Gastroenterology Commons^™

Urinary Cytokines As Potential Biomarkers Of Mild Cognitive Impairment And Alzheimer’S Disease: A Pilot Study, Nadia Ashrafi, Sumeyya Akyol, Sangeetha Vishweswaraiah, Abhishek Maiti, Ilyas Ustun, Sarah Bartolone, Travonia Brown-Hughes, Roland Thorpe Jr, Tammy Osentoski, Stacey Ruff, Amita Pai, Michael E. Maddens, Zaid Imam, Stewart Graham

Conference Presentation Abstracts

No abstract provided.

Safety And Indications For Endoscopic Retrograde Cholangiopancreatography In Liver Transplant Patients: An Analysis Of The United States’ National Inpatient Sample Database, Zahid Ijaz Tarar, Umer Farooq, Mustafa Gandhi, Muhammad Usman Zafar, Saad Saleem, Faisal Kamal

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is performed to treat biliary complications after a liver transplantation; however, the previously available literature on the safety of ERCP in liver transplant patients is limited. We aimed to study the safety of ERCP in liver transplant patients.

METHODS: We used a National Inpatient Sample database from 2016-2019 to identify patients who underwent ERCP and had a history of a liver transplantation, using the international classification of diseases, 10

RESULTS: Liver transplant patients who underwent ERCP had a higher rate of post-ERCP pancreatitis and bleeding compared to the general adult population (11.39% vs. 9.19%, 0.83% …

Diagnostic Role Of Fractional Exhaled Nitric Oxide In Pediatric Eosinophilic Esophagitis, Relationship With Gastric And Duodenal Eosinophils., Panamdeep Kaur, Rachel Chevalier, Craig A. Friesen, Jamie Ryan, Ashley K. Sherman, Stephanie Page

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Eosinophilic esophagitis (EoE) is an eosinophilic-predominant inflammation of the esophagus diagnosed by upper endoscopy and biopsies. A non-invasive and cost-effective alternative for management of EoE is being researched. Previous studies assessing utility of fractional exhaled nitric oxide (FeNO) in EoE were low powered. None investigated the contribution of eosinophilic inflammation of the stomach and duodenum to FeNO.

AIM: To assess the utility of FeNO as a non-invasive biomarker of esophageal eosinophilic inflammation for monitoring disease activity.

METHODS: Patients aged 6-21 years undergoing scheduled upper endoscopy with biopsy for suspected EoE were recruited in our observational study. Patients on steroids …

Gastrointestinal Bleeding As Initial Manifestation Of Injection Drug Use-Associated Amyloidosis, Mohammed Rifat Shaik, Nishat Anjum Shaikh, Elvina Yunasan, Erika Wheeler, Robert T Chow

Journal of Community Hospital Internal Medicine Perspectives

Systemic amyloidosis has been reported in the context of injection drug use, usually related to ongoing chronic inflammation and persistent cutaneous infections. The kidneys are almost always the first organs affected in that setting. Involvement of the gastrointestinal tract is less common and rarely the initial site of presentation. We present a case of systemic amyloidosis that primarily manifested in the gastrointestinal tract, occurring in the setting of chronic injection drug use. The patient's hemoglobin level dropped progressively over time due to ongoing, slow gastrointestinal bleeding, prompting an endoscopic examination that ultimately confirmed the presence of gastrointestinal amyloidosis. As the …

Recurrent Psychosis In Non-Celiac Gluten Sensitivity, Scarlet Louis-Jean, Shire Chaudhry

Journal of Community Hospital Internal Medicine Perspectives

Neuropsychological manifestations following food exposures in patients with food sensitivities are increasingly being identified in the literature, as understanding of the gut-brain axis is further improved. Non-celiac gluten sensitivity (NCGS) has been shown to occur in individuals without serological or biopsied evidence of celiac disease (CD), who manifest psychotic or mood disorders that resolve following elimination of gluten. In this case history, we discuss a similar manifestation in a 31-year-old woman without serological evidence of CD, whose psychiatric symptoms improve with gluten elimination.

