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GASTROENTEROLOGY (145 journals)                  1 2     

Abdominal Imaging     Hybrid Journal   (Followers: 11)
Acta Endoscopica     Hybrid Journal  
Acta Gastroenterologica Latinoamericana     Open Access   (Followers: 2)
Actualités Odonto-Stomatologiques     Open Access   (Followers: 4)
Advances in Diabetes and Metabolism     Open Access   (Followers: 3)
Advances in Digestive Medicine     Full-text available via subscription  
AJP Gastrointestinal and Liver Physiology     Full-text available via subscription   (Followers: 4)
Alimentary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 103)
Alimentary Pharmacology & Therapeutics Symposium Series     Hybrid Journal   (Followers: 4)
American Journal of Gastroenterology Supplements     Full-text available via subscription   (Followers: 5)
American Journal of Gastroenterology, The     Hybrid Journal   (Followers: 101)
Arab Journal of Gastroenterology     Full-text available via subscription   (Followers: 3)
Arquivos de Gastroenterologia     Open Access   (Followers: 1)
Australian and New Zealand Continence Journal     Full-text available via subscription   (Followers: 1)
Avances en Odontoestomatologia     Open Access  
Best Practice & Research Clinical Gastroenterology     Full-text available via subscription   (Followers: 6)
BMC Gastroenterology     Open Access   (Followers: 10)
BMJ Open Diabetes Research & Care     Open Access   (Followers: 1)
BMJ Open Gastroenterology     Open Access  
Canadian Journal of Gastroenterology & Hepatology     Hybrid Journal   (Followers: 3)
Case Reports in Gastroenterology     Open Access   (Followers: 5)
Case Reports in Gastrointestinal Medicine     Open Access   (Followers: 3)
Case Reports in Hepatology     Open Access  
Cellular and Molecular Gastroenterology and Hepatology     Open Access  
Clinical and Experimental Gastroenterology     Open Access   (Followers: 4)
Clinical and Molecular Hepatology     Open Access   (Followers: 1)
Clinical and Translational Gastroenterology     Open Access   (Followers: 3)
Clinical Diabetes     Full-text available via subscription   (Followers: 26)
Clinical Gastroenterology and Hepatology     Hybrid Journal   (Followers: 16)
Clinical Journal of Gastroenterology     Hybrid Journal   (Followers: 9)
Clinical Medicine Insights : Gastroenterology     Open Access   (Followers: 5)
Clinics and Research in Hepatology and Gastroenterology     Hybrid Journal   (Followers: 5)
Clinics in Liver Disease     Full-text available via subscription   (Followers: 3)
Colon & Rectum     Hybrid Journal   (Followers: 4)
coloproctology     Hybrid Journal   (Followers: 1)
Colorectal Disease     Hybrid Journal   (Followers: 9)
Comparative Hepatology     Open Access   (Followers: 2)
Current Colorectal Cancer Reports     Hybrid Journal   (Followers: 1)
Current Diabetes Reports     Hybrid Journal   (Followers: 17)
Current Gastroenterology Reports     Hybrid Journal   (Followers: 3)
Current Hepatitis Reports     Hybrid Journal   (Followers: 2)
Current Opinion in Gastroenterology     Hybrid Journal   (Followers: 9)
Current Treatment Options in Gastroenterology     Hybrid Journal   (Followers: 5)
Der Gastroenterologe     Hybrid Journal  
Diabetes     Full-text available via subscription   (Followers: 256)
Diabetes Spectrum     Full-text available via subscription   (Followers: 8)
Diagnostic and Therapeutic Endoscopy     Open Access  
Digestion     Full-text available via subscription   (Followers: 6)
Digestive and Liver Disease     Hybrid Journal   (Followers: 8)
Digestive and Liver Disease Supplements     Full-text available via subscription   (Followers: 4)
Digestive Diseases     Full-text available via subscription   (Followers: 45)
Digestive Diseases and Sciences     Hybrid Journal   (Followers: 4)
Digestive Endoscopy     Hybrid Journal   (Followers: 4)
Diseases of the Colon & Rectum     Full-text available via subscription   (Followers: 7)
Diseases of the Esophagus     Hybrid Journal   (Followers: 1)
Dysphagia     Hybrid Journal   (Followers: 90)
Endoscopy     Hybrid Journal   (Followers: 1)
Endoscopy International Open     Open Access  
Endoskopie heute     Hybrid Journal  
Esophagus     Hybrid Journal  
European Journal of Gastroenterology & Hepatology     Hybrid Journal   (Followers: 9)
Evidence-Based Gastroenterology     Full-text available via subscription   (Followers: 4)
Expert Review of Gastroenterology and Hepatology     Full-text available via subscription   (Followers: 4)
Frontline Gastroenterology     Full-text available via subscription   (Followers: 3)
Gastric Cancer     Hybrid Journal  
Gastroenterología y Hepatología     Full-text available via subscription  
Gastroenterología y Hepatología Continuada     Full-text available via subscription  
Gastroenterologie up2date     Hybrid Journal   (Followers: 1)
Gastroenterology     Hybrid Journal   (Followers: 109)
Gastroenterology and Hepatology from bed to bench     Open Access   (Followers: 4)
Gastroenterology Clinics of North America     Full-text available via subscription   (Followers: 5)
Gastroenterology Insights     Open Access   (Followers: 3)
Gastroenterology Report     Open Access   (Followers: 2)
Gastroenterology Research     Open Access   (Followers: 4)
Gastroenterology Research and Practice     Open Access   (Followers: 5)
Gastrointestinal Cancer : Targets and Therapy     Open Access   (Followers: 2)
Gastrointestinal Endoscopy     Hybrid Journal   (Followers: 11)
Gastrointestinal Endoscopy Clinics of North America     Full-text available via subscription   (Followers: 6)
Gastrointestinal Intervention     Full-text available via subscription  
GE-Portuguese Journal of Gastroenterology     Open Access  
Gut     Full-text available via subscription   (Followers: 144)
Gut Microbes     Full-text available via subscription   (Followers: 3)
Gut Pathogens     Full-text available via subscription   (Followers: 1)
Hepatic Medicine: Evidence and Research     Open Access   (Followers: 3)
Hepatitis B Annual     Open Access   (Followers: 2)
Hepatitis Monthly     Open Access   (Followers: 1)
Hepatitis Research and Treatment     Open Access   (Followers: 4)
Hepatology     Hybrid Journal   (Followers: 17)
Hepatology International     Hybrid Journal   (Followers: 3)
Hepatology Research     Hybrid Journal   (Followers: 8)
HPB: The official journal of the International Hepato Pancreato Biliary Association     Hybrid Journal   (Followers: 3)
Immuno-Gastroenterology     Full-text available via subscription  
Indian Journal of Gastroenterology     Open Access   (Followers: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 68)
Info Diabetologie     Full-text available via subscription  
International Journal of Celiac Disease     Open Access   (Followers: 2)
International Journal of Colorectal Disease     Hybrid Journal  
International Journal of Hepatology     Open Access   (Followers: 2)
International Journal of Stomatological Research     Open Access  
Journal Africain d'Hépato-Gastroentérologie     Hybrid Journal   (Followers: 2)

