Best Practice and Research. Clinical Gastroenterology 
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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.“Can MRE replace ileo-colonoscopy for evaluating disease activity in Crohn’s Disease?”
Publication date: Available online 31 May 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Fumi Varyani, Sunil SamuelAbstractCrohn's disease is a form of chronic inflammatory bowel disease that can lead to structural bowel damage due to transmural inflammation. Ileo-colonosocopy is currently essential for initial diagnosis. Reassessment of disease burden is frequently needed during episodes of active disease and when evaluating treatment efficacy. This review compares the role of Magnetic Resonance Enterography (MRE) and ileocolonoscopy in Crohn's disease management and whether cross-sectional imagi...
Source: Best Practice and Research Clinical Gastroenterology - June 1, 2019 Category: Gastroenterology Source Type: research
Endoscopic scoring systems for the evaluation and monitoring of disease activity in Crohn's disease
Publication date: Available online 28 May 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Lara Hart, Talat BessissowAbstractCrohn's disease is a chronic relapsing idiopathic condition that can affect any part of the gastrointestinal tract. It has been shown that mucosal healing is associated with improved clinical outcomes such as reduced risk of surgery, hospitalization and complications. Nowadays mucosal healing is considered the optimal target of medical therapy. To evaluate the mucosa in an objective and standardized manner, it is important to rely on accurate and validated endoscopic scores. T...
Source: Best Practice and Research Clinical Gastroenterology - May 29, 2019 Category: Gastroenterology Source Type: research
In the absence of head-to-head trials, what do real world studies tell us about the comparative effectiveness of biologics in Crohn’s disease
Publication date: Available online 29 May 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Joseph Meserve, Maria Barsky, Parambir S. Dulai (Source: Best Practice and Research Clinical Gastroenterology)
Source: Best Practice and Research Clinical Gastroenterology - May 29, 2019 Category: Gastroenterology Source Type: research
The Role of Colonoscopy and Endotherapy in the Management of Lower Gastrointestinal Bleeding
Publication date: Available online 29 May 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Neil SenguptaAbstractColonoscopy is an integral diagnostic and therapeutic tool in the management of patients with lower gastrointestinal bleeding (LGIB). After resuscitation, reversal of coagulopathy, and exclusion of a proximal source of bleeding, colonoscopy should be performed in most patients with LGIB. Bowel preparation, typically with polyethylene glycol based solutions, is needed to closely inspect the colonic mucosa for bleeding sources. Colonoscopy within 24 hours is recommended for high-risk patient...
Source: Best Practice and Research Clinical Gastroenterology - May 29, 2019 Category: Gastroenterology Source Type: research
Interfering with leukocyte trafficking in Crohn’s Disease
Publication date: Available online 28 May 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Sujata Biswas, Robert V. Bryant, Simon TravisAbstractThe discovery of gut-specific leukocytes and the ability to modulate their function has been a groundbreaking development in the treatment of inflammatory bowel disease. Drugs target the interaction between lymphocytes and endothelial cells via integrins and their ligand cellular adhesion molecules. Safety, efficacy and sustainability of effect are key to this drug class, notwithstanding the association of natalizumab with fatal polyoma virus infection. Vedo...
Source: Best Practice and Research Clinical Gastroenterology - May 29, 2019 Category: Gastroenterology Source Type: research
Pathophysiology of the irritable bowel syndrome – reflections of today
Publication date: Available online 24 May 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Per M. HellströmAbstractIrritable bowel syndrome (IBS) is a chronic gastrointestinal symptom complex defined by abdominal pain and disturbed bowel habits over 3 months within a period of 6 months, in absence of any identifiable organic pathology. Over the years, speculations of the pathophysiology of IBS has moved from elusive central nervous symptoms impinging on psychosomatic disease, to objective signs of intestinal fermentation with abdominal bloating and intestinal dysmotility. The specific subgroup of p...
Source: Best Practice and Research Clinical Gastroenterology - May 25, 2019 Category: Gastroenterology Source Type: research
PREFACE - Functional Gastrointestinal Disorders
Publication date: Available online 16 May 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Per M. Hellström (Source: Best Practice and Research Clinical Gastroenterology)
Source: Best Practice and Research Clinical Gastroenterology - May 17, 2019 Category: Gastroenterology Source Type: research
Therapeutic potential of an anaerobic cultured human intestinal microbiota, ACHIM for treatment of IBS
Publication date: Available online 29 April 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): P. Benno, E. Norin, T. Midtvedt, P.M. HellströmAbstractBy administering an anaerobic cultivated human intestinal microbiota (ACHIM) via upper gastrointestinal route using endoscopy we aimed to rectify intestinal dysbiosis and simultaneously achieve a treatment response in IBS patients. The study population fulfilled the Rome III IBS criteria and comprised 50 patients. During 10 days, patients recorded the irritable bowel syndrome symptom severity scale (IBS-SSS) along with the Bristol stool scale and number...
