Current Gastroenterology Reports最新文献_第4页

Esophagogastric Junction Outflow Obstruction (EGJOO): A Manometric Phenomenon or Clinically Impactful Problem. 食管胃交界流出道梗阻 (EGJOO)：是人体测量现象还是有临床影响的问题？

Current Gastroenterology Reports Pub Date : 2024-07-01 Epub Date: 2024-03-28 DOI: 10.1007/s11894-024-00928-6

Laura Bach, Marcelo F Vela

{"title":"Esophagogastric Junction Outflow Obstruction (EGJOO): A Manometric Phenomenon or Clinically Impactful Problem.","authors":"Laura Bach, Marcelo F Vela","doi":"10.1007/s11894-024-00928-6","DOIUrl":"10.1007/s11894-024-00928-6","url":null,"abstract":"Purpose of review: Esophagogastric junction outflow obstruction (EGJOO), defined manometrically by impaired esophagogastric junction relaxation (EGJ) with preserved peristalsis, can be artifactual, due to secondary etiologies (mechanical, medication-induced), or a true motility disorder. The purpose of this review is to go over the evolving approach to diagnosing and treating clinically relevant EGJOO.Recent findings: Timed barium esophagram (TBE) and the functional lumen imaging probe (FLIP) are useful to identify clinically relevant EGJOO that merits lower esophageal sphincter (LES) directed therapies. There are no randomized controlled trials evaluating EJGOO treatment. Uncontrolled trials show effectiveness for pneumatic dilation and peroral endoscopic myotomy to treat confirmed EGJOO; Botox and Heller myotomy may also be considered but data for confirmed EGJOO is more limited. Diagnosis of clinically relevant idiopathic EGJOO requires symptoms, exclusion of mechanical and medication-related etiologies, and confirmation of EGJ obstruction by TBE or FLIP. Botox LES injection has limited durability, it can be used in patients who are not candidates for other treatments. PD and POEM are effective in confirmed EGJOO, Heller myotomy may also be considered but data for confirmed EGJOO is limited. Randomized controlled trials are needed to clarify optimal management of EGJOO.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"173-180"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305145","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

Does Ileus Represent the Forgotten End Organ Failure in Critical Illness? 回肠是否代表了危重病中被遗忘的终末器官衰竭？

Current Gastroenterology Reports Pub Date : 2024-06-01 Epub Date: 2024-04-01 DOI: 10.1007/s11894-023-00910-8

Christy M Lawson, Chris Jones, Michael Herman, Cecilia Kim, Elizabeth Mannino, Endashaw Omer, Carlas Venegas

引用次数: 0

Peri-Operative Optimization of Patients with Crohn's Disease. 克罗恩病患者的围手术期优化。

Current Gastroenterology Reports Pub Date : 2024-05-01 Epub Date: 2024-02-29 DOI: 10.1007/s11894-024-00925-9

Hareem Syed, Ahmed Nadeem, David Gardinier, Kendra Weekley, Dovid Ribakow, Stephen Lupe, Shubha Bhat, Stefan Holubar, Benjamin L Cohen

{"title":"Peri-Operative Optimization of Patients with Crohn's Disease.","authors":"Hareem Syed, Ahmed Nadeem, David Gardinier, Kendra Weekley, Dovid Ribakow, Stephen Lupe, Shubha Bhat, Stefan Holubar, Benjamin L Cohen","doi":"10.1007/s11894-024-00925-9","DOIUrl":"10.1007/s11894-024-00925-9","url":null,"abstract":"Purpose of review: The management of patients with Crohn's disease (CD) undergoing surgery is complex and optimization of modifiable factors perioperatively can improve outcomes. This review focuses on the perioperative management of CD patients undergoing surgery, emphasizing the need for a multi-disciplinary approach.Recent findings: Research highlights the benefits of a comprehensive strategy, involving nutritional optimization, psychological assessment, and addressing septic complications before surgery. Despite many CD patients being on immune-suppressing medications, studies indicate that most of these medications are safe to use and should not delay surgery. However, a personalized approach for each case is needed. This review underscores the importance of multi-disciplinary team led peri-operative management of CD patients. We suggest that this can be done at a dedicated perioperative clinic for prehabilitation, with the potential to enhance outcomes for CD patients undergoing surgery.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"125-136"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989564","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

