Category: Feature
Transition of Care in Inflammatory Bowel Disease
Gastroenterology & hepatology October 2014, Volume 10, Issue 10 Bincy P. Abraham, MD, MS, and Stacy A. Kahn, MD Dr Abraham is an assistant professor […]
Noninvasive Markers of Disease Activity in Inflammatory Bowel Disease
Gastroenterology & Hepatology September 2014, Volume 10, Issue 9 Raluca Vrabie, MD, and Sunanda Kane, MD Dr Vrabie is an assistant professor of clinical medicine […]
Current Diagnosis and Management of Suspected Reflux Symptoms Refractory to Proton Pump Inhibitor Therapy
Gastroenterology & Hepatology September 2014, Volume 10, Issue 9 Joel E. Richter, MD Dr Richter is a professor of medicine, the Hugh F. Culverhouse Chair […]
Management Strategies for Abdominal Bloating and Distension
Gastroenterology & Hepatology September 2014, Volume 10, Issue 9 Anna Foley, MBBS, FRACP, Rebecca Burgell, MBBS, FRACP, Jacqueline S. Barrett, MNutDiet, PhD, and Peter R. […]
Therapeutic Drug Monitoring of TNF Antagonists in Inflammatory Bowel Disease
Gastroenterology & Hepatology August 2014, Volume 10, Issue 8 Reena Khanna, MD, Barrett G. Levesque, MD, William J. Sandborn, MD, and Brian G. Feagan, MD Dr […]
Endoscopic Management of Gastrointestinal Fistulae
Gastroenterology & Hepatology August 2014, Volume 10, Issue 8 Nitin Kumar, MD, Michael C. Larsen, MD, and Christopher C. Thompson, MD, MSc, FACG, FASGE Dr Kumar […]
A Health Survey of Gastroenterologist Prescribing Practices of Adalimumab for Treatment of Crohn’s Disease: Final Results
troenterology & Hepatology August 2014, Volume 10, Issue 8 Samantha Zullow, MD, Mark H. Flasar, MD, MS,Deborah Greenberg, J. Kathleen Tracy, PhD, Ankur Rustgi, MBBS, MPH, and […]
Effects of Statins on the Risk of Hepatocellular Carcinoma
July 2014, Volume 10, Issue 7 Pejman G. Mansourian, MD, Masato Yoneda, MD, PhD, M. Krishna Rao, Fernando J. Martinez, MD, Emmanuel Thomas, MD, PhD, and […]
Eosinophilic Esophagitis and Proton Pump Inhibitors: Controversies and Implications for Clinical Practice
July 2014, Volume 10, Issue 7 W. Asher Wolf, MD, MPH, and Evan S. Dellon, MD, MPH Dr Wolf is a fellow in gastroenterology and hepatology […]
Obesity and Irritable Bowel Syndrome: A Comprehensive Review
July 2014, Volume 10, Issue 7 Octavia Pickett-Blakely, MD, MHS Dr Pickett-Blakely is the director of the Small Bowel Disorders and Nutrition Program in the Division […]
Immunizations in Children with Inflammatory Bowel Disease Treated with Immunosuppressive Therapy
Gastroenterology & Hepatology June 2014, Volume 10, Issue 6 Ying Lu, MD, and Athos Bousvaros, MD, MPH Dr Lu is an assistant professor in the Division of […]
Gastric Intestinal Metaplasia and Early Gastric Cancer in the West: A Changing Paradigm
Gastroenterology & Hepatology June 2014, Volume 10, Issue 6 Justin M. Gomez, MD, and Andrew Y. Wang, MD, FACG, FASGE Dr Gomez is a clinical instructor in […]
Hepatitis C Virus Infection and Its Rheumatologic Implications
Gastroenterology & Hepatology Volume 10, Issue 5 May 2014 287 Zeynel A. Sayiner, MD, Uzma Haque, MD, Mohammad U. Malik, MD, and Ahmet Gurakar, MD The […]
Common Anorectal Disorders
Gastroenterology & Hepatology May 2014, Volume 10, Issue 5 Amy E. Foxx-Orenstein, DO, Sarah B. Umar, MD, and Michael D. Crowell, PhD Dr Foxx-Orenstein is an associate […]
Controversies in the Diagnosis and Management of NAFLD and NASH
Gastroenterology & Hepatology April 2014, Volume 10, Issue 4 Mary E. Rinella, MD, Rohit Loomba, MD, MHSc, Stephen H. Caldwell, MD, Kris Kowdley, MD, Michael Charlton, MBBS, […]
Intestinal Microbiota and the Efficacy of Fecal Microbiota Transplantation in Gastrointestinal Disease
Gastroenterology & Hepatology April 2014, Volume 10, Issue 4 Olga C. Aroniadis, MD, and Lawrence J. Brandt, MD, AGA-F Dr Aroniadis is a gastroenterology fellow at Montefiore […]
Identifying Patients Most Likely to Have a Common Bile Duct Stone After a Positive Intraoperative Cholangiogram
Gastroenterology & Hepatology April 2014, Volume 10, Issue 4 Raja Vadlamudi, MD, MPH, Jason Conway, MD, MPH, Girish Mishra, MD, MS, John Baillie, MB ChB, FRCP, John […]
Current Management of Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. Despite efforts for prevention and screening as well as development of new technologies for diagnosis and treatment, the incidence of HCC has doubled, and mortality rates have increased in recent decades. A variety of important risk factors are associated with the development of HCC, with any type of cirrhosis, regardless of etiology, being the major contributor. Hepatitis C virus infection with bridging fibrosis or cirrhosis and hepatitis B virus infection are independent risk factors. The diagnosis of HCC is made without liver biopsy in over 90% of cases. Screening with ultrasound and alpha-fetoprotein (AFP) at 6-month intervals is advised; however, it is not adequate for patients on the orthotopic liver transplantation (OLT) list. Triple-phase computed tomography and/or magnetic resonance imaging are used in combination with the detection of AFP, AFP-L3%, and/or des-gamma-carboxy prothrombin due to their superior sensitivities and specificities. Several treatment modalities are available, but only surgical resection and OLT are curative. OLT is available only for patients who meet or are downstaged into Milan or University of California, San Francisco criteria. Other treatment options include radiofrequency ablation, microwave ablation, percutaneous ethanol injection, transarterial chemoembolization, radioembolization, cryoablation, radiation therapy, stereotactic radiotherapy, systemic chemotherapy, and molecularly targeted therapies. The management of HCC is based on tumor size and location, extrahepatic spread, and underlying liver function. Given the complexity of the disease, patients are often best served in centers with experience in HCC management, where a multidisciplinary approach can take place.
Irritable Bowel Syndrome: The Role of Food in Pathogenesis and Management
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that affects approximately 10% to 20% of the general adult population in Europe and the Americas and is characterized by abdominal pain and altered bowel habits in the absence of reliable biomarkers. The pathophysiology of IBS is poorly understood and is currently thought to represent a complex interplay among the gut microbiota, low-grade inflammation, impaired mucosal barrier function, visceral hypersensitivity, gut motility, and alterations in the gut-brain axis. In any individual patient, 1 or more of these factors may interact to generate symptoms. Although up to 50% of patients report postprandial exacerbation of symptoms, few studies have critically assessed the role of diet in IBS. Furthermore, although many patients with IBS adopt any one of a host of dietary changes in an attempt to alleviate their symptoms, there has been, up until recently, little scientific basis for any dietary recommendation in IBS. This review discusses the contribution of diet to the pathophysiology and symptoms of IBS.
Frontiers in the Treatment of Hepatitis C Virus Infection
In the United States, chronic hepatitis C virus (HCV) infection is the leading cause of blood-borne, virus-associated death related to advanced liver disease and the leading indication for liver transplantation. Although the diagnostic test for HCV has been available for more than 20 years, the majority of persons with HCV infection still have not received a diagnosis. This has led to a recent change in screening recommendations by the Centers for Disease Control and Prevention. Moreover, new medications were approved in 2011 after nearly a decade of minimal progress in the development of treatments for HCV infection. This was followed by the highly anticipated approval of sofosbuvir and simeprevir in 2013. In the past 3 years, there has been an explosion of reports on medications from different classes, promising a dramatic expansion to an all-oral regimen for the treatment of HCV genotype 1 infection within the next few years. This article reviews the current screening recommendations and standard of care for treatment of HCV infection and highlights specific agents in the pipeline that should change the landscape of how HCV infection is treated in the near future.