        1 2     

Journal Cover   Gastroenterology Clinics of North America
  [SJR: 1.142]   [H-I: 62]   [5 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 0889-8553
   Published by Elsevier Homepage  [2811 journals]
  • Epidemiology of Barrett’s Esophagus and Esophageal Adenocarcinoma
    • Abstract: Publication date: Available online 9 April 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Thomas M. Runge , Julian A. Abrams , Nicholas J. Shaheen

      Teaser Barrett’s esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC), a disease with increasing burden in the Western world, especially in white men. Risk factors for BE include obesity, tobacco smoking, and gastroesophageal reflux disease (GERD). EAC is the most common form of esophageal cancer in the United States. Risk factors include GERD, tobacco smoking, and obesity, whereas nonsteroidal antiinflammatory drugs and statins may be protective. Factors predicting progression from nondysplastic BE to EAC include dysplastic changes on esophageal histology and length of the involved BE segment. Biomarkers have shown promise, but none are approved for clinical use.

      PubDate: 2015-04-12T00:10:55Z
       
  • Barrett’s Esophagus: New Insights and Progress
    • Abstract: Publication date: Available online 9 April 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Prasad G. Iyer , Navtej S. Buttar



      PubDate: 2015-04-12T00:10:55Z
       
  • Barrett’s Esophagus
    • Abstract: Publication date: Available online 9 April 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Gary W. Falk



      PubDate: 2015-04-12T00:10:55Z
       
  • Role of Obesity in the Pathogenesis and Progression of Barrett’s
           Esophagus
    • Abstract: Publication date: Available online 4 April 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Apoorva Krishna Chandar , Prasad G. Iyer

      Teaser Central obesity is involved in the pathogenesis and progression of Barrett’s esophagus to esophageal adenocarcinoma. Involved are likely both mechanical and nonmechanical effects. Mechanical effects of increased abdominal fat cause disruption of the gastroesophageal reflux barrier leading to increased reflux events. Nonmechanical effects may be mediated by inflammation, via classically activated macrophages, pro-inflammatory cytokines, and adipokines such as Leptin, all of which likely potentiate reflux-mediated inflammation. Insulin resistance, associated with central obesity, is also associated with both Barrett’s pathogenesis and progression to adenocarcinoma. Molecular pathways activated in obesity, inflammation and insulin resistance overlap with those involved in Barrett’s pathogenesis and progression.

      PubDate: 2015-04-07T14:20:51Z
       
  • Challenges with Endoscopic Therapy for Barrett’s Esophagus
    • Abstract: Publication date: Available online 18 March 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Sachin Wani , Prateek Sharma

      Teaser Barrett’s esophagus is the only identifiable premalignant condition for esophageal adenocarcinoma. Endoscopic eradication therapy (EET) has revolutionized the management of Barrett’s-related dysplasia and intramucosal cancer. The primary goal of EET is to prevent progression to invasive esophageal adenocarcinoma and ultimately improve survival rates. There are several challenges with EET that can be encountered before, during, or after the procedure that are important to understand to optimize the effectiveness and safety of EET and ultimately improve patient outcomes. This article focuses on the challenges with EET and discusses them under the categories of preprocedural, intraprocedural, and postprocedural challenges.

