Gastroenterology (all articles)

Have a🔎at our latest comprehensive review covering all u need to know📜about hereditary 🧬colorectal, gastric & pancreatic🦀! https://t.co/y1LL0DNRiy @Adductor @DrRABurkhart #SoMe4Surgery #StepUp4CRC #SurgEd #MedTwitter @BJSAcademy @BJSurgery @juliomayol @young_bjs Great read! pic.twitter.com/JmmOmMBydO

— BJS Open (@BjsOpen) May 11, 2023

Podcast | Dysphagia pearls

18 May, 2023 | 13:42h | UTC

#395 Dysphagia with Dr. Diana Snyder – The Curbsiders

RCT | Per-oral endoscopic myotomy outperforms pneumatic dilation for post-laparoscopic heller myotomy achalasia

16 May, 2023 | 14:36h | UTC

The Efficacy of Peroral Endoscopic Myotomy vs Pneumatic Dilation as Treatment for Patients With Achalasia Suffering From Persistent or Recurrent Symptoms After Laparoscopic Heller Myotomy: A Randomized Clinical Trial – Gastroenterology

RCT | Prophylactic antibiotics show no statistically significant survival improvement in severe alcohol-related hepatitis

15 May, 2023 | 13:21h | UTC

Summary: This multicenter, randomized, double-blind clinical trial aimed to determine the efficacy of amoxicillin-clavulanate combined with prednisolone compared to placebo combined with prednisolone on mortality in patients hospitalized with severe alcohol-related hepatitis. The study involved 284 patients from 25 centers in France and Belgium with biopsy-proven severe alcohol-related hepatitis, who were followed up for 180 days.

The primary outcome was all-cause mortality at 60 days, while secondary outcomes included mortality at 90 and 180 days, infection rates, hepatorenal syndrome, and changes in Model for End-stage Liver Disease (MELD) and Lille scores. The results showed no statistically significant difference in 60-day mortality between the two groups, with 17.3% in the amoxicillin-clavulanate group and 21.3% in the placebo group. However, infection rates at 60 days were significantly lower in the amoxicillin-clavulanate group compared to the placebo group.

It is worth noting that the study may have been underpowered, as the absolute risk difference of 4% did not achieve statistical significance. In conclusion, the combination of amoxicillin-clavulanate and prednisolone did not show a statistically significant improvement in 2-month survival in patients hospitalized with severe alcohol-related hepatitis compared to prednisolone alone. These findings do not support the use of prophylactic antibiotics to improve survival in this patient population, but the potential underpowered nature of the study should be considered.

Article: Effect of Prophylactic Antibiotics on Mortality in Severe Alcohol-Related Hepatitis: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

Commentary on Twitter

Among patients with severe alcohol-related #hepatitis receiving prednisolone, amoxicillin-clavulanate did not improve survival at 60-day follow-up compared with placebo. https://t.co/4XkVL2CTsP #DDW pic.twitter.com/9sh5vennkK

— JAMA (@JAMA_current) May 9, 2023

APASL clinical practice guidance: the diagnosis and management of patients with primary biliary cholangitis – Hepatology International

A consensus integrated care pathway for patients with primary biliary cholangitis.

Biliary Endoscopy in the Management of Primary Sclerosing Cholangitis and its Complications

Review | Diagnosis and management of cirrhosis and its complications

10 May, 2023 | 16:06h | UTC

Diagnosis and Management of Cirrhosis and Its Complications: A Review – JAMA (free for a limited period)

Author Interview: Management of Cirrhosis in 2023

Guideline | Use of non-invasive biomarkers for diagnosis of colorectal neoplasia

10 May, 2023 | 15:46h | UTC

Joint Asian Pacific Association of Gastroenterology (APAGE)–Asian Pacific Society of Digestive Endoscopy (APSDE) clinical practice guidelines on the use of non-invasive biomarkers for diagnosis of colorectal neoplasia – Gut

Study shows unenhanced CT shows 30% lower diagnostic accuracy in abdominal pain evaluation

9 May, 2023 | 15:02h | UTC

Diagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department – JAMA Surgery (free for a limited period)

