January 2018 Vol XLII Issue 1

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Arsenic Levels in Celiac Patients

Runa Diwadkar Watkins, Dana Hong, Elaine Lynne Leonard Puppa, Anca Safta, Samra Sarigol Blanchard

For persons with celiac disease, wheat, barley and rye trigger an autoimmune response in the small intestine, specifically destroying the villi of the duodenum and triggering systemic inflammation. To avoid this immune response, people with celiac disease substitute rice and rice products for wheat, barley and rye. Concerns regarding arsenic levels in rice have prompted the celiac community to question whether increased rice consumption puts them at an increased risk for arsenic toxicity. Some studies have suggested children may be at greater risk than adults. The purpose of this study was to evaluate the risk for increased arsenic levels in persons with celiac disease.


Moo-ove Over, Cow's Milk - The Rise of Plant-Based Dairy Alternatives

Meagan Bridges

Consumer demand for alternatives to dairy is on the rise, and with it, an ever-expanding array of plant-based products from which to choose. This is especially evident when considering milk substitutes. Each type of non-dairy milk offers a unique nutritional profile, with a wide range of values for protein, carbohydrates and fat, along with vitamins and minerals. In this article, we review which non-dairy beverages are gaining in popularity and how these options compare nutritionally to cow's milk.


The Microbiome and Inflammatory Bowel Disease

Sabine Hazan Steinberg, Daniel Frochtzwajg, Jessica Murray

An IBD patient's quality of life can be significantly diminished when treated with conventional therapies. However, like the trend of fecal microbiota transplantation (FMT) for the treatment of Clostridium difficile infection, there is promising evidence that a similar approach will prove efficacious in treating UC and Crohn's, especially given the increasingly predictable intestinal microbiome perturbation.


Acute Esophageal Necrosis Caused by Gallstone Pancreatitis

Bradley M. Yamanaka, Brian J. Hanson

Departments Section

From the Literature

Late Recurrence of Barrett's Esophagus After Complete Eradication of Intestinal Metaplasia

The long term durability of CEIM (complete eradication of intestinal metaplasia) has not been well characterized. Results of a 5-year analysis of patients with Barrett's esophagus (BE) and dysplasia treated by radiofrequency ablation (RFA) in the randomized, controlled Ablation of Intestinal Metaplasia Containing Dysplasia (AIM) trial was carried out.

Low Risk Adenomas at Colonoscopy Prognosis

A systematic review and meta-analysis of the risk of advanced adenomas (AAs), colorectal cancer (CRC), and/or CRC-related death among individuals with Low-Risk Adenomas (LRAs) was conducted.

PPI Use and Alzheimer's Disease

To investigate whether PPI use is associated with an increased risk of clinically verified Alzheimer's disease (AD), a Finnish, nationwide nested case-controlled study, MEDALZ, included all community-dwelling individuals with newly diagnosed AD during 2005 to 2011 (N = 70,718), and up to four age, sex, and region of residence matched comparison individuals for each case (222,858).

Peripheral Eosinophilia and IBD

Little data exists on the long-term impact of peripheral blood eosinophilia (PBE) on the disease course of inflammatory bowel disease/UC in its active state. To investigate the multi-year pattern of PBE and its impact on disease severity in a large IBD cohort, a registry analysis was performed of a consented, prospective, natural-history IBD cohort at a tertiary center from 2009 to 2014.

Value of Urgent Colonoscopy in Lower GI Bleeding

Colonoscopy is indicated in all hospitalized patients with LGIB (lower GI bleeding), yet the timeframe for performing that procedure remains unclear. To compare several outcomes between urgent and elective colonoscopy in patients hospitalized for LGIB, a systemic review and meta-analysis were performed on studies that compared urgent and elective colonoscopy in these patients.

Budesonide Oral Suspension in Eosinophilic Esophagitis

A randomized, controlled phase trial to assess the ability of budesonide oral suspension (BOS), a novel muco-adherent topical steroid formulation to reduce symptoms and esophageal eosinophilia in adolescents and adults with eosinophilic esophagitis (EoE) was carried out.

From the Pediatric Literature

Intestinal Inflammation in Pediatric Cystic Fibrosis

Abdominal pain and poor weight gain are common in children with cystic fibrosis (CF). Fecal calprotectin (FC) is used as a marker of intestinal inflammation, and the authors of this study evaluated the results of serial FC in children with CF to determine the risk of intestinal inflammation in this specific patient population.

Pancreatic Enzyme Replacement Therapy Use in Pediatric Malnutrition

Childhood malnutrition is a worldwide health issue, and diarrhea associated with malnutrition is associated with increased mortality in the pediatric population. Exocrine pancreatic insufficiency does occur in the setting of severe acute malnutrition, and the authors of this study evaluated the effect of pancreatic enzyme replacement therapy (PERT) in preventing complications of severe acute malnutrition in Malawi children.

Medical Bulletin Board


MEMPHIS, Tenn., - A new study has been published regarding Tru-D and its deployment at Virginia Commonwealth University Health System (VCU). The study, Deployment of a touchless ultraviolet light robot for terminal room disinfection: The importance of audit and feedback, appeared online recently in the American Journal of Infection Control.

Meetings Calendar

Jan. 18-20, 2018 - The Crohn's & Colitis Congress
February 11-14, 2018 - The 2nd Annual The GUILD Conference 2018
May 19 - 23, 2018 - The 2018 American Society of Colon and Rectal Surgeons (ASCRS) Annual Scientific Meeting
June 2-5, 2018 - Digestive Disease Week (DDW)