      PubDate: 2015-04-02T08:15:11Z
       
  • The Effect of Proton Pump Inhibitors on Barrett’s Esophagus
    • Abstract: Publication date: Available online 18 March 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Kerry B. Dunbar , Rhonda F. Souza , Stuart J. Spechler

      Teaser Proton pump inhibitors (PPIs) may protect against carcinogenesis in Barrett’s esophagus because they eliminate the chronic esophageal inflammation of reflux esophagitis, and because they decrease esophageal exposure to acid, which can cause cancer-promoting DNA damage and increase proliferation in Barrett’s metaplasia. Most clinical studies of PPIs and cancer development in Barrett’s esophagus have found a cancer-protective effect for these drugs, although there are some contradictory data. Chemoprevention of dysplasia and cancer in Barrett’s esophagus with PPIs appears to be cost-effective, and the indirect evidence supporting a cancer-protective role for PPIs is strong enough to warrant PPI treatment of virtually all patients with Barrett’s esophagus.

      PubDate: 2015-04-02T08:15:11Z
       
  • Surveillance in Barrett’s Esophagus Utility and Current
           Recommendations
    • Abstract: Publication date: Available online 18 March 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Joel H. Rubenstein

      Teaser Surveillance of Barrett’s esophagus for preventing death from esophageal adenocarcinoma is attractive and widely practiced. However, empirical evidence supporting its effectiveness is weak. Longer intervals between surveillance examinations are being recommended, supported by computer simulation analyses. If surveillance is performed, an adequate number of biopsies should be performed or the effect of surveillance would be squandered.

      PubDate: 2015-04-02T08:15:11Z
       
  • Biomarkers in Barrett’s Esophagus Role in Diagnosis, Risk
           Stratification, and Prediction of Response to Therapy
    • Abstract: Publication date: Available online 18 March 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Ajay Bansal , Rebecca C. Fitzgerald

      Teaser Esophageal adenocarcinoma (EAC) has increased dramatically in the past 3 decades, making its precursor lesion Barrett’s esophagus (BE) an important clinical problem. Effective interventions are available, but overall outcomes remain unchanged. Most of the BE population remains undiagnosed; most EACs are diagnosed late, and most BE patients will never progress to cancer. These epidemiologic factors make upper endoscopy an inefficient and ineffective strategy for BE diagnosis and risk stratification. In the current review, biomarkers for diagnosis, risk stratification, and predictors of response to therapy in BE are discussed.

      PubDate: 2015-04-02T08:15:11Z
       
  • Advanced Imaging in Barrett's Esophagus
    • Abstract: Publication date: Available online 24 March 2015
      Source:Gastroenterology Clinics of North America
      Author(s): V. Raman Muthusamy , Stephen Kim , Michael B. Wallace

      Teaser Barrett's esophagus (BE) is present in up to 5.6% of the US population and is the precursor lesion for esophageal adenocarcinoma. Surveillance endoscopy is the primary management approach for BE. However, standard protocol biopsies have been associated with significant miss rates of dysplastic lesions in patients with BE. Thus, a variety of methods to optimize the imaging of BE have been developed to improve the efficiency and diagnostic yield of surveillance endoscopy in detecting early neoplasia. These techniques use changes that occur at macroscopic, microscopic, and subcellular levels in early neoplasia and are the focus of this article.

      PubDate: 2015-04-02T08:15:11Z
       
  • Cost-Analyses Studies in Barrett’s Esophagus What Is Their
           Utility'
    • Abstract: Publication date: Available online 29 March 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Lauren B. Gerson

      Teaser Approximately 10% to 15% of the chronic gastroesophageal reflux disease population is at risk for the development of Barrett’s esophagus, particularly in the setting of other risk factors, including male gender, Caucasian race, age more than 50, and central obesity. The risk of cancer progression for patients with nondysplastic BE has been estimated to be approximately 0.2% to 0.5% per year. Given these low progression rates and the high cost of endoscopic surveillance, cost-effectiveness analyses in this area are useful to determine appropriate resource allocation.

      PubDate: 2015-04-02T08:15:11Z
       
  • Surgical Management of Barrett’s Esophagus
    • Abstract: Publication date: Available online 24 March 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Christian G. Peyre , Thomas J. Watson

      Teaser Patients with gastroesophageal reflux disease and Barrett’s esophagus can be a management challenge for the treating physician or surgeon. The goals of therapy include relief of reflux symptoms, induction of histologic regression, and prevention of progression of intestinal metaplasia to dysplasia or invasive carcinoma. Antireflux surgery is effective at achieving these end points, although ongoing follow-up and endoscopic surveillance are essential. In cases of dysplasia or early esophageal neoplasia associated with Barrett’s esophagus, endoscopic resection and ablation have supplanted esophagectomy as the standard of care in most cases. Esophageal resection continues to have a role, however, in a minority of appropriately selected candidates.

