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 'Gastroenterology Clinics of North America' source. Sun, 21 Mar 2010 15:08:01 +0100 http://www.medworm.com/index.php?rid=3328652&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855310000105%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328652 Mon, 01 Mar 2010 00:00:00 +0100 3328652 http://www.medworm.com/index.php?rid=3328651&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001253%2Fabstract%3Frss%3Dyes Follow-up of the large numbers of patients undergoing bariatric surgery poses problems for surgical programs and for internists who care for morbidly obese patients. Early surgical follow up is concentrated on the perioperative period to ensure healing and care for any surgical complications. It is especially important to treat persistent vomiting to avoid thiamine deficiency. Subsequently, monitoring weight loss and resolution of comorbidities assumes more importance. Identification and management of nutritional deficiencies and other unwanted consequences of surgery may become the responsibility of internists if the patient no longer attends the office of the operating surgeon. The long-term goal is to avoid weight regain and deficiencies, especially of protein, iron and vitamin B12, and... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328651 Mon, 01 Mar 2010 00:00:00 +0100 3328651 http://www.medworm.com/index.php?rid=3328650&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001241%2Fabstract%3Frss%3Dyes The disease of obesity has continued to increase in the United States. Obesity is defined as a body mass index (BMI) greater than 30 kg/m2. In 1991, the National Institute of Health Consensus Panel on Gastric Surgery for Severe Obesity defined the population who would most likely benefit from bariatric surgery. These same criteria continue to be used today to determine which patients should undergo metabolic and weight loss surgery. These recommendations include patients who have a BMI greater than 35 kg/m2 with significant comorbid conditions such as diabetes, hypertension, or obstructive sleep apnea; and patients who have a BMI greater than 40 kg/m2 with or without any significant comorbid conditions because they have a significant increased risk for developing these conditions. (Source:... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328650 Mon, 01 Mar 2010 00:00:00 +0100 3328650 http://www.medworm.com/index.php?rid=3328649&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001174%2Fabstract%3Frss%3Dyes Bariatric surgery has become an increasingly important method for management of medically complicated obesity. In patients who have undergone bariatric surgery, up to 87% with type 2 diabetes mellitus develop improvement or resolution of their disease postoperatively. Bariatric surgery can reduce the number of absorbed calories through performance of either a restrictive or a malabsorptive procedure. Patients who have undergone bariatric surgery require indefinite, regular follow-up care by physicians who need to follow laboratory parameters of macronutrient as well as micronutrient malnutrition. Physicians who care for patients after bariatric surgery need to be familiar with common postoperative syndromes that result from specific nutrient deficiencies. (Source: Gastroenterology Clinics ... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328649 Mon, 01 Mar 2010 00:00:00 +0100 3328649 http://www.medworm.com/index.php?rid=3328648&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001228%2Fabstract%3Frss%3Dyes This article discusses the different options available for endoscopists who are faced with the need to perform endoscopic retrograde cholangiopancreatography in patients after Roux-en-Y reconstruction, with special emphasis on those after RYGB. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328648 Mon, 01 Mar 2010 00:00:00 +0100 3328648 http://www.medworm.com/index.php?rid=3328647&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS088985530900123X%2Fabstract%3Frss%3Dyes This article reviews the special risks that obese patients face while undergoing endoscopy, endoscopic management of patients postbariatric surgery, and future role of endoscopy in the management of obese patients. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328647 Mon, 01 Mar 2010 00:00:00 +0100 3328647 http://www.medworm.com/index.php?rid=3328646&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001265%2Fabstract%3Frss%3Dyes This article discusses the factors that a gastroenterologist should assess before the surgery. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328646 Mon, 01 Mar 2010 00:00:00 +0100 3328646 http://www.medworm.com/index.php?rid=3328645&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855310000026%2Fabstract%3Frss%3Dyes This article examines the transitions in pharmacological therapy for obesity. It reviews the current options approved by the Food and Drug Administration and several drugs approved for other indications that can be used to treat obesity as well. Because weight regulation is complex and redundant systems protect against perceived starvation, optimal treatment of obesity in individual patients will likely require different combinations of behavioral, nutritional, pharmacologic, endoscopic, and surgical therapies. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328645 Mon, 01 Mar 2010 00:00:00 +0100 3328645 http://www.medworm.com/index.php?rid=3328644&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001150%2Fabstract%3Frss%3Dyes This article reviews mechanisms that mediate the pathogenesis of obesity-related liver disease, summarizes clinical evidence that demonstrates obesity-related liver disease can be life-threatening, and discusses whether or not treatments for obesity or related comorbidities impact liver disease outcomes. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328644 Mon, 01 Mar 2010 00:00:00 +0100 3328644 http://www.medworm.com/index.php?rid=3328643&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001198%2Fabstract%3Frss%3Dyes Obesity is a risk factor for colorectal cancer and adenomatous polyps. The increased prevalence of neoplasia coupled with the observation that obesity may be associated with a suboptimal bowel preparation may diminish the adequate detection of adenomas for obese who undergo colonoscopy. The colonic complications of obesity are reviewed in this article. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328643 Mon, 01 Mar 2010 00:00:00 +0100 3328643 http://www.medworm.com/index.php?rid=3328642&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001162%2Fabstract%3Frss%3Dyes Gastroesophageal reflux disease (GERD) is a common condition, with multifactorial pathogenesis, affecting up to 40% of the population. Obesity is also common. Obesity and GERD are clearly related, both from a prevalence and causality association. GERD symptoms increase in severity when people gain weight. Obese patients tend to have more severe erosive esophagitis and obesity is a risk factor for the development of Barrett's esophagus and adenocarcinoma of the esophagus. Patients report improvement in GERD when they lose weight and there are several reports suggesting a decrease in GERD symptoms after bariatric surgery. At present, there is little evidence that obesity has any effect on the efficacy of antisecretory therapy, with conflicting data on surgical outcomes. This review attempts ... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328642 Mon, 01 Mar 2010 00:00:00 +0100 3328642 http://www.medworm.com/index.php?rid=3328641&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001204%2Fabstract%3Frss%3Dyes Obesity is a leading cause of illness and death worldwide. It is a risk factor for many common gastrointestinal symptoms and digestive disorders, including many cancers. Disruption of mechanisms that regulate appetite and satiety are fundamental to the development of obesity. Knowledge of these issues that are discussed in this article will provide the basis to develop health strategies to prevent obesity-related diseases. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328641 Mon, 01 Mar 2010 00:00:00 +0100 3328641 http://www.medworm.com/index.php?rid=3328640&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001216%2Fabstract%3Frss%3Dyes Until recently, the epidemiology of gastrointestinal (GI) symptoms had not been adequately studied in relation to increasing body mass index. To date there are only a few studies in the literature, and thus the relationship between obesity and specific GI symptoms is poorly understood. Future studies that incorporate different ethnicities from varied geographic locations are urgently required. A greater understanding of how GI symptoms are related to obesity and the physiology will be important in the clinical management of these patients. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328640 Mon, 01 Mar 2010 00:00:00 +0100 3328640 http://www.medworm.com/index.php?rid=3328639&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001289%2Fabstract%3Frss%3Dyes This article describes some of the epidemiologic features of obesity, including global prevalence, secular trends, risk factors, and burden of illness related to obesity with special emphasis on obesity trends in the United States. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328639 Mon, 01 Mar 2010 00:00:00 +0100 3328639 http://www.medworm.com/index.php?rid=3328638&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001277%2Fabstract%3Frss%3Dyes Obesity has emerged as a major global health problem with disease prevalence reaching epidemic proportions. In the United States alone, obesity is responsible for more than 300,000 deaths per year. Additionally, the direct and indirect related costs for care of obesity-related disease exceed $100 billion per year. Obesity has a particular relevance to gastroenterologists given the wide spectrum of causally related disease implications specific to this specialty. It is increasingly apparent that obesity has significant implications for gastrointestinal diseases and increased risks of serious consequences, including cancer. Gastroenterologists are increasingly involved in the care of obese and overweight patients. This involvement includes assessing for appropriate screening for neoplasia, a... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328638 Mon, 01 Mar 2010 00:00:00 +0100 3328638 http://www.medworm.com/index.php?rid=3328637&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855310000099%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328637 Mon, 01 Mar 2010 00:00:00 +0100 3328637 http://www.medworm.com/index.php?rid=3328636&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855310000087%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328636 Mon, 01 Mar 2010 00:00:00 +0100 3328636 http://www.medworm.com/index.php?rid=3328635&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855310000075%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=3328635 Mon, 01 Mar 2010 00:00:00 +0100 3328635 http://www.medworm.com/index.php?rid=2986666&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS088985530900106X%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986666 Fri, 13 Nov 2009 14:14:17 +0100 2986666 http://www.medworm.com/index.php?rid=2986665&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000752%2Fabstract%3Frss%3Dyes Crohn disease often recurs after surgical resection. Despite extensive research in the prevention of postoperative Crohn disease, optimal management strategies have yet to be defined. Risk of disease recurrence needs to be carefully balanced against potential risks associated with treatment. Patients with low risk of postoperative recurrence may not require medication, whereas those at moderate risk may benefit from antibiotics or immunomodulators. Those at highest risk of recurrence may benefit from biologic therapy for maintenance of surgical remission. Postoperative colonoscopy within 1 year of resective surgery is important for identification of disease recurrence and modification of medications. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986665 Fri, 13 Nov 2009 14:14:17 +0100 2986665 http://www.medworm.com/index.php?rid=2986664&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000892%2Fabstract%3Frss%3Dyes Inflammatory bowel disease remains a complex disease with variable clinical presentations and often nonspecific symptoms. Physicians must rely on diagnostic tools for clarification of disease diagnosis and for guiding management of patients with established disease. Advances in radiologic imaging modalities facilitate early and accurate detection of luminal disease and extraluminal complications. The introduction and dissemination of small bowel capsule endoscopy and double-balloon enteroscopy permit detailed visualization and sampling of the mucosa throughout the entire bowel. Serologic biomarkers are evolving as a valuable tool to clarify diagnosis and stratify patients by disease phenotypes and patterns of behavior. Neutrophil-derived fecal biomarkers are emerging as useful surrogate ma... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986664 Fri, 13 Nov 2009 14:14:16 +0100 2986664 http://www.medworm.com/index.php?rid=2986663&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000703%2Fabstract%3Frss%3Dyes This article summarizes the available literature on the impact of C difficile infection on IBD and discusses the various diagnostic testing and treatment options available. Also reviewed are clinical situations specific to patients with IBD that are important for the treating physician to recognize. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986663 Fri, 13 Nov 2009 14:14:16 +0100 2986663 http://www.medworm.com/index.php?rid=2986662&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000727%2Fabstract%3Frss%3Dyes Over the last decade, the medical treatment of inflammatory bowel disease (IBD) has been revolutionized, with increasing use of both immunomodulatory and biologic medications. Corticosteroids have increasingly been associated with an elevated risk of serious and opportunistic infections, both independently and in combination with immunomodulator and biologic agents. There are limited data on the infectious risk of immunomodulators. It is unclear if anti-tumor necrosis factor agents increase overall infectious risk in patients with IBD, but the available literature has demonstrated an increased risk of opportunistic infections, particularly in terms of tuberculosis and histoplasmosis. Combination therapy likely increases the risk of opportunistic infections in patients with IBD but this has... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986662 Fri, 13 Nov 2009 14:14:16 +0100 2986662 http://www.medworm.com/index.php?rid=2986661&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000715%2Fabstract%3Frss%3Dyes This article describes the cancer risks of commonly used inflammatory bowel disease (IBD) medications, with an emphasis on hematologic malignancy risks. The increasing use of immunosuppressant therapies in the treatment of IBD has raised this question to an even greater importance. Studies evaluating these medications are complicated due to varying disease severity and concomitant use of other immunosuppressant medication. The potential risks of all therapies must be weighed against the benefits these therapies can offer these patients. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986661 Fri, 13 Nov 2009 14:14:16 +0100 2986661 http://www.medworm.com/index.php?rid=2986660&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000697%2Fabstract%3Frss%3Dyes Restorative proctocolectomy with ileal pouch-anal anastomosis has become the surgical treatment of choice for most patients with ulcerative colitis who require surgery. Although the surgical procedure offers a cure in some patients, postoperative inflammatory and noninflammatory complications are common. Pouchitis is the most common long-term complication of the procedure. Pouchitis represents a spectrum of disease processes with heterogeneous risk factors, clinical phenotypes, natural history, and prognosis. Accurate diagnosis and classification are important for proper treatment and prognosis. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986660 Fri, 13 Nov 2009 14:14:16 +0100 2986660 http://www.medworm.com/index.php?rid=2986659&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000739%2Fabstract%3Frss%3Dyes This review covers important questions that arise for physicians caring for women with inflammatory bowel disease. Fertility, pregnancy outcomes and the safety of medications in pregnancy and lactation are discussed. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986659 Fri, 13 Nov 2009 14:14:16 +0100 2986659 http://www.medworm.com/index.php?rid=2986658&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000764%2Fabstract%3Frss%3Dyes This article discusses clinically relevant epidemiology and treatment aspects of pediatric IBD, with special focus on similarities and differences in pediatric and adult IBD. Evidence-based treatment algorithms, with special focus on pediatric studies and care for children, are also highlighted. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986658 Fri, 13 Nov 2009 14:14:16 +0100 2986658 http://www.medworm.com/index.php?rid=2986657&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000880%2Fabstract%3Frss%3Dyes Fistulas manifest frequently in Crohn disease and can result in significant morbidity and often lead to the need for surgical intervention. Historically, it has been more difficult to obtain complete fistula closure in patients with perianal Crohn disease. Anti-tumor necrosis factor-alpha agents and the use of more accurate imaging modalities such as magnetic resonance imaging and rectal endoscopic ultrasound have enhanced the ability to manage fistulizing Crohn disease. A combined medical and surgical approach usually presents the best option for most patients. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986657 Fri, 13 Nov 2009 14:14:16 +0100 2986657 http://www.medworm.com/index.php?rid=2986656&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000740%2Fabstract%3Frss%3Dyes This article provides an overview of the current approaches to therapy for CD and UC and focuses on the evidence supporting the rationale for changing paradigms in the management of IBD, including mucosal healing as an end point and earlier use of immunosuppressive and biologic agents, particularly in CD (so-called top-down therapy). (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986656 Fri, 13 Nov 2009 14:14:16 +0100 2986656 http://www.medworm.com/index.php?rid=2986655&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000983%2Fabstract%3Frss%3Dyes We are honored to serve as the editors for this issue of Gastroenterology Clinics of North America titled “Challenges in Inflammatory Bowel Disease.” The authors comprise a distinguished group of physician scientists and clinicians who are leaders in the field of inflammatory bowel disease (IBD). In this issue, they share their insights and expertise into how they manage challenging IBD presentations. We believe this issue provides an invaluable consulting reference for all health care providers. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986655 Fri, 13 Nov 2009 14:14:16 +0100 2986655 http://www.medworm.com/index.php?rid=2986654&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001058%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986654 Fri, 13 Nov 2009 14:14:16 +0100 2986654 http://www.medworm.com/index.php?rid=2986653&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309001046%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2986653 Fri, 13 Nov 2009 14:14:16 +0100 2986653 http://www.medworm.com/index.php?rid=2721727&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000843%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721727 Sat, 22 Aug 2009 10:24:51 +0100 2721727 http://www.medworm.com/index.php?rid=2721726&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000673%2Fabstract%3Frss%3Dyes This article reviews the alterations in pharmacokinetic disposition of medications that occur with aging and highlights the pharmacology of commonly used GI drugs. Selected GI conditions that are drug induced and preventable are identified, and recommendations for GI drugs to be avoided in older adults are provided. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721726 Sat, 22 Aug 2009 10:24:51 +0100 2721726 http://www.medworm.com/index.php?rid=2721725&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000661%2Fabstract%3Frss%3Dyes This article focuses on two of the less commonly diagnosed diseases: solitary rectal ulcer syndrome and stercoral ulceration, both related to local tissue ischemia and often seen in the elderly population. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721725 Sat, 22 Aug 2009 10:24:51 +0100 2721725 http://www.medworm.com/index.php?rid=2721724&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000582%2Fabstract%3Frss%3Dyes This article reviews the clinical spectrum of mesenteric ischemia in the elderly with particular emphasis on the varied presentations, evaluation, and management of ischemic disorders of the intestines. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721724 Sat, 22 Aug 2009 10:24:51 +0100 2721724 http://www.medworm.com/index.php?rid=2721723&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000600%2Fabstract%3Frss%3Dyes Colonic diverticulosis is a common, usually asymptomatic, entity of Western countries, with an incidence that increases with age. When these diverticula become infected and inflamed, patients can present with a wide variety of clinical manifestations. Management of acute, uncomplicated diverticulitis can often be treated successfully with antibiotics alone and the decision to proceed with more aggressive measures such as surgical intervention is made on a case-by-case basis. The treatment algorithm for diverticular disease continues to evolve as the pathophysiology, etiology, and natural history of the disease becomes better understood. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721723 Sat, 22 Aug 2009 10:24:50 +0100 2721723 http://www.medworm.com/index.php?rid=2721722&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000636%2Fabstract%3Frss%3Dyes Fecal incontinence affects up to 20% of community-dwelling adults and more than 50% of nursing home residents, and is one of the major risk factors for elderly persons in the nursing home. Institutionalization itself is a risk factor (eg, immobility due to physical restraints). Management should focus on identifying and treating underlying causes, such as diet- or medication induced diarrhea, constipation, and fecal impaction. Use of absorbent pads and special undergarments is useful. Anorectal physiologic testing of nursing home residents has revealed an association between constipation, stool retention, and fecal incontinence. Impaired sphincter function (risk factor for fecal incontinence), decreased rectal sensation, and sphincter dyssynergia (risk factor for constipation and impaction... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721722 Sat, 22 Aug 2009 10:24:47 +0100 2721722 http://www.medworm.com/index.php?rid=2721721&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000648%2Fabstract%3Frss%3Dyes This article reviews the impact of diarrhea in the elderly, many of whom are less fit physiologically to withstand the effect of diarrhea on fluid balance and nutritional balance. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721721 Sat, 22 Aug 2009 10:24:47 +0100 2721721 http://www.medworm.com/index.php?rid=2721720&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000570%2Fabstract%3Frss%3Dyes Chronic constipation is a common problem in the elderly, with a variety of causes, including pelvic floor dysfunction, medication effects, and numerous age-specific conditions. A stepwise diagnostic and therapeutic approach to patients with chronic constipation based on historical and physical examination features is recommended. Prudent use of fiber supplements and laxative agents may be helpful for many patients. Based on their capabilities, patients with pelvic floor dysfunction should be considered for pelvic floor rehabilitation (biofeedback), although efficacy in the elderly is uncertain. Clinical awareness and focused testing to identify the physiologic abnormalities underlying constipation, while being mindful of situations unique to the elderly, facilitate management, and improve ... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721720 Sat, 22 Aug 2009 10:24:47 +0100 2721720 http://www.medworm.com/index.php?rid=2721719&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000624%2Fabstract%3Frss%3Dyes This article reviews the epidemiology, clinical manifestations, diagnosis, prognosis, and treatment of inflammatory bowel disease (IBD), which will grow in prevalence as the population ages. Prognosis of late-onset ulcerative colitis (UC) is generally similar to that of early-onset UC, whereas in Crohn disease it is probably better because of a tendency for colonic involvement. Disease complications are related more to the duration of the inflammatory bowel disease than the subject's current age. The diagnosis in elderly patients can be challenging due to the large number of conditions that mimic IBD on radiologic, endoscopic, and histologic testing. Distinguishing these conditions from IBD will significantly alter prognosis and treatment. Complications related to IBD and its treatment are... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721719 Sat, 22 Aug 2009 10:24:47 +0100 2721719 http://www.medworm.com/index.php?rid=2721718&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000612%2Fabstract%3Frss%3Dyes It has become apparent recently that celiac disease, once believed to be primarily a childhood disease, can affect people of any age. Epidemiologic studies have suggested that a substantial portion of patients are diagnosed after the age of 50. Indeed, in one study, the median age at the diagnosis was just under the age of 50 with one-third of new patients diagnosed being older than 65 years. The purpose of this review is to address the prevalence, clinical features, diagnosis, and consequences of celiac disease in the elderly. The authors also review management strategies for celiac disease and adjust these with emphasis on the particular nutritional and nonnutritional consequences or associations of celiac disease as they pertain to the elderly. (Source: Gastroenterology Clinics of North... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721718 Sat, 22 Aug 2009 10:24:47 +0100 2721718 http://www.medworm.com/index.php?rid=2721717&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000594%2Fabstract%3Frss%3Dyes Although the aging process per se can produce measurable changes in the normal oropharyngeal swallow, these changes alone are rarely sufficient to cause clinically apparent dysphagia. The causes of oropharyngeal dysphagia in the elderly are predominantly neuromyogenic, with the most common cause being stroke. The evaluation of oropharyngeal dysphagia in the elderly involves early exclusion of structural abnormalities, detection of aspiration by videofluoroscopy which might dictate early introduction of nonoral feeding, and exclusion of underlying systemic and neuromyogenic causes that have specific therapies in their own right. Such conditions include Parkinson disease, myositis, myasthenia, and thyrotoxicosis. Management is best delivered by a multidisciplinary team involving physician, s... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721717 Sat, 22 Aug 2009 10:24:47 +0100 2721717 http://www.medworm.com/index.php?rid=2721716&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS088985530900065X%2Fabstract%3Frss%3Dyes This article provides a brief overview of the prevalence and consequences of undernutrition, age-related changes to appetite, food intake, and body composition, the factors contributing to the development of anorexia and undernutrition, and recommended management strategies. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721716 Sat, 22 Aug 2009 10:24:47 +0100 2721716 http://www.medworm.com/index.php?rid=2721715&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000685%2Fabstract%3Frss%3Dyes This issue of the Gastroenterology Clinics of North America devoted to gastroenterology in the elderly is timely and important, because the evidence is overwhelming: the demographics of the population in the United States and worldwide are rapidly changing, with a growing proportion of older people. With this change will come an accentuation of many clinical disease states. Baby boomers have just started to retire; by the year 2030, there will be 27 million people aged 65 years and older in the United States. Their maladies, along with their desire to stay young and healthy, create a tension that only intensifies with each passing year, and gastroenterologists will need to be able to expertly tackle their relevant medical issues. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721715 Sat, 22 Aug 2009 10:24:47 +0100 2721715 http://www.medworm.com/index.php?rid=2721714&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000831%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721714 Sat, 22 Aug 2009 10:24:47 +0100 2721714 http://www.medworm.com/index.php?rid=2721713&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS088985530900082X%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2721713 Sat, 22 Aug 2009 10:24:47 +0100 2721713 http://www.medworm.com/index.php?rid=2419193&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000491%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419193 Tue, 19 May 2009 17:29:50 +0100 2419193 http://www.medworm.com/index.php?rid=2419192&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000375%2Fabstract%3Frss%3Dyes Despite improved understanding of peptic ulcer disease (PUD) pathogenesis, advances in diagnostic modalities, and the availability of modern pharmalogical, endoscopic and surgical treatments, gastroduodenal ulcer remains a major cause of morbidity and mortality worldwide. The predominant risk factors of this disorder remain Helicobacter pylori and ulcerogenic drugs. However, the proportion of idiopathic PUD is increasing worldwide often coinciding with the declining prevalence of H pylori infection. PUD heterogeneity worldwide is due to host genetic, bacterial and environmental factors. Variable ages in the acquisition of H pylori may influence the distribution of gastric versus duodenal ulcers as has the increasing use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs). Pharmac... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419192 Tue, 19 May 2009 17:29:49 +0100 2419192 http://www.medworm.com/index.php?rid=2419191&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000314%2Fabstract%3Frss%3Dyes A vast majority of ulcers of the stomach and duodenum are due to H pylori infection or nonsteroidal anti-inflammatory drug (NSAID) usage. In patients with apparent H pylori negative NSAID negative ulcers, it is essential to ensure that the H pylori tests are not falsely negative and that the patient is not taking mucosal damaging drugs unknowingly. There are a variety of rare causes of true H pylori negative NSAID negative ulcers which need to be considered, including underlying cancer/lymphoma, Crohn's disease, rare infections and the Zollinger Ellison syndrome. Patients with idiopathic ulcers should be maintained on proton pump inhibitor therapy and may require higher doses than traditionally used in H pylori positive ulcers. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419191 Tue, 19 May 2009 17:29:48 +0100 2419191 http://www.medworm.com/index.php?rid=2419190&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS088985530900034X%2Fabstract%3Frss%3Dyes Nonsteroidal anti-inflammatory drug (NSAID)-associated intestinal damage to the small and/or large bowel is frequent and may be present in up to 60% to 70% of patients taking these drugs long term. Intestinal damage is subclinical in most cases (eg, increased mucosal permeability, inflammation, erosions, ulceration), but more serious clinical outcomes, such as anemia and overall bleeding, perforation, obstruction, diverticulitis, and deaths, have also been described. Recent data suggest that serious lower gastrointestinal (GI) clinical events linked to NSAID use may be as frequent and severe as upper GI complications. Treatment and prevention strategies of NSAID-induced damage to the lower GI tract have not been defined so far. Misoprostol, antibiotics, and sulphasalazine have been proven ... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419190 Tue, 19 May 2009 17:29:47 +0100 2419190 http://www.medworm.com/index.php?rid=2419189&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000284%2Fabstract%3Frss%3Dyes Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for treatment of pain and inflammation, despite their association with gastrointestinal complications, including bleeding and perforation. Inhibition of cyclooxygenases (COXs), is the main mechanism of action of aspirin and NSAIDs. Inhibition of COX-1 derived prostanoids in the stomach represent the underlying mechanism involved in development of gastric and duodenal ulcers in patients taking NSAIDs. Selective COX-2 inhibitors (coxibs) spare the gastrointestinal tract, but their use increases the risk of heart attack and stroke. In addition to prostanoids, two gaseous mediators, nitric oxide (NO) and hydrogen sulfide (H2S) exert protective effects in the gastric mucosa. In rodent model administration of NO donors attenuate... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419189 Tue, 19 May 2009 17:29:43 +0100 2419189 http://www.medworm.com/index.php?rid=2419188&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000338%2Fabstract%3Frss%3Dyes The recognition that nonsteroidal anti-inflammatory drugs (NSAIDs) increase not only gastrointestinal (GI) but cardiovascular (CV) adverse events as well has created a dilemma for practicing physicians. Clinicians selecting appropriate NSAID therapy must estimate each patient's baseline risk for both (GI) and (CV) adverse events, and then estimate the impact of each medication (and its dose) for the individual patient. To synthesize a rational current treatment approach, we have developed a 2×2 table to guide NSAID medication choice, considering the use of concomitant aspirin as well as gastroprotective therapy. COX-2 inhibitors were an important scientific advance in pain therapy, and using them in a safe and cost-effective manner is possible when all the competing risks are carefully we... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419188 Tue, 19 May 2009 17:29:43 +0100 2419188 http://www.medworm.com/index.php?rid=2419187&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000326%2Fabstract%3Frss%3Dyes Increasing use of antiplatelet therapies is associated with increasing GI complications, such as ulceration and GI bleeding. Identification of high-risk patients and, in such patients, incorporation of strategies to reduce their GI risk would be clinically prudent. After assessment and treatment of H pylori in patients with prior ulcer or GI bleeding histories, further reduction in GI risk in other high-risk patients who require antiplatelet agents is primarily accomplished by prescribing drugs that when coadministered with antiplatelet agents protect against mucosal ulceration, primarily proton pump inhibitors (PPIs). However, observational studies indicate a higher cardiovascular event rate in patients taking PPIs along with clopidogrel and aspirin compared with that of patients undergo... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419187 Tue, 19 May 2009 17:29:42 +0100 2419187 http://www.medworm.com/index.php?rid=2419186&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000387%2Fabstract%3Frss%3Dyes Refractory peptic ulcer disease (PUD) manifests as either hemorrhagic complications (persistent or recurrent bleeding) or gastrointestinal (GI) complications (perforation, stricture, obstruction). Treatment strategies for hemorrhagic complications include Endoscopic therapy, surgery, and transcatheter angiographic embolization. Treatment strategies for GI complications include endoscopic dilation for stricture and surgery for perforation and obstruction. Potential etiologies of persistent or worsening PUD must be considered in these cases and include the following: patient risk factors and noncompliance, persistent Helicobacter pylori infection, and non–H pylori–related infection, related to underlying idiopathic gastric hypersecretion or Zollinger-Ellison syndrome and gastrinoma. An a... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419186 Tue, 19 May 2009 17:29:41 +0100 2419186 http://www.medworm.com/index.php?rid=2419185&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000296%2Fabstract%3Frss%3Dyes This article describes the epidemiology, pathogenesis, risk factors, and management of stressrelated bleeding. The various prophylactic agents should be used judiciously to prevent unwanted drug side effects. Standard algorithms for critically ill patients are needed to identify those at high risk and to delineate criteria for the use of prophylactic therapeutic options in these patients. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419185 Tue, 19 May 2009 17:29:41 +0100 2419185 http://www.medworm.com/index.php?rid=2419184&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000302%2Fabstract%3Frss%3Dyes Managing massive bleeding from a peptic ulcer remains a challenge, and it should involve a multidisciplinary team. Endoscopy is the first-line treatment. Even with larger ulcers, endoscopic hemostasis can be achieved in the majority of cases. Surgery is clearly indicated in patients in whom arterial bleeding cannot be controlled at endoscopy. Angiographic embolization is an alternate option, particularly in those unfit for surgery. In selected patients judged to belong to the high-risk group, a more aggressive postendoscopy management is warranted. The role of early elective surgery or angiographic embolization in selected high-risk patients to forestall recurrent bleeding remains controversial. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419184 Tue, 19 May 2009 17:29:40 +0100 2419184 http://www.medworm.com/index.php?rid=2419183&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000363%2Fabstract%3Frss%3Dyes Acute upper gastrointestinal (GI) hemorrhage is one of the commonest causes for hospitalization worldwide. Endoscopic therapy is effective in achieving primary hemostasis. The shift of management from the operating theater to the endoscopy suite has not changed the rate of mortality over the past 20 years. Several hypotheses are discussed that may account for the lack of improvement in the mortality resulting from bleeding peptic ulcer. One potential way to improve management is to identify those at risk for adverse outcomes, which may improve the initial triage, timing of primary endoscopic hemostasis, and postendoscopic management. Two adverse outcomes generally considered as significant for acute upper GI hemorrhage are rebleeding and mortality. Numerous clinical risk models have been d... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419183 Tue, 19 May 2009 17:29:37 +0100 2419183 http://www.medworm.com/index.php?rid=2419182&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000351%2Fabstract%3Frss%3Dyes This article summarizes and appraises the evidence from randomized controlled trials (RCT) and meta-analyses of RCTs on the role of proton pump inhibitors (PPIs) in non-variceal upper gastrointestinal bleeding, with a specific emphasis on peptic ulcer bleeding. PPIs have an established role in the management of endoscopically documented peptic ulcer bleeding. PPIs, compared with H2-receptor antagonists or placebo, consistently reduce re-bleeding rates. All-cause mortality is reduced in patients with high risk endoscopic signs and in Asian populations. The optimal dose and route of PPI administration in peptic ulcer bleeding has not yet been defined. The role of PPIs prior to endoscopy in patients presenting with non-variceal upper gastrointestinal bleeding is still somewhat controversial; ... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419182 Tue, 19 May 2009 17:29:37 +0100 2419182 http://www.medworm.com/index.php?rid=2419181&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000533%2Fabstract%3Frss%3Dyes This issue provides an extensive overview of recently published literature on peptic ulcer disease that differ in many respects from the previous issue of the Gastroenterology Clinics of North America. A collection of authorities in the field has been assembled to provide focused overviews of new scientific information in key areas. The series begins with an overview of the role of proton-pump inhibitor in the management of upper gastrointestinal bleeding. Controversial issues like pre-endoscopic administration of proton-pump inhibitor and the impact of proton-pump inhibitor therapy on mortality are discussed. Recurrent bleeding and death continue to be a major problem despite advances in therapeutic endoscopy and pharmacotherapy. The authors critically reviewed predictive models of poor o... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419181 Tue, 19 May 2009 17:29:34 +0100 2419181 http://www.medworm.com/index.php?rid=2419180&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS088985530900048X%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419180 Tue, 19 May 2009 17:29:34 +0100 2419180 http://www.medworm.com/index.php?rid=2419179&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000478%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2419179 Tue, 19 May 2009 17:29:33 +0100 2419179 http://www.medworm.com/index.php?rid=2355107&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000247%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355107 Sun, 01 Mar 2009 05:00:00 +0100 2355107 http://www.medworm.com/index.php?rid=2355105&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000028%2Fabstract%3Frss%3Dyes The progress that has been made against esophageal carcinoma is limited. Many relevant issues remain. Herein the author discusses his outlook for the treatment of this disease, which has a steadily rising incidence. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355105 Sun, 01 Mar 2009 05:00:00 +0100 2355105 http://www.medworm.com/index.php?rid=2355103&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000119%2Fabstract%3Frss%3Dyes Esophageal cancer is an aggressive disease with an overall poor prognosis. Esophagectomy remains a key therapeutic option in treating patients who have this disease. Tailoring the surgical approach to the patient and the nature of his or her malignancy is essential. Over time, advances in staging, preoperative assessment, operative techniques, and postoperative care have resulted in decreased operative mortality and better long-term outcomes. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355103 Sun, 01 Mar 2009 05:00:00 +0100 2355103 http://www.medworm.com/index.php?rid=2355101&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000089%2Fabstract%3Frss%3Dyes Traditional Chinese medicines are sometimes used as an adjunct to radiotherapy or chemotherapy for esophageal cancer. These medicines may have a benefit on the survival and quality of life of patients who have advanced esophageal cancer. Evidence from current studies appears weak due to methodological limitations. Due to conflicting reports, it is difficult to argue for or against the use of traditional Chinese medicines as a treatment for esophageal cancer. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355101 Sun, 01 Mar 2009 05:00:00 +0100 2355101 http://www.medworm.com/index.php?rid=2355099&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000132%2Fabstract%3Frss%3Dyes This article examines the role of combined-modality therapy for treating locally advanced esophageal cancer. Although surgery remains a cornerstone of treatment, recent studies have demonstrated that pre- or perioperative chemotherapy is associated with improved survival for patients who have adenocarcinoma histology. Primary chemoradiotherapy is the accepted standard of care for medically inoperable patients. Recent studies also suggest that definitive chemoradiotherapy is acceptable for patients who have squamous histology, while subsequent surgery improves local control without conferring a clear survival benefit. Neoadjuvant chemoradiotherapy continues to be investigated but is associated with several advantages over neoadjuvant chemotherapy alone, including an improvement in the patho... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355099 Sun, 01 Mar 2009 05:00:00 +0100 2355099 http://www.medworm.com/index.php?rid=2355097&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000144%2Fabstract%3Frss%3Dyes While frank esophageal carcinoma rarely presents a diagnostic challenge, early lesions are often tricky to assess. This difficulty stems in part from drawbacks in the classification systems designed to stratify early lesions as a guide for deciding treatment. These systems are complex and wrought with specific pathologic challenges brought on by new treatment modalities. Such interventions as endoscopic mucosal resection, photodynamic therapy, and chemotherapy/radiation combinations present the pathologist with new histologic challenges that have a direct impact on patient care. In this article, we discuss staging issues pertinent to early cancers, histologic sequelae of various treatments, and how these factors affect the pathologist's role in evaluating esophageal carcinoma. (Source: Ga... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355097 Sun, 01 Mar 2009 05:00:00 +0100 2355097 http://www.medworm.com/index.php?rid=2355095&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000090%2Fabstract%3Frss%3Dyes This article discusses the literature assessing these modalities, particularly with regard to the practical management of the patient in the clinic. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355095 Sun, 01 Mar 2009 05:00:00 +0100 2355095 http://www.medworm.com/index.php?rid=2355093&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000077%2Fabstract%3Frss%3Dyes Esophageal malignancy is a major source of morbidity and mortality, despite the recently increased attention to screening and early detection. Prognosis for esophageal cancer remains grim, with advanced tumor stage and lymph node metastases conferring even graver outcomes. Several studies have demonstrated that the addition of preoperative neoadjuvant chemoradiotherapy may improve survival in patients with locally advanced tumor (T3) disease or local lymph node metastases. It is here that endoscopic ultrasonography finds its niche in the precise staging of these tumors and the subsequent use of stage-dependent treatment protocols. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355093 Sun, 01 Mar 2009 05:00:00 +0100 2355093 http://www.medworm.com/index.php?rid=2355091&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000120%2Fabstract%3Frss%3Dyes Investigations into inherited genetic variations in the DNA code (known as polymorphisms) in the field of oncology have provided preliminary support for an association with cancer risks and outcomes. Early studies have highlighted several genes with this potential predictive and prognostic power. However, these studies have had methodological limitations and have produced inconsistent results, making impractical as yet the routine evaluation of such genetic polymorphisms in general clinical practice. Continued research in this area is essential if we are to be able to soon use genetic polymorphisms to better select patients for targeted anticancer interventions. This review discusses the role of genetic polymorphisms and their association with esophageal cancer risk and prognosis. The arti... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355091 Sun, 01 Mar 2009 05:00:00 +0100 2355091 http://www.medworm.com/index.php?rid=2355090&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000168%2Fabstract%3Frss%3Dyes The incidence of esophageal cancer, especially esophageal adenocarcinoma, is increasing and its high mortality rate is a notable fact. Improving survival rates of this disease depend on earlier detection through screening and surveillance; however, standard diagnostic modalities, such as endoscopy with biopsy, have several limitations as screening tools, including low negative predictive value and relatively high cost. Recently developed biomarkers such as FISH and improved imaging techniques, may help overcome current problems and provide improved screening and surveillance for esophageal cancer. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355090 Sun, 01 Mar 2009 05:00:00 +0100 2355090 http://www.medworm.com/index.php?rid=2355089&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000065%2Fabstract%3Frss%3Dyes This article reviews the environmental risk factors and predisposing conditions for the two main histologic types of esophageal cancer. Tobacco smoking, excessive alcohol consumption, drinking maté, low intake of fresh fruits and vegetables, achalasia, and low socioeconomic status increase the risk of esophageal squamous cell carcinoma. Results of investigations on other potential risk factors, including opium consumption, intake of hot drinks, eating pickled vegetables, poor oral health, and exposure to human papillomavirus, polycyclic aromatic hydrocarbons, N-nitroso compounds, acetaldehyde, and fumonisins are discussed. Gastroesophageal reflux, obesity, tobacco smoking, hiatal hernia, achalasia, and, probably, absence of H pylori in the stomach increase the risk of esophageal adenocar... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355089 Sun, 01 Mar 2009 05:00:00 +0100 2355089 http://www.medworm.com/index.php?rid=2355088&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000107%2Fabstract%3Frss%3Dyes The epidemiology of esophageal cancer has radically changed in the last fifty-years in the Western world. Changes in the predominant type of squamous cell carcinoma to adenocarcinoma, disparities between different ethnicities, and the exponential increase in incidence rates of adenocarcinoma have established esophageal cancer as a major public health problem requiring urgent attention. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355088 Sun, 01 Mar 2009 05:00:00 +0100 2355088 http://www.medworm.com/index.php?rid=2355087&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000053%2Fabstract%3Frss%3Dyes The history of esophageal cancer dates back to ancient Egyptian times, circa 3000 bc. Since then, the progress in the diagnosis and treatment of esophageal cancer has been steady. Over the last few centuries there have been advancements in the visualization and removal of these lesions, but with no real overall impact on survival rates. The twenty-first century is the time to make major progress in not only improving survival rates, but also in diagnosing esophageal cancer in the very early stages. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355087 Sun, 01 Mar 2009 05:00:00 +0100 2355087 http://www.medworm.com/index.php?rid=2355086&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000041%2Fabstract%3Frss%3Dyes I would like to dedicate this issue of the Gastroenterology Clinics of North America to a colleague, Associate Professor Philip G. McManis, MD, who died peacefully of esophageal cancer on September 17 in 2004 at age 51 years (Neurology 2005;64:598–599). Philip possessed great charm, a fierce determination, an acute intelligence, and a fine sense of humor. He was widely loved and respected. He was a wonderful husband and father. He was a supreme physician. Many thousands of friends and patients are in his debt. (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355086 Sun, 01 Mar 2009 05:00:00 +0100 2355086 http://www.medworm.com/index.php?rid=2355085&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000156%2Fabstract%3Frss%3Dyes It is with tremendous optimism that I welcome you to this issue of Gastroenterology Clinics of North America, which is devoted to esophageal cancer. Esophageal cancer is on the rise in terms of incidence in the Western world, and survival rates have not improved much in the last 30 years. This lack of progress in survival rates is mainly because, unfortunately, most individuals only develop symptoms after the cancer has already metastasized to other organs, by which time a cure is usually out of the question. Esophageal cancer is a devastating disease. As Lyman A. Brewer IIII said, “No patients with malignancy are more miserable than those suffering unrelieved malignant obstruction of the esophagus, because they ultimately die of slow starvation” (Am J Surg 1980:139:730–43). Esophag... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355085 Sun, 01 Mar 2009 05:00:00 +0100 2355085 http://www.medworm.com/index.php?rid=2355084&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000235%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355084 Sun, 01 Mar 2009 05:00:00 +0100 2355084 http://www.medworm.com/index.php?rid=2355083&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.gastro.theclinics.com%2Farticle%2FPIIS0889855309000223%2Fabstract%3Frss%3Dyes (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2355083 Sun, 01 Mar 2009 05:00:00 +0100 2355083 http://www.medworm.com/index.php?rid=2309326&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327562%26dopt%3DAbstract Authors: Eslick GD PMID: 19327562 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309326 Sun, 01 Mar 2009 05:00:00 +0100 2309326 http://www.medworm.com/index.php?rid=2309325&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327563%26dopt%3DAbstract Authors: Eslick GD PMID: 19327563 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309325 Sun, 01 Mar 2009 05:00:00 +0100 2309325 http://www.medworm.com/index.php?rid=2309324&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327564%26dopt%3DAbstract Authors: Eslick GD The history of esophageal cancer dates back to ancient Egyptian times, circa 3000 bc. Since then, the progress in the diagnosis and treatment of esophageal cancer has been steady. Over the last few centuries there have been advancements in the visualization and removal of these lesions, but with no real overall impact on survival rates. The twenty-first century is the time to make major progress in not only improving survival rates, but also in diagnosing esophageal cancer in the very early stages. PMID: 19327564 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309324 Sun, 01 Mar 2009 05:00:00 +0100 2309324 http://www.medworm.com/index.php?rid=2309323&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327565%26dopt%3DAbstract Authors: Eslick GD The epidemiology of esophageal cancer has radically changed in the last fifty-years in the Western world. Changes in the predominant type of squamous cell carcinoma to adenocarcinoma, disparities between different ethnicities, and the exponential increase in incidence rates of adenocarcinoma have established esophageal cancer as a major public health problem requiring urgent attention. PMID: 19327565 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309323 Sun, 01 Mar 2009 05:00:00 +0100 2309323 http://www.medworm.com/index.php?rid=2309322&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327566%26dopt%3DAbstract This article reviews the environmental risk factors and predisposing conditions for the two main histologic types of esophageal cancer. Tobacco smoking, excessive alcohol consumption, drinking maté, low intake of fresh fruits and vegetables, achalasia, and low socioeconomic status increase the risk of esophageal squamous cell carcinoma. Results of investigations on other potential risk factors, including opium consumption, intake of hot drinks, eating pickled vegetables, poor oral health, and exposure to human papillomavirus, polycyclic aromatic hydrocarbons, N-nitroso compounds, acetaldehyde, and fumonisins are discussed. Gastroesophageal reflux, obesity, tobacco smoking, hiatal hernia, achalasia, and, probably, absence of H pylori in the stomach increase the risk of esophageal adeno... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309322 Sun, 01 Mar 2009 05:00:00 +0100 2309322 http://www.medworm.com/index.php?rid=2309320&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327567%26dopt%3DAbstract Authors: Tomizawa Y, Wang KK The incidence of esophageal cancer, especially esophageal adenocarcinoma, is increasing and its high mortality rate is a notable fact. Improving survival rates of this disease depend on earlier detection through screening and surveillance; however, standard diagnostic modalities, such as endoscopy with biopsy, have several limitations as screening tools, including low negative predictive value and relatively high cost. Recently developed biomarkers such as FISH and improved imaging techniques, may help overcome current problems and provide improved screening and surveillance for esophageal cancer. PMID: 19327567 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309320 Sun, 01 Mar 2009 05:00:00 +0100 2309320 http://www.medworm.com/index.php?rid=2309318&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327568%26dopt%3DAbstract Authors: Cheung WY, Liu G Investigations into inherited genetic variations in the DNA code (known as polymorphisms) in the field of oncology have provided preliminary support for an association with cancer risks and outcomes. Early studies have highlighted several genes with this potential predictive and prognostic power. However, these studies have had methodological limitations and have produced inconsistent results, making impractical as yet the routine evaluation of such genetic polymorphisms in general clinical practice. Continued research in this area is essential if we are to be able to soon use genetic polymorphisms to better select patients for targeted anticancer interventions. This review discusses the role of genetic polymorphisms and their association with esophageal cance... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309318 Sun, 01 Mar 2009 05:00:00 +0100 2309318 http://www.medworm.com/index.php?rid=2309316&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327569%26dopt%3DAbstract Authors: Brijbassie A, Shami VM Esophageal malignancy is a major source of morbidity and mortality, despite the recently increased attention to screening and early detection. Prognosis for esophageal cancer remains grim, with advanced tumor stage and lymph node metastases conferring even graver outcomes. Several studies have demonstrated that the addition of preoperative neoadjuvant chemoradiotherapy may improve survival in patients with locally advanced tumor (T3) disease or local lymph node metastases. It is here that endoscopic ultrasonography finds its niche in the precise staging of these tumors and the subsequent use of stage-dependent treatment protocols. PMID: 19327569 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309316 Sun, 01 Mar 2009 05:00:00 +0100 2309316 http://www.medworm.com/index.php?rid=2309314&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327570%26dopt%3DAbstract This article discusses the literature assessing these modalities, particularly with regard to the practical management of the patient in the clinic. PMID: 19327570 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309314 Sun, 01 Mar 2009 05:00:00 +0100 2309314 http://www.medworm.com/index.php?rid=2309312&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327571%26dopt%3DAbstract Authors: Scudiere JR, Montgomery EA While frank esophageal carcinoma rarely presents a diagnostic challenge, early lesions are often tricky to assess. This difficulty stems in part from drawbacks in the classification systems designed to stratify early lesions as a guide for deciding treatment. These systems are complex and wrought with specific pathologic challenges brought on by new treatment modalities. Such interventions as endoscopic mucosal resection, photodynamic therapy, and chemotherapy/radiation combinations present the pathologist with new histologic challenges that have a direct impact on patient care. In this article, we discuss staging issues pertinent to early cancers, histologic sequelae of various treatments, and how these factors affect the pathologist's role in evalu... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309312 Sun, 01 Mar 2009 05:00:00 +0100 2309312 http://www.medworm.com/index.php?rid=2309311&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327572%26dopt%3DAbstract This article examines the role of combined-modality therapy for treating locally advanced esophageal cancer. Although surgery remains a cornerstone of treatment, recent studies have demonstrated that pre- or perioperative chemotherapy is associated with improved survival for patients who have adenocarcinoma histology. Primary chemoradiotherapy is the accepted standard of care for medically inoperable patients. Recent studies also suggest that definitive chemoradiotherapy is acceptable for patients who have squamous histology, while subsequent surgery improves local control without conferring a clear survival benefit. Neoadjuvant chemoradiotherapy continues to be investigated but is associated with several advantages over neoadjuvant chemotherapy alone, including an improvement in the patho... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309311 Sun, 01 Mar 2009 05:00:00 +0100 2309311 http://www.medworm.com/index.php?rid=2309309&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327573%26dopt%3DAbstract Authors: Wu T, Yang X, Zeng X, Eslick GD Traditional Chinese medicines are sometimes used as an adjunct to radiotherapy or chemotherapy for esophageal cancer. These medicines may have a benefit on the survival and quality of life of patients who have advanced esophageal cancer. Evidence from current studies appears weak due to methodological limitations. Due to conflicting reports, it is difficult to argue for or against the use of traditional Chinese medicines as a treatment for esophageal cancer. PMID: 19327573 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309309 Sun, 01 Mar 2009 05:00:00 +0100 2309309 http://www.medworm.com/index.php?rid=2309307&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327574%26dopt%3DAbstract Authors: Tomaszek S, Cassivi SD Esophageal cancer is an aggressive disease with an overall poor prognosis. Esophagectomy remains a key therapeutic option in treating patients who have this disease. Tailoring the surgical approach to the patient and the nature of his or her malignancy is essential. Over time, advances in staging, preoperative assessment, operative techniques, and postoperative care have resulted in decreased operative mortality and better long-term outcomes. PMID: 19327574 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309307 Sun, 01 Mar 2009 05:00:00 +0100 2309307 http://www.medworm.com/index.php?rid=2309305&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19327575%26dopt%3DAbstract Authors: Ajani JA The progress that has been made against esophageal carcinoma is limited. Many relevant issues remain. Herein the author discusses his outlook for the treatment of this disease, which has a steadily rising incidence. PMID: 19327575 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=2309305 Sun, 01 Mar 2009 05:00:00 +0100 2309305 http://www.medworm.com/index.php?rid=1986668&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028315%26dopt%3DAbstract Authors: Falk GW PMID: 19028315 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986668 Thu, 27 Nov 2008 03:55:11 +0100 1986668 http://www.medworm.com/index.php?rid=1986667&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028316%26dopt%3DAbstract Authors: Reddymasu SC, Sharma P The introduction of flexible fiberoptic endoscopy in the 1960s was a major step forward in the diagnosis and management of various esophageal disorders. Since then, there has been steady progress in the development of novel gastrointestinal endoscopy techniques. Magnification and high-resolution endoscopy, chromoendoscopy, narrow-band imaging, autofluorescence imaging, and confocal laser endomicroscopy are some of the recent advances that have shown promise in the diagnosis of squamous cell carcinoma, gastroesophageal reflux disease, Barrett's esophagus, and adenocarcinoma of the esophagus. The purpose of this review is to summarize the recent advances in endoscopic imaging of the esophagus and their practical application for the gastroenterologist. ... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986667 Thu, 27 Nov 2008 03:55:08 +0100 1986667 http://www.medworm.com/index.php?rid=1986666&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028317%26dopt%3DAbstract Authors: Bredenoord AJ, Smout AJ Esophageal function tests are widely used, not only to obtain insight into esophageal physiology and pathophysiology in a research setting, but also to diagnose esophageal motor disorders in patients with symptoms such as dysphagia and chest pain. While esophageal function testing has long been considered almost synonymous with manometry, recently new techniques such as impedance measurement and high-resolution manometry have emerged. With impedance monitoring the transit of a bolus through the esophagus can be studied without the use of ionizing radiation. High-resolution manometry offers a highly detailed and comprehensive view of esophageal pressure patterns. Multichannel high resolution manometry with color plotting facilitates positioning of the ca... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986666 Thu, 27 Nov 2008 03:55:05 +0100 1986666 http://www.medworm.com/index.php?rid=1986665&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028318%26dopt%3DAbstract This article discusses the technical details, clinical indications, and applications of these diagnostic techniques. PMID: 19028318 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986665 Thu, 27 Nov 2008 03:54:59 +0100 1986665 http://www.medworm.com/index.php?rid=1986664&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028319%26dopt%3DAbstract This article incorporates these recent developments into the current understanding of achalasia. PMID: 19028319 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986664 Thu, 27 Nov 2008 03:54:53 +0100 1986664 http://www.medworm.com/index.php?rid=1986663&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028320%26dopt%3DAbstract This article explores the interplay between pathophysiology and epidemiology by focusing on these risk factors and their potential effect on GERD pathogenesis. PMID: 19028320 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986663 Thu, 27 Nov 2008 03:54:50 +0100 1986663 http://www.medworm.com/index.php?rid=1986662&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028321%26dopt%3DAbstract Authors: Frye JW, Vaezi MF The manifestations of gastroesophageal reflux disease (GERD) have been classified into either esophageal or extraesophageal syndromes. Cough, reflux laryngitis, and asthma have been classified as extraesophageal syndromes, whereas reflux chest pain has been classified as a symptomatic syndrome of GERD. In extraesophageal syndromes, patients usually do not display the classic symptoms of reflux, such as heartburn and regurgitation. Upper gastrointestinal endoscopy and pH monitoring, when used to diagnose reflux in patients with symptoms not classic for GERD, have proved to have poor sensitivity and are often not diagnostically helpful. In contrast, an empiric trial of proton pump inhibitors is a well-established, cost-effective tool. PMID: 19028321 [PubMed... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986662 Thu, 27 Nov 2008 03:54:47 +0100 1986662 http://www.medworm.com/index.php?rid=1986661&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028322%26dopt%3DAbstract This article examines three decades of studies from around the world. It concludes that new research into additional mechanisms involved in visceral pain appears promising; but that future studies using improved selective adenosine receptor antagonists and other therapeutic interventions are needed. PMID: 19028322 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986661 Thu, 27 Nov 2008 03:54:44 +0100 1986661 http://www.medworm.com/index.php?rid=1986660&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028323%26dopt%3DAbstract Authors: Wang C, Hunt RH Antisecretory therapies that raise intragastric pH provide the best healing of the esophageal mucosal damage that occurs in gastroesophageal reflux disease. Continuous maintenance therapy is also effective to reduce the likelihood of recurrence of esophagitis and control symptoms in the long term. Proton pump inhibitor (PPI) therapy is an effective approach for healing esophagitis and controlling symptoms. Endoscopic and surgical treatments may provide an option for patients who are refractory to PPIs in whom reflux has been clearly demonstrated. Long-term antireflux medication is often needed after surgical treatment because of persisting or recurrent pathologic reflux and symptoms. An alternative approach to controlling transient lower esophageal sphincter re... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986660 Thu, 27 Nov 2008 03:54:38 +0100 1986660 http://www.medworm.com/index.php?rid=1986659&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028324%26dopt%3DAbstract Authors: Rice TW, Blackstone EH Managing gastroesophageal reflux disease (GERD) is difficult because it is a chronic relapsing disease. Surgical management of GERD is indicated only after medical management has failed. In patients who have the most advanced forms of GERD, surgical therapy is good for treating symptoms and healing esophagitis, but far from a gold standard. Freedom from symptoms, side effects, medical therapy, or reoperation cannot be guaranteed. Care must be taken when prescribing surgery for GERD, and it is best that an experienced surgeon at a specialty center participate in the patient's lifelong care. PMID: 19028324 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986659 Thu, 27 Nov 2008 03:54:35 +0100 1986659 http://www.medworm.com/index.php?rid=1986658&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028325%26dopt%3DAbstract Authors: Bird-Lieberman EL, Fitzgerald RC Barrett's esophagus is an important step in the pathway to esophageal adenocarcinoma. Since most patients with Barrett's esophagus are undiagnosed and patients present with advanced adenocarcinoma de novo, prognosis for this disease remains poor. To identify those people with Barrett's esophagus who are at particular risk many new technologies are being developed. In association with these advances in risk stratification, progress is being made in the endoscopic treatment of Barrett's. Chemoprevention is also an area of interest and trials are underway. PMID: 19028325 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986658 Thu, 27 Nov 2008 03:54:33 +0100 1986658 http://www.medworm.com/index.php?rid=1986657&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028326%26dopt%3DAbstract Authors: Siersema PD The incidence of esophageal cancer, in particular esophageal adenocarcinoma, is increasing, largely due to an increase in risk factors for adenocarcinoma. When esophageal cancer is confirmed by upper endoscopy, staging is required for the optimal selection of patients who should undergo esophageal resection. Neoadjuvant chemoradiation may be able to improve survival after esophageal cancer surgery. Endoscopic therapy for early esophageal neoplasia is effective and safe, with the best results being obtained by an individualized approach using endoscopic mucosal resection, ablative therapy, or both. Finally, dysphagia from esophageal cancer can be successfully treated with stent placement or single-dose brachytherapy. Future research should establish whether combinat... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986657 Thu, 27 Nov 2008 03:54:29 +0100 1986657 http://www.medworm.com/index.php?rid=1986656&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028327%26dopt%3DAbstract Authors: Dubecz A, Molena D, Peters JH Primary treatment of carcinoma of the esophagus and cardia rests on surgical resection. Although recent advances have shown the suitability of endoscopic treatment in selected patients with very early cancers, and preliminary studies have suggested that responders to primary chemoradiation may be equivalent to resection in selected patients with squamous cell carcinoma, surgical resection remains the mainstay of therapy, as it has for the past 50 years. Various changes support highly individualized treatment decisions, in which each patient receives the treatment with the best chance of eliminating all disease. PMID: 19028327 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986656 Thu, 27 Nov 2008 03:54:26 +0100 1986656 http://www.medworm.com/index.php?rid=1986655&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19028328%26dopt%3DAbstract Authors: Liacouras CA Eosinophilic esophagitis (EoE) is a disease based on a clinicopathologic diagnosis that involves a localized eosinophilic inflammation of the esophagus. A significant increase in the diagnosis of pediatric EoE has occurred over the past 10 years not only due to a greater recognition of the disease among gastroenterologists, allergists, and pathologists but also secondary to an increased incidence of the disease. EoE is defined by the presence of 15 or more esophageal eosinophils per high-power field isolated to the esophagus associated with clinical symptoms that do not respond to acid suppression therapy. Although the exact mechanism of EoE is unknown, food allergens are thought to have an important role. Effective treatment options include dietary restrictions a... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1986655 Thu, 27 Nov 2008 03:54:23 +0100 1986655 http://www.medworm.com/index.php?rid=1801114&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18793992%26dopt%3DAbstract Authors: Rao SS PMID: 18793992 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801114 Mon, 01 Sep 2008 04:00:00 +0100 1801114 http://www.medworm.com/index.php?rid=1801113&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18793993%26dopt%3DAbstract This article discusses the relevance of pelvic floor to the anal opening and closure function, and discusses new findings with regards to the role of these muscles in the vaginal and urethra closure mechanisms. PMID: 18793993 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801113 Mon, 01 Sep 2008 04:00:00 +0100 1801113 http://www.medworm.com/index.php?rid=1801112&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18793994%26dopt%3DAbstract Authors: Scott SM, Gladman MA With advances in diagnostic technology, it is now accepted that in the field of functional bowel disorders, symptom-based assessment is unsatisfactory as the sole means of directing therapy. A robust taxonomy based on underlying pathophysiology has been suggested, highlighting a crucial role for physiologic testing in clinical practice. A wide number of complementary investigations currently exist for the assessment of anorectal structure and function, some of which have a clinical impact in patients with functional disorders of evacuation and continence by markedly improving diagnostic yield and altering management. The techniques, limitations, measurements, and clinical use of manometric, sensorimotor, and neurophysiologic tests of anorectal function are... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801112 Mon, 01 Sep 2008 04:00:00 +0100 1801112 http://www.medworm.com/index.php?rid=1801111&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18793995%26dopt%3DAbstract This article describes typical urodynamic studies and their roles in the evaluation of common pelvic floor disorders, including stress urinary incontinence, overactive bladder, and pelvic organ prolapse. PMID: 18793995 [PubMed - as supplied by publisher] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801111 Mon, 01 Sep 2008 04:00:00 +0100 1801111 http://www.medworm.com/index.php?rid=1801110&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18793996%26dopt%3DAbstract This article focuses on standard imaging procedures including defecography, ultrasonography, and MRI and discusses its use in clinical practice by illustrating both normal and abnormal patterns. PMID: 18793996 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801110 Mon, 01 Sep 2008 04:00:00 +0100 1801110 http://www.medworm.com/index.php?rid=1801109&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18793997%26dopt%3DAbstract Authors: Rao SS Constipation caused by dyssynergic defecation is common and affects up to one half of patients with this disorder. It is possible to diagnose this problem through history, prospective stool diaries, and anorectal physiologic tests. Randomized controlled trials have now established that biofeedback therapy is not only efficacious but superior to other modalities and that the symptom improvement is caused by a change in underlying pathophysiology. Development of userfriendly approaches to biofeedback therapy and use of home biofeedback programs will significantly enhance the adoption of this treatment by gastroenterologists and colorectal surgeons. PMID: 18793997 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801109 Mon, 01 Sep 2008 04:00:00 +0100 1801109 http://www.medworm.com/index.php?rid=1801108&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18793998%26dopt%3DAbstract Authors: Norton C Biofeedback as delivered in most clinical settings in Western medicine has been consistently reported to improve symptoms of fecal incontinence. Closer scrutiny of the elements of the intervention and controlled studies, however, have consistently failed to find any benefit of the biofeedback element of this complex package of care; nor has any superiority been found for one modality over another. There is a need for further well-designed and adequately powered randomized controlled trials. Meanwhile, there can be little doubt that conservative interventions improve many patients with fecal incontinence to the point where most report satisfaction with treatment and do not wish to consider more invasive options, such as surgery. PMID: 18793998 [PubMed - in process]... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801108 Mon, 01 Sep 2008 04:00:00 +0100 1801108 http://www.medworm.com/index.php?rid=1801107&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18793999%26dopt%3DAbstract This article describes the rationale, indications (including patient selection), results, and current position controversies of surgical procedures for constipation and fecal incontinence, dividing these into those regarded as historical, contemporary, or evolving. Reported surgical outcome data must be interpreted with caution because for most studies the evidence is of low quality, making comparison of different procedures problematic and emphasizing the need for better designed and conducted clinical trials. PMID: 18793999 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801107 Mon, 01 Sep 2008 04:00:00 +0100 1801107 http://www.medworm.com/index.php?rid=1801106&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18794000%26dopt%3DAbstract Authors: Chong PS, Bartolo DC Hemorrhoids and anal fissures are common benign anorectal conditions that form a significant part of a colorectal surgeon's workload. This review summarizes and evaluates the current techniques available in their management. PMID: 18794000 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801106 Mon, 01 Sep 2008 04:00:00 +0100 1801106 http://www.medworm.com/index.php?rid=1801105&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18794001%26dopt%3DAbstract Authors: Felt-Bersma RJ, Stella MT, Cuesta MA Rectal prolapse is best diagnosed by physical examination and by having the patient strain as if to defecate; a laparoscopic rectopexy is the preferred treatment approach. Intussusception is more an epiphenomena than a defecatory disorder and should be managed conservatively. Solitary rectal ulcer syndrome is a consequence of chronic straining and therapy should be aimed at restoring a normal bowel habit with behavioral approaches including biofeedback therapy. Rectocele correction may be considered if it can be definitively established that it is a cause of defecation disorder and only after conservative measures have failed. An enterocele should only be operated when pain and heaviness are predominant symptoms and it is refractory to cons... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801105 Mon, 01 Sep 2008 04:00:00 +0100 1801105 http://www.medworm.com/index.php?rid=1801104&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18794002%26dopt%3DAbstract Authors: Tekkis PP, Nicholls RJ Restorative proctocol ectomy is the elective surgical procedure of choice for most patients who have ulcerative colitis or familial adenomatous polyposis. This major advance has offered an alternative to permanent ileostomy in these patients. PMID: 18794002 [PubMed - as supplied by publisher] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801104 Mon, 01 Sep 2008 04:00:00 +0100 1801104 http://www.medworm.com/index.php?rid=1801103&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18794003%26dopt%3DAbstract This article describes functional disorders in which chronic pelvic and anorectal pain cannot be explained by a structural or other specified pathology. Currently, these functional disorders are classified into urogynecologic conditions or cystitis and painful bladder syndrome, anorectal disorders, and the levator ani syndrome. Although nomenclature suggests that these conditions are distinct, there is considerable overlap of their symptoms and these disorders have much in common. PMID: 18794003 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801103 Mon, 01 Sep 2008 04:00:00 +0100 1801103 http://www.medworm.com/index.php?rid=1801102&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18794004%26dopt%3DAbstract This article reviews the results of studies that have documented how prompted voiding programs can significantly reduce urinary and fecal incontinence, particularly if the intervention includes dietary and exercise components. Documentation of noninvasive and efficacious interventions by randomized, controlled trials and the labor costs of implementing these measures can lead to changes in how nursing home care is provided and funded. PMID: 18794004 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801102 Mon, 01 Sep 2008 04:00:00 +0100 1801102 http://www.medworm.com/index.php?rid=1801101&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18794005%26dopt%3DAbstract This article reports the clinical, physiopathologic, diagnostic, and therapeutic aspects of the most common anorectal disorders in children. In particular, it focuses on the differential diagnosis between organic and functional constipation. In addition, the authors separately examine some of the clinical conditions such as atopy, neurologic diseases, and anorectal malformations, in which chronic constipation may be an important clinical manifestation. PMID: 18794005 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801101 Mon, 01 Sep 2008 04:00:00 +0100 1801101 http://www.medworm.com/index.php?rid=1801100&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18794006%26dopt%3DAbstract Authors: Nijman RJ The ability to maintain normal continence for urine and stools is not achievable in all children by a certain age. Gaining control of urinary and fecal continence is a complex process, and not all steps and factors involved are fully understood. While normal development of anatomy and physiology are prerequisites to becoming fully continent, anatomic abnormalities, such as bladder exstrophy, epispadias, ectopic ureters, and neurogenic disturbances that can usually be recognized at birth and cause incontinence, will require specialist treatment, not only to restore continence but also to preserve renal function. Most forms of urinary incontinence are not caused by an anatomic or physiologic abnormality and, hence, are more difficult to diagnose and their management re... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1801100 Mon, 01 Sep 2008 04:00:00 +0100 1801100 http://www.medworm.com/index.php?rid=1690536&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499021%26dopt%3DAbstract Authors: Talley NJ PMID: 18499021 [PubMed - indexed for MEDLINE] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1690536 Sun, 01 Jun 2008 04:00:00 +0100 1690536 http://www.medworm.com/index.php?rid=1464716&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499021%26dopt%3DAbstract Authors: Talley NJ PMID: 18499021 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464716 Sat, 24 May 2008 13:40:38 +0100 1464716 http://www.medworm.com/index.php?rid=1464715&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499022%26dopt%3DAbstract Authors: Talley NJ Eosinophilic gastroenteritis is a rare disease characterized by striking tissue eosinophilia in any layer of the gut wall; however, many diseases can cause increased gut eosinophilia. Allergic reactions to food are an important cause of gut eosinophilia. Not all adverse reactions to food are IgE mediated, and most cases of IgE-mediated food allergy do not have eosinophilic gastroenteritis. Parasitic, bacterial, and viral pathogens as well as certain systemic diseases such as vasculitis can cause gut eosinophilia. These heterogeneous conditions are reviewed in this article. PMID: 18499022 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464715 Sat, 24 May 2008 13:40:36 +0100 1464715 http://www.medworm.com/index.php?rid=1464714&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499023%26dopt%3DAbstract Authors: Khan S, Orenstein SR Eosinophilic gastroenteritis is an infrequently diagnosed condition that is characterized by prominent eosinophilic infiltration of the stomach or small intestine, generally localized to one level of the intestinal wall; the variable organ locus and wall depth produce heterogeneous clinical presentations. A strong association with atopy is present in most cases, supported by circumstantial evidence and the demonstration of Th-2 proinflammatory cytokine profiles in animal studies. A high degree of suspicion is required to establish the diagnosis, which must be based on intense gastrointestinal eosinophilia. Management is directed toward removal of offending allergens and use of anti-inflammatory agents. Novel and emerging treatments on the horizon are biolo... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464714 Sat, 24 May 2008 13:40:32 +0100 1464714 http://www.medworm.com/index.php?rid=1464713&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499024%26dopt%3DAbstract Authors: Prasad GA, Talley NJ Eosinophilic esophagitis in adults is a disease characterized by eosinophilic infiltration of the esophageal mucosa and symptoms of long-standing solid food dysphagia and food impactions. First described in 1978, this syndrome is being recognized increasingly in the developed world, with multiple case series reported from the United States, Europe, and Australia during the past decade. Diagnosis requires the presence of greater than or equal to 15 eosinophils/high-power field on esophageal biopsies. Successful treatment in adults has been reported with the use of systemic and topical swallowed steroids. Endoscopic treatment has been associated with increased an risk for tears and perforations. PMID: 18499024 [PubMed - in process] (Source: Gastroenterol... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464713 Sat, 24 May 2008 13:40:27 +0100 1464713 http://www.medworm.com/index.php?rid=1464712&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499025%26dopt%3DAbstract This article provides a broad framework for recognizing the remarkable variety of clinical manifestations of eosinophilic esophagitis in children, which must be considered as part of the differential diagnosis in many different clinical situations. PMID: 18499025 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464712 Sat, 24 May 2008 13:40:24 +0100 1464712 http://www.medworm.com/index.php?rid=1464711&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499026%26dopt%3DAbstract Authors: Walker MM, Talley NJ The eosinophil-mast cell-neural pathway may be important in the pathophysiology of functional gastrointestinal disorders characterized by unexplained abdominal pain, disordered defecation, or meal-related discomfort. There is evidence that duodenal eosinophils are increased in functional dyspepsia, whereas mast cells are increased in the lower gut in irritable bowel syndrome, directly supporting a role for a hypersensitivity-type reaction in these disorders. The trigger may be a pathogen, food, or other allergen in the gut mucosa. This trigger may evoke eosinophils, mast cells, and other components to cascade to up-regulate serotonin release, with modulation of the enteric and central nervous systems, creating a vicious cycle. If correct, this theory sugge... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464711 Sat, 24 May 2008 13:40:21 +0100 1464711 http://www.medworm.com/index.php?rid=1464710&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499027%26dopt%3DAbstract Authors: Kashyap P, Farrugia G Increasing evidence suggests that a subset of gastrointestinal motility disorders is associated with the presence of circulating antibodies. These antibodies are directed against various molecular targets, the best known being anti-neuronal nuclear antibody (ANNA-1 or anti-Hu) associated with paraneoplastic motility disorders. There is also evidence that the presence of distinct autoantibody profiles is associated with non-paraneoplastic motility disorders. This review focuses on the types of antibodies associated with gastrointestinal motility disorders and the significance of these antibodies. Algorithms are suggested for the work-up and treatment of patients with circulating antibodies associated with gastrointestinal motility disorders. PMID: 1849... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464710 Sat, 24 May 2008 13:40:18 +0100 1464710 http://www.medworm.com/index.php?rid=1464709&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499028%26dopt%3DAbstract Authors: Barton SH, Murray JA This review focuses on the autoimmune connective tissue diseases, endocrine, and dermatologic conditions associated with celiac disease, as well as the related gut inflammatory disorders of refractory celiac disease, autoimmune enteropathy, collagenous enteritis, and collagenous colitis. PMID: 18499028 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464709 Sat, 24 May 2008 13:40:15 +0100 1464709 http://www.medworm.com/index.php?rid=1464708&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499029%26dopt%3DAbstract Authors: Vermeire S, Vermeulen N, Van Assche G, Bossuyt X, Rutgeerts P Patients who have inflammatory bowel diseases (IBD) express strong antibody responses to a variety of epitopes. A number of (auto)antibodies have been described in patients who have Crohn's disease or ulcerative colitis. These markers reflect a loss of tolerance toward bacterial and fungal flora and have been studied for their clinical value in IBD patients. However, currently, they have no place in the diagnostic work up. Their real promise may lie in their use as surrogate markers of complicated aggressive disease as shown in various retrospective studies, but prospective data are lacking. PMID: 18499029 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464708 Sat, 24 May 2008 13:40:11 +0100 1464708 http://www.medworm.com/index.php?rid=1464707&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499030%26dopt%3DAbstract Authors: Gardner TB, Chari ST Autoimmune pancreatitis is the pancreatic manifestation of a systemic disorder that affects various organs, including the bile duct, retroperitoneum, kidney, and parotid and lacrimal glands. It represents a recently described subset of chronic pancreatitis that is immune mediated and has unique histologic, morphologic, and clinical characteristics. A hallmark of the disease is its rapid response to corticosteroid treatment. Although still a rare disease, autoimmune pancreatitis is increasingly becoming recognized clinically, leading to evolution in the understanding of its prognosis, clinical characteristics, and treatment. PMID: 18499030 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464707 Sat, 24 May 2008 13:40:06 +0100 1464707 http://www.medworm.com/index.php?rid=1464706&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499031%26dopt%3DAbstract This article provides a brief summary of the diagnosis of AIH, the natural history of AIH, an approach to the treatment and follow-up of AIH, and the role of liver transplantation in the treatment of AIH. PMID: 18499031 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464706 Sat, 24 May 2008 13:39:57 +0100 1464706 http://www.medworm.com/index.php?rid=1464705&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18499032%26dopt%3DAbstract Authors: Mendes F, Lindor KD There is a subset of patients who have biochemical and histologic features consistent with primary biliary cirrhosis (PBC) who lack antimitochondrial antibodies (AMA). This entity is usually referred to as AMA-negative PBC or alternatively autoimmune cholangitis. Patients who have AMA-negative PBC are believed to have a similar clinical course, response to treatment, and prognosis as their AMA-positive counterparts. As more sensitive and specific serologic tests are developed to detect serum AMA, it is possible we may find that these patients initially believed to be AMA-negative are indeed AMA-positive, suggesting a single disease process. PMID: 18499032 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1464705 Sat, 24 May 2008 13:38:36 +0100 1464705 http://www.medworm.com/index.php?rid=1276255&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313536%26dopt%3DAbstract Authors: Cappell MS PMID: 18313536 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276255 Sat, 01 Mar 2008 05:00:00 +0100 1276255 http://www.medworm.com/index.php?rid=1276254&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313537%26dopt%3DAbstract Authors: Cappell MS Colon cancer is believed to arise from two types of precursor polyps via two distinct pathways: conventional adenomas by the conventional adenoma-to-carcinoma sequence and serrated adenomas according to the serrated adenoma-to-carcinoma theory. Conventional adenomas arise from mutation of the APC gene; progression to colon cancer is a multistep process. The fundamental genetic defect in serrated adenomas is unknown. Environmental factors can increase the risk for colon cancer. Advanced colon cancer often presents with symptoms, but early colon cancer and premalignant adenomatous polyps commonly are asymptomatic, rendering them difficult to detect and providing the rationale for mass screening of adults over age 50. PMID: 18313537 [PubMed - in process] (Source: G... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276254 Sat, 01 Mar 2008 05:00:00 +0100 1276254 http://www.medworm.com/index.php?rid=1276253&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313538%26dopt%3DAbstract This article briefly reviews the evidence for this serrated pathway, provides diagnostic criteria for clinically significant hyperplastic polyps and allied serrated polyps, and suggests how this information may be translated into safe, effective guidelines for colonoscopy-based colon cancer prevention. Consideration also is given to the definition and management of hyperplastic polyposis syndrome. The currently proposed management plan for serrated polyps is tentative because of incomplete knowledge of the nature and behavior of these polyps. This article highlights key areas warranting further research. PMID: 18313538 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276253 Sat, 01 Mar 2008 05:00:00 +0100 1276253 http://www.medworm.com/index.php?rid=1276252&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313539%26dopt%3DAbstract Authors: Desai TK, Barkel D Colon cancer, the third leading cause of mortality from cancer in the United States, afflicts about 150,000 patients annually. More than 10% of these patients exhibit familial clustering. The most common and well characterized of these familial colon cancer syndromes is hereditary nonpolyposis colon cancer syndrome (Lynch syndrome), which accounts for about 2% to 3% of all cases of colon cancer in the United States. We review the current knowledge of familial cancer syndromes, with an emphasis on Lynch syndrome and familial adenomatous polyposis. PMID: 18313539 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276252 Sat, 01 Mar 2008 05:00:00 +0100 1276252 http://www.medworm.com/index.php?rid=1276251&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313540%26dopt%3DAbstract This article focuses on preventing the initiation and promotion of neoplastic growth in colon cancer, particularly with dietary measures. A goal of dietary epidemiology is to identify chemopreventive agents and strategies. The effects of diet are analyzed by observational approaches and experimental dietary, nutritional, or chemopreventive interventions. Short-term trials that alter intermediate biomarkers that are more sensitive than the adenoma to interventions may be necessary. The same logic needs to be applied to chemoprevention. Nonsteroidal anti-inflammatory drugs, calcium, and selenium have some individual effects that could be potentiated if added together. The current evidence is that the combined effect of all three agents is modest, compared with the effects of screening, or ev... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276251 Sat, 01 Mar 2008 05:00:00 +0100 1276251 http://www.medworm.com/index.php?rid=1276250&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313541%26dopt%3DAbstract This article reviews colorectal cancer screening from an epidemiologist's perspective to provide the theoretic evidence-based underpinning for the role of the gastroenterologist in colorectal screening. PMID: 18313541 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276250 Sat, 01 Mar 2008 05:00:00 +0100 1276250 http://www.medworm.com/index.php?rid=1276249&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313542%26dopt%3DAbstract This article reviews methods for screening, including fecal occult blood tests, flexible sigmoidoscopy, colonoscopy, CT colonography, capsule endoscopy, and double contrast barium enema. A simple, inexpensive, noninvasive, and relatively sensitive screening test is needed to identify people at risk for developing advanced adenomas or colorectal cancer who would benefit from colonoscopy. It is hoped that new markers will be identified that perform better. Until then we fortunately have a variety of screening strategies that do work. PMID: 18313542 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276249 Sat, 01 Mar 2008 05:00:00 +0100 1276249 http://www.medworm.com/index.php?rid=1276248&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313543%26dopt%3DAbstract Authors: Mihalko SL As awareness of colon cancer by the public continues to increase, screening colonoscopy procedures will proportionately increase. There is much written on the design of new ambulatory gastroenterology clinics, but little practical information about high-volume, mass colonoscopic screening of patients in the hospital outpatient setting. Many institutions struggle with inefficient endoscopy units that cannot always meet the dual needs of high quality and efficient performance of screening endoscopy. The patient undergoing screening colonoscopy seeks an efficient unit with state-of-the-art equipment, highly skilled physicians, highly competent staff, accurate case documentation, comfortable surroundings, and consumer-friendly follow-through of care. Optimizing these fa... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276248 Sat, 01 Mar 2008 05:00:00 +0100 1276248 http://www.medworm.com/index.php?rid=1276247&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313544%26dopt%3DAbstract Authors: Cappell MS Most colon cancers arise from conventional adenomatous polyps (conventional adenoma-to-carcinoma sequence), while some colon cancers appear to arise from the recently recognized serrated adenomatous polyp (serrated adenoma-to-carcinoma theory). Because conventional adenomas and serrated adenomas are usually asymptomatic, mass screening of asymptomatic patients has become the cornerstone for detecting and eliminating these precursor lesions to reduce the risk of colon cancer. Colonoscopy has become the primary screening test because of its high sensitivity and specificity, and the ability to perform polypectomy. Other screening tests include guaiac tests or fecal immunochemical tests (FIT) for fecal occult blood, and flexible sigmoidoscopy. A minimal colonoscopic wit... Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276247 Sat, 01 Mar 2008 05:00:00 +0100 1276247 http://www.medworm.com/index.php?rid=1276246&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313545%26dopt%3DAbstract This article reviews the CTC literature, including imaging and adjunctive techniques, radiologic interpretation, procedure indications, contraindications, risks, sensitivity, interpretation pitfalls, and controversies. PMID: 18313545 [PubMed - as supplied by publisher] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276246 Sat, 01 Mar 2008 05:00:00 +0100 1276246 http://www.medworm.com/index.php?rid=1276245&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313546%26dopt%3DAbstract This article reviews the CRC risks associated with these conditions and the currently recommended surveillance strategies. PMID: 18313546 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276245 Sat, 01 Mar 2008 05:00:00 +0100 1276245 http://www.medworm.com/index.php?rid=1276244&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313547%26dopt%3DAbstract This article reviews the clinical applications of EUS for imaging and intervention in colorectal cancer, with an emphasis on the most recent clinical studies. PMID: 18313547 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276244 Sat, 01 Mar 2008 05:00:00 +0100 1276244 http://www.medworm.com/index.php?rid=1276243&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313548%26dopt%3DAbstract Authors: Tolliver KA, Rex DK Colonoscopic polypectomy is the most effective visceral cancer prevention tool in clinical medicine. In general, risks associated with the technique of polyp removal should match the likelihood that the polyp will become or already is malignant (eg, low-risk technique for low risk for malignant potential). Cold techniques are preferred for most diminutive polyps. Polypectomy techniques must be effective and minimize complications. Complications can occur even with proper technique, however. Aggressive evaluation and treatment of complications helps ensure the best possible outcome. PMID: 18313548 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276243 Sat, 01 Mar 2008 05:00:00 +0100 1276243 http://www.medworm.com/index.php?rid=1276242&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313549%26dopt%3DAbstract This article briefly reviews the general principles of surgical management and describes recent developments. PMID: 18313549 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276242 Sat, 01 Mar 2008 05:00:00 +0100 1276242 http://www.medworm.com/index.php?rid=1276241&cid=s_33225_17_f&fid=33225&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18313550%26dopt%3DAbstract This article reviews these trials to illustrate key concepts, places these trials in perspective, and provides direction for future research. PMID: 18313550 [PubMed - in process] (Source: Gastroenterology Clinics of North America) Gastroenterology Clinics of North America journals http://www.medworm.com/rss/comments.php?id=1276241 Sat, 01 Mar 2008 05:00:00 +0100 1276241