The American journal of gastroenterology
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Am. J. Gastroenterol. · Feb 2009
Review Meta AnalysisHelicobacter pylori infection and Barrett's esophagus: a systematic review and meta-analysis.
The majority of distal esophageal adenocarcinomas are believed to arise in patients with Barrett's esophagus (BE). Helicobacter pylori (H. pylori) infection plays an etiological role in gastric carcinogenesis, but any possible role in BE is uncertain. We aimed to explore the possible relationship between H. pylori infection and BE by meta-analysis. ⋯ H. pylori infection and BE are inversely related when compared with endoscopically normal controls but not blood donor controls. Limited evidence suggests that there is no clear association between H. pylori infection and BE. To determine more accurately the effect size of H. pylori infection in BE, high quality prospective case-control studies with age-matched, endoscopically normal healthy controls are needed.
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Am. J. Gastroenterol. · Feb 2009
Review Meta AnalysisHelicobacter pylori infection and Barrett's esophagus: a systematic review and meta-analysis.
The majority of distal esophageal adenocarcinomas are believed to arise in patients with Barrett's esophagus (BE). Helicobacter pylori (H. pylori) infection plays an etiological role in gastric carcinogenesis, but any possible role in BE is uncertain. We aimed to explore the possible relationship between H. pylori infection and BE by meta-analysis. ⋯ H. pylori infection and BE are inversely related when compared with endoscopically normal controls but not blood donor controls. Limited evidence suggests that there is no clear association between H. pylori infection and BE. To determine more accurately the effect size of H. pylori infection in BE, high quality prospective case-control studies with age-matched, endoscopically normal healthy controls are needed.
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Am. J. Gastroenterol. · Dec 2008
ReviewClinical review of the management of fulminant clostridium difficile infection.
Clostridium difficile infection (CDI) is a frequent cause of morbidity and mortality among elderly hospitalized patients. A small but increasing number of patients have developed fulminant CDI, and a significant number of these patients require emergency colectomy. In this review, we discuss the risk factors, pathophysiology, diagnosis, and management of fulminant CDI. ⋯ Both the incidence and severity of CDI are increasing. Fulminant CDI is underappreciated as a life-threatening disease because of a lack of awareness of its severity and its nonspecific clinical syndrome. Early diagnosis and treatment are essential for a good outcome, and early surgical intervention should be used in patients who are unresponsive to medical therapy. The surgical procedure of choice is a total abdominal colectomy with end ileostomy, although the mortality rate remains high.
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Am. J. Gastroenterol. · Nov 2007
ReviewGastrointestinal and nutritional complications after bariatric surgery.
The prevalence of obesity has increased to epidemic proportions, making obesity and its comorbid conditions a major public health concern. Bariatric surgery is the most effective treatment, but it carries substantial morbidity. ⋯ As part of the multidisciplinary team taking care of obese patients, gastroenterologists should be familiar with the types of bariatric surgery and their associated complications. We review the most common gastrointestinal and nutritional complications after bariatric procedures and examine how gastroenterologists may best prevent, investigate, and treat them.