      PubDate: 2015-04-02T08:15:11Z
       
  • Predictors of Progression to High-Grade Dysplasia or Adenocarcinoma in
           Barrett’s Esophagus
    • Abstract: Publication date: Available online 31 March 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Matthew J. Whitson , Gary W. Falk

      Teaser The prevalence of esophageal adenocarcinoma is increasing dramatically. Barrett’s esophagus remains the most well-established risk factor for the development of esophageal adenocarcinoma. There are multiple clinical, endoscopic, and pathologic factors that increase the risk of neoplastic progression to high-grade dysplasia or esophageal adenocarcinoma in Barrett’s esophagus. This article reviews both risk and protective factors for neoplastic progression in patients with Barrett’s esophagus.

      PubDate: 2015-04-02T08:15:11Z
       
  • Molecular Pathogenesis of Barrett Esophagus Current Evidence
    • Abstract: Publication date: Available online 29 March 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Kausilia K. Krishnadath , Kenneth K. Wang

      Teaser This article focuses on recent findings on the molecular mechanisms involved in esophageal columnar metaplasia. Signaling pathways and their downstream targets activate specific transcription factors leading to the expression of columnar and the more specific intestinal-type of genes, which gives rise to Barrett metaplasia. Several animal models have been generated to validate and study these distinct molecular pathways but also to identify the Barrett progenitor cell. Currently, the many aspects involved in the development of esophageal metaplasia that have been elucidated can serve to develop novel molecular therapies to improve treatment or prevent metaplasia. Nevertheless, several key events are still poorly understood and require further investigation.

      PubDate: 2015-04-02T08:15:11Z
       
  • Genetic and Epigenetic Alterations in Barrett’s Esophagus and
           Esophageal Adenocarcinoma
    • Abstract: Publication date: Available online 1 April 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Andrew M. Kaz , William M. Grady , Matthew D. Stachler , Adam J. Bass

      Teaser Esophageal adenocarcinoma (EAC) develops from Barrett’s esophagus (BE), wherein normal squamous epithelia is replaced by specialized intestinal metaplasia in response to chronic gastroesophageal acid reflux. BE can progress to low- and high-grade dysplasia, intramucosal, and invasive carcinoma. Both BE and EAC are characterized by loss of heterozygosity, aneuploidy, specific genetic mutations, and clonal diversity. Given the limitations of histopathology, genomic and epigenomic analyses may improve the precision of risk stratification. Assays to detect molecular alterations associated with neoplastic progression could be used to improve the pathologic assessment of BE/EAC and to select high-risk patients for more intensive surveillance.

      PubDate: 2015-04-02T08:15:11Z
       
  • Gastroparesis
    • Abstract: Publication date: March 2015
      Source:Gastroenterology Clinics of North America, Volume 44, Issue 1
      Author(s): Henry P. Parkman , Pankaj Jay Pasricha



      PubDate: 2015-02-08T14:37:02Z
       
  • Gastroparesis
    • Abstract: Publication date: March 2015
      Source:Gastroenterology Clinics of North America, Volume 44, Issue 1
      Author(s): Gary W. Falk



      PubDate: 2015-02-08T14:37:02Z
       
  • Diabetic Gastroparesis
    • Abstract: Publication date: March 2015
      Source:Gastroenterology Clinics of North America, Volume 44, Issue 1
      Author(s): Kenneth L. Koch , Jorge Calles-Escandón

      Teaser Gastroparesis is a complication of long-standing type 1 and type 2 diabetes mellitus. Symptoms associated with gastroparesis include early satiety, prolonged postprandial fullness, bloating, nausea and vomiting, and abdominal pain. Mortality is increased in patients with diabetic gastroparesis. A subset of patients with diabetic gastroparesis have pylorospasm that results in obstructive gastroparesis. Current treatment approaches include improving glucose control with insulin and prescribing antinauseant drugs, prokinetic agents, and gastric electric stimulation. Future directions include improved diet counseling based on gastric emptying rate, continuous insulin delivery systems with glucose sensor-augmented monitoring, and drugs for correcting gastric neural and electric abnormalities.

      PubDate: 2015-02-08T14:37:02Z
       
  • Index
    • Abstract: Publication date: March 2015
      Source:Gastroenterology Clinics of North America, Volume 44, Issue 1




      PubDate: 2015-02-08T14:37:02Z
       
  • Copyright
    • Abstract: Publication date: March 2015
      Source:Gastroenterology Clinics of North America, Volume 44, Issue 1




      PubDate: 2015-02-08T14:37:02Z
       
  • Contributors
    • Abstract: Publication date: March 2015
      Source:Gastroenterology Clinics of North America, Volume 44, Issue 1




      PubDate: 2015-02-08T14:37:02Z
       
  • Contents
    • Abstract: Publication date: March 2015
      Source:Gastroenterology Clinics of North America, Volume 44, Issue 1




