EoE – Recent Developments in Diagnosis & Treatment: Dietary treatment: chances and limitations
The most important facts summarized: • Dietary therapy can be beneficial for a certain group of EoE-patients • The best results are achieved with an amino-acid-based elemental diet, which, however, is hard to follow in the long run • More practical is an elimination diet with the exclusion of up to six food groups • A targeted elimination of foods after allergy testing shows the least satisfying results • Dr. Lucendo recommends a step-wise and endoscopically monitored step-up elimination diet where initially two food groups are removed, followed by four...
Bowel
Biomarker for Crohn’s disease:
An observational genome-wide association study found a highly significant association between HLA-DQA1*05 and the development of antibodies against anti-TNF agents. Testing for this allele may therefore be useful to predict patient outcomes and to select anti-TNF and combination therapies.
Peppermint oil to treat irritable bowel syndrome:
Neither small-intestinal release nor ileocolonic-release peppermint oil for 8 weeks produced statistically significant reductions in abdominal pain response or overall symptom relief in a randomized trial.
Timing of endoscopy in patients with acute lower gastrointestinal bleeding:
Colonoscopy within 24 hours after hospital admission does not increase the detection of stigmata of recent hemorrhage and did not reduce the rebleeding rates as compared to elective colonoscopy within 24–96 hours.
Liver
Hepatocellular carcinoma (HCC):
Survival in patients with HCC has improved significantly over the past 20 years. Screening programs are likely to be responsible for this development, since these lead to diagnosis in earlier tumor stages and thus allow better treatment options. However, survival in patients with metastasis when diagnosed has not improved.
Primary sclerosing cholangitis (PSC):
The risk estimate tool “PREsTo” accurately predicts hepatic decompensation (HD) in PSC and exceeds the performance among other widely available, non-invasive prognostic scoring systems. It consists of 9 variables: bilirubin, albumin, alkaline phosphatase, platelets, aspartate aminotransferase (AST), hemoglobin, sodium, patient age, and number of years since PSC was diagnosed.
Chronic hepatitis B and non-alcoholic steatohepatitis (NASH):
A current cohort study confirms the negative impact of an additional NASH on the course of chronic hepatitis B. Almost every 5. patient with chronic hepatitis B also has a NASH; these patients have a significantly increased risk of advanced fibrosis, hepatocellular carcinoma and death.
Oesophagus
Celiac disease autoimmunity in adults:
Analysis of serum samples collected from a community hospital over 8.8 years reveals that less than 1% of adults with negative tissue transglutaminase antibodies (tTGA) develop such antibodies over time. Among persons with positive tTGA (celiac disease autoimmunity), less than 20% develop celiac disease over time.
Novel endoscopic therapy for type 2 diabetes mellitus:
Endoscopic duodenal mucosal resurfacing was found to be a safe and feasible endoscopic procedure that elicited durable glycemic improvement in suboptimally controlled type 2 diabetes patients.
Helicobacter pylori infection and gastric cancer risk:
Results of a randomized trial indicate that eradication therapy strongly reduces the risk to develop gastric cancer in persons with H. pylori infection and first-degree relatives with gastric cancer.
Pancreas
Risk for pancreatic cancer in patients with branch-duct intraductal papillary mucinous neoplasia (IPMN):
A large observational trial indicates that the incidence of pancreatic cancer is 3.3% after 5 years and 15% after 15 years.
Current Falk literature
Download: GastroScope Symposium 216
GastroScope Symposium 216 Building Bridges in IBD Brussels (Belgium) September 13 – 14, 2019 Issue 02/2019 (22 Seiten) GS216e
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