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Gastroenterology Clinics of North America
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ISSN (Print) 0889-8553
Published by Elsevier

[3175 journals]

Nutritional Management of Gastrointestinal Disease
- Authors: Andrew Ukleja
  Abstract: Publication date: March 2018
  Source:Gastroenterology Clinics of North America, Volume 47, Issue 1
  Author(s): Andrew Ukleja
  
  PubDate: 2018-02-15T08:34:54Z
  DOI: 10.1016/s0889-8553(17)30146-2
The Role of Diet in the Treatment of Irritable Bowel Syndrome
- Authors: Rajdeep Singh; Ahmed Salem; Julie Nanavati; Gerard E. Mullin
  Pages: 107 - 137
  Abstract: Publication date: March 2018
  Source:Gastroenterology Clinics of North America, Volume 47, Issue 1
  Author(s): Rajdeep Singh, Ahmed Salem, Julie Nanavati, Gerard E. Mullin
  Teaser Irritable bowel syndrome (IBS) is a multifaceted illness involving maladaptive shifts in the gut microbiota that affect the enteric nervous and immune systems, mucosal barrier function, the balance of neurotransmitters and hormones, and emotional well-being. There is abundant evidence indicating that certain foods elicit symptoms in IBS. Numerous elimination-type diets have been shown to alleviate symptoms. However, among these, the most controversial is a group of foods called fructo, oligo-, di-, and monosaccharides and polyols (FODMAPs). This paper reviews the role of diet and systematically analyze the literature for the role of FODMAPs in IBS.
  
  PubDate: 2018-02-15T08:34:54Z
  DOI: 10.1016/j.gtc.2017.10.003
The Need to Reassess Dietary Fiber Requirements in Healthy and Critically
Ill Patients
- Authors: Stephen J.D. O’Keefe
  Pages: 219 - 229
  Abstract: Publication date: March 2018
  Source:Gastroenterology Clinics of North America, Volume 47, Issue 1
  Author(s): Stephen J.D. O’Keefe
  Teaser This article provides evidence that current dietary fiber intake levels may be insufficient to maintain colonic mucosal health and defense, and reduce inflammation and cancer risk in otherwise healthy people. Current commercial tube feeds generally overlook the metabolic needs of the colon and may predispose patients to dysbiosis, bacterial overgrowth with pathogens such as Clostridium difficile, and acute colitis. These results raise concern about the wide-scale use of prophylactic antibiotics in the intensive care unit and the use of elemental, fiber-depleted tube feeds. Nutrition support is not complete without the addition of sufficient fiber to meet colonic nutritional needs.
  
  PubDate: 2018-02-15T08:34:54Z
  DOI: 10.1016/j.gtc.2017.10.005
Adult Intestinal Transplantation
- Authors: Cal S. Matsumoto; Sukanya Subramanian; Thomas M. Fishbein
  Abstract: Publication date: Available online 4 April 2018
  Source:Gastroenterology Clinics of North America
  Author(s): Cal S. Matsumoto, Sukanya Subramanian, Thomas M. Fishbein
  Teaser Adult intestinal transplantation differs significantly from pediatric intestinal transplantation. While indications have remained largely consistent since 2000, indications for adults have expanded over the last two decades to include motility disorders and desmoid tumors. Graft type in adult recipients depends on the distinct anatomic characteristics of the adult recipient. Colonic inclusion, while initially speculated to portend unfavorable outcomes due to complex host-bacterial interactions has increased over the past two decades with superior graft survival and improved patient quality of life. Overall, outcomes have steadily improved. For adult intestinal transplant candidates, intestinal transplantation remains a mainstay therapy for complicated intestinal failure and is a promising option for other life threatening and debilitating conditions.
  
  PubDate: 2018-04-15T08:22:11Z
  DOI: 10.1016/j.gtc.2018.01.011
Pediatric Intestinal Transplantation
- Authors: Neslihan Celik; George V. Mazariegos; Kyle Soltys; Jeffrey A. Rudolph; Yanjun Shi; Geoffrey J. Bond; Rakesh Sindhi; Armando Ganoza
  Abstract: Publication date: Available online 4 April 2018
  Source:Gastroenterology Clinics of North America
  Author(s): Neslihan Celik, George V. Mazariegos, Kyle Soltys, Jeffrey A. Rudolph, Yanjun Shi, Geoffrey J. Bond, Rakesh Sindhi, Armando Ganoza
  Teaser Pediatric intestinal transplantation has moved from the theoretic to an actual therapy for children with irreversible intestinal failure who are suffering from complications of total parenteral nutrition. Owing to significant advancement in the management of intestinal failure and prevention of parenteral nutrition-related complications that have led to reduction in incidence of parenteral nutrition-associated liver disease and have improved intestinal adaptation, the indications for intestinal transplantation are evolving. Long-term outcomes have improved, but challenges in long-term graft function owing to chronic rejection and immunosuppressant-related complications remain the major opportunities for improvement.
  
