Best Practice and Research. Clinical Gastroenterology This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Primary biliary cholangitis and bone disease
Publication date: Available online 14 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Albert Parés, Núria GuañabensAbstractOsteoporosis, characterized by compromised bone strength leading to fragility fractures, is a common event in patients with primary biliary cholangitis (PBC). Osteomalacia, defined by poor bone mineralization is very uncommon. The pathogenesis of osteoporosis is not well clarified, but it mainly results from low bone formation. Few reports have revealed increased bone resorption, particularly in end-stage disease. The prevalence of osteoporosis is about 35% in the most ...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research

Surgery in ulcerative colitis: When? How?
Publication date: Available online 14 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Gaetano Gallo, Paulo Gustavo Kotze, Antonino SpinelliAbstractUlcerative Colitis (UC) is an idiopathic chronically-remitting inflammatory bowel disorder characterized by a contiguous inflammation of the colonic mucosa affecting the rectum that generally extends proximally in a continuous manner through the entire colon. Patients typically experience intermittent exacerbations, with symptoms characterized by bloody diarrhea associated with urgency and tenesmus. The anatomical extent of mucosal involvement is th...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research

Symptoms of PBC – Pathophysiology and management
Publication date: Available online 14 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Amardeep Khanna, Jess Leighton, Lin Lee Wong, David E. JonesAbstractPrimary biliary cholangitis is a chronic cholestatic liver disease characterised by progressive bile duct damage and, ultimately, biliary cirrhosis. Though up to fifty percent of the patients can be asymptomatic at presentation, symptoms when present are frequently debilitating with significant impact on quality of life and functional status. Characteristic symptoms include pruritus, fatigue and an increasingly recognised mild cognitive impai...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research

Improving prognosis in primary biliary cholangitis – Therapeutic options and strategy
Publication date: Available online 14 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Maren H. Harms, Henk R. van Buuren, Adriaan J. van der MeerAbstractOverall survival in primary biliary cholangitis is diminished. As patients are often asymptomatic, the disease may silently progress towards cirrhosis and liver failure. Timely diagnosis and effective treatment options are of vital importance to improve the prognosis of affected patients. Ursodeoxycholic acid is the standard of care first-line therapy and is associated with a reduced risk of liver transplantation and death. Treatment with UDCA...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research

Is PBC a viral infectious disease?
Publication date: Available online 14 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Andrew L. MasonAbstractThe human betaretrovirus and the closely related mouse mammary tumor virus have been linked with the development of cholangitis and mitochondrial antibody production in patients with primary biliary cholangitis (PBC) and mouse models of autoimmune biliary disease, respectively. In vitro, betaretroviruses have been found to stimulate the expression of mitochondrial autoantigens on the cell surface of biliary epithelial cells. In vivo, both mitochondrial autoantigens and viral proteins ...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research

Patterns of disease progression and incidence of complications in primary biliary cholangitis (PBC)
Publication date: Available online 14 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Ashnila Janmohamed, Palak J. TrivediAbstractClinical outcome for patients with primary biliary cholangitis (PBC) is dictated by development of cirrhosis, portal hypertension and its associated complications; including for some, a predisposition toward hepatocellular carcinoma. However rates of clinical progression vary, and accurately identifying disease course is of critical importance to patients, clinicians, as well as industry, who are committed to developing new effective and life-prolonging therapy as w...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research

Evolution of our understanding of PBC
Publication date: Available online 15 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Atsushi Tanaka, Patrick S.C. Leung, M. Eric GershwinAbstractThe discovery of mitochondrial autoantigens recognized by antimitochondrial antibodies (AMAs) in 1987 marked the dawn of a new era in primary biliary cholangitis (PBC) research. Since then, there has been substantial progress in our understanding of PBC partly bestowed by the development of innovative technologies in molecular biology, immunology, and genetics. Here, we review this evolutionary progress in understanding PBC. We now recognize that the...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research

Risk stratification and prognostic modelling in primary biliary cholangitis
Publication date: Available online 18 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Jorn C. Goet, Maren H. Harms, Marco Carbone, Bettina E. HansenAbstractPrimary biliary cholangitis (PBC) is a slowly progressive chronic cholestatic liver disease that, in a subgroup of patients, may result in liver failure or death. The definition of specific risk profiles, i.e. risk stratification, is of critical importance for the identification of these subgroups and thereby the targeting of care. Over the last few years large multicentre cohort studies have improved our knowledge regarding factors associa...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research

