolytes; 2) disorders of enterocyte differentiation and polarization; 3) defects of enteroendocrine cell differentiation; and 4) dysregulation of the intestinal immune response. The present review focuses on the recent advances made in understanding the pathophysiology of CDD that could potentially improve the clinical approach to... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4726490 Thu, 14 Apr 2011 17:01:53 +0100 4726490 http://www.medworm.com/index.php?rid=4687145&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp56t444700367174%2F Abstract  Chronic cough is a common problem resulting in significant impairment of quality of life. Along with cough variant asthma and nasal disease, gastroesophageal reflux is considered one of three main causes of cough. Despite this, acid suppression therapy is often far from effective. This review aims to explore whether reflux can lead to cough, the circumstances in which this is most likely to occur, and the potential mechanisms linking these processes. Particular mechanisms to be explored include laryngopharyngeal reflux, microaspiration, and neuronal cross-organ sensitization. Finally, diagnostic approaches are considered. Content Type Journal ArticlePages 1-10DOI 10.1007/s11894-011-0192-xAuthors Jaclyn A. Smith, Respiratory Research Group, University of Manch... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4687145 Tue, 05 Apr 2011 09:59:12 +0100 4687145 http://www.medworm.com/index.php?rid=4665424&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft3ht608761016460%2F Abstract  Differences in growth curves can influence the diagnosis of under- and overnutrition, and the interpretation of adequate growth following nutrition intervention. This effect is notable when comparing the World Health Organization (WHO) 2006 Growth Standard and the Centers for Disease Control and Prevention (CDC) 2000 Growth Reference for infants and children to 59 months of age. Important differences relate to conceptual approaches for generating growth standards to describe what population growth should be, compared to a reference of what growth is. WHO included only term infants exclusively or predominantly breast-fed beyond 4 months, and data for infants and children indicative of excess adiposity and growth failure were removed. Thus, fewer children ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4665424 Tue, 29 Mar 2011 07:06:29 +0100 4665424 http://www.medworm.com/index.php?rid=4632690&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb6097678w3l54122%2F Abstract  Achalasia is a primary esophageal motility disorder characterized by aperistalsis and incomplete or absent relaxation of the lower esophageal sphincter (LES). The cause of the disease remains elusive and there is no intervention that improves the esophageal body function. Currently, treatment options focus on palliation of symptoms by reducing the LES pressure. The most effective and well-tolerated treatments continue to be the laparoscopic Heller myotomy and endoscopic pneumatic dilation; however, newer techniques (eg, peroral endoscopic myotomy and self-expanding metal stents) show promise. Botulinum toxin and pharmacologic therapy are reserved for those who are unable to undergo more effective therapies. Treatment options should be tailored to the patient, usin... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4632690 Mon, 21 Mar 2011 18:55:54 +0100 4632690 http://www.medworm.com/index.php?rid=4632691&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fjxl388737060u847%2F Abstract  Epidemiologic, endoscopic, and pathophysiologic studies document the relationship between obesity and gastroesophageal reflux disease (GERD). Increased body mass index and accumulation of visceral fat are associated with a two- to threefold increased risk of developing reflux symptoms and esophageal lesions. Given this association, many studies were designed to evaluate the outcome of reflux symptoms following conventional and surgical treatment of obesity. Among bariatric procedures, gastric sleeve and banded gastroplasty were shown to have no effect or even worsen reflux symptoms in the postoperative setting. Gastric banding improves reflux symptoms and findings (endoscopic and pH-measured distal esophageal acid exposure) in many patients, but is associated with... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4632691 Mon, 21 Mar 2011 18:55:51 +0100 4632691 http://www.medworm.com/index.php?rid=4623385&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb8684u817j54379q%2F Abstract  Management of children with portal hypertension has evolved considerably over the past decades. Development of physiologic shunts (meso-Rex bypass) and successful liver transplant has changed the paradigm of portal hypertension surgery. Children with pre-hepatic portal hypertension are investigated and, if suitable, candidates are offered the mesenteric-to-left portal vein bypass (meso-Rex) preemptively, before development of symptoms of portal hypertension. Aggressive medical management, endoscopic ligation of bleeding varices, and radiologically placed intrahepatic stents have greatly reduced the need for emergent surgical procedures. A larger number of surgical options offer a permanent solution for children with portal hypertension in the setting of well-compe... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4623385 Sat, 19 Mar 2011 02:51:35 +0100 4623385 http://www.medworm.com/index.php?rid=4611713&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8084t73x8818311n%2F Abstract  Percutaneous endoscopic gastrostomy (PEG) is a relatively safe and minimally invasive surgical method for providing enteral access in children. In pediatrics, the indications for PEG placement frequently include malnutrition or failure to thrive, as well as oropharyngeal dysphagia, especially in children with neurological impairment (NI). The risk for postoperative complications is low. However, among children with NI, gastroesophageal reflux disease (GERD) may necessitate fundoplication prior to gastrostomy tube placement. Preoperative pH probe testing has not been shown to be an effective screening tool prior to PEG placement among patients with GERD. Laparoscopic gastrostomy tube insertion was introduced in pediatric patients in an attempt to decrease complicat... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4611713 Wed, 16 Mar 2011 11:50:59 +0100 4611713 http://www.medworm.com/index.php?rid=4567320&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx02354r211808170%2F Abstract  Meconium ileus at birth, distal intestinal obstruction syndrome (DIOS), and constipation are an interrelated group of intestinal obstruction syndromes with a variable severity of obstruction that occurs in cystic fibrosis patients. Long-term follow-up studies show that today meconium ileus is not a risk factor for impaired nutritional status, pulmonary function, or survival. DIOS and constipation are frequently seen in cystic fibrosis patients, especially later in life; genetic, dietary, and other associations have been explored. Diagnosis of DIOS is based on suggestive symptoms, with a right lower quadrant mass confirmed on abdominal radiography, whereas symptoms of constipation are milder and of longer standing. In DIOS, early aggressive laxative treatment with ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4567320 Mon, 07 Mar 2011 16:58:59 +0100 4567320 http://www.medworm.com/index.php?rid=4562161&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg0l6721575q7173u%2F Abstract  Barrett’s esophagus has gained increased clinical attention because of its association with esophageal adenocarcinoma, a cancer with increasing incidence and poor survival rates. The goals of ablating Barrett’s esophagus are to decrease esophageal cancer rates and to improve overall survival and quality of life. Different techniques have been developed and tested for their effectiveness eradicating Barrett’s epithelium. This review assesses the literature associated with different ablative techniques. The safety and efficacy of different techniques are discussed. This review concludes with recommendations for the clinician, including specific strategies for patient care decisions for patients with Barrett’s esophagus with varying degrees of dysplasia. ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4562161 Fri, 04 Mar 2011 11:07:17 +0100 4562161 http://www.medworm.com/index.php?rid=4541711&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm884xv4655537323%2F Abstract  Laryngopharyngeal reflux (LPR) is associated with symptoms of laryngeal irritation such as throat pain, cough, and voice change. Currently, the two main diagnostic tools are laryngoscopy and reflux monitoring. On laryngoscopy, the signs most commonly used to diagnose LPR are erythema and edema of the larynx; however, these signs are not specific for LPR, may be associated with other causes, and may even be found in healthy individuals. In addition, pH testing has low sensitivity in diagnosing gastroesophageal reflux disease-related laryngeal findings. Proton pump inhibitor (PPI) therapy remains the cornerstone of treatment. The current management recommendation for this group of patients is empiric therapy with twice-daily PPIs for 1 to 2 months. In the major... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4541711 Mon, 28 Feb 2011 16:48:12 +0100 4541711 http://www.medworm.com/index.php?rid=4541710&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F615657513112n835%2F Abstract  Eosinophilic esophagitis (EoE), a chronic inflammatory condition with a rapidly evolving epidemiology, is now a major cause of esophageal disease. Current guidelines emphasize that EoE is a clinicopathologic condition with the following criteria: clinical symptoms of esophageal dysfunction; at least 15 eosinophils in one high-power field on esophageal biopsy; and lack of responsiveness to high-dose proton-pump inhibition or normal pH monitoring of the distal esophagus. Challenges in diagnosis include lack of standardized esophageal biopsy protocols, variability in how eosinophil counts are determined, variability in the size of microscope high-power fields, and the need to evaluate the differential diagnosis of esophageal eosinophilia. In particular, the complex i... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4541710 Mon, 28 Feb 2011 16:48:12 +0100 4541710 http://www.medworm.com/index.php?rid=4442938&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F84qx828ln2tm2k62%2F Abstract  About one quarter of children with inflammatory bowel disease (IBD) experience an extraintestinal manifestation, with the most common being arthritis or arthralgia. Because of the frequency of these joint complaints and their effect on quality of life, it is important to consider all possible etiologies in order to promptly evaluate, diagnose, and possibly refer to other specialists. Pediatric gastroenterologist and IBD specialists are cognizant of the extraintestinal joint manifestations, but may be less familiar with rheumatic disease and the musculoskeletal examination. We explore the differential diagnosis of joint complaints in children, with a focus on IBD-related disease and rheumatic disease. Content Type Journal ArticlePages 1-8DOI 10.1007/s11894-011-... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4442938 Fri, 04 Feb 2011 17:49:23 +0100 4442938 http://www.medworm.com/index.php?rid=4442940&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F74xw5p4657580853%2F Abstract  Recurrent acute pancreatitis is a common clinical problem. Most cases of pancreatitis are identified by a careful history and physical examination. Despite advanced evaluation, the cause is not apparent in about 10% of cases. The etiology of recurrent acute pancreatitis appears to be multifactorial, with genetic and environmental influences playing a significant role. The strength of evidence for certain etiologies is highly variable, and natural history data are limited. Controversy exists regarding the most appropriate diagnostic and therapeutic approach. Recurrent acute pancreatitis often represents a continuum with chronic pancreatitis. Content Type Journal ArticlePages 1-10DOI 10.1007/s11894-011-0176-xAuthors Nalini M. Guda, University of Wisconsin Scho... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4442940 Tue, 01 Feb 2011 08:39:44 +0100 4442940 http://www.medworm.com/index.php?rid=4442939&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ffu4604307j618627%2F Content Type Journal ArticlePages 1-2DOI 10.1007/s11894-011-0180-1Authors Brian L. Pearlman, Center for Hepatitis C, Atlanta Medical Center, 285 Boulevard NE, Suite 140, Atlanta, GA 30312, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4442939 Tue, 01 Feb 2011 08:39:44 +0100 4442939 http://www.medworm.com/index.php?rid=4415744&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy663k01h70373mkq%2F Abstract  Cholangiocarcinoma (CCA) is a rare tumor arising from the epithelium of the intrahepatic or the extrahepatic bile ducts. It is rarely diagnosed before 40 years of age except in patients with primary sclerosing cholangitis. CCA is usually clinically silent until the tumor obstructs the bile ducts. Carbohydrate antigen 19-9 is the most commonly used tumor marker, and magnetic resonance cholangiopancreatography is the best available imaging modality for CCA. Endoscopic retrograde cholangiopancreatography and cholangioscopy allow tissue acquisition. Positron emission tomography may play a role in identifying occult metastases. Tissue diagnosis is obtained by brush cytology or bile duct biopsy. Content Type Journal ArticlePages 1-6DOI 10.1007/s11894-011-0178-8... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4415744 Thu, 27 Jan 2011 01:08:43 +0100 4415744 http://www.medworm.com/index.php?rid=4401303&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy3q7t0232417n541%2F Abstract  The investigation and treatment of disorders of the human biliary tree depend considerably on invasive endoscopic and radiologic procedures. These are associated with a significant risk of complications, some of which can be fatal. This review looks at these complications through the lens of 40 years of publications in the medical literature, and identifies the strengths and weaknesses of their current classification, diagnosis, and treatment. Content Type Journal ArticlePages 1-9DOI 10.1007/s11894-011-0179-7Authors Klaus Mergener, GI Hospitalist Program, Digestive Health Specialists, 3209 South 23rd Street, Suite 340, Tacoma, WA 98405, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroente... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4401303 Fri, 21 Jan 2011 20:32:57 +0100 4401303 http://www.medworm.com/index.php?rid=4401304&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fpw8881jp6q652288%2F Abstract  Pancreatic adenocarcinoma presents in an advanced stage and has a dismal prognosis. Extensive recent research efforts have provided us with greater insight into the etiology of pancreatic cancer and have also improved our means of prognostication. Molecular analysis demonstrated that specific pathways involved in pancreatic carcinogenesis are perhaps more valuable to study than single genetic aberrations. Previous risk factors, including family history, body mass index, and current cigarette smoking, were validated and novel risks, such as ABO blood group alleles, were identified. Similar to other illnesses, combinations of healthful habits, such as not smoking, adhering to a Mediterranean dietary pattern, and engaging in physical activity, may decrease pancreatic... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4401304 Fri, 21 Jan 2011 20:32:56 +0100 4401304 http://www.medworm.com/index.php?rid=4378859&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1117184845121725%2F Abstract  Significant literature on the management of acute severe acute pancreatitis has emerged in recent years. The new information ranges from data on newer single or multiparameter severity assessment tools and classification systems to therapeutic modalities. However, a few basic issues—the ideal severity assessment modality, volume of intravenous fluids required in the first 48 to 72 h, and the role of prophylactic antibiotics—are still not clear and are subject to controversy. The International Working Group has devised the Revised Atlanta Classification, which will be published soon. This new classification is eagerly awaited worldwide, and hopefully clarifies many of the problems of the original Atlanta Classification. In this article, we discuss the deve... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4378859 Mon, 17 Jan 2011 20:40:38 +0100 4378859 http://www.medworm.com/index.php?rid=4378860&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F84m8l6045685h881%2F Abstract  Clinical observation has defined the medical profile of alcoholic pancreatitis, but its low incidence and prevalence has limited characterizing the disease at a population level, the contribution of environmental exposures, and a clear picture of its natural history. Recent studies have defined the impact of alcohol use and smoking on disease risk, and a threshold for alcohol consumption has been identified. Recurrent attacks of acute pancreatitis have been linked with continued alcohol consumption, and aggressive alcohol intervention has been shown to decrease recurrence. Progression from alcoholic acute pancreatitis to chronic pancreatitis is now believed to occur infrequently, and factors associated with progression have been identified. Alcoholic pancreatitis ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4378860 Mon, 17 Jan 2011 20:40:35 +0100 4378860 http://www.medworm.com/index.php?rid=4363776&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F352r8v1453628138%2F Content Type Journal ArticlePages 1-3DOI 10.1007/s11894-010-0168-2Authors Christopher E. Forsmark, Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Box 100214, Room HD 602, 1600 SW Archer Road, Gainesville, FL 32610-0214, USAShailendra Chauhan, Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Box 100214, Room HD 602, 1600 SW Archer Road, Gainesville, FL 32610-0214, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4363776 Sat, 15 Jan 2011 00:57:14 +0100 4363776 http://www.medworm.com/index.php?rid=4345982&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F97465173pm670706%2F Abstract  Biliary diseases in children are infrequent; however, they can be associated with high morbidity and mortality if an accurate diagnosis is not made and adequate treatment provided in a timely fashion. Biliary atresia, choledochal cysts, gallbladder disease, and Alagille syndrome can be associated with similar clinical symptoms, laboratory findings, and radiographic findings, which makes accurate diagnosis difficult. The correct treatment for each of these clinical entities is different and can significantly reduce morbidity and mortality from these diseases. In this article, we discuss the epidemiology, approach to diagnosis, prognosis, and treatment modalities for these four disease processes. Content Type Journal ArticlePages 1-9DOI 10.1007/s11894-010-0169-1... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4345982 Tue, 11 Jan 2011 18:05:26 +0100 4345982 http://www.medworm.com/index.php?rid=4345983&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0078188u512k5r03%2F Abstract  Gallbladder dyskinesia is a functional (motility) disorder of the gallbladder resulting in episodic abdominal pain that, in carefully selected cases, resolves with cholecystectomy. It is a diagnosis of exclusion: several functional and organic disorders have to be excluded, and confounding factors addressed, before a diagnosis of gallbladder dyskinesia can be entertained. The combination of high clinical suspicion and an abnormally low gallbladder ejection fraction on cholecystokinin stimulated-cholescintigraphy predict benefit from removing the gallbladder. Content Type Journal ArticlePages 1-5DOI 10.1007/s11894-010-0172-6Authors Geoffrey Francis, Wake Forest University Baptist Medical Center, Nutrition Building, Floor E, Medical Center Boulevard, Winston-Sa... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4345983 Mon, 10 Jan 2011 15:54:42 +0100 4345983 http://www.medworm.com/index.php?rid=4345984&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fpn3x810wh16l6607%2F Abstract  We review important new clinical observations in pancreas divisum (PD) made since 2007. PD is common and has the same prevalence in the general population and idiopathic pancreatitis (IP). Up to 53% of patients with PD and IP have underlying idiopathic chronic pancreatitis (CP), and in rigorous prospective clinical follow-up and/or natural history studies, many with idiopathic recurrent acute pancreatitis (IRAP) have idiopathic CP. According to retrospective studies, PD does not modify the natural course of nonalcoholic or alcoholic CP. CFTR and/or SPINK1 gene mutations associate with IP (idiopathic CP and IRAP) independently of the presence of PD. More than one third of patients with pancreatitis or presumed pancreaticobiliary pain respond to placebo. Authors of u... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4345984 Mon, 10 Jan 2011 15:54:41 +0100 4345984 http://www.medworm.com/index.php?rid=4327673&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn8mkl55865110q3p%2F Content Type Journal ArticlePages 1-3DOI 10.1007/s11894-010-0173-5Authors John Baillie, Section on Gastroenterology, Wake Forest University Baptist Medical Center, Nutrition Building, Floor E, Medical Center Boulevard, Winston-Salem, NC 27157, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4327673 Fri, 07 Jan 2011 14:51:47 +0100 4327673 http://www.medworm.com/index.php?rid=4319395&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8702q55q76280140%2F Abstract  Acute cholangitis is a potentially life-threatening systemic disease resulting from a combination of infection and obstruction of the biliary tree, secondary to different underlying etiologies. Common causes of cholangitis (eg, gallstones, benign and malignant biliary strictures) are well known. However, others (eg, immunoglobulin-G subclass-4–related sclerosing cholangitis) have been described only recently, are still under evaluation, and need to gain broader attention from clinicians. The diagnosis of acute cholangitis is based on clinical presentation and laboratory data indicating systemic infection, as well as diagnostic imaging modalities revealing signs of biliary obstruction and possibly an underlying etiology. The clinical presentation varies, and init... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4319395 Tue, 04 Jan 2011 17:55:15 +0100 4319395 http://www.medworm.com/index.php?rid=4273143&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr2m3j356m2021236%2F Abstract  Chronic pancreatitis (CP) remains an important healthcare problem that adversely affects quality of life. Endoscopic ultrasound (EUS) is a preferred test for the diagnosis of early CP. The Rosemont classification strictly defines and assigns weighting to the previously described ductal and parenchymal criteria. Recent histological correlation studies have improved our understanding of the accuracy of EUS criteria. Digital imaging analysis and complementary functional testing may complement endosonographic diagnosis. EUS-directed celiac plexus blockade and ductal access techniques have expanded the therapeutic armamentarium for pain management in CP. Content Type Journal ArticleDOI 10.1007/s11894-010-0167-3Authors Tyler Stevens, Department of Gastroenterology... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4273143 Fri, 17 Dec 2010 17:42:02 +0100 4273143 http://www.medworm.com/index.php?rid=4231187&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq5818145x5271422%2F Abstract  Pulmonary vascular complications of liver disease comprise two distinct clinical entities: hepatopulmonary syndrome (HPS—microvascular dilatation and angiogenesis) and portopulmonary hypertension (POPH—vasoconstriction and remodeling in resistance vessels). These complications occur in similar pathophysiologic environments and may share pathogenic mechanisms. HPS is found in 15% to 30% of patients with cirrhosis and its presence increases mortality and the risks of liver transplantation, particularly when hypoxemia is present. Contrast echocardiography and arterial blood gas analysis are required to establish the diagnosis. No medical therapies are available, although liver transplantation is effective in reversing the syndrome. POPH is found in 4% to 8% of pa... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4231187 Wed, 01 Dec 2010 20:20:24 +0100 4231187 http://www.medworm.com/index.php?rid=4206562&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F19555118r1554650%2F Content Type Journal ArticleDOI 10.1007/s11894-010-0162-8Authors Bruce R. Bacon, James F. King, MD, Endowed Chair in Gastroenterology, Professor of Internal Medicine, Saint Louis University School of Medicine, 3635 Vista Avenue at Grand Boulevard, St. Louis, MO 63110-0250, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4206562 Wed, 24 Nov 2010 20:23:33 +0100 4206562 http://www.medworm.com/index.php?rid=4198150&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk411164pr54h422x%2F Abstract  Bone disease is a major complication of chronic liver disease. Osteomalacia is quite uncommon despite low vitamin D levels in the majority of patients with cirrhosis. In contrast, osteoporosis is quite common, occurring in up to 50% of patients. Osteoporosis can result in spontaneous or low-impact fractures in patients with chronic liver diseases, adversely affecting morbidity, quality of life, and survival. The general biology of osteoporosis, including its pathogenesis, diagnostic tools, and rationale for treatment, have been determined largely empirically from studies of postmenopausal women with osteoporosis. Treatment regimens with modification of risk factors, use of vitamin D, and supplementation with calcium and bisphosphonates have been shown to be effect... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4198150 Mon, 22 Nov 2010 13:22:40 +0100 4198150 http://www.medworm.com/index.php?rid=4198151&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F36h0546r1466w821%2F Abstract  Hepatocellular carcinoma (HCC) used to be considered a universally fatal disease. Today, however, we have tools to identify patients at risk for HCC with more accuracy. We are able to provide surveillance using ultrasonography that is sufficiently sensitive to detect small HCC lesions. Treatment of these lesions, whether by resection or by radiofrequency ablation, is highly effective. These advances mean that HCC is theoretically curable in the majority of patients, provided these tools are used. Microarray technology has been applied to the study of the genetic changes in HCC, and has defined several distinct genetic variants of this disease, as well as identifying gene signatures that predict poor outcome, and predict metastases. These techniques are now being u... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4198151 Mon, 22 Nov 2010 13:22:38 +0100 4198151 http://www.medworm.com/index.php?rid=4187455&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp4130424u5m94381%2F This article reviews recent advances in mechanisms and therapy related to five major areas of direct relevance to ALD: oxidative stress; gut-liver axis and cytokine signaling; malnutrition; fibrin/clotting; and stellate cell activation/fibrosis. We also review why therapies related to these mechanisms have performed well in experimental animals and in vitro systems, but have not necessarily translated into effective therapy for humans with ALD. Content Type Journal ArticleDOI 10.1007/s11894-010-0157-5Authors Juliane I. Beier, Department of Pharmacology and Toxicology, University of Louisville Health Sciences Center, Louisville, KY 40292, USAGavin E. Arteel, Department of Pharmacology and Toxicology, University of Louisville Health Sciences Center, Louisville, KY 40292, USACraig J... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4187455 Thu, 18 Nov 2010 17:56:45 +0100 4187455 http://www.medworm.com/index.php?rid=4187456&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8742q1lw23763622%2F Abstract  Variceal hemorrhage is one of the leading causes of death in patients with cirrhosis, with the 6-week mortality after each episode ranging from 15% to 20%. The two main strategies for primary prevention of variceal bleeding in patients with cirrhosis and varices are the administration of nonselective β-blockers or the obliteration of varices with use of endoscopic band ligation. In this review, we present and critically review the latest data on primary prevention of variceal hemorrhage. We advocate that nonselective β-blockers should be the first line therapy, and band ligation should be offered only in cases of intolerance or side effects. We also explore potential future therapies based on preliminary experimental and clinical data. Content Type Journal A... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4187456 Thu, 18 Nov 2010 07:58:17 +0100 4187456 http://www.medworm.com/index.php?rid=4180272&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg08r8146q7074743%2F Abstract  One of the most common manifestations of the development of portal hypertension in the patient with cirrhosis is the appearance of ascites. Once ascites develops, the prognosis worsens and the patient becomes susceptible to complications such as bacterial peritonitis, hepatic hydrothorax, hyponatremia, and complications of diuretic therapy. As the liver disease progresses, the ascites becomes more difficult to treat and many patients develop renal failure. Most patients can be managed by diuretics which, when used correctly, will control the ascites. Spontaneous bacterial peritonitis can be treated effectively, but portends a worse prognosis. Once the ascites becomes refractory to diuretics, liver transplantation is the best option, although use of transjugular in... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4180272 Tue, 16 Nov 2010 07:02:07 +0100 4180272 http://www.medworm.com/index.php?rid=4180273&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp073600530736t4l%2F Abstract  The hypothesis that host genetics play an essential role in the ability not only to clear acute hepatitis C infection but also to achieve sustained virologic response (SVR) to interferon (IFN)-based therapy has been proved with the recent discovery of two single-nucleotide polymorphisms on chromosome 19. Variants in the minor allele rs8099917 and the proximate polymorphism rs12979860, 3 kb upstream of the interleukin (IL)-28B gene, which encodes the endogenous antiviral cytokine IFN-λ, are associated with SVR and with natural viral clearance. The disparate frequencies of these alleles in ethnic groups worldwide may well explain differing rates of SVR among them. The test for one of these polymorphisms is now commercially available and can serve as a powerful... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4180273 Tue, 16 Nov 2010 07:02:06 +0100 4180273 http://www.medworm.com/index.php?rid=4176483&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F161r3u07l226354t%2F Abstract  The incidence of gastric neuroendocrine tumors (NETs) has increased exponentially based on widespread use of endoscopy and a greater pathological awareness of the condition. A key concern is the potential association with hypergastrinemia induced by proton pump inhibitor administration. Previous confusion regarding diagnosis and therapy has been diminished by a series of international consensus statements defining the biology and management strategies for the disease. Overall, gastric NETs are categorized as well-differentiated or poorly differentiated neoplasms. Well-differentiated gastric NETs are enterochromaffin-like (ECL) cell tumors subclassified into three types based on their relationship to gastrin, a key regulator of ECL cell neoplastic transformation. T... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4176483 Mon, 15 Nov 2010 18:07:52 +0100 4176483 http://www.medworm.com/index.php?rid=4176482&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh2025716n7t422q3%2F Abstract  Advances in the treatment of inflammatory bowel disease (IBD) are published routinely in medical journals. Some treatments are sufficiently helpful that their conclusions are incorporated into clinical guidelines. However, such publications and proclamations may go unheeded among practitioners. Underuse, overuse, and misuse of clinical therapeutics, diagnostics, and routine medical processes are sufficiently prevalent among IBD practitioners that movements are afoot to determine the best methods for achieving a minimal uniformity of effective care. Such explorations are part of an effort to improve the quality of care. In this article, we review the background that has led to a push toward quality improvements in medicine in general, in gastroenterology in general... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4176482 Mon, 15 Nov 2010 18:07:52 +0100 4176482 http://www.medworm.com/index.php?rid=4165160&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp007474813xw1317%2F Content Type Journal ArticleDOI 10.1007/s11894-010-0159-3Authors George Sachs, Department of Physiology and Medicine, David Geffen School of Medicine, University of California at Los Angeles, and VA Greater Los Angeles Healthcare System, Room 324, Building 113, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USAJai Moo Shin, Department of Physiology and Medicine, David Geffen School of Medicine, University of California at Los Angeles, and VA Greater Los Angeles Healthcare System, Room 324, Building 113, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USARichard Hunt, Farncombe Family Digestive Disease Research Institute, Division of Gastroenterology, McMaster University Health Sciences Centre, 1200 Main Street West, Room 4W8A, Hamilton, ON L8N 3Z5, Canada Journal Current Gast... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4165160 Thu, 11 Nov 2010 17:53:06 +0100 4165160 http://www.medworm.com/index.php?rid=4156330&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg036j43kq1355hn0%2F Abstract  The story of hepatitis C virus (HCV) therapy is about to add one of its biggest chapters. From the serendipitous beginnings in the 1980s when investigators noted that interferon improves liver enzymes in non-A, non-B hepatitis, to the discovery and naming of the hepatitis virus, to the addition of ribavirin, to the pegylation of interferon, and now to the first direct-acting antivirals (DAA), the history of HCV is an intriguing one that continues to unfold. Along with the first DAAs, other important findings have helped explain long-observed differences between various ethnic groups, as well as new predictive information that can be gleaned from some of the observed adverse events. Content Type Journal ArticleDOI 10.1007/s11894-010-0153-9Authors Fred Poordad... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4156330 Tue, 09 Nov 2010 12:52:58 +0100 4156330 http://www.medworm.com/index.php?rid=4141277&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F81n8g05513767063%2F Abstract  Drug-induced liver injury (DILI) is a rare but potentially devastating adverse drug reaction. Its presentation can range from asymptomatic elevation in liver biochemistries to fulminant liver failure. Over the past decade, clinical and research interest in the field of idiosyncratic DILI has been intense, and several new findings have been reported. In this article, we provide an update on implicated agents, clinical features, outcomes, and the results of recently reported genetic studies. Content Type Journal ArticleDOI 10.1007/s11894-010-0154-8Authors Haripriya Maddur, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, RG 4100, 1050 Wishard Boulevard, Indianapolis, IN 46202, USANaga Chalasani, Division of Gastroenterology and... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4141277 Wed, 03 Nov 2010 17:18:51 +0100 4141277 http://www.medworm.com/index.php?rid=4135954&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F78813575j2365216%2F Abstract  Poorly controlled Crohn’s disease (CD) often requires surgery for such complications as strictures, fistulas, and abscesses. The goal of postoperative treatment is to suppress or prevent inflammation and maintain mucosal healing. Probiotics, antibiotics, 5-aminosalicylates, immunomodulators, and antibodies to tumor necrosis factor are all used to prevent postoperative recurrence. In this article, recent studies are reviewed. Azathioprine/6-mercaptopurine are moderately effective at preventing and treating postoperative CD, whereas infliximab/adalimumab are highly effective and probiotics and 5-aminosalicylates minimally effective. We base the choice of postoperative medical therapy on the patient’s risk profile for postoperative recurrence. Whatever postoperati... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4135954 Tue, 02 Nov 2010 15:21:54 +0100 4135954 http://www.medworm.com/index.php?rid=4069089&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fwhj5u7q86t6675ut%2F Abstract  Luminal amino acids and lack of luminal acidity as a result of acid neutralization by intragastric foodstuffs are powerful signals for acid secretion. Although the hormonal and neural pathways underlying this regulatory mechanism are well understood, the nature of the gastric luminal pH sensor has been enigmatic. In clinical studies, high pH, tryptic peptides, and luminal divalent metals (Ca2+ and Mg2+) increase gastrin release and acid production. The calcium-sensing receptor (CaSR), first described in the parathyroid gland but expressed on gastric G cells, is a logical candidate for the gastric acid sensor. Because CaSR ligands include amino acids and divalent metals, and because extracellular pH affects ligand binding in the pH range of the gastric content, its ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4069089 Mon, 11 Oct 2010 16:58:58 +0100 4069089 http://www.medworm.com/index.php?rid=4041892&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fpr84093751547231%2F Abstract  Management of portal hypertension in children has evolved over the past several decades. Portal hypertension can result from intrahepatic or extrahepatic causes. Management should be tailored to the child based on the etiology of the portal hypertension and on the functionality of the liver. The most serious complication of portal hypertension is gastroesophageal variceal bleeding, which has a mortality of up to 30%. Initial treatment of bleeding focuses on stabilizing the patient. Further treatment measures may include endoscopic, medical, or surgical interventions as appropriate for the child, depending on the cause of the portal hypertension. β-Blockers have not been proven to effectively prevent primary or secondary variceal bleeding in children. Sclerotherapy... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4041892 Wed, 06 Oct 2010 16:46:44 +0100 4041892 http://www.medworm.com/index.php?rid=4041893&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa46v4x2452277151%2F Abstract  Minimal hepatic encephalopathy (MHE) is a neurocognitive disorder that affects up to 80% of cirrhotic patients. Similar to overt hepatic encephalopathy, ammonia and oxidative stress play key roles in the pathogenesis of MHE. However, MHE is characterized by subtle deficits and psychomotor abnormalities that can only be elicited by specialized psychometric tests. Although no gold standard exists for the diagnosis, MHE remains an important entity for clinicians to recognize because of its negative impact on a patient’s health-related quality of life and association with driving impairment and vehicle accidents. MHE has also been associated with an increased rate in the development of overt hepatic encephalopathy and increased mortality; therefore, identification a... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4041893 Tue, 05 Oct 2010 18:09:44 +0100 4041893 http://www.medworm.com/index.php?rid=4041894&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2907j0266517433p%2F Abstract  The gastric H,K-adenosine triphosphatase (ATPase) is the primary target for treatment of acid-related diseases. Proton pump inhibitors (PPIs) are weak bases composed of two moieties, a substituted pyridine with a primary pKa of about 4.0 that allows selective accumulation in the secretory canaliculus of the parietal cell, and a benzimidazole with a second pKa of about 1.0. Protonation of this benzimidazole activates these prodrugs, converting them to sulfenic acids and/or sulfenamides that react covalently with one or more cysteines accessible from the luminal surface of the ATPase. The maximal pharmacodynamic effect of PPIs as a group relies on cyclic adenosine monophosphate–driven H,K-ATPase translocation from the cytoplasm to the canalicular membrane of the pa... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4041894 Tue, 05 Oct 2010 18:09:43 +0100 4041894 http://www.medworm.com/index.php?rid=4033053&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw4552568m80q0h54%2F Abstract  The decision to start immunosuppressive therapy comes with benefits and risks. Patient selection is as important as medication selection, because some patients are not appropriate for certain therapies. The decision is based on many factors, including diagnosis, level of disease activity, comorbidities, and sometimes socioeconomic status. Frank discussion about side effects, possible adverse events (different from side effects), and monitoring protocols needs to occur after the clinician has decided on a therapy. Some therapies require additional screening prior to initiation (eg, tuberculosis testing before initiating biologics). Steroids are aggressive treatment, but need to have an end point. Thiopurines need to be monitored routinely with blood tests, and are ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4033053 Sat, 02 Oct 2010 05:57:01 +0100 4033053 http://www.medworm.com/index.php?rid=4033055&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv81382118h722623%2F Abstract  Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the surgical treatment of choice for patients with medically refractory ulcerative colitis (UC) or UC with dysplasia and for the majority of patients with familial adenomatous polyposis. However, UC patients with IPAA are susceptible to inflammatory and noninflammatory sequelae, such as pouchitis, Crohn’s disease of the pouch, cuffitis, and irritable pouch syndrome, in addition to common surgery-associated complications, which adversely affect the surgical outcome and compromise health-related quality of life. Pouchitis is the most frequent long-term complication of IPAA in patients with UC, with a cumulative prevalence of up to 50%. Pouchitis may be classified based on the etiology ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4033055 Sat, 02 Oct 2010 05:57:00 +0100 4033055 http://www.medworm.com/index.php?rid=4033054&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd603822517329v60%2F This article reviews the role of recently studied serologic and fecal markers in the diagnosis of IBD, and differentiation between subtypes of IBD. Content Type Journal ArticleDOI 10.1007/s11894-010-0145-9Authors Poonam Beniwal, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USALaura Harrell, University of Chicago Medical Center, 5841 South Maryland Avenue, MC 6084, Chicago, IL 60637, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4033054 Sat, 02 Oct 2010 05:57:00 +0100 4033054 http://www.medworm.com/index.php?rid=4033056&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc5mr380472567842%2F Abstract  The mucosal immune system is constantly exposed to a wide range of commensal and potentially pathogenic microbial species. Chronic exposure to foreign organisms makes generation of an appropriate immune response critical in maintaining a balance between elimination of harmful pathogens, peaceful coexistence with commensals, and prevention of autoimmunity. Intestinal intraepithelial lymphocytes provide a first line of defense at this extensive barrier with the outside world, and as such, understanding their role in immunity is critical. Content Type Journal ArticleDOI 10.1007/s11894-010-0148-6Authors Brian S. Sheridan, Department of Immunology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USALeo Lefrançois, Department ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4033056 Sat, 02 Oct 2010 05:56:59 +0100 4033056 http://www.medworm.com/index.php?rid=4026230&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fkn1811p655682278%2F Abstract  The definition of remission in Crohn’s disease and ulcerative colitis has evolved to include mucosal healing as a measure of treatment efficacy. Randomized, controlled trials have demonstrated mucosal healing is attainable with the current arsenal of therapies available to treat inflammatory bowel disease. Mucosal healing has been shown to reduce the likelihood of clinical relapse, reduce the risk of future surgeries, and reduce hospitalizations. This review focuses on the latest studies addressing clinical outcomes of mucosal healing in the clinical trial and practice setting. Content Type Journal ArticleDOI 10.1007/s11894-010-0146-8Authors Christina Ha, Division of Gastroenterology and Hepatology, The Johns Hopkins School of Medicine, 1830 East Monument S... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4026230 Fri, 01 Oct 2010 07:03:06 +0100 4026230 http://www.medworm.com/index.php?rid=4024187&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7p308552g2631254%2F Abstract  Proton pump inhibitors (PPI) are one of the most widely used classes of drugs. PPIs have a very favorable safety profile, and it is unusual for a patient to stop them because of side effects. However, with increasing numbers of patients chronically taking PPIs for gastroesophageal reflux disease and other common, persistent conditions, the long-term potential adverse effects are receiving increasing attention. An insufficiently studied area receiving much attention is the long-term effect of chronic acid suppression on the absorption of vitamins and nutrients. This increased attention results from the reported potential adverse effect of chronic PPI treatment leading to an increased occurrence of bone fractures. Interest in this area has led to examination of the ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4024187 Thu, 30 Sep 2010 08:00:39 +0100 4024187 http://www.medworm.com/index.php?rid=4019678&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk0t6740155621162%2F Abstract  Constipation is a common problem in the elderly, and abnormalities in the neural innervation of the colon play a significant role in abnormalities in colonic motility leading to delayed colonic transit. The scope of this review encompasses the latest advances to enhance our understanding of the aging colon with emphasis on enteric neurodegeneration, considered a likely cause for the development of constipation in the aging gut in animal models. Neural innervation of the colon and the effects of aging on intrinsic and extrinsic nerves innervating the colonic smooth muscle is discussed. Evidence supporting the concept that neurologic disorders, such as Parkinson’s disease, not only affect the brain but also cause neurodegeneration within the enteric nervous system... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4019678 Tue, 28 Sep 2010 19:07:21 +0100 4019678 http://www.medworm.com/index.php?rid=4005942&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr624t425w781n551%2F Abstract  In this article, the recent literature exploring the epidemiology of inflammatory bowel disease (IBD) is reviewed. Epidemiologic studies present data on disease burden, but may also provide clues to disease etiology. The emergence of IBD in developing nations warrants a systematic search for environmental changes in those countries to explain the evolution of IBD. The hygiene hypothesis suggests that an alteration in the microbial environment experienced by the host facilitates the evolution of chronic immune-mediated diseases. One complex database study suggested that areas with high species richness of human intestinal helminthes are areas with genetic changes in interleukin gene loci. In other words, over the years, the microbial ecology has affected human gene... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=4005942 Mon, 27 Sep 2010 16:52:43 +0100 4005942 http://www.medworm.com/index.php?rid=3995563&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv475513143276133%2F Content Type Journal ArticleDOI 10.1007/s11894-010-0138-8Authors Joseph R. Pisegna, CURE: Digestive Diseases Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USABijal Surti, CURE: Digestive Diseases Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USADavid R. Scott, CURE: Digestive Diseases Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3995563 Tue, 21 Sep 2010 11:27:33 +0100 3995563 http://www.medworm.com/index.php?rid=3995564&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu0v3861t48204836%2F Abstract  Answering a need for a thoroughly validated infant gastroesophageal reflux questionnaire, the Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) was designed, refined, and validated using state-of-the-art psychometric methods. Diagnostic and evaluative (tracking) validity was identified. However, perplexing results of some clinical trials using the I-GERQ-R for diagnosis prompted analysis of possible reasons, including ambiguities in defining symptomatic gastroesophageal reflux disease (GERD) and aspects of the validation process. Symptomatic GERD is defined by “troublesomeness” of symptoms and attribution of their causation to reflux—two crucial issues. Methods of quantifying symptom-reflux associations are described and their limitations ident... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3995564 Tue, 21 Sep 2010 11:27:32 +0100 3995564 http://www.medworm.com/index.php?rid=3948361&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F55t624r277663527%2F Abstract  Acid-related disorders represent a major healthcare concern. In recent years, our understanding of the physiologic processes underlying gastric acid secretion has improved notably. The identity of several apical ion transport proteins, which are necessary for acid secretion to take place, has been resolved. The recent developments have uncovered potential therapeutic targets for the treatment of acid-related disorders. This brief review provides an update on the mechanisms of gastric acid secretion, with a particular focus on apical ion transport. Content Type Journal ArticleDOI 10.1007/s11894-010-0137-9Authors Sascha Kopic, Departments of Surgery and Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT USAJohn P. Geibel, Department of Su... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3948361 Tue, 07 Sep 2010 17:25:54 +0100 3948361 http://www.medworm.com/index.php?rid=3886927&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw84q635gr8178v18%2F Abstract  The digestive system is endowed with its own, local nervous system, referred to as the enteric nervous system (ENS). Given the varied functions of small intestine, its ENS has developed individualized characteristics relating to motility, secretion, digestion, and inflammation. The ENS regulates the major enteric processes such as immune response, detecting nutrients, motility, microvascular circulation, intestinal barrier function, and epithelial secretion of fluids, ions, and bioactive peptides. Remarkable progress has been made in understanding the signaling pathways in this complex system and how they work. In this article, we focus on recent advances that have led to new insights into small intestinal ENS function and the development of new therapies. Co... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3886927 Thu, 19 Aug 2010 16:49:03 +0100 3886927 http://www.medworm.com/index.php?rid=3874099&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F12j6x1tj614773u8%2F Content Type Journal ArticleDOI 10.1007/s11894-010-0133-0Authors Joseph H. Sellin, Division of Gastroenterology, Department of Medicine, Baylor College of Medicine, BCM 620, One Baylor Plaza, Houston, TX 77030, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3874099 Mon, 16 Aug 2010 05:50:33 +0100 3874099 http://www.medworm.com/index.php?rid=3874100&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F26w7428986908k80%2F Abstract  Mast cells have been considered for many years to participate specifically in allergic reactions through the release of cytokines, chemokines, proteases, leukotrienes, and bioactive polyamines. Emerging roles for mast cells have been identified recently, which highlight their relevance in both innate and adaptive immunity. Mast cells play a role in many different processes, including clearance of enteric pathogens, food allergies, visceral hypersensitivity, and intestinal cancer. The activation of mast cells can initiate inflammatory reactions that are life-saving in some circumstances (eg, nematode infection) but life-threatening in others (eg, allergy). In recent years, mast cells, their products, and the mechanisms by which mast cell activity can be regulated b... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3874100 Sat, 14 Aug 2010 08:39:58 +0100 3874100 http://www.medworm.com/index.php?rid=3866060&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg8w77t70523v54j5%2F Abstract  Sampling of intestinal pathogens and commensals is an important aspect of the gut immune system, and is accomplished through the action of specialized epithelial M cells. Although their sampling abilities have been appreciated for decades, few molecular details of their development or function are known. This review discusses several recent advances in our understanding of these cells, including signals controlling their development, the mechanisms they use for taking up microbes, and their exploitation by certain pathogens. Future research directions are discussed, including development of oral vaccines. Content Type Journal ArticleDOI 10.1007/s11894-010-0128-xAuthors Joseph M. Pickard, Department of Pathology, University of Chicago, 5841 South Maryland Aven... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3866060 Fri, 13 Aug 2010 07:06:21 +0100 3866060 http://www.medworm.com/index.php?rid=3866061&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk68t25725m3h1366%2F Abstract  The mucus layer coating the gastrointestinal tract is the front line of innate host defense, largely because of the secretory products of intestinal goblet cells. Goblet cells synthesize secretory mucin glycoproteins (MUC2) and bioactive molecules such as epithelial membrane-bound mucins (MUC1, MUC3, MUC17), trefoil factor peptides (TFF), resistin-like molecule β (RELMβ), and Fc-γ binding protein (Fcgbp). The MUC2 mucin protein forms trimers by disulfide bonding in cysteine-rich amino terminal von Willebrand factor (vWF) domains, coupled with crosslinking provided by TFF and Fcgbp proteins with MUC2 vWF domains, resulting in a highly viscous extracellular layer. Colonization by commensal intestinal microbiota is limited to an outer “loose” mucus layer, and int... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3866061 Thu, 12 Aug 2010 06:04:21 +0100 3866061 http://www.medworm.com/index.php?rid=3866062&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff1w0445688626807%2F This article reviews the techniques and indications of SEMS placement for benign and malignant colorectal obstructions. Content Type Journal ArticleDOI 10.1007/s11894-010-0136-xAuthors Eduardo A. Bonin, Division of Gastroenterology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USATodd H. Baron, Division of Gastroenterology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3866062 Wed, 11 Aug 2010 19:11:59 +0100 3866062 http://www.medworm.com/index.php?rid=3866064&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn6778r658wj63px3%2F Abstract  New therapies are being developed for irritable bowel syndrome (IBS). These advances are based on understanding pathophysiology or the development of medications with greater selectivity in classes of agents with known efficacy. Prucalopride, the newest European Medicines Agency-approved 5-hydroxytryptamine receptor 4 (5-HT4) agonist, is effective in the treatment of chronic constipation with improved cardiovascular safety relative to older 5-HT4 drugs; similarly, ramosetron, the 5-hydroxytryptamine receptor 3 (5-HT3) antagonist, appears efficacious in diarrhea-predominant IBS. Secretagogues with different mechanisms of action target apical domains in enterocytes that are involved in chloride secretion, such as chloride channels, the cystic fibrosis transmembrane re... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3866064 Mon, 09 Aug 2010 05:44:59 +0100 3866064 http://www.medworm.com/index.php?rid=3866063&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx6074j27850v6282%2F Abstract  Diverticular disease is one of the most prevalent gastrointestinal conditions to afflict Western populations. Although the majority of patients with diverticulosis remain asymptomatic, about one third will develop symptoms at some point in their lives. Symptomatic diverticular disease can range from chronic mild gastrointestinal distress to acute bouts of diverticulitis complicated by abscess or frank colonic perforation. The mainstay of treatment of symptomatic diverticular disease has long been bowel rest, antibiotics, and pain control, reserving surgery for those with complicated disease. This review discusses the epidemiology, pathophysiology, clinical presentation, and management of the spectrum of diverticular disease, including recent advances in the treatm... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3866063 Mon, 09 Aug 2010 05:44:59 +0100 3866063 http://www.medworm.com/index.php?rid=3866065&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw111211647668911%2F Abstract  Functional abdominal pain syndrome (FAPS) is a relatively less common functional gastrointestinal (GI) disorder defined by the presence of constant or frequently recurring abdominal pain that is not associated with eating, change in bowel habits, or menstrual periods (Drossman Gastroenterology 130:1377–1390, 2006), which points to a more centrally targeted (spinal and supraspinal) basis for the symptoms. However, FAPS is frequently confused with irritable bowel syndrome and other functional GI disorders in which abdominal pain is associated with eating and bowel movements. FAPS also differs from chronic abdominal pain associated with entities such as chronic pancreatitis or chronic inflammatory bowel disease, in which the pain is associated with peripherally acti... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3866065 Mon, 09 Aug 2010 05:44:56 +0100 3866065 http://www.medworm.com/index.php?rid=3832539&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fvu34r82682210354%2F Abstract  Ischemic colitis is the most common manifestation of ischemic injury to the gastrointestinal tract, and the variety of defined causes is increasing. Local hypoperfusion and reperfusion injury are both thought to contribute to the disease process, which manifests with a wide spectrum of injury including reversible colopathy (subepithelial hemorrhage and edema), transient colitis, chronic colitis, stricture, gangrene, and fulminant universal colitis. The distribution is typically segmental. Older studies showed that any portion of the colon can be involved; recently, it was established that the site of involvement and prognosis can be correlated. In particular, isolated involvement of the right side of the colon was shown to have a different presentation and worse o... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3832539 Fri, 06 Aug 2010 07:14:31 +0100 3832539 http://www.medworm.com/index.php?rid=3832540&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl7716636552l4022%2F Abstract  The non–white blood cell mesenchymal elements of the intestinal lamina propria are the myofibroblasts, fibroblasts, pericytes, stromal stem cells, muscularis mucosae, and the smooth muscle of the villus core associated with the lymphatic lacteal. We review the functional anatomy of these mesenchymal cells, what is known about their origin in the embryo and their replacement in adults, their putative role in intestinal mucosal morphogenesis, and the intestinal stem cell niche, and we consider new information about myofibroblasts as nonprofessional immune cells. Although our knowledge of the function of mesenchymal cells in intestinal disease is rudimentary, we briefly consider here their roles in cancer and intestinal inflammation. Content Type Journal Articl... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3832540 Fri, 06 Aug 2010 07:14:30 +0100 3832540 http://www.medworm.com/index.php?rid=3829219&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr261r22628250617%2F Content Type Journal ArticleCategory Clinical Trial ReportDOI 10.1007/s11894-010-0134-zAuthors Brooks D. Cash, 8901 Wisconsin Avenue, Building 9 Bethesda MD 20889 USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3829219 Wed, 04 Aug 2010 20:54:33 +0100 3829219 http://www.medworm.com/index.php?rid=3818545&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fgk17766q28u05350%2F Abstract  Self-renewal in the intestinal epithelia is fueled by a population of undifferentiated intestinal stem cells (ISCs) that give rise to daughter or progenitor cells, which can subsequently differentiate into the mature cell types required for normal gut function. The cellular signals that regulate self-renewal are poorly understood and the factors that mediate the transition from a stem cell to a progenitor cell in the gut are unknown. Recent studies have suggested that ISCs are located either at the crypt base interspersed between the Paneth cells (eg, Lgr-5+ve cells) or at or near position 4 within the intestinal crypt (eg, DCAMKL-1 or Bmi-1+ve cells). This raises the possibility that distinct stem cell regions exist in the crypts and that ISC’s state of activat... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3818545 Tue, 03 Aug 2010 17:28:30 +0100 3818545 http://www.medworm.com/index.php?rid=3800281&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv21j71772108657k%2F Abstract  Visceral hypersensitivity plays a key role in the pathogenesis of esophageal functional disorders such as functional heartburn and chest pain of presumed esophageal origin (noncardiac chest pain). About 80% of patients with unexplained noncardiac chest pain exhibit lower esophageal sensory thresholds when compared to controls during esophageal sensory testing (ie, esophageal barostat, impedance planimetry). Such information has led to prescription of peripherally and/or centrally acting therapies for the management of these patients. This review summarizes and highlights recent and significant findings regarding the pathophysiology, evaluation, and treatment of the hypersensitive esophagus, a central factor in functional esophageal disorders. Content Type Jour... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3800281 Wed, 28 Jul 2010 17:45:52 +0100 3800281 http://www.medworm.com/index.php?rid=3778349&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa9w561077867q685%2F Abstract  Colonoscopy requires adequate bowel cleansing to be safe and effective. Current options for preparation include dietary restrictions plus cathartics and purgatives, large-volume gut lavage solutions, and sodium phosphate preparations. Gut lavage with or without a stimulant laxative is safe and effective, and traditionally is taken the evening before the procedure. Sodium phosphate formulations also provide effective cleansing, but fluid and electrolyte disturbances can occur. Recent advances include split administration of gut lavage solutions—ingesting only half of the solution the evening prior to, and the rest the morning of, the procedure. Split administration can yield adequate preparations in inpatients, traditionally a difficult group for proper cleansing... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3778349 Mon, 19 Jul 2010 12:03:54 +0100 3778349 http://www.medworm.com/index.php?rid=3778350&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F287717w212167451%2F Abstract  Nearly two thirds of American adults are either overweight or obese. Accordingly, bariatric surgery experienced explosive growth during the past decade. Current estimates place the worldwide volume of bariatric procedures at greater than 300,000 cases annually. Micronutrient deficiencies are well-described following bariatric surgery, and they may present with devastating and sometimes irreversible neurologic manifestations. Clinical symptoms range from peripheral neuropathy to encephalopathy, and are most commonly caused by thiamine, copper, and B12 deficiencies. Content Type Journal ArticleDOI 10.1007/s11894-010-0120-5Authors Ali Kazemi, University of Louisville Department of Medicine Louisville KY USAThomas Frazier, University of Louisville Department of M... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3778350 Mon, 19 Jul 2010 12:03:28 +0100 3778350 http://www.medworm.com/index.php?rid=3715878&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa1h2nn2171118522%2F Abstract  The topic of perianal infections covers a broad range of illnesses that can be difficult to differentiate from each other. As a result, patients may suffer from unnecessary examinations and ineffective or delayed therapeutic interventions. This article reviews common and unusual infectious pathology and inflammatory or malignant conditions that should be considered in the differential diagnosis. Presentations of infectious pathology specific to HIV are discussed. New treatment strategies, where available, are noted. Content Type Journal ArticleDOI 10.1007/s11894-010-0115-2Authors Masood Mansour, Scripps Clinic Torrey Pines, Internal Medicine Resident PGY-3 10666 North Torrey Pines Road, 403 C La Jolla CA 92037 USALynn A. Weston, Scripps Clinic Torrey Pines De... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3715878 Tue, 29 Jun 2010 16:34:47 +0100 3715878 http://www.medworm.com/index.php?rid=3708269&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9712576571252401%2F Abstract  After many decades debating whether the clinical manifestations of patients with functional digestive symptoms originate “in their minds” or “in their guts,” arguments remain strong on both sides of the controversy. However, advances in understanding of gut physiology and pathophysiology, and persuasive evidence on the bidirectionality of the regulatory traffic between the enteric and central nervous systems, are helping to characterize clinical situations in which we can legitimately speak of gut dysfunction, as opposed to others where symptoms are not associated with apparent or detectable gut disturbances and may truly represent somatization of an affective disorder. In this review, we describe available clinically applicable technology, albeit in speci... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3708269 Mon, 28 Jun 2010 06:03:42 +0100 3708269 http://www.medworm.com/index.php?rid=3688792&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm01j78q261762w3u%2F Abstract  Obesity is a global epidemic and children are affected in increasing numbers. Overweight children are at increased risk of becoming overweight adults with associated chronic diseases. In this update, we present key findings from a review of the current literature focused on potential causes and strategies for preventing childhood obesity. We highlight recent evidence regarding the role of genetics, maternal body mass index, postnatal influences, and environmental effects throughout childhood in predicting overweight. We also summarize the results of new research that examined the effectiveness of intervention strategies implemented in a variety of settings: home, school, community, and health care system. Statements recently released by the Centers for Disease Con... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3688792 Sun, 20 Jun 2010 23:09:27 +0100 3688792 http://www.medworm.com/index.php?rid=3673802&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F661426384h7502x4%2F Abstract  Bariatric operations are increasingly being used to induce weight loss and ameliorate or cure most of the morbidities that accompany obesity. These procedures not only produce substantial weight loss (>50% body weight), but they cure or ameliorate the comorbidities (diabetes type 2, hypertension, sleep apnea, hyperlipidemia) in the vast majority of patients. These procedures can usually be performed laparoscopically with a mortality of less than 0.5% and a hospital stay of 1 to 3 days. Presently they are the only effective treatment for weight loss in the extremely obese patient (body mass index ≥ 35). Content Type Journal ArticleDOI 10.1007/s11894-010-0117-0Authors Clifford W. Deveney, Oregon Health and Science University Division of General Surger... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3673802 Thu, 17 Jun 2010 09:30:45 +0100 3673802 http://www.medworm.com/index.php?rid=3668330&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F585553247p34r054%2F Content Type Journal ArticleCategory Clinical Trial ReportDOI 10.1007/s11894-010-0114-3Authors Keith R. Miller, University of Louisville School of Medicine Department of Surgery Louisville KY USAStephen A. McClave, University of Louisville School of Medicine Department of Medicine Louisville KY USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3668330 Wed, 16 Jun 2010 07:18:41 +0100 3668330 http://www.medworm.com/index.php?rid=3650092&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2456264281182n44%2F Abstract  About 100 trillion microorganisms compose the microbiome of the gastrointestinal tract and are predominantly found within the colon. Until recently, few bacteria were thought to inhabit the normal healthy esophagus and stomach. However, contemporary studies using molecular techniques have contradicted these assumptions. In this review, we summarize the pertinent findings of these studies that demonstrate established, complex mixed-microbial communities within the foregut in both health and disease. These studies contribute to improved understanding of interactions between the host immunity and the microbiome that may ultimately allow for novel therapeutic targets. Content Type Journal ArticleDOI 10.1007/s11894-010-0111-6Authors R. Daniel Lawson, Naval Medica... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3650092 Mon, 07 Jun 2010 17:16:00 +0100 3650092 http://www.medworm.com/index.php?rid=3650094&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq03h6n212w574157%2F Abstract  Ileitis, or inflammation of the ileum, is often caused by Crohn’s disease. However, ileitis may be caused by a wide variety of other diseases. These include infectious diseases, spondyloarthropathies, vasculitides, ischemia, neoplasms, medication-induced, eosinophilic enteritis, and others. The clinical presentation of ileitis may vary from an acute and self-limited form of right lower quadrant pain and/or diarrhea, as in the majority of cases of bacterial ileitis, but some conditions (ie, vasculitis or Mycobacterium tuberculosis) follow a chronic and debilitating course complicated by obstructive symptoms, hemorrhage, and/or extraintestinal manifestations. Ileitis associated with spondylarthropathy or nonsteroidal anti-inflammatory drugs is typically subclinical... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3650094 Mon, 07 Jun 2010 17:15:58 +0100 3650094 http://www.medworm.com/index.php?rid=3650093&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq187m8h615140g51%2F Content Type Journal ArticleCategory Clinical Trial ReportDOI 10.1007/s11894-010-0118-zAuthors Walter J. Coyle, Scripps Clinic Torrey Pines Gastroenterology Fellowship Program Director, Division of Gastroenterology and Hepatology 10666 North Torrey Pines Road, N203 La Jolla CA 92037 USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3650093 Mon, 07 Jun 2010 17:15:58 +0100 3650093 http://www.medworm.com/index.php?rid=3650095&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F07705835t36jh70h%2F Abstract  Diarrhea is a symptom common to a wide variety of gastrointestinal illnesses, and is an important public health challenge in underdeveloped regions of the world. Normal intestinal absorption is a complex process. Recent research offers new insights into normal physiology and pathophysiology. The role of the enteric nervous system and neurotransmitters in the pathogenesis of diarrhea in inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) is being actively investigated. In patients with IBD, ileal and sigmoid biopsies showed altered transepithelial sodium and fluid transport, specifically from decreased expression of the NHE3, NHERF-1, and NHE1 epithelial Na channel. This results in changes in normal intestinal electroneutral NaCl absorption and may ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3650095 Mon, 07 Jun 2010 17:15:56 +0100 3650095 http://www.medworm.com/index.php?rid=3650096&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff192p1137466hxn7%2F Abstract  Since the original postmortem diagnosis of “intestinal lipodystrophy” by Dr. George H. Whipple in 1907, the complexities of Whipple’s disease have been elucidated through case reports. Universally fatal prior to the advent of antibiotics, Tropheryma whipplei is increasingly recognized as an organism that can be treated only if the clinician seeks to identify it. Whipple’s disease is primarily a gastrointestinal disease manifesting as a malabsorption syndrome, and is detected through endoscopy and intestinal biopsy. Nongastrointestinal manifestations of the disease, although less common, are reported and have aided in its recognition as a multiorgan disease entity. Because of its rarity, treatment recommendations are currently based on observational studies ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3650096 Mon, 07 Jun 2010 17:15:55 +0100 3650096 http://www.medworm.com/index.php?rid=3544247&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff7hv4243341614p6%2F Abstract  Pediatric feeding problems are common among children and present severe issues for families. Unfortunately, treatment outcome studies with this population are sparse. The current study reviews the literature regarding treatment studies of children with severe feeding issues, provides an overview of empirically supported treatments for children who do eat orally, and finally summarizes interventions that attempt to reintroduce oral feeding to children who have been fed by gastrostomy tube or other non-oral feeding route. Content Type Journal ArticleDOI 10.1007/s11894-010-0100-9Authors Ann McGrath Davis, University of Kansas Medical Center Department of Pediatrics 3901 Rainbow Boulevard, MS 4004 Kansas City KS 66160 USAAmanda Bruce, University of Kansas Medical... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3544247 Thu, 06 May 2010 08:03:54 +0100 3544247 http://www.medworm.com/index.php?rid=3531669&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk51029m97225463r%2F Content Type Journal ArticleCategory Clinical Trial ReportDOI 10.1007/s11894-010-0099-yAuthors Susan R. Orenstein, University of Pittsburgh School of Medicine Pediatric Gastroenterology 303 Church Lane Pittsburgh PA 15238 USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3531669 Sat, 01 May 2010 07:14:39 +0100 3531669 http://www.medworm.com/index.php?rid=3523516&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fbh3u98hl02706566%2F Abstract  Eosinophilic esophagitis (EoE) has emerged as an important cause of dysphagia and food impactions in young adults. Previously considered a rare condition, an increasing number of cases of EoE have been attributable to a rising incidence and a growing awareness of the condition. Typical endoscopic features include concentric mucosal rings, linear furrowing, white exudates, and a narrow caliber esophagus. Current consensus guidelines define EoE by 1) the presence of characteristic symptoms, especially dysphagia and food impactions in adults, 2) ≥ 15 eosinophils per high power field in esophageal tissue, and 3) exclusion of other disorders with similar presentations (eg, gastroesophageal reflux disease). Current knowledge about the pathophysiology implicates fo... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3523516 Thu, 29 Apr 2010 21:16:56 +0100 3523516 http://www.medworm.com/index.php?rid=3516833&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh1549qq01114x713%2F We describe well-known animal models, human syndromes, and associations involving EA/TEF, indicating its etiologically heterogeneous nature. Recent advances in genotyping technology and in knowledge of human genetic variation will improve clinical counseling on etiologic factors. This review provides a clinical summary of environmental and genetic factors involved in EA/TEF. Content Type Journal ArticleDOI 10.1007/s11894-010-0108-1Authors Elisabeth M. de Jong, Erasmus MC—Sophia Children’s Hospital Department of Pediatric Surgery PO Box 2060 3000 CB Rotterdam The NetherlandsJanine F. Felix, Erasmus MC—Sophia Children’s Hospital Department of Pediatric Surgery PO Box 2060 3000 CB Rotterdam The NetherlandsAnnelies de Klein, Erasmus MC Department of Clinical Genetics Rotter... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3516833 Wed, 28 Apr 2010 08:23:53 +0100 3516833 http://www.medworm.com/index.php?rid=3509375&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh0122j124w0u6157%2F This report reviews the scientific hypothesis, biologic plausibility, and the most recent clinical trial data for both areas of controversy. Content Type Journal ArticleDOI 10.1007/s11894-010-0103-6Authors David A. Johnson, Eastern Virginia Medical School Division of Gastroenterology 885 Kempsville Road, Suite 114 Norfolk VA 23505 USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3509375 Sat, 24 Apr 2010 08:10:12 +0100 3509375 http://www.medworm.com/index.php?rid=3509376&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1h03j78444856243%2F Abstract  Sclerosing cholangitis is a rare progressive cholestatic liver disease affecting the biliary tract. It may be associated with other diseases including autoimmune hepatitis, immunodeficiencies, cystic fibrosis, and sickle cell disease. Sclerosing cholangitis not associated with other diseases is termed “primary sclerosing cholangitis,” which has a strong association with male gender, Caucasian race, and inflammatory bowel disease. Diagnosis is based on typical biochemical, radiologic, and histologic features. Medical management is directed mainly at managing complications (pruritus, cholangitis, strictures, and nutritional deficiencies). Administration of ursodeoxycholic acid results in biochemical improvement, but has not been proven to prolong transplant-free ... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3509376 Sat, 24 Apr 2010 08:10:10 +0100 3509376 http://www.medworm.com/index.php?rid=3502239&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fjx02085655617511%2F This article reviews the recent advances in minimally invasive pediatric surgery, and the direction we foresee for the field. Content Type Journal ArticleDOI 10.1007/s11894-010-0109-0Authors Jeffrey A. Blatnik, University Hospitals Case Medical Center Department of General Surgery, Division of Pediatric Surgery 11100 Euclid Avenue Cleveland OH 44106-5047 USATodd A. Ponsky, University Hospitals Case Medical Center Department of General Surgery, Division of Pediatric Surgery 11100 Euclid Avenue Cleveland OH 44106-5047 USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3502239 Thu, 22 Apr 2010 09:28:54 +0100 3502239 http://www.medworm.com/index.php?rid=3502240&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F940p08506ju15376%2F Abstract  Gastrojejunal (GJ) tubes are increasingly used for enteral feeding in children in whom gastric feeding either is not tolerated or is contraindicated. The most common complications associated with GJ tube use are mechanical failure (clogging, cracking, deterioration) and dislodgement. Less common, but more significant, complications are bowel perforation, aspiration, and feeding intolerance. Some of these complications may be prevented by replacing GJ tubes at regular intervals. Methods to direct a GJ tube include 1) guidewire, 2) gastroduodenoscopy-guidewire, 3) esophagogastroduodenoscopy-forceps, and 4) fluoroscopy-guidewire. Clinical experience to determine the ideal method and optimal timing of GJ tube replacement is evolving. GJ tube replacement using a guidew... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3502240 Thu, 22 Apr 2010 09:28:53 +0100 3502240 http://www.medworm.com/index.php?rid=3495711&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd5k4030q2u872247%2F Abstract  The use of esophageal stents has been commonplace in adults for many years and for a variety of indications, including palliative care for malignant lesions involving the esophagus. The use of esophageal stents in the pediatric population, however, was limited by the inability to remove them and the implications this has for the growing child, especially for primarily benign esophageal lesions. With the advent of removable, covered stents, the potential uses for stents in children expanded to include treatment of a wide variety of congenital and acquired esophageal strictures. Stenting offers tremendous potential advantage over more traditional pneumatic or bougie dilation in its ability to provide continuous, radially oriented dilation pressure sustained over a p... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3495711 Wed, 21 Apr 2010 09:24:56 +0100 3495711 http://www.medworm.com/index.php?rid=3495712&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F58821w30642jx876%2F Abstract  Lung transplantation has become a valuable treatment for end-stage pulmonary disorders in an attempt to improve quality of life and extend survival. Development of chronic rejection, also known as bronchiolitis obliterans syndrome (BOS), is responsible for the vast majority of deaths after lung transplantation. Up to 50% of lung transplant patients develop BOS within the first 5 years after transplantation. A high prevalence of gastroesophageal reflux and aspiration of gastric components has been described after lung transplantation. Reflux and aspiration have been implicated in the development of BOS and antireflux surgery has been proposed; however, the causal relationship with BOS and the impact of reflux in lung transplantation survival needs to be furthe... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3495712 Wed, 21 Apr 2010 09:24:55 +0100 3495712 http://www.medworm.com/index.php?rid=3481648&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh1856210435q6027%2F Abstract  Proton pump inhibitors are highly successful in treating gastroesophageal reflux disease, but a significant proportion of patients have persistent symptoms from weakly or nonacidic reflux. Transient lower esophageal sphincter relaxation (TLESR) represents the dominant mechanism of gastroesophageal reflux and has therefore become the most intensely investigated therapeutic target. The triggering of TLESR involve the vagal pathways and the γ-aminobutyric type B (GABA(B)) and metabotropic glutamate type 5 (mGluR5) receptors. Baclofen is a GABA(B) receptor agonist that is effective in inhibiting TLESR and reducing the number of reflux episodes, but is associated with significant central nervous system (CNS) side effects. The newer GABA(B) agonists, such as AZD9343 an... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3481648 Wed, 14 Apr 2010 16:54:12 +0100 3481648 http://www.medworm.com/index.php?rid=3451085&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F802174601837377l%2F Abstract  Hemobilia is an uncommon medical problem that presents in a varied fashion and is increasingly of iatrogenic origin. The diagnosis of hemobilia needs to be considered in patients presenting with upper gastrointestinal bleeding, particularly if they are jaundiced with abdominal pain in the setting of recent or previous percutaneous liver intervention or abdominal trauma. Multislice computed tomographic angiography is increasingly being used in the investigation, but transcatheter arterial embolization remains the cornerstone of managing those patients requiring intervention. The majority of patients with hemobilia will be managed supportively or with radiologic intervention; most do not require surgical intervention. Content Type Journal ArticleDOI 10.1007/s118... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3451085 Mon, 05 Apr 2010 21:36:31 +0100 3451085 http://www.medworm.com/index.php?rid=3386409&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa05jx60876103331%2F Abstract  Acute pancreatitis is a common cause for hospitalization that carries a substantial burden of disease in the United States and worldwide. Recent reports have encompassed a wide array of topics including new insights into the acinar cell pH microenvironment, signal pathways for acinar cell fate, and the innate immune response. Clinical researchers have reported new methods to assess disease severity, innovative techniques for management of local complications, the importance of early recognition of pancreatic or extrapancreatic infection, and prevention of disease recurrence. Recent data also suggest that specialized centers may be of benefit for the management of severe acute pancreatitis. This review summarizes a number of recent advances in basic and clinical sc... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3386409 Thu, 18 Mar 2010 15:26:16 +0100 3386409 http://www.medworm.com/index.php?rid=3371714&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fbvp2x844k4464524%2F This article reviews the recognized findings, advantages, and disadvantages of the various imaging modalities in the management of chronic pancreatitis, specifically CT, MRI with or without MRCP and/or S-MRCP, ERCP, and EUS. Content Type Journal ArticleDOI 10.1007/s11894-010-0093-4Authors Nabil Elia Choueiri, Saint Louis University Health Sciences Center Division of Gastroenterology and Hepatology 3635 Vista Avenue at Grand Boulevard, 9th Floor Saint Louis MO 63110 USANuman Cem Balci, Saint Louis University Health Sciences Center Department of Radiology St. Louis MO USASamer Alkaade, Saint Louis University Health Sciences Center Division of Gastroenterology and Hepatology 3635 Vista Avenue at Grand Boulevard, 9th Floor Saint Louis MO 63110 USAFrank R. Burton, Saint Louis Universit... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3371714 Mon, 15 Mar 2010 18:00:22 +0100 3371714 http://www.medworm.com/index.php?rid=3371715&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj40x68n65792v71v%2F Abstract  Many childhood pancreatic disorders are rare, although they can represent significant and potentially severe disease. The spectrum of disease is very broad, ranging from the complex and bizarre congenital anomalies to the more typical acquired causes (eg, drug-induced pancreatitis or trauma injury). Genetics appears to play a major role in many childhood pancreas diseases, unlike adults where alcohol is a major factor. Nevertheless, there are similarities, and most of the disorders discussed here can be found in both the pediatric and adult age groups. Some of these disorders may be evolving and may be seen in both young and older patients. Newer imaging modalities and therapeutic endoscopy continue to be studied, although their ultimate role and utility in childr... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3371715 Mon, 15 Mar 2010 18:00:15 +0100 3371715 http://www.medworm.com/index.php?rid=3360809&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa521264v10842867%2F Abstract  Both autoimmune pancreatitis (AIP) and pancreatic cancer frequently present with obstructive jaundice. However, AIP is a rare disease and its diagnosis carries vastly different therapeutic and prognostic implications compared with that of pancreatic cancer. The clinical challenge is to distinguish AIP from pancreatic cancer, because the price of misdiagnosis can be heavy. Recently, two strategies for differentiating AIP from pancreatic cancer were published, one from Japan and the other from the United States. The Japanese strategy relies on cross-sectional imaging, endoscopic retrograde pancreatogram, and serum IgG4. The American strategy uses imaging (CT scan), serology (serum IgG4), and evidence of other organ involvement (on CT scan) as the first tier of tests... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3360809 Thu, 11 Mar 2010 18:26:57 +0100 3360809 http://www.medworm.com/index.php?rid=3360810&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg6j6n7064144254r%2F This article reviews current guidelines for the evaluation of pancreatic cystic lesions, underscores the challenges posed by these lesions, and discusses current and future studies that will aid in patient management. Content Type Journal ArticleDOI 10.1007/s11894-010-0097-0Authors Brian G. Turner, Massachusetts General Hospital Gastroenterology Unit, 55 Fruit Street Boston MA 02114 USAWilliam R. Brugge, Massachusetts General Hospital Gastroenterology Unit, 55 Fruit Street Boston MA 02114 USA Journal Current Gastroenterology ReportsOnline ISSN 1534-312XPrint ISSN 1522-8037 (Source: Current Gastroenterology Reports) Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3360810 Thu, 11 Mar 2010 02:24:27 +0100 3360810 http://www.medworm.com/index.php?rid=3360812&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp06v5556h5w7h145%2F Abstract  Sphincter of Oddi dysfunction (SOD) is a poorly-understood disorder, typically presenting as postcholecystectomy, “biliary-type,” right-sided abdominal and/or chest wall pain. Most patients referred to specialist clinics for work-up of presumed SOD do not, in fact, have anything wrong with their bile ducts or biliary sphincter mechanisms. A careful history and focused physical examination will often identify the true source of the pain syndrome, ranging from chest wall costochondritis and nerve injury at surgical trochar sites, to gastroparesis and visceral hypersensitivity (“irritable bowel”). The Rome III classification of functional gallbladder and biliary disorders defines SOD as episodic (not daily) pain lasting more than 30 min, which is disrupt... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3360812 Thu, 11 Mar 2010 02:24:24 +0100 3360812 http://www.medworm.com/index.php?rid=3360811&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fyqu43665046q5290%2F Abstract  Current methods for imaging the biliary tree include ultrasound, CT, MRI, endoscopic retrograde cholangiography, and endoscopic ultrasound (EUS). Bile duct abnormalities may be identified during evaluation of patient symptoms or laboratory abnormalities, or incidentally during imaging for another problem. Biliary dilatation, when identified, may be separated into obstructive or nonobstructive causes. Clinical presentation should guide decisions on which, if any, additional investigations are necessary. Choledocholithiasis is the most common cause of obstructive dilatation and frequently requires decompression. Nonobstructive causes include cystic dilatation, aging, and possibly post-cholecystectomy state. Data are limited regarding the yield of further investigati... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3360811 Thu, 11 Mar 2010 02:24:24 +0100 3360811 http://www.medworm.com/index.php?rid=3360813&cid=s_35933_17_f&fid=35933&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft571r2w10p778t78%2F Abstract  Endoscopic retrograde cholangiopancreatography (ERCP) is the most technically challenging procedure routinely performed by endoscopists. ERCP cannulation requires the insertion of a subcentimeter catheter through a tiny orifice at a distance of almost a meter from the operator. Only after successful cannulation of the bile duct can the real “business” of ERCP be performed (eg, sphincterotomy, stone extraction, stent placement). Selective bile duct cannulation is all the more exacting due to the occasional anatomic challenge (eg, postsurgical anatomy, duodenal stricture) or wayward catheter. Serious morbid complications can and do occur, even in the hands of the most gifted and facile endoscopists. Although there are some “tricks” to facilitate successful c... Current Gastroenterology Reports journals http://www.medworm.com/rss/comments.php?id=3360813 Wed, 10 Mar 2010 16:20:22 +0100 3360813