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[Diseases and diagnosis of the biliary system : When does the gastroenterologist need the radiologist?].

CLINICAL ISSUE: Biliary diseases require fast and rational use of diagnostic tests by both gastroenterologists and radiologists. STANDARD TREATMENT: Standard diagnostic workup includes transabdominal ultrasound, endoscopic retrograde cholangiography (ERC), endoscopic ultrasound, direct cholangioscopy, magnetic resonance cholangiopancreatography (MRI/MRCP), and computed tomography (CT). TREATMENT INNOVATIONS: Modular cholangioscopy is a novel diagnostic method. DIAGNOSTIC WORK-UP: The goal of diagnostic examinations is the determination of the location of obstructions and differentiation of …

Gastrointestinal diseases during pregnancy: what does the gastroenterologist need to know?

Pregnancy is characterized by numerous physiological changes that may lead to a diversity of symptoms and frequently to gastrointestinal com … y-to-day practice, knowledge of pregnancy-related diseases is fundamental and collaboration between gastroenterologists and obstetricians is often necessary. Herein, we review pregnancy-related diseases and systematize the most appropriate treatment choices according to the recent literature and guidelines, so that the article can serve as a guide to the gastroentero …

New and emerging therapies for the treatment of irritable bowel syndrome: an update for gastroenterologists.

Irritable bowel syndrome is a functional bowel disorder with gastrointestinal symptoms (e.g. abdominal pain, straining, urgency, incomplete evacuation, nausea, and bloating) that occur alongside bowel function alterations (i.e. constipation, diarrhea, or both). Patients with irritable bowel syndrome may also experience comorbid anxiety and depression. Irritable bowel syndrome is common, with a prevalence estimated between 3% and 28%, affecting patient health and quality of life. Patients with moderate or severe irritable bowel syndrome generally seek medical care, whereas those with milder sym

Quality assessment of colonoscopy in Flanders: a voluntary survey among Flemish gastroenterologist.

Colonoscopy is an important endoscopic examination for the diagnosis and treatment of pathological conditions of the colon, like polyps and colorectal cancer. However, several factors determine the quality of colonoscopy and thus the quality of polyp and colorectal cancer detection. The Flemish Society of Gastroenterology (VVGE) performed a voluntary on-line registry among its members to identify quality of colonoscopy in Flanders, Belgium. 64 gastroenterologists voluntarily registered 4276 consecutive colonoscopies performed during a 3 month study period. Colonoscopy quality indicators were p…

The liver involvement of the hydatid disease: a systematic review designed for the hepato-gastroenterologist.

Hydatidosis is not uncommon in Western Europe, mainly due to the presence of immigrants from endemic countries, and hepato-gastroenterologist must then be able to manage this infectious disease. The hepatic hydatidosis is due to development in the liver of the larvae of Echinococcus granulosus that causes liver cysts. It can grow in size throughout the years and can give rise to complications, mainly pain, super-infection or cyst rupture. Recent progresses in imaging modalities play an important role in diagnosis, classification and evaluation of response to treatment of the cysts. Imaging tec

Food allergy testing in eosinophilic esophagitis: what the gastroenterologist needs to know.

Eosinophilic esophagitis (EoE) is a clinicopathologic disease of increasing prevalence in children and adults. The triggering antigen in EoE … bject by an allergist, consideration for allergy testing, and an integrated approach by allergists, gastroenterologists, and pathologists in EoE management.

Massive ascites as the initial manifestation of mantle cell lymphoma: a challenge for the gastroenterologist.

Involvement of the serosa may be the presenting feature in a wide and complex variety of lymphoproliferative diseases, with differing clinical outcomes covering a spectrum of benign and malignant conditions. Effusions involving peritoneal and pericardial cavities are uncommon during the course of hematological malignancies. Obstructive and/or infiltrative tumor mass or vascular leakage due to stimulation by vascular endothelial growth factor contribute to the pathogenesis. In addition to clinical findings, cytomorphology and flow cytometric immunophenotyping of the serosal fluid yield valuable

What every gastroenterologist needs to know about common anorectal disorders.

Anorectal complaints are very common and are caused by a variety of mostly benign anorectal disorders. Many anorectal conditions may be successfully treated by primary care physicians in the outpatient setting, but patients tend not to seek medical attention due to embarrassment or fear of cancer. As a result, patients frequently present with advanced disease after experiencing significant decreases in quality of life. A number of patients with anorectal complaints are referred to gastroenterologists. However, gastroenterologists' knowledge and experience in approaching these conditions may no…

[Cooperation between a surgeon and a gastroenterologist in the management of vascular complications of the liver cirrhosis].

AIM: The aim of this work was to confirm indications for surgical procedures in cases of relapsing bleeding from oesophageal varices as a consequence of the liver cirrhosis. METHODOLOGY: Based on the retrospective study of the endoscopical examinations results and the patient records, the criteria of the patient selection for the surgical procedure, the type of the surgical procedure, the postoperative complications and the long-term assessment, were revised. RESULTS: During the six-year period, 7625 gastrofibroscopies were conducted. In this group, the oesophageal varices were diagnosed in

Geographic Distribution of Gastroenterologists and Patients With Inflammatory Bowel Disease in the United States.

