Gastroenterology

Background: The incidence of microscopic colitis (MC) is increasing, but its etiology remains unknown. Case reports and limited controlled data suggest that commonly prescribed drugs may be triggers. The aim of this study was to evaluate the prevalence of selected medication use [Proton pump inhibitors (PPIs), HMG-CoA reductase inhibitors...

Functional Dyspepsia (FD) is a common affliction in western countries effecting approximately 25% of the population. Due to its heterogeneous pathogenesis, effective therapeutics are limited. Mosapride, a serotonin receptor agonist with enterokinetic properties, has been evaluated for treating dyspeptic symptoms in a limited number of clinical trials. Most trials found...

Esomeprazole (S-omeprazole) is a single optical enantiomer proton-pump inhibitor (PPI) approved for the management of gastro-oesophageal reflux disease, the prevention and treatment of Non-Steroidal Anti-Inflammatory Drugs (NSAID) associated gastric ulcer disease, treatment of duodenal ulcer disease associated with Helicobacter pylori infection, and the treatment of Zollinger- Ellison syndrome. Esomeprazole has...

The past decade has brought great change to the treatment of pediatric Crohn’s disease. The majority of affected patients now receive therapy directed at the underlying immune dysregulation that is associated with this chronic disease. The monoclonal antibodies directed against tumor necrosis factor alpha play an increasing role in such...

Background: We have previously reported on a Phase II study of S-1 monotherapy as a first line, combination therapy of S-1 plus cisplatin as a second line, and weekly paclitaxel monotherapy as a third line therapy in patients with advanced gastric carcinomas. The median survival time (MST) of patients over...

Goals of treatment for ulcerative colitis (UC) include inducing remission, reducing symptom burden, and maintaining disease quiescence. Mesalamine is indicated for the management of mild to moderate ulcerative colitis. There are various dosages, formulations, and mechanisms of delivery that are efficacious and currently utilized in the treatment of UC. Mesalamine...

Aim: This study was designed to determine if there is a relationship between celiac disease (CD) and the presence of gastrointestinal disease (GI) disease in children with autism. Subjects and Methods: One hundred twenty-two children were tested for IgG and IgA anti-transglutaminase autoantibodies (55 autistic children with GI disease, 28 non...

Prokinetic drugs are being used with increasing frequency in the treatment of functional gastrointestinal disorders including functional dyspepsia (FD) and constipation-predominant Irritable Bowel Syndrome (IBS-C). Mosapride is a gastro-prokinetic agent that acts as a selective 5-HT4 agonist thereby accelerating gastric emptying. It has been used for the treatment of irritable...

Objective: The purpose of this community-based study was to determine factors associated with hepatitis B virus (HBV) screening compliance and non-compliance among Chinese, Korean, Vietnamese and Cambodian adults with varying levels of English language proficiency. Methods: A cross-sectional design was used consisting of a sample of 1,603 Asian adult men and...

Is gastrointestinal disease more prevalent in children with autism? There are arguments favoring both sides of the controversy. We present data collected from the medical history of a recent Autistic Genetic Resource Exchange (AGRE) database of autistic children and their siblings, demonstrating that autistic children may be significantly more susceptible...

Objectives: Review and summarize the mechanism of action of methylnaltrexone bromide (methylnaltrexone) and its effectiveness in the treatment of opioid-induced constipation. Data Source: A multi-database search was conducted using PubMed and MEDLINE databases, in addition to electronic links to related articles and references. Background: Opioids are effective medications for the management of...

Introductory Editorial by Dr Karna Dev Bardhan

Background: Children with developmental disorders experience chronic gastrointestinal symptoms. Aims: To examine the nature of these gastrointestinal symptoms and histologic findings in children with autism spectrum/developmental disorders and ileocolonic disease. Methods: Chart review. 143 autism spectrum/developmental disorder patients, with chronic gastrointestinal symptoms, undergoing diagnostic ileocolonoscopy. Results: Diarrhea was present...

Aim: To assess serum Cu/Zn SOD (Superoxide Dismutase) concentration in autistic children and evaluate its possible relationship to GI Symptoms. Subjects and Methods: Serum from 50 autistic children (31 with chronic digestive disease (most with ileo-colonic lymphoid nodular hyperplasia (LNH) and inflammation of the colorectum, small bowel and/or stomach) and 19...

