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February 08, 2010 Irritable bowel syndrome made simple - The Clinical Advisor Sherman C – Neither colonic imaging nor a full panel of blood, serum chemistries, and stool analyses are necessary in most cases. There is insufficient evidence to support a position on food allergy or exclusion diets. Antidepressants have been shown to be superior to placebo for IBS symptoms including abdominal pain. There is some evidence of the benefits of Chinese herbal therapy. Trials of acupuncture have been inconclusive.... Breast feeding facilitates acceptance of a novel dietary flavour compound - Clinical Nutrition Hausner H et al. – The study suggests that breastfeeding facilitates acceptance of novel flavours. This effect is not necessarily due to exposure to specific flavour compounds.... Performance of the AST-to-Platelet Ratio Index as a Noninvasive Marker of Fibrosis in Pediatric Patients With Chronic Viral Hepatitis - Journal of Pediatric Gastroenterology and Nutrition McGoogan KE et al. – All of the patients 0 to 20 years old with chronic hepatitis B or C presenting at a tertiary medical center from 1992 to 2008 were identified. Thirty–six patients were evaluated with 48 biopsy results. The areas under the receiver operating characteristic curve were 0.71 for fibrosis and 0.52 for cirrhosis. When examining subgroups, the APRI performed better in older patients and in those with vertically transmitted hepatitis C virus. Further research into APRI and the other noninvasive markers of fibrosis in children with chronic viral hepatitis is warranted.... Intestinal Spirochetosis: An Unusual Cause of Asymptomatic Colonic Ulceration - Clinical Gastroenterology and Hepatology Khashab M et al. – Repeat colonoscopy after a course of metronidazole showed a complete resolution of the cecal ulcer, and random colonic biopsies were without evidence of spirochetes or other colonic pathology. The patient remained asymptomatic for more than 1 year of follow–up.... Disinfection by-products in drinking water and colorectal cancer: a meta-analysis - International Journal of Epidemiology Rahman MB et al. – The study findings provide limited evidence of a positive association between colorectal cancer and exposure to disinfection by–products (DBPs) in drinking water. The small number of studies and limitations in study quality prevent causal inference.... The Yield of a Continuously Patent Gastroesophageal Junction During Upper Endoscopy as a Predictor of Esophagitis in Children - Digestive Diseases and Sciences Shaoul R et al. – A continuously patent GEJ predicts quite accurately the presence of esophagitis in biopsies and may serve an additional endoscopic finding for the diagnosis of esophagitis especially non–erosive GER.... The Cannabis Hyperemesis Syndrome Characterized by Persistent Nausea and Vomiting, Abdominal Pain, and Compulsive Bathing Associated with Chronic Marijuana Use: A Report of Eight Cases in the United States - Digestive Diseases and Sciences Cappell MS et al. – Cannabis hyperemesis is characterized by otherwise unexplained recurrent nausea and vomiting, compulsive bathing, abdominal pain, and polydipsia associated with chronic cannabis use. This syndrome can occur in the United States as well as in Australia. Cannabis cessation may result in complete symptomatic recovery.... Robotic versus manual control in magnetic steering of an endoscopic capsule - Endoscopy Ciuti G et al. – Robotic control for magnetic steering of a capsular endoscope was demonstrated to be more precise and reliable than manual operation. Validation of the proposed robotic system paves the way for automation of capsular endoscopy and advanced endoscopic techniques.... The future of bariatrics: endoscopy, endoluminal surgery, and natural orifice transluminal endoscopic surgery - Endoscopy Tsesmeli N et al. – Gastrointestinal stimulation with implanted electrodes may have potential in the treatment of obesity and endoscopic applications have a role to play in post–surgical interventions. Evolving research into endosurgical approaches is described. Current work on the feasibility of a NOTES approach to bariatric procedures is described.... Colonic stenting: a palliative measure only or a bridge to surgery - Endoscopy Baron TH – Self–expandable metal stents (SEMS) are used to relieve malignant luminal obstruction throughout the gastrointestinal tract. Colonic SEMS are used most often for palliation of obstruction in nonoperative candidates or in patients with advanced disease. The other indication for colonic stent placement is as a preoperative modality for the relief of acute obstruction so that resection can be done on an elective basis after stabilization of the acute illness and bowel preparation.... More News...