  PubDate: 2018-04-15T08:22:11Z
  DOI: 10.1016/j.gtc.2018.01.007
Intestinal Failure and Rehabilitation
- Authors: Alan L. Buchman
  Abstract: Publication date: Available online 4 April 2018
  Source:Gastroenterology Clinics of North America
  Author(s): Alan L. Buchman
  Teaser The rendering of proper care for the patient with intestinal failure requires the provider to have a functional understanding of digestion and absorption, nutrient requirements, and intestinal adaptation. Inherent in those concepts is that not only is nutritional absorption compromised, but medication absorption is as well. The principles of the management of home parenteral nutrition must be mastered and then proper and controlled weaning of parenteral nutrition may be commenced by use of dietary and pharmacologic means with appropriate clinical outcome measures followed. This complicated management requires a team experienced in both medical and surgical management of intestinal failure.
  
  PubDate: 2018-04-15T08:22:11Z
  DOI: 10.1016/j.gtc.2018.01.006
Modern Management of Acute Liver Failure
- Authors: Ruben Khan; Sean Koppe
  Abstract: Publication date: Available online 4 April 2018
  Source:Gastroenterology Clinics of North America
  Author(s): Ruben Khan, Sean Koppe
  Teaser Acute liver failure is a rare but life-threatening disease that can lead to progressive encephalopathy, intracranial hypertension, and multiorgan failure. In the developed world, the most common cause remains acetaminophen overdose, but there are still many cases in which there is acute liver failure of unknown etiology. The mainstay of acute liver failure management remains supportive care in the critical care setting. If supportive treatment does not stabilize the disease process, the patient may require emergent liver transplantation. This article summarizes the current management of acute liver failure.
  
  PubDate: 2018-04-15T08:22:11Z
  DOI: 10.1016/j.gtc.2018.01.005
Living Donor Intestinal Transplantation
- Authors: Ivo Tzvetanov; Kiara Tulla; Giuseppe D’Amico; Enrico Benedetti
  Abstract: Publication date: Available online 4 April 2018
  Source:Gastroenterology Clinics of North America
  Author(s): Ivo Tzvetanov, Kiara Tulla, Giuseppe D’Amico, Enrico Benedetti
  Teaser Living donor intestinal transplantation (LDIT) has been improved leading to results comparable to those obtained with deceased donors. LDIT should be limited to specific indications and patient selection. The best indication is combined living donor intestinal/liver transplantation in pediatric recipients with intestinal and hepatic failure; the virtual elimination of waiting time may avoid the high mortality experienced by candidates on the deceased waiting list. Potentially, LDIT could be used in highly sensitized recipients to allow the application of de-sensitization protocols. In the case of available identical twins or HLA-identical sibling, LDIT has a significant immunologic advantage and should be offered.
  
  PubDate: 2018-04-15T08:22:11Z
  DOI: 10.1016/j.gtc.2018.01.008
Robotic Pancreas Transplantation
- Authors: Mario Spaggiari; Ivo G. Tzvetanov; Caterina Di Bella; Jose Oberholzer
  Abstract: Publication date: Available online 4 April 2018
  Source:Gastroenterology Clinics of North America
  Author(s): Mario Spaggiari, Ivo G. Tzvetanov, Caterina Di Bella, Jose Oberholzer
  Teaser Obesity is considered a relative contraindication to pancreas transplantation due to an overall increased risk in wound-related complications and surgical site infections. The rationale for performing pancreas transplantation in a minimally invasive fashion is to reduce these risks, which can be associated with inferior patient and graft survival following pancreas transplantation in morbidly obese patients. At the University of Illinois at Chicago, the initial series of robotic-assisted pancreas transplantation in obese patient with type 1 and 2 diabetes has been performed. In this article, surgical technique and world experience in robotic pancreas transplantation are described.
  