Artificial Intelligence and IBD: Where are We Now and Where Will We Be in the Future? 人工智能与 IBD：我们现在在哪里，未来会在哪里？

Current Gastroenterology Reports Pub Date : 2024-05-01 Epub Date: 2024-02-27 DOI: 10.1007/s11894-024-00918-8

Mehwish Ahmed, Molly L Stone, Ryan W Stidham

{"title":"Artificial Intelligence and IBD: Where are We Now and Where Will We Be in the Future?","authors":"Mehwish Ahmed, Molly L Stone, Ryan W Stidham","doi":"10.1007/s11894-024-00918-8","DOIUrl":"10.1007/s11894-024-00918-8","url":null,"abstract":"Purpose of review: Artificial intelligence (AI) is quickly demonstrating the ability to address problems and challenges in the care of IBD. This review with commentary will highlight today's advancements in AI applications for IBD in image analysis, understanding text, and replicating clinical knowledge and experience.Recent findings: Advancements in machine learning methods, availability of high-performance computing, and increasing digitization of medical data are providing opportunities for AI to assist in IBD care. Multiple groups have demonstrated the ability of AI to replicate expert endoscopic scoring in IBD, with expansion into automated capsule endoscopy, enterography, and histologic interpretations. Further, AI image analysis is being used to develop new endoscopic scoring with more granularity and detail than is possible using conventional methods. Advancements in natural language processing are proving to reduce laborious tasks required in the care of IBD, including documentation, information searches, and chart review. Finally, large language models and chatbots that can understand language and generate human-like replies are beginning to exhibit clinical intelligence that will revolutionize how we deliver IBD care. Today, AI is being deployed to replicate expert judgement in specific tasks where disagreement, subjectivity, and bias are common. However, the near future will herald contributions of AI doing what we cannot, including new detailed measures of IBD, enhanced analysis of images, and perhaps even fully automating care. As we speculate on future technologic capabilities that may improve how we care for IBD, this review will also consider how we will implement and fairly use AI in practice.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"137-144"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11320710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971189","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

Managing Risks with Newer Oral Small Molecules in Patients with Inflammatory Bowel Diseases. 管理炎症性肠病患者使用新型口服小分子药物的风险。

Current Gastroenterology Reports Pub Date : 2024-05-01 Epub Date: 2024-02-14 DOI: 10.1007/s11894-024-00923-x

Malek Ayoub, Shivani Mattay, Andres J Yarur, Parakkal Deepak

引用次数: 0

The Role of the Gut Microbiome in Health and Disease in the Elderly. 肠道微生物组在老年人健康和疾病中的作用。

Current Gastroenterology Reports Pub Date : 2024-04-20 DOI: 10.1007/s11894-024-00932-w

Lea Ann Chen, Kaitlyn Boyle

引用次数: 0

Capsules for the Diagnosis and Treatment of Gastrointestinal Motility Disorders- A Game Changer. 用于诊断和治疗胃肠道运动障碍的胶囊--游戏规则的改变者。

Current Gastroenterology Reports Pub Date : 2024-04-17 DOI: 10.1007/s11894-024-00926-8

Irene Sonu, Sun Jung Oh, Satish S C Rao

引用次数: 0

GERD after Bariatric Surgery: A Review of the Underlying Causes and Recommendations for Management. 减肥手术后的胃食管反流病：肥胖手术后胃食管反流病：病因综述及治疗建议。

Current Gastroenterology Reports Pub Date : 2024-04-01 Epub Date: 2024-02-14 DOI: 10.1007/s11894-024-00919-7

