July 2018 Vol XLII Issue 7

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FRONTIERS IN ENDOSCOPY, SERIES #44

Radiofrequency Ablation for Biliary Disease

Patrick Powers, Douglas G. Adler

Biliary RFA has emerged as a viable method for the ablation and palliation of biliary strictures, and studies suggest that endobiliary RFA is a safe and feasible technique. In this article we discuss important issues for the clinician to be aware of: Adverse events common to endobiliary RFA, the effect of chemotherapy on survival, plastic vs metal stents and the continued investigation to further elucidate the efficacy of endobiliary RFA in the management of biliary strictures.



GASTROINTESTINAL MOTILITY AND FUNCTIONAL BOWEL DISORDERS, SERIES #25

Revisiting Achalasia and Esophageal Squamous Cell Carcinoma

Fernando Moran, Cong Phan, Richard W. McCallum

After immediate endoscopic or surgical management of achalasia, many patients may not follow through with long-term care. Though less common than adenocarcinoma, squamous cell carcinoma of the esophagus can be associated with achalasia. This article highlights current care in diagnosis, treatment and possible long-term esophageal surveillance strategies.



DISPATCHES FROM THE GUILD CONFERENCE, SERIES #14

An Overview of Irritable Bowel Syndrome and its Relation to Small Intestinal Bacterial Overgrowth

Priya Kathpalia, Mark Pimentel

Previously thought to be a diagnosis of exclusion, it is now clear that Irritable Bowel Syndrome (IBS) can be safely diagnosed at the time of an initial patient encounter by a gastroenterologist. Here we discuss the intimate relationship between small intestinal bacterial overgrowth (SIBO) and IBS and treatment options now targeted to reduce the bacterial load below a threshold that may cause symptoms. The pathophysiology of IBS based on alterations of the gut microbiome has taken a front seat in understanding this condition.



NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #177

Got Lactase? A Clinician's Guide to Lactose Intolerance

Meagan Bridges

Intolerance of lactose-containing foods is a very common condition that usually arises as a result of a genetically programmed decline in the enzyme lactase. Here we discuss the management of lactose intolerance and the challenge of maintaining proper nutrition status - particularly as it pertains to calcium and vitamin D. We provide a variety of additional tools available to help address symptoms. Further work is needed to evaluate the role of lactose and dairy foods in other GI conditions, as well as on methods to avoid unnecessary dietary restriction.



Departments Section


From the Pediatric Literature

Safety of Fecal Transplantation in Pediatric Inflammatory Bowel Disease

Therapeutic manipulation of the intestinal microbiome using fecal microbiota transplantation (FMT) has the potential to treat various diseases, including inflammatory bowel disease (IBD). However, the efficacy of FMT in the treatment of IBD, including Crohn disease and ulcerative colitis, is unclear and this aspect is especially true in pediatric patients. The authors of this study performed an open-label prospective trial at a single children's hospital in the United States.



Colonic Eosinophilia in Children

Children who undergo endoscopy for gastrointestinal issues often have eosinophils noted in colonic biopsies. However, the presence of eosinophils as a cause of gastrointestinal disease in children is unknown, and the authors of this study performed a retrospective study of all patients with colonic eosinophilia at a tertiary children's hospital with expertise in allergic gastrointestinal disease. An analysis of pathology specimens over an 8-year period was performed to identify any colonic pathology specimen with eosinophils mentioned in a pathology database. This cohort of specimens was labeled as colonic eosinophilia, and the group was compared to control subjects with no colonic eosinophils or inflammation noted using the same database.



Probiotics and Necrotizing Enterocolitis: Still Confusion

Necrotizing enterocoliltis (NEC) is a significant cause of mortality in premature infants. Probiotics have been proposed as a potential preventative therapy for NEC by theoretically changing the intestinal microbiome to a more protective profile; however, research outcomes are unclear, as different probiotic strains, dosing, and timing of administration have been used. The authors of this retrospective observational study at a single newborn intensive care unit (NICU) evaluated the effect of one probiotic, Lactobacillus rhamnosus GG (LGG).



Medical Bulletin Board

TAKEDA HIGHLIGHTS FAVORABLE SAFETY PROFILE OF ENTYVIO® (VEDOLIZUMAB) THROUGH COMPARATIVE REAL-WORLD DATA VERSUS TNFa-ANTAGONIST THERAPY IN ULCERATIVE COLITIS AND CROHN'S DISEASE

Takeda demonstrates leadership in GI by featuring new U.S. VICTORY Consortium data among its 24 sponsored Entyvio abstracts presented at the Digestive Disease Week (DDW) 2018 meeting



OSHI HEALTH LAUNCHES FIRST ALL-IN-ONE MOBILE APP TO EMPOWER PATIENTS WITH INFLAMMATORY BOWEL DISEASE (IBD), INCLUDING CROHN'S DISEASE AND ULCERATIVE COLITIS

New Mobile App for iOS and Android Provides Critical Patient Tools and Fresh Educational Content for Navigating Life with IBD



Meetings Calendar

August 25, 2018 Great Debates & Updates in Inflammatory Bowel Disease
October 5-10, 2018 American College of Gastroenterology 2018
December 13-15, 2018 Advances in Inflammatory Bowel Diseases - Multidisciplinary Approaches to IBD Patient-Centered Care