Current Gastroenterology Reports最新文献_第8页

TIPS: indications, Contraindications, and Evaluation. TIPS:适应症、禁忌症和评估。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-08-21 DOI: 10.1007/s11894-023-00884-7

Allison Carroll, Justin R Boike

引用次数: 0

Nutrition in Liver Disease - A Review. 肝病中的营养——综述。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-10-17 DOI: 10.1007/s11894-023-00887-4

Corrin Hepburn, Natasha von Roenn

{"title":"Nutrition in Liver Disease - A Review.","authors":"Corrin Hepburn, Natasha von Roenn","doi":"10.1007/s11894-023-00887-4","DOIUrl":"10.1007/s11894-023-00887-4","url":null,"abstract":"PURPOSE OF REVIEW : Nutrition is commonly overlooked in chronic liver disease. Both obesity and malnutrition are independent risk factors of poor prognosis in cirrhosis. This review aims to summarize the current literature regarding how nutrition contributes to liver disease, how to screen patients, and what nutritional and activity recommendations can help prevent adverse outcomes. RECENT FINDINGS: Screening for malnutrition, obesity, and sarcopenia through ambulatory bedside methods is recommended every 8-12 weeks in high risk patients. A Mediterranean diet with emphasis on high protein intake of 1.2-1.5 g/kg/day, and increasing physical activity can help to improve nutritional status. It remains critical to screen and identify patients with liver disease for malnutrition, obesity, and sarcopenia. Identifying an individualized action plan through a multidisciplinary approach can be helpful. Dietary recommendations to improve outcomes should be based on well-studied approaches. These can include the use of the Mediterranean diet in those with metabolic dysfunction-associated steatotic liver disease (MASLD) and a high protein diet in those with cirrhosis and sarcopenia. Routine assessment of improvement or decline should continue throughout a patient's clinical course.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"242-249"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41233013","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

Current Status of Living Donor Liver Transplantation: Impact, Advantages, and Challenges. 活体肝移植的现状:影响、优势和挑战。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-08-21 DOI: 10.1007/s11894-023-00882-9

Hao Liu, Eishan Ashwat, Abhinav Humar

{"title":"Current Status of Living Donor Liver Transplantation: Impact, Advantages, and Challenges.","authors":"Hao Liu, Eishan Ashwat, Abhinav Humar","doi":"10.1007/s11894-023-00882-9","DOIUrl":"10.1007/s11894-023-00882-9","url":null,"abstract":"Purpose of this review: This review provides an overview of the current status of Living Donor Liver Transplant (LDLT). It discusses the impact of LDLT on waitlist and post-transplantation outcomes, highlighting the technical challenges and unique advantages of LDLT.Recent findings: Recent findings show that LDLT offers several theoretical advantages over deceased donor liver transplant, including shorter wait times, better graft quality, and improved post-transplant outcomes. Non-alcoholic fatty liver disease (NAFLD) and hepatocellular carcinoma (HCC) are emerging as the leading indications for adult LDLT in the US. LDLT demonstrates comparable or better overall survival rates and organ-specific outcomes compared to deceased donor transplants. However, challenges exist, including donor and recipient risks such as biliary complications and small-for-size syndrome. Ongoing research focuses on refining surgical techniques, exploring minimally invasive approaches, utilizing predetermined donors to modulate the recipient's immune system, and ensuring ethical practices. LDLT is a valuable solution for patients with end-stage liver failure or disorders requiring transplantation. It offers advantages such as shorter wait times as well as improved waitlist and post-transplant outcomes. Continued research and advancements in LDLT will benefit patients in need of liver transplantation.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"225-231"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10029571","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

Advances in the Management of Pain in Chronic Pancreatitis. 慢性胰腺炎疼痛治疗进展。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-09-15 DOI: 10.1007/s11894-023-00898-1

