Gastroenterology Commons^™

Comparative Analysis Of Health Outcomes In Gastric Cancer: Robotic Vs. Laparoscopic Gastrectomy, Maftuna Kurbonnazarova

Rowan-Virtua Research Day

Exploring the most effective surgical approach for gastrectomy is crucial for determining superior health outcomes in patients. This research compares robotic and laparoscopic techniques with the aim of pinpointing the optimal method, offering valuable insights for improved postoperative well-being.

A Case Of Esophagogastric Junction Outflow Obstruction Resulting To Megaesophagus In A 37-Year-Old Male, Dean Esma, Robin Lahr, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Esophagogastric junction outflow obstruction (EGJOO) is a major motility disorder characterized by an increase of > 15 mmHg in the integrated relaxation pressure (IRP) with or without problems in esophageal motility. This presents as dysphagia, chest pain, regurgitation, heartburn, cough, and a globus sensation, with dysphagia. Severe cases may lead to a megaesophagus causing compression of mediastinal structures.6 Its similarity to other esophageal disorders urge an investigation to improve its identification and treatment. This report presents a case of EGJOO in a 37-year-old cachectic male patient with dysphagia and vomiting, eventually determined to be EGJOO with diagnostic manometry.

Case Report: Diverticulitis Involving A Meckel’S Diverticulum, Samuel M. Thalathoti, Russell A. Mordecai

Rowan-Virtua Research Day

We report a case of a 65-year-old female who presented with abdominal pain and was diagnosed with diverticulitis involving a Meckel‘s Diverticulum. The differential diagnosis of abdominal pain is vast, in this age group includes, but is not limited to appendicitis, diverticulitis, cholecystitis, and small bowel obstruction. In the absence of complicated features, conservative management with oral antibiotics and close outpatient follow is advised. However, in the case of complicated diverticulitis and a rare manifestation such as a Meckel’s Diverticulum, careful management is indicated.

Dense Colon Scarring After Infliximab For Acute Severe Ulcerative Colitis, Rahul Patel, Sriya Vutukuru, Neethi Dasu, Charles Snyder

Rowan-Virtua Research Day

Introduction: Infliximab is a monoclonal antibody against tumor necrosis factor alpha used in the treatment of ulcerative colitis. It has been shown to be efficacious in patients with moderate to severe ulcerative colitis and/or those who have failed intravenous steroids. We present a unique finding of profoundly dense colonic scarring after a year of infliximab therapy in a patient with acute severe ulcerative colitis.

Case: A female in her early 60s presented to the hospital with a three month history of rectal bleeding and intermittent fevers. A colonoscopy was done which demonstrated severe Mayo 3 left-sided colitis, consistent with a …

Limonene Exerts Anti-Inflammatory Effect On Lps-Induced Jejunal Injury In Mice By Inhibiting Nf-Κb/Ap-1 Pathway, Sarmed H. Kathem, Yasameen Sh. Nasrawi, Shihab H. Mutlag, Surya M. Nauli

Pharmacy Faculty Articles and Research

The human gastrointestinal system is a complex ecosystem crucial for well-being. During sepsis-induced gut injury, the integrity of the intestinal barrier can be compromised. Lipopolysaccharide (LPS), an endotoxin from Gram-negative bacteria, disrupts the intestinal barrier, contributing to inflammation and various dysfunctions. The current study explores the protective effects of limonene, a natural compound with diverse biological properties, against LPS-induced jejunal injury in mice. Oral administration of limonene at dosages of 100 and 200 mg/kg was used in the LPS mouse model. The Murine Sepsis Score (MSS) was utilized to evaluate the severity of sepsis, while serum levels of urea and …

Diagnostic Accuracy Of Bowel Ultrasonography In Patients With Inflammatory Bowel Disease: A Systematic Review And Meta-Analysis, Sheza Malik, Sruthi Venugopalan, Bettina Gabrielle Tenorio, Shahab R. Khan, Priyadarshini Loganathan, Udayakumar Navaneethan, Babu P. Mohan

Ateneo School of Medicine and Public Health Publications

Background

Bowel ultrasonography (BUS) is emerging as a promising noninvasive tool for assessing disease activity in inflammatory bowel disease (IBD) patients. We evaluated the diagnostic accuracy of BUS in IBD patients against the gold standard diagnostic method, standard colonoscopy.