      PubDate: 2015-02-08T14:37:02Z
       
  • Forthcoming Issues
    • Abstract: Publication date: March 2015
      Source:Gastroenterology Clinics of North America, Volume 44, Issue 1




      PubDate: 2015-02-08T14:37:02Z
       
  • Improving Our Understanding of Gastroparesis
    • Abstract: Publication date: Available online 13 January 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Henry P. Parkman , Pankaj Jay Pasricha



      PubDate: 2015-01-15T12:18:36Z
       
  • Pyloric Sphincter Therapy Botulinum Toxin, Stents, and Pyloromyotomy
    • Abstract: Publication date: Available online 13 January 2015
      Source:Gastroenterology Clinics of North America
      Author(s): John O. Clarke , William J. Snape

      Teaser Gastroparesis is a syndrome characterized by delayed gastric emptying with associated symptoms. Gastric emptying is a complex process and pyloric dysfunction may play a key role in select subsets of patients with gastroparesis. Diagnostic tests to measure pyloric physiology are now available and have the potential to be more widely used in clinical practice. Targeted therapies including botulinum toxin, transpyloric stent placement, surgical pyloroplasty and endoscopic pyloromyotomy have been developed. Data are emerging regarding efficacy and durability, but these therapies may play a prominent role in select patients with gastroparesis and pyloric dysfunction.

      PubDate: 2015-01-15T12:18:36Z
       
  • Clinical Presentation and Pathophysiology of Gastroparesis
    • Abstract: Publication date: Available online 5 January 2015
      Source:Gastroenterology Clinics of North America
      Author(s): Linda Anh Nguyen , William Snape Jr.

      Teaser Gastroparesis is a heterogeneous disorder defined by delay in gastric emptying. Symptoms of gastroparesis are nonspecific, including nausea, vomiting, early satiety, bloating, and/or abdominal pain. Normal gastric motor function and sensory function depend on a complex coordination between the enteric and central nervous system. This article discusses the pathophysiology of delayed gastric emptying and the symptoms of gastroparesis, including antropyloroduodenal dysmotility, impaired gastric accommodation, visceral hypersensitivity, and autonomic dysfunction. The underlying pathophysiology of gastroparesis is complex and multifactorial. The article discusses how a combination of these factors leads to symptoms of gastroparesis.

      PubDate: 2015-01-06T07:20:50Z
       
  • Gastric Arrhythmias in Gastroparesis Low- and High-Resolution Mapping of
           Gastric Electrical Activity
    • Abstract: Publication date: Available online 29 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Gregory O’Grady , Thomas L. Abell

      Teaser Gastric arrhythmias occur in gastroparesis but their significance is debated. An improved understanding is currently emerging, including newly-defined histopathologic abnormalities in gastroparesis. In particular, the observation that interstitial cells of Cajal are depleted and injured provides mechanisms for arrhythmogenesis in gastroparesis. Electrogastrography has been the dominant clinical method of arrhythmia analysis, but is limited by summative nature, low signal quality, and incomplete sensitivity and specificity. Recently, high-resolution (HR; multi-electrode) mapping has emerged, providing superior spatial data on arrhythmic patterns and mechanisms. However, HR mapping is invasive, and low-resolution approaches are being assessed as bridging techniques until endoscopic mapping is achieved.

      PubDate: 2015-01-01T04:41:25Z
       
  • Surgical Approaches to Treatment of Gastroparesis Gastric Electrical
           Stimulation, Pyloroplasty, Total Gastrectomy and Enteral Feeding Tubes
    • Abstract: Publication date: Available online 29 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Irene Sarosiek , Brian Davis , Evelin Eichler , Richard W. McCallum

      Teaser Gastric electrical stimulation (GES) is neurostimulation; its mechanism of action is affecting central control of nausea and vomiting and enhancing vagal function. GES is a powerful antiemetic available for patients with refractory symptoms of nausea and vomiting from gastroparesis of idiopathic and diabetic causes. GES is not indicated as a way of reducing abdominal pain in gastroparetic patients. The need for introducing a jejunal feeding tube means intensive medical therapies are failing, and is an indication for the implantation of the GES system, which should always be accompanied by a pyloroplasty to guarantee accelerated gastric emptying.

      PubDate: 2015-01-01T04:41:25Z
       
  • Complementary and Alternative Medicine for Gastroparesis
    • Abstract: Publication date: Available online 29 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Linda A. Lee , Jiande Chen , Jieyun Yin

      Teaser Complementary and alternative medicine is of great interest to patients with gastrointestinal disorders and some will choose to ask their health care providers about those therapies for which some scientific evidence exists. This review focuses on those therapies most commonly used by patients, namely acupuncture/electroacupuncture and various herbal formulations that have been the focus of clinical and laboratory investigation. A discussion of their possible mechanisms of action and the results of clinical studies are summarized.

