Current Gastroenterology Reports最新文献_第10页

Food as Medicine: How to Influence the Microbiome and Improve Symptoms in Patients with Irritable Bowel Syndrome. 食物作为药物:如何影响肠道易激综合征患者的微生物群并改善症状。

Current Gastroenterology Reports Pub Date : 2023-03-01 DOI: 10.1007/s11894-023-00861-0

Shyam Vedantam, Erica Graff, Nabiha Shabbir Khakoo, Nidah Shabbir Khakoo, Michelle Pearlman

{"title":"Food as Medicine: How to Influence the Microbiome and Improve Symptoms in Patients with Irritable Bowel Syndrome.","authors":"Shyam Vedantam, Erica Graff, Nabiha Shabbir Khakoo, Nidah Shabbir Khakoo, Michelle Pearlman","doi":"10.1007/s11894-023-00861-0","DOIUrl":"https://doi.org/10.1007/s11894-023-00861-0","url":null,"abstract":"Purpose of review: This review highlights effects of dietary interventions on the gut microbiome and gastrointestinal symptoms in those with irritable bowel syndrome (IBS).Recent findings: It is hypothesized that gut dysbiosis factors into the pathophysiology of IBS. Various diets that influence the microbiome and intestinal physiology may have therapeutic properties. At present, data suggests that implementation of personalized dietary interventions have a mixed, but overall positive effect on the gut microbiome and IBS symptoms. The effect of dietary modification on the gut microbiome and GI symptoms in patients with IBS is a topic that has garnered interest due to the increasing prevalence of IBS and heightened awareness of the importance of gut health. The composition of the gut microbiome may be modulated by promoting fiber intake and implementation of exclusionary diets and dietary supplements; however, additional studies are needed to provide evidence-based guidelines in this patient population.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"25 3","pages":"52-60"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9479462","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: 2

Mild Crohn's Disease: Definition and Management. 轻度克罗恩病:定义和管理。

Current Gastroenterology Reports Pub Date : 2023-03-01 DOI: 10.1007/s11894-023-00863-y

Jennifer Claytor, Pushkar Kumar, Ashwin N Ananthakrishnan, Jean-Frederic Colombel, Manasi Agrawal, Ryan C Ungaro

{"title":"Mild Crohn's Disease: Definition and Management.","authors":"Jennifer Claytor, Pushkar Kumar, Ashwin N Ananthakrishnan, Jean-Frederic Colombel, Manasi Agrawal, Ryan C Ungaro","doi":"10.1007/s11894-023-00863-y","DOIUrl":"https://doi.org/10.1007/s11894-023-00863-y","url":null,"abstract":"Purpose of review: Crohn's Disease (CD) is a chronic inflammatory disease that can lead to progressive damage to the gastrointestinal tract and significant disability. Early, \"top-down\" biologic therapy is recommended in moderate-to-severe CD to induce remission and to prevent hospitalization and complications. However, an estimated 20-30% of patients with CD have a mild disease course and may not garner sufficient benefit from expensive, immunosuppressing agents to justify their risks. Herein, we review characteristics of patients with mild CD, the available options for disease treatment and monitoring, and future directions of research.Recent findings: For ambulatory outpatients with low-risk, mild, ileal or ileocolonic CD, induction of remission with budesonide is recommended. For colonic CD, sulfasalazine is a reasonable choice, although other aminosalicylates have no role in the treatment of CD. No large, randomized trial has supported the use of antibiotics or antimycobacterials in the treatment of CD. Partial Enteral Nutrition and Crohn's Disease Exclusion Diets may be appropriate for inducing remission in some adult patients, with trials ongoing. Select patients with mild-to-moderate CD may benefit from maintenance therapy with azathioprines or gut specific biologics, such as vedolizumab. The role of complementary and alternative medicine is not well defined. The identification, risk stratification, and monitoring of patients with mild CD can be a challenging clinical scenario. Some patients with low risk of disease progression may be appropriate for initial induction of remission with budesonide or sulfasalazine, followed by close clinical monitoring. Future research should focus on pre-clinical biomarkers to stratify disease, novel therapies with minimal systemic immune suppression, and validation of rigorous clinical monitoring algorithms.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"25 3","pages":"45-51"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9463280","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: 1

Food Allergies and Alpha-gal Syndrome for the Gastroenterologist. 胃肠病学家的食物过敏和α -gal综合征。

Current Gastroenterology Reports Pub Date : 2023-02-01 DOI: 10.1007/s11894-022-00860-7

