Expert review of gastroenterology & hepatology
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Expert Rev Gastroenterol Hepatol · Mar 2014
ReviewSurgical techniques for improving outcomes in pancreatic ductal adenocarcinoma.
Pancreatic ductal adenocarcinoma is a devastating disease with extremely poor survival despite patients undergoing potentially curative resections and improvements in chemotherapeutic agents. Surgery for operable cancer in the head of the pancreas typically involves an open pancreaticoduodenectomy with a post-operative median survival of 21 months. ⋯ This article focuses on the evidence to date for some of these surgical techniques including laparoscopic and robotic surgery, the no-touch technique, venous and arterial resection, intra-operative radiofrequency ablation and intra-operative irreversible electroporation. With the increased use of these techniques we hope to see better quality of life and survival for these patients.
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Expert Rev Gastroenterol Hepatol · Feb 2014
ReviewThe use of fecal calprotectin as a biomarker in gastrointestinal disease.
Abdominal discomfort including pain, bloating and diarrhea is common. It often arises from functional gastrointestinal disorders but may indicate inflammatory bowel disease (IBD). Calprotectin is an abundant neutrophil protein that is released during inflammation. ⋯ Fecal calprotectin might also be useful to monitor patients with IBD under treatment and to predict the risk of recurrence of active disease prior to clinical relapse. The use of fecal calprotectin has been investigated in a number of gastrointestinal disorders other than IBD, for example, as screening test for colorectal cancer but the available data are limited. This article summarizes the current literature on the use of fecal calprotectin in clinical practice.
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Expert Rev Gastroenterol Hepatol · Sep 2013
ReviewAlteration of the intestinal microbiome: fecal microbiota transplant and probiotics for Clostridium difficile and beyond.
Clostridium difficile infection is increasingly common with a high risk of recurrence despite antibiotic treatment. In cases of recurrent C. difficile infection, fecal microbiota transplant (FMT) is a highly effective treatment option promoting the restoration of normal gut microbiota. ⋯ Probiotics have been utilized broadly for many disease processes, including gastrointestinal, cardiovascular and allergic disease settings, although with limited and inconsistent results. Multiple potential areas for research are also identified.
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Expert Rev Gastroenterol Hepatol · Jul 2013
ReviewPerspectives on irritable bowel syndrome: where have we been? Where are we now?
Irritable bowel syndrome is a chronic functional disorder with a complex etiology and multiple overlapping symptoms. Irritable bowel syndrome is characterized by long-lasting abdominal pain or discomfort, abnormal bowel habits and typically inadequate response to many of the available therapies.