Falk Gastro Info 10/2020

Video report

Examination of the adrenal gland:
Right adrenal gland

Author: Prof. Dr. Christoph F. Dietrich, Caritas Krankenhaus Bad Mergentheim. ©2019 Falk Foundation e.V., Freiburg. All rights reserved.

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Link to Falk Mediacenter

Latest research in brief:

Bowel

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Brenner EJ et al, Gastroenterology. 2020;159(2):481–91.e3
Management of patients with inflammatory bowel diseases and immCOVID-19 outcomes in patients with inflammatory bowel diseases (IBD): Results of an international registry comprising more than 500 IBD patients with COVID-19 demonstrate that increasing age, comorbidities and corticosteroid therapy are associated with severe COVID-19 among patients with IBD, while anti-TNF antibodies are not.

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BMaaser C et al, Gut. 2020;69(9):1629–36
Intestinal ultrasound to monitor ulcerative colitis: Results ofthe TRUST&UC study suggest that intestinal ultrasound may be useful in general practice for monitoring disease course and assessing short-term response to therapy.

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Repici A et al, Gastroenterology. 2020;159(2):512–20.e7
HeReal-time computer-aided detection (CAD) of colorectal neoplasia: : In a multicenter randomized trial, implementing CAD in real-time colonoscopy significantly increased the adenoma detection rate as well as the number of adenomas detected per colonoscopy without affecting withdrawal time.

Link to text Liver Biliary Tracts

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Gerussi A et al, Dig Liver Dis. 2020;52(7):761–7
Autoimmune hepatitis (AIH): A recent retrospective cohort study indicates that normalization of serum immunoglobulin G (IgG) levels is an independent predictor for transplant-free survival. Thus, normalization of IgG levels should be a treatment target along with normalization of transaminases.

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Corpechot C et al, J Hepatol. 2020;73(3):559–65
Primary biliary cholangitis (PBC): A large retrospective cohort study analyzed preventive treatment with ursodeoxycholic acid (UDCA) in patients who received liver transplantation for PBC. Preventive UDCA treatment was associated with a reduced risk of disease recurrence, graft loss, and death. A regimen combining cyclosporine and preventive UDCA was associated with the lowest risk of PBC recurrence and mortality.

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Sarkar M et al, J Hepatol. 2020;73(3):516–22
Non-alcoholic fatty liver disease (NAFLD): The prevalence of NAFLD in pregnancy has nearly tripled in the last decade and is independently associated with hypertensive complications, postpartum hemorrhage and preterm birth. NAFLD should thus be considered a high-risk obstetric condition.

Link to text Oesophagus Stomach Duodenum

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Yoshino M et al, N Engl J Med. 2020;383(8):721–32
Diet vs. gastric bypass and metabolic function in diabetes: Metabolic benefits of gastric bypass surgery and diet were similar and were apparently related to weight loss itself, with no evidence of clinically important effects independent of weight loss.

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Shitara K et al, N Engl J Med. 2020;382(25):2419–30
Novel approach to treat HER-2-positive gastric cancer: Therapy with trastuzumab deruxtecan, a conjugate of an anti-HER2 antibody and a topoisomerase I inhibitor, resulted in improved objective response rates and overall survival, as compared to conventional chemotherapy in a phase II trial enrolling Asian patients with advanced tumors. Myelosuppression and interstitial lung disease were the notable side effects.

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Sung JJY et al, Gut. 2020;69(9):1572–80
Bacterial factors contributing to the development of gastric cancer: This basic science report demonstrates that gastric microbes are specifically associated with gastric inflammation, atrophy and intestinal metaplasia 1 year after successful eradication of Helicobacter pylori and may therefore promote carcinogenesis in the stomach.

Link to text Pancreas

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Schepers NJ et al, Lancet. 2020;396(10245):167–76
PreERCP for patients with acute severe biliary pancreatitis: Results of a randomized trial indicate that urgent ERCP with sphincterotomy did not reduce a composite end point of major complications or mortality as compared to conservative treatment in patients with predicted severe biliary pancreatitis. These findings suggest that ERCP should be performed only in patients with concomitant cholangitis or persistent cholestasis.

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Current Falk literature:

The Microbiota and Gastrointestinal Disorders
Authors: M.A. Storr
(63 pages)
RE19E