{"title":"Elderly Onset Celiac Disease: A Narrative Review.","authors":"Maria Cappello, Gaetano C Morreale, Anna Licata","doi":"10.4137/CGast.S38454","DOIUrl":"https://doi.org/10.4137/CGast.S38454","url":null,"abstract":"<p><p>Celiac sprue is a chronic disease, which usually occurs in children and young adults. However, it can develop in any age group, and the prevalence is increasing even in the elderly population. The atypical patterns of clinical presentation in this age group sometimes can cause a delay in diagnosis. Given the lower sensitivity and specificity of serological tests in the aged population, clinical suspect often arises in the presence of complications (autoimmune disorders, fractures, and finally, malignancy) and must be supported by endoscopic and imaging tools. In this review, we highlight the incidence and prevalence of celiac disease in the elderly, the patterns of clinical presentation, diagnosis, and the most frequent complications, with the aim of increasing awareness and reducing the diagnostic delay of celiac disease even in the elderly population. </p>","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"9 ","pages":"41-9"},"PeriodicalIF":0.0,"publicationDate":"2016-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CGast.S38454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34727635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Taghi Safari, Mohammad Bager Miri, Shahram Ebadi, Shabnam Shahrokh, Amir Houshang Mohammad Alizadeh
{"title":"Comparing the Roles of EUS, ERCP and MRCP in Idiopathic Acute Recurrent Pancreatitis.","authors":"Mohammad Taghi Safari, Mohammad Bager Miri, Shahram Ebadi, Shabnam Shahrokh, Amir Houshang Mohammad Alizadeh","doi":"10.4137/CGast.S37927","DOIUrl":"https://doi.org/10.4137/CGast.S37927","url":null,"abstract":"<p><p>Acute recurrent pancreatitis (ARP) is defined as more than two attacks of acute pancreatitis with complete or almost complete resolution of symptoms and signs of pancreatitis between episodes. The initial evaluation fails to detect the cause of ARP in 10%-30% of patients, whose condition is classified as idiopathic ARP. Endoscopic ultrasound (EUS) has gained increasing attention as a useful imaging modality for the pancreas and the extrahepatic biliary tree. The close proximity of the pancreas to the digestive tract allows EUS to obtain detailed images of this organ. This review aims to record pancreaticobiliary endoscopic ultrasound (EUS) and other imaging modalities in the clinical management of patients with idiopathic ARP. </p>","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"9 ","pages":"35-9"},"PeriodicalIF":0.0,"publicationDate":"2016-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CGast.S37927","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34698138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edmund Leung, Simon Bramhall, Prajeesh Kumar, Moustafa Mourad, Amdad Ahmed
{"title":"Internal Herniation Through Foramen of Winslow: A Diagnosis Not to Be Missed.","authors":"Edmund Leung, Simon Bramhall, Prajeesh Kumar, Moustafa Mourad, Amdad Ahmed","doi":"10.4137/CGast.S38453","DOIUrl":"https://doi.org/10.4137/CGast.S38453","url":null,"abstract":"<p><strong>Introduction: </strong>Hernias through the foramen of Winslow are extremely rare, accounting for 0.1% of all abdominal hernias. Delayed diagnosis is often observed, resulting in bowel strangulation and high mortality.</p><p><strong>Method: </strong>We present a case of a patient with strangulated ileum herniated through the foramen of Winslow. Recent literature review was undertaken on \"PubMed\" as a search platform using the keywords \"foramen of Winslow\" and \"hernia\".</p><p><strong>Case summary: </strong>A 66-year-old man presented acutely with severe epigastric pain and vomiting. An emergency computed tomography scan revealed a loop of ileum in the lesser sac. At emergency laparotomy, a herniated loop of ileum that had become strangulated at its entry to the lesser sac via the foramen of Winslow was confirmed. The loop of ileum was reduced but was nonviable, which had to be resected with a primary anastomosis. The patient's postoperative recovery was uneventful.</p><p><strong>Conclusion: </strong>Herniation through the foramen of Winslow is a difficult diagnosis and must not be missed. Early cross-sectional imaging and surgical intervention are advised in order to reduce morbidity.