Amit Maydeo, Nagesh Kamat, Ankit Dalal, Gaurav Patil

{"title":"Advances in the Management of Pain in Chronic Pancreatitis.","authors":"Amit Maydeo, Nagesh Kamat, Ankit Dalal, Gaurav Patil","doi":"10.1007/s11894-023-00898-1","DOIUrl":"10.1007/s11894-023-00898-1","url":null,"abstract":"Purpose of review: The data on recent advances in managing chronic pancreatitis (CP) pain is limited. This review highlights the role of endotherapy and the advances in the overall management of pain in CP.Recent findings: Of late, pancreatic biodegradable stents have been used in endotherapy with appreciable success. These include slow, medium, and fast degrading stents, which optimize the overall management of CP and could prevent the need for multiple procedures. Endoscopic ultrasound-guided celiac plexus block is reserved in selected patients to treat debilitating pain. Total pancreatectomy with islet autotransplantation in small duct disease has shown promising results. The indications for treating pain in CP with endoscopy and surgery need to be better defined. The complexity of pain control due to the incomplete understanding of pathomorphology makes the management of CP challenging. The current treatment methods are still evolving. Therapy aims to reduce pain, optimize recovery, maintain quality of life, and meet postoperative needs. Initial management includes lifestyle modification, nutrition optimization, risk factor reduction with abstinence from alcohol, cessation of tobacco and smoking. Supportive medical management involves the judicial use of analgesics, neuromodulators, antioxidants, pancreatic enzyme replacement for insufficiency, and diabetes management. Patients with intractable pain are ideal for therapeutic intervention. Being less invasive with an acceptable complication rate makes endotherapy the preferred first-line treatment. If found to be cost-effective, biodegradable stents can reduce the overall cost. Unfortunately, if patients remain symptomatic, surgery is preferred in case of failure or recurrence. For optimal results, appropriate patient selection is vital to maximizing outcomes.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"260-266"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10592224","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

Screening, Diagnosis, and Staging of Non-Alcoholic Fatty Liver Disease (NAFLD): Application of Society Guidelines to Clinical Practice. 非酒精性脂肪肝（NAFLD）的筛查、诊断和分期：社会指南在临床实践中的应用。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-09-28 DOI: 10.1007/s11894-023-00883-8

Ysabel C Ilagan-Ying, Bubu A Banini, Albert Do, Robert Lam, Joseph K Lim

{"title":"Screening, Diagnosis, and Staging of Non-Alcoholic Fatty Liver Disease (NAFLD): Application of Society Guidelines to Clinical Practice.","authors":"Ysabel C Ilagan-Ying, Bubu A Banini, Albert Do, Robert Lam, Joseph K Lim","doi":"10.1007/s11894-023-00883-8","DOIUrl":"10.1007/s11894-023-00883-8","url":null,"abstract":"Purpose of review: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly nonalcoholic fatty liver disease (NAFLD), is the most common chronic liver disease affecting 30% of the global population. In this article, we summarize current expert guidelines, review clinical practice implications, and provide insight into the utility of non-invasive tests (NITs).Recent findings: The burden of MASLD is growing with the obesity epidemic, yet disease awareness and diagnosis is low. Patients can progress to metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH), which can advance to liver fibrosis, cirrhosis, hepatic decompensation, and liver cancer. NITs help identify high-risk patients who may benefit from specialty referral and MASH-directed therapy. Global societies offer various recommendations for the screening and diagnosis of MASLD utilizing evidence-based, widely accessible methods such as serum indices, NITs, and liver biopsy. Several targeted steatotic liver disease (SLD) screening tools and novel therapies are under development.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"213-224"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118181","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

Immune Checkpoint Inhibitor-Induced (Type 3) Autoimmune Pancreatitis. 免疫检查点抑制剂诱导的（3型）自身免疫性胰腺炎。

Current Gastroenterology Reports Pub Date : 2023-10-01 Epub Date: 2023-10-17 DOI: 10.1007/s11894-023-00885-6

Anusha Shirwaikar Thomas, Suresh T Chari

{"title":"Immune Checkpoint Inhibitor-Induced (Type 3) Autoimmune Pancreatitis.","authors":"Anusha Shirwaikar Thomas, Suresh T Chari","doi":"10.1007/s11894-023-00885-6","DOIUrl":"10.1007/s11894-023-00885-6","url":null,"abstract":"Purpose of review: Immune checkpoint inhibitors (ICI) have revolutionized cancer care and work primarily by blocking CTLA-4 (cytotoxic T-lymphocyte-associated protein 4), and/or PD-1 (programmed cell death protein 1), and/or PD-L1 (programmed death-ligand 1), thereby providing highly efficacious anti-tumor activity. However, this unmitigated immune response can also trigger immune related adverse events (irAEs) in multiple organs, with pancreatic irAEs (now referred to as type 3 Autoimmune pancreatitis (AIP) being infrequent.Recent findings: Type 3 AIP is a drug-induced, immune mediated progressive inflammatory disease of the pancreas that may have variable clinical presentations viz., an asymptomatic pancreatic enzyme elevation, incidental imaging evidence of pancreatitis, painful pancreatitis, or any combination of these subtypes. Management is largely supportive with intravenous fluid hydration, pain control and holding the inciting medication. Steroids have not been shown to demonstrate a clear benefit in acute management. A rapid development pancreatic atrophy is observed on imaging as early as 1 year post initial injury. Type 3 AIP is a chronic inflammatory disease of the pancreas that though predominantly asymptomatic and mild in severity can lead to rapid organ volume loss regardless of type of clinical presentation and despite steroid therapy.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":" ","pages":"255-259"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41233012","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

