Current Gastroenterology Reports最新文献

Rectal Prolapse in the Pediatric Population. 小儿直肠脱垂

Current Gastroenterology Reports Pub Date : 2025-12-01 Epub Date: 2024-11-23 DOI: 10.1007/s11894-024-00953-5

James K Moon, John D Stratigis, Aaron M Lipskar

{"title":"Rectal Prolapse in the Pediatric Population.","authors":"James K Moon, John D Stratigis, Aaron M Lipskar","doi":"10.1007/s11894-024-00953-5","DOIUrl":"10.1007/s11894-024-00953-5","url":null,"abstract":"Purpose of review: Rectal prolapse in the pediatric population presents a clinical challenge with wide variability in etiology, presentation, work-up and management. In this article, we reviewed the evidence supporting various medical and surgical treatment options as well as the recent trends amongst pediatric surgeons.Recent findings: Medical therapy is highly effective in most patients, with bowel management programs being particularly successful. Nonetheless, medically refractory disease, often seen in older children and in children with behavioral/psychiatric disorders, can be challenging. Sclerotherapy with ethanol or 5% phenol can be effective local treatments. 15% hypertonic saline, 50% dextrose, and Deflux are additional safe alternatives. Perianal procedures and perineal procedures are less invasive surgical options, but transabdominal rectopexy appears to be the favored treatment for disease refractory to local treatment. Transabdominal rectopexy with sigmoidectomy, the recommended operation in the adult population for patients with prolapse and constipation, appears only to be preferred in the pediatric population for postoperative recurrences.Recent findings: While outcomes of medical treatment for pediatric rectal prolapse are excellent, sclerotherapy and transabdominal rectopexy are effective options for refractory disease preferred by most pediatric surgeons.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695051","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}

引用次数: 0

Gastric Per-Oral Endoscopy Myotomy (G-POEM): Tips, Tricks, and Pitfalls. 胃经口腔内窥镜肌切开术（G-POEM）：诀窍、技巧和陷阱。

Current Gastroenterology Reports Pub Date : 2025-12-01 Epub Date: 2024-11-06 DOI: 10.1007/s11894-024-00952-6

Grace E Kim, Mahnoor Khan, Sunil Amin, Amrita Sethi

引用次数: 0

Esophageal ESD Training; Perspective of West vs. East.

Current Gastroenterology Reports Pub Date : 2025-12-01 Epub Date: 2024-11-30 DOI: 10.1007/s11894-024-00951-7

Abdulrahman Qatomah, Hiroyuki Aihara

{"title":"Esophageal ESD Training; Perspective of West vs. East.","authors":"Abdulrahman Qatomah, Hiroyuki Aihara","doi":"10.1007/s11894-024-00951-7","DOIUrl":"10.1007/s11894-024-00951-7","url":null,"abstract":"PURPOSE OF REVIEW: Esophageal cancer is one of the most common cancers in the world and carries a poor prognosis. While esophagectomy poses considerable mortality and morbidity risks, endoscopic resection can provide a safer and less invasive alternative. RECENT FINDINGS: Endoscopic resection therapy has allowed a less invasive approach with comparable outcomes to esophagectomy. EMR is considered safe and requires less intensive training, yet it does not offer complete histopathological assessment due to the nature of piecemeal resection for larger lesions. Alternatively, ESD offers an R0 resection, therefore allowing precise histopathological evaluation. Training in ESD is essential; however, a uniform training model has not been agreed upon. The Japanese apprenticeship training model has proven effective, with promising training outcomes from the Eastern experience. In the West, a comprehensive training model through a combination of apprenticeship with progressive exposure, including ex-vivo and live animal hands-on training, could be the optimal approach. Different methods of ESD training are currently available, all of which aim to provide the experience needed to perform safe ESD. Despite the differences in training styles between the East and the West, a modified apprenticeship model could potentially result in more effective and better training outcomes. The currently available technologies provide the environment to enhance ESD training.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754844","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}

引用次数: 0

The Current Landscape of Endoscopic Submucosal Training in the United States. 美国内镜粘膜下培训的现状。

Current Gastroenterology Reports Pub Date : 2025-12-01 Epub Date: 2024-11-07 DOI: 10.1007/s11894-024-00950-8