</p>","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"9 ","pages":"31-3"},"PeriodicalIF":0.0,"publicationDate":"2016-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CGast.S38453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34599761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Primary Sclerosing Cholangitis: Therapeutic Options and Surveillance Management.","authors":"Aditi Kumar, Daniel Wheatley, Amar Puttanna","doi":"10.4137/CGast.S38451","DOIUrl":"10.4137/CGast.S38451","url":null,"abstract":"<p><p>Primary sclerosing cholangitis is a chronic immune-mediated liver disease. Though rare, it poses several clinical concerns for the managing physician. There are currently limited therapeutic options in the management of the condition and weak evidence base behind them. Endoscopic intervention is limited to those patients with obstructing stricture-related disease, and even liver transplantation has a risk of disease recurrence. Surveillance for inflammatory bowel disorders, metabolic bone disease, and malignancy is paramount when managing such patients. This article provides an overview of the condition with further focus on current therapeutic options and guidance on surveillance management. </p>","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"9 ","pages":"25-9"},"PeriodicalIF":0.0,"publicationDate":"2016-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4902039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34665091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vishnu Prasad Nelamangala Ramakrishnaiah, Somanath Malage, G S Sreenath, Sudhakar Kotlapati, Sunu Cyriac
{"title":"Palliation of Dysphagia in Carcinoma Esophagus.","authors":"Vishnu Prasad Nelamangala Ramakrishnaiah, Somanath Malage, G S Sreenath, Sudhakar Kotlapati, Sunu Cyriac","doi":"10.4137/CGast.S30303","DOIUrl":"https://doi.org/10.4137/CGast.S30303","url":null,"abstract":"<p><p>Esophageal carcinoma has a special place in gastrointestinal carcinomas because it contains two main types, namely, squamous cell carcinoma and adenocarcinoma. Carcinoma esophagus patients require some form of palliation because of locally advanced stage or distant metastasis, where it cannot be subjected to curable treatment with surgery and chemoradiation. Many modalities of palliation of dysphagia are available, but the procedure with least morbidity, mortality, and long-term palliation of dysphagia needs to be chosen for the patient. This study aims to discuss the recent trends in palliation of dysphagia with promising results and the most suitable therapy for palliation of dysphagia in a given patient. A total of 64 articles that were published between years 2005 and 2015 on various modes of palliation of dysphagia in carcinoma esophagus were studied, which were mainly randomized and prospective studies. Through this study, we conclude that stents are the first choice of therapy for palliation, which is safe and cost-effective, and they can be combined with either radiotherapy or chemotherapy for long-term palliation of dysphagia with good quality of life. Radiotherapy can be used as a second-line treatment modality. </p>","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"9 ","pages":"11-23"},"PeriodicalIF":0.0,"publicationDate":"2016-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CGast.S30303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34560705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gastric Hamartomatous Polyps-Review and Update.","authors":"Monika Vyas, Xiu Yang, Xuchen Zhang","doi":"10.4137/CGast.S38452","DOIUrl":"https://doi.org/10.4137/CGast.S38452","url":null,"abstract":"<p><p>Gastric polyps are frequently encountered on endoscopic examinations. While many of these represent true epithelial lesions, some of the polyps may result from underlying stromal or lymphoid proliferations or even heterotopic tissue. Histologic examination is essential for accurate typing of the polyps to predict malignant potential and underlying possible genetic abnormalities. The focus of this review is on gastric hamartomatous polyps, which are relatively rare and diagnostically challenging. Though most of the gastric hamartomatous polyps are benign, certain types are associated with increased malignant potential. These include certain polyps associated with specific genetic familial polyposis syndromes and gastric inverted hamartomatous polyps. Identification of these polyps can result in the prevention or early diagnosis of gastric carcinoma and also help in the identification of family members with polyposis syndromes. The aim of this review is to categorize gastric hamartomatous polyps and aid in the identification of high-risk categories. </p>","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"9 ","pages":"3-10"},"PeriodicalIF":0.0,"publicationDate":"2016-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CGast.S38452","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34464397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"“Pinstripe Pattern” in an Achalasia Patient","authors":"A. Imagawa, Keiko Takeuchi, K. Suto","doi":"10.4137/CGast.S34258","DOIUrl":"https://doi.org/10.4137/CGast.S34258","url":null,"abstract":"Endoscopic image of achalasia usually shows dilated esophageal cavity with retained liquids and foods. Recently, “pinstripe pattern” (PSP) in the case of achalasia patient was reported as an endoscopic image of the indicator for early detection of achalasia. The typical endoscopic image of PSP can be recognized in this case.","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"6 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2016-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89404349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Matuso, H. Yasuda, Midori Suzuki, S. Ishigooka, Shun-ichiro Ozawa, M. Yamashita, Hiroyuki Yamamoto, F. Itoh
