Journal of gastroenterology and hepatology
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Pancreatic exocrine insufficiency (PEI) is one of the long-term consequences of chronic pancreatitis (CP). Majority of patients with PEI were undiagnosed or undertreated. Inadequately treated or subclinical severe PEI causes malnutrition and may pose the patients at risk of premature atherosclerosis and cardiovascular events. ⋯ Patients unresponsive to PERT should be checked for compliance, increase the dose of lipase to 90,000 units/meal or co-therapy with proton pump inhibitor. In patient with previous gastrointestinal surgery that may interfere enzyme-food mixing, opening the capsules and administering the enzyme granules with meals. Finally, search for small intestinal bacterial overgrowth syndrome and other causes of small bowel malabsorption.
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J. Gastroenterol. Hepatol. · Aug 2013
ReviewVitamin D in liver diseases: from mechanisms to clinical trials.
Traditionally regarded as a typical vitamin regulating calcium and phosphorus homeostasis, vitamin D is now discovered as a highly versatile molecule with emerging roles in immunity, cancer, infectious diseases, fibrosis, fatty liver diseases, and alcoholic liver diseases. A large body of clinical evidence has demonstrated the prevalence and risks of vitamin D deficiency in various chronic diseases. Biologically active vitamin D, 1,25-dihydroxylvitamin D3, is synthesized in two distinct systems. ⋯ A recent study showed that 25-dihydroxyvitamin D rather than 1,25-dihydroxyvitamin D could directly suppress hepatitis C virus assembly. Moreover, clinical evidence has shown that vitamin D deficiency is associated with alcoholic and non-alcoholic fatty liver diseases. In this review, we highlight some recent advances in vitamin D researches and clinical trails.
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J. Gastroenterol. Hepatol. · Jan 2013
ReviewCurrent prospects for interferon-free treatment of hepatitis C in 2012.
Present interferon-based therapy for chronic hepatitis C is limited by both efficacy and tolerability. Telaprevir and boceprevir are the first two direct-acting antiviral drugs (DAAs) that inhibit hepatitis C virus replication to be licensed for use in conjunction with pegylated interferon and ribavirin. Numerous other DAAs are in clinical development, and phases 2 and 3 trials are evaluating interferon-free combination DAA therapy. ⋯ Some drugs are genotype-specific in their activity, whereas others are pan-genotypic, and differential responses for the genotype 1 subtypes 1a and 1b have emerged with many DAA combinations. Viral breakthrough and resistance are important considerations for future trial design. The prospect of interferon-free combination DAA therapy for hepatitis C virus is now finally becoming a reality.
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J. Gastroenterol. Hepatol. · Jun 2012
Review Meta AnalysisTreatment of high-frequency gastric electrical stimulation for gastroparesis.
The aim of this study was to assess the effects of gastric electrical stimulation (GES) on symptoms and gastric emptying in patients with gastroparesis, and the effects of GES on the three subgroups of gastroparesis. ⋯ Based on this meta-analysis, the substantial and significant improvement of symptoms and gastric emptying, and the good safety we observed, indicate that high-frequency GES is an effective and safe method for treating refractory gastroparesis. DG patients seem the most responsive to GES, both subjectively and objectively, while the IG and PSG subgroups are less responsive and need further research.
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J. Gastroenterol. Hepatol. · Apr 2011
ReviewA review of the irritable bowel syndrome investigation on epidemiology, pathogenesis and pathophysiology in China.
Irritable bowel syndrome (IBS) is a highly prevalent functional disorder with poor understanding on its pathogenesis and pathology. China has huge amount of population and have a lot of literatures on IBS in Chinese publications. The aim of this article was to review the reported investigations on IBS in China and discuss the difference between China and other country. ⋯ Comparing to the findings from other area, literatures from China provided more evidences on epidemiological data of IBS in China, post-infection IBS, visceral hypertension and gastrointestinal motility abnormalities in IBS. This detailed literature review may help the understanding and promoting the future studies on IBS.