Reviews in gastroenterological disorders (REV GASTROENTEROL DI)
REVIEWS IN GASTROENTEROLOGICAL DISORDERS is designed to review the latest advances in the diagnosis and treatment of a wide range of gastroenterological disorders to help the busy, practicing gastroenterologist keep up-to-date with the rapidly evolving field of gastroenterology.
Journal Impact: 1.14*
Journal impact history
|2016 Journal impact||Available summer 2017|
|2010 Journal impact||1.14|
|2009 Journal impact||1.40|
|2008 Journal impact||1.21|
|2007 Journal impact||1.57|
|2006 Journal impact||2.43|
|2005 Journal impact||2.37|
|2004 Journal impact||2.16|
|2003 Journal impact||0.96|
Journal impact over time
|Website||Reviews in Gastroenterological Disorders website|
|Other titles||Reviews in gastroenterological disorders (Online), Reviews in gastroenterological disorders, Gastroenterological disorders|
|Material type||Document, Periodical, Internet resource|
|Document type||Internet Resource, Computer File, Journal / Magazine / Newspaper|
Publications in this journal
Article: Irritable Bowel Syndrome
- [Show abstract] [Hide abstract] ABSTRACT: The most effective colonoscopy misses polyps, and both barium enema and computed tomography colonography studies have identified hidden areas on the proximal sides of folds, flexures, and valves where colonoscopy can miss even substantially sized lesions. This article reviews the rationale, efficacy, and clinical challenges associated with one of the most promising devices for improvement of mucosal exposure during colonoscopy, the Third Eye Retroscope (Avantis Medical, Sunnyvale, CA).
- [Show abstract] [Hide abstract] ABSTRACT: Capsule endoscopy (CE) is now recognized as a significant technologic advancement in gastrointestinal endoscopy that provides noninvasive, high-resolution imaging of the small bowel and esophagus. There is also growing evidence that it may be useful in the colon. Since the introduction of CE to clinical practice, its diagnostic utility has become well established for evaluation of patients with obscure gastrointestinal bleeding. It seems also to be useful in evaluating small-bowel Crohn's disease, compared with other imaging modalities. With respect to esophageal diseases, CE shows promise in the screening of esophageal varices and possibly Barrett's esophagus. A colon capsule endoscope has also been developed, and its potential use in screening for colorectal neoplasia is currently being studied. The technology and software of CE is also rapidly expanding to allow the physician to read and evaluate the capsule videos in a more efficient manner. The Given Imaging system has progressed significantly over the past several years. In addition to Given Imaging, Olympus now offers a small-bowel capsule endoscope system. This new Olympus capsule technology and how it compares with the Given Imaging System is reviewed, in addition to the various clinical uses of CE.
- [Show abstract] [Hide abstract] ABSTRACT: The current guidelines for the management of Crohn's disease (CD) suggest a stepwise approach to treatment according to the severity of clinical presentation. The use of tumor necrosis factor (TNF) antagonists are currently reserved for patients who do not respond to conventional nonbiological therapies such as corticosteroids and immunosuppressants. However, as TNF-alpha antagonists have the potential to produce mucosal healing in CD, earlier more aggressive treatment with biologics has been advocated. Anti-TNF therapy may be most beneficial in the early stages of inflammatory disease, before patients develop complications such as fibrostenotic or penetrating disease. Thus, the use of the more aggressive "top-down" strategy involving early introduction of biologics has been explored. Emerging data suggest that earlier use of biological therapy is associated with improved clinical outcomes and potential disease-modifying effects. Future studies are warranted and will likely lead to the expanded use of such agents in the treatment of CD.
- [Show abstract] [Hide abstract] ABSTRACT: Proton pump inhibitors (PPIs) are currently the most effective and most widely used agents for gastroesophageal reflux disease (GERD). Despite the efficacy of these agents in healing and symptom relief, a substantial proportion of patients require twice-daily therapy with PPIs, and break-through symptoms cause others to use over-the-counter antacids and histamine 2-receptor antagonists to supplement their PPI therapy. Major strategies that are being pursued include the development of agents that have a faster onset of action for on-demand therapy; have better control of acid secretion, resulting in improved healing in advanced grades of esophagitis and better symptom control; and agents that decrease transient lower esophageal sphincter relaxations (TLESRs), thereby reducing distal acid exposure and weakly acidic refluxate. A number of new pharmaceutical agents are currently undergoing clinical evaluation for the treatment of GERD. These include agents that reduce TLESRs, serotonergic agents/ prokinetics, long-acting PPIs, mucosal protectants, and antigastrin agents. One or more of these agents may be the future of GERD therapy.
