Wednesday, October 20, 2021

Revista Gastroenterología

Bowel

Oral antibiotic use and risk of colorectal cancer:

A large English cohort study suggests that oral antibiotic use is associated with a significantly increased risk to develop colon carcinoma, but reduced risk for rectal cancer. These results may suggest different functions of the gut microbiota in tumor pathogenesis along the large intestine.

Anti-TNF therapy for Crohn’s disease:

A large English cohort study suggests that oral antibiotic use is associated with a significantly increased risk to develop colon carcinoma, but reduced risk for rectal cancer. These results may suggest different functions of the gut microbiota in tumor pathogenesis along the large intestine.

Liver

Obeticholic acid in non-alcoholic steatohepatitis (NASH):

A current phase 3 trial demonstrates the efficacy of obeticholic acid, especially in improving fibrosis. This effect was most prominent, however, at a higher dose (25 mg daily) that was associated with mostly mild to moderate pruritus in approx. 50% of patients.

Hepatitis B virus (HBV) reactivation with corticosteroids:

A current study from Hong Kong analyzed the risk of HBV reactivation and hepatitis flares after steroid treatment. HBV reactivation occurred in 1.8% of patients with “resolved” hepatitis B within 1 year; within 10 years, the risk was 5.5% in patients with anti-HBc only. More common, however, was the occurrence of HBV-independent hepatitis flares (11.9% within 1 year), with a dose > 20 mg prednisolone equivalents and treatment duration > 7 days as risk factors.

Hepatocellular adenoma (HCA) during pregnancy:

A current prospective cohort study in 51 pregnancies of women with HCA < 5 cm showed that HCA increased in size during a quarter of pregnancies with a median increase of 14 mm. Clinically relevant complications such as bleeding, however, occurred in none of the pregnancies. Thus, HCA < 5 cm confer minimal risk to a pregnant woman and her child.

Oesophagus

Oral immunotherapy for peanut allergy:

Results of a phase 2 trial suggest that oral immunotherapy with 4000 mg peanut protein can effectively desensitize individuals with peanut allergy, but discontinuation or dose reduction could increase the risk of regaining clinical reactivity to peanut. Moreover, allergological lab test results at baseline predicted response to desensitization and could be useful for selecting the appropriate patient population.

Treatment of idiopathic achalasia:

In a randomized trial, peroral endoscopic myotomy (POEM) was non-inferior to laparoscopic myotomy and fundoplication in controlling symptoms of achalasia, but gastrointestinal reflux was more common following POEM.

Pancreas

Current Falk literature:

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