August 2015 Vol XXXIX Issue 8

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NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #144

Getting Critical About Constipation

Jean-Louis Vincent, Jean-Charles Preiser

Gastrointestinal motility is a complex process, which is often altered during critical illness, an effect that can lead to constipation. There is no consensus definition for constipation and it is therefore difficult to accurately assess incidence across studies. The etiology of constipation in ICU patients is multifactorial and includes immobility, fluid and electrolyte disturbances, adverse effects of medication, and sepsis. Management must focus on treating the underlying cause and re-establishing regular bowel movements.



INFLAMMATORY BOWEL DISEASE: A PRACTICAL APPROACH, SERIES #96

Inflammatory Bowel Disease in the Elderly: Hazards of Generalizing the Evidence

Vineet S. Gudsoorkar, Bincy P. Abraham

Several challenges exist in managing the geriatric population with inflammatory bowel disease (IBD). The physiology of aging affects not only disease expression, but also the treatment and surveillance strategies. The existing evidence for their treatment is extrapolated from studies that often suffer from a suboptimal representation of this patient subgroup. In this review, we discuss the existing evidence for IBD in the elderly and the potential hazards of its unchecked extrapolation to, arguably, a more fragile and susceptible population.



GASTROINTESTINAL MOTILITY AND FUNCTIONAL BOWEL DISORDERS, SERIES #10

Making Sense of Patients with Gas and Bloating of Undetermined Origin

Juan Castro-Combs, Evelyn Eichler, Richard W. McCallum

Unexplained bloating is one of the most common and bothersome gastroenterology complaints in gastrointestinal (GI) specialty and primary care clinics. This article attempts to provide physicians with a simple and rational approach to unexplained abdominal bloating and to identify underdiagnosed entities that could be responsible for this symptom.



A CASE REPORT

Staghorn Renal Calculus with Xanthogranulomatous Pyelonephritisand Renocolic Fistula

Risheng Xu, Khawaja Azimuddin



A CASE REPORT

Malignant Extrarenal Rhabdoid Tumor (MERT) of the Colon

Deepti Dhavaleshwar, Kofi Clarke



UNUSUAL CAUSES OF ABDOMINAL PAIN, #9

Unusual Causes of Abdominal Pain

Stanley Yakubov, Rabin Rahmani



A CASE REPORT

Autoimmune Pancreatitis

Tianna E. Johnson, Kenneth M. Sigman



Departments Section


From the Literature

In Vitro Fertilization in UC with Ileal Pouch Anal Anastomosis

Women with UC who require ileal pouch anal anastomosis (IPAA) have up to a 3-fold incidence of infertility. To examine the success rate of in vitro fertilization (IVF), in women who have undergone IPAA, a retrospective cohort study was conducted at the Brigham Women’s Hospital and Beth Israel Deaconess Medical Center.



Fecal Calprotectin as Measure of Postoperative Recurrence of Crohn's Disease

To analyze the relationships between levels of fecal calprotectin (fCal) and high sensitivity CRP (hsCRP), and the presence and severity of postoperative endoscopic recurrence in asymptomatic CD patients (Harvey-Bradshaw Index 3 or less), blood and fecal samples were collected in consecutive asymptomatic CD patients who had undergone an ileocolonic resection, with hsCRP and fCal measured and routine ileal colonoscopy was performed within 18 months (median 7 months) from resection to detect endoscopic recurrence according to the Rutgeerts Score.



Fecal Calprotectin and Lactoferrin for Early Diagnosis of Pouchitis After Restorative Proctocolectomy for UC

A prospective study was conducted to evaluate the significance of consecutive monitoring of fecal calprotectin and lactoferrin for the early diagnosis and prediction of pouchitis after restorative proctocolectomy for UC.



Coffee and Chronic Liver Disease

To evaluate the association of coffee intake with HCC and chronic liver disease (CLD) in 162,022 African Americans, Native Hawaiians, Japanese Americans, Latinos and Whites in the US Multiethnic Cohort (MEC), data was collected from the MEC.



Prevention of Recurrence of HCV Post Liver Transplantation

Patients with detectable HCV RNA at the time of liver transplantation universally experience recurrent HCV infection. Antiviral treatment before transplantation can prevent HCV recurrence, but existing interferon-based regimens are poorly tolerated and are either ineffective or contraindicated in most patients.



Post-ERCP Pancreatitis and Failed Pancreatic Stent Placement

Unsuccessful attempts to place a prophylactic pancreatic stent substantially increase the risk of post-ERCP pancreatitis (PEP). To better understand the risk of PEP in patients with failed pancreatic stent placement (FPS), and the impact of rectal Indomethacin on this risk, a secondary analysis of randomized, controlled trial data was carried out.



Difficulty in Endoscopic Resection of Large Colorectal Polyps

Endoscopic manipulations, including biopsy sampling, tattoo application on the lesion itself, and sampling of the lesion with a polypectomy snare are frequently performed on large, nonpedunculated colorectal lesions greater than 20 mm (LNCL), before referral for endoscopic resection.



AFP Benefits in HCC Surveillance in Patients With Cirrhosis

To assess the effectiveness of alpha-fetoprotein (AFP) measurement in hepatocellular carcinoma (HCC) surveillance, a retrospective analysis on all patients with cirrhosis who received that surveillance through ultrasound (US), and AFP measurement between January 2002 and July 2010 was carried out.