Prevalence And Impact Of Gastrointestinal Manifestations In Covid-19 Patients: A Systematic Review, Bassam Hossain, Shoreh Qazi, Sumair Ahmad, Atif Saleem, Amanke Oranu, Fahad Malik

Journal of Community Hospital Internal Medicine Perspectives

Background and Objective: The aim of this study is to systematically analyze and summarize the implications of COVID-19 on the digestive system by quantitatively evaluating the prevalence of gastrointestinal symptoms such as nausea, vomiting, abdominal pain, constipation, diarrhea, anorexia. reported in COVID-19 cases. We simultaneously investigated other variables to determine the association of such symptoms in COVID-19 patients which can potentially influence the disease prognosis and outcome. This systematic review presents an updated literature on the issue as it requires more scientific discussion in order to better inform the medical community and authorities so that appropriate measures can be taken …

Management Of Patient With Impaction Secondary To Undigested Sunflower Seed Bezoar: A Case Report, Sufia Ahmed, Anthony Adetomiwa

Research Day

Introduction: Bezoars are aggregates of undigested plant fibers, hair, or seeds that may impact in any portion of the GI tract. These bezoars if left can lead to significant complications, including perforation and peritonitis.

Methods: We report a case of a 4-year-old female patient who presented to the emergency department with constipation and severe lower abdominal pain following unsupervised consumption of a large unknown volume of sunflower seeds. Initial radiograph revealed an undigested bezoar of seeds in the sigmoid colon and rectum. The patient was managed with mineral oil enema and manual disimpaction under conscious sedation. Subsequent radiographs revealed a …

Colonic Stenosis In An Elderly Female, Tiffany R. Pittman, Kylie A. Parrish, Grace M. Perry, Oyindamola C. Orekoya, Shiv Dhiman, Savita Arya

Research Day

Introduction

Colonic stenosis is commonly caused by chronic inflammation and is a known side effect of inflammatory conditions, such as diverticulitis and irritable bowel syndrome. Diverticulosis is a common condition where parts of the colon wall become weakened, forming outpouches. These outpouchings may become inflamed, leading to diverticulitis. This chronic inflammation can cause scarring and fibrosis of the colon, resulting in colonic stenosis. Inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, may also result in scarring and colonic stenosis. The incidence rate of patients developing colonic stenosis is 8-13.5% for Crohn's disease and 1-11% for ulcerative colitis. Patients …

Evaluating The Impact Of Routine Enteral Iron Fortification On Gastrointestinal Dysbiosis In Premature Infants, Matthew Van Ormer

Theses & Dissertations

The gastrointestinal microbiome in preterm infants bears significant influence on optimal outcomes – dysbiosis is shown to substantially increase the risk of the life-threatening necrotizing enterocolitis, whereas optimal microbiome composition improves nutrient digestion and immune function. Iron is a vital nutrient especially during the perinatal window of rapid hemoglobin production, tissue growth, and foundational neurological development. However, excess colonic iron exhibits potent oxidation capacity and alters the competitive environment of microbes – potentially facilitating the proliferation of pathological bacterial strains in the gut. Of note, breastfed preterm infants routinely receive iron fortification starting at 14 days of life and are …

When Constipation Becomes Lethal: Septic Shock Induced By Stercoral Colitis In A 77-Year-Old Female, Anna Delancy, Nicholas Tomasello, Joan Wiley, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Stercoral colitis is a form of colitis caused by fecal impaction distending the colon and causing fecaloma formation. Fecalomas lead to pressure necrosis of the colon and eventual perforation. The increased intraluminal pressure from the distention of the colon causes vascular compromise and ischemia. The most common locations of necrosis are in the sigmoid colon and rectum . When progressed to perforation, the mortality rate is as high as 60%. The most common cases of stercoral colitis occur in nursing home patients, mentally impaired patients, or those with chronic constipation. Here we describe an unusual case of stercoral colitis causing …

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.

