Gastroenterology

Diagnosis and management of solid benign liver lesions
As the incidental discovery of benign liver lesions increases with more widespread use of medical imaging, a better understanding of the natural history of these lesions is required to inform medical management. This Review discusses improved imaging techniques in diagnosing and managing patients with benign liver lesions. The changing attitudes to performing biopsies and surgery for diagnosis ...


Women with Celiac Disease Present with Fertility Problems No More often than Women in the General Population
Studies have associated infertility with celiac disease. However, these included small numbers of women attending infertility specialist services and subsequently screened for celiac disease, so they may not be representative of the general population. We carried out a large population-based study of infertility and celiac disease in women from the United Kingdom. We identified 2,426,225 women ...
Intestinal sweet-sensing pathways and metabolic changes after Roux-en-Y gastric bypass surgery
Studies suggest that improvements in type 2 diabetes (T2D) post- Roux-en-Y gastric bypass (RYGB) surgery are attributable to decreased intestinal glucose absorption capacity mediated by exclusion of sweet taste-sensing pathways in isolated proximal bowel. We probed these pathways in rat models that had undergone RYGB with catheter placement in the biliopancreatic (BP) limb to permit post-RYGB e...


A detailed, conductance-based computer model of intrinsic sensory neurons of the gastrointestinal tract
Intrinsic sensory neurons (ISNs) of the enteric nervous system respond to stimuli such as muscle tension, muscle length, distortion of the mucosa, and the chemical content in the lumen. ISNs form recurrent networks that probably drive many intestinal motor patterns and reflexes. ISNs express a large number of voltage- and calcium-gated ion channels, some of which are modified by inflammation or...
Allergen-induced resistin-like molecule-alpha promotes esophageal epithelial cell hyperplasia in eosinophilic esophagitis
Resistin-like molecule (Relm)-α is a secreted, cysteine-rich protein belonging to a newly defined family of proteins, including resistin, Relm-β, and Relm-. Although resistin was initially defined based on its insulin-resistance activity, the family members are highly induced in various inflammatory states. Earlier studies implicated Relm-α in insulin resistance, asthmatic resp...


TCF-1-mediated Wnt signaling regulates Paneth cell innate immune defense effectors HD-5 and -6: implications for Crohn's disease
Wnt signaling regulates small intestinal stem cell maintenance and Paneth cell differentiation. In patients with ileal Crohn's disease (CD), a decrease of Paneth cell α-defensins has been observed that is partially caused by impaired TCF-4 and LRP6 function. Here we show reduced expression of the Wnt signaling effector TCF-1 (also known as TCF-7) in patients with ileal CD. Reporter gene a...
Rectal Effluent as a Research Tool
Studies of localized secretions are generally superior to those of blood because they contain higher concentrations of molecules specific to the organ of interest. A common method used to analyze localized secretions is lavage. The flow of fluid over the lining of a cavity picks up both cells and soluble factors, and the effluent can be collected for study. Gastrointestinal (GI) lavage is easil...

Viral Suppression and Cirrhosis Regression with Tenofovir Disoproxil Fumarate in Asians with Chronic Hepatitis B
Chronic hepatitis B (CHB) is a major public health concern, particularly in endemic areas like Asia–Pacific. Sustained virologic suppression correlates with regression of histologic fibrosis and cirrhosis. This study evaluated efficacy and safety of tenofovir disoproxil fumarate (TDF) in Asian patients through 240 weeks of treatment. Post hoc analysis of the Asian subpopulation from two phas...
Evaluation of Endoscopic Transpapillary Brushing Cytology for the Diagnosis of Bile Duct Cancer Based on the Histopathologic Findings
Diagnosis of the bile duct cancer still needs more accuracy. Studies on endoscopic retrograde cholangiopancreatography (ERCP)-guided brushing cytology were carried to evaluate the role of the endoscopic transpapillary brushing cytology for the diagnosis of bile duct cancer. The study involved 76 consecutive patients who underwent ERCP-guided bile duct cytology for the diagnosis of bile duct can...

Preprocedural Rabeprazole Treatment Before Endoscopic Submucosal Dissection for Gastric Neoplasms
The maximal effect of proton pump inhibitors (PPI) is reported to take 5 days. However, most current protocols start PPI on the day of gastric endoscopic submucosal dissection (ESD). We aimed to evaluate the benefit of 5 days pretreatment with oral PPI before ESD to prevent bleeding. This was a prospective randomized controlled trial. Patients were administered oral rabeprazole 20 mg or plac...
Cholangiocarcinoma and High-Grade Dysplasia in Young Patients with Primary Sclerosing Cholangitis
Cholangiocarcinoma (CCA) is very often an adulthood disease with primary sclerosing cholangitis (PSC) as one of the risk factors. It is rarely seen in the pediatric population, and when it is diagnosed before adulthood, it can be associated with PSC as well as HIV infection, biliary atresia, radiation therapy, and choledochal cyst. Although there have been some case reports of pediatric CCA, ca...

HBV: Stowaway of NTCP
Several recent papers support the view that Na-taurocholate cotransporting polypeptide (NTCP), the sinusoidal bile acid transporter of hepatocytes, is a cell surface receptor enabling entry into these cells of the hepatitis B virus (HBV). This major advance in the understanding of the HBV life cycle paves the way to new therapeutic strategies aimed at blocking HBV entry into hepatocytes.
Current imaging of rectal cancer
Recent advances in rectal cancer surgery and treatment as well as new developments in magnetic resonance imaging (MRI) technique have led to extensive research in the field of preoperative imaging of rectal cancer and to an abundant literature. Pelvic MRI has indeed become an important part of the decision-making process for patients with rectal cancer. The aim of this article is to give curren...
A case series of Meckel's diverticulum: usefulness of double-balloon enteroscopy for diagnosis
Meckel's diverticulum is a congenital anomaly of the gastrointestinal tract. About 98% of affected patients are asymptomatic. Small intestinal examination has become easier since the development of double-balloon enteroscopy. The present case series describes 10 patients with Meckel's diverticulum in whom double-balloon enteroscopy was useful for diagnosis. Case presentationTen patients (8 men,...
Une ataxie cérébelleuse révélant une maladie coeliaque. A propos d’un cas et revue de la littérature
La maladie coeliaque est une entéropathie autoimmune liée à ľintolérance au gluten. Diverses manifestations extradigestives peuvent survenir dans les formes inhabituelles de la maladie. Ľataxie cérébelleuse constitue une de ces rares manifestations, présente dans 9% des cas [1,2]. Elle peut être un signe révélateur de la maladie. Le mécanisme impliqué reste mal élucidé, les care...