November 2007 Vol 0 Issue 11

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Guide to Discussing the Risk of Immunomodulator and Anti-TNF Therapy with Inflammatory Bowel Disease Patients

Corey A. Siegel

The risks of treatment with immunomodulators and biologic therapy for inflammatory bowel disease (IBD) are of concern to both patients and physicians. When communicating risk information to patients it is important to present the information so the patient will clearly understand.


Chronic Hepatitis B: Who and How to Treat

Stephen W. Landreneau and Jorge L. Herrera

Chronic hepatitis B virus (HBV) is diagnosed by the presence of hepatitis B surface antigen (HBsAG) in serum on two occasions separated by six months. Several effective pharmacologic therapies are available for treatment but patient selection and the correct treatment are the key to having the best chance of remission or cure.


The Gourmet Colon Prep

Stacey McCray and David H. Balaban

The purpose of this article is to provide guidance on dietary measures that may make bowel preparation more tolerable and ultimately more successful.


A Wolf in Sheep's Clothing: Acute Ideopathic Subdiaphragmatic Mesenteroaxial Gastric Volvulus

Antwan Atia and Calvin H. Hall, Jr.

Gastric volvulus is an abnormal rotation of the stomach. Presented here, is an unusual case of acute ideopathic subdiaphragmatic mesenteroaxial gastric volvulus.


Timothy Wong and Howard Taubin

A case for you to solve.

Departments Section

From the Literature

Terminal Ileal Photography or Biopsy to Verify Total Colonoscopy

Various modalities exist to document the extent of colonoscopy, including terminal ileum (TI) biopsy, which is considered the criterion standard by some authority. ASGE Guidelines concerning quality indicators for colonoscopy suggested visualization and photo documentation of the cecum to be performed in all colonoscopies. However, the ASGE concedes that
"cecal photography may not be convincing in all cases."

Diagnostic Yield of EUS-Guided FNA in Solid Pancreatic Masses

The diagnostic yield of EUS-FNA of solid pancreatic masses is a potential benchmark for EUS-FNA quality, because the majority of solid pancreatic masses should be diagnostic for malignancy.

Endotherapy for a Large Gastric Stoma After Bariatric Surgery

To determine the effect of endoscopic injection by using a sclerosant (sodium morrhuate) to induce stomal stenosis in patients who present with stomal dilation complicated by weight gain, 28 patients after bariatric surgery with GI bypass were referred with weight gain after initial weight loss. The weight gain was believed to be the result of a large gastric stoma.

Hepatic Venous Pressure Gradient (HVPG) in Evaluation of Compensated Cirrhosis

Two hundred thirteen patients with compensated cirrhosis and portal hypertension, but without varices, were included in a trial evaluating the use of B-blockers preventing varices.

Feasibility Trial of Narrow Band Imaging Endoscopy in GERD

Narrow band imaging (NBI) endoscopy system enhances visualization of microvasculature and mucosal patterns. In order to assess the utility of NBI in patients with GERD symptoms, patients with and without symptoms completed two validated GERD questionnaires prior to enrollment. The distal esophagus was examined by standard white light endoscopy, followed by NBI. Features seen only by NBI were compared between GERD patients and controls.

Mucosal Healing in IBD and Its Significance

In order to examine the possible predictors of mucosal healing and the impact of healing on subsequent course of disease in inflammatory bowel disease, 740 incident patients diagnosed with ulcerative colitis (UC) or Crohn's disease (CD) between 1990 and 1994, with no biologic therapy available, were recorded in reference to demographics and symptoms. Clinical and endoscopic evaluations were done at baseline before treatment and repeated after one and five years in 495 patients.

Central Adiposity and Barrett's Esophagus

A case-controlled study investigating body mass index (BMI), central adiposity and cigarette smoking was carried out in reference to the risk of Barrett's esophagus (BE).

Statins and NSAIDs in Colorectal Cancer Risk

A nested case-controlled study was conducted within 454 general practices in the United Kingdom, using the QRESEARCH database.

Findings Suggesting Crohn's Disease in Diagnosed Ulcerative Colitis

Some patients diagnosed with UC undergo a change in diagnosis to CD. Predictors of diagnostic change could potentially impact the management of patients with chronic inflammatory bowel disease.

Oligoclonal T-Cells in Biliary Atresia

Biliary atresia is one of the most common causes of liver transplant in infancy, and its cause remains unknown. One theory of its etiology is a viral-induced T-cell reaction with oligoclonal expansion leading to inflammation and fibrosis of the biliary epithelium.

Oral Tacrolimus for Ulcerative Colitis in Children

There are limited medical options for children with steroid-dependent and steroid-resistant ulcerative colitis, and colectomy is often necessary in this population. This study evaluated oral tacrolimus usage for children with steroid-dependent and steroid-resistant ulcerative colitis.

Book Reviews

Liver Disease in Children, 3rd edition

Suchy FJ, Sokol RJ, Balistreri WF, Eds
Cambridge University Press, New York, NY, 2007
ISBN: 978-0-521-85657-7; $185

Over the last decade, pediatric hepatology has evolved to become a distinct subspecialty within the field of Pediatric Gastroenterology with specialized areas of study even within this field.

GI Epidemiology

Talley NJ, Locke GR III, and Saito YA, Editors
Blackwell Publishing, Inc, 2007
ISBN: 9781405149495; $99.95

The editors' purpose for this book is to establish a field of epidemiology of gastrointestinal [GI] diseases.