Drug consumption and additional risk factors associated with microscopic colitis: Case-control study.

Background: Microscopic colitis has now emerged as a common cause of chronic diarrhoea, but its aetiology remains unknown. Some studies suggest that commonly prescribed drugs and other additional risk factors may be triggers.

Aims: To evaluate the effects of drug intake and other risk factors on microscopic colitis patients.

Epidemiology and temporal trends (2000-2012) of inflammatory bowel disease in adult patients in a central region of Spain.

Background And Aim: A growing incidence of inflammatory bowel disease (IBD) has been reported recently in southern Europe, with records of pediatric cases confirming these tendencies in Spain. Data on adult populations, however, have not been provided for over 10 years and need to be updated.

Patients And Methods: A multicenter retrospective registry of all adult patients with a diagnosis of IBD, including both Crohn's disease (CD) and ulcerative colitis (UC), attending five public hospitals covering a population of 514 368 inhabitants, was assessed.

Same-day bidirectional endoscopy with nonanesthesiologist administration of propofol: safety and cost-effectiveness compared with separated exams.

Background And Aim: The safety and cost-effectiveness of a combination of esophagogastroduodenoscopy (EGD) and colonoscopy [or bidirectional endoscopy (BDE)] versus alternative-day EGD and colonoscopy when using nonanesthesiologist administration of propofol have never been evaluated.

Patients And Methods: This was a single-center prospective registry of consecutive American Society of Anaesthesiology class I-III outpatients undergoing EGD, colonoscopy, and BDE. Propofol was the sole sedative used.

The relationship between proximal and distal colonic adenomas: is screening sigmoidoscopy enough in the presence of a changing epidemiology?

Background And Study Aims: Because the relationship between distal and proximal colonic findings remains uncertain, controversy exists over whether proctosigmoidoscopy or colonoscopy is more suitable for colorectal cancer (CRC) screening. We aim to describe the distribution and characteristics of polyps removed in colonoscopy screening.

Patients And Methods: A prospective registry of a colonoscopy-based CRC screening program was developed on asymptomatic individuals over 50 years.

Empiric 6-food elimination diet induced and maintained prolonged remission in patients with adult eosinophilic esophagitis: a prospective study on the food cause of the disease.

Background: Although empiric exclusion from the diet of the 6 food groups most likely to trigger allergies achieves eosinophilic esophagitis (EoE) remission in children, data on its prolonged efficacy and effects on adults are lacking.

Objective: We sought to evaluate the efficacy of a 6-food elimination diet in inducing and maintaining prolonged remission in patients with adult EoE.

Methods: Sixty-seven consecutive patients with adult EoE were prospectively recruited and treated exclusively with a diet avoiding cereals, milk, eggs, fish/seafood, legumes/peanuts, and soy for 6 weeks.

Nutritional treatment in inflammatory bowel disease. An update.

Background And Aims: enteral (EN) and parenteral (TPN) nutrition exert variable therapeutic effects on the induction and maintenance of remission in inflammatory bowel disease (IBD). This review aims to provide an updated discussion on the complex relationship between diet and IBD.

Methods: medline, Cochrane and Scopus database searches were conducted.

Nonanesthesiologist-administered propofol sedation for colonoscopy is safe and effective: a prospective Spanish study over 1000 consecutive exams.

Background And Study Aims: Propofol is increasingly being used in sedated colonoscopy. This paper assesses the safety and efficacy of nonanesthesiologist-administered propofol in a large series of colonoscopies.

Patients And Methods: A prospective registry of consecutive American Society of Anesthetics (ASA) class I and II outpatients undergoing colonoscopy was carried out.

Prevalence and incidence of microscopic colitis in patients with diarrhoea of unknown aetiology in a region in central Spain.

Background: Often previously overlooked, microscopic colitis, including collagenous colitis and lymphocytic colitis, has now emerged as a common cause of chronic diarrhoea.

Aims: To evaluate the prevalence and incidence of microscopic colitis in patients with diarrhoea of unknown aetiology.

Methods: 271 consecutive patients who were referred to the General Hospital of Tomelloso from April 2008 to December 2010 for diarrhoea of unknown aetiology underwent a full colonoscopy to obtain biopsy samples to diagnose microscopic colitis on the basis of commonly accepted histological criteria.