Can we move directly from 5-ASA to a biologic agent in ulcerative colitis?
Publication date: Available online 20 June 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Pieter Hindryckx, Gregor NovakAbstractEuropean consensus guidelines and reimbursement policies position biologic drugs for ulcerative colitis (UC) as a third-line treatment, after failure of 5-aminosalicylic acid (5-ASA) and corticosteroids/thiopurines. While 5-ASA have a very favorable safety profile, (prolonged) use of corticosteroids and thiopurines is associated with potentially serious adverse events. The therapeutic landscape of UC is rapidly evolving and selective biologic drugs with improved safety ar...
Source: Best Practice and Research Clinical Gastroenterology - July 10, 2018 Category: Gastroenterology Source Type: research

Alcohol, smoking and the GI tract
Publication date: October 2017Source: Best Practice & Research Clinical Gastroenterology, Volume 31, Issue 5Author(s): Stephen McCain, Helen G. Coleman (Source: Best Practice and Research Clinical Gastroenterology)
Source: Best Practice and Research Clinical Gastroenterology - July 5, 2018 Category: Gastroenterology Source Type: research

Communication of alcohol and smoking lifestyle advice to the gastroenterological patient
Publication date: October 2017Source: Best Practice & Research Clinical Gastroenterology, Volume 31, Issue 5Author(s): Andrew D. Spence, Mais Khasawneh, Patrick B. Allen, Jennifer AddleyAbstractEffective communication between healthcare staff and patients is central to development of the patient-professional relationship. Many barriers influence this communication, often resulting in patients' lack of understanding and retention of information, particularly affecting advice regarding lifestyle habits, such as alcohol consumption and smoking. Alcohol and smoking misuse are potentially modifiable risk factors known to advers...
Source: Best Practice and Research Clinical Gastroenterology - July 5, 2018 Category: Gastroenterology Source Type: research

Impact of alcohol & smoking on the surgical management of gastrointestinal patients
Publication date: October 2017Source: Best Practice & Research Clinical Gastroenterology, Volume 31, Issue 5Author(s): Niall D. Kennedy, Des C. WinterAbstractAlcohol and smoking are repeatedly described as modifiable risk factors in clinical studies across all surgical specialities. These lifestyle choices impart a sub-optimal physiology via multiple processes and play an important role in the surgical management of the gastrointestinal patient. Cessation is imperative to optimise the patient's fitness for surgery with surgery itself being a prime opportunity for sustained cessation. A consistent, planned and integrated ma...
Source: Best Practice and Research Clinical Gastroenterology - July 5, 2018 Category: Gastroenterology Source Type: research

The interaction between smoking, alcohol and the gut microbiome
Publication date: October 2017Source: Best Practice & Research Clinical Gastroenterology, Volume 31, Issue 5Author(s): Gabriele Capurso, Edith LahnerAbstractThe gastrointestinal microbiome is a complex echosystem that establishes a symbiotic, mutually beneficial relation with the host, being rather stable in health, but affected by age, drugs, diet, alcohol, and smoking. Alcohol and smoking contribute to changes in the stomach and affect H pylori-related disorders including the risk of gastric cancer. In the small intestine and in the colon alcohol causes depletion of bacteria with anti-inflammatory activity, eventually re...
Source: Best Practice and Research Clinical Gastroenterology - July 5, 2018 Category: Gastroenterology Source Type: research

Do smoking and alcohol behaviours influence GI cancer survival?
Publication date: October 2017Source: Best Practice & Research Clinical Gastroenterology, Volume 31, Issue 5Author(s): Úna C. McMenamin, Stephen McCain, Andrew T. KunzmannAbstractLittle is known about the role of alcohol and smoking in GI cancer survival compared to GI cancer development. We systematically reviewed the evidence for a role of smoking and alcohol in prognosis among GI cancer patients and inform whether smoking or alcohol cessation interventions or guidelines for GI cancer patients are likely to improve prognosis. A total of 84 relevant studies were identified. Continued smokers, particularly heavy smokers, ...
Source: Best Practice and Research Clinical Gastroenterology - July 5, 2018 Category: Gastroenterology Source Type: research

Alcohol, smoking and the risk of premalignant and malignant colorectal neoplasms
Publication date: October 2017Source: Best Practice & Research Clinical Gastroenterology, Volume 31, Issue 5Author(s): Ifewumi O. Fagunwa, Maurice B. Loughrey, Helen G. ColemanAbstractColorectal cancer (CRC) is the third most common cancer worldwide and has a complex aetiology consisting of environmental and genetic factors. In this review, we evaluate the roles of alcohol and tobacco smoking in colorectal neoplasia. Alcohol intake and tobacco smoking are associated with modest, but significantly, increased risks of CRC, adenomatous and serrated polyps. There is consistent evidence of dose-response relationships for both a...
Source: Best Practice and Research Clinical Gastroenterology - July 5, 2018 Category: Gastroenterology Source Type: research