Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018.

Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the 'gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages.

Best Practice Recommendations for Diagnosis and Management of Helicobacter pylori-Synthesizing the Guidelines.

Purpose of review Three guidelines on Helicobacter pylori have been published recently with recommendations that differ from past guidelines. In this review, we summarize the Toronto consensus statement, the Maastricht V/Florence consensus report and the American College of Gastroenterology guidelines on H. pylori, comparing and contrasting the recommendations.

Editorial: Intravenous Proton Pump Inhibitors for Bleeding Peptic Ulcer: What is the Most Cost-Effective Approach?

During their lifetime, about 10% of the population will develop a peptic ulcer. Despite major advancements in the approach to peptic ulcer bleeding over the last 10-20 years including newer endoscopic hemostatic techniques and the advent of proton pump inhibitors (PPIs), upper gastrointestinal bleeding due to peptic ulcers results in substantial morbidity, mortality, and cost. Both oral and intravenous PPIs have proven to be effective in preventing recurrent bleeding from peptic ulcers.

Cardiovascular risks of cyclooxygenase-2 inhibitors and traditional anti-inflammatory drugs: necessary but not sufficient for clinical decision making.

Cyclooxygenase-2 inhibitors were initially developed, then received regulatory approval and were subsequently widely marketed to achieve effective pain relief in patients with inflammatory conditions while decreasing gastrointestinal complications. Gastrointestinal symptoms as well as signs had been a major concern with the use of traditional non-steroidal anti-inflammatory drugs. Individual clinical judgements about the prescription of cyclooxygenase-2 inhibitors and non-steroidal anti-inflammatory drugs for relief of pain from inflammatory arthritis should not be limited to risks of cardiovascular disease but should also consider gastrointestinal complications, symptoms as well as signs, and other benefits which include, but are not limited to improvements in quality of life resulting from decreases in pain or impairment from musculoskeletal pain syndromes.

Documentation of competency on sedation for gastrointestinal endoscopy.

There is general consensus in national and societal guidelines that training for sedation should be part of basic training for endoscopy. There is no clear consensus, however, on the structure of that training. More importantly, these same guidelines are often silent on the specific requirements to demonstrate competency for administration of sedation, ways to document that competency and measures to assure that competency is maintained.

Endoscopic balloon dilation compared with sphincterotomy for extraction of bile duct stones.

Background And Aims: Endoscopic retrograde cholangiopancreatography is commonly performed to remove bile duct stones. The aim of this study was to determine short-term outcomes of endoscopic balloon dilation of the sphincter of Oddi compared with sphincterotomy for stone extraction.

Methods: A randomized, controlled multicenter study of 117 patients assigned to dilation and 120 to sphincterotomy was performed in a spectrum of clinical and academic practices.

Urgent vs. elective endoscopy for acute non-variceal upper-GI bleeding: an effectiveness study.

Background: Urgent endoscopy in patients with acute upper-GI bleeding identifies many patients who may be safely treated without hospitalization. The aim of this multicenter trial was to determine whether urgent endoscopy effectively decreases health care resource utilization in a real-life setting where primary care providers determine the course of care.

Methods: Ninety-three outpatients with acute upper-GI bleeding were randomized to either urgent endoscopy (before hospitalization) or elective endoscopy after admission.

The efficacy of oral 5-ASAs in the treatment of active ulcerative colitis: a systematic review.

The authors set out to critically review the current data on the efficacy of oral 5-aminosalicylic acid (5-ASA) agents for active ulcerative colitis (UC). Thirty-one studies were identified; 19 met entry criteria. Three trials with mesalamine showed statistical significance versus placebo; those with olsalazine or balsalazide did not.