Journal of gastroenterology and hepatology
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Pancreatic exocrine insufficiency (PEI) is one of the long-term consequences of chronic pancreatitis (CP). Majority of patients with PEI were undiagnosed or undertreated. Inadequately treated or subclinical severe PEI causes malnutrition and may pose the patients at risk of premature atherosclerosis and cardiovascular events. ⋯ Patients unresponsive to PERT should be checked for compliance, increase the dose of lipase to 90,000 units/meal or co-therapy with proton pump inhibitor. In patient with previous gastrointestinal surgery that may interfere enzyme-food mixing, opening the capsules and administering the enzyme granules with meals. Finally, search for small intestinal bacterial overgrowth syndrome and other causes of small bowel malabsorption.
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J. Gastroenterol. Hepatol. · Dec 2013
Adjuvant chemotherapy in resectable cholangiocarcinoma patients.
Cholangiocarcinoma patients usually have poor treatment outcome and a high mortality rate. The role of adjuvant chemotherapy (AC) is controversial. Our study aimed to evaluate benefits of AC in resectable cholangiocarcinoma patients. ⋯ AC significantly prolongs survival time in resectable cholangiocarcinoma patients, particularly in the high risk group.
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J. Gastroenterol. Hepatol. · Dec 2013
Meta AnalysisMeta-analysis: is sequential therapy superior to standard triple therapy for Helicobacter pylori infection in Asian adults?
Although several meta-analyses suggested that sequential therapy (SQT) is superior to standard triple therapy (STT) for the eradication of Helicobacter pylori, these results were mainly based on the studies from Italy. The aim of this study was to assess the efficacy of 10-day SQT for H. pylori infection compared with STT in Asian adults. ⋯ Ten-day SQT appears to be superior to STT for H. pylori eradication in Asian adults. However, the pooled efficacy is lower than results from earlier European studies.
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J. Gastroenterol. Hepatol. · Dec 2013
ReviewRefeeding syndrome: screening, incidence, and treatment during parenteral nutrition.
The possible deleterious effects of feeding after a period of prolonged starvation have been known for over 60 years. The resultant biochemical disturbance, symptoms, and signs have been termed the refeeding syndrome (RS). The key to the pathophysiology is the stimulation of insulin release resulting in anabolic activity. ⋯ RS is still underrecognized. Patients receiving PN should be counted as being in a high-risk category and feeding protocols to avoid RS applied. Low rates of RS then occur and death from this cause be avoided.