Christopher J Lee, Sarah K McGill

{"title":"Food Allergies and Alpha-gal Syndrome for the Gastroenterologist.","authors":"Christopher J Lee, Sarah K McGill","doi":"10.1007/s11894-022-00860-7","DOIUrl":"https://doi.org/10.1007/s11894-022-00860-7","url":null,"abstract":"Purpose of review: Food allergies are typically not considered as a cause of gastrointestinal (GI) distress without additional allergic symptoms, apart from celiac disease and eosinophilic esophagitis. However, recent reports of patients with alpha-gal syndrome who presented with GI-only symptoms like abdominal pain, vomiting, and diarrhea challenge this paradigm. Alpha-gal syndrome is an IgE-mediated allergy characterized by delayed reactions after eating mammalian meat or mammalian-derived products that contain galactose-alpha-1,3-galactose (alpha-gal). The purpose of this review is to discuss our current understanding of food allergies, GI illness, and the GI manifestations of alpha-gal syndrome.Recent findings: Among Southeastern U.S. GI clinic patients who screened positive for serum alpha-gal IgE, a majority of patients reported significant symptom improvement on an alpha-gal-avoidant diet, suggesting that the allergy had played a role in their GI symptoms. Diagnosis of alpha-gal syndrome is typically made with concerning allergic symptoms, elevated alpha-gal specific IgE in the serum, and symptom improvement on an alpha-gal avoidant diet. Alpha-gal syndrome can cause a delayed allergic response that is increasingly recognized worldwide, including among patients with predominant GI symptoms.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"25 2","pages":"21-30"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10657147","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: 2

Gut Microbiome and Its Impact on Obesity and Obesity-Related Disorders. 肠道微生物组及其对肥胖和肥胖相关疾病的影响。

Current Gastroenterology Reports Pub Date : 2023-02-01 DOI: 10.1007/s11894-022-00859-0

Senthilkumar Sankararaman, Kimberly Noriega, Sujithra Velayuthan, Thomas Sferra, Robert Martindale

{"title":"Gut Microbiome and Its Impact on Obesity and Obesity-Related Disorders.","authors":"Senthilkumar Sankararaman, Kimberly Noriega, Sujithra Velayuthan, Thomas Sferra, Robert Martindale","doi":"10.1007/s11894-022-00859-0","DOIUrl":"https://doi.org/10.1007/s11894-022-00859-0","url":null,"abstract":"Purpose of review: The prevalence of overweight and obesity has been increasing worldwide at an alarming rate. Gut microbiota intimately influence host energy metabolism, and immune response. Studies indicate a prominent role of gut dysbiosis in propagating inflammation that is associated with the development of obesity and obesity-related disorders such as type 2 diabetes mellitus, metabolic syndrome, and non-alcoholic fatty liver disease. This article will review the current literature on gut microbiome and its impact on obesity and obesity-related disorders.Recent findings: An altered gut microbial composition in obesity and obesity-related disorders is associated with enhanced energy extraction from the non-digestible dietary carbohydrates, increased gut permeability, increased production of proinflammatory metabolites, such as lipopolysaccharides, resulting in systemic inflammation and insulin resistance. Gut microbiota modulation can be achieved either by dietary manipulation or by administration of probiotics, prebiotics, synbiotics, and/or fecal microbiota transplantation aiming at the improvement of the gut dysbiosis in obesity and metabolic disorders. Further clinical trials are required to better elucidate the dose, and frequency of these interventions and also their long-term impact on host metabolism.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"25 2","pages":"31-44"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10657250","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: 7

When Should the Appropriateness of PEG be Questioned? 何时应该质疑钉住汇率制的适当性?

Current Gastroenterology Reports Pub Date : 2023-01-01 DOI: 10.1007/s11894-022-00857-2

Keelin Flannery Roche, Katie L Bower, Bryan Collier, Dustin Neel, Laura Esry

引用次数: 1

All Fiber is Not Fiber. 并非所有的纤维都是纤维。

Current Gastroenterology Reports Pub Date : 2023-01-01 DOI: 10.1007/s11894-022-00858-1

Shahrose Rahman, Kristin Trone, Caleb Kelly, Andrea Stroud, Robert Martindale

{"title":"All Fiber is Not Fiber.","authors":"Shahrose Rahman, Kristin Trone, Caleb Kelly, Andrea Stroud, Robert Martindale","doi":"10.1007/s11894-022-00858-1","DOIUrl":"https://doi.org/10.1007/s11894-022-00858-1","url":null,"abstract":"Purpose of review: Epidemiologic studies and clinical trials have demonstrated the benefits of dietary fiber. This occurs through a combination of the physiochemical properties of fiber and through microbial fermentation that occurs in the colon which result in the production of short-chain fatty acids (SCFA). The purpose of this review is to highlight the physiochemical properties of fiber that result in the range of physiologic effects and to review the literature on the health benefits of acetate, propionate, and butyrate.Recent findings: Of the variety of properties and functions exerted by dietary fibers, the fermentability and production of SCFA's are emphasized in this review. Studies done in both animal and humans reveal the anti-obesity, anti-inflammatory, and possible anti-neoplastic roles SCFAs exert at the mucosal level. Many clinical questions remain regarding the optimal dose, type, and method of delivery of fiber to exert the desired beneficial effects. It has the potential to be used in the management of clinical symptoms, prevention of disease, and improvement in human health. Further studies to address this novel use of fiber has the potential to make a large impact in clinical practice.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"25 1","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9082688","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: 4

Update on Immune Checkpoint Inhibitor Enterocolitis. 免疫检查点抑制剂肠炎的最新进展。

Current Gastroenterology Reports Pub Date : 2022-12-01 Epub Date: 2022-10-20 DOI: 10.1007/s11894-022-00852-7

