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Acute pancreatitis (AP) accounts for over 230 000 US and 28 000 UK hospital admissions annually. Abdominal pain is the most common presenting symptom in AP but may not reflect severity. The clinical challenge is identifying the 20% of patients in whom AP will be severe. We summarise the common aetiologies, the risk stratification strategies including the simplified Bedside Index for Severity in Acute Pancreatitis, acute management approaches in the initial presentation setting, conditions for using advance imaging and opinions on antibiotic use. Some warning signs of impending complications are also discussed. [ABSTRACT FROM AUTHOR]

The article focuses on the use of SpyGlass single operator cholangioscope (SOC) for the diagnosis and treatment of radiographically negative biliary stones. Topics discussed include the use of endoscopic retrograde cholangiopancreatography (ERCP) for pancreaticobiliary intervention; the advantage of Spyglass over ERCP in finding out hidden stones; and two case studies of women suffering from biliary stones.

Helicobacter pylori is a common worldwide bacterium, possessing adaptability that has created difficulty achieving eradication. While the standard treatment was thought to be triple therapy with a proton pump inhibitor, amoxicillin, and clarithromycin, growing rates of treatment failure and antibiotic resistance have stimulated research into novel regimens. Quadruple therapy with bismuth has been compared for both first- and second-line treatments, but eradication still has not reached expected goals. Innovative regimens including sequential and concomitant therapy, as well as the introduction of new antibiotics into previous treatment schedules, have shown promising improvements in eradication rates. We discuss and compare these unique regimens, reviewing the current literature to deduce those which are most likely to provide the highest success in curing H. pylori infection. [ABSTRACT FROM AUTHOR]

Wheat-related disorders have become a growing area of clinical and scientific interest and can be categorized broadly as: autoimmune-mediated; allergic; and non-autoimmune/non-allergic conditions. Non-celiac gluten sensitivity (NCGS) and non-celiac wheat sensitivity (NCWS) present on this spectrum as disorders associated with adverse gastrointestinal and extra-intestinal manifestations following exposure to gluten and/or other wheat-related constituents. NCGS/NCWS is increasingly considered in patients with unexplained symptoms after the exclusions of celiac disease and wheat allergy. As objective diagnostic data and specific biomarkers are lacking, response to a gluten-free/wheat-free diet can confirm the presence of NCGS/NCWS. An association with irritable bowel syndrome has been detected, and the effects of other food components, such as fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, may contribute. Our organization and synthesis of extant knowledge pertaining to wheat-related disorders may advance current practice and research efforts toward an improved understanding of NCGS/NCWS as an evolving clinical entity. [ABSTRACT FROM AUTHOR]

In this article, the author focuses on the detection tests for colorectal cancer (CRC) screening including fecal occult blood testing (FOBT), stool DNA (sDNA) and fecal immunochemical testing (FIT). It mentions the importance of colon cancer screening in colon cancer awareness. It also mentions that according to the Centers for Disease Control and Prevention colonoscopy is commonly used test for CRC.

The authors discuss research on the association of streptococcus bovis bacteremia with liver and gastrointestinal disease in Hispanic population. Topics of the study highlighted include the mixed ethnicities reflected, the insufficient evidence of colorectal cancer, and the impact of ethnic-focused research on health care.

The author reflects on the diagnosis of irritable bowel syndrome (IBS). He notes that diagnosing IBS is not always straight-forward and is still challenge by the fact that there is no consistent biological marker of IBS currently existing. He adds that there can be wide range of symptoms among individuals who have IBS and symptoms are often difficult to quantify objectively. He also implies not to overlook other co-morbid conditions that may worsen IBS such as depression, anxiety, and insomnia.

The author reflects on the use of stress ulcer prophylaxis (SUP) for patients admitted at the intensive care unit (ICU) with comorbid conditions of coagulopathy or a history of gastrointestinal (GI) bleed. He notes that the American Society of Health-System Pharmacists (ASHP) expounds a set of guidelines for SUP and these were created by reviewing the validated evidence of usage. The agents typically used for SUP include sucralfate, H2-receptor antagonists and proton pump inhibitors (PPIs).

Colorectal cancer (CRC) is the third most common cancer in the United States. Early detection through colonoscopy significantly improves survival rates. Detecting colon polyps depends on the quality of bowel preparation. However, inadequate bowel preparation remains a significant issue in clinical practice. Efforts to address this challenge have led to the development of bowel preparation regimens emphasizing efficacy, tolerability, and safety. Bowel preparation options can be categorized by their osmotic and volume properties. Isosmotic solutions based on polyethylene glycol-electrolyte lavage solutions (PEG-ELS) are available in both low-volume PEG-ELS with ascorbic acid (PEG-Asc) (e.g., MoviPrep, PLENVU) and high-volume formulations (e.g., GoLYTELY, CoLyte), as well as sulfate-free high-volume PEG-ELS formulations (SF-PEG-ELS). Hyperosmotic solutions include oral sulfate solution (OSS) (e.g., SUPREP), sodium phosphate tablets (NaP) (e.g., OsmoPrep), oral sulfate tablets (OST) (e.g., SUTAB), flavored PEG with sulfate salts (FPSS) (e.g., SUFLAVE), and magnesium citrate. Hypoosmotic solutions consist of PEG-sports drink (PEG-SD). In addition, combination solutions are available, such as sodium picosulfate with magnesium citrate (SPMC) with laxatives (e.g., CLENPIQ), and OSS with SF-PEG-ELS (Suclear). Each regimen differs in terms of cost, volume, taste, contraindications, and potential adverse effects. Therefore, clinicians must carefully evaluate each patient to determine the most suitable regimen for their patients., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

The management of ingested foreign bodies is a challenging task because each case is unique with multiple varying factors including a patient's age, anatomical considerations, clinical presentation, and the type and location of the foreign body ingested. Additionally, concern over complications associated with button battery ingestion typically drives management decisions. The common practice is the urgent retrieval of the foreign body within two to six hours of presentation. An unusual case is presented here that demonstrated significantly delayed endoscopic removal of an ingested button battery without complication, avoiding the many risks associated with any emergent endoscopic procedure. However, this practice is a case-by-case decision because there is a lack of literature to guide the current management., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2024, Bhumi et al.)