June 2015 Vol XXXIX Issue 6

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Domperidone: Everything a Gastroenterologist Needs to Know

Marco Bustamante-Bernal, Priyanka Wani, Richard W. McCallum

Domperidone, first synthesized approximately 40 years ago, has been approved worldwide for specific clinical applications. However, in the United States it is only available through an FDA-approved Limited Access Program. In this article we review all the literature regarding its clinical efficacy and we provide a comprehensive list of recommendations and guidelines when considering initiating domperidone in patients that are suitable for this medication.


Non-Celiac Gluten Sensitivity Where are We Now in 2015?

Anna Sapone, Daniel A. Leffler, Rupa Mukherjee

Non-celiac gluten sensitivity (NCGS) is a term that is used to describe individuals who are not affected by celiac disease or wheat allergy yet who have intestinal and/ or extraintestinal symptoms related to gluten ingestion with improvement in symptoms upon gluten withdrawal. The prevalence of this condition remains unknown. In this paper, we will discuss the current advances in our understanding of NCGS including definition, epidemiology, clinical characteristics, diagnostic criteria and management.

ARTICLE CORRECTION - Non-Celiac Gluten Sensitivity Ė Where are We Now in 2015


Transgastric Endoscopic Necrosectomy Using a Dedicated Transluminal Stent

James P. D. Walker, Kyle Eliason, Douglas G. Adler

In the treatment of pancreatic fluid collections and walled off pancreatic necrosis (WOPN) from pancreatitis, there are three main approaches: surgical, interventional radiology (IR) and endoscopic. These approaches are effectively used either alone or in tandem based on the specifics of the patientís disease, the comfort level of the care team and the stability of the patientís condition.


Biliary Tubulopapillary Adenoma with Concurrent Biliary Stone Presenting with Pruritus and Obstructive Jaundice: A Case Report and Review of Literature

Jehangir Ansari, Padmini Krishnamurthy


Hepatocellular Carcinoma

Nitin Sardana, Elie Aoun

There are many factors that determine the appropriate treatment for patients with HCC including underlying liver disease, size, number of lesions, vascular involvement and extravascular disease. Further studies are needed to help refine the best treatment options in patients with early-,intermediate-, and late-stage disease who are either neither transplant candidates or unresectable. With current screening guidelines as well as improved and well-tolerated treatments for hepatitis C now available, there is hope that both the incidence and mortality from HCC will decrease.

Departments Section

From the Literature

Comparison of Immunosuppressants and Biologics in Crohn's Disease

To compare therapies for induction and maintenance of remission in patients with Crohn's disease based on direct and indirect evidence, systematic reviews were performed of MEDLINE, EMBASE, and Cochrane Central databases through June 2014.

Portal Vein Thrombosis With Cirrhosis

Data was analyzed from a prospective trial of ultrasound screening for hepatocellular carcinoma in order to identify risk factors for, and the impact of portal vein thrombosis (PVT) in patients with cirrhosis.

Transoral Fundoplication for Treatment of Regurgitation

Transoral esophagogastric fundoplication (TF) can decrease or eliminate features of GERD in some patients whose symptoms persist despite PPI therapy.

Treatment of Chronic Radiation Proctopathy

Chronic radiation proctopathy (CRP) is a common sequelae occurring even many years after pelvic radiation. Current ablative therapies for bleeding ectatic vessels have the potential for deep tissue injury leading to ulcerations, perforation, and fistulas.

Endoscopic Versus Surgical Approach to Early Gastric Cancer

To compare long-term outcomes of endoscopic resection (ER) with those of surgery in patients with early gastric cancer (EGC), who met the absolute indication for endoscopic resection, a retrospective cohort study was carried out at a specialized center for the treatment of cancer.

Budesonide Foam in the Treatment of IBD

Two randomized, stage 3 trials were carried out to evaluate the ability of Budesonide rectal foam formulated to optimize retention and provide uniform delivery of that drug to the rectum and distal colon to induce remission in patients with ulcerative proctitis or ulcerative proctosigmoiditis.

Functional Abdominal Distention Associated with Abdominophrenic Dyscoordination

A prospective study of 45 patients of which 42 were women and ranging from 24 to 71 years of age was carried out with functional intestinal disorders (27 with IBS with constipation, 15 with functional bloating, and 3 with IBS with alternating bowel habits and discrete episodes of visible abdominal distention).

FIB-4 as a Marker for HCC in HBV Carrier

To investigate the possible role of FIB-4, a noninvasive marker for liver fibrosis, based on routine laboratory tests as a clinical indicator for predicting future HCC among HBV carriers, a retrospective cohort study was carried out involving 986 Korean HBsAg carriers 40 years of age or older who visit Seoul National University Hospital for a health checkup.

Mixed Cryoglobulinemia and Response to SVR for HCV

To evaluate the influence of mixed cryoglobulinemia (MC) on the virological response and the long-term effects of viral eradication on MC, a total of 424 HCV patients were prospectively enrolled, belonging to the following groups...

From the Pediatric Literature

Overuse of Food Allergy Testing

Food allergies are very common in children, but misunderstanding of the indications for allergy testing leads to inappropriate treatment and increased healthcare costs. The authors of this study retrospectively evaluated all pediatric patients over a 15-month period who had been referred to a tertiary pediatric allergy center and who previously had undergone food-specific IgE testing.

Anxiety and Pediatric Crohn Disease

Patients with inflammatory bowel disease (IBD), including children, can have significant anxiety associated with their disease. The authors of this study evaluated the prevalence of anxiety symptoms in a cohort of pediatric patients with Crohn disease (CD) and attempted to correlate severity of anxiety symptoms with CD symptom severity.

C-Reactive Protein and Pediatric Inflammatory Bowel Disease

Serum markers, such as the C-reactive protein (CRP) can be used in pediatric patients with inflammatory bowel disease (IBD) to monitor for disease activity and response to medical therapy. However, CRP levels may not necessarily match IBD activity, and the authors of this study evaluated CRP genotype at the time of IBD diagnosis to correlate with pediatric IBD phenotype.

Stool Color Card Use for Biliary Atresia Screening

Biliary atresia (BA), a progressive sclerosing disease of unknown etiology affecting the intra- and extrahepatic bile ducts, is one of the most common reasons for liver transplantation in infants and children.

Medical Bulletin Board


Xifaxan® 550 mg is the first-and-only nonsystemic antibiotic approved for the treatment of IBS-D in adults

Meetings Calendar

July 18, 2015 Mastering Clinical Challenges and Emerging Therapies in IBD
October 16-21, 2015 American College of Gastroenterology Annual Meeting
December 10-12, 2015 2015 Advances in Inflammatory Bowel Diseases, Crohn's & Colitis Foundation's Clinical & Research Conference