Update in Gastroenterology
- From University of Kansas Medical Center, Kansas City, Kansas. Requests for Reprints: Norton J. Greenberger, MD, Department of Medicine, University of Kansas Medical Center, Rainbow Boulevard at 39th Street, Kansas City, KS 66103. Current Author Addresses: Dr. Greenberger: Department of Medicine, University of Kansas Medical Center, Rainbow Boulevard at 39th Street, Kansas City, KS 66103.
1997-98 Series
John Roberts, MD, Editor
In the past year, major advances have been reported in almost every area of gastroenterology, including esophageal disease, gastric disease, lower gastrointestinal tract disease, and biliary tract disease.
Long-term therapy with proton-pump inhibitors has now been shown to control symptoms and maintain healing in patients with erosive esophagitis. Treatment regimens for Helicobacter pylori infection should achieve an eradication rate of at least 90%, and the search for simpler, effective regimens continues. It is well known that the risk for colorectal cancer is higher among patients whose first-degree relatives have had this type of cancer. A key study has shown that relatives of patients with adenomatous polyps are also at increased risk for developing colorectal cancer. Chronic unexplained diarrhea is common among patients with AIDS, and the best approach to diagnosis has been elusive. An important study has shown that clinical variables can help predict which patients with AIDS and diarrhea will benefit from endoscopic studies. Endoscopic biliary sphincterotomy is the procedure used most frequently to remove common bile duct stones, and more than 150 000 sphincterotomies are done each year in the United States. A seminal paper has demonstrated that complications of the procedure are related to several factors, including the technical skill of the endoscopist.
Esophageal Disease
In 1996, important findings in the area of esophageal disease included the further elucidation of the benefits and risks of proton-pump inhibitors; the discovery that some patients with achalasia benefit from injection of botulinum toxin; and the finding that the antiosteoporosis agent alendronate causes esophagitis, albeit rarely.
Lansoprazole Maintained Healing
Robinson M, Lanza F, Avner D, Haber M. Effective maintenance treatment of reflux esophagitis with low-dose lansoprazole. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1996; 124:859-67.
Erosive esophagitis is a chronic disorder, and up to 80% of patients have relapse …
This 100-word excerpt has been provided in the absence of an abstract.
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