Epidemiology and natural history of intestinal metaplasia of the gastroesophageal junction and Barrett's esophagus: a population-based study.

Objectives: Population-based data on the epidemiology and outcomes of subjects with intestinal metaplasia of the gastroesophageal junction (IMGEJ) and Barrett's esophagus (BE) are limited. The objectives of this study were to (i) estimate the incidence of IMGEJ and BE diagnosed from clinically indicated endoscopy in Olmsted County, MN, over three decades (1976-2006) and prevalence as of 1 January 2007, (ii) compare baseline characteristics of subjects with IMGEJ and BE, and (iii) study the natural history and survival of both cohorts.

Methods: This was a population-based cohort study.

Factor analysis identifies subgroups of constipation.

Aim: To determine whether distinct symptom groupings exist in a constipated population and whether such grouping might correlate with quantifiable pathophysiological measures of colonic dysfunction.

Methods: One hundred and ninety-one patients presenting to a Gastroenterology clinic with constipation and 32 constipated patients responding to a newspaper advertisement completed a 53-item, wide-ranging self-report questionnaire. One hundred of these patients had colonic transit measured scintigraphically.

Efficacy of 5-aminosalicylates in Crohn's disease: systematic review and meta-analysis.

Objectives: Crohn's disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract. Evidence for treatment with 5-aminosalicylic acid (5-ASA) drugs is conflicting. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine this issue.

Efficacy of 5-aminosalicylates in ulcerative colitis: systematic review and meta-analysis.

Objectives: The efficacy of 5-aminosalicylic acids (5-ASAs) in ulcerative colitis (UC) has been studied previously in meta-analyses. However, several randomized controlled trials (RCTs) have been published recently, and no previous meta-analysis has studied the effect of 5-ASA dosage used.

Methods: MEDLINE, EMBASE, and the Cochrane central register of controlled trials were searched (through December 2010).

Antibiotic therapy in inflammatory bowel disease: a systematic review and meta-analysis.

The etiology of inflammatory bowel disease (IBD) is unknown but may relate to an unidentified bacterial pathogen or an immunological reaction to gut microbiota. Antibiotics have therefore been proposed as a therapy for Crohn's disease (CD) and ulcerative colitis (UC) to induce remission in active disease to prevent relapse. Current data are conflicting and we therefore conducted a systematic review of randomized controlled trials (RCTs) evaluating antibiotics in IBD.

Efficacy of immunosuppressive therapy for inflammatory bowel disease: a systematic review and meta-analysis.

Objectives: There remains controversy regarding the efficacy of thiopurine analogs (azathioprine (AZA) and 6-mercaptopurine (6-MP)), methotrexate (MTX), and cyclosporine for the treatment of inflammatory bowel disease (IBD). We performed an updated systematic review of the literature to clarify the efficacy of immunosuppressive therapy at inducing remission and preventing relapse in ulcerative colitis (UC) and Crohn's disease (CD).

Methods: Only parallel group randomized controlled trials (RCTs) were considered eligible.

Efficacy of biological therapies in inflammatory bowel disease: systematic review and meta-analysis.

Objectives: Crohn's disease (CD) and ulcerative colitis (UC) are inflammatory disorders of the gastrointestinal tract of unknown etiology. Evidence for treatment of the condition with biological therapies exists, but no systematic review and meta-analysis has examined this issue in its entirety.

Methods: MEDLINE, EMBASE, and the Cochrane central register of controlled trials were searched (through to December 2010).

Glucocorticosteroid therapy in inflammatory bowel disease: systematic review and meta-analysis.

Objectives: The use of glucocorticosteroids to treat both Crohn's disease (CD) and ulcerative colitis (UC) is widespread, but no systematic review and meta-analysis has examined the issue of efficacy of these agents in its entirety.

Methods: MEDLINE, EMBASE, and the Cochrane central register of controlled trials were searched (through December 2010). Randomized controlled trials (RCTs) recruiting adults with active or quiescent CD comparing standard glucocorticosteroids or budesonide with placebo or each other, or comparing standard glucocorticosteroids with placebo in active UC, were eligible.

Health Insurance Portability and Accountability Act (HIPAA) authorization and survey nonresponse bias.

Objectives: To extend earlier work (Beebe et al, Med Care. 2007;45:959-965) that demonstrated Health Insurance Portability and Accountability Act authorization form (HAF) introduced potential nonresponse bias (toward healthier respondents).

Research Design: The sample frame from the earlier experiment was linked to administrative medical record data, enabling the comparison of background and clinical characteristics of each set of respondents (HAF and No HAF) to the sample frame.

Screening for celiac disease in a North American population: sequential serology and gastrointestinal symptoms.

Objectives: The prevalence of diagnosed celiac disease is <1 in 2,000 in the United States, but screening studies undertaken in European and other populations have revealed a much higher prevalence. The objective of this study was to determine the prevalence of celiac disease and the utility of screening in the general adult population of a geographically isolated area.