Methods

Major databases were searched from inception to May 2023 for studies on BUS diagnostic accuracy in IBD. Outcomes of interest were pooled sensitivity, specificity, positive (PPV), and negative (NPV) predictive values. Endoscopic confirmation served as ground truth. Standard meta-analysis methods with a random-effects model and I2 statistics were applied. Risk of bias was assessed using the Quality Assessment of Diagnostic …

Advancing School Nursing Practice: A Novel Approach To Screening For Gastrointestinal Disorders In Children, Ashley Bunting, Isabella Cavlan

Nursing | Student Research Posters

California schools currently only screen for vision and hearing, leaving many other health concerns unaddressed. Among these, gastrointestinal (GI) health is particularly significant, as digestive disorders can lead to severe consequences, like malnutrition and stunted growth. By incorporating routine GI screenings, school nurses can promote the early detection of disease, allowing for timely intervention and improved health outcomes in children.

Based on existing literature, we have developed a novel pediatric GI screening tool for school nurses to use in routine screenings, presented below.

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Dietary Analysis For Hashimoto’S Thyroiditis: An Integrative Review, Evan Thompson, Alison Hultquist

Master of Science in Nursing Final Projects

Abstract

Hashimoto’s Thyroiditis (HT) is the leading cause of primary hypothyroidism in the United States. In HT, there is an infiltration by lymphocytes which leads to the production of autoantibodies against the thyroid gland. Throughout this integrative review, the aim was to evaluate the effectiveness of micronutrient supplementation and dietary management as adjunct treatments in HT. The purpose was to assist primary care providers in the development of a more holistic plan of care. Literature published within the past seven years was gathered and reviewed from PubMed, CINAHL, and Cochrane Library. Findings indicate that many patients with HT may benefit …

Implementation Of Standardized Patient Education To Improve Adherence With Colonoscopy For Colorectal Cancer Screening, Melissa Leal Hearn, Melissa M. Hessock, Tara L. Hahn

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Colorectal cancer (CRC) is the third leading cause of cancer deaths among men and women in the U.S. CRC is preventable and manageable when detected early. Approximately 30% of average-risk Americans are overdue for colonoscopy screening. Colonoscopy screenings can reduce death by 67%. Current evidence suggests CRC screening education improves screening uptake among men and women at average-risk age.

LOCAL PROBLEM: The setting of this practice improvement project was a private colorectal surgery practice in South Texas, serving primarily Hispanic/Latino and Caucasian patients. Cancellation rates before colonoscopy were 16.8%, and there was no standardized education for CRC …

Slow Surgical Correction Affects More Than Just The Bowels, Emilia M. Clementi

Clinical Research in Practice: The Journal of Team Hippocrates

Reflection on how delayed colostomy reversal affects a patient's mental and physical well-being.

Scutellaria Baicalensis Enhances 5-Fluorouracil-Based Chemotherapy Via Inhibition Of Proliferative Signaling Pathways, Haizhou Liu, Hui Liu, Zhiyi Zhou, Jessica Chung, Guojing Zhang, Jin Chang, Robert A Parise, Edward Chu, John C Schmitz

Abington Jefferson Health Papers

Fluoropyridine-based chemotherapy remains the most widely used treatment for colorectal cancer (CRC). In this study, we investigated the mechanism by which the natural product Scutellaria baicalensis (Huang Qin; HQ) and one of its main components baicalin enhanced 5-fluorouracil (5-FU) antitumor activity against CRC. Cell proliferation assays, cell cycle analysis, reverse-phase protein array (RPPA) analysis, immunoblot analysis, and qRT-PCR were performed to investigate the mechanism(s) of action of HQ and its active components on growth of CRC cells. HQ exhibited in vitro antiproliferative activity against drug resistant human CRC cells, against human and mouse CRC cells with different genetic backgrounds and …

Case Report: Proximal Large Bowel Obstruction Due To Constipation Requiring Subtotal Colectomy And Ileostomy, Brian Lim, Russell Mordecai, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Large bowel obstructions are an abdominal emergency with morbidity and mortality dependent on early diagnosis . This case is of a 58-year-old male who presented with large bowel obstruction due to constipation. Differential diagnosis of large bowel obstruction ranges from benign to emergent should include conditions such as Ogilvie’s syndrome, paralytic ileus, small bowel obstruction to toxic megacolon. This male with only a risk factor of opioid use after spinal surgery. Attempts at medical management were made but the patient ultimately needed definitive management through exploratory laparostomy.