  PubDate: 2018-04-15T08:22:11Z
  DOI: 10.1016/j.gtc.2018.01.010
Gastrointestinal Transplantation
- Authors: Enrico Benedetti; Ivo G. Tzvetanov
  Abstract: Publication date: Available online 4 April 2018
  Source:Gastroenterology Clinics of North America
  Author(s): Enrico Benedetti, Ivo G. Tzvetanov
  
  PubDate: 2018-04-15T08:22:11Z
  DOI: 10.1016/j.gtc.2018.01.014
Forthcoming Issues
- Abstract: Publication date: March 2018
  Source:Gastroenterology Clinics of North America, Volume 47, Issue 1
  
  PubDate: 2018-02-15T08:34:54Z
Nutritional Management of Gastrointestinal Diseases
- Authors: Andrew Ukleja
  Abstract: Publication date: Available online 27 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Andrew Ukleja
  
  PubDate: 2018-01-04T22:52:24Z
Nutrition and Disease
- Authors: Alan Buchman
  Abstract: Publication date: Available online 27 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Alan L. Buchman
  
  PubDate: 2018-01-04T22:52:24Z
Complementary and Alternative Medicine in Inflammatory Bowel Disease
- Authors: Ali Keshavarzian; Ece A. Mutlu
  Abstract: Publication date: December 2017
  Source:Gastroenterology Clinics of North America, Volume 46, Issue 4
  Author(s): Ali Keshavarzian, Ece A. Mutlu
  
  PubDate: 2017-12-01T08:17:31Z
  DOI: 10.1016/s0889-8553(17)30126-7
Complementary and Alternative Treatments Are Needed to Enhance the Care of
the Inflammatory Bowel Disease Patient
- Authors: Ali Keshavarzian; Ece A. Mutlu
  Abstract: Publication date: December 2017
  Source:Gastroenterology Clinics of North America, Volume 46, Issue 4
  Author(s): Ali Keshavarzian, Ece A. Mutlu
  
  PubDate: 2017-12-01T08:17:31Z
  DOI: 10.1016/j.gtc.2017.09.001
Use of Complementary and Alternative Medicine in Inflammatory Bowel
Disease Around the World
- Authors: Petros Zezos; Geoffrey C. Nguyen
  Pages: 679 - 688
  Abstract: Publication date: December 2017
  Source:Gastroenterology Clinics of North America, Volume 46, Issue 4
  Author(s): Petros Zezos, Geoffrey C. Nguyen
  Teaser Use of complementary sand alternative medicine (CAM) is common among patients with inflammatory bowel disease (IBD). CAM can be broadly categorized as whole medical systems, mind-body interventions, biologically based therapies, manipulative and body-based methods, and energy therapies. Most do not use it to treat IBD specifically, and most take it as an adjunct to conventional therapy not in place of it. However, patients are frequently uncomfortable initiating a discussion of CAM with their physicians, which may impact adherence to conventional therapy. A greater emphasis on CAM in medical education may facilitate patient-physician discussions regarding CAM.
  
  PubDate: 2017-12-01T08:17:31Z
  DOI: 10.1016/j.gtc.2017.08.001
Complementary and Alternative Medicine Strategies for Therapeutic Gut
Microbiota Modulation in Inflammatory Bowel Disease and their
Next-Generation Approaches
- Authors: Abigail R. Basson; Minh Lam; Fabio Cominelli
  Pages: 689 - 729
  Abstract: Publication date: December 2017
  Source:Gastroenterology Clinics of North America, Volume 46, Issue 4
  Author(s): Abigail R. Basson, Minh Lam, Fabio Cominelli
  Teaser The human gut microbiome exerts a major impact on human health and disease, and therapeutic gut microbiota modulation is now a well-advocated strategy in the management of many diseases, including inflammatory bowel disease (IBD). Scientific and clinical evidence in support of complementary and alternative medicine, in targeting intestinal dysbiosis among patients with IBD, or other disorders, has increased dramatically over the past years. Delivery of “artificial” stool replacements for fecal microbiota transplantation (FMT) could provide an effective, safer alternative to that of human donor stool. Nevertheless, optimum timing of FMT administration in IBD remains unexplored, and future investigations are essential.
  
  PubDate: 2017-12-01T08:17:31Z
  DOI: 10.1016/j.gtc.2017.08.002
Dietary Therapies in Pediatric Inflammatory Bowel Disease
- Authors: Erin R. Lane; Dale Lee; David L. Suskind
  Pages: 731 - 744
  Abstract: Publication date: Available online 3 October 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Erin R. Lane, Dale Lee, David L. Suskind
  Teaser Nutrition has long been recognized as a critical component in the treatment of pediatric inflammatory bowel disease (IBD). Formerly, nutritional interventions have focused on targeting improved weight gain and linear growth, as well as correction of micronutrient deficiencies. Recently, there has been growing interest and study of dietary interventions for induction and maintenance of remission. In addition to exclusive enteral nutrition, successes have been achieved with specific exclusion diets. This article evaluates current literature regarding the role of diet and nutrition in pathogenesis of disease, as well as the role of diet as primary therapy for pediatric IBD.
  
