{"title":"Endoscopic Assessment of Early Neoplasia in the Gastrointestinal Tract","authors":"P. Didden, A. Koch","doi":"10.33590/emjgastroenterol/10312935","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10312935","url":null,"abstract":"Endoscopic detection and evaluation of early neoplasia in the gastrointestinal tract should be carried out by systematic assessment of a standard set of lesional characteristics. First of all, attention should be given to the microvasculature and pit pattern of the mucosal surface. These features can distinguish neoplastic from non-neoplastic lesions and are used to assess the presence of dysplasia or malignancy. High resolution endoscopy combined with narrow band imaging usually provides sufficient detailed visualisation for characterisation. Secondly, estimating the risk of invasion beyond the mucosal layer is important, because the depth of invasion corresponds to the risk of lymph node metastasis. This prediction can be based on the gross morphology according to the Paris classification, but also size, the presence of converging folds with clubbing, ulceration and discoloration are considered predictive characteristics. This editorial provides a practical approach to assessing early neoplasia in the gastrointestinal tract. We would encourage endoscopists to appreciate these features systematically before proceeding to endoscopic or even surgical resection.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82183154","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}
{"title":"The Role of Environmental Factors in Digestive Cancer","authors":"R. Lambert","doi":"10.33590/emjgastroenterol/10313915","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10313915","url":null,"abstract":"The risk of digestive cancer in each country is analyzed in cancer registries for Incidence and Mortality. Survival is estimated from registries with a correct follow-up. Estimated values of Incidence and Mortality, expressed as an age standardized rate (ASR) for 100 000 persons, for all the population of a country are also found in the WHO-IARC database Globocan, recently edited for the year 2008. At each site of digestive tumors, the variations between countries, in cancer incidence, mortality and survival, depend on the resources and the global health status of the country. Indeed environmental causal factors linked to lifestyle may have an increasing or decreasing impact on the risk of cancer. Such factors are classified on 3 categories: 1- nutrition plays a determinant role in colorectal cancer with a higher risk in countries with more resources and more calories in the diet. 2- Toxic agents like alcohol and tobacco increase the risk at all sites of digestive cancer; their role is preponderant in esophageal cancer. Aflatoxin, a food contaminant in tropical, less developed countries, increases the risk of liver cancer. 3 – Infectious agents play a major role with the Bacteria H.pylori for stomach cancer over the world, and the Hepatitis virus B and C for liver cancer in less developed countries of Africa and Asia. The control of carcinogenic causal environmental factors is included in the primary prevention of digestive cancer.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74877059","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}
{"title":"Acute Pancreatitis – Beyond Gallstones and Alcohol","authors":"O. Sadr-Azodi","doi":"10.33590/emjgastroenterol/10314312","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10314312","url":null,"abstract":"Acute pancreatitis is the most common disorder of the pancreas. The incidence of the disease has increased markedly during the past decades. Whilst alcohol abuse and gallstone disease might explain a large proportion of the disease etiology, in one quarter of the patients, the cause remains unknown. Life-style and pharmaceutical drug use are potential risk factors for the disease. This brief review highlights the recent research on the role of these factors in the etiology of acute pancreatitis.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"117 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86808006","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}
{"title":"Practical Evaluation and Handling of Patients with Irritable Bowel Syndrome","authors":"B. Ohlsson","doi":"10.33590/emjgastroenterol/10313126","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10313126","url":null,"abstract":"Irritable bowel syndrome (IBS) is a functional bowel disorder by unknown aetiology. Several reviews are written about pharmacological and psychological treatment of the disease. Nevertheless, healthcare professionals consider these patients difficult to handle in daily practice. There is an uncertainty about how to measure symptoms and to evaluate the effect of any given treatment. In the absence of objective markers, professionals feel unsure of how to manage the condition and the patients do not feel that they are taken seriously. The development of the short, self-reported questionnaire, Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS), offers a practical guide to objective measurement of symptoms and effect of given treatments into numerical values in the daily practice.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73379631","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}
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