Seeing The Big Picture: System Architecture Trends In Endoscopy And Led-Based Hyperspectral Subsystem Intergration, Craig M. Browning

<strong> Theses and Dissertations </strong>

Early-stage colorectal lesions remain difficult to detect. Early development of neoplasia tends to be small (less than 10 mm) and flat and difficult to distinguish from surrounding mucosa. Additionally, optical diagnosis of neoplasia as benign or malignant is problematic. Low rates of detection of these lesions allow for continued growth in the colorectum and increased risk of cancer formation. Therefore, it is crucial to detect neoplasia and other non-neoplastic lesions to determine risk and guide future treatment. Technology for detection needs to enhance contrast of subtle tissue differences in the colorectum and track multiple biomarkers simultaneously. This work implements one …

Accuracy Of Noninvasive Diagnostic Tests For The Detection Of Significant And Advanced Fibrosis Stages In Nonalcoholic Fatty Liver Disease: A Systematic Literature Review Of The Us Studies, Dhaval Gosalia, Vlad Ratziu, Filip Stanicic, Djurdja Vukicevic, Vladimir Zah, Nadege Gunn, Dina Halegoua-De Marzio, Tram Tran

Department of Medicine Faculty Papers

Background: The purpose of this systematic literature review (SLR) was to evaluate the accuracy of noninvasive diagnostic tools in detecting significant or advanced (F2/F3) fibrosis among patients with nonalcoholic fatty liver (NAFL) in the US healthcare context.

Methods: The SLR was conducted in PubMed and Web of Science, with an additional hand search of public domains and citations, in line with the PRISMA statement. The study included US-based original research on diagnostic test sensitivity, specificity and accuracy.

Results: Twenty studies were included in qualitative evidence synthesis. Imaging techniques with the highest diagnostic accuracy in F2/F3 detection and differentiation were magnetic …

Effectiveness Of Stabilized Hypochlorous Acid In Acute Peritonitis Treatment: A Murine Surgical Study, Benjamin Michael Pomeroy

MSU Graduate Theses

Peritonitis is an inflammatory condition affecting the mesothelial cells that line the peritoneal cavity and is commonly induced by bowel perforations. This medical emergency is treated through antibiotic therapy and surgical intervention followed by tissue irrigation (lavage). Acute treatments aim to remove the bacterial burden, however recurring peritoneal infections occur at high rates and contribute to patient morbidity. These recurring infections are likely due to the inability of lavage solutions to remove the entire massive intra-abdominal bacterial load due to intestinal perforation. Numerous antiseptic solutions and antibiotic additives have been evaluated in their ability to improve source control by abdominal …

Infliximab As Rescue Therapy In Pediatric Severe Colitis, Kayla B. Briggs

Research Days

Background: Infliximab has been shown to be effective in achieving clinical remission in patients with ulcerative colitis (UC) refractory to conventional therapy. However, there is conflicting data in the literature regarding its effectiveness as rescue therapy in acute severe colitis. Furthermore, most studies were conducted in adults, and pediatric onset of inflammatory bowel disease (IBD) is associated with more severe disease that may be less amenable to rescue therapy.

Objectives/Goal: We reviewed our experience with pediatric severe colitis and report outcomes following attempted rescue therapy with infliximab.

Methods/Design: A retrospective review was conducted of patients with UC or indeterminate colitis …

The Role Of Fractionated Exhaled Nitric Oxide (Feno) In Eosinophilic Esophagitis And The Relationship With Downstream Eosinophils, Panamdeep Kaur

Research Days

Background: Eosinophilic Esophagitis (EoE) is a chronic immune mediated disease of the esophagus characterized by symptoms of esophageal dysfunction and eosinophilic-predominant inflammation of the esophagus. It can lead to feeding difficulties, failure to thrive, and esophageal stricturing. Currently, the gold standard for diagnosis and assessing response to therapy is upper endoscopy and histopathological analysis of biopsies. A noninvasive, cost-effective, and low risk alternative that can aid in the management of EoE is not currently available. Previous studies assessing correlation of fractionated exhaled nitric oxide (FeNO) with degree of esophageal eosinophilic inflammation were low powered but noted a trend for association. …

Gastric Antral Diverticula: A Rare Diverticula With A Unique Presentation, Pratishtha Singh, Kathleen Raynor, Chadley Froes

Gastroenterology

Gastric diverticula are the least common gastrointestinal diverticula. Patients can be diagnosed incidentally on EGD or present with variable symptoms such as abdominal fullness, anorexia, and perforation. Gastric diverticula can be acquired from malignancy, peptic ulcer disease, or prior surgery or be congenital. Treatment varies based on symptomatology ranging from conservative medical management with proton pump inhibitors to surgical treatment with open or laparoscopic resection. We present a case of a 73-year-old female with acquired gastric diverticulum presenting as a gastric outlet obstruction who was successfully treated with conservative medical therapy.