  PubDate: 2017-10-08T06:27:08Z
  DOI: 10.1016/j.gtc.2017.08.012
Diet as a Therapeutic Option for Adult Inflammatory Bowel Disease
- Authors: Samir Kakodkar; Ece A. Mutlu
  Pages: 745 - 767
  Abstract: Publication date: December 2017
  Source:Gastroenterology Clinics of North America, Volume 46, Issue 4
  Author(s): Samir Kakodkar, Ece A. Mutlu
  Teaser There are many mechanisms to explain how food may drive and ameliorate inflammation. Although there are no consistent macronutrient associations inflammatory bowel disease (IBD) development, many exclusion diets have been described: IgG-4 guided exclusion diet; semivegetarian diet; low-fat, fiber-limited exclusion diet; Paleolithic diet; Maker’s diet; vegan diet; Life without Bread diet; exclusive enteral nutrition (EEN), the Specific Carbohydrate Diet (SCD) and the low FODMAP diet. The literature on diet and IBD is reviewed with a particular focus on EEN, SCD, and low FODMAP diets. Lessons learned from the existing observations and strengths and shortcomings of existing data are presented.
  
  PubDate: 2017-12-01T08:17:31Z
  DOI: 10.1016/j.gtc.2017.08.016
Probiotics in Inflammatory Bowel Disease
- Authors: Bincy P. Abraham; Eamonn M.M. Quigley
  Pages: 769 - 782
  Abstract: Publication date: Available online 3 October 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Bincy P. Abraham, Eamonn M.M. Quigley
  Teaser Evidence indicates that the gut microbiota and/or interactions between the microbiota and the host immune system are involved in the pathogenesis of inflammatory bowel disease (IBD). Strategies that target the microbiota have emerged as potential therapies and, of these, probiotics have gained the greatest attention. Data derived from animal models of IBD have revealed the potential of several bacterial strains to modify the natural history of IBD. However, there has been little indication that probiotics exert any benefit in Crohn disease. More targeted approaches involving live bacteria, genetically modified bacteria, and bacterial products are now being evaluated.
  
  PubDate: 2017-10-08T06:27:08Z
  DOI: 10.1016/j.gtc.2017.08.003
Prebiotics and Inflammatory Bowel Disease
- Authors: Heather E. Rasmussen; Bruce R. Hamaker
  Pages: 783 - 795
  Abstract: Publication date: Available online 4 October 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Heather E. Rasmussen, Bruce R. Hamaker
  Teaser Dietary fiber, specifically prebiotics, is the primary source of energy for the gut microbiota and thus has the potential to beneficially modify microbiota composition. Prebiotics have been used in both in vitro studies and with animal models of colitis with largely positive results. Human studies are few and have been conducted with only a few select prebiotics, primarily fructan-containing fibers. Although disease activity and inflammatory markers have improved, more needs to be learned about the specific prebiotic compounds and how they can be used to best improve the gut microbiota to counter changes induced by inflammatory bowel disease.
  
  PubDate: 2017-10-08T06:27:08Z
  DOI: 10.1016/j.gtc.2017.08.004
Vitamins and Minerals in Inflammatory Bowel Disease
- Authors: Fayez K. Ghishan; Pawel R. Kiela
  Pages: 797 - 808
  Abstract: Publication date: Available online 3 October 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Fayez K. Ghishan, Pawel R. Kiela
  Teaser Indiscriminate multivitamin and mineral supplementation is seen as useless and sometimes harmful, and patients with chronic inflammatory bowel disease (IBD) must be monitored for nutritional and metabolic losses. Mechanistic links between vitamin and mineral deficiencies and IBD has been found for some nutrients; normalizing their systemic level is beneficial. Others, like vitamin A, although instinctively desirable, had disappointing results. Restoring normal levels of selected vitamins and minerals requires elevated doses to compensate for defects in absorptive mechanisms or signaling pathways. This article describes some aspects of vitamin and mineral deficiencies in IBD and summarizes results of supplementation.
  
  PubDate: 2017-10-08T06:27:08Z
  DOI: 10.1016/j.gtc.2017.08.011
Herbs and Inflammatory Bowel Disease
- Authors: Gregory M. Sebepos-Rogers; David S. Rampton
  Pages: 809 - 824
  Abstract: Publication date: Available online 3 October 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Gregory M. Sebepos-Rogers, David S. Rampton
  Teaser Although herbal preparations are widely used by patients with inflammatory bowel disease (IBD), evidence for their efficacy is limited and they may not always be safe. Mainly small studies of varying quality have suggested that several herbal preparations could be of benefit in IBD, but larger better-designed trials are needed to establish their place in inducing and maintaining remission. Patients and health care workers need to be made more aware of the limitations and risks of using herbal products for IBD.
  
