Current Opinion in Gastroenterology最新文献_第10页

Population level screening for celiac disease: is now the time? 乳糜泻的人群水平筛查：现在是时候了吗？

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-11-01 Epub Date: 2023-08-24 DOI: 10.1097/MOG.0000000000000969

Brianne Shuler, Edwin Liu, Marisa G Stahl

{"title":"Population level screening for celiac disease: is now the time?","authors":"Brianne Shuler, Edwin Liu, Marisa G Stahl","doi":"10.1097/MOG.0000000000000969","DOIUrl":"10.1097/MOG.0000000000000969","url":null,"abstract":"Purpose of review: As incidence and prevalence of celiac disease is increasing, subclinical and asymptomatic presentations are more commonly identified through celiac disease screening. However, the United States Preventive Services Task Force released a statement in 2017 maintaining that there is insufficient evidence to recommend general population screening for celiac disease for asymptomatic individuals. This review summarizes the current available evidence on celiac disease screening.Recent findings: Literature demonstrates that by limiting screening to individuals with recognized symptoms, celiac disease diagnosis is frequently delayed or missed entirely. Most individuals with screening-identified celiac disease have previously unrecognized symptoms that improve through treatment with a gluten-free diet. Screening-identified individuals also demonstrate signs of impaired nutrition, growth, bone health, and quality of life which improve with treatment. Overall, celiac disease screening is viewed favorably by those identified through celiac disease screening programs.Summary: Individuals with screening-identified celiac disease may still incur complications from untreated disease and receive benefit from treatment with a gluten-free diet. More data is needed to determine the cost effectiveness of different mass screening approaches that incorporate the societal perspective towards screening.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"455-462"},"PeriodicalIF":2.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10534697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Small intestinal bacterial overgrowth: current update. 小肠细菌过度生长：最新进展。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-11-01 Epub Date: 2023-09-18 DOI: 10.1097/MOG.0000000000000971

Hammad Zafar, Brenda Jimenez, Alison Schneider

{"title":"Small intestinal bacterial overgrowth: current update.","authors":"Hammad Zafar, Brenda Jimenez, Alison Schneider","doi":"10.1097/MOG.0000000000000971","DOIUrl":"10.1097/MOG.0000000000000971","url":null,"abstract":"Purpose of review: This article aims to provide an up-to-date review of small intestinal bacterial overgrowth (SIBO), including etiology and risk factors, clinical manifestations, diagnostic evaluation for suspected SIBO, and therapeutic options.Recent findings: Recent advances in breath testing, capsule and urine-based testing have opened new avenues and improved diagnostic yield of SIBO. Nonantibiotic-based treatment strategies have shown promising results in initial trials.Summary: Small intestinal bacterial overgrowth (SIBO) is a condition defined by the excess bacteria or changes in bacterial composition of the small intestine. These are associated with various gastrointestinal (GI) symptoms such as bloating, abdominal distension, diarrhea, nutrient deficiencies, and even frank weight loss. Small bowel jejunal aspirate of >10 5 CFU/ml has traditionally been considered the gold standard for diagnosis. Glucose and lactulose breath testing have become more common in clinical practice as they are noninvasive, easily accessible, and have lower cost. Treatment focuses on the eradication of excess bacteria in the small bowel and is traditionally done with the use of oral antibiotics. Other emerging therapies may include probiotics, diet manipulation, and prokinetic agents.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"39 6","pages":"522-528"},"PeriodicalIF":2.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Diagnosis and management of acute lower gastrointestinal bleeding. 急性下消化道出血的诊断和处理。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-10-30 DOI: 10.1097/mog.0000000000000984

Yotam Elimeleh, Ian M Gralnek

引用次数: 0

High volume, low volume, or pills, which way should we go? a review of bowel preparation for colonoscopy. 结肠镜检查前的肠道准备回顾：大容量、小容量或药片，我们该走哪条路？

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-10-19 DOI: 10.1097/mog.0000000000000983

Jasmine M Haydel, Anthony A Xu, Nabil M Mansour

引用次数: 0

Irritable bowel syndrome - less irritable, or better treatments? 肠易激综合征--不那么易怒，还是更好的治疗方法？

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-10-19 DOI: 10.1097/mog.0000000000000987