Association Of Presenting Symptoms With Abnormal Laboratory Values For Vector-Borne Illness — Experience In An Urban Gastroenterology Practice, Michael D. Erdman, Niloofar Kossari, Jessica Ye, Kristen H. Reynolds, Emily Blodget, B. Robert Mozayeni, Farshid Sam Rahbar

Journal of Patient-Centered Research and Reviews

Background: In the clinical setting, it is not common practice to consider a vector bite, such as from a tick or flea, to be a contributing factor to chronic digestive symptoms. This article investigates associations we have observed among symptomatic patients and positive blood tests for vector-borne illness (VBI).

Methods: Patients who visited an urban gastroenterology clinic over a 3-year period were retrospectively reviewed. A total of 270 patients presenting with a constellation of digestive symptoms — and who had no apparent digestive pathology and reported no prior diagnosis or treatments for VBI — were analyzed. Before the initial visit, …

Challenges During Colonoscopy In Women With A Prior Hysterectomy, Lubna Kamani, Nazish Butt, Hanisha Khemani

Section of Gastroenterology

No abstract provided.

Internal Hernia As A Late Complication Of Roux-En-Y Gastric Bypass Procedure, Samantha Purton, Gabriel Meshekow, My Myers, Edgar Mercado, Allan Katz

West Florida Division Virtual Research Day 2020

As the prevalence of obesity continues to rise, so does the popularity of bariatric surgery. Previously the Roux-en-Y gastric bypass was the most common bariatric procedure, but now falls second to the gastric sleeve. It remains a relevant procedure, however, accounting for 17% of bariatric procedures in 2018. Due to its prevalence, it is important that the radiologist be familiar with the procedure and its complications such as leak, obstruction, stricture, or, as in this case, internal herniation through a mesenteric defect. Internal hernias are more commonly associated with the laparoscopic approach versus open. This is likely due to fewer …

A Rare Cause Of Pneumoperitoneum, Robert Zusman, George Michael, Anna E. Augustin, My Myers, Dudith Pierre-Victor

West Florida Division Virtual Research Day 2020

Pneumoperitoneum is most commonly associated with a perforated viscus. When free air is seen on imaging, the most common course of action is an emergent exploratory laparotomy. However, pneumoperitoneum may not always be indicative of a perforated bowel. In the case described below, we will discuss a patient who developed acute peritonitis and pneumoperitoneum after undergoing chest compressions during cardiopulmonary resuscitation (CPR) and positive pressure mechanical ventilation.

A Rare Case Of Perforated Jejunal Diverticulitis, Mohamed Nagi Md, Stanley Deturris Md, Ang Darwin

General Surgery

Introduction: Jejunal diverticulosis is a rare condition with clinical incidence of 0.5%. It is less common than colonic and duodenum diverticulosis. It is usually asymptomatic and diagnosed incidentally but it may cause chronic symptoms and acute complications. The aim of the case report to increase the awareness about the disease Case Report: This is a 56-year-old Caucasian male who presented with abdominal pain and fever and was diagnosed with transverse colon diverticulitis with microperforation on CT scan. Patient was treated nonoperatively with antibiotics and was discharged home. Two months later, he presented with similar recurrent abdominal pain and was found …

Color-Based Template Selection For Detection Of Gastric Abnormalities In Video Endoscopy, Hussam Ali, Muhammad Sharif, Mussarat Yasmin, Mubashir Husain Rehmani

Publications

Computer-aided diagnosis of gastric diseases from endoscopy frames is an important task. It facilitates both the patient and gastroenterologist in terms of time, money and most important health. Colors are the basic visual features of endoscopic images and also provide clues about abnormal regions in endoscopy frames. A variety of color spaces available for representation of color frames. However, we are not certain about which color space is more suitable for representing color features of gastric images. This paper presents a comparison of color features in different color spaces for detection of abnormal areas in chromoendoscopy (CH) frames. In addition, …