Editorial: Intravenous Contrast in Computed Tomography Imaging for Acute Abdominal Pain – JAMA Surgery (free for a limited period)

News Release: Bypassing contrast in patients with kidney disease and contrast allergies may lead to less accurate scans – University of Michigan

Commentary: New data suggest clinicians should think twice before foregoing contrast-enhanced imaging – Health Imaging

Commentary on Twitter

In a general population of emergency department patients with abdominal pain, using unenhanced CT to avoid risks of intravenous contrast medium administration is associated with a large diagnostic penalty. https://t.co/CVg04763yd

— JAMA Surgery (@JAMASurgery) May 3, 2023

Summary: Stool transplantation for treatment of repeated Clostridioides difficile infection – Cochrane Library

Commentaries:

Cochrane study finds stool transplants more effective than antibiotics for treating recurring, life-threatening gut infections – Cochrane Library

Expert reaction to two Cochrane reviews looking at stool transplants for recurrent Clostridium difficile infection, and for inflammatory bowel disease – Science Media Centre

Fecal microbiota transplant: Effective solution for recurrent C. difficile infections – News Medical

Long-term safety of fecal microbiota transplantation for recurrent Clostridioides difficile infection

Commentary on Twitter

💩 Stool transplantation for treatment of repeated Clostridioides difficile infection
🔎 #SystematicReview looked at the evidence from 6 clinical trials
🌟 'More effective than antibiotics for treating recurring, life-threatening gut infections' https://t.co/NHSZYWccoN pic.twitter.com/q8kRVExvMg

— The Cochrane Library (@CochraneLibrary) April 28, 2023

Consensus definition of sludge and microlithiasis as a possible cause of pancreatitis

3 May, 2023 | 15:22h | UTC

Consensus definition of sludge and microlithiasis as a possible cause of pancreatitis – Gut

RCT | High vs. low target mean arterial pressure in patients with cirrhosis and septic shock

3 May, 2023 | 15:01h | UTC

A randomized-controlled trial (TARGET-C) of high vs. low target mean arterial pressure in patients with cirrhosis and septic shock – Journal of Hepatology

Cohort Study | Overweight or obesity in early and middle adulthood linked to higher gastrointestinal cancer risk

AASLD-IDSA Guideline | Updated 2023 recommendations for the testing, management, and treatment of Hepatitis C virus infection

SR | Systematic review finds 16.4-36.18 severe bleedings, 7.62-8.5 perforations per 10,000 colonoscopies

RCT | JAK inhibitor Upadacitinib shows superiority over placebo for moderate-to-severe Crohn’s disease

Guidelines | Management of ascites in liver disease

AASLD practice guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma

Liver cystic echinococcosis: a parasitic review

AGA/ACG Guideline | Pharmacological management of chronic idiopathic constipation

Review | Hereditary colorectal, gastric, and pancreatic cancer

Podcast | Dysphagia pearls

RCT | Per-oral endoscopic myotomy outperforms pneumatic dilation for post-laparoscopic heller myotomy achalasia

RCT | Prophylactic antibiotics show no statistically significant survival improvement in severe alcohol-related hepatitis

Review | Heart failure and liver disease: cardiohepatic interactions

Review | Nonalcoholic fatty liver disease from a primary care perspective

Recent advances in the management of primary sclerosing cholangitis

Review | Diagnosis and management of cirrhosis and its complications

Guideline | Use of non-invasive biomarkers for diagnosis of colorectal neoplasia

Study shows unenhanced CT shows 30% lower diagnostic accuracy in abdominal pain evaluation

Review | The global burden of liver disease

Review | Identifying, understanding and managing fecal urgency in inflammatory bowel diseases

Review | Carvedilol as the new non-selective beta-blocker of choice in patients with cirrhosis and portal hypertension

Review | Lynch syndrome genetics and clinical implications

SR | Fecal microbiota transplantation effective in recurrent C. difficile treatment

Consensus definition of sludge and microlithiasis as a possible cause of pancreatitis

RCT | High vs. low target mean arterial pressure in patients with cirrhosis and septic shock

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