Alison Pletch, Anne Lidor

引用次数: 0

Endoscopic Non-ablative Radiofrequency Treatment (Stretta) for Gastroesophageal Reflux Disease (GERD). 治疗胃食管反流病（GERD）的内窥镜非烧蚀射频治疗（Stretta）。

Current Gastroenterology Reports Pub Date : 2024-04-01 Epub Date: 2024-02-23 DOI: 10.1007/s11894-024-00917-9

George Triadafilopoulos

{"title":"Endoscopic Non-ablative Radiofrequency Treatment (Stretta) for Gastroesophageal Reflux Disease (GERD).","authors":"George Triadafilopoulos","doi":"10.1007/s11894-024-00917-9","DOIUrl":"10.1007/s11894-024-00917-9","url":null,"abstract":"Purpose of review: Gastroesophageal reflux disease (GERD) is very common in the general population and poses a large societal socio-economic burden. In this article, we review the evidence supporting non-ablative radiofrequency treatment (Stretta) for the endoscopic management of GERD and we compare it to pharmacologic and other minimally invasive and surgical interventions.Recent findings: Proton pump inhibitors (PPI) are a key therapy for GERD. For patients without associated significant sliding hiatal hernia, who have inadequate relief of their reflux symptoms, Stretta and other endoscopic therapies, such as transoral fundoplication (TIF), may improve symptoms and GERD-related quality of life. Unfortunately, there are no recent large randomized controlled trials, and most of the evidence is based on meta-analyses and small scale, prospective and retrospective single center efforts. Comparisons of Stretta efficacy to other anti-reflux endoscopic modalities and anti-reflux surgery (ARS) are also presented. There are several endoscopic and minimally invasive modalities to manage PPI-refractory GERD acting through various mechanisms that have been found effective in managing GERD symptoms and quality of life. Among them, Stretta has the longest track record of efficacy and safety. Larger-scale and longer-term comparative efficacy trials in selected populations of patients with acid reflux with and without hiatal hernia will be needed.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"93-98"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930435","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

Mast Cell Activation Syndrome and Gut Dysfunction: Diagnosis and Management. 肥大细胞活化综合征与肠道功能紊乱：诊断与管理》。

Current Gastroenterology Reports Pub Date : 2024-04-01 Epub Date: 2024-02-14 DOI: 10.1007/s11894-024-00924-w

Matthew J Hamilton

{"title":"Mast Cell Activation Syndrome and Gut Dysfunction: Diagnosis and Management.","authors":"Matthew J Hamilton","doi":"10.1007/s11894-024-00924-w","DOIUrl":"10.1007/s11894-024-00924-w","url":null,"abstract":"Purpose of review: Mast cell activation syndrome (MCAS) is a clinical disorder that may explain irritable bowel syndrome (IBS) type symptoms as well as other allergic symptoms experienced by an individual. The diagnosis and treatment of MCAS with specific focus on gastrointestinal (GI) manifestations is reviewed.Recent findings: Although biomarkers for MCAS remain elusive, testing for baseline serum tryptase will distinguish the type of mast cell disorder and urine tests for mast cell mediator metabolites may support the diagnosis. Endoscopy and Colonoscopy with biopsies is not used to diagnose MCAS but is important to rule out other conditions that may cause symptoms. There is increased awareness of the association between MCAS and autonomic dysfunction, small fiber neuropathy, and connective tissue disorders which all impact GI symptoms. MCAS is a disorder often of unknown etiology (idiopathic) and characterized by intermittent allergy type symptoms that affect multiple organ systems after exposure to a trigger. GI symptoms including abdominal cramping and loose stool are prominent and mimic those of IBS. Diagnostic testing is performed to assess for elevations in mast cell mediators during symptoms and to rule out other conditions. A comprehensive treatment plan includes medications that target mast cells, treatments for associated conditions including autonomic dysfunction, and management of comorbid psychiatric illness and nutritional deficits.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"107-114"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729225","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