Falk Gastro Info 7/2021

Video course abdominal ultrasound

Examination of the abdominal vessels – Renal arteries, flow characteristics

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

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Latest research in brief:

Bowel

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Mahadevan U et al, Gastroenterology. 2021;160(4):1131–9
Pregnancy and neonatal outcomes after fetal exposure to biologics and thiopurines among women with inflammatory bowel disease: results of a prospective cohort study suggest that biologic, thiopurine or combination therapy exposure during pregnancy was not associated with increased adverse maternal or fetal outcomes at birth or infections in the first year of life. Higher disease activity was associated with risk of spontaneous abortion and preterm birth.

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Song M et al, BMJ. 2021;373:n877
Risk for colorectal cancer among first-degree relatives of patients with colorectal polyps: Results of a nationwide population-based analysis from Sweden reveal that first-degree relatives of patients with colorectal polyps are still at higher risk of colorectal carcinoma and in particular early onset cancer, even after adjusting for family history of colorectal cancer.

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Weimers P et al, J Crohns Colitis. 2021;15(4):594–602
Disease course, mortality and risk for colorectal cancer in patients with microsopic colitis (MC): Results from a nationwide population-based study from Denmark reveal that most MC patients have an uncomplicated and self-limited disease course. Only patients with severe colitis have a moderately elevated mortality while the risk for colorectal cancer is rather reduced.

Link to text Liver Biliary Tracts

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Gorris M et al, J Viral Hepat. 2021;28(3):454–63
Chronic hepatitis E virus infection: A current systematic review and meta-analysis on the therapy of chronic hepatitis E virus infection demonstrates that a reduction of immunosuppressive medication and treatment with ribavirin are safe, generally well tolerated and in 32% and 78% of patients, respectively, induce virus elimination. Treatment with pegylated interferon-alpha, in contrast, increases the risk of transplant rejection and should therefore be administered with great caution.

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Sundaram V et al, Hepatology. 2021;73(5):1932–44
Non-alcoholic fatty liver disease (NAFLD) and acute on chronic liver failure (ACLF): NAFLD is the fastest rising etiology of cirrhosis associated with ACLF among patients listed in the United States. As the NAFLD population continues to grow and age, patients with NAFLD-ACLF will likely have the highest risk of waitlist mortality.

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De Martin E et al, J Hepatol. 2021;74(6):1325–34
Acute severe autoimmune hepatitis (SA-AIH): A current retrospective multicenter study demonstrates that in AS-AIH, INR at the introduction of corticosteroids and the evolution of INR and bilirubin are predictive of liver transplantation or death. Within 3 days of initiating corticosteroids, the SURFASA score can identify non-responders who require a referral for liver transplantation. This score needs to be validated in a prospective cohort.

Link to text Oesophagus Stomach Duodenum

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Barret M et al, Gut. 2021;70(6):1014–22
Endoscopic radiofrequency ablation or surveillance in patients with Barrett’s esophagus with confirmed low-grade dysplasia: Radiofrequency ablation modestly reduced the prevalence of low-grade dysplasia as well as malignant progression risk at 3 years in a randomized multicenter trial involving 82 patients. The risk-benefit ratio of radiofrequency ablation should therefore be carefully weighted against surveillance in these patients.

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Syn NL et al, Lancet. 2021;397(10287):1830–41
Impact of metabolic-bariatric surgery on long-term survival: This meta-analysis involving more than 170, 000 patients revealed that among adults with obesity, metabolic-bariatric surgery was associated with substantially lower all-cause mortality rates while life expectancy was increased by 9.3 years in patients with preexisting diabetes and 5.1 years in patients without diabetes.

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Yuan J et al, Gut. 2021;70(6):1070–7
Association between proton-pump inhibitor (PPI) therapy and diabetes: Results of prospective studies involving more than 200,000 participants reveal that regular use of PPIs was associated with a higher risk of type 2 diabetes and the risk increased with longer duration of use.

Link to text Pancreas

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Pandanaboyana S et al, Gut. 2021;70(6):1061–9
Impact of SARS-CoV-2 infection on disease outcomes in patients with acute pancreatitis: Patients with acute pancreatitis and coexisting SARS-CoV-2 infection were at increased risk of severe pancreatitis disease course, worse clinical outcomes, prolonged hospital stay and high 30-day mortality in a prospective multicenter cohort study.

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Current Falk literature:

Primary Biliary Cholangitis (PBC)

Compiled by: T. Berg, T. Herta
(35 pages)
U47E