Paul Travers, Brian E Lacy, David J Cangemi

引用次数: 0

Radiofrequency ablation for the management of pancreatic mass lesions. 射频消融治疗胰腺肿块病变。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-09-01 Epub Date: 2023-04-25 DOI: 10.1097/MOG.0000000000000939

Ambreen A Merchant, Anna M Goebel, Field F Willingham

{"title":"Radiofrequency ablation for the management of pancreatic mass lesions.","authors":"Ambreen A Merchant, Anna M Goebel, Field F Willingham","doi":"10.1097/MOG.0000000000000939","DOIUrl":"10.1097/MOG.0000000000000939","url":null,"abstract":"Purpose of review: Patients with pancreatic tumors may have limited treatment options. Pancreatic tumor ablation is a novel and emerging treatment modality which can now be performed using endoscopic ultrasound (EUS) guidance. This modality is well suited to guide energy delivery for radiofrequency ablation (RFA) and microwave ablation. These approaches provide minimally invasive, nonsurgical methods for delivering energy to ablate pancreatic tumors in situ . This review summarizes the current data and safety profile for ablation in managing pancreatic cancer and pancreatic neuroendocrine tumors.Recent findings: RFA uses thermal energy to induce cell death by coagulative necrosis and protein denaturation. Studies have reported increased overall survival in patients with pancreatic tumors treated with EUS-guided RFA in a multimodality systemic approach and when used in palliative surgeries. Radiofrequency ablation may have corollary benefits in inducing an immune-modulatory effect. Tumor marker carbohydrate antigen 19-9 has been reported to decrease in response to RFA. Microwave ablation is an emerging modality.Summary: RFA utilizes focal thermal energy to induce cell death. RFA has been applied through open, laparoscopic, and radiographic modalities. EUS-guided approaches are now allowing RFA and microwave ablation to be performed for pancreatic tumors in situ .","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"39 5","pages":"448-454"},"PeriodicalIF":2.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9984555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic approaches to small intestinal strictures. 小肠狭窄的内窥镜治疗方法。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-09-01 Epub Date: 2023-06-22 DOI: 10.1097/MOG.0000000000000958

Munish Ashat, Rami El-Abiad, Mouen A Khashab

{"title":"Endoscopic approaches to small intestinal strictures.","authors":"Munish Ashat, Rami El-Abiad, Mouen A Khashab","doi":"10.1097/MOG.0000000000000958","DOIUrl":"10.1097/MOG.0000000000000958","url":null,"abstract":"Purpose of review: Gastric outlet obstruction (GOO) occurs from benign or malignant causes. Historically, the treatment of benign strictures revolved around endoscopic balloon dilation, whereas, in the case of malignant strictures, the placement of self-expandable metallic stents was the focus. The advent of lumen-apposing metal stent has opened new horizons in addressing shortcomings of enteral stenting and surgical gastroenterostomies. The purpose of the review is to discuss the endoscopic approaches to small bowel strictures and to examine the supporting data behind each practice.Recent findings: Given the risk and futility of balloon dilation for malignant strictures, enteral stenting is pursued in patients who are poor surgical candidates and with life expectancy less than 6 months. For patients with longer survival, surgical gastroenterostomy (S-GE) should be considered. Recent data have shown comparable technical and clinical success rates between EUS-gastroenterostomy and S-GE but with lower adverse event rate and hospital length of stay.Summary: In recurrent benign strictures and malignant GOO, EUS-GE has recently gained momentum in providing an effective and a well tolerated alternative. Individualized therapy centered around the patient's prognosis and preference while factoring in the local expertise for the specific indication is vital.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"39 5","pages":"356-361"},"PeriodicalIF":2.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9922306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial intelligence in digestive endoscopy: recent advances. 消化内镜检查中的人工智能：最新进展。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-09-01 Epub Date: 2023-07-17 DOI: 10.1097/MOG.0000000000000957