Sigmoid Perforation Extending Into The Abdominal Wall, Zamran Masih, Wayne Tamaska, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Sigmoid colon perforation and spread into the abdominal wall is a rare condition that can occur due to various causes such as diverticulitis, trauma, malignancy, or iatrogenic injury during surgery. Although rare, sigmoid colon perforation into the abdominal wall can result in significant morbidity and mortality if not promptly diagnosed and treated. Most common cause of diverticular disease leading to perforation is diverticulitis, accounting for 60% of all colonic perforations.

Effects Of Nstemi On Patients With Eating Disorders: Insights From The National Inpatient Sample, Rafail Beshai, Keri Anacker, Keith Anacker, Tony Elias, David Halim-Banoub, Maziyar Daneshvar, Howard Weinberg

Rowan-Virtua Research Day

Introduction: Eating disorders (ED) such as bulimia and anorexia nervosa have detrimental implications on the health and wellbeing of children and young adults across the country. Cardiovascular implications are known to accompany these conditions, however there is a paucity of data looking specifically on the effects of NSTEMI on patients with these disorders. We sought to analyze this relationship further by examining these disorders within the national inpatient sample database to describe in-hospital trends and outcomes among those patients.

Methods: Data were extracted from the National Inpatient Sample (NIS) Database for the years 2019 and 2020. The NIS was searched …

Use, Durability, And Risks For Discontinuation Of Initial And Subsequent Biologics In A Large Pediatric-Onset Ibd Cohort., Jess L. Kaplan, Chunyan Liu, Eileen C. King, Julie A. Bass, Ashish S. Patel, Jeanne Tung, Shiran Chen, Trevor Lissoos, Ninfa Candela, Shehzad Saeed, Richard B. Colletti, Improvecarenow Network

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Biologic medications are recommended for treatment of moderately-to-severely active Crohn disease (CD) or ulcerative colitis (UC) in children. However, many patients require sequential biologic treatment because of nonresponse or loss of response to the initial biologic.

METHODS: We analyzed pediatric inflammatory bowel disease (IBD) data from the ImproveCareNow Network registry between May 2006 and September 2016, including time to biologic initiation, choice of first subsequent biologics, biologic durability, and reasons for discontinuation.

RESULTS: Of 17,649 patients with IBD [CD: 12,410 (70%); UC: 5239 (30%)], 7585 (43%) were treated with a biologic agent before age 18 (CD: 50%; UC: 25%). …

Drug Metabolizing Enzymes And Transporters May Help Determine Effective Budesonide Dosing In Eoe, Laurie Mccann, Lisa Harvey, Norah Almahbub, Wendy Y. Wang, Erin C. Boone, Janelle R. Noel-Macdonnell, Rachel Chevalier

Posters

Background: Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder diagnosed in children with painful or difficult swallowing, vomiting, or poor weight gain.  Current treatment models adopt a trial-and-error approach in regard EoE treatment, including restrictive elimination diets, proton pump inhibitors, and topical budesonide. This approach can delay effective treatment which increases risk of disease progression and increases medical costs to families for frequent clinic visits and endoscopy.   Objectives/Goal: The objective of this study is to determine the CYP3A5 genotype and expression of patients with eosinophilic esophagitis to discover which patients will respond to standard dosing of topical budesonide treatment (1, …

The Inherited Intestinal Microbiota From Myeloid-Specific Zip8ko Mice Impairs Pulmonary Host Defense Against Pneumococcal Pneumonia, Derrick R. Samuelson, Deandra R. Smith, Kelly C. Cunningham, Sabah Haq, Daniel N. Villageliú, Christi Christi Ellis, Niaz Bahar Chowdhury, Amanda E. Ramer-Tait, Jeff Price, Daren L. Knoell

Food for Health: Publications

Intestinal dysbiosis increases susceptibility to infection through the alteration of metabolic profiles, which increases morbidity. Zinc (Zn) homeostasis in mammals is tightly regulated by 24 Zn transporters. ZIP8 is unique in that it is required by myeloid cells to maintain proper host defense against bacterial pneumonia. In addition, a frequently occurring ZIP8 defective variant (SLC39A8 rs13107325) is strongly associated with inflammation-based disorders and bacterial infection. In this study, we developed a novel model to study the effects of ZIP8-mediated intestinal dysbiosis on pulmonary host defense independent of the genetic effects. Cecal microbial communities from a myeloid-specific Zip8 knockout mouse …