  PubDate: 2017-10-08T06:27:08Z
  DOI: 10.1016/j.gtc.2017.08.009
Fecal Transplant in Inflammatory Bowel Disease
- Authors: Alexander S. Browne; Colleen R. Kelly
  Pages: 825 - 837
  Abstract: Publication date: Available online 3 October 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Alexander S. Browne, Colleen R. Kelly
  Teaser Patients with inflammatory bowel disease (IBD) have differences in their gastrointestinal microbiome compared with healthy individuals, although it is unclear whether this is a cause or consequence of chronic inflammation. There is hope that manipulation of the gut microbiome through fecal microbiota transplant (FMT), commonly used to treat patients with Clostridium difficile infection, may also be an effective therapy in IBD. This article reviews the evidence supporting FMT in IBD, including case reports, case series, and randomized controlled trials. The article also focuses on questions of safety and speculates on the future of this therapy.
  
  PubDate: 2017-10-08T06:27:08Z
  DOI: 10.1016/j.gtc.2017.08.005
The Brain-Gut Axis and Stress in Inflammatory Bowel Disease
- Authors: Charles N. Bernstein
  Pages: 839 - 846
  Abstract: Publication date: Available online 3 October 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Charles N. Bernstein
  Teaser The brain-gut axis serves as a circuit that incorporates the human experience, the state of mind, the gut microbiome, and the immune response that ultimately drives the phenotypic expression of inflammatory bowel disease (IBD). There are several biological pathways through which stress can play a deleterious role, including through increasing intestinal permeability, which can facilitate intestinal translocation of bacteria. Stress has an impact on symptoms in IBD; however, there is limited evidence that stress triggers increased intestinal inflammation. Although attention to stress and psychiatric comorbidity is important in the management of IBD, there are few clinical trials to direct management.
  
  PubDate: 2017-10-08T06:27:08Z
  DOI: 10.1016/j.gtc.2017.08.006
Psychological Considerations and Interventions in Inflammatory Bowel
Disease Patient Care
- Authors: Tiffany H. Taft; Sarah Ballou; Alyse Bedell; Devin Lincenberg
  Pages: 847 - 858
  Abstract: Publication date: Available online 3 October 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Tiffany H. Taft, Sarah Ballou, Alyse Bedell, Devin Lincenberg
  Teaser The presence of psychological comorbidities, specifically anxiety and depression, is well documented in inflammatory bowel disease (IBD). The drivers of these conditions typically reflect 4 areas of concern: disease impact, treatment concerns, intimacy, and stigma. Various demographic and disease characteristics increase risk for psychological distress. However, the risk for anxiety and depression is consistent throughout IBD course and is independent of disease activity. Early intervention before psychological distress becomes uncontrolled is ideal, but mental health often is unaddressed during patient visits. Understanding available psychological treatments and establishing referral resources is an important part of the evolution of IBD patient care.
  
  PubDate: 2017-10-08T06:27:08Z
  DOI: 10.1016/j.gtc.2017.08.007
Mindfulness-Based Interventions in Inflammatory Bowel Disease
- Authors: Megan M. Hood; Sharon Jedel
  Pages: 859 - 874
  Abstract: Publication date: Available online 3 October 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Megan M. Hood, Sharon Jedel
  Teaser Mindfulness-based interventions may be beneficial psychosocial treatments for improving the health and well-being of patients with inflammatory bowel disease. This article reviews eight studies, assessing seven psychosocial interventions, which include mindfulness and/or meditation components. Strongest effects of the interventions were found in quality of life and anxiety/depression, with inconsistent or minimal changes in other psychosocial areas, such as perceived stress and in disease-related outcomes and other physiologic functioning. Mindfulness interventions for patients with inflammatory bowel disease may be a supplemental treatment option to improve quality of life and distress in this population, although results are preliminary and interventions require additional testing.
  
  PubDate: 2017-10-08T06:27:08Z
  DOI: 10.1016/j.gtc.2017.08.008
Massage Acupuncture, Moxibustion, and Other Forms of Complementary and
Alternative Medicine in Inflammatory Bowel Disease
- Authors: Daniel J. Stein
  Pages: 875 - 880
  Abstract: Publication date: Available online 3 October 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Daniel J. Stein
  Teaser Complementary and alternative medicine is frequently used by inflammatory bowel disease (IBD) patients; most common are massage, acupuncture, and moxibustion therapy. Massage therapy is poorly studied in IBD patients; therefore, its benefits remain unknown. Acupuncture and moxibustion therapy have been shown to improve inflammation and symptoms in animal and human studies. However, current clinical trials of acupuncture and moxibustion are of insufficient quality to recommend them as alternative therapy. Nonetheless, because these therapies seem generally to be safe, they may have a role as complementary to conventional therapy.
  
