November 2012 Vol XXXVI Issue 11

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Inflammatory Bowel Disease: A Practical Approach, Series #79

Clostridium Difficile Infection in Patients with Inflammatory Bowel Disease

N.M. Joshi, D.S. Rampton

Patients with inflammatory bowel disease (IBD) are at higher risk of developing Clostridium difficile infection (CDI) than are those without; patients with both IBD and CDI also appear to have poorer outcomes than those with CDI alone. Here we discuss testing and treatment of CDI complicating IBD.

Practical Approaches to the Diagnosis and Treatment of Colorectal Cancer, Series #8

Colonic Polyps: The Harm of Overdiagnosis

James Allison, Gerrit A. Meijer

The primary care physician and lay people have been led to believe that any polyp is a threat and that advanced polyps (adenomas) are particularly worrisome. Inquisitive clinicians and policy makers are wondering if polyps, even the advanced ones, are "sheep in wolves' clothing." Could they be a form of "over diagnosis" thus labeling innocuous tumors as cancer and treating them as though they could be lethal when in fact most are not dangerous? In this article we address these questions.

Nutrition Issues in Gastroenterology, Series #111

Dermatitis Herpetiformis: What Practitioners Need to Know

Freda C. Sansaricq, Vesna Petronic-Rosic

Dermatitis herpetiformis (DH) is an autoimmune blistering disorder with a multifactorial etiology associated with a gluten-sensitive enteropathy. With current medical management and lifestyle adjustments, treatment can be highly successful. This review highlights distinguishing clinical symptoms and serves to aid the reader in the diagnosis and treatment of DH.

A Special Article

Evaluation and Management of Cirrhotic Ascites

Sohaib Hassan, Mazen Albeldawi, William Carey

The development of ascites is a major event in the natural history of cirrhosis and is associated with a significant deterioration in prognosis. Although cirrhosis accounts for approximately 75% of patients with ascites, other causes should be kept in mind. In this review we discuss key analysis, evaluation and management of ascites.

A Case Report

Osseous Metaplasia in a Colon Polyp

Michael Hjelkrem, Kevaghn Fair, Ajay Pabby

Departments Section

From the Literature

H. Pylori-Associated Gastric Mucosal Lymphoma and Risk For Secondary Cancers

Cure of Helicobacter pylori infection induces remission in most patients with gastric mucosa-associated lymphoid tissue lymphoma (GML).

Gastric and Esophageal Malignancies are Increased in People with AIDS

To evaluate the risks of different histologic and anatomic subtypes of carcinomas and non-Hodgkin?s lymphomas (NHLs) of the stomach and esophagus in people with AIDS, data was analyzed from the HIV-AIDS Cancer Match Study, which linked data collected from 1980 to 2007 for 16 US population-based HIV and AIDS and cancer registries.

EUS-FNA in Diagnosis of Autoimmune Pancreatitis

To determine whether EUS-guided FNA by using 22-gauge needles is useful for the diagnosis or evaluation of autoimmune pancreatitis (AIP), a retrospective study was carried out in which a total of 273 patients, including 25 with AIP, underwent EUSFNA and histologic examination.

Effect of Inadequate Bowel Preparation on Screening Colonoscopy

To determine the prevalence of missed adenomas on average-risk patients presenting for screening colonoscopy who are found to have inadequate bowel preparation, a retrospective chart review was carried out with endoscopic and pathology reports examined to determine the characteristics of polyps.

Cocaine-Related Ischemic Colitis

A retrospective review of medical records at two affiliated teaching hospitals located in a downtown area of Milwaukee was carried out over a 9-year period. A total of 208 patients were identified by ICD-9 codes with a confirmed diagnosis of bowel ischemia, with imaging and endoscopic findings and self-report of recent cocaine use or positive urine toxicology screen within 6 months of a hospital admission for ischemia.

Varying Appearance of Proximal Colorectal Neoplasms

To investigate the differences in endoscopic appearance (i.e., diminutive size and nonpolypoid shape), of proximal compared with distal colorectal neoplasms, endoscopists in the Netherlands who were previously trained in the detection and classification of nonpolypoid colorectal lesions, carried out examination on consecutive patients undergoing elective colonoscopy and including 3,720 patients.

Serrated Polyposis and Risk in Relatives For Carcinoma

In order to explore cancer risk for relatives of patients who have identified serrated polyps, including hyperplastic polyposis with serrated architecture in the colon and rectum, while the patients themselves are at increased risk of colorectal carcinoma, the aim of this study was to estimate the risks of CRC and extracolonic cancers for relatives of these patients.

Risk of HCC in Hepatitis B Patients with a Low HBV Load

To evaluate whether higher levels of HBsAg increase risk for hepatocellular carcinoma (HCC), a total of 2688 Taiwanese HBsAg-positive patients without evidence of cirrhosis were followed for a mean time period of 14.7 years. In addition to the known risk factors of HCC, the association between levels of HBsAg and the development of HCC were investigated.

Crohn?s Ileocolitis and Mucosal Healing with Adalimumab

To investigate the efficacy of adalimumab for inducing and maintaining mucosal healing in patients with Crohn's disease (CD), a randomized, double-blind, placebo-controlled trial (EXTEND) evaluated that drug for induction and maintenance of mucosal healing in 135 adults with moderate to severe ileocolonic CD.

Medical Bulletin Board

Synergy Pharmaceuticals Highlights Mechanistic Features of Plecanatide, a Novel Investigational Drug for Chronic Idiopathic Constipation

Scientific Poster Presentations at ACG 2012 and UEG Week

Given Imaging Reports Data Showing Greater Role for Capsule Endoscopy in Detecting and Monitoring Crohn’s disease

Capsule Endoscopy Found to Be Superior to Magnetic Resonance Enterography for Detecting Crohn’s Disease Lesions

Given Imaging Reports New Studies Confirming Clinical Utility Of Its Functional Gastrointestinal Diagnostics Products

Studies Show Value of Incorporating High Resolution Manometry in the Diagnostic Examination of Achalasia and Anorectal Disorders.
Expanding the Duration of pH Measurement Allows Doctors to Confidently Separate Healthy Patients From Those With Reflux