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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  [813 journals]
  • Message from the editors: coeliac disease focused issue
    • Pages: 105 - 105
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640615578353
      Issue No: Vol. 3, No. 2 (2015)
  • Screening for celiac disease in the general population and in high-risk
    • Authors: Ludvigsson, J. F; Card, T. R, Kaukinen, K, Bai, J, Zingone, F, Sanders, D. S, Murray, J. A.
      Pages: 106 - 120
      Abstract: Background Celiac disease (CD) occurs in approximately 1% of the Western population. It is a lifelong disorder that is associated with impaired quality of life (QOL) and an excessive risk of comorbidity and death. Objectives To review the literature on screening for CD in relation to the current World Health Organization (WHO) criteria for mass screening. Methods We performed a PubMed search to identify indexed papers on CD screening with a publication date from 1900 until 1 June 2014. When we deemed an abstract relevant, we read the corresponding paper in detail. Results CD fulfills several WHO criteria for mass screening (high prevalence, available treatment and difficult clinical detection), but it has not yet been established that treatment of asymptomatic CD may reduce the excessive risk of severe complications, leading to higher QOL nor that it is cost-effective. Conclusions Current evidence is not sufficient to support mass screening for CD, but active case-finding may be appropriate, as we recognize that most patients with CD will still be missed by this strategy. Although proof of benefit is still lacking, screening for CD may be appropriate in high-risk groups.
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640614561668
      Issue No: Vol. 3, No. 2 (2015)
  • The gluten-free diet and its current application in coeliac disease and
           dermatitis herpetiformis
    • Authors: Ciacci, C; Ciclitira, P, Hadjivassiliou, M, Kaukinen, K, Ludvigsson, J. F, McGough, N, Sanders, D. S, Woodward, J, Leonard, J. N, Swift, G. L.
      Pages: 121 - 135
      Abstract: Background A gluten-free diet (GFD) is currently the only available therapy for coeliac disease (CD). Objectives We aim to review the literature on the GFD, the gluten content in naturally gluten-free (GF) and commercially available GF food, standards and legislation concerning the gluten content of foods, and the vitamins and mineral content of a GFD. Methods We carried out a PubMed search for the following terms: Gluten, GFD and food, education, vitamins, minerals, calcium, Codex wheat starch and oats. Relevant papers were reviewed and for each topic a consensus among the authors was obtained. Conclusion Patients with CD should avoid gluten and maintain a balanced diet to ensure an adequate intake of nutrients, vitamins, fibre and calcium. A GFD improves symptoms in most patients with CD. The practicalities of this however, are difficult, as (i) many processed foods are contaminated with gluten, (ii) staple GF foods are not widely available, and (iii) the GF substitutes are often expensive. Furthermore, (iv) the restrictions of the diet may adversely affect social interactions and quality of life. The inclusion of oats and wheat starch in the diet remains controversial.
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640614559263
      Issue No: Vol. 3, No. 2 (2015)
  • Psychological morbidity of celiac disease: A review of the literature
    • Authors: Zingone, F; Swift, G. L, Card, T. R, Sanders, D. S, Ludvigsson, J. F, Bai, J. C.
      Pages: 136 - 145
      Abstract: Background Celiac disease has been linked to decreased quality of life and certain mood disorders. The effect of the gluten free diet on these psychological aspects of the disease is still unclear. Objectives The objective of this article is to review the literature on psychological morbidity of celiac disease. Methods We performed a PubMed search for the time period from 1900 until June 1, 2014, to identify papers on psychological aspects of celiac disease looking specifically at quality of life, anxiety, depression and fatigue. Results Anxiety, depression and fatigue are common complaints in patients with untreated celiac disease and contribute to lower quality of life. While aspects of these conditions may improve within a few months after starting a gluten-free diet, some patients continue to suffer from significant psychological morbidity. Psychological symptoms may affect the quality of life and the dietary adherence. Conclusion Health care professionals need to be aware of the ongoing psychological burden of celiac disease in order to support patients with this disease.
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640614560786
      Issue No: Vol. 3, No. 2 (2015)
  • Support for patients with celiac disease: A literature review
    • Authors: Ludvigsson, J. F; Card, T, Ciclitira, P. J, Swift, G. L, Nasr, I, Sanders, D. S, Ciacci, C.
      Pages: 146 - 159
      Abstract: Background Celiac disease (CD) is a lifelong disorder. Patients are at increased risk of complications and comorbidity. Objectives We conducted a review of the literature on patient support and information in CD and aim to issue recommendations about patient information with regards to CD. Methods Data source: We searched PubMed for English-language articles published between 1900 and June 2014, containing terms related to costs, economics of CD, or education and CD. Study selection: Papers deemed relevant by any of the participating authors were included in the study. Data synthesis: No quantitative synthesis of data was performed. Instead we formulated a consensus view of the information that should be offered to all patients with CD. Results There are few randomized clinical trials examining the effect of patient support in CD. Patients and their families receive information from many sources. It is important that health care personnel guide the patient through the plethora of facts and comments on the Internet. An understanding of CD is likely to improve dietary adherence. Patients should be educated about current knowledge about risk factors for CD, as well as the increased risk of complications. Patients should also be advised to avoid other health hazards, such as smoking. Many patients are eager to learn about future non-dietary treatments of CD. This review also comments on novel therapies but it is important to stress that no such treatment is available at present. Conclusion Based on mostly observational data, we suggest that patient support and information should be an integral part of the management of CD, and is likely to affect the outcome of CD.
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640614562599
      Issue No: Vol. 3, No. 2 (2015)
  • Non-coeliac gluten sensitivity: piecing the puzzle together
    • Authors: Biesiekierski, J. R; Iven, J.
      Pages: 160 - 165
      Abstract: The avoidance of wheat- and gluten-containing products is a worldwide phenomenon. While coeliac disease is well-established, much remains unknown about whether gluten can be a trigger of gastrointestinal and/or extra-intestinal symptoms in patients without coeliac disease. In this article, we discuss the latest scientific evidence and our current understanding for the possible mechanisms of this largely ambiguous group, termed ‘non-coeliac gluten sensitive’ (NCGS). We can conclude that NCGS should be regarded as an independent disease outside of coeliac disease and wheat allergy, and that the number of patients affected is likely to be limited. Many questions remain unanswered and it needs to be verified whether the elimination of dietary gluten alone is sufficient for the control of symptoms, and to understand the overlap with other components of wheat.
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640615578388
      Issue No: Vol. 3, No. 2 (2015)
  • Dental erosions and other extra-oesophageal symptoms of gastro-oesophageal
           reflux disease: Evidence, treatment response and areas of uncertainty
    • Authors: Pauwels A.
      Pages: 166 - 170
      Abstract: Extra-oesophageal symptoms of gastro-oesophageal reflux disease (GORD) are often studied, but remain a subject of debate. It has been clearly shown that there is a relationship between the extra-oesophageal symptoms chronic cough, asthma, laryngitis and dental erosion and GORD. Literature is abundant concerning reflux-related cough and reflux-related asthma, but much less is known about reflux-related dental erosions. The prevalence of dental erosion in GORD and vice versa, the prevalence of GORD in patients with dental erosion is high but the exact mechanism of reflux-induced tooth wear erosion is still under review.
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640615575972
      Issue No: Vol. 3, No. 2 (2015)
  • Endoscopic mucosal resection of large colorectal adenomas: Only for expert
    • Authors: Anders, M; Rosch, T.
      Pages: 171 - 173
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640615577535
      Issue No: Vol. 3, No. 2 (2015)
  • Gastro-oesophageal reflux is common in oligosymptomatic patients with
           dental erosion: A pH-impedance and endoscopic study
    • Authors: Wilder-Smith, C. H; Materna, A, Martig, L, Lussi, A.
      Pages: 174 - 181
      Abstract: Background Dental erosion is a complication of gastro-oesophageal reflux disease (GORD) according to the Montreal consensus statement. However, GORD has not been comprehensively characterized in patients with dental erosions and pH-impedance measures have not been reported. Objectives Characterize GORD in patients with dental erosions using 24-h multichannel intraluminal pH-impedance measurements (pH-MII) and endoscopy. Methods This single-centre study investigated reflux in successive patients presenting to dentists with dental erosion using pH-MII and endoscopy. Results Of the 374 patients, 298 (80%) reported GORD symptoms
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640614550852
      Issue No: Vol. 3, No. 2 (2015)
  • Incidence and distribution of coeliac disease in Campania (Italy):
    • Authors: Zingone, F; West, J, Auricchio, R, Maria Bevilacqua, R, Bile, G, Borgheresi, P, Erminia Bottiglieri, M, Caldore, M, Capece, G, Cristina Caria, M, Crudele, A, Cuomo, R, Lucia Garofano, M, Giardullo, N, Gerarda Gravina, A, Greco, L, Iannotta, P, Kosova, P, Lamanda, R, Malamisura, B, Marmo, R, Napoli, G, Nardone, G, Pacelli, M, Pascarella, F, Riccio, E, Riegler, G, Rispo, A, Rocco, A, Romano, M, Saffiotti, O, Saviano, P, Sorrentini, I, Speranza, P, Tolone, C, Tortora, R, Troncone, R, Ciacci, C.
      Pages: 182 - 189
      Abstract: Background There exists a wide variation in the reported incidence of coeliac disease in recent decades. We aimed to evaluate the incidence rate of coeliac diagnoses performed in an Italian region, Campania, between 2011 and 2013 and its variation therein. Methods All coeliac diagnoses made from 2011 to 2013 and registered within the Campania coeliac disease register (CeliacDB) were identified. Incidence rates were analysed by sex, age and province of residence, with a Poisson model fitted to determine incidence rate ratios. Results We found 2049 coeliac disease diagnoses registered in the CeliacDB between 2011 and 2013; 1441 of these patients were female (70.4%) and 1059 were aged less than 19 years (51.7%). The overall incidence of coeliac disease in Campania was 11.8 per 100,000 person-years (95% CI 11.3–12.3) during the study period, with marked variation by age [27.4 per 100,000 person-years (95% CI 25.8–29.1) in children under 19 years of age and 7.3 per 100,000 (95% CI 6.8–7.8) in adults] and sex [16.1 per 100,000 person-years in females (95% CI 15.3–16.9) and 7.2 per 100,000 person-years in males (95% CI 6.6–7.8)]. Coeliac disease incidence was roughly similar in Naples, Salerno, Caserta and Avellino, but about half in Benevento. More than 80% of our study population was diagnosed by the combination of positive antitransglutaminase IgA and Marsh 3. More than half of the patients were symptomatic at the time of coeliac disease diagnosis (39.7% had a classical presentation and 21.1% a non-classical one according to the Oslo definition). Conclusions Coeliac disease incidence was roughly similar among Campania provinces, except in Benevento where it was about half, probably due to less awareness of coeliac disease in this area. The incidence of coeliac disease in Campania appears to be lower than that reported by most of the previous literature, suggesting the necessity of new coeliac awareness programmes.
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640615571021
      Issue No: Vol. 3, No. 2 (2015)
  • Prevalence estimation of celiac disease in the general adult population of
           Latvia using serology and HLA genotyping
    • Authors: Leja, M; Shums, Z, Nikitina-Zake, L, Gavars, M, Kikuste, I, Milo, J, Daugule, I, Pahomova, J, Pirags, V, Dzerve, V, Klovins, J, Erglis, A, Norman, G. L.
      Pages: 190 - 199
      Abstract: Background Prevalence estimates for celiac disease (CD) depend on the method used. The role of deamidated gliadin peptide (DGP) and genetic testing in epidemiological studies and diagnostic settings of celiac disease (CD) has still to be established. Objectives The objective of this article is to assess the prevalence of CD in Latvia by combining serological tests with DQ2.5/DQ8 testing. Methods A total of 1444 adults from a randomly selected cross-sectional general population sample were tested by ELISA for tTG IgA, DGP IgA and IgG antibodies (QUANTA Lite®, Inova Diagnostics Inc). Samples with tTG IgA ≥20U were tested for EMA IgA by indirect immunofluorescence assay, and all specimens with tTG IgA ≥15U were tested by QUANTA-Flash® chemiluminescent assays (CIA) (Inova Diagnostics Inc) for tTG IgA, DGP IgA and IgG. DQ2.5/8 was detected in individuals with any positive ELISA test and a subgroup of controls. Results Forty-three individuals (2.98%; 95% CI: 2.10–3.86%) tested positive by at least one ELISA test; 41.86% of the serology-positive individuals (any test above the cutoff) were DQ positive. Six individuals (0.42%; 95% CI: 0.09–0.75%) were triple ELISA positive, and DQ2.5 or DQ8 was positive in all; 0.35% (95% CI: 0.05–0.65%) were tTG IgA and EMA positive. Two tTG IgA-negative cases were both DGP IgG and IgA positive, both being DQ positive; including them in the "serology-positive" group would increase the prevalence to 0.49% (95% CI: 0.13–0.85%). CIA tests revealed 2 tTG IgA-positive and EMA-negative cases with a positive genotype. DQ2.5 or DQ8 genotype was positive in 28.6% of the serology-negative population. Conclusions Estimates of the prevalence of CD in Latvia based on the serogenetic testing approach range from 0.35% to 0.49% depending on the criteria used. There is a rationale for combining serological tests and DQ2.5/8 genotyping.
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640615569379
      Issue No: Vol. 3, No. 2 (2015)
  • Efficacy and cost-effectiveness of screening colonoscopy according to the
           adenoma detection rate
    • Authors: Hassan, C; Rex, D. K, Zullo, A, Kaminski, M. F.
      Pages: 200 - 207
      Abstract: Background The adenoma detection rate of the endoscopist has been related to the post-colonoscopy interval risk of colorectal cancer. Objective The objective of this article is to estimate the impact of adenoma detection rate on the long-term colorectal cancer prevention rate. Methods A Markov model was constructed to simulate the efficacy and cost of colonoscopy screening according to the adenoma detection rate of the endoscopist in 100,000 individuals. Post-colonoscopy interval colorectal cancer risk and the relative risk of interval cancer among endoscopists with different adenoma detection rates were extracted from the literature. A 1.5 relative risk was assumed between endoscopists with low and average adenoma detection rates, and a relative risk of 11 between those with average and high adenoma detection rates. Both efficacy and costs were projected over a steady-state American population. Results Screening colonoscopy performed by endoscopists with low adenoma detection rates resulted in a 7% absolute reduction in the long-term colorectal cancer incidence prevention rate as compared to the same procedure performed by those with an average adenoma detection rate (70% vs. 77%). This difference increased to 21% when comparing endoscopists with an average with those with a high adenoma detection rate. When projected on the US population, this reduced efficacy resulted in an additional 1728 and 16,123 colorectal cancer cases and the loss of $117 million and $906 million per year in the two scenarios, respectively. These estimates were sensitive to the risk of post-colonoscopy interval colorectal cancer. Conclusions A substantial reduction in long-term colorectal cancer prevention rate may be expected when screening colonoscopy is performed by endoscopists with a suboptimal adenoma detection rate. A substantial saving may be expected when implementing policies to improve endoscopist adenoma detection rate.
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640614565199
      Issue No: Vol. 3, No. 2 (2015)
  • Increasing ultraviolet light exposure is associated with reduced mortality
           from Clostridium difficile infection
    • Authors: Govani, S. M; Waljee, A. K, Stidham, R. W, Higgins, P. D.
      Pages: 208 - 214
      Abstract: Background Clostridium difficile infection (CDI) is an increasingly common cause of inpatient mortality. Vitamin D deficiency is associated with more aggressive CDI. We aimed to determine if average annual ultraviolet light (UV) exposure was associated with mortality in patients with CDI. Methods We used the US National Inpatient Sample (NIS) from 2004–2011 to assess the mortality risk in patients with a diagnosis of CDI (as per ICD-9CM 008.45). Annual average state UV exposure was assigned to each hospitalization. Logistic regression was used to determine the effects of UV exposure on mortality, controlling for age, gender, race and other comorbidities. Results During the study period, there were 2.61 million hospitalizations with a diagnosis of CDI. The mortality rate was 9.0%. In univariate analysis, the odds ratio (OR) of inpatient mortality for the UV index was 0.97 (95% CI 0.95–0.99; p = 0.008) per unit of UV exposure. In a multivariable model adjusting for age, gender, race, Charlson-Deyo index, season and coexisting inflammatory bowel disease, the UV index remained a protective predictor, with an OR of 0.94 (95% CI 0.92–0.96; p < 0.001). In the multivariate model, a seasonal effect was also present, with the highest risk of inpatient mortality in the period from January to March (OR 1.11; 95% CI 1.08–1.14) and the lowest risk, from July to September (OR 0.95; 95% CI 0.92–0.98). Conclusions An increase in UV exposure index is associated with a reduced risk of inpatient mortality in patients with CDI. A seasonal effect is also present, with the highest risk of death during winter months. Further studies exploring the role of UV light in CDI are necessary.
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640614567185
      Issue No: Vol. 3, No. 2 (2015)
  • How GI practice can benefit from social media
    • Authors: IBRAHIM M.
      Pages: 215 - 215
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640615578074
      Issue No: Vol. 3, No. 2 (2015)
  • The past, present and future of gastroenterology in Europe and worldwide
    • Authors: Fichna, J; Serra, J.
      Pages: 217 - 217
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640615578075
      Issue No: Vol. 3, No. 2 (2015)
  • UEG Week Barcelona 2015 - the place to be for clinicians and researchers
    • Pages: 218 - 218
      PubDate: 2015-03-30T08:40:40-07:00
      DOI: 10.1177/2050640615578076
      Issue No: Vol. 3, No. 2 (2015)
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