      PubDate: 2015-01-01T04:41:25Z
       
  • Gastroparesis Definitions and Diagnosis
    • Abstract: Publication date: Available online 24 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Pankaj Jay Pasricha , Henry P. Parkman

      Teaser Gastroparesis is a chronic symptomatic disorder of the stomach characterized by delayed emptying without evidence of mechanical obstruction. Symptoms of gastroparesis include nausea, vomiting, early satiety, postprandial fullness, and upper abdominal pain. The 3 main causes are diabetic, postsurgical, and idiopathic. Diagnosis is confirmed by demonstrating delayed gastric emptying. Gastric emptying rates measured by gastric motor testing generally correlate poorly with symptoms and quality of life in patients with gastroparesis. It may be appropriate to reconsider the definition of gastroparesis, recognizing it as a broader spectrum of gastric neuromuscular dysfunction.

      PubDate: 2014-12-28T01:25:15Z
       
  • Prokinetics in Gastroparesis
    • Abstract: Publication date: Available online 23 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Andres Acosta , Michael Camilleri

      Teaser Prokinetic agents are medications that enhance coordinated gastrointestinal motility and transit of content in the gastrointestinal tract, mainly by amplifying and coordinating the gastrointestinal muscular contractions. In addition to dietary therapy, prokinetic therapy should be considered as a means to improve gastric emptying and symptoms of gastroparesis, balancing benefits and risks of treatment. In the United States, metoclopramide remains the first-line prokinetic therapy, because it is the only approved medication for gastroparesis. Newer agents are being developed for the management of gastroparesis. This article provides detailed information about prokinetic agents for the treatment of gastroparesis.

      PubDate: 2014-12-28T01:25:15Z
       
  • Idiopathic Gastroparesis
    • Abstract: Publication date: Available online 24 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Henry P. Parkman

      Teaser Gastroparesis is a chronic symptomatic disorder of the stomach characterized by delayed emptying without evidence of mechanical obstruction. Idiopathic gastroparesis refers to gastroparesis of unknown cause not from diabetes; not from prior gastric surgery; not related to other endocrine, neurologic, rheumatologic causes of gastroparesis; and not related to medications that can delay gastric emptying. There is overlap in the symptoms of idiopathic gastroparesis and functional dyspepsia. Patients with idiopathic gastroparesis often have a constellation of symptoms including nausea, vomiting, early satiety, postprandial fullness, and upper abdominal pain. Current treatment options of dietary management, prokinetics agents, antiemetic agents, and symptom modulators do not adequately address clinical need for idiopathic gastroparesis.

      PubDate: 2014-12-28T01:25:15Z
       
  • Symptomatic Management for Gastroparesis Antiemetics, Analgesics, and
           Symptom Modulators
    • Abstract: Publication date: Available online 26 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): William L. Hasler

      Teaser Although prokinetic agents typically are used for gastroparesis, antiemetic, analgesic, and neuromodulatory medications may help manage nausea, vomiting, pain, or discomfort. Antiemetic benefits are supported by few case reports. An open series reported symptom reductions with transdermal granisetron in gastroparesis. Opiates are not advocated in gastroparesis because they worsen nausea and delay emptying. Neuromodulators have theoretical utility, but the tricyclic agent nortriptyline showed no benefits over placebo in an idiopathic gastroparesis study raising doubts about this strategy. Neurologic and cardiac toxicities of these medications are recognized. Additional controlled study is warranted to define antiemetic, analgesic, and neuromodulator usefulness in gastroparesis.

      PubDate: 2014-12-28T01:25:15Z
       
  • Future Directions in the Treatment of Gastroparesis
    • Abstract: Publication date: Available online 20 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Pankaj Jay Pasricha

      Teaser Understanding of gastroparesis is evolving, in part because of systematic studies on the pathology, pathophysiology, and outcomes. It is clear that simply accelerating gastric emptying may not effectively control symptoms in this syndrome and more creative approaches are required that address aberrant sensation (vagal and spinal) as well as regional disturbances in motility. Further, with the growing recognition of a possible inflammatory basis, the prospects of disease modifying now seem realistic.

      PubDate: 2014-12-22T22:42:45Z
       
  • Nutritional Considerations in the Patient with Gastroparesis
    • Abstract: Publication date: Available online 19 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Carol Rees Parrish

      Teaser Gastroparesis, or delayed gastric emptying, has many origins and can wax and wane depending on the underlying cause. Not only do the symptoms significantly alter quality of life, but the clinical consequences can also be life threatening. Once a patient develops protracted nausea and vomiting, providing adequate nutrition, hydration, and access to therapeutics such as prokinetics and antiemetics can present an exceptional challenge to clinicians. This article reviews the limited evidence available for oral nutrition, as well as enteral and parenteral nutritional support therapies. Practical strategies are provided to improve the nutritional depletion that often accompanies this debilitating condition.

      PubDate: 2014-12-22T22:42:45Z
       
  • Histologic Changes in Diabetic Gastroparesis
    • Abstract: Publication date: Available online 19 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Gianrico Farrugia

      Teaser The cellular abnormalities that lead to diabetic gastroparesis are increasingly being understood. Several key cell types are affected by diabetes, leading to gastroparesis. These changes include abnormalities in the extrinsic innervation to the stomach, loss of key neurotransmitters at the level of the enteric nervous system, smooth muscle abnormalities, loss of interstitial cells of Cajal, and changes in the macrophage population resident in the muscle wall. This article reviews the current understanding with a focus on data from human studies when available.

