Alimentary pharmacology & therapeutics
-
Aliment. Pharmacol. Ther. · Jan 2015
Clinical TrialThe response of patients with bile acid diarrhoea to the farnesoid X receptor agonist obeticholic acid.
Bile acid diarrhoea is a common cause of chronic diarrhoea, occurring as a primary condition or secondary to ileal disease or resection. Many patients have reduced levels of the ileal hormone fibroblast growth factor 19 (FGF19), an inhibitory regulator of hepatic bile acid synthesis, secreted in response to farnesoid X receptor (FXR) activation. ⋯ This proof-of-concept study indicates that obeticholic acid stimulates FGF19, reduces bile acid synthesis and produces clinical benefits in bile acid diarrhoea. FXR agonists have therapeutic potential in chronic diarrhoea. EudraCT 2011-003777-28; Clinical Trials: NCT01585025.
-
Aliment. Pharmacol. Ther. · Jan 2015
Hypercoagulability following major partial liver resection - detected by thrombomodulin-modified thrombin generation testing.
Conventional coagulation tests are frequently prolonged after liver surgery, suggesting a post-operative hypocoagulability. However, these tests are unreliable for assessment of the haemostatic status in these patients. In contrast, thrombin generation testing measures the true balance between pro- and anti-coagulant factors. ⋯ Thrombin generation in the presence of thrombomodulin revealed hypercoagulability in patients following liver resection. These results support the recently advocated restrictive use of plasma during liver resection and the exploration of more extensive use of post-operative thrombosis prophylaxis.
-
Aliment. Pharmacol. Ther. · Dec 2014
Oesophageal narrowing is common and frequently under-appreciated at endoscopy in patients with oesophageal eosinophilia.
Estimation of the prevalence of oesophageal narrowing and its clinical relevance in patients with oesophageal eosinophilia is probably underestimated by endoscopy. ⋯ Symptomatic oesophageal narrowing identified by barium oesophagography is common and under-recognised at endoscopy in patients with oesophageal eosinophilia.