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Journal Cover   United European Gastroenterology Journal
  [3 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2050-6406 - ISSN (Online) 2050-6414
   Published by Sage Publications Homepage  [757 journals]
  • The clinical value of faecal calprotectin and lactoferrin measurement in
           postoperative Crohn's disease
    • Authors: Yamamoto; T.
      Pages: 5 - 10
      Abstract: Most patients with Crohn’s disease (CD) ultimately require one or more operations over their lifetime. Nevertheless, surgery is not a cure and postoperative CD recurrence is common. Ileocolonoscopy has been considered to be the gold standard in the diagnosis and monitoring of postoperative recurrence in patients with CD. However, endoscopy is a time-consuming and invasive procedure. Simple and non-invasive methods for the detection of postoperative recurrence are desirable. Faecal inflammatory biomarkers such as calprotectin and lactoferrin provide an accurate and non-invasive diagnostic and monitoring modality for inflammatory bowel disease. However, there have been limited data on the role of faecal biomarkers in the postoperative setting. Recently, several studies evaluated the value of faecal calprotectin and lactoferrin measurement after surgery for CD. This review was conducted to assess the role of faecal calprotectin and lactoferrin measurements in patients with postoperative CD.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614558106
      Issue No: Vol. 3, No. 1 (2015)
  • Changes in serum ghrelin level in relation to meal-time in patients with
           functional dyspepsia
    • Authors: Kazemi, M; Eshraghian, A, Hamidpour, L, Taghavi, S.
      Pages: 11 - 16
      Abstract: Background Ghrelin is a peptide hormone that is involved in gastrointestinal motility and secretion; and therefore, may play a role in functional dyspepsia. Objectives To compare the change of serum ghrelin level in relation to meal-time, between patients with functional dyspepsia and a control group. Materials and methods In a cross-sectional study, 18 subjects with functional dyspepsia according to the Rome III criteria were enrolled in our study. Blood samples were collected five times: 30 minutes (min) before a standard breakfast; at the time as serving breakfast; and 30, 60 and 90 min after breakfast. Serum ghrelin concentration was measured in these patients and compared with eight normal individuals, as controls. Results The serum ghrelin level 30 minutes after breakfast was significantly higher in dyspepsia patients, compared to controls (751 ± 171.84 pg/ml versus 576.9 ± 195.62 pg/ml, p = 0.033). Although patients had a higher mean serum ghrelin level 30 minutes before, exactly at the time of serving breakfast and 60 min after breakfast there was no statistically significant difference between patients and controls. The shape of the curve was also different between the two groups, from 30 min until 90 min after breakfast, which is the time that most dyspeptic symptoms usually occur, although this difference was not significant (p > 0.05). Conclusion The significantly different ghrelin levels between dyspeptic patients and the normal population showed that ghrelin may have an important role in inducing symptoms, in functional dyspeptic patients.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614563373
      Issue No: Vol. 3, No. 1 (2015)
  • Helicobacter pylori infection but not small intestinal bacterial
           overgrowth may play a pathogenic role in rosacea
    • Authors: Gravina, A; Federico, A, Ruocco, E, Lo Schiavo, A, Masarone, M, Tuccillo, C, Peccerillo, F, Miranda, A, Romano, L, de Sio, C, de Sio, I, Persico, M, Ruocco, V, Riegler, G, Loguercio, C, Romano, M.
      Pages: 17 - 24
      Abstract: Background and aims Recent studies suggest a potential relationship between rosacea and Helicobacter pylori (H. pylori) infection or small intestinal bacterial overgrowth (SIBO), but there is no firm evidence of an association between rosacea and H. pylori infection or SIBO. We performed a prospective study to assess the prevalence of H. pylori infection and/or SIBO in patients with rosacea and evaluated the effect of H. pylori or SIBO eradication on rosacea. Methods We enrolled 90 patients with rosacea from January 2012 to January 2013 and a control group consisting of 90 patients referred to us because of mapping of nevi during the same period. We used the 13C Urea Breath Test and H. pylori stool antigen (HpSA) test to assess H. pylori infection and the glucose breath test to assess SIBO. Patients infected by H. pylori were treated with clarithromycin-containing sequential therapy. Patients positive for SIBO were treated with rifaximin. Results We found that 44/90 (48.9%) patients with rosacea and 24/90 (26.7%) control subjects were infected with H. pylori (p = 0.003). Moreover, 9/90 (10%) patients with rosacea and 7/90 (7.8%) subjects in the control group had SIBO (p = 0.6). Within 10 weeks from the end of antibiotic therapy, the skin lesions of rosacea disappeared or decreased markedly in 35/36 (97.2%) patients after eradication of H. pylori and in 3/8 (37.5%) patients who did not eradicate the infection (p < 0.0001). Rosacea skin lesions decreased markedly in 6/7 (85.7%) after eradication of SIBO whereas of the two patients who did not eradicate SIBO, one (50%) showed an improvement in rosacea (p = 0.284). Conclusions Prevalence of H. pylori infection was significantly higher in patients with rosacea than control group, whereas SIBO prevalence was comparable between the two groups. Eradication of H. pylori infection led to a significant improvement of skin symptoms in rosacea patients.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614559262
      Issue No: Vol. 3, No. 1 (2015)
  • ERCP-related perforations in the new millennium: A large tertiary referral
           center 10-year experience
    • Authors: Kodali, S; Monkemuller, K, Kim, H, Ramesh, J, Trevino, J, Varadarajulu, S, Wilcox, C. M.