Source: Best Practice and Research Clinical Gastroenterology - April 30, 2019 Category: Gastroenterology Source Type: research
Proton pump inhibitors for upper gastrointestinal bleeding
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Omar Kherad, Sophie Restellini, Myriam Martel, Alan BarkunSummaryAcute upper gastrointestinal bleeding (UGIB) remains a public health burden with a persistent high mortality despite advances in modern day management. Proton pump inhibitors (PPI) as medical therapy is an attractive adjuvant to endoscopic treatment in UGIB but the method and dose of PPI therapy remains controversial. This chapter aims to describe the current evidence addressing acute PPI use in the management of UGIB. It will explore the evide...
Source: Best Practice and Research Clinical Gastroenterology - April 18, 2019 Category: Gastroenterology Source Type: research
Changing epidemiology and etiology of upper and lower gastrointestinal bleeding
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Kathryn OaklandAbstractUpper gastrointestinal bleeding (UGIB) develops in the oesophagus, stomach or duodenum and has an incidence of 47/100,000. Lower GIB (LGIB) develops in the small bowel, colon or anorectum and has an incidence of 33/100,000. Where the incidence of UGIB has fallen, driven by helicobacter pylori eradication and the use of proton pump inhibitors, the incidence of LGIB may be increasing. Interventions such as early endoscopy, risk assessment and national guidelines have improved clinical ou...
Source: Best Practice and Research Clinical Gastroenterology - April 18, 2019 Category: Gastroenterology Source Type: research
When all else fails - radiological management of severe gastrointestinal bleeding
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Romaric Loffroy, Nicolas Falvo, Motoki Nakaï, Lorenzo Pescatori, Marco Midulla, Olivier ChevallierAbstractAlthough most cases of acute nonvariceal gastrointestinal bleeding (GIB) either spontaneously resolve or respond to medical management and endoscopic therapy, there are still a significant proportion of severe patients who require emergency angiography and endovascular treatment. Over the past three decades, transcatheter arterial embolization (TAE) has become the first-line therapy for the management o...
Source: Best Practice and Research Clinical Gastroenterology - April 18, 2019 Category: Gastroenterology Source Type: research
Risk stratification in upper and upper and lower GI bleeding: which scores should we use?
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Dr Kathryn OaklandABSTRACTRisk assessment is widely used in upper gastrointestinal bleeding (UGIB) however no score accurately predicts all important clinical outcomes. This review discusses the performance of the Rockall score, pre-endsocopy Rockall score, Glasgow-Blatchford score, AIMS-65 and newer scores such as Progetto Nazionale Emorragia Digestiva and CANUKA scores. The quality of external validation varies considerably for each score. There is a relative lack of risk scores available for use in lower ...
Source: Best Practice and Research Clinical Gastroenterology - April 18, 2019 Category: Gastroenterology Source Type: research
Endoscopic management of nonvariceal upper gastrointestinal bleeding
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Pablo Cañamares, Francis K.L. ChanAbstractEndoscopic therapy is the mainstay of treatment for nonvariceal upper gastrointestinal bleeding (NVUGIB). Injection plus mechanical or thermal therapy continues to be the most widely used option. New endoscopic devices such as the use of an inert powder or a new class of over-the-scope clip system have demonstrated encouraging results as a rescue therapy for difficult hemostasis. Emerging data suggest that Doppler ultrasound- guided endoscopic therapy may improve th...
Source: Best Practice and Research Clinical Gastroenterology - April 18, 2019 Category: Gastroenterology Source Type: research
Optimal management of the patient presenting with small bowel bleeding
Publication date: Available online 17 April 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Michael Sai Lai Sey, Brian Michael YanAbstractThe management of small bowel bleeding, also known as obscure gastrointestinal bleeding, has changed substantially over the past two decades due to revolutionary technological advances in small intestinal endoscopy. This clinical review will summarize the evolving definition of small bowel bleeding, how to perform a detailed initial assessment of patients with the condition, the strengths and limitations of small bowel endoscopy, and the treatment of small bowel ...
Source: Best Practice and Research Clinical Gastroenterology - April 18, 2019 Category: Gastroenterology Source Type: research
Pharmacology, Efficacy and Safety of JAK Inhibitors in Crohn’s Disease
Publication date: Available online 6 March 2019Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Ma Christopher, Jairath Vipul, Vande Casteele NielsAbstractOrally bioavailable inhibitors of the tyrosine kinases (TYKs), also referred to as Janus kinases (JAKs), are being evaluated for the treatment of patients with Crohn’s disease (CD), ulcerative colitis (UC), and other chronic inflammatory disorders. To date, three JAK inhibitors have been tested in patients with moderate-to-severe CD: tofacitinib (pan-JAK inhibitor), filgotinib (JAK1 inhibitor) and upadacitinib (JAK1 inhibitor). Clinical development ...
Source: Best Practice and Research Clinical Gastroenterology - March 7, 2019 Category: Gastroenterology Source Type: research
