Falk Gastro Info 2/2022

Dietary therapy for adult patients with Crohn’s disease: Crohn’s disease exclusion diet with or without partial enteral nutrition was effective for induction and maintenance of remission in biological-naive adults with mild-to-moderate active Crohn’s disease and even induced endoscopic remission in a subset of patients.

Oral CBD-rich cannabis for Crohn’s disease: Eight weeks of cannabidiol (CBD)-rich cannabis treatment induced significant clinical and quality-of-life improvement without significant changes in inflammatory parameters or endoscopic scores in a placebo-controlled trial with Crohn’s disease patients.

Risks of post-colonoscopic polypectomy bleeding (PPB) in patients with warfarin and direct oral anticoagulants: Apixaban was associated with a significantly lower risk of PPB and thromboembolism than warfarin, dabigatran and rivaroxaban, particularly in older patients with right-sided polyps.

Transfusion-transmitted hepatitis E virus infection: residual risk depending on screening method: Screening of blood donors for hepatitis E virus (HEV) RNA with a limit of detection (LOD) of 2000 IU/ml is currently mandatory in Germany. A recent study shows that when using this little sensitive detection limit (e.g. when testing samples in pools), only 73% of HEV transmissions by red blood cell concentrates and only 42% of HEV transmissions by platelet and fresh plasma transfusions can be prevented.

Association between non-alcoholic fatty liver disease and chronic kidney disease: A recent meta-analysis shows that non-alcoholic fatty liver disease (NAFLD) is significantly associated with an approx. 1.45-fold increased long-term risk of stage ≥ 3 chronic kidney disease (CKD). The risk was independent of age, sex, obesity, hypertension, diabetes and other conventional risk factors for chronic kidney disease.

Outcome of pregnancy in autoimmune hepatitis: favorable prognosis, but increased risk of complications: A recent American population-based study shows that autoimmune hepatitis in pregnancy is associated with significant maternal and perinatal risks such as gestational diabetes, hypertensive complications (pre-eclampsia, eclampsia and HELP syndrome with hemolysis, elevated liver enzymes and low platelet count) and premature birth. However, autoimmune hepatitis is not associated with postpartum hemorrhage, maternal, or perinatal death.

Cagrilintide for weight management in people with overweight and obesity: Treatment with cagrilintide – an analog of the pancreas hormone amylin that induces satiety – led to significant reductions in body weight and was well tolerated in a phase 2 trial.

Gastric peroral endoscopic myotomy (G-POEM) for refractory gastroparesis: G-POEM was a safe procedure in a prospective trial but showed only modest overall effectiveness in the treatment of refractory gastroparesis. Therefore, further studies are required to identify the best candidates for G-POEM and unselective use of this procedure should be discouraged.

Outcomes of seronegative celiac disease: A 20-year multicenter follow-up study demonstrates that seronegative celiac disease has a more aggressive disease phenotype and a higher mortality than seropositive celiac disease. These data argue against over-reliance on serology for the diagnosis of celiac disease.