Mike T Wei, Shai Friedland, Joo Ha Hwang

{"title":"The Current Landscape of Endoscopic Submucosal Training in the United States.","authors":"Mike T Wei, Shai Friedland, Joo Ha Hwang","doi":"10.1007/s11894-024-00950-8","DOIUrl":"https://doi.org/10.1007/s11894-024-00950-8","url":null,"abstract":"Purpose of review: Endoscopic submucosal dissection (ESD) has been found to increase en bloc and R0 resection as well as decrease risk of recurrence. However, despite literature supporting the benefits of endoscopic submucosal dissection, adoption of ESD in the United States has been challenging, driven by factors including requirement for specialized training as well as limitations in training availability.Recent findings: Many devices have been developed to improve ease and therefore adoption for the procedure, with advancements in stability, resection as well as closure of the mucosal defect following resection. While the Japanese model of training in ESD centers around the Master-Apprentice model, this is scarce in the United States. Most US endoscopists therefore must follow other paths to learn and become proficient at ESD. There has been a rapid expansion in literature on ESD, fellowship programs, opportunities for case observation, and significant evolution in ex vivo training models that can assist an endoscopist in receiving training in ESD. Currently, there are three main ways of learning to perform ESD in the United States: 1. Third space endoscopy fellowship; 2. Master-apprentice model; 3. Utilization of live courses and proctored procedures. ESD is the optimal method to ensure en bloc resection of large mucosal neoplasms of the gastrointestinal tract. While several barriers hinder adoption of ESD in the United States, there has been significant development both in procedural and training aspects. Further research and discussions are needed to determine criteria for credentialing and proficiency in ESD.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603516","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}

引用次数: 0

Synergistic Benefits of Dietary Strategies in the Management of IBD.

Current Gastroenterology Reports Pub Date : 2025-12-01 Epub Date: 2024-12-19 DOI: 10.1007/s11894-024-00949-1

Gerald W Dryden, Sara M Dryden

{"title":"Synergistic Benefits of Dietary Strategies in the Management of IBD.","authors":"Gerald W Dryden, Sara M Dryden","doi":"10.1007/s11894-024-00949-1","DOIUrl":"https://doi.org/10.1007/s11894-024-00949-1","url":null,"abstract":"Purpose of review: Inflammatory bowel disease (IBD) patients commonly inquire about the role of diet in the onset and management of their disease process. This review sought to assess the impact of the inflammatory bowel diseases on the nutritional state of patients and evaluate the evidence supporting nutritional interventions as therapy.Recent findings: The role of nutrition has evolved from one of deficient nutrient and calorie replacement alone into a proactive therapeutic for treating active inflammatory disease symptoms. The realization that initiating total parenteral nutrition (TPN) in place of oral take could improve disease symptoms provided the first indication that food intake played a causative role in the IBD. The evolution of TPN to enteral nutrition improved tolerance and reduced side effects but clouded the role of oral intake in the pathophysiology of IBD. Advanced understanding of the role of the microbiota in IBD combined with recognition of the influence of nutrients on microbial composition have ushered in a new era of food as therapy. The role of nutrition in IBD has evolved significantly over the past 30-40 years. From complete elimination of oral intake to the carefully curated menu intended to mold the intestinal microbiota to a non-inflammatory milieu has revolutionized the approach to dietary intervention. Additional studies are warranted to optimize dietary intervention strategies.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863465","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}

引用次数: 0

Endoscopic Gallbladder Drainage EUS LAMS vs. ERCP Trans-papillary Drainage. 内镜胆囊引流术 EUS LAMS 与 ERCP 经乳头引流术对比。

Current Gastroenterology Reports Pub Date : 2025-12-01 Epub Date: 2024-11-16 DOI: 10.1007/s11894-024-00948-2

Maham Hayat, Yasi Xiao, Mustafa A Arain, Dennis Yang

{"title":"Endoscopic Gallbladder Drainage EUS LAMS vs. ERCP Trans-papillary Drainage.","authors":"Maham Hayat, Yasi Xiao, Mustafa A Arain, Dennis Yang","doi":"10.1007/s11894-024-00948-2","DOIUrl":"10.1007/s11894-024-00948-2","url":null,"abstract":"Purpose of review: In this review, we discuss the role of endoscopic gallbladder drainage for acute cholecystitis in non-surgical candidates, describe technical aspects, clinical outcomes, and elaborate on considerations when determining which approach to adopt for a given patient.Recent findings: Cholecystectomy remains the criterion standard for management of acute cholecystitis in patients who can safely undergo surgery. For non-surgical candidates, percutaneous cholecystostomy (PTC-GBD) has been the traditional strategy to drain and decompress the gallbladder. Advances in endoscopy have further expanded the nonsurgical interventions and approaches to cholecystitis. Both endoscopic transpapillary gallbladder drainage (ET-GBD) and endoscopic ultrasound guided gallbladder drainage (EUS-GBD) have become acceptable alternatives to PTC-GBD, with growing literature supporting their efficacy, safety and improved patient quality of life when compared to a percutaneous approach. Choosing the appropriate endoscopic technique for gallbladder drainage should be tailored to each patient, keeping in view the specific clinical scenarios, endoscopist preference and following a multi-disciplinary approach.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643445","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}