- [Show abstract] [Hide abstract] ABSTRACT: Self-expanding metal stents (SEMS) have changed the management of malignant gastrointestinal obstruction. In malignant gastroduodenal obstruction for which curative surgical resection is not possible, endoscopic placement of SEMS is an ideal option. Endoscopic placement of SEMS has a high rate of technical and clinical success and a low rate of complications. Most studies have shown better outcomes as compared with surgical diversion procedures. Similar to the gastroduodenal stent, colonic SEMS have a role in colonic malignancy, both as a palliative modality and as a bridge to surgery. Placement of colonic SEMS has been highly technically and clinically successful. Published series have reported low complication rates for SEMS, with excellent outcomes in the context of palliation as well as a bridge to surgical resection.
- [Show abstract] [Hide abstract] ABSTRACT: The consequences of nocturnal gastroesophageal reflux disease (GERD) may be greater than daytime GERD in terms of clinical complications such as increased risk of esophageal lesions and respiratory conditions, as well as issues of health-related quality of life, sleep, work productivity, and economics. Proton pump inhibitors (PPIs) are the most effective therapy for patients with GERD; however, treatment success is greater in the improvement of daytime symptoms and acid control. Acid suppression of most PPIs, which are administered once daily before breakfast, wanes during the nighttime hours. Although nighttime heartburn improves with once-daily PPI treatment, PPIs are unable to eliminate nighttime heartburn completely. Increasing the dose of a PPI provides longer acid suppression, but the benefits have not been shown to be consistently greater than standard once-daily dosing. Twice-daily dosing, with a dose given before bedtime, would extend the duration of acid suppression into the nighttime hours; however, nocturnal acid breakthrough remains an issue. As a result, improved PPIs that will more reliably control nighttime symptoms and provide on-demand relief have been developed and studied. These newer PPI formulations offer significant hope for the advancement of treatment opportunities.
- [Show abstract] [Hide abstract] ABSTRACT: Clarithromycin resistance is a growing problem in many countries. Eradication rates for Helicobacter pylori have declined to unacceptable levels in recent years, in large measure because of clarithromycin resistance. Two treatment strategies (quadruple therapy and sequential therapy) are emerging as alternatives to triple therapy for the initial treatment of patients infected with H. pylori. Evidence shows that both quadruple therapy and sequential therapy are superior to triple therapy in patients with resistant strains of H. pylori. Studies that compare sequential and quadruple therapy are necessary and are awaited.
- [Show abstract] [Hide abstract] ABSTRACT: With the introduction of biologic therapies for inflammatory bowel disease, significant questions have arisen regarding their best optimization. Although initial recommendations were to combine immunosuppressives with biologics to reduce immunogenicity, trials with 3 different anti-tumor necrosis factor agents (infliximab, adalimumab, and certolizumab) and a humanized monoclonal antibody that targets alpha-4 integrins (natalizumab) have failed to demonstrate the clinical superiority of combination therapy when high-dose induction and scheduled maintenance therapy was prescribed for up to 1 year. However, immunosuppressive agents should be considered with episodic biologic therapy to decrease immunogenicity and secondary loss of response. The issue of whether induction with biologics and maintenance therapy with immunosuppressives as monotherapy is as safe and effective as induction and maintenance with biologics alone still remains to be addressed. Further, with the use of concomitant immunosuppressives and biologics, evolving data raise concerns for an increase in adverse events, including opportunistic infections, neurological disorders, and cancer. Specific therapeutic decisions need to be individualized and the clinician must help the patient weigh quality-of-life issues with readiness to assume possible risks.
Article: Infectious disease. The nose knows
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.