Jean-Francois Rey

{"title":"Artificial intelligence in digestive endoscopy: recent advances.","authors":"Jean-Francois Rey","doi":"10.1097/MOG.0000000000000957","DOIUrl":"10.1097/MOG.0000000000000957","url":null,"abstract":"Purpose of review: With the incessant advances in information technology and its implications in all domains of our life, artificial intelligence (AI) started to emerge as a need for better machine performance. How it can help endoscopists and what are the areas of interest in improving both diagnostic and therapeutic endoscopy in each part of the gastrointestinal (GI) tract. What are the recent benefits and clinical usefulness of this new technology in daily endoscopic practice.Recent findings: The two main AI systems categories are computer-assisted detection 'CADe' for lesion detection and computer-assisted diagnosis 'CADx' for optical biopsy and lesion characterization. Multiple softwares are now implemented in endoscopy practice. Other AI systems offer therapeutic assistance such as lesion delineation for complete endoscopic resection or prediction of possible lymphanode after endoscopic treatment. Quality assurance is the coming step with complete monitoring of high-quality colonoscopy. In all cases it is a computer-aid endoscopy as the overall result rely on the physician. Video capsule endoscopy is the unique example were the computer conduct the device, store multiple images, and perform accurate diagnosis.Summary: AI is a breakthrough in digestive endoscopy. Screening gastric and colonic cancer detection should be improved especially outside of expert's centers. Prospective and multicenter trials are mandatory before introducing new software in clinical practice.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"39 5","pages":"397-402"},"PeriodicalIF":2.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9922836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

G-POEM for gastroparesis: past, present and future. 治疗胃痉挛的 G-POEM：过去、现在和未来。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-09-01 Epub Date: 2023-05-11 DOI: 10.1097/MOG.0000000000000950

Ishaan Vohra, Harishankar Gopakumar, Douglas G Adler

{"title":"G-POEM for gastroparesis: past, present and future.","authors":"Ishaan Vohra, Harishankar Gopakumar, Douglas G Adler","doi":"10.1097/MOG.0000000000000950","DOIUrl":"10.1097/MOG.0000000000000950","url":null,"abstract":"Purpose of review: Gastroparesis is a chronic debilitating condition with rising incidence and healthcare burden. As abdominal surgeries, diabetes, viral infections and autoimmune diseases become more prevalent, gastroparesis will continue to upsurge. Conservative treatment options for gastroparesis are limited by their side effects and short-term efficacy. Gastric endoscopic pyloromyotomy (G-POEM) is a novel incisionless endosurgical technique with excellent long-term outcomes. This review is in time, as the demand for G-POEM will continue to escalate.Recent findings: This review encompasses the conservative and nonconservative treatment options for gastroparesis. G-POEM is a nonconservative treatment option, and the aim of this review is to discuss the variations in technique of G-POEM, short-term and long-term clinical efficacy of G-POEM and adverse events associated with it.Summary: G-POEM has high technical and clinical success with minimal adverse events. G-POEM outcomes are similar or superior when compared with other treatment options for refractory gastroparesis. G-POEM is being widely adopted and will become the preferred treatment choice in patients with refractory gastroparesis.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"39 5","pages":"390-396"},"PeriodicalIF":2.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9931051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endotherapy in pediatric pancreatitis. 小儿胰腺炎的内部疗法

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-09-01 Epub Date: 2023-07-17 DOI: 10.1097/MOG.0000000000000955

Nicholas Norris, David M Troendle

{"title":"Endotherapy in pediatric pancreatitis.","authors":"Nicholas Norris, David M Troendle","doi":"10.1097/MOG.0000000000000955","DOIUrl":"10.1097/MOG.0000000000000955","url":null,"abstract":"Purpose of review: Some children with acute recurrent and chronic pancreatitis stand to benefit from therapeutic endoscopic interventions. The purpose of this review is to summarize specific endoscopic therapies used for these conditions and highlight areas of future research.Recent findings: Multicenter collaboration and consortium efforts have provided more data now than ever on the technical outcomes and safety of therapeutic endoscopic procedures for pancreatitis in children. Indications are growing but more research is needed to help guide patient selection.Summary: Advanced endoscopic procedures including endoscopic retrograde cholangiopancreatography, endoscopic-ultrasound guided therapies, and single-operator pancreatoscopy may be used in patients with acute recurrent or chronic pancreatitis to manage pancreatic duct obstruction or local complications including pseudocysts and walled-off necrosis. Patient and procedural factors differ between adults and children. Access to these procedures for younger children is growing, and technical outcomes and adverse event rates appear similar between adults and children.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"39 5","pages":"416-420"},"PeriodicalIF":2.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9931880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0