Relationships of Intestinal Lactase and the Small Intestinal Microbiome with Symptoms of Lactose Intolerance and Intake in Adults.

Background: Approximately two-thirds of adults are genetically predisposed to decreased lactase activity after weaning, putting them at risk of lactose intolerance. However, symptoms are a poor marker of lactose maldigestion.

Aims: We assessed association between self-reported lactose intolerance and intestinal lactase, lactose intake, and the small intestinal microbiome.

Not FIT for Use: Fecal Immunochemical Testing in the Inpatient and Emergency Settings.

Background: Fecal immunochemical testing (FIT) is widely used for colorectal cancer screening, its only indication. Its effect on clinical decision-making beyond screening is unknown. We studied the use of FIT in emergency and inpatient settings and its impact on patient care.

Optical diagnosis of colorectal polyps using novel blue light imaging classification among trainee endoscopists.

Background: Blue light imaging (BLI) has been shown to improve the characterization of colorectal polyps among the endoscopy experts. We aimed to determine if this technology could be taught to endoscopy trainees while maintaining high accuracy and interobserver agreement.

Methods: Twenty-one gastroenterology trainees (fellows) from two academic institutions participated in this prospective study.

Lactose Intolerance: A Concise Review to Skim the Surface.

Lactose intolerance is a common but poorly understood cause of gastrointestinal symptoms. Contrary to popular belief, there is much more to its diagnosis beyond symptoms with exposure and management beyond milk- and dairy-product avoidance. In this article, we review definitions, genetic basis, pathogenesis, clinical signs, as well as diagnostic and management strategies.

Fulminant Infection Cured by Fecal Microbiota Transplantation in a Bone Marrow Transplant Recipient With Critical Neutropenia.

infection is the most prevalent health care-associated infection. Treatment relies on antimicrobial therapy with mounting evidence supporting fecal microbiota transplant (FMT) in refractory cases. Cohort studies have documented the safety of FMT in immunocompromised patients.

Ischemic Cholangiopathy 11 Years after Liver Transplantation from Asymptomatic Chronic Hepatic Artery Thrombosis.

Hepatic artery thrombosis is a concerning complication of orthotopic liver transplantation, and it most often occurs early in the posttransplant period. However, on rare occasions it can occur at a time remote from transplant. We present a case of ischemic cholangiopathy complicated by stricture and anastomotic bile leak from chronic hepatic artery thrombosis that occurred 11 years after the transplant.

Nuts and Bolts of Fecal Microbiota Transplantation.

Clostridium difficile infection (CDI) has become the leading cause of nosocomial infection in the United States with significant risk of both morbidity and mortality. While antimicrobial therapy forms the basis of treatment, there are several clinical scenarios in which antimicrobial therapy alone is insufficient. Evidence continues to show the safety and efficacy fecal microbiota transplantation (FMT) in recurrent and severe CDI.

An acute care approach to functional abdominal pain.

Functional abdominal pain disorders are commonly seen in the acute care setting and can be a source of frustration for patients and providers given their inherent chronic nature. However, an understanding of both the general approach to these disorders and the approach to specific common subtypes can help alleviate this frustration and lead to both short-term and long-term therapeutic success. This article describes the pathophysiology of these disorders and outlines a diagnostic and therapeutic approach to commonly seen functional abdominal pain disorders in adults.

Early Infections and the Risk of Irritable Bowel Syndrome: A Case-Control Study.

Goals: The goal of this study is to evaluate the association between early life infections and subsequent adult onset irritable bowel syndrome (IBS).

Background: Infections during adulthood are a known risk factor for adult-onset IBS. This investigation examined the role of childhood infections and infection risk factors in the development of IBS symptoms.

Cytomegalovirus and the Seemingly Immunocompetent Host: A Case of a Perforating Gastric Ulcer.

Cytomegalovirus (CMV) infection of the gastrointestinal tract has a variety of presentations. We present a case of gastric perforation, which is a relatively infrequent presentation of CMV infection. If the cause of gastric perforation is not readily apparent, testing for CMV should be considered.

Small Intestinal Bacterial Overgrowth: A Primary Care Review.

Gastrointestinal symptoms are commonly seen in the primary care setting. These patient presentations can be nonspecific, leading to a broad differential diagnosis. Small intestinal bacterial overgrowth is a clinical entity that can present with many of these nonspecific gastrointestinal symptoms.