Revista Gastroenterología

November 2021

Bowel

Disease course in patients with microscopic colitis

Results of a large European inception cohort indicate that a minority of patients with microscopic colitis follow a quiescent disease course whereas the majority suffers from chronic active or relapsing disease with significantly impaired quality of life.

Liver

COVID-19 and liver disease

A recent study reveals that chronic liver disease increased the risk of COVID-19-related death in France in 2020. Therapeutic effort limitation may have contributed to COVID-19-related death in patients with a liver-related complication or an alcohol use disorder.

Primary biliary cholangitis (PBC)

Accuracy of transient elastography at diagnosis of PBC (and thus in naive patients) has not been defined. A current study demonstrates that advanced fibrosis can indeed be excluded (liver stiffness measurement ≤ 6.5 kPa) or confirmed (> 11.0 kPa) in many patients in this setting using transient elastography. However, transient elastography is not reliable between these 2 cut-offs, and a liver biopsy may be necessary. BMI and liver biochemistry did not affect transient elastography.

Non-alcoholic fatty liver disease (NAFLD)

There are numerous non-invasive scoring systems for predicting fibrosis in patients with NAFLD. A current study examined the predictive power of these scores for the long-term outcome (risk of fibrosis, liver-related complications, or death). The NAFLD fibrosis score (NFS), hepamet fibrosis score (HFS) and fibrosis 4 index (FIB-4) performed best.

Oesophagus Stomach Duodenum

Helicobacter pylori resistance to antibiotics

European study confirms higher resistance against clarithromycin and levofloxacin in Central/Western and Southern as compared to Northern Europe, which correlates with higher consumption of macrolides and quinolones. These findings should be considered when choosing eradication therapies.

Pancreas

Prevention of post-ERCP pancreatitis

A meta-analysis involving 55 trials and 17,062 patients revealed that rectal diclofenac (100 mg) was the best performing rectal non-steroidal anti-inflammatory drug. Combinations with intravenous fluid therapies or pancreatic stenting may further increase the efficacy.

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