291 results match your criteria: "Digestive Diseases Institute[Affiliation]"

Hedonic Responses to Meal Ingestion in Patients With Functional Dyspepsia and Postprandial Symptoms.

Am J Gastroenterol

November 2024

Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), UniversitatAutònoma de Barcelona, Barcelona, Spain.

Introduction: It is not clear whether patients with postprandial symptoms enjoy the meal.

Methods: Prospective trial in patients with postprandial distress syndrome and healthy controls, comparing their responses with stepwise ingestion of a comfort meal.

Results: Healthy individuals (N = 18) enjoyed the meal and experienced digestive well-being.

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Eosinophilic Esophagitis (EoE) is a chronic inflammatory esophageal disorder, often associated with dysphagia, chest discomfort, and heartburn. There is limited information on persistent esophageal symptoms despite histologic remission (HR). We aimed to assess the prevalence and predictors of persistent esophageal symptoms in adult patients with EoE in HR.

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3-Dimensional Pouchography: A Video Tutorial.

Dis Colon Rectum

December 2024

Department of Colon & Rectal Surgery, Digestive Diseases Institute, Cleveland Clinic, Cleveland, Ohio.

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Creeping Fat-Derived Free Fatty Acids Induce Hyperplasia of Intestinal Muscularis Propria Muscle Cells: A Novel Link Between Fat and Intestinal Stricture Formation in Crohn's Disease.

Gastroenterology

November 2024

Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio; Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases Institute, Cleveland Clinic Foundation, Cleveland, Ohio; Cleveland Clinic Program for Global Translational Inflammatory Bowel Diseases. Electronic address:

Background & Aims: In Crohn's disease, wrapping of mesenteric fat around the bowel wall, so-called "creeping fat," is highly associated with strictures. The strongest contributor to luminal narrowing in strictures is a thickening of the human intestinal muscularis propria (MP). We investigated creeping fat-derived factors and their effect on mechanisms of human intestinal MP smooth muscle cell (HIMC) hyperplasia.

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Background: Perianal fistulas of Crohn's disease (CD) create a significant burden on patients' lives. However, the efficacy and safety of adipose-derived mesenchymal stem cell treatment are contradicting, and real-world evidence is lacking.

Aims: To examine the usability of darvadstrocel therapy in managing perianal CD.

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Background: The evidence for the management of patients with Crohn's disease (CD) and permanent ileostomy (PI) is limited. We aimed to summarize the interventional studies related to the provision of adjunctive ostomy care in this population.

Methods: MEDLINE, Embase, and Cochrane CENTRAL were searched from inception to January 5, 2024.

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Post-Discharge Outcomes of Elderly Patients Hospitalized for Inflammatory Bowel Disease Flare Complicated by Clostridioides difficile Infection.

J Crohns Colitis

October 2024

Division of Gastroenterology, Rabin Medical Center, affiliated with the Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.

Objectives: Elderly hospitalized patients with inflammatory bowel disease (IBD) flare and concurrent Clostridioides difficile infection (CDI) are considered at high risk of IBD-related complications. We aimed to evaluate the short, intermediate, and long-term post-discharge complications among these patients.

Methods: A retrospective multicenter cohort study assessing outcomes of elderly individuals (≥60 years) hospitalized for an IBD flare who were tested for CDI (either positive or negative) and discharged.

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Utilizing the glucose challenge test during pregnancy as a predictor of future diabetes risk.

BMC Pregnancy Childbirth

October 2024

Department of Endocrinology and Metabolism, Clalit Health Services, 8 Hanania St, Jerusalem, 9310609, Israel.

Article Synopsis
  • Gestational Diabetes Mellitus (GDM) is a major health issue that can lead to future diabetes, yet many women don't follow postpartum screening guidelines effectively.
  • A study examined the 50-gram glucose challenge test (GCT) results of 8,675 pregnant women to see how well they predict diabetes development after pregnancy.
  • The findings show that higher GCT values significantly increase the risk of future diabetes, suggesting that abnormal GCT results should be used for early diagnosis and intervention.
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  • Obesity significantly increases the risk of idiopathic intracranial hypertension (IIH), and this study investigates how bariatric surgery impacts clinical outcomes for patients with both conditions.
  • The study analyzed data from 97 predominantly female patients (median age 46.7) who underwent various types of bariatric surgery, leading to a median weight loss of 24% and notable improvements in IIH symptoms, including headaches and visual issues.
  • Results showed a significant reduction in mean lumbar opening pressure and a decrease in the usage of medications for IIH post-surgery, indicating that bariatric surgery can effectively alleviate IIH symptoms in obese patients.
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Article Synopsis
  • Upadacitinib, an oral Janus kinase inhibitor, showed effectiveness in treating moderate-to-severe Crohn's disease through phase 3 trials, specifically focusing on patients with fistulizing disease.
  • * In these studies, patients with fistulas were treated with either upadacitinib or a placebo, and outcomes included resolution of drainage and closure of external openings.
  • * Results indicated that upadacitinib significantly improved rates of drainage resolution and closure of perianal fistulas compared to placebo, showing promising clinical benefits for this patient group.
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Management of complications in patients with an ileostomy: an umbrella review of systematic reviews for the EndOTrial Consortium.

