Here are Healio’s top 10 peer-reviewed articles from Digestive Disease Week 2022, which highlight research on restrictive diets, gallstone disease, dog ownership and Crohn’s disease, the response of COVID-19 antibodies and more.
Restrictive diets offer greater symptom reduction compared to medical treatment in patients with IBS
Two restrictive diets were superior in reducing symptoms compared to optimized medical treatment alone in patients with irritable bowel syndrome.
“There are several different treatment options that are effective in relieving IBS symptoms, and dietary treatment may indeed be encouraged as a first-line treatment option,” Sana NybackaRD, PhD, from the Department of Molecular and Clinical Medicine at the University of Gothenburg in Sweden, Healio told. “Our findings support current IBS treatment guidelines, where a positive IBS diagnosis is crucial for successful management of IBS and should be followed by general lifestyle intervention and dietary advice. Medical treatment should be guided by the patient’s symptom profile and preferences as a second-line treatment option.
Cholelithiasis may be predictive of pancreatic cancer
Patients with pancreatic ductal adenocarcinoma were six times more likely to have had cholelithiasis or cholecystitis in the year before diagnosis compared to the general population.
“Pancreatic cancer is often fatal, as it is often only diagnosed at an advanced stage. What complicates the initial diagnosis is that early symptoms often mirror those associated with gallstone disease and gallbladder inflammation, both of which have been shown to be risk factors for pancreatic cancer.” , Teviah E.Sachs, MD, MPH, associate professor and chief of surgical oncology at Boston Medical Center, said at the DDW press conference. “Unfortunately, little is known about how often these conditions occur before the diagnosis of pancreatic cancer.” Read more.
Early dog ownership may protect against developing Crohn’s disease
Ownership of a dog and close interactions with these pets in early childhood could help prevent the later development of Crohn’s disease.
“Our study appears to add to others that have explored the ‘hygiene hypothesis’ which suggests that lack of exposure to microbes early in life may lead to a lack of immune regulation towards environmental microbes” , Williams Turpin, Ph.D., research associate at Mount Sinai Hospital and the University of Toronto, said in a news release. Read more.
Unrecognized alcoholic hepatitis linked to higher mortality, hospitalization
A significant proportion of alcoholic hepatitis cases remain unrecognized and are correlated with higher 30-day mortality, length of hospital stay, and ICU admission.
“It remains to be determined whether this increased mortality is due to untreated versus the decreased tendency in this group to seek medical attention (presence of other comorbidities),” Julton Tomanguillo Chumbedoctor, from the division of gastroenterology at Charleston Area Medical Center in West Virginia, and colleagues wrote. Read more.
Rectal expulsion device may predict outcome in patients with chronic constipation
An experimental point-of-care rectal expulsion device may help determine whether patients with chronic constipation will improve with pelvic floor physical therapy.
“The Rectal Expulsion Device was specifically designed to simplify and pull the tertiary care paradigm of anorectal function testing downstream to the medical office of any general gastroenterologist for patients with chronic constipation,” Eric D. Shah, MD, MBA, assistant professor at Dartmouth College Geisel School of Medicine and Dartmouth-Hitchcock Medical Center in New Hampshire, Healio told. Read more.
Antibiotic use linked to increased risk of older-onset IBD
Antibiotic use, particularly those targeting gastrointestinal pathogens, was associated with an increased risk of older-onset inflammatory bowel disease.
“This risk is higher with each subsequent antibiotic treatment prescribed, within 1-2 years of antibiotic use, and with antibiotics targeting gastrointestinal pathogens,” Adam S. Faye, MD, MS, assistant professor of medicine and population health at NYU Grossman School of Medicine, Healio told. Read more.
Biologics linked to lower rate of dementia in older patients with IBD
Older patients with IBD who were treated with biologics had a lower incidence of dementia than those who were never treated with biologics.
“When we looked at a national database, we found an increased rate of dementia in patients with IBD,” Ahmad Eltelbanydoctor, an internist at the Cleveland Clinic, told Healio. “However, when we further stratified our study to examine the use of biologics among these groups of patients, we found that the group that used biologics had a reduced prevalence of dementia compared to the group that did not receive biologics. Organic Products.” Read more.
Debate: “Safety, suitability, cost” still favor percutaneous ultrasound biopsy over endoscopic biopsy
Although percutaneous liver biopsy is still the “gold standard”, technical advances and the increased use of ultrasound-guided endoscopic biopsy may soon change this dynamic.
“Endoscopic ultrasound-guided liver biopsy has several advantages, not the least of which is patient comfort.” David L. Diehl, MD, FASGE, from Geisinger Medical Center in Danville, Pa., told attendees. “It provides exceptional sampling yields with current techniques, and it is possible to do bi-lobar sampling in a very simple way, which can reduce sampling error.” Read more.
Cannabinoid use increases the need for higher sedation during endoscopy
Baseline cannabinoid use associated with the need for increased sedation in patients who underwent endoscopy with conscious sedation directed by an endoscopist.
“Endoscopist-directed conscious sedation, or EDCS, is widely used for routine endoscopic procedures such as gastroscopy and colonoscopy. Although effective and cost-effective, EDCS can be limited by the inability to achieve sufficient levels of sedation”, Yasmin Nasser, MD, PhD, assistant professor of medicine at the University of Calgary, said. “With the legalization [of cannabis] over the past decade there has been increasing use. …Given the underlying properties of cannabinoids and their potential for interactions with opiates and benzodiazepines frequently used in EDCS, it is biologically plausible that baseline cannabinoid use may influence sedation requirements for endoscopy. Read more.
Additional doses of SARS-CoV-2 vaccine increase antibody response in patients with IBD
Seroconversion rates and antibody response increased significantly after a third dose of SARS-CoV-2 vaccine in patients with IBD.
“Responses to the third and fourth doses were significantly stronger than a two-dose regimen,” Joshua Quan, MSc, a master’s student at the University of Calgary’s Cumming School of Medicine, told attendees. “Furthermore, the antibody responses deteriorated over time from the second to the third dose of vaccination, which really highlights the need for a third dose of vaccination.” Read more.