      PubDate: 2014-12-22T22:42:45Z
       
  • Epidemiology and Natural History of Gastroparesis
    • Abstract: Publication date: Available online 18 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Adil E. Bharucha

      Teaser Gastroparesis is characterized by delayed gastric emptying and symptoms thereof in the absence of gastric outlet obstruction. Most studies on the epidemiology of gastroparesis have been conducted in selected case series rather than in the population at large. In the only community-based study of gastroparesis in diabetes mellitus (DM), the average cumulative incidence of symptoms and delayed gastric emptying over 10 years was higher in type 1 DM (5%) than in type 2 DM (1%) and controls (1%). In the United States, the incidence of hospitalizations related to gastroparesis increased substantially between 1995 and 2004, and particularly after 2000.

      PubDate: 2014-12-19T17:07:35Z
       
  • Other Forms of Gastroparesis Postsurgical, Parkinson, Other Neurologic
           Diseases, Connective Tissue Disorders
    • Abstract: Publication date: Available online 17 December 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Eamonn M.M. Quigley

      Teaser Although many surgical procedures originally associated with gastroparesis are less commonly performed nowadays, several more recently developed upper abdominal procedures may be complicated by the development of gastroparesis. Gastroparesis has been described in association with neurologic disorders ranging from Parkinson disease to muscular dystrophy, and its presence may have important implications for patient management and prognosis. Although scleroderma is most frequently linked with gastrointestinal motility disorder, gastroparesis has been linked to several other connective tissue disorders. The management of these patients presents several challenges, and is best conducted in the context of a dedicated and skilled multidisciplinary team.

      PubDate: 2014-12-19T17:07:35Z
       
  • Contents
    • Abstract: Publication date: December 2014
      Source:Gastroenterology Clinics of North America, Volume 43, Issue 4




      PubDate: 2014-10-26T12:29:21Z
       
  • Contributors
    • Abstract: Publication date: December 2014
      Source:Gastroenterology Clinics of North America, Volume 43, Issue 4




      PubDate: 2014-10-26T12:29:21Z
       
  • Emerging Endoscopic Therapies for Nonvariceal Upper Gastrointestinal
           Bleeding
    • Abstract: Publication date: December 2014
      Source:Gastroenterology Clinics of North America, Volume 43, Issue 4
      Author(s): Louis M. Wong Kee Song , Michael J. Levy

      Teaser Several new devices and innovative adaptations of existing modalities have emerged as primary, adjunctive, or rescue therapy in endoscopic hemostasis of gastrointestinal hemorrhage. These techniques include over-the-scope clip devices, hemostatic sprays, cryotherapy, radiofrequency ablation, endoscopic suturing, and endoscopic ultrasound–guided angiotherapy. This review highlights the technical aspects and clinical applications of these devices in the context of nonvariceal upper gastrointestinal bleeding.

      PubDate: 2014-10-26T12:29:21Z
       
  • What if Endoscopic Hemostasis Fails? Alternative Treatment Strategies:
           Interventional Radiology
    • Abstract: Publication date: December 2014
      Source:Gastroenterology Clinics of North America, Volume 43, Issue 4
      Author(s): Sujal M. Nanavati

      Teaser Since the 1960s, interventional radiology has played a role in the management of gastrointestinal bleeding. What began primarily as a diagnostic modality has evolved into much more of a therapeutic tool. And although the frequency of gastrointestinal bleeding has diminished thanks to management by pharmacologic and endoscopic methods, the need for additional invasive interventions still exists. Transcatheter angiography and intervention is a fundamental step in the algorithm for the treatment of gastrointestinal bleeding.

      PubDate: 2014-10-26T12:29:21Z
       
  • Forthcoming Issues
    • Abstract: Publication date: December 2014
      Source:Gastroenterology Clinics of North America, Volume 43, Issue 4




      PubDate: 2014-10-26T12:29:21Z
       
  • Upper GI Bleeding
    • Abstract: Publication date: December 2014
      Source:Gastroenterology Clinics of North America, Volume 43, Issue 4
      Author(s): Ian M. Gralnek



      PubDate: 2014-10-26T12:29:21Z
       
  • Upper Gastrointestinal Bleeding Patient Presentation, Risk Stratification,
           and Early Management
    • Abstract: Publication date: December 2014
      Source:Gastroenterology Clinics of North America, Volume 43, Issue 4
      Author(s): Andrew C. Meltzer , Joshua C. Klein

      Teaser The established quality indicators for early management of upper gastrointestinal (GI) hemorrhage are based on rapid diagnosis, risk stratification, and early management. Effective preendoscopic treatment may improve survivability of critically ill patients and improve resource allocation for all patients. Accurate risk stratification helps determine the need for hospital admission, hemodynamic monitoring, blood transfusion, and endoscopic hemostasis before esophagogastroduodenoscopy (EGD) via indirect measures such as laboratory studies, physiologic data, and comorbidities. Early management before the definitive EGD is essential to improving outcomes for patients with upper GI bleeding.