引用次数: 0

Frailty: An Underappreciated Risk Factor for IBD Complications. 虚弱：被忽视的 IBD 并发症风险因素。

Current Gastroenterology Reports Pub Date : 2024-12-01 Epub Date: 2024-09-05 DOI: 10.1007/s11894-024-00945-5

Ananya Venkatesh, Ammu T Susheela, Bharati Kochar

引用次数: 0

Perspectives and Advice from an Interventional Gastroenterologist at a Tertiary Academic Center. 一位三级学术中心介入胃肠病学家的观点和建议。

Current Gastroenterology Reports Pub Date : 2024-12-01 Epub Date: 2024-08-20 DOI: 10.1007/s11894-024-00944-6

Salmaan Jawaid

引用次数: 0

Proton Pump Inhibitors in Patients with Cirrhosis: Pharmacokinetics, Benefits and Drawbacks. 肝硬化患者的质子泵抑制剂：药代动力学、优点和缺点。

Current Gastroenterology Reports Pub Date : 2024-12-01 Epub Date: 2024-08-21 DOI: 10.1007/s11894-024-00943-7

Gasser El-Azab

{"title":"Proton Pump Inhibitors in Patients with Cirrhosis: Pharmacokinetics, Benefits and Drawbacks.","authors":"Gasser El-Azab","doi":"10.1007/s11894-024-00943-7","DOIUrl":"10.1007/s11894-024-00943-7","url":null,"abstract":"Purpose of review: This review explores the pharmacokinetics, benefits, and risks of proton pump inhibitors (PPIs) in cirrhotic patients, focusing on the appropriateness of their use and potential adverse effects.Recent findings: Recent studies highlight significant pharmacokinetic alterations in PPIs among cirrhotic patients, with marked increases in lansoprazole and pantoprazole exposure and relatively stable levels of esomeprazole. While effective for managing acid-related disorders and post-band ulcer rebleeding, evidence supporting PPI use for portal hypertension-related bleeding is lacking. Emerging research suggests potential adverse effects such as hepatic decompensation, spontaneous bacterial peritonitis, hepatic encephalopathy, and increased mortality, possibly linked to dysbiosis and bacterial translocation. PPI use in cirrhotic patients alters pharmacokinetics significantly, with esomeprazole potentially safer in advanced cirrhosis. The review advises caution in routine PPI use beyond acid-related conditions due to limited evidence and substantial risks. It underscores the need for careful risk-benefit assessments and exploration of alternative therapies. Future research should aim to identify safer management strategies for portal hypertension complications and to develop evidence-based guidelines for PPI use in patients with cirrhosis.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"323-334"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016606","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}

引用次数: 0

Generative AI in Pediatric Gastroenterology. 小儿胃肠病学中的生成式人工智能。

Current Gastroenterology Reports Pub Date : 2024-12-01 Epub Date: 2024-09-07 DOI: 10.1007/s11894-024-00946-4

John M Rosen

{"title":"Generative AI in Pediatric Gastroenterology.","authors":"John M Rosen","doi":"10.1007/s11894-024-00946-4","DOIUrl":"10.1007/s11894-024-00946-4","url":null,"abstract":"Purpose of review: The integration of digital technology into medical practice is often thrust upon clinicians, with standards and routines developed long after initiation. Clinicians should endeavor towards a basic understanding even of emerging technologies so that they can direct its use. The intent of this review is to describe the current state of rapidly evolving generative artificial intelligence (GAI), and to explore both how pediatric gastroenterology practice may benefit as well as challenges that will be faced.Recent findings: Although little research demonstrating the acceptance, practice, and outcomes associated with GAI in pediatric gastroenterology is published, there are relevant data adjacent to the specialty and overwhelming potential as professed in the media. Best practice guidelines are widely developed in academic publishing and resources to initiate and improve practical user skills are prevalent. Initial published evidence supports broad acceptance of the technology as part of medical practice by clinicians and patients, describes methods with which higher quality GAI can be developed, and identifies the potential for bias and disparities resulting from its use. GAI is broadly available as a digital tool for incorporation into medical practice and holds promise for improved quality and efficiency of care, but investigation into how GAI can best be used remains at an early stage despite rapid evolution of the technology.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"342-348"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145356","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}

引用次数: 0