Post-ERCP Pancreatitis

To determine the incidence, severity, and mortality of post-ERCP pancreatitis (PEP), from a systematic review of the placebo or no-stent arms of randomized, controlled trials (RCTs), MEDLINE, EMBASE and COCHRANE databases were searched to identify RCTs, evaluating the efficacy of drugs and/or pancreatic stents to prevent PEP.



Medication-Related Lower Gastrointestinal Bleeding

To investigate the risk of lower gastrointestinal bleeding (LGIB) associated with NSAIDs, low-dose aspirin, thienopyridine (ticlodipine or clopidogrel), or other antiplatelet medications used, a prospective study in an emergency hospital and gastroenterology department was carried out.



SVR in HCV Treated With Sofosbuvir Regimens

To assess the concordance between sustained virological response (SVR) at various post-treatment time points in phase III clinical trials of Sofosbuvir-containing regimens, a retrospective analysis of 5 trials, enrolling 863 patients infected with HCV genotypes 1 to 6 was completed.



Correlation of ALT With Liver Fat and Insulin Resistance in Fatty Liver Disease

AST and ALT are usually increased in patients with NAFLD. The factors behind their elevation remain unclear. In order to study and assess the role of insulin resistance (IR), and liver triglyceride content in relation to histology in patients with NAFLD/NASH with normal or elevated ALT levels, 440 patients were enrolled.



Metformin in the Treatment of Cirrhosis in Patients with Diabetes

To investigate whether continuation of metformin after cirrhosis diagnosis improves survival of patients with diabetes, those diagnosed between 2000 and 2010 who were on metformin at the time of cirrhosis diagnosis and identified in 250 patients, with data extracted from the medical record, study was carried out.



Coffee and Relationship to Liver Enzyme Levels

To determine whether decaffeinated coffee is associated with liver enzyme changes, a study population, including 7,793 participants, age 20 or older in the U.S. National Health and Nutrition Examination Survey (1999 to 2010), was carried out.



Magnetic Resonance Elastography to Evaluate Fibrosis in NAFLD

To prospectively assess the diagnostic accuracy of two- dimensional magnetic resonance elastography (2D MRE), in the detection of advanced fibrosis in NAFLD, a cross-sectional analysis of prospective study, including 117 consecutive patients (56% women), with biopsy- proven NAFLD who underwent standardized research visits, history, exam, liver biopsy assessment using the Nonalcoholic Steatohepatitis Clinical Research Network Histologic Scoring System, and 2D-MRE was carried out from 2011 to 2013.



Clinical Outcomes of HBV and HCV Coinfection

The National Veterans Affairs HCV Clinical Case Registry was used to identify patients with confirmed HCV viremia from 1997 to 2005, and coinfection was interpreted from a positive HBsAg, HBV DNA, or hepatitis Be antigen.



Alkaline Phosphatase and Bilirubin as Surrogate End Points in Primary Biliary Cirrhosis

A meta-analysis of individual patient data from cohort studies was carried out to evaluate whether patient levels of alkaline phosphatase (AP) and bilirubin correlate with their outcomes to be used as surrogate end points.



Probiotic Treatment for Hepatic Encephalopathy

A double-blind trial at a tertiary care hospital in India was carried out in patients with cirrhosis who had recovered range of motion an episode of hepatic encephalopathy (HE), during the previous month.



Medical Bulletin Board

TECHNIVIE™ (OMBITASVIR, PARITAPREVIR, AND RITONAVIR TABLETS) RECEIVES FDA APPROVAL AS THE FIRST AND ONLY ALL-ORAL, INTERFERON-FREE TREATMENT FOR GENOTYPE 4 CHRONIC HEPATITIS C IN THE U.S.

ECHNIVIE PROVIDES AN OPPORTUNITY TO TREAT ADULTS IN THE U.S. WHO HAVE GENOTYPE 4 (GT4) CHRONIC HEPATITIS C VIRUS (HCV) INFECTION WITHOUT CIRRHOSIS, A POPULATION HISTORICALLY CONSIDERED DIFFICULT-TO-TREAT



PANCRAGEN™ (FORMERLY PATHFINDERTG®-PANCREAS) TO HELP DIAGNOSE PANCREATIC CYSTS

Data on the benefits of current standards used to manage diagnosis of pancreatic cysts in the context of healthcare costs and patient outcomes were published online in Endoscopy International.



NESTLÉ HEALTH SCIENCE LAUNCHES ENACT™:QUALITY IMPROVEMENT THROUGH NUTRITION PROGRAM FOR HEALTHCARE PROFESSIONALS

Clinical nutrition continues to be critically under- leveraged and under-valued - yet enteral nutrition protocols can help improve patient and hospital outcomes and lower costs



STAY STRONG, STAY ACTIVE WITH BOOST® NESTLÉ HEALTH SCIENCE INTRODUCES INNOVATIVE BOOST® NUTRITIONAL DRINKS IN COMPACT SIZES

Florham Park, N.J. - Nestlé Health Science has announced the launch of the next generation of nutrition drinks - 4 fluid (fl) ounce (oz) size BOOST Calorie Smart® 100 Calories Balanced Nutritional Drink and BOOST® Compact Complete Nutritional Drink.



Meetings Calendar

August 14 & 15, 2015 Chicago Live 2015: Advances in Diagnostic and Therapeutic Endoscopy
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