The accuracy of intestinal ultrasound compared with small bowel capsule endoscopy in assessment of suspected Crohn's disease in patients with negative ileocolonoscopy.

Background: Small bowel involvement in Crohn's disease (CD) is frequently proximal to the ileocecal valve and inaccessible by conventional ileocolonoscopy (IC). Small bowel capsule endoscopy (SBCE) is among the prime modalities for assessment of small bowel disease in these patients. Intestinal ultrasound (IUS) is an accurate bedside fast and low-cost diagnostic modality utilized in CD for both diagnosis and monitoring.

Comparison of strategies and goals for treatment of chronic constipation among gastroenterologists and general practitioners.

Background: Although guidelines have been published for the treatment of chronic constipation, little is known about the actual treatment strategies, the definitions of drug efficacy, the parameters for drug selection, and the conceived limitations of the available treatments. The purpose of this study was to address these issues by comparing treatment strategies among gastroenterology specialists (GIs) and general practitioners (GPs).

Methods: An internet survey was sent nationwide and at random to GIs and GPs in order to define treatment strategies, drug efficacy, main parameters for drug selections and the main limitations of the available drug therapy.

The Severity of Symptoms Related to Irritable Bowel Syndrome is a Risk Factor for the Misclassification of Significant Organic Disease.

Background And Aims: The diagnosis of irritable bowel syndrome (IBS) is based mainly on clinical evaluation. The reported incidence of misclassification of significant organic diseases in previously diagnosed IBS patients differs between studies. The aim of this study was to examine the incidence and risk factors for the misclassification of significant organic disease [colon cancer, inflammatory bowel disease (IBD), Celiac disease, and thyroid dysfunction] in a cohort of young patients with symptoms attributed to IBS.

The incidence of gastrointestinal pathology and subsequent anemia in young men presenting with iron deficiency without anemia.

Background And Aims: The etiology of iron deficiency (ID) without anemia in young men is unclear, and there are no evidence-based recommendations for the required gastrointestinal (GI) evaluation. The aims of this study were to examine the incidence of significant GI pathology and the development of anemia during the follow-up of young men presenting with ID, but without anemia.

Methods: All young men (18-30 years) who served in the Israel Defense Forces during the years 2005-2013 and had at least a single laboratory test indicative of ID without anemia were followed until the diagnosis of significant GI pathology or discharge from military service.

PillCam small bowel capsule endoscopy gastric passage interval association with patient's complaints and pathological findings: a prospective study.

Background And Aims: Prolonged gastric transit interval of small bowel video capsule endoscopy (SBCE) can potentially indicate a motility disorder and disrupt whole small bowel visualization. The aim of this study was to prospectively examine the association of prolonged gastric passage interval with symptoms, anthropometric and laboratory factors, and factors related to the SBCE examination, such as indications and pathological findings.

Materials And Methods: This was a prospective single-center study that included 100 patients who underwent SBCE for any indication.

Comparison of procedural sequence in same-day consecutive bidirectional endoscopy using moderate sedation: a prospective randomized study.

Background: A sequential bidirectional endoscopy is commonly performed. However, the optimal sequence of procedures for same-day bidirectional endoscopy using moderate sedation has not been established.

Goals: The aim of this study was to characterize the optimal sequence of endoscopies for sequential bidirectional endoscopy.

Management of antithrombotic agents for colonoscopic polypectomies in Israeli gastroenterologists relative to published guidelines.

Background: Endoscopic procedures are commonly performed in patients taking antithrombotic agents.

Objective: To examine the correlation between the management of antithrombotic drugs for colonoscopic polypectomies and the published guidelines.

Design And Settings: A structured survey delivered to gastroenterologists in 15 major Israeli hospitals and three central HMO clinics.

A survey of colonoscopic polypectomy practice amongst Israeli gastroenterologists.

Background: Polypectomy techniques have been implicated as factors in the effectiveness of polyp resection. The range of polypectomy practices among gastroenterologists in Israel is unknown.

Methods: A structured survey was sent to all Israeli gastroenterology departments in all 15 major academic hospitals and to 3 central outpatient clinics.

Endoscopic ultrasound (EUS) before gastric polyp resection: is it mandatory?

Introduction: Gastric polypectomy is associated with increased risk of bleeding. The use of endoscopic ultrasound (EUS) before polypectomy to decrease the rate of bleeding in such patients has not been studied.

Methods: All gastric polyps excised by snare polypectomy were evaluated.

Diverticulitis in the young patient--is it different ?

Aim: To prospectively study the incidence and the natural history of acute diverticulitis in young patients.

Methods: A total of 207 patients hospitalized at our hospital between January 2000 to February 2005 with the diagnosis of acute diverticulitis were included. Their demographic characteristics, medical history, physical, radiographic and endoscopic findings as well as therapy were recorded.

Necrotizing granulomata in the lung preceding colonic involvement in 2 patients with Crohn's disease.

Extraintestinal involvement, including the chest, is common in the late course of Crohn's disease. We describe 2 female patients in whom the course of the disease was unique in two aspects: (1) each had a pulmonary mass with granulomatous inflammation and necrosis, and (2) these findings had preceded the colonic involvement by 5 years. This sequence supports some of the theories on the pathogenesis of Crohn's disease and on its possible relation with sarcoidosis, another idiopathic granulomatous disease.