Hepatic osteodystrophy: An important matter for consideration in chronic liver disease.

Hepatic osteodystrophy (HO) is the generic term defining the group of alterations in bone mineral metabolism found in patients with chronic liver disease. This paper is a global review of HO and its main pathophysiological, epidemiological and therapeutic aspects. Studies examining the most relevant information concerning the prevalence, etiological factors, diagnostic and therapeutic aspects involved in HO were identified by a systematic literature search of the PubMed database.

Subepithelial collagen deposition, profibrogenic cytokine gene expression, and changes after prolonged fluticasone propionate treatment in adult eosinophilic esophagitis: a prospective study.

Background: Recent research shows that both pediatric and adult patients with eosinophilic esophagitis (EoE) experience esophageal remodeling marked by increased collagen deposition in which TGF-β plays an important role. However, limited data are available on the intensity and reversibility of fibrous remodeling in adults with EoE.

Objective: We sought to analyze differences in collagen deposition in the lamina propria (LP) and profibrogenic cytokine gene expression along with other changes induced by prolonged treatment with fluticasone propionate in adults with EoE.

Resolution of metabolic syndrome after following a gluten free diet in an adult woman diagnosed with celiac disease.

Adult celiac disease (CD) presents with very diverse symptoms that are clearly different from those typically seen in pediatric patients, including ferropenic anemia, dyspepsia, endocrine alterations and elevated transaminase concentration. We present the case of a 51-year-old overweight woman with altered basal blood glucose, hypercholesterolemia, hypertriglyceridemia and persisting elevated transaminase levels, who showed all the symptoms for a diagnosis of metabolic syndrome. Because she presented iron deficiency anemia, she was referred to the gastroenterology department and subsequently diagnosed with celiac disease after duodenal biopsies and detection of a compatible HLA haplotype.

Montelukast was inefficient in maintaining steroid-induced remission in adult eosinophilic esophagitis.

Background And Aims: Leukotriene D4 is produced by and functions as a chemotactic factor for eosinophils. Eosinophilic esophagitis (EoE) is characterized by esophageal eosinophilic infiltration, determining structural changes and dismotility symptoms. Montelukast, a selective leukotriene D4 receptor antagonist, has gained increasing consideration as a therapeutic agent for EoE.

[Endoscopic percutaneous gastrostomy: an update on the indications, technique and nursing care].

There are numerous conditions and pathologies in which the patient's swallowing ability is diminished or prevented despite having working digestive system. These are the fundamental requirements for the placement of a percutaneous gastrostomy tube (PEG) as a method of choice to provide safe, effective, and prolonged enteral nutrition for the patient at home or when admitted to hospital. Due to its simplicity, safety and low cost, PEG offers several advantages over other feeding techniques, particularly nasogastric tube and parenteral feeding, although it does require simple and accurate knowledge and application of care that ensures low incidence of complications.

Treatment of eosinophilic esophagitis: how should we manage the disease?

Eosinophilic esophagitis (EE) is a chronic clinicopathologic syndrome and is the latest inflammatory disease of the esophagus described in literature. It seems to have a multifactorial etiology. Its causes include exposure to food or airborne allergens that affect individuals who may be genetically predisposed and exposure to the acid could also modulate the inflammatory response at esophageal level.

Adult patients with eosinophilic esophagitis do not show an increased frequency of the HLA-DQ2/DQ8 genotypes predisposing to celiac disease.

Background: Recent articles have described patients that share eosinophilic esophagitis (EoE) and celiac disease (CD) suggesting a true relationship between both diseases.

Aims: The purpose of this study was to investigate whether HLA DQ2 and DQ8 predisposing to CD are increased in adult patients with EoE.

Methods: HLA alleles conferring risk for CD was assessed in 75 adult EoE patients attended at two hospitals located in different Spanish regions over the past 2 years.

Eosinophilic Esophagitis: Current Aspects of a Recently Recognized Disease.

Eosinophilic esophagitis (EoE) is a chronic clinicopathological entity characterized by large numbers of intraepithelial eosinophils infiltrating the esophageal mucosa. The inflammation leads to alterations in the caliber and the motility of the organ, which determines esophageal symptoms, especially dysphagia and frequent food impaction. Firstly described in 1978, EoE represents today an increasingly recognized disease, with cases coming from all developed countries and rising epidemiology.