Revista Gastroenterología

May 2021

Bowel

Risk factors for microscopic colitis

Results from a nationwide case-control study from Sweden indicate that gastrointestinal infections, particularly with Clostridioides difficile and norovirus, are associated with an increased risk of subsequent microscopic colitis.

Rates of postoperative recurrence of Crohn’s disease

Use of immunosuppressants and tumor necrosis factor antagonists to treat patients with an asymptomatic endoscopic postoperative recurrence of Crohn’s disease did not reduce long-term risk of clinical recurrence in patients with Rutgeerts score i2, but had a small effect in patients with scores of i3 or i4.

Liver

Liver transplantation (LT)

Direct-acting antivirals (DAAs) allow hepatitis C virus (HCV) elimination with little side effects in almost all patients. Therefore, transplants from HCV-seropositive donors can now be considered for LT. A recent prospective cohort study demonstrates that LT from HCV-seropositive donors into HCV-seronegative recipients resulted in excellent short-term outcomes. Antiviral therapy after LT was effective and well tolerated.

Non-alcoholic steatohepatitis (NASH)

A recent and much discussed study shows that semaglutide leads to resolution of NASH without worsening of fibrosis in a higher proportion of patients than placebo. However, it did not show any superiority in terms of improvement of the stage of fibrosis as a further relevant clinical end point.

Hepatitis C virus (HCV)

There are no well-established algorithms available to identify patients in need of continued monitoring after sustained virological response to HCV therapy. A current study demonstrates that liver stiffness measurement (LSM) and von Willebrand factor/platelet count ratio (VITRO) after therapy are strong and independent predictors of posttreatment hepatic decompensation in HCV-induced advanced chronic liver disease.

Oesophagus Stomach Duodenum

Palliative radiotherapy after esophageal cancer stenting

In a randomized phase III trial, patients with advanced esophageal cancer requiring insertion of self-expandable metal stents for the primary management of dysphagia did not gain additional benefit from concurrent palliative radiotherapy, which should not be routinely offered. For a minority of patients at high risk of tumor bleeding, concurrent palliative radiotherapy might reduce bleeding risk and the need for associated interventions.

Pancreas

Abdominal Imaging in Gastroenterology and Hepatology

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