{"title":"Hemostasis Achieved Endoscopically for Diverticular Bleeding from the Horizontal Portion of the Duodenum","authors":"Y. Matuso, H. Yasuda, Midori Suzuki, S. Ishigooka, Shun-ichiro Ozawa, M. Yamashita, Hiroyuki Yamamoto, F. Itoh","doi":"10.4137/CGast.S32421","DOIUrl":"https://doi.org/10.4137/CGast.S32421","url":null,"abstract":"Diverticulum of the horizontal portion of the duodenum is a rare cause of upper gastrointestinal (GI) bleeding. Since it is difficult to access the horizontal portion of the duodenum by standard upper GI endoscopy, only a very few cases of endoscopic hemostasis have been reported. Herein, we report a case of diverticular bleeding from the horizontal portion of the duodenum for which hemostasis was achieved using a small-caliber colonoscope, which has an insertion part designed with a passive-bending function/high-force transmission and a transparent tip hood.","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"335 1","pages":"61 - 64"},"PeriodicalIF":0.0,"publicationDate":"2015-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75343074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryan V. Marshall, I. Taylor, C. Lahr, T. Abell, I. Espinoza, N. Gupta, C. Gomez
{"title":"Bioelectrical Stimulation for the Reduction of Inflammation in Inflammatory Bowel Disease","authors":"Ryan V. Marshall, I. Taylor, C. Lahr, T. Abell, I. Espinoza, N. Gupta, C. Gomez","doi":"10.4137/CGast.S31779","DOIUrl":"https://doi.org/10.4137/CGast.S31779","url":null,"abstract":"Crohn's disease and ulcerative colitis are the primary inflammatory bowel diseases (IBDs) affecting the gastrointestinal tract. The current therapy aims at decreasing inflammation and reducing symptoms. This typically requires immune suppression by steroids, thiopurines, methotrexate, or tumor necrosis factor inhibitors. Patients may be unreceptive to medical therapy, and some may discontinue the treatment due to adverse effects. Noninvasive, transcutaneous vagus nerve stimulation (VNS) is currently used as a treatment for depression and epilepsy, and it is being investigated for the treatment of conditions such as multiple sclerosis, migraines, and Alzheimer's disease. Recent studies have demonstrated the importance of splenic and vagus nerve functions in the inflammatory process through the production of certain cytokines. We hypothesize that using transcutaneous VNS via the auricular afferent branch could achieve a selective anti-inflammatory effect on the intestinal wall. This review examines the possibility of using vagal stimulators as a therapy for IBD. This could open the door to novel treatments for numerous vagally mediated diseases characterized by poor responses to current therapies.","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"11 1","pages":"55 - 59"},"PeriodicalIF":0.0,"publicationDate":"2015-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76422514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sunmin Lee, Shumenghui Zhai, G. Zhang, Xiang S. Ma, Xiaoxiao Lu, Yin Tan, Philip T. Siu, B. Seals, G. Ma
{"title":"Factors Associated with Hepatitis C Knowledge Before and After an Educational Intervention among Vietnamese Americans","authors":"Sunmin Lee, Shumenghui Zhai, G. Zhang, Xiang S. Ma, Xiaoxiao Lu, Yin Tan, Philip T. Siu, B. Seals, G. Ma","doi":"10.4137/CGast.S24737","DOIUrl":"https://doi.org/10.4137/CGast.S24737","url":null,"abstract":"Background Hepatitis C virus (HCV) is a major cause of chronic liver disease and cancer. Vietnamese Americans are at high risk of HCV infection, with men having the highest US incidence of liver cancer. This study examines an intervention to improve HCV knowledge among Vietnamese Americans. Study Seven Vietnamese community-based organizations in Pennsylvania and New Jersey recruited a total of 306 Vietnamese participants from 2010 to 2011. Results Average knowledge scores for pretest and posttest were 3.32 and 5.88, respectively (maximum 10). After adjusting for confounding variables, age and higher education were positively associated with higher pretest scores and having a physician who spoke English or Vietnamese was negatively associated with higher pretest scores. Additionally, after adjusting for confounding variables, household income, education, and having an HCV-infected family member significantly increased knowledge scores. Conclusions Promotion and development of HCV educational programs can increase HCV knowledge among race and ethnic groups, such as Vietnamese Americans. Giving timely information to at-risk groups provides the opportunity to correct misconceptions, decrease HCV risk behaviors, and encourage testing that might improve timely HCV diagnosis and treatment.","PeriodicalId":10382,"journal":{"name":"Clinical Medicine Insights. Gastroenterology","volume":"71 1","pages":"45 - 53"},"PeriodicalIF":0.0,"publicationDate":"2015-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80421786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}