Aim: To assess serum Hepatocyte Growth Factor (HGF) levels in autistic children with severe gastrointestinal (GI) disease and to test the hypothesis that there is a relationship between GI pathology and HGF concentration. Subjects and Methods: Serum from 29 autistic children with chronic digestive disease (symptoms for a minimum of 6–12...

Common variable immunodeficiency (CVID) is a heterogeneous group of primary immunodeficiency disorders characterized by defective antibody production, low levels of serum immunoglobulins and increased susceptibility to infection. The patient was a 39-year-old male who was admitted to the gastroenterology department with a two week history of diarrhea, blunt abdominal pain...

Dexlansoprazole MR, an enantiomer of lansoprazole, is a unique proton pump inhibitor with a duel release mechanism. This release mechanism produces two distinct peak concentrations that result in a prolonged mean residence time with increased duration of plasma concentrations and a greater percent time the pH is maintained above 4....

Thrombocytopenia is the most common hematological abnormality in patients with chronic, advanced liver disease. In these patients, the presence of severe thrombocytopenia is an obstacle to the performance of invasive diagnostic and therapeutic procedures, and the current standard treatment for these patients is platelet transfusions, a remedy whose characteristics are...

GISTs are rare neoplasms, which were recently identified to be a distinct pathologic entity. They can develop in patients with neurofibromatosis type 1 (NF1) or may be sporadic. NF1 is one of the most common inherited diseases and is a complex disease, with patients having an increased prevalence of benign...

Aim: To assess serum Anti-Neutrophil cytoplasmic Antibody (ANCA—PR3 and MPO) and Anti-Saccharomyces Cerevisiæ Antibody (ASCA) levels in autistic children with severe gastrointestinal (GI) disease and to test the hypothesis that there is generalized autoimmunity in a subpopulation of autistic children with severe GI disease and that this autoimmunity is associated...

MMXTM mesalazine is a novel delayed release mesalazine formulation with a high-strength 1.2 g tablet for the treatment of active mild to moderate colitis and maintenance of remission. In vitro and in vivo studies show initiation of drug release in the terminal ileum and caecum with gradual release of 5-ASA...

The treatment for localized advance gastrointestinal stromal tumor (GIST) is far from ideal. Up to 50% of patient developed post-operative recurrence and died within 5 years. Recently, imatinib was found to significantly improve recurrence-free survival in post-operative patients. The role of adjuvant therapy in high risk GIST patients is discussed....

Infliximab is a chimeric monoclonal antibody to human tumor necrosis factor alpha. While its use was developed in the treatment of rheumatologic diseases its effects on Crohn’s disease have revolutionized the management of this chronic illness. Infliximab has effects on both immune and epithelial cells leading to a reduction in...

Metastatic tumors to the liver resulting in fulminant hepatic failure are a rare occurrence and have not been previously described in patients with gastrointestinal stromal tumor (GIST). A 70 year-old man was referred to hospital with postprandial discomfort. On examination a 19.5 cm large epithelioid GIST of the stomach was...

Mycophenolic acid inhibits an enzyme, inosine monophosphate dehydrogenase (IMPDH), blocking purine synthesis of lymphocytes and therefore functioning as an effective immunosuppressive agent in transplantation. Currently, there are two available forms of mycophenolic acid (MPA) available; mycophenolate mofetil (MMF) and enteric-coated, delayed-release mycophenolate sodium (EC-MPS). Both products are approved for prophylaxis...

Gastroesophageal reflux disease (GERD) is very common and is a costly problem to manage. The annual direct cost for managing the disease is estimated to be more than $9 billion dollars in the USA. In western populations, 25% of people over age 30 report having heartburn at least once a...

Endoscopic papillectomy is a promising and challenging endoscopic intervention. The aim of this study was i) to classify the differential indication, and ii) to study the outcome in papillectomy of suspicious tumor lesions of the papilla of Vater (papilla). Methods: Thirty nine patients were enrolled (22 males/17 females; range of age,...

Mr. Smith is an 85-year-old nursing home patient who has suffered from dementia for the past eight years. He has been bed bound and uncommunicative for the last six months. He was admitted with aspiration pneumonia three times in the past year. Over the last few months he has lost...

Abdominal pain is one of the most common reasons why people seek medical care, and is often due to spasm of intra-abdominal visceral organs. Hyoscine butylbromide (HBB) is a quaternary ammonium compound which blocks the action of acetylcholine at parasympathetic sites (both muscarinic and nicotinic receptors) in smooth muscle, and...