Molly R Kelly-Goss, Yousef R Badran, Michael Dougan

{"title":"Update on Immune Checkpoint Inhibitor Enterocolitis.","authors":"Molly R Kelly-Goss, Yousef R Badran, Michael Dougan","doi":"10.1007/s11894-022-00852-7","DOIUrl":"10.1007/s11894-022-00852-7","url":null,"abstract":"Purpose of review: Immune checkpoint inhibitor (ICI) therapy revolutionized the treatment of multiple solid and hematologic malignancies. Yet, with it came profound inflammatory toxicities that mimic autoimmune diseases, termed immune-related adverse events (irAEs). Prominent among these is gastrointestinal inflammation, including a spectrum of gastritis, enteritis, and colitis. Here we synthesize an approach to immune checkpoint related enterocolitis (irEC) - including diagnostics and therapeutics - underpinned by new insights into the mechanism behind these phenomena.Recent findings: This review presents updated insights on how to approach irEC, including novel approaches to selective immunosuppressive therapy, the role of fecal microbiota transplant, and the underlying cellular mechanisms of irEC. This review provides an update on irEC diagnosis and therapy, with considerations of new therapies and special patient populations. The field of gastrointestinal irAEs requires additional investigation, which will ultimately provide the tools required for patients to continue to receive life-saving ICI therapy.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"24 12","pages":"171-181"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9583048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10334579","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

Therapeutic Drug Monitoring in Practice for Inflammatory Bowel Disease. 炎性肠病治疗药物监测的实践。

Current Gastroenterology Reports Pub Date : 2022-12-01 DOI: 10.1007/s11894-022-00854-5

Bryant W Megna, Byron P Vaughn

引用次数: 0

Article Topic: Positioning Ulcerative Colitis Therapies in 2022 and Beyond. 文章主题:2022年及以后溃疡性结肠炎治疗的定位。

Current Gastroenterology Reports Pub Date : 2022-12-01 DOI: 10.1007/s11894-022-00853-6

Amneet Hans, Robert Battat, Dana J Lukin

{"title":"Article Topic: Positioning Ulcerative Colitis Therapies in 2022 and Beyond.","authors":"Amneet Hans, Robert Battat, Dana J Lukin","doi":"10.1007/s11894-022-00853-6","DOIUrl":"https://doi.org/10.1007/s11894-022-00853-6","url":null,"abstract":"Purpose of review: Ulcerative colitis (UC) is a chronic disease with an increasing incidence. Recent guidelines emphasize treating toward objective targets, requiring the use of effective, steroid-sparing therapies. This review summarizes the safety and efficacy data of available therapies as well comparative effectiveness studies in order to help the reader make rational treatment decisions.Recent findings: Following the approval of tumor necrosis factor alpha antagonists, we have seen recent regulatory approval of several additional biologic and small molecule agents from several therapeutic classes (integrin antagonists, interleukin 12/23 antagonists, Janus kinase inhibitors, and sphingosine-1-phosphate receptor antagonists) for UC. Randomized, controlled trials, real-world analyses, and network meta-analyses have investigated the comparative safety and efficacy of these therapies in order to help clinicians better position these therapies in clinical practice. Numerous agents are now approved for the treatment of UC. This evidence-based review will help the reader understand the important factors weighing into treatment decisions for patients with UC and enable patient education and discussion with a focus on a shared decision-making approach.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"24 12","pages":"157-170"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10335070","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: 1

The Role of Pediatric Gastroenterologists in the Evaluation of Complex Aerodigestive Disorders. 儿科胃肠病学家在评估复杂气消化系统疾病中的作用。

Current Gastroenterology Reports Pub Date : 2022-12-01 DOI: 10.1007/s11894-022-00855-4

Isha Kaul, Eric H Chiou

{"title":"The Role of Pediatric Gastroenterologists in the Evaluation of Complex Aerodigestive Disorders.","authors":"Isha Kaul, Eric H Chiou","doi":"10.1007/s11894-022-00855-4","DOIUrl":"https://doi.org/10.1007/s11894-022-00855-4","url":null,"abstract":"Purpose of review: Children with aerodigestive disorders frequently have concerns regarding difficulty breathing, swallowing, and growing. In this review, we explored the role of pediatric gastroenterologists in the evaluation of complex aerodigestive disorders and the overall approach to these often-challenging patients.Recent findings: Pediatric gastroenterologists evaluate children with aerodigestive concerns ranging from dysphagia and gastroesophageal reflux to complex congenital abnormalities such as esophageal atresia. Diagnostic tools, such as multichannel intraluminal impedance-pH monitoring, are used for diagnosing gastroesophageal reflux and assessing the correlation with symptoms. Endoscopic evaluation, and in some complex cases, with therapeutic dilations may also be performed. Gastrointestinal dysmotility evaluation with manometry studies are also being increasingly utilized. Multidisciplinary aerodigestive programs can provide a coordinated approach to children with complex airway, pulmonary and gastrointestinal tract disorders. A pediatric gastroenterologist's expertise and specialized skills not only offer many diagnostic tools for these complicated medical cases but are also important in long term medical management.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"24 12","pages":"211-221"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10336128","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