INTRODUCTION: We aimed to map the distribution of patients with inflammatory bowel disease (IBD) and gastroenterologists throughout the United States and identify local-level and state-level variations in the availability of specialist care. METHODS: For each first 3-digit ZIP code tabulation area (ZCTA) and state in the United States, we calculated the density of patients with IBD (Crohn's disease or ulcerative colitis) per 100,000 population, gastroenterologists per 100,000 population, and gastroenterologists per 100 patients with IBD. We used 2022 claims data to identify patients with IBD,…

Pediatric Constipation: What Can We Learn from the Adult Gastroenterologist?

Functional constipation is a common pediatric problem with significant impact on quality of life. Effective management requires a combination of behavioral strategies and pharmacologic treatments. This article discusses current pediatric approaches, evaluates how insights from adult gastroenterology can be implemented in pediatric care, and explores emerging therapies with the potential for pediatric use. Additionally, it addresses challenges in pediatric constipation management and the future research directions.

Amyloidosis for the Gastroenterologist: A Comprehensive Systematic Review of Diagnosis and Management of Gastrointestinal Manifestations.

BackgroundAmyloidosis is a rare, multisystem disorder characterized by extracellular deposition of misfolded protein fibrils. Gastrointestinal (GI) amyloidosis is uncommon but under-recognized due to nonspecific symptoms, but early diagnosis is critical to improve quality of life and prognosis. This comprehensive systematic review aimed to summarize current literature on GI and hepatic manifestations of amyloidosis, highlighting diagnostic and management strategies across the major subtypes of amyloidosis, in particular AL (immunoglobulin light chain), ATTR (transthyretin), and AA (serum amylo

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… Gastroenterologists should be vigilant, as gastrointestinal symptoms in amyloidosis often mimic other disorders. The development of standardized diagnostic and management guidelines would be invaluable in improving both mortality and, more importantly, quality of life for affected patients. …

Patients' and paediatric gastroenterologists' assessments of the follow-up of coeliac disease in Spain.

INTRODUCTION: There is high variability in the follow-up of paediatric patients with coeliac disease (CD) in Europe. The aim of this study was to know the current reality of paediatric CD follow-up in Spain through professionals and the patients themselves and their families. PATIENTS AND METHODS: A cross-sectional descriptive study was conducted using 2 anonymous web surveys, one aimed at paediatric gastroenterologists, and the other at members of CD patients' associations. RESULTS: A total of 96 responses from paediatricians and 4745 from patients (1362<15 years) were analysed. Among the p…

Surgical treatment of inflammatory bowel disease: From the gastroenterologist's stand-point.

Treatment of ulcerative colitis (UC) and Crohn's disease (CD) represents, in the majority of cases, a real challenge to the gastroenterologi … result in patients with severe inflammatory bowel disease in today's era; the close cooperation of gastroenterologists with surgeons, pathologists, imaging, and nutritionists is of paramount importance.

Drug-Induced Acne in Inflammatory Bowel Disease: A Practical Guide for the Gastroenterologist.

Drug-induced acne is a common side effect to a wide array of pharmacological therapies and is characterized by a monomorphic, papulopustular … examines the characteristics of drug-induced acne in IBD treatments, provides a practical guide for gastroenterologists to manage mild-to-moderate occurrences, and highlights when to seek specialist dermatology advice. Such approaches enable early treatment of a common and often distressing adverse event and optimize the management of IBD by preventing the premature …

The Role of Endoscopy in the Management of Adolescent Bariatric Patients: A Primer For Pediatric Gastroenterologists.

PURPOSE OF REVIEW: The prevalence of childhood and adolescent obesity in the United States has reached alarming levels, necessitating effect … management of morbid obesity in adolescents but has significant associated complications. Pediatric gastroenterologists must be familiar in the endoscopic management of these complications and are crucial in creating a high functioning adolescent bariatric program.

Childhood Cholestatic Liver Diseases that Persist Into Adulthood: Lessons for the Adult Gastroenterologist.

Children with cholestatic liver diseases are increasingly living into adulthood, thanks to innovations in medical and surgical therapies. The excellent outcomes observed in pediatric liver transplantation for diseases, such as biliary atresia, have transformed the life trajectory of children born with once-fatal liver diseases. The evolution of molecular genetic testing, has helped expedite the diagnosis of other cholestatic disorders, improving the clinical management, disease prognosis, and family planning for inherited disorders, such as progressive familial intrahepatic cholestasis and bil

Drivers of Variation in Diagnosis and Management of Eosinophilic Esophagitis: A Survey of Pediatric Gastroenterologists.

BACKGROUND: Widespread variation in the diagnosis and treatment of eosinophilic esophagitis (EoE) has previously been reported among adult gastroenterologists; however, variation in EoE practice in among pediatric populations is poorly characterized. The study objectives were to describe guideline adherence and understand reasons for variation in EoE practice among pediatric gastroenterologists following publication of the updated 2018 international EoE guidelines. METHODS: We developed and administered a 28-item survey to pediatric gastroenterologists via an email listserv using the PEDGI Bu…