Methods: Serum tissue transglutaminase antibodies (tTG-IgA) were measured in volunteer health-care participants aged ≥ 18 years at the annual Casper, Wyoming, Blue Envelope Health Fair blood draw.

Pathways connecting cognitive behavioral therapy and change in bowel symptoms of IBS.

Objective: A single previous paper on this topic found a direct pathway between cognitive behavioral therapy (CBT) and an irritable bowel syndrome (IBS) global symptom score. This is controversial since under the biopsychosocial model, the expectation is that CBT's effect would be mediated by mood. Using more sensitive bowel symptom scales and measurements at additional time points, we aimed to compare the relative strengths of direct pathways between CBT and change in IBS symptoms and indirect pathways that operate via mood state using structural equation modeling.

Mucosal inflammation as a potential etiological factor in irritable bowel syndrome: a systematic review.

Background: The causes of irritable bowel syndrome (IBS) remain obscure. Some investigators have proposed chronic low-grade mucosal inflammation as a potential etiological factor. We performed a systematic review to examine this issue in detail.

Low grade esophageal eosinophilia in adults: an unrecognized part of the spectrum of eosinophilic esophagitis?

Background: Eosinophilic esophagitis (EoE) is defined by a minimum of 15 eosinophils (eos) per high-powered field (HPF) on esophageal biopsy, along with esophageal symptoms and the exclusion of gastroesophageal reflux (GERD). The clinical significance of fewer eosinophils is unknown.

Methods: Fifty-nine adult patients without a previous diagnosis of EoE with esophageal biopsies containing 1-14 eos per HPF (low grade eosinophilia) and 418 adult patients with ≥15 eos per HPF were identified by retrospective review.

IBS in 2010: advances in pathophysiology, diagnosis and treatment.

IBS is a chronic, fluctuating disorder that continues to be the subject of considerable research. 2010 saw some key advances across all aspects of IBS, including further advances in our understanding of the pathophysiology, diagnosis and treatment of this condition.

Small bowel homing T cells are associated with symptoms and delayed gastric emptying in functional dyspepsia.

Objectives: Immune activation may have an important pathogenic role in the irritable bowel syndrome (IBS). While little is known about immunologic function in functional dyspepsia (FD), we have observed an association between cytokine secretion by peripheral blood mononuclear cells (PBMCs) and symptoms in IBS. Upper gastrointestinal inflammatory diseases are characterized by enhanced small bowel homing α4-, β7-integrin, chemokine receptor 9 (CCR9) positive T lymphocytes.

Neural autoantibody evaluation in functional gastrointestinal disorders: a population-based case-control study.

Background: Our goal is to investigate the serum profile of neural autoantibodies in community-based patients with irritable bowel syndrome (IBS) or functional dyspepsia. The pathogenesis of functional gastrointestinal (GI) disorders, including IBS and dyspepsia, are unknown. Theories range from purely psychological to autoimmune alterations in GI tract neuromuscular function.

An update on irritable bowel syndrome: from diagnosis to emerging therapies.

Purpose Of Review: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by abdominal discomfort or pain that is accompanied by a disturbance in defecation. Although the exact etiopathogenesis is not completely understood, recent advances in the understanding of the biochemical, physiologic, and biopsychosocial mechanisms of IBS have resulted in exciting new insights as well as therapies. This article will review the recent developments in pathogenesis, diagnosis, and treatment.

Occurrence of and risk factors for complications after endoscopic dilation in eosinophilic esophagitis.

Background: Several small series have suggested an increased risk of complications associated with esophageal dilation in patients with eosinophilic esophagitis (EoE).

Objective: To quantitate the risk and identify risk factors for esophageal complications in dilation in EoE patients.

Design: Retrospective, uncontrolled, single-center study.

Prospective diary evaluation of unexplained abdominal pain and bowel dysfunction: a population-based colonoscopy study.

Introduction: Diagnostic criteria for irritable bowel syndrome (IBS) have not been validated by prospective symptom diary. We investigated the bowel patterns in community subjects with and without non-organic abdominal pain, and compared the symptoms with subjects fulfilling the Rome II criteria (IBS).

Methods: From the Swedish population register, a random sample completed an abdominal symptom questionnaire.

Variation in prevalence, diagnostic criteria, and initial management options for eosinophilic gastrointestinal diseases in the United States.

Objectives: Variation in the prevalence of eosinophilic gastrointestinal diseases in different geographical regions has not been extensively studied. The aim of the present study was to define the regional and national prevalence of eosinophilic gastrointestinal diseases, and differences in practice approaches.

Patients And Methods: We administered a survey electronically to members of the American College of Gastroenterology, the American Academy of Allergy, Asthma, and Immunology, and the North American Society Pediatric Gastroenterology, Hepatology, and Nutrition.