April 2009 Vol XXXIII Issue 4

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Introduction to a New Series

Andrew K. Roorda


I Spy Biliary and Pancreatic Ducts: The SpyGlass Single-Operator Peroral Cholangiopancreatoscopy System

Andrew K. Roorda, Justin T. Kupec, Uma Sundaram

The authors write that the technology of the SpyGlass system provides the endoscopist with a direct intraluminal view of the biliary duct system thus, allowing biopsy under direct vision.


Exclusive Enteral Nutrition: A Nutritional Approach to Crohn's Disease

A.S. Day, A.R. Otley

The benefits of exclusive enteral nutrition have been confirmed and are especially efficacious in children. Benefits include induction of remission, superior rates of mucosal healing and nutritional improvement.


Metabolic Acidosis in Patients with Gastrointestinal Disorders: Metabolic and Clinical Consequences

Mitchell H. Rosner

Patients with ileostomies, biliary or pancreatic drainage may develop significant metabolic acidosis due to enteric bicarbonate loss and volume depletion. Over time this condition can lead to bone and mineral abnormalities that can impair health. This article gives various methods of bicarbonate supplementation.


N. Li, S. Salguti, K. Sideridis

A case for you to solve.

Departments Section

Book Reviews

Insulin Resistance: Childhood Precursors and Adult Disease

In light of the depressing statistic that one in three American children and adolescents are now overweight or obese, Insulin Resistance: Childhood Precursors and Adult Disease, edited by Philip S. Zeitler and Kristen J. Nadeau, provides a timely and comprehensive overview of insulin resistance in children, and the clustering of associated metabolic and cardiovascular risk factors known as the metabolic syndrome.

Grading and Staging in Gastroenterology

Grading and Staging in Gastroenterology is divided into three chapters including Instruments for Overall Patient and Disease Assessment, Organ-Related Staging and Grading, and Assessment of Quality of Life (QoL).

From the Literature

Diclofenac-Associated Liver Injury

A total of 17,289 patients treated for rheumatoid arthritis or osteoarthritis received diclofenac for a mean of 18 months. They had been chosen randomly, assigned to either diclofenac (150 mg daily), or Etoricoxib (60 or 90 mg daily).

Barrett's Esophagus with Dysplasia/Treatment

Barrett's Esophagus with Dysplasia/Treatment Ablation using the HALO system was studied to assess safety and efficacy of a stepwise regimen of circumferential and focal ablation with that system for the treatment of Barrett's esophagus (BE), with dysplasia.

Budesonide in Crohn's Disease During Pregnancy

Inflammatory Bowel Disease Center database was reviewed to identify patients with Crohn's disease who receive treatment with budesonide for induction and/or maintenance of remission during pregnancy, identifying the maternal and fetal outcomes in a series of eight mothers and their babies.

MMX Mesalamine Therapy for Ulcerative Colitis

To determine the effects of eight weeks high-dose MMX Mesalamine extension therapy in patients with active, mild-to-moderate UC who had previously failed to achieve complete remission in two phase III, double-blind, placebo-controlled studies of MMX Mesalamine was carried out.

Antibiotics in Treatment of Perianal Fistulas in Crohn's Disease

A placebo-controlled pilot trial to evaluate the efficacy and safety of metronidazole and ciprofloxacin was carried out in patients with perianal CD.

From the Pediatric Gastroenterology Literature

Clostridium difficile Infections in Pediatric Inpatient Admissions

Clostrium difficile (C. diff) associated disease is becoming a common cause of diarrhea in the pediatric population, in a manner similar to what has been observed in the adult population. This large pediatric study evaluated the incidence of C. diff infection in children's hospitals in the United States.

Intestinal Inflammation in Children with Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) and the similar childhood symptoms of functional abdominal pain (FAP) are very common in the pediatric population. Adult studies suggest that IBS may be associated with increased intestinal inflammation and permeability. This study is the first endeavor to evaluate both intestinal inflammation and permeability in the pediatric IBS and FAP population.

Medical Bulletin Board

The Children's Hospital of Philadelphia: New Gene-Searching Method Uncovers Possible New Targets for Crohn's Disease Drugs Broadens Power of Current Genetic Discovery Techniques

Using a novel approach that combines a statistical tool that identifies genes interacting on the same biological pathways with highly automated gene-hunting techniques that scan the whole genome, an international team of researchers has discovered new genes involved in Crohn's disease.

Endoscopic Cryotherapy System, Polar Wand, Effectively Treats Mucosal Lesions of the GI Tract

Non-Contact CO2 Spray System Features Low Cost, Ease of Operation and Ability to Target Large Areas Clinical studies have shown Polar Wand to be effective in patients that have had resistance to other types of treatment.

American College of Gastroenterology Issues Updated Colorectal Cancer Guidelines

Colonoscopy Every Ten Years is Preferred Screening Strategy According to Experts

Common GI Drug Receives Black Box Warning from FDA

Reglan (metoclopramide) is a very common medication used by doctors to improve the muscle tone of the esophagus and intestines. It is often used to treat heartburn and acid reflux in adults and children. On February 26, the United States Food and Drug Administration issued a "Black Box Warning" for Reglan because of the many Adverse Reaction Reports filed.