Revista Gastroenterología

February 2021

Bowel

Antibiotic use and the development of inflammatory bowel disease (IBD)

A national case-control study in Sweden suggests that higher cumulative exposure to systemic antibiotic therapy, particularly with broad spectrum antibiotics, may be associated with an approx. 2-fold increased risk of new-onset IBD. This association did not appear to differ when predisposed siblings were used as control group.

Epidemiologic trends for microscopic colitis

According to a nationwide cohort study from Denmark, the incidence of microscopic colitis has increased 10-fold between 2001 and 2016 and has surpassed that of Crohn’s disease and ulcerative colitis. However, incidence has stabilized since 2012, suggesting that a plateau has been reached.

Bowel

Antibiotic therapy versus operation for appendicitis

In a randomized trial including 1552 patients,antibiotics were non-inferior to appendectomy on the basis of results of a standard health-status measure. In the antibiotics group, nearly 3 in 10 participants had undergone appendectomy by 90 days. Participants with an appendicolith were at a higher risk for appendectomy and for complications than those without an appendicolith.

Liver

Endoscopic interventions in cirrhosis

A current database analysis shows that serious anesthesia complications associated with endoscopic interventions in cirrhosis are rare (0.4%). Serious complications were predominantly cardiac and associated with sicker patients undergoing general anesthesia. The complexity of end-stage liver disease may thus warrant anesthesia monitoring during endoscopic interventions.

Alcohol-related liver disease (ALD)

A current Swedish cohort study underlines the high mortality of this disease: In patients with alcohol-related cirrhosis, mortality is almost 5-fold increased, however, in patients with ALD without cirrhosis, mortality is also increased by a factor of 2.7. Specific programs for diagnosis and treatment of ALD should thus be established.

Hepatitis C virus and COVID-19:

A current modeling study demonstrates that COVID-19 could lead to almost 45,000 additional cases of hepatocellular carcinoma (HCC) and 72,000 liver-associated deaths worldwide by delaying screening, diagnosis and treatment. Thus, programs to eliminate hepatitis should be stepped up as soon as it becomes appropriate to do so.

Oesophagus Stomach Duodenum

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