  PubDate: 2017-10-08T06:27:08Z
  DOI: 10.1016/j.gtc.2017.08.015
Sleep and Circadian Hygiene and Inflammatory Bowel Disease
- Authors: Garth R. Swanson; Helen J. Burgess
  Pages: 881 - 893
  Abstract: Publication date: December 2017
  Source:Gastroenterology Clinics of North America, Volume 46, Issue 4
  Author(s): Garth R. Swanson, Helen J. Burgess
  Teaser There is increasing evidence that sleep and circadian disruption can worsen the disease course in inflammatory bowel disease (IBD). Sleep and circadian disruption are prevalent in society and are associated with worse outcomes in IBD. Emerging research suggests sleep and circadian disruption can impact key components in IBD disease flares, including intestinal permeability, translocation of bacterial endotoxins, intestinal dysbiosis, and proinflammatory cytokines. Much of this research has been conducted in animal models. There is a clear need for large randomized controlled trials in human patients with IBD, where the potential for chronotherapeutic strategies to improve disease course can be tested.
  
  PubDate: 2017-12-01T08:17:31Z
  DOI: 10.1016/j.gtc.2017.08.014
Exercise and Inflammatory Bowel Disease
- Authors: Jana G. Hashash; David G. Binion
  Pages: 895 - 905
  Abstract: Publication date: December 2017
  Source:Gastroenterology Clinics of North America, Volume 46, Issue 4
  Author(s): Jana G. Hashash, David G. Binion
  Teaser There is sparse information regarding exercise and inflammatory bowel disease (IBD). Furthermore, the importance of regular exercise in the optimal management of IBD has not received attention in guidelines and is often overlooked by practitioners. This article summarizes evidence regarding health benefits of exercise, guidelines regarding exercise in the general population and chronic inflammatory disorder populations, limitations regarding exercise capacity in patients with IBD, the association of lack of exercise with IBD pathogenesis, the role of exercise in beneficially modulating IBD clinical course, and extraintestinal benefits of exercise in patients with IBD.
  
  PubDate: 2017-12-01T08:17:31Z
  DOI: 10.1016/j.gtc.2017.08.010
Malnutrition in Gastrointestinal Disorders
- Authors: Lori Jane Curtis; Paule Bernier; Khursheed Jeejeebhoy; Johane Allard; Donald Duerksen; Leah Gramlich; Manon Laporte; Heather H. Keller
  Pages: 1391 - 1396
  Abstract: Publication date: Available online 7 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Khursheed N. Jeejeebhoy, Donald R. Duerksen
  Teaser All patients with significant gastrointestinal disease should be clinically assessed for protein calorie malnutrition by using the Subjective Global Assessment. Blood tests for anemia, electrolytes, calcium, phosphorus, magnesium, ferritin, vitamin B12, and folate should be considered for assessment of major micronutrients. Where malabsorption or inflammatory bowel disease is diagnosed, bone mineral density using dual beam x-ray absorptiometry, 25-OH vitamin D levels, and measurement of other vitamins and trace elements should be considered. In addition, in at-risk patients, vitamin and trace element clinical deficiency syndromes should be considered during patient assessment.
  
  PubDate: 2017-12-12T09:36:56Z
  DOI: 10.1016/j.clnu.2016.09.009
Parenteral Nutrition
- Authors: Brian Lappas; Dhyanesh Patel Vanessa Kumpf Dawn Wiese Adams Douglas
  Abstract: Publication date: Available online 15 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Brian M. Lappas, Dhyanesh Patel, Vanessa Kumpf, Dawn Wiese Adams, Douglas L. Seidner
  Teaser Parenteral nutrition (PN) is a life-sustaining therapy in patients with intestinal failure who are unable to tolerate enteral feedings. Patient selection should be based on a thorough assessment to identify those at high nutrition risk based on both disease severity and nutritional status. This article reviews both the acute and chronic indications for PN as well as special formulation consideration in specific disease states, vascular access, and complications of both short-term and long-term PN.
  
  PubDate: 2017-12-24T18:47:14Z
Enteral Access and Associated Complications
- Authors: Mark DeLegge
  Abstract: Publication date: Available online 7 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Mark H. DeLegge
  Teaser Enteral access is the foundation for feeding in patients unable to meet their nutrition needs orally and have a functional gastrointestinal tract. Enteral feeding requires placement of a feeding tube. Tubes can be placed through an orifice or percutaneously into the stomach or proximal small intestine at the bedside or in specialized areas of the hospital. Bedside tubes can be placed by the nurse or the physician, such as in the intensive care unit. Percutaneous feeding tubes are placed by the gastroenterologist, surgeon, or radiologist. This article reviews the types of enteral access and the associated complications.
  
  PubDate: 2017-12-12T09:36:56Z
Nutritional Therapy in Chronic Pancreatitis
- Authors: Enrique Mary; Phillips
  Abstract: Publication date: Available online 7 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): J. Enrique Domínguez-Muñoz, Mary Phillips
  Teaser Malnutrition is a frequent complication in patients with chronic pancreatitis. Maldigestion as a consequence of pancreatic exocrine insufficiency is the major cause of malnutrition in these patients. Together with that, toxic habits and alterations of the gastroduodenal transit may play a relevant role. Malnutrition in chronic pancreatitis is associated with osteoporosis, sarcopenia, poor quality of life, and increased mortality. An adequate nutritional evaluation including anthropometric, biochemical, and morphologic parameters is recommended in these patients. Nutritional advice and support together with an adequate pancreatic enzyme replacement therapy are indicated.
  
  PubDate: 2017-12-12T09:36:56Z
Nutritional Therapy in Gastrointestinal Cancers
- Authors: Ronaldo Sousa Oliveira Filho; Priscila Casarin Garla; Raquel Susana Torrinhas; Ricardo Alexandre Garib; Alweyd Tesser; Felipe Garcia Gutierres Aprobato; Erika Midori Tamanaha; Marcia de Souza Antunes; Dan Linetzky Waitzberg
  Abstract: Publication date: Available online 7 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Priscila Garla, Dan Linetzky Waitzberg, Alweyd Tesser
  Teaser Malnutrition is the most frequent nutritional disorder in patients with gastrointestinal cancer and is associated with cachexia syndrome, worsening of prognosis, and shortened survival rate. Early nutrition screening, assessment, and intervention are able to favorably modify the clinical evolution of affected patients. The adequate provision of nutritional requirements has been associated with improvement of immunologic status, and avoidance of further complications related to poor nutritional status, surgical treatment, and anticancer therapy. In malnourished patients, the supplementation of perioperative immunonutrition might contribute to fewer infectious and noninfectious complications, shorter length of hospitalization, and improved wound healing.
  
  PubDate: 2017-12-12T09:36:56Z
  DOI: 10.1016/j.nut.2017.11.021
Small Intestinal Bacterial Overgrowth
- Authors: Abimbola Adike; John DiBaise
  Abstract: Publication date: Available online 7 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Abimbola Adike, John K. DiBaise
  Teaser Small intestinal bacterial overgrowth (SIBO), characterized by the presence of excessive bacteria in the small intestine, is typically described as a malabsorptive syndrome occurring in the context of gut stasis syndromes. SIBO is now considered to be a disorder associated with diverse clinical conditions without classic risk factors for SIBO and a cause of several nonspecific gastrointestinal and nongastrointestinal symptoms. Because there is currently no gold standard for diagnosing SIBO, its prevalence and role in the pathogenesis of other diseases remain uncertain; as does optimal treatment of patients with relapsing symptoms.
  
  PubDate: 2017-12-12T09:36:56Z
Nutritional Consideration in Celiac Disease and Nonceliac Gluten
Sensitivity
- Authors: Rishi Naik; Douglas Seidner Dawn Adams
  Abstract: Publication date: Available online 7 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Rishi D. Naik, Douglas L. Seidner, Dawn W. Adams
  Teaser Celiac disease is an autoimmune disorder due to the inflammatory response to gluten in genetically predisposed individuals. It causes an enteropathy associated with several nutritional complications. Strict compliance to a gluten-free diet (GFD) is the current primary therapy. Nonceliac gluten sensitivity (NCGS) is a condition in which gluten ingestion leads to systemic symptoms but is not associated with small bowel atrophy or abnormal celiac serologies. A GFD heals celiac disease enteropathy and improves symptoms in NCGS. However, a long-term GFD can be associated with nutritional deficiencies and requires monitoring and guidance.
  
  PubDate: 2017-12-12T09:36:56Z
Nutritional Interventions in the Patient with Inflammatory Bowel Disease
- Authors: Berkeley Limketkai; Andrea Wolf Joanna Maryam Tajamal Alyssa Parian
  Abstract: Publication date: Available online 7 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Berkeley N. Limketkai, Andrea Wolf, Joanna Ye, Maryam Tajamal, Alyssa M. Parian
  Teaser Nutritional strategies have been explored as primary or adjunct therapies for inflammatory bowel disease (IBD). Exclusive enteral nutrition is effective for the induction of remission in Crohn disease and is recommended as a first-line therapy for children. Dietary strategies focus on adjusting the ratio of consumed nutrients that are proinflammatory or antiinflammatory. Treatments with dietary supplements focus on the antiinflammatory effects of the individual supplements (eg, curcumin, omega-3 fatty acids, vitamin D) or their positive effects on the intestinal microbiome (eg, prebiotics, probiotics). This article discusses the role of diets and dietary supplements in the treatment of IBD.
  
  PubDate: 2017-12-12T09:36:56Z
The Role of Prebiotics and Probiotics in Gastrointestinal Disease
- Authors: Martin Floch
  Abstract: Publication date: Available online 7 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Martin H. Floch
  Teaser With the advent of the scientific realization that the microbiota of the gastrointestinal tract was more than the cells that exist in the body, the full importance of prebiotics and probiotics has come forth. The importance has been stressed and is available in the new textbook entitled, “The Microbiota in Gastrointestinal Pathophysiology: Implication for Human Health, Prebiotics, Probiotics and Dysbiosis.” There is enough evidence now published in the literature so that the scientific world now believes that prebiotics and probiotics are important in gastrointestinal disease.
  
  PubDate: 2017-12-12T09:36:56Z
Nutritional Considerations in Liver Disease
- Authors: Asim Shuja; Miguel Malespin James Scolapio
  Abstract: Publication date: Available online 6 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Asim Shuja, Miguel Malespin, James Scolapio
  Teaser Malnutrition occurs in most patients with advanced liver diseases and is associated with higher rates of morbidity and mortality. In this article, the authors discuss the pathophysiology of malnutrition and methods to optimize nutrition status in liver disease and include a brief section on perioperative and postoperative nutrition.
  
  PubDate: 2017-12-12T09:36:56Z
Nutritional Therapy in Adult Short Bowel Syndrome Patients with Chronic
Intestinal Failure
- Authors: Palle Bekker; Jeppesen Kristian Asp Fuglsang
  Abstract: Publication date: Available online 6 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Palle Bekker Jeppesen, Kristian Asp Fuglsang
  Teaser Intestinal failure (IF) is the reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that parenteral support (PS) is required to maintain health and/or growth. This article critically revises the gaps in and evidence for providing general nutritional therapy recommendations in the Short Bowel Syndrome-IF population. It addresses the need for an individualized approach, aiming to reduce or even eliminate the need for PS, and emphasizes a need to focus on effects of dietary interventions on the quality of life of these patients.
  
  PubDate: 2017-12-12T09:36:56Z
Nutritional Aspects of Acute Pancreatitis
- Authors: Kristen Roberts; Marcia Nahikian-Nelms Andrew Ukleja Luis Lara
  Abstract: Publication date: Available online 6 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Kristen M. Roberts, Marcia Nahikian-Nelms, Andrew Ukleja, Luis F. Lara
  Teaser The goal of nutritional support in acute pancreatitis is to reduce inflammation, prevent nutritional depletion, correct a negative nitrogen balance, and improve outcomes. Enteral nutrition (EN) in severe acute pancreatitis (SAP) should be preferred to parenteral nutrition. It maintains the integrity of the gut barrier, decreases intestinal permeability, downregulates the systemic inflammatory response, maintains intestinal microbiota equilibrium, and reduces the complications of the early phase of SAP, improving morbidity and possibly improving mortality, and it is less expensive. Further studies to understand optimal timing of nutrition, route of delivery of EN, and the type of nutrition and nutrients are necessary.
  
  PubDate: 2017-12-12T09:36:56Z
Nutritional Interventions in Chronic Intestinal Pseudoobstruction
- Authors: Donald Kirby; Sulieman Abdal Raheem Mandy Corrigan
  Abstract: Publication date: Available online 6 December 2017
  Source:Gastroenterology Clinics of North America
  Author(s): Donald F. Kirby, Sulieman Abdal Raheem, Mandy L. Corrigan
  Teaser Although chronic intestinal pseudo-obstruction (CIPO) is a rare disorder, it presents a wide spectrum of severity that ranges from abdominal bloating to severe gastrointestinal dysfunction. In the worst cases, patients may become dependent upon artificial nutrition via parenteral nutrition or choose to have an intestinal transplant. However, whatever the severity, a patient’s quality of life can be seriously compromised. This article defines the disorder and discusses the spectrum of disease and challenges to providing adequate nutrition to help improve a patient’s quality of life.
  
  PubDate: 2017-12-12T09:36:56Z
Forthcoming Issues
- Abstract: Publication date: December 2017
  Source:Gastroenterology Clinics of North America, Volume 46, Issue 4
  
  PubDate: 2017-12-01T08:17:31Z