Safety Of Endoscopic Retrograde Cholangiopancreatography (Ercp) In Pregnancy: A Systematic Review And Meta-Analysis, Mohamed Azab, Shishira Bharadwaj, Mahendran Jayaraj, Annie S. Hong, Pejman Solaimani, Mohamad Mubder, Hyeyoung Yeom, Ji Won Yoo, Michael L. Volk

School of Medicine Faculty Publications

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging procedure rarely associated with severe postprocedure complications. Hormonal changes during pregnancy promote cholelithiasis, but there are limited clinical data available on the outcomes of ERCP in pregnant women. ERCP techniques without irradiation were recently introduced as potential alternative. We performed a systematic review and meta-analysis to assess the safety of ERCP in pregnancy and to compare outcomes of radiation versus nonradiation ERCP. Materials and Methods: A systematic search of PubMed, Medline/Ovid, Web of Science, and Google Scholar through April 18th, 2018 using PRISMA and MOOSE guidelines identified 27 studies reporting the …

Role Of The Pharmacist In Improving Treatment For Children With Concurrent Gastrointestinal And Autism Spectrum Disorders, Whitney R. Henry, Kaitlin A. Sanders, Jenna L. Schaffner, Leslie M. Hart, Whitney N. Detillion, Anne F. Gentry

Pharmacy and Wellness Review

Over the last several years, a noteworthy association between gastrointestinal (GI) disorders and autism spectrum disorders (ASD) has been documented, although no large population-based studies exist. GI disorders in ASD children may stem from the underlying behavioral, communication, sensory or neurological issues intrinsic to the autistic disorder itself; therefore, the incorporation of alternative therapies, including behavioral modification, may be compelling treatment additions to the GI care traditionally recommended in children. To improve GI symptoms and quality of life in ASD children, a multidisciplinary approach is optimal, with pharmacists playing an active role in determining appropriate pharmacotherapy. Although there is a …

Double Pylorus: Case Report Of Atypical Presentation, Christopher Lozano Orpiano Do, Gurjeet Kang Do, Michael Quinn Do, Lakshminarasimhan Venu Md, Joseph Staffetti Md

Gastroenterology

Introduction: Double pylorus is a rare endoscopic finding that has been reported in 0.001% to 0.4% of upper gastrointestinal endoscopies, consisting of a gastroduodenal fistula extending from the prepyloric gastric antrum to the duodenal bulb through an accessory channel. In the majority of cases, it is a complication when peptic ulcers erode and create a fistula between the duodenal bulb and the distal stomach. It usually presents on the lessor curvature of the gastric antrum and on a superior wall of the duodenal bulb. It is commonly an endoscopic finding, since clinical presentation is similar to other peptic diseases.

Case …

Iron Pill-Induced Gastropathy In Elderly Patients: A Case Series Report, Isin Y. Comba Md, Richard Henriquez, Sundeep Kumar, Ruthvik Srinvasa-Murthy, Maria Wallis-Crespo, Lakhinder Bhatia Md, Joshua Shultz

Gastroenterology

Introduction: Iron deficiency anemia is a global health problem with an estimated two billion cases worldwide. Oral iron supplementation is considered the first line treatment. However, recent studies favor the use of short-term IV iron especially in patients with drug tolerance and efficacy concerns. In this report, we present three cases of iron pill gastropathy in patient's whose clinical courses were complicated by gastric erosion, ulcer or gastrointestinal (GI) bleeding. All of our patients had a history of iron deficiency anemia and were being treated with oral ferrous sulfate.

Case Description/Methods: The first case involved a 72-year-old male with multiple …

Size Matters: A Case Of Recurrent Proximal Esophageal Stenoses Treated With A Biliary Self Expanding Metal Stent (Sems), Sahityan Viswanathan, Timothy Dobin, Long T. Hoang

Gastroenterology

Esophageal stenosis after radiotherapy occurs in up to 15% of patients within three months of treatment. Endoscopic dilation remains the standard of care for cervical esophageal stenosis with refractory cases requiring stenting. Proximal stenosis poses a challenge as standard esophageal stents can cause cervicalgia and globus sensation due to their size and expansive force. We report on the usage of a biliary SEMS for a severe-recurrent stricture at the level of the proximal esophageal sphincter.