      Pages: 25 - 30
      Abstract: Introduction Endoscopic retrograde cholangiopancreatography (ERCP) is an important diagnostic and therapeutic modality for pancreatic and biliary disorders. Perforation is one of the most dreaded complications of ERCP. Since it is uncommon, there has been little study of incidence, risk factors, and outcomes of management. Objectives We aim to assess the incidence of ERCP-related perforations and outcomes at a large tertiary referral center. Methods We undertook a review of an ERCP database for all perforations from 2002 to December 2012. Results The cumulative incidence of ERCP-related perforations was 0.14% (12 out of 8264), and sphincterotomy-related perforations constituted the most common cause. The mean age of these 12 patients was 58.6 years and majority were female (83.3%). The most common indications for ERCP were: suspected sphincter of Oddi dysfunction (SOD) 41%, and common bile duct stones (CBD stones) 41%. Nine of the 12 patients (75%) had a leak and were managed medically, and four who had a perforation had surgical repair (25%). Conclusions In our study, leaks were much more common than perforations and the majority of patients were successfully managed with conservative therapy alone. We report a very low perforation rate and most perforations can be managed conservatively with a good outcome.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614560784
      Issue No: Vol. 3, No. 1 (2015)
  • Bacterial infections in childhood: A risk factor for gastrointestinal and
           other diseases'
    • Authors: Schwille-Kiuntke, J; Unverdorben, A, Weimer, K, Schlarb, A. A, Gulewitsch, M. D, Ellert, U, Enck, P.
      Pages: 31 - 38
      Abstract: Background There is evidence for post-infectious irritable bowel syndrome (PI-IBS) in adults, but little is known about PI-IBS in children. The nationwide representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS) assessed children’s health. Objective and methods We identified 643 children (50.1% males) in the KiGGS cohort (N = 15,878, 51% males) with a history of Salmonella infection. The number was validated comparing this group with the known infection statistics from the Robert Koch-Institute registry. We compared this group to the remaining KiGGS cohort (n = 12,951) with respect to sociodemographic characteristics, pain and quality of life. To check for specificity, we repeated the comparisons with a group with a history of scarlet fever. Results Infection statistics predicted 504 cases of Salmonella infection in the KiGGS cohort, indicating high validity of the data. In children between 3 and 10 years with a history of Salmonella infection, significantly more abdominal pain (31.7% versus 21.9%, p < 0.001) and headache (27.2% versus 15.1%, p < 0.001) were reported. This group showed lower quality of life (p < 0.001). Comparison to a group of scarlet fever-infected children revealed poor specificity of the data. Conclusion Differences found between children with and without Salmonella infection reveal the role of gastrointestinal infection in the development of post-infectious abdominal problems, but poor specificity may point toward a psychosocial ("somatization") rather than a Salmonella-specific mechanism.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614558346
      Issue No: Vol. 3, No. 1 (2015)
  • An exploration of the barriers to the confident diagnosis of irritable
           bowel syndrome: A survey among general practitioners, gastroenterologists
           and experts in five European countries
    • Authors: Andresen, V; Whorwell, P, Fortea, J, Auziere, S.
