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1. A single dedicated vaccination visit improves vaccination coverage of patients with inflammatory bowel disease

Author: Guillaume Le Cosquer, Lionel Grangeon, Pauline Rivière, Arthur Berger, Frank Zerbib, David Laharie, and Florian Poullenot
Subjects: Diseases of the digestive system. Gastroenterology, RC799-869
Abstract: Introduction: Patients treated with biologics for inflammatory bowel disease (IBD) have an increased risk of severe infections. Real-life vaccination coverage in this population remains low despite international vaccination guidelines. The aim of this study was to evaluate the impact of a dedicated vaccination visit on vaccination coverage. Methods: A dedicated vaccination visit was offered to all patients admitted for an infusion of a biologic in a tertiary IBD center during a 4-week period. At baseline, vaccination status was collected. Patients received specific information on recommended vaccinations. Perceived utility of both vaccination and the dedicated visit were assessed by visual analogue scale (VAS). Vaccination coverage was reassessed 6 months later by phone call. Results: Among the 207 patients analyzed (1 patient declined), rates of vaccination at baseline and 6 months later against diphtheria were 52.7% and 68.6% ( p
Published: 2022
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2. Refractory Gastroesophageal Reflux Disease: A Management Update

Author: Francesco Rettura, Francesco Bronzini, Michele Campigotto, Christian Lambiase, Andrea Pancetti, Ginevra Berti, Santino Marchi, Nicola de Bortoli, Frank Zerbib, Edoardo Savarino, and Massimo Bellini
Subjects: gastroesophageal reflux disease (GERD), refractory GERD (rGERD), 24-h multