Pub Date : 2023-10-06DOI: 10.33590/emjgastroenterol/10303980.
Morven Cunningham
Immune checkpoint inhibitors (ICI) are a novel class of anticancer therapy that have been transformative in treating a diverse range of cancers, extending survival in some patients, and producing significant and durable tumour responses. ICI enhance immunological responses against tumour cells by inhibiting receptor-ligand interactions in immune checkpoint pathways, which may be subverted by tumour cells to prevent their destruction by cytotoxic T cells. The two classes of ICI currently in routine clinical use are monoclonal antibodies targeting CTLA-4 and PD-L1.1,2
{"title":"Challenges in Management of Immune Checkpoint Inhibitor-Associated Hepatitis","authors":"Morven Cunningham","doi":"10.33590/emjgastroenterol/10303980.","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10303980.","url":null,"abstract":"Immune checkpoint inhibitors (ICI) are a novel class of anticancer therapy that have been transformative in treating a diverse range of cancers, extending survival in some patients, and producing significant and durable tumour responses. ICI enhance immunological responses against tumour cells by inhibiting receptor-ligand interactions in immune checkpoint pathways, which may be subverted by tumour cells to prevent their destruction by cytotoxic T cells. The two classes of ICI currently in routine clinical use are monoclonal antibodies targeting CTLA-4 and PD-L1.1,2","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"232 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135350965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-21DOI: 10.33590/emjgastroenterol/10302591.
{"title":"Preventive Medicine in Gastroenterology","authors":"","doi":"10.33590/emjgastroenterol/10302591.","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10302591.","url":null,"abstract":"","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135876855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helicobacter pylori infection can be observed with increased frequency in patients with iron deficiency anaemia (IDA), especially in resistant cases. This case report describes a case of resistant IDA that responded to probiotic (Lactobacillus reuteri DSMZ17648) and oral haeme iron polypeptide supplementation, highlighting that oral probiotic supplement trial may be considered before antibiotic therapy for H. pylori treatment in a patient with IDA.
{"title":"Severe, Refractory Anaemia Associated with Helicobacter Pylori Infection Managed With L. Reuteri DSMZ17648 (Probiotic) and Haeme Iron Supplements: A Case Report","authors":"A. Hinduja","doi":"10.33590/emj/10300357","DOIUrl":"https://doi.org/10.33590/emj/10300357","url":null,"abstract":"Helicobacter pylori infection can be observed with increased frequency in patients with iron deficiency anaemia (IDA), especially in resistant cases. This case report describes a case of resistant IDA that responded to probiotic (Lactobacillus reuteri DSMZ17648) and oral haeme iron polypeptide supplementation, highlighting that oral probiotic supplement trial may be considered before antibiotic therapy for H. pylori treatment in a patient with IDA.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87058884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-05DOI: 10.33590/emjgastroenterol/10308417
Prabhjot Kaur, D. Bhasin, T. S. Kundra
Background: Valproate-induced pancreatitis is an idiosyncratic reaction of the drug, commonly seen in the paediatric age group, between 1 week to 8 years of starting the drug. Case: The authors present a case report of a 61-year-old patient who presented with acute pancreatitis. All common causes were ruled out. The patient had a significant treatment history of taking valproate for bipolar disorder for 12 years. The patient was resuscitated with intravenous fluids and analgesics. Sodium valproate was stopped. The patient was monitored to detect early symptoms of systemic inflammatory response syndrome or any organ dysfunction or failure. The patient was sent to the ward after 4 days. The patient had a good outcome due to early diagnosis and resuscitation. Conclusion: Acute pancreatitis is a rare and potentially fatal complication in patients on valproate. After ruling out other common causes, a detailed medical and treatment history can lead to the diagnosis of this entity. Healthcare providers should be vigilant about the early signs and symptoms of pancreatitis, including acute abdomen, vomiting, and raised serum amylase and lipase.
{"title":"A Rare Complication of Valproate-Induced Acute Pancreatitis in an Adult Patient with Bipolar Disorder: A Case Report","authors":"Prabhjot Kaur, D. Bhasin, T. S. Kundra","doi":"10.33590/emjgastroenterol/10308417","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10308417","url":null,"abstract":"Background: Valproate-induced pancreatitis is an idiosyncratic reaction of the drug, commonly seen in the paediatric age group, between 1 week to 8 years of starting the drug.\u0000\u0000Case: The authors present a case report of a 61-year-old patient who presented with acute pancreatitis. All common causes were ruled out. The patient had a significant treatment history of taking valproate for bipolar disorder for 12 years. The patient was resuscitated with intravenous fluids and analgesics. Sodium valproate was stopped. The patient was monitored to detect early symptoms of systemic inflammatory response syndrome or any organ dysfunction or failure. The patient was sent to the ward after 4 days. The patient had a good outcome due to early diagnosis and resuscitation.\u0000\u0000Conclusion: Acute pancreatitis is a rare and potentially fatal complication in patients on valproate. After ruling out other common causes, a detailed medical and treatment history can lead to the diagnosis of this entity. Healthcare providers should be vigilant about the early signs and symptoms of pancreatitis, including acute abdomen, vomiting, and raised serum amylase and lipase.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72695722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-20DOI: 10.33590/emjgastroenterol/10033131
Nicola Humphry
Interdisciplinary sessions at the recent United European Gastroenterology (UEG) Week, held in Vienna, Austria, from 8th to 11th October 2022, covered new approaches to the diagnosis and treatment of gastrointestinal and hepatic disorders, with a focus on advances in the non-invasive management of these diseases. Abstract-based and poster sessions presented original research from Europe and other parts of the world. This review summarises selected data presented in the fields of inflammatory bowel disease (IBD), disorders of gut–brain interaction (DGBI), gastro-oesophageal reflux disease (GORD), and disorders of the pancreas. Previously termed functional gastrointestinal disorders, the Rome Foundation is gradually moving toward the use of DGBI in place of functional gastrointestinal disorders to avoid stigma. Cristina Rubín de Célix, Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain, described a systematic review and meta-analysis of real-world evidence for ustekinumab in the treatment of Crohn’s disease. Regarding irritable bowel syndrome (IBS), Salvatore Crucillà, Gastroenterology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Italy, showed that following a Mediterranean diet resulted in symptom improvement and faecal microbiota changes in patients with constipation-predominant IBS. Fiona Kinnear, Novozymes A/S, Cork, Ireland, reported patients’ experiences of probiotics for IBS. Tatyana Kugler, Department of Internal Medicine, Donetsk National Medical University, Ukraine, discussed quality of life (QoL) in patients with functional dyspepsia (FD), and Ayesha Shah, Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, and Faculty of Medicine and Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia, considered the impact of a diagnosis of more than one DGBI. James White, Medscape Global Education, London, UK, considered the impact of continuing medical education (CME) on confidence in the management of GORD. Additionally, Peter Macinga, Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czechia, provided evidence that chronic pancreatitis is associated with an alteration in the gut microbiota, and Joakim Svahn, Viatris AB, Stockholm, Sweden, described the use of a patient support programme (PSP) in patients prescribed pancreatic enzyme replacement therapy (PERT) for pancreatic exocrine insufficiency (PEI).
最近于2022年10月8日至11日在奥地利维也纳举行的欧洲胃肠病学联合周(UEG)上的跨学科会议涵盖了胃肠道和肝脏疾病诊断和治疗的新方法，重点是这些疾病的非侵入性管理方面的进展。摘要和海报会议介绍了来自欧洲和世界其他地区的原创研究。本文综述了炎症性肠病(IBD)、肠脑相互作用障碍(DGBI)、胃食管反流病(GORD)和胰腺疾病领域的精选数据。以前被称为功能性胃肠疾病，罗马基金会正在逐步转向使用DGBI代替功能性胃肠疾病，以避免污名化。西班牙公主大学医院消化内科、Investigación公主卫生研究所(IIS-Princesa)、Autónoma马德里大学(UAM)和Investigación de biomdica en Red de Enfermedades Hepáticas y消化道研究中心(CIBEREHD)的Cristina Rubín de c，西班牙，对ustekinumab治疗克罗恩病的真实证据进行了系统回顾和meta分析。关于肠易激综合征(IBS)，意大利维罗纳整合大学消化科的Salvatore crucillou研究表明，在以便秘为主的IBS患者中，遵循地中海饮食可导致症状改善和粪便微生物群改变。Fiona Kinnear, Novozymes A/S, Cork, Ireland，报道了患者使用益生菌治疗肠易激综合征的经历。乌克兰顿涅茨克国立医科大学内科医学系Tatyana Kugler讨论了功能性消化不良(FD)患者的生活质量(QoL)，布里斯班亚历山德拉公主医院消化科和肝病科Ayesha Shah以及澳大利亚布里斯班昆士兰大学医学院和健康与行为科学学院考虑了诊断不止一种DGBI的影响。James White, Medscape Global Education，伦敦，英国，考虑了继续医学教育(CME)对GORD管理信心的影响。此外，捷克布拉格临床和实验医学研究所胃肠病学和肝病科的Peter Macinga提供了慢性胰腺炎与肠道微生物群改变相关的证据，瑞典斯德哥尔摩Viatris AB公司的Joakim Svahn描述了在处方胰腺外分泌功能不全(PEI)的胰腺酶替代疗法(PERT)患者中使用患者支持计划(PSP)的情况。
{"title":"Recent Advances in the Management of Gastrointestinal Disease","authors":"Nicola Humphry","doi":"10.33590/emjgastroenterol/10033131","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10033131","url":null,"abstract":"Interdisciplinary sessions at the recent United European Gastroenterology (UEG) Week, held in Vienna, Austria, from 8th to 11th October 2022, covered new approaches to the diagnosis and treatment of gastrointestinal and hepatic disorders, with a focus on advances in the non-invasive management of these diseases. Abstract-based and poster sessions presented original research from Europe and other parts of the world. This review summarises selected data presented in the fields of inflammatory bowel disease (IBD), disorders of gut–brain interaction (DGBI), gastro-oesophageal reflux disease (GORD), and disorders of the pancreas. Previously termed functional gastrointestinal disorders, the Rome Foundation is gradually moving toward the use of DGBI in place of functional gastrointestinal disorders to avoid stigma. Cristina Rubín de Célix, Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain, described a systematic review and meta-analysis of real-world evidence for ustekinumab in the treatment of Crohn’s disease. Regarding irritable bowel syndrome (IBS), Salvatore Crucillà, Gastroenterology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Italy, showed that following a Mediterranean diet resulted in symptom improvement and faecal microbiota changes in patients with constipation-predominant IBS. Fiona Kinnear, Novozymes A/S, Cork, Ireland, reported patients’ experiences of probiotics for IBS. Tatyana Kugler, Department of Internal Medicine, Donetsk National Medical University, Ukraine, discussed quality of life (QoL) in patients with functional dyspepsia (FD), and Ayesha Shah, Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, and Faculty of Medicine and Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia, considered the impact of a diagnosis of more than one DGBI. James White, Medscape Global Education, London, UK, considered the impact of continuing medical education (CME) on confidence in the management of GORD. Additionally, Peter Macinga, Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czechia, provided evidence that chronic pancreatitis is associated with an alteration in the gut microbiota, and Joakim Svahn, Viatris AB, Stockholm, Sweden, described the use of a patient support programme (PSP) in patients prescribed pancreatic enzyme replacement therapy (PERT) for pancreatic exocrine insufficiency (PEI).","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88314237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-19DOI: 10.33590/emjgastroenterol/10023216
Nicola Humphry
Excess production of TNF-α leads to chronic inflammation and tissue damage in immune-mediated inflammatory diseases (IMID) such as Crohn’s Disease (CD), rheumatoid arthritis, and psoriasis. The introduction of anti-TNF agents revolutionised therapy for patients with IMIDs, and two anti-TNFs are currently approved for use in CD in Europe: infliximab and adalimumab. The chronic transmural inflammation associated with CD commonly leads to intestinal complications such as intra-abdominal abscesses, which present a challenge to a multidisciplinary medical team. While surgical management may ultimately be required in some patients, it is associated with a risk of morbidity and loss of function, particularly in a patient who requires immunosuppression to address their underlying CD. This mini review summarises the current evidence surrounding the use of anti-TNFs in CD complicated by intra-abdominal abscess, including current treatment guidelines, the use of anti-TNFs in combination with conservative (non-surgical) management, and the impact of anti-TNFs on post-operative complications and abscess recurrence.