      Pages: 39 - 52
      Abstract: Background The diagnostic processes for chronic abdominal conditions are challenging. Despite their tendency for diagnostic tests in patients with irritable bowel syndrome (IBS) symptoms, clinicians are encouraged to make a positive diagnosis based on symptom criteria without alarm signs. We explored how European physicians diagnose and manage patients suffering from IBS. Methods We conducted a vignette-based survey to evaluate the diagnostic approaches in four standardized patients with IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), inflammatory bowel disease (IBD) and chronic constipation (CC). General practitioners (GP, n = 104), gastroenterologists (GE, n = 100) and IBS experts (n = 25) from five European countries participated. Results Experts showed the highest rates of correct diagnoses (88%–92%) for all cases except CC (only 60%) and were more prone to a positive diagnosis (64%/68% in IBS-C/CC), whereas GEs and GPs tended toward a diagnosis by exclusion (63%/63% and 62%/60% in IBS-C/CC). In the CC vignette, conducting tests was more frequent than prescribing treatment among 44% experts, 63% GEs and 36% GPs. The diagnosis of IBD presented little difficulty for any of the participants. Conclusions This study highlights the difficulties in confidently diagnosing chronic functional bowel conditions, especially for non-experts, whereas IBD caused little difficulty. Differentiating between IBS-C and CC seemed particularly challenging, even for experts.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614558344
      Issue No: Vol. 3, No. 1 (2015)
  • Comparison of adequate relief with symptom, global, and responder
           endpoints in linaclotide phase 3 trials in IBS-C
    • Authors: Camilleri, M; Lembo, A. J, Lavins, B. J, MacDougall, J. E, Carson, R. T, Williams, V. S, Nelson, L. M, Shiff, S. J, Currie, M. G, Kurtz, C. B, Johnston, J. M.
      Pages: 53 - 62
      Abstract: Background Optimal clinical trial endpoints for irritable bowel syndrome with constipation (IBS-C) are uncertain. Objective The objective of this article is to compare adequate relief (AR) to abdominal/bowel symptoms, global endpoints, and FDA and EMA responder criteria; and to use AR as an anchor to assess clinically meaningful change (CMC) in IBS-C symptoms. Methods Using pooled 12-week data from two phase 3 linaclotide clinical trials, daily abdominal/bowel symptoms and weekly global assessments were correlated with AR. Symptom CMC thresholds were estimated using AR as an anchor. Agreement between AR and FDA/EMA responder criteria was assessed. Results Correlations of AR with percentage change in abdominal symptoms, bowel symptoms, and global endpoints ranged from 0.48–0.54, 0.32–0.39, and 0.61–0.71, respectively. Using AR as an anchor, CMC thresholds were 29% improvement in abdominal pain, 29% improvement in abdominal discomfort, and 0.7/week increase in CSBMs, similar to thresholds for IBS-C responder endpoints recommended by the FDA and EMA. There was considerable agreement of weekly responder rates between AR and the FDA and EMA endpoints (on average, 70%–76% and 71%–82% of weeks with agreement, respectively). Conclusions AR bridges IBS-C clinical trials, putting into perspective the disparate primary endpoints recommended by professional societies and regulatory authorities, and allowing researchers, practitioners, and regulators to compare trial results.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614555946
      Issue No: Vol. 3, No. 1 (2015)
  • Gray scale and contrast-enhanced ultrasound imaging of malignant liver
           tumors of vascular origin
    • Authors: Schweitzer, N; Soudah, B, Gebel, M, Manns, M. P, Boozari, B.
      Pages: 63 - 71
      Abstract: Objectives Malignant vascular tumors of the liver are rare. The aim of this study was to investigate the applicability of gray scale and contrast-enhanced ultrasonography in patients with epithelioid hemangioendothelioma (EHE) of the liver and hepatic angiosarcoma (HA) and to describe the clinical presentation. Methods We retrospectively analyzed all patients with epithelioid hemangioendothelioma or hemangiosarcoma of the liver from 1998 to 2011, who underwent ultrasound investigation. We describe the findings in gray scale and contrast-enhanced ultrasound and the clinical course of the disease of seven patients with EHE and five patients with HA. Results Ultrasound investigation in EHE showed mostly multiple hypoechoic irregular lesions close to the liver capsule and with a halo in some cases. Contrast enhancement revealed inhomogeneously and through all contrast phases vascularized tumors with a rim enhancement in 50%, with or without early wash out. All tumors had avascular parts. HA presented as multiple and irregular hypo-, iso- or hyperechoic lesions. After contrast enhancement, hypervascularization with individual patterns was evident in all patients. Of five, three had liquid parts. Patients with HA were significantly older (58 vs. 37 years, p = 0.014) and presented with lower thrombocyte counts (84 vs. 264, p = 0.0025) and with higher CEA levels (4.6 vs. 1.5, p = 0.03). Conclusion EHE and HA are inhomogeneous tumors, explaining the high inter-individual variability and heterogeneity in ultrasound examination. The presence of multifocal lesions, heterogeneity and undefined margins may differentiate EHE or HA from hemangioma. A biopsy is essential in the diagnosis of vascular tumors.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614560604
      Issue No: Vol. 3, No. 1 (2015)
  • Pharmacological intervention based on fecal calprotectin levels in
           patients with ulcerative colitis at high risk of a relapse: A prospective,
           randomized, controlled study
    • Authors: Lasson, A; Ohman, L, Stotzer, P.-O, Isaksson, S, Uberbacher, O, Ung, K.-A, Strid, H.
      Pages: 72 - 79
      Abstract: Background Targeted therapy, using biomarkers to assess disease activity in ulcerative colitis (UC), has been proposed. Objective The objective of this study was to evaluate whether pharmacological intervention guided by fecal calprotectin (FC) prolongs remission in patients with UC. Methods A total of 91 adults with UC in remission were randomized to an intervention group or a control group. Analysis of FC was performed monthly, during 18 months. A FC value of 300 µg/g was set as the cut-off for intervention, which was a dose escalation of the oral 5-aminosalicylate (5-ASA) agent. The primary study end-point was the number of patients to have relapsed by month 18. Results There were relapses in 18 (35.3%) and 20 (50.0%) patients in the intervention and the control groups, respectively (p = 0.23); and 28 (54.9%) patients in the intervention group and 28 (70.0%) patients in the control group had a FC > 300 µg/g, of which 8 (28.6%) and 16 (57.1%) relapsed, respectively (p < 0.05). Conclusion Active intervention significantly reduced relapse rates, although no significant difference was reached between the groups overall. Thus, FC-levels might be used to identify patients with UC at risk for a flare, and a dose escalation of their 5-ASA agent is a therapeutic option for these patients.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614560785
      Issue No: Vol. 3, No. 1 (2015)
  • Managing complications in cirrhotic patients
    • Authors: Peck-Radosavljevic, M; Angeli, P, Cordoba, J, Farges, O, Valla, D.
      Pages: 80 - 94
      Abstract: Liver cirrhosis is a serious and potentially life-threatening condition. This life-threatening condition usually arises from complications of cirrhosis. While variceal bleeding is the most acute and probably best studied, several other complications of liver cirrhosis are more insidious in their onset but nevertheless more important for the long-term management and outcome of these patients. This review summarizes the topics discussed during the UEG-EASL Hepatology postgraduate course of the United European Gastroenterology Week 2013 and discusses emergency surgical conditions in cirrhotic patients, the management of hepatic encephalopathy, ascites and hepatorenal syndrome, coagulation disorders, and liver cancer.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614560452
      Issue No: Vol. 3, No. 1 (2015)
  • Efficacy of reduced-dose regimen of a capsule containing bismuth
           subcitrate, metronidazole, and tetracycline given with amoxicillin and
           esomeprazole in the treatment of Helicobacter Pylori infection
    • Authors: Harb, A. H; El Reda, Z. D, Sarkis, F. S, Chaar, H. F, Sharara, A. I.
      Pages: 95 - 96
      Abstract: It is well known that triple therapy for Helicobacter pylori is losing efficacy worldwide. A regimen containing proton pump inhibitor and multiple-dose capsules of bismuth, metronidazole, and tetracycline has proven efficacy. In addition, a literature review on dosage of previous regimens shows that half-dose clarithromycin-based regimens are equally effective to full-dose regimens. However, the applicability of dose reduction to bismuth-based therapy is unknown. This communication shows that a reduced-dose bismuth-based regimen fails to achieve acceptable eradication rates.
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640614560787
      Issue No: Vol. 3, No. 1 (2015)
  • Why submit an abstract to UEG Week'
    • Authors: Fitzgerald; R.
      Pages: 97 - 97
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640615570210
      Issue No: Vol. 3, No. 1 (2015)
  • Rejuvenating UEG: The Young Talent Group and the Young GI Network
    • Authors: Burisch; J.
      Pages: 99 - 99
      PubDate: 2015-02-03T08:22:17-08:00
      DOI: 10.1177/2050640615570211
      Issue No: Vol. 3, No. 1 (2015)
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