Current Opinion in Gastroenterology最新文献_第7页

Updates in endoscopic management of ampullary and duodenal adenomas. 壶腹和十二指肠腺瘤内镜治疗的最新进展。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-11-01 Epub Date: 2023-10-05 DOI: 10.1097/MOG.0000000000000976

Pravallika Chadalavada, Tilak Upendra Shah

{"title":"Updates in endoscopic management of ampullary and duodenal adenomas.","authors":"Pravallika Chadalavada, Tilak Upendra Shah","doi":"10.1097/MOG.0000000000000976","DOIUrl":"10.1097/MOG.0000000000000976","url":null,"abstract":"Purpose of review: Adenomas are the most common benign lesions of the gastrointestinal tract. The current review aims to summarize recent literature regarding risk factors, natural history, diagnostic and staging technique, and management strategies for ampullary and nonampullary duodenal adenomas.Recent findings: Recent studies identified several possible risks factors for duodenal adenomas (e.g., cholecystectomy, proton pump inhibitor use), although these associations require corroboration. Chromoendoscopy and endocystoscopy may offer accuracy comparable to biopsies in expert hands. Recent publications underscore the reduction in morbidity with endoscopic resection for lesions without signs of malignancy with submucosal invasion. Submucosal injection did not improve safety of endoscopic ampullectomy.Summary: Surveillance may be a reasonable strategy for sub-centimeter ampullary adenomas occurring in familial adenomatous polyposis, as they carry a relatively low risk of malignancy. Endoscopic resection is the preferred strategy over surgery in patients without lesions suggestive of invasive malignancy. For nonampullary duodenal adenomas, several endoscopic resection techniques are available, each with their unique advantages and trade-offs. In patients who are not operative candidates but have intraductal extension, endoscopic ablation is an emerging option.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"39 6","pages":"496-502"},"PeriodicalIF":2.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41138876","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

Gastroparesis: time for a paradigm change. 胃轻瘫：是时候改变模式了。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-11-01 Epub Date: 2023-09-05 DOI: 10.1097/MOG.0000000000000978

Brian E Lacy, Journey L Wise, David J Cangemi

{"title":"Gastroparesis: time for a paradigm change.","authors":"Brian E Lacy, Journey L Wise, David J Cangemi","doi":"10.1097/MOG.0000000000000978","DOIUrl":"10.1097/MOG.0000000000000978","url":null,"abstract":"Purpose of review: Gastroparesis (GP) is a syndrome defined by symptoms and delayed gastric emptying in the absence of mechanical obstruction. Typical symptoms include nausea, vomiting, abdominal pain, and early satiety. Only one medication is currently FDA-approved for the treatment of GP. This review highlights recent research findings pertaining to GP and provides evidence to support a change in the current GP diagnostic and treatment paradigm.Recent findings: An analysis of GP trials over the past four decades demonstrates the power of placebo and the need to perform longer studies with clearly defined patient populations. Two studies highlight the need to evaluate patients with suspected GP carefully and to perform gastric emptying studies properly. The misdiagnosis of GP symptoms is reviewed, preceded by a discussion of whether GP should be considered a disorder of gut-brain interaction. Finally, new data on therapies that target the pylorus are highlighted.Summary: Gastroparesis is frequently over-diagnosed and incorrectly diagnosed. Performing a proper gastric emptying study which adheres to standard protocol, and accurately interpreting the results in the context of the individual patient, are critical to making an accurate diagnosis of GP. The treatment paradigm needs to shift from simply aiming to accelerate gastric emptying to treating global symptoms of a chronic syndrome that may represent gut-brain dysfunction in many patients.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"503-511"},"PeriodicalIF":2.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10534694","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

Stomach and duodenum: what's current in 2023. 胃和十二指肠：2023年的现状。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-11-01 Epub Date: 2023-10-05 DOI: 10.1097/MOG.0000000000000975

Tilak U Shah

引用次数: 0

Controversies regarding management of Helicobacter pylori infections. 关于幽门螺杆菌感染管理的争议。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-11-01 Epub Date: 2023-09-05 DOI: 10.1097/MOG.0000000000000981

Alyssa Price, David Y Graham, Mimi C Tan

{"title":"Controversies regarding management of Helicobacter pylori infections.","authors":"Alyssa Price, David Y Graham, Mimi C Tan","doi":"10.1097/MOG.0000000000000981","DOIUrl":"10.1097/MOG.0000000000000981","url":null,"abstract":"Purpose of review: The recognition that Helicobacter pylori should be considered and treated as an infectious disease has yet to fundamentally change diagnostic and treatment practices and has resulted in many controversies.Recent findings: We discuss the following controversies: whether the current 'per-patient' approach to H. pylori testing based on symptoms should be expanded to include achieving population-level H. pylori eradication, whether H. pylori should be approached as an infectious gastrointestinal disease similar to that of other infectious diseases of similar severity and outcome, whether treatment of H. pylori should be primarily empiric or based on antibiotic susceptibility and locally proven successful therapies as are other infectious diseases, whether it is necessary to obtain confirmation of treatment success in every patient treated for H. pylori , and whether potassium-competitive acid blockers should replace proton pump inhibitors in H. pylori therapy.Summary: Available guidelines and meta-analyses do not yet address H. pylori as an infectious disease. The diagnosis and management and treatment success of H. pylori infections trails behind that of other important infectious diseases. We provide new insights and propose changes in the traditional understanding required to modernize the management of H. pylori infections.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"482-489"},"PeriodicalIF":2.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10592071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10237836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pathophysiology updates: gastroduodenal injury and repair mechanisms. 病理生理学更新：胃十二指肠损伤和修复机制。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2023-11-01 Epub Date: 2023-08-29 DOI: 10.1097/MOG.0000000000000973

Susan J Hagen

{"title":"Pathophysiology updates: gastroduodenal injury and repair mechanisms.","authors":"Susan J Hagen","doi":"10.1097/MOG.0000000000000973","DOIUrl":"10.1097/MOG.0000000000000973","url":null,"abstract":"Purpose of review: Although the mucosal barrier serves as a primary interface between the environment and host, little is known about the repair of acute, superficial lesions or deeper, persistent lesions that if not healed, can be the site of increased permeability to luminal antigens, inflammation, and/or neoplasia development.Recent findings: Recent studies on acute superficial lesions have focused on calcium signaling and focal adhesion kinase, which regulate cell migration and controlled matrix adhesion during restitution. Microfluidic organ-on-a-chip and gut-on-a-chip models continued in development to support reductionist studies of epithelial-bacterial and/or epithelial-immune cell interactions during mucosal barrier disruption. In fact, these models may allow personalized medicine studies in the future using patient-derived cells to evaluate injury and repair mechanisms. Work done in the past year evaluated the safety and efficacy of acid blocking drugs on ulcer healing, with new animal studies providing evidence that each drug affects the microbiome in a different way that can be correlated with its efficacy in ulcer healing. Lastly, work to understand the way in which mature epithelial cells or committed stem cells dedifferentiate, reprogram, proliferate, and then regenerate the gastroduodenal mucosa after injury was a major focus of studies in the past year.Summary: Recent studies highlight novel mechanisms that promote restitution and mucosal regeneration after injury of the gastroduodenal mucosa.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"512-516"},"PeriodicalIF":2.6,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10592096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10237842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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