{"title":"Anti-TNF Treatment in Crohn’s Disease Complicated by Intra-abdominal Abscess","authors":"Nicola Humphry","doi":"10.33590/emjgastroenterol/10023216","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10023216","url":null,"abstract":"Excess production of TNF-α leads to chronic inflammation and tissue damage in immune-mediated inflammatory diseases (IMID) such as Crohn’s Disease (CD), rheumatoid arthritis, and psoriasis. The introduction of anti-TNF agents revolutionised therapy for patients with IMIDs, and two anti-TNFs are currently approved for use in CD in Europe: infliximab and adalimumab. The chronic transmural inflammation associated with CD commonly leads to intestinal complications such as intra-abdominal abscesses, which present a challenge to a multidisciplinary medical team. While surgical management may ultimately be required in some patients, it is associated with a risk of morbidity and loss of function, particularly in a patient who requires immunosuppression to address their underlying CD. This mini review summarises the current evidence surrounding the use of anti-TNFs in CD complicated by intra-abdominal abscess, including current treatment guidelines, the use of anti-TNFs in combination with conservative (non-surgical) management, and the impact of anti-TNFs on post-operative complications and abscess recurrence.","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87814978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-22DOI: 10.33590/emjgastroenterol/10181909
Robin Stannard
IN A symposium session presented at United European Gastroenterology (UEG) Week 2022, experts delved into the challenges presented by Clostridium difficile infection (CDI) and the opportunity that faecal microbiota transplants (FMT) can provide. Benjamin Mullish, Gastroenterology and Hepatology Division of Digestive Diseases, Imperial College London, UK, and Georgiana-Emmanuela Gîlcă-Blanariu, Grigore T. Popa University of Medicine and Pharmacy, Iași, Romania, shared novel research and real-world experience. The symposium examined all aspects of CDI from the importance of understanding pathways of pathophysiology to the logistical challenges that pioneering an FMT clinic can prese
在联合欧洲胃肠病学(UEG) 2022周的一次研讨会上，专家们深入探讨了艰难梭菌感染(CDI)带来的挑战以及粪便微生物群移植(FMT)可以提供的机会。英国伦敦帝国理工学院消化疾病胃肠病学和肝病科的Benjamin Mullish和罗马尼亚Grigore T. Popa医学和药学大学Iași的Georgiana-Emmanuela g lc - blanariu分享了新的研究和现实世界的经验。研讨会考察了CDI的各个方面，从理解病理生理学途径的重要性到开创FMT诊所可能面临的后勤挑战
{"title":"Challenges and Opportunities for Treating Clostridium difficile in 2022","authors":"Robin Stannard","doi":"10.33590/emjgastroenterol/10181909","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10181909","url":null,"abstract":"IN A symposium session presented at United European Gastroenterology (UEG) Week 2022, experts delved into the challenges presented by Clostridium difficile infection (CDI) and the opportunity that faecal microbiota transplants (FMT) can provide. Benjamin Mullish, Gastroenterology and Hepatology Division of Digestive Diseases, Imperial College London, UK, and Georgiana-Emmanuela Gîlcă-Blanariu, Grigore T. Popa University of Medicine and Pharmacy, Iași, Romania, shared novel research and real-world experience. The symposium examined all aspects of CDI from the importance of understanding pathways of pathophysiology to the logistical challenges that pioneering an FMT clinic can prese","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78980460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-22DOI: 10.33590/emjgastroenterol/10163417
Mina Soliman, K. Kapur
{"title":"Barrett’s Oesophagus Surveillance: Can We Do Better?","authors":"Mina Soliman, K. Kapur","doi":"10.33590/emjgastroenterol/10163417","DOIUrl":"https://doi.org/10.33590/emjgastroenterol/10163417","url":null,"abstract":"","PeriodicalId":92504,"journal":{"name":"EMJ. Gastroenterology","volume":"367 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76589957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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