Int J Colorectal Dis

September 2024

Department of Medicine, Division of Gastroenterology, Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.

Background: Standardized clinical care processes for patients with Crohn's disease (CD) and a permanent ileostomy (PI) are lacking. The EndOTrial consortium aims to address this gap by developing pathways for care.

Methods: In this umbrella review, we searched major databases for relevant systematic reviews (SRs) or scoping reviews (ScR) published until January 5, 2024.

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Management of Small Bowel Crohn's Disease Strictures: To Cut, to Stretch, or to Treat Inflammation?

Gastroenterology

December 2024

Department of Gastroenterology, Hepatology & Nutrition, Digestive Diseases Institute, Cleveland Clinic Foundation, Cleveland, Ohio; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Program for Global Translational Inflammatory Bowel Diseases, Cleveland Clinic, Cleveland, Ohio. Electronic address:

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Salt of the earth: Predicting and treating alcohol relapse in high-risk patients after liver transplantation.

Liver Transpl

December 2024

Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan, USA.

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Unraveling Twisted Pouch Syndrome: A Narrative Review of Classification, Diagnosis, Treatment, and Prevention.

Inflamm Bowel Dis

August 2024

Dept. of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic, Cleveland OH, USA.

Background: We recently described a cluster of symptoms known as twisted pouch syndrome that rarely affects patients with ileoanal pouches. Herein, we present a narrative review in which we describe the diagnosis, treatment, and prevention of twisted pouch syndrome, with a focus on a simple classification schema.

Methods: Diagnostic signs from endoscopic and radiological examinations, treatment, and prevention strategies are presented.

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Cellular immunotherapies and immune cell depleting therapies in inflammatory bowel diseases: the next magic bullet?

Gut

December 2024

Department of Gastroenterology, Hepatology & Nutrition, Digestive Diseases Institute; Department of Inflammation and Immunity, Lerner Research Institute, Center for Global Translational Inflammatory Bowel Disease Research, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Despite significant advances in biologic and small molecule treatments and the emergence of combination therapies to treat inflammatory bowel diseases (IBD) a large unmet need remains to control intestinal inflammation. New approaches targeting several pathways simultaneously with a favorable safety profile and agents that trigger anti-inflammatory pathways to drive durable resolution of inflammation are needed. This article discusses novel cellular immunotherapies and immune cell depleting therapies in IBD, including CAR-T cell approaches, Tr1 and T regulatory (Treg) cells and cell depleting antibodies such as rosnilimab.

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There is increasing recognition of the associated bi-directional impact of inflammatory bowel disease (IBD) on patient well-being and the potential benefit of multidisciplinary teams to address these unique needs. At certain IBD centers, there has been an evolution towards patient-centric, holistic care to enhance well-being and improve health-related outcomes. Multiple models, incorporating various disciplines, care modalities, digital tools and care delivery, and resource support have arisen in IBD.

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Article Synopsis
  • - Significant advances in managing large laterally spreading tumors (LSTs) in colorectal polyps exist, but management practices vary globally, prompting the need for an international consensus.
  • - A Delphi study involving 43 experts from 18 countries led to 42 statements reaching consensus regarding training, evaluation, resection techniques, and post-resection care for LSTs.
  • - The resulting expert consensus aims to standardize practices and provide clear guidance for evaluating, resecting, and following up on LSTs worldwide.
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Long-term ileoanal pouch survival after pouch urinary tract fistulae.

Tech Coloproctol

June 2024

Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic Main Campus, 9500 Euclid Ave, A30, Cleveland, OH, 44122, USA.

Background: Ileoanal pouch is a demanding procedure with many potential technical complications including bladder or ureteral injury, while inflammation or stricture of the anastomosis or anal transition zone may lead to the formation of strictures and fistulae, including to the adjacent urethra. Pouch urinary tract fistulae are rare. We aimed to describe the presentation, diagnostic workup, and management of patients with pouch urinary at our center.

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Introduction: Revisional bariatric surgery is associated with higher perioperative complications over primary procedures. Adjustable gastric bands (AGB) continue to be the most frequently converted bariatric configuration. This study examines trends in current clinical indication and safety profile of the most frequently pursued AGB conversions.

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Background: The long-term risk of pouch failure after restorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) range from 5% to 15%. Salvage surgery for failing IPAA may be achieved by disconnecting the IPAA and either repairing and reusing the existing pouch (REP) or constructing a neopouch (NEO). We aimed to evaluate whether there are differences in long-term functional pouch survival and functional outcomes between the REP group and the NEO group.

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