Effect of aging on bolus kinematics during the pharyngeal phase of swallowing.

Swallowing difficulty is a common complaint in the elderly and, although there are data for the biomechanics of liquid swallows, little is known about solid bolus motion, or kinematics, in the elderly. The aims of this study were as follows: 1) to characterize and compare solid and liquid bolus kinematics in the elderly and compare the findings with those in young subjects and 2) to correlate bolus kinematics and dynamics. Concurrent manometric-fluoroscopic techniques were used to study eight young and eight elderly subjects.

Increasing the infliximab dose is beneficial in Crohn's disease patients who responded to a lower dose and relapsed.

Background: Relapse after an initial response to infliximab therapy poses a problem for maintenance treatment.

Aim: To assess the effects of increasing the infliximab dosage in Crohn's disease (CD) patients who initially responded but flared during maintenance therapy.

Methods: This was an observational study.

A prospective study of the diagnostic accuracy of PillCam ESO esophageal capsule endoscopy versus conventional upper endoscopy in patients with chronic gastroesophageal reflux diseases.

Introduction: Endoscopy is commonly performed to evaluate for suspected or established esophageal diseases including gastroesophageal reflux disease (GERD) and its complications. The newly developed PillCam ESO Esophageal Capsule offers an alternative approach to visualize the esophagus and to evaluate patients with suspected esophageal disease.

Aim: Compare the accuracy (specificity, sensitivity, positive predictive value [PPV], and negative predictive value [NPV]) of esophageal capsule endoscopy (ECE) compared with esophagogastroduodenoscopy (EGD) in evaluating patients with GERD.

Second capsule endoscopy for patients with severe iron deficiency anemia.

Background: Patients with iron deficiency anemia are subjected to multiple endoscopic and radiologic examinations of the GI tract. If negative, some of the examinations are repeated, occasionally with positive findings. The diagnostic yield of a second capsule endoscopy in such patients is unknown.

Effect of lower esophageal sphincter tone and crural diaphragm contraction on distensibility of the gastroesophageal junction in humans.

Previous studies of distensibility of the gastroesophageal junction (GEJ) in humans have not tried to distinguish between the effects of muscle action and passive elastic tissue properties of the GEJ. We studied 15 healthy subjects (ages 23-67 yr, 11 men/4 women) by using a catheter with a highly complaint bag positioned manometrically at the GEJ. The bag was distended with air at a rate of 20 ml/min while intrabag pressure was recorded.

Colorectal cancer screening in patients presenting with an inguinal hernia: is it necessary?

Background: It has been suggested that patients presenting with an inguinal hernia have an increased risk for colorectal cancer. Therefore, surgeons frequently request screening for colorectal cancer before surgery. The aim of this study was to assess the frequency of premalignant and malignant colonic lesions in a group of patients with an inguinal hernia, and to compare this with a control group of subjects undergoing screening colonoscopy.

Pharyngoesophageal pH monitoring.

Pharyngeal acid reflux events may be significant in the pathogenesis of various supraesophageal manifestations of gastroesophageal reflux disease. Intragroup variation and an extensive overlap among subject groups and normal controls make proximal esophageal 24-hour pH monitoring studies unreliable for the diagnosis of pharyngeal reflux. However, the clinical value of pharyngeal pH monitoring still remains uncertain.

Association between mutations in the CARD15 (NOD2) gene and Crohn's disease in Israeli Jewish patients.

Ulcerative colitis (UC) and Crohn's disease (CD) are heterogeneous disorders characterized by chronic intestinal inflammation. Genetic predisposition is a major risk factor in both diseases. The CARD15 (NOD2) gene has been implied as a candidate gene in the pathogenesis CD.

Cholesterol crystal embolization to the digestive system: characterization of a common, yet overlooked presentation of atheroembolism.

In the 1359 published patients with multiorgan cholesterol crystal embolism (CCE), the digestive system seems to be the third most frequently affected system. Yet, this system received hitherto only little attention in the medical literature. Therefore, the aim of the present study was to clinically characterize the subset of patients with CCE involving the digestive system, based on our institutional experience and a review of the literature.

Intrapharyngeal distribution of gastric acid refluxate.

Objectives/hypothesis: Determination of intrapharyngeal distribution of gastric acid refluxate is needed to better understand the pathogenesis of reflux-attributed aerodigestive tract disorders. The aims of the study were to determine intrapharyngeal distribution of gastric acid refluxate and to determine whether this distribution can better differentiate patients from control subjects compared with data obtained from a single hypopharyngeal site.

Methods: We prospectively studied 10 healthy volunteers, 12 patients with reflux laryngitis, and 15 patients with vasomotor rhinitis using a concurrent dual pharyngeal/dual esophageal pH recording technique.

Pharyngoglottal closure reflex: characterization in healthy young, elderly and dysphagic patients with predeglutitive aspiration.

Background: Mechanism(s) of aspiration, a common complication of oropharyngeal dysphagia, is not completely elucidated. Since the pharyngoglottal closure reflex induces vocal cord adduction in healthy young humans, it may help prevent aspiration during premature spill of oral content.

Objective: The objective of this study was to characterize this reflex in normal young and elderly humans and dysphagic patients with predeglutitive aspiration; a potential group for developing abnormalities of this reflex.