Impact Of Risk Factors On The Evolution Of Severe Acute Pancreatitis, Andra Maria Trotea, Raluca Grigorescu, Dragos Serban, Radu Palade, Simona Balasescu, Cristian Mihai Branescu, Daniel Radu, Corneliu Tudor, Tiberiu Alexandru Trotea

Journal of Mind and Medical Sciences

Introduction. Severe acute pancreatitis (SAP) is an acute inflammatory condition of the pancreas with increasing incidence and mortality rates in recent years. The aim of this study was to evaluate the impact of age, comorbidities, and different scoring systems on the complications and outcomes of SAP. Materials and Methods. A retrospective study was conducted on 161 patients diagnosed and treated for SAP at the Bucharest University Hospital in the intensive care unit (ICU), in the period 2014-2021. The impact of risk factors for the development of SAP, occurrence of complications (respiratory, cardiac, etc.), length of hospital stays and mortality was …

Matrix Gla Protein – A New Marker For Colorectal Cancer Detection? A Systematic Review, Mirela-Georgiana Perné, Lorena Ciumărnean, Olga-Hilda Orășan, Vasile Negrean, Teodora-Gabriela Alexescu, Mircea Vasile Milaciu, Ioana Roșca, Răzvan Dan Togănel, Gabriel Emil Petre, Lucia Procopcoiuc, Cristina Drugan, Alexandra Crăciun

Journal of Mind and Medical Sciences

Background. Colorectal cancer is a real public health issue, with high morbidity and severe impact on quality of life. Although mortality from this type of cancer is decreasing due to modern diagnostic and treatment methods, the understanding of its genetic and molecular mechanisms is important to develop a broader range of diagnostic and therapeutic approaches. Genetic therapy is an important strategy in cancer treatment, and the matrix Gla protein (MGP) gene expression has been described in numerous studies as increased in tumour pathology. In this article, we have summarized the currently available evidence on the connection between MGP and colorectal …

Tips And Tricks For Laparoscopic Cholecystectomy In The Patient With Ventriculoperitoneal Shunt; A Case Report, Carmen Popa, Andrei Moisin, Mihai Faur, Mihaela Racheriu, Ramona Coca, Cristian Mihai Branescu, Tiberiu Trotea, Denisa Tănăsescu

Journal of Mind and Medical Sciences

Laparoscopic surgery in patients with ventriculo-peritoneal shunt is challenging in terms of technical approach. The severity of possible complications and the lack of studies on this association increase the surgeon's discomfort with such surgery. The main complications that may occur are increased intracranial pressure, secondary pneumo-peritoneum pneumocephalus, encephalitis and the risk of catheter injury during laparoscopic procedures. We present the case of a 56-year-old patient operated in 2004 for a basilar artery top aneurysm with subarachnoid hemorrhage and secondary hydrocephalus, for which a ventriculo-peritoneal shunt was fitted. This patient presented in our clinic with diffuse abdominal pain, more accentuated in …

Haemorrhoidal Artery Ligation Compared To Alternative Surgical Techniques For The Treatment Of Grade Ii-Iv Haemorrhoids: A Systematic Review, Dayna Van De Hoef, Aisling Hogan

Journal of Mind and Medical Sciences

Background. Haemorrhoidal disease is a common disorder in the Western World that commonly requires surgical treatment, but original open techniques were associated with significant complications and pain. Haemorrhoidal Arterial Ligation (HAL) has gained popularity for relatively low complication and postoperative pain rates. This review assesses clinical outcomes of this technique in comparison to alternative modern techniques. Methods. The literature was searched on MEDLINE, EMBASE, Google Scholar, and Cochrane Library databases. Search terms: dearterialization, artery ligation, mucopexy, recto-anal repair. Inclusion criteria: RCTs, original publications, grade II, III and/or grade IV haemorrhoids, elective procedures. Exclusion criteria: non-English, non-adults, published pre-2016. Results. 14 …