September 2014 Vol XXXVIII Issue 9

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GASTROINTESTINAL MOTILITY AND FUNCTIONAL BOWEL DISORDERS

Introduction to a New Series: The Clinical Spectrum of Gastrointestinal Motility and Functional Bowel Disorders for the Practitioner

Richard W. McCallum



GASTROINTESTINAL MOTILITY AND FUNCTIONAL BOWEL DISORDERS, #1

Status of Pharmacologic Management of Gastroparesis: 2014

Richard W. McCallum, Joseph Sunny, Jr

Gastroparesis is characterized by delayed gastric emptying without mechanical obstruction of the gastric outlet or small intestine. The main etiologies are diabetes, idiopathic and post- gastric and esophageal surgical settings. The management of gastroparesis is challenging due to a limited number of medications and patients often have symptoms, which are refractory to available medications. This article reviews current treatment options for gastroparesis including adverse events and limitations as well as future directions in pharmacologic research.



FRONTIERS IN ENDOSCOPY, SERIES # 13

Endoscopic Ultrasound Guided Intervention for Gastric Variceal Bleeding

Larissa L. Fujii-Lau, Louis M. Wong Kee Song, Michael J. Levy

Acute hemorrhage from gastric varices (GV) is more severe and difficult to treat, often leading to a poorer patient prognosis, as compared to esophageal varices (EV). Currently, the recommended treatment of bleeding GV is endoscopic cyanoacrylate injection. Endoscopic ultrasound (EUS) may enhance variceal detection and improve therapeutic targeting. Newer endosonographic techniques have been developed to offer an alternative treatment and improve patient outcome. This article serves to review these EUS techniques used to treat GV.



NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #133

Coding for Malnutrition in the Adult Patient: What the Physician Needs to Know

Wendy Phillips

At least half of all hospitalized patients are malnourished, which increases the duration of recovery, length of stay, as well as the resources spent to treat the patient. Reimbursement to cover the additional costs may only be realized if the malnutrition is identified, diagnosed, and treated by the physician while providing care for the primary illness. This article will discuss the importance of identifying and documenting malnutrition in hospitalized patients, with practical tips for licensed independent practitioners to aid in this documentation.



UNUSUAL CAUSES OF ABDOMINAL PAIN, #6

Unusual Causes of Abdominal Pain

George W. Meyer



INFLAMMATORY BOWEL DISEASE: A PRACTICAL APPROACH, SERIES #90

Diagnosis and Management of IgG4-associated Pouchitis

Darren N. Seril, Bo Shen

Chronic pouchitis is an inflammatory complication of total proctocolectomy with ileal pouch- anal anastomosis that can be difficult to manage. The role of IgG4-associated inflammation in pouchitis is continuing to emerge. In this article we cover diagnosis and effective treatment options that should be considered early in the management of pouch patients with established IgG4-associated pouchitis.



A CASE REPORT

A Rare Complication of PEG Tube Placement

Tanmayee Bichile, Thandar Aung, John Vainder



Departments Section


Book Reviews

Making Sense of IBS: A Physician Answers Your Questions about Irritable Bowel Syndrome

Making Sense of IBS is a resource for anyone who wants to know more about this common gastrointestinal disorder. Based on his experience as a clinician treating IBS paired with the latest findings from the scientific literature, Dr. Lacy explains clearly causes, diagnoses and treatment of IBS.



Fluorescent Imaging: Treatment of Hepatobiliary and Pancreatic Disease

The success of tumor removal during surgery is affected by the surgeon’s ability to differentiate tumor from normal tissue using subjective criteria that are not easily quantifiable. A way to objectively evaluate tumor margins during surgery in patients would be of great value. Written in an engaging, easy-to-read style, Fluorescent Imaging: Treatment of Hepatobiliary and Pancreatic Disease concisely covers topics related to indocyanine green ( ICG ) fluorescence intra-operative imaging and other unique chemicals in relation to improved surgical outcomes.



From the Literature

HCC in HBV Cirrhotic Patients on Entecavir

To evaluate the risk of development of hepatocellular carcinoma (HCC), according to the underlying liver status and virological response (VR) to Entecavir (ETV), in chronic hepatitis B patients with cirrhosis, a total of 306 patients with clinically diagnosed liver cirrhosis treated with ETV for 12 months or more were subsequently followed up for recurrence of HCC with a median followup duration of 37 months.



Evaluation of Pharmacokinetics of Adalimumab in IBD

A prospective study included all consecutive patients with IBD, having a disease flare while being on Adalimumab (ADA) 40 mg every 2 weeks was carried out and all were primary responders to ADA therapy and were antitumor necrosis factor (TNF) naïve.



From the Pediatric Literature

Is There a Role for Steroids in Treatment of Biliary Atresia?

Biliary atresia (BA) is an inflammatory and fibro- obliterative disease of unknown cause of the biliary tree which is a leading cause of liver transplantation in children. A bridging procedure prior to transplantation is the hepatoportoenterostomy (also known as the Kasai procedure) in which biliary drainage is enhanced through a Roux-en-Y anastomosis directly attached to the porta hepatis. Although it theoretically feasible that steroids would decrease post-procedure inflammation after a Kasai procedure, it is unknown if steroids are truly effective in promoting bile flow through the hepatoportoenterostomy.



Celiac Disease Prevalence in Children with Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) and recurrent abdominal pain (RAP) are relatively common among children, and it is important to determine if such children, in actuality, have a serious gastrointestinal (GI) disorder, such as celiac disease. This prospective, observational, cohort study was done to determine the prevalence of celiac disease from a large pediatric referral population in Italy.



Medical Bulletin Board

FDA APPROVES EXACT SCIENCES’ COLOGUARD® THE FIRST AND ONLY FDA APPROVED STOOL DNA NONINVASIVE COLORECTAL CANCER SCREENING TEST

First time in history a technology receives FDA approval and proposed national coverage by CMS on the same day Screening test detects 92% of colorectal cancer.



AMERICAN REGENT HIGHLIGHTS CHALLENGES AND TREATMENT OPTIONS FOR GASTROINTESTINAL- RELATED IRON DEFICIENCY ANEMIA AT DIGESTIVE DISEASE WEEK 2014

Iron deficiency anemia common but underdiagnosed and undertreated in patients with gastrointestinal conditions; high-dose intravenous iron an effective treatment option.



ORASURE TECHNOLOGIES ANNOUNCES NEW CO- PROMOTION AGREEMENT FOR ORAQUICK® HCV RAPID ANTIBODY TEST

BETHLEHEM, Pa - OraSure Technologies (NASDAQ: OSUR), a market leader in point of care diagnostics, announced that it has entered into a Master Program Services and Co-Promotion Agreement with AbbVie under which AbbVie and OraSure will co-promote the Company’s OraQuick® HCV Rapid Test in the United States.



Meetings Calendar

October 8-11, 2014
77th Annual University of Minnesota Colon and Rectal Surgery: Current Principles & Practice
October 17-22, 2014
ACG Annual Scientific Meeting and Postgraduate Course
December 4-6, 2014
Advances in Inflammatory Bowel Diseases, Crohn’s & Colitis Foundation’s Clinical & Research Conference