Nutrition Considerations in Patients with Functional Diarrhea. 功能性腹泻患者的营养注意事项。

Current Gastroenterology Reports Pub Date : 2023-09-01 DOI: 10.1007/s11894-023-00878-5

Courtney Kay Ford

{"title":"Nutrition Considerations in Patients with Functional Diarrhea.","authors":"Courtney Kay Ford","doi":"10.1007/s11894-023-00878-5","DOIUrl":"https://doi.org/10.1007/s11894-023-00878-5","url":null,"abstract":"Purpose: Functional diarrhea (FD) is a functional gastrointestinal disorder that affects a great percentage of the population and has damaging nutritional and psychological effects. In this review, evidence has been assessed and analyzed to provide nutrition considerations and recommendations for patients with functional diarrhea.Recent findings: The traditional irritable bowel syndrome (IBS) diet, the low FODMAP diet, and general recommendations for diarrhea have been established as interventions for FD. Additionally, nutrition outcomes such as vitamin and mineral deficiencies, hydration levels, and mental health status should be at the forefront of assessment. The importance of medical management of FD and IBS-D is established, with many existing evidence-based recommendations and approved medications available. Nutrition management of FD from a registered dietitian/dietitian nutritionist, from symptom control to dietary advice, is imperative. There are no \"one-size-fits-all\" approaches to nutrition management of FD, but there is promising literature that can shape personalized nutrition interventions from a registered dietitian.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"25 9","pages":"198-203"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10380492","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

Providing Trauma Informed Care During Anorectal Evaluation. 在肛肠评估中提供创伤知情护理。

Current Gastroenterology Reports Pub Date : 2023-09-01 DOI: 10.1007/s11894-023-00879-4

Christina H Jagielski, Jessica P Naftaly, Megan E Riehl

引用次数: 0

Update on the Diagnosis and Management of Acute Colonic Pseudo-obstruction (ACPO). 急性结肠假性梗阻(ACPO)的诊断和治疗进展。

Current Gastroenterology Reports Pub Date : 2023-09-01 DOI: 10.1007/s11894-023-00881-w

Ahana Sen, Reena Chokshi

{"title":"Update on the Diagnosis and Management of Acute Colonic Pseudo-obstruction (ACPO).","authors":"Ahana Sen, Reena Chokshi","doi":"10.1007/s11894-023-00881-w","DOIUrl":"https://doi.org/10.1007/s11894-023-00881-w","url":null,"abstract":"Purpose of review: Acute Colonic Pseudo-obstruction (ACPO) is a cause of large intestinal dilation and obstruction without any physical transition point. It remains difficult to diagnose and treat. We review the recent updates on diagnosis and management of ACPO.Recent findings: Recent guidelines have posited that conservative management can be tried in most cases of ACPO, but that early decompression and surgery should be considered. Use of neostigmine is still a viable option but there is also promising data on pyridostigmine as well as prucalopride. Resolution of ACPO should be followed by daily use of polyethylene glycol (PEG) to help prevent recurrence. ACPO warrants early and accurate diagnosis with exclusion of alternate causes of large bowel dilation. Conservative management can be attempted for 48-72 h in those with cecal diameters < 12 cm and without signs of peritonitis and perforation. Early escalation of management should be attempted with neostigmine followed by endoscopy and/or surgery as needed, given that longer periods of dilation are associated with worse outcomes. There is promising new evidence for use of pyridostigmine and prucalopride, but further trials are needed prior to incorporating them into regular use. Finally, studies are lacking regarding prevention of ACPO after initial resolution.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"25 9","pages":"191-197"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10024456","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

Who Places Feeding Tubes and in What Scenario? 谁放置饲管，在什么情况下?

Current Gastroenterology Reports Pub Date : 2023-08-01 DOI: 10.1007/s11894-023-00880-x

Apeksha Shah, Rebecca A Busch, Erica Knavel Koepsel, Mohamed Eisa, Michael Woods, Sonali Palchaudhuri

引用次数: 0