November 2010 Vol XXXIV Issue 11

Previous MonthNext Month


Nutrition Interventions Before and After Adult Intestinal Transplantation: The Pittsburgh Experience

Laura E. Matarese

The University of Pittsburgh has the largest single center experience in the world having performed over 500 intestinal transplants. This review will cover the University of Pittsburgh Medical Center's experience related to nutritional aspects of intestinal transplantation during the entire perioperative period.


Irritable Bowel Syndrome and Inflammatory Bowel Disease: Is There an Overlap?

Eamonn M. M. Quigley, Fergus Shanahan

Recent descriptions of immune activation and even subtle mucosal inflammation in IBS have raised the possibility of a more fundamental relationship between IBS and IBD. This review will address two issues: firstly, at a pathophsyiological level, the relationships between IBS and IBD and, secondly, in a clinical context, the interpretation of IBS-type symptoms among IBD patientsin apparent remission.


Fever of Unknown Origin in an Immunosuppressed Patient with Crohn's Disease: An Unusual Cause

Leyla J. Ghazi, Raymond K. Cross

We illustrate a case of an immunosuppressed patient with Crohn's disease who did not have an identifiable organic cause for fever of unknown origin (FUO). This case underscores the importance of formulating a broad differential diagnosis in IBD patients who develop fevers while on chronic immunosuppressants.

Departments Section

Book Reviews

Gastroenterological Endoscopy (Second Edition)

This large tome, now in its second edition, is fascinating. In a field that is rapidly changing it is quite up to date with multiple references from 2008 and occasional references from 2009. It is a heavy book with thick glossy pages allowing for color photos throughout.

Capsule Endoscopy Simplified

Capsule Endoscopy Simplified is an excellent beginner's guide on capsule endoscopy technology that has been rapidly gaining popularity and clinical application within adult and pediatric gastroenterology.

Interventional and Therapeutic Gastrointestinal Endoscopy

This well-organized, hard cover text is designed to present 'a concise yet instructive overview of the most common interventional and therapeutic GI endoscopic procedures' and is described by the editors as a 'cookbook' following evidence-based medical guidelines. It consists of over 500 pages and 51 chapters covering topics ranging from anticoagulation and antibiotic prophylaxis to intraluminal stenting, ERCP, endoscopic ultrasound and endoscopic submucosal dissection.

Hepatocellular Carcinoma: Diagnosis and Treatment (Second Edition)

Hepatology has undergone a revolution in recent years. The emergence of hepatocellular carcinoma (HCC) as a significant problem in Western countries after being relegated to relative obscurity is not a minimal influence on this fact. The recent publication of Hepatocellular Carcinoma: Diagnosis and Treatment (Second Edition) has added a solid new tool that is well suited to clinicians who need to update their knowledge base on the modern approach to the management of this disease for the benefit of their patients. Because HCC is an entity that lends itself to multi-disciplinary management strategies, this effort incorporates a very wide cast of contributors, including hepatologists, oncologists, surgeons, radiologists, and of course, basic scientists.

From the Literature

PEG Ifn Alpha-2A Vs. PEG Ifn Alpha-2B in Chronic Hepatitis C

A systematic review of head-to-head, randomized trials to assess the benefits and harms of the two treatments was carried out, searching the Cochrane Central Register of Controlled Trials, MEDLine, MBASE, and LILACS, and carried out through July 2009.

Treatment of Collagenous Sprue

Collagenous sprue (CS) is a rare enteropathy characterized by villous atrophy and a distinctive band of subepithelial collagen that clinically includes chronic diarrhea, malabsorption and weight loss that is often unresponsive to a gluten-free diet (GFD) alone.

Accuracy of EUS in Gastric Subepithelial Lesions

To evaluate the accuracy of EUS in diagnosing small gastric subepithelial lesions by using histology as the criterion, a retrospective study was carried out in an academic tertiary care center, including 22 patients with endoscopically resected gastric subepithelial lesions.

Endoscopic Spray Cryotherapy for Esophageal Cancer

To assess the safety and efficacy of cryotherapy in esophageal carcinoma, a multicenter, retrospective cohort study in 10 academic and community medical centers between 2006 and 2009 was carried out in subjects with esophageal carcinoma, in whom conventional therapy failed, and those who refused or were ineligible for conventional therapy.

Spray Cryotherapy For Barrett's Esophagus with High-Grade Dysplasia

To assess the safety and efficacy of CRYO (cryotherapy) in Barrett's esophagus (BE) with high-grade dysplasia (HGD) in a multicenter, retrospective cohort study in 9 academic and community centers from 2007 to 2009, 98 subjects with BE and HGD with a mean length of 5.3 cm, underwent 333 treatments (3.4 treatments per subject).

From the Pediatric Gastroenterology Literature

Capsule Endoscopy in Patients with Cystic Fibrosis

Cystic fibrosis (CF) is a multi-organ disease and is associated with various GI symptoms such as abdominal pain, nausea, and constipation. Certain gastrointestinal diseases, such as distal intestinal obstruction syndrome (DIOS), are often encountered in the CF population. However, small bowel mucosal disease has not been well described. The authors of this study used wireless capsule endoscopy (WCE) to evaluate for the presence of mucosal changes in pediatric and adult CF patients.

Probiotics and Colic

Infantile colic is a frustrating condition for both parents and the treating physician. The cause of this condition is unknown although increase in certain types of bacterial flora, such as Escherichia coli, has been noted in some infants with colic. The authors of this study evaluated the addition of the probiotic, Lactobacillus reuteri DSM 17938, to the diet of infants with colic.

Survival After Pediatric Intestinal Transplant

Intestinal transplantation often is considered in the pediatric patient who has intestinal failure but has progressive clinical deterioration despite parenteral nutrition. The authors of the study utilized the United Network of Organ Sharing (UNOS)/Organ Procurement and Transplantation Network (OPTN) to evaluate pediatric patients listed for intestinal transplantation over a 17-year period (19912008).

Severe Ulcerative in Children

As in adults, ulcerative colitis (UC) in children can become very severe and have no response to standard intravenous glucocorticoid therapy. However, it is difficult to follow long-term data on the sickest of these patients due to the rare nature of this disease. Data was provided from several academic children's hospitals to provide a prospective multicenter study called 'Outcome of Steroid Therapy in Colitis Individuals.'

Medical Bulletin Board

Gore Delivers New Choice for Complex Soft Tissue Reinforcement

W. L. Gore & Associates (Gore) announced the availability of larger sized GORE® BIO-A® Tissue Reinforcement, a valuable alternative to biologics for reinforcement of soft tissue in surgical procedures. GORE BIO-A Tissue Reinforcement is a unique nonbiologic scaffold that is gradually absorbed by the body.

Two Pivotal Vectibix® Phase 3 Studies in First and Second-Line Treatment of Metastatic Colorectal Cancer Published in the Journal of Clinical Oncology

Amgen announced that results from the PRIME '203' and '181' pivotal Phase 3 trials evaluating Vectibix® (panitumumab) in combination with chemotherapy (FOLFOX or FOLFIRI) as a first and second-line treatment for metastatic colorectal cancer (mCRC), respectively, were published online in theJournal of Clinical Oncology.

Recent Patient Series Demonstrates Spirus Medical's Power Spiral Endoscope Enables Unprecedented Access to GI Tract

New Technology Poised to Radically Change How GI Endoscopy is Performed. Spirus Medical, Inc. (, a leading developer of diagnostic and therapeutic advancement systems for gastroenterology announces a series of panendoscopies in an average time of 60 minutes, using a flexible endoscope with an integral drive to power a single use spiral component.