      PubDate: 2014-10-26T12:29:21Z
       
  • Upper GI Bleeding
    • Abstract: Publication date: Available online 11 October 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Gary W. Falk



      PubDate: 2014-10-12T16:32:07Z
       
  • Epidemiology, Diagnosis and Early Patient Management of Esophagogastric
           Hemorrhage
    • Abstract: Publication date: Available online 3 October 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Sumit Kumar , Sumeet K. Asrani , Patrick S. Kamath

      Teaser Acute variceal bleeding (AVB) is a potentially life-threatening complication of cirrhosis and portal hypertension. Combination therapy with vasoactive drugs and endoscopic variceal ligation is the first-line treatment in the management of AVB after adequate hemodynamic resuscitation. Short-term antibiotic prophylaxis, early resuscitation, early use of lactulose for prevention of hepatic encephalopathy, targeting of conservative goals for blood transfusion, and application of early transjugular intrahepatic portosystemic shunts in patients with AVB have further improved the prognosis of AVB. This article discusses the epidemiology, diagnosis, and nonendoscopic management of AVB.

      PubDate: 2014-10-08T05:08:53Z
       
  • Endoscopic Management of Acute Peptic Ulcer Bleeding
    • Abstract: Publication date: Available online 16 September 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Yidan Lu , Yen-I Chen , Alan Barkun

      Teaser This review discusses the indications, technical aspects, and comparative effectiveness of the endoscopic treatment of upper gastrointestinal bleeding caused by peptic ulcer. Pre-endoscopic considerations, such as the use of prokinetics and timing of endoscopy, are reviewed. In addition, this article examines aspects of postendoscopic care such as the effectiveness, dosing, and duration of postendoscopic proton-pump inhibitors, Helicobacter pylori testing, and benefits of treatment in terms of preventing rebleeding; and the use of nonsteroidal anti-inflammatory drugs, antiplatelet agents, and oral anticoagulants, including direct thrombin and Xa inhibitors, following acute peptic ulcer bleeding.

      PubDate: 2014-09-21T05:11:07Z
       
  • Epidemiology and Diagnosis of Acute Nonvariceal Upper Gastrointestinal
           Bleeding
    • Abstract: Publication date: Available online 12 September 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Gianluca Rotondano

      Teaser Acute upper gastrointestinal bleeding (UGIB) is a common gastroenterological emergency. A vast majority of these bleeds have nonvariceal causes, in particular gastroduodenal peptic ulcers. Nonsteroidal antiinflammatory drugs, low-dose aspirin use, and Helicobacter pylori infection are the main risk factors for UGIB. Current epidemiologic data suggest that patients most affected are older with medical comorbidit. Widespread use of potentially gastroerosive medications underscores the importance of adopting gastroprotective pharamacologic strategies. Endoscopy is the mainstay for diagnosis and treatment of acute UGIB. It should be performed within 24 hours of presentation by skilled operators in adequately equipped settings, using a multidisciplinary team approach.

      PubDate: 2014-09-17T04:31:01Z
       
  • What If Endoscopic Hemostasis Fails' Alternative Treatment Strategies:
           Surgery
    • Abstract: Publication date: Available online 12 September 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Philip Wai Yan Chiu , James Yun Wong Lau

      Teaser Management of bleeding peptic ulcers is increasingly challenging in an aging population. Endoscopic therapy reduces the need for emergency surgery in bleeding peptic ulcers. Initial endoscopic control offers an opportunity for selecting high-risk ulcers for potential early preemptive surgery. However, such an approach has not been supported by evidence in the literature. Endoscopic retreatment can be an option to control ulcer rebleeding and reduce complications. The success of endoscopic retreatment largely depends on the severity of rebleeding and ulcer characteristics. Large chronic ulcers with urgent bleeding are less likely to respond to endoscopic retreatment. Expeditious surgery is advised.

      PubDate: 2014-09-17T04:31:01Z
       
  • Endoscopic Management of Nonvariceal, Nonulcer Upper Gastrointestinal
           Bleeding
    • Abstract: Publication date: Available online 12 September 2014
      Source:Gastroenterology Clinics of North America
      Author(s): Eric T.T.L. Tjwa , I. Lisanne Holster , Ernst J. Kuipers

      Teaser Upper gastrointestinal bleeding (UGIB) is the most common emergency condition in gastroenterology. Although peptic ulcer and esophagogastric varices are the predominant causes, other conditions account for up to 50% of UGIBs. These conditions, among others, include angiodysplasia, Dieulafoy and Mallory-Weiss lesions, gastric antral vascular ectasia, and Cameron lesions. Upper GI cancer as well as lesions of the biliary tract and pancreas may also result in severe UGIB. This article provides an overview of the endoscopic management of these lesions, including the role of novel therapeutic modalities such as hemostatic powder and over-the-scope-clips.

      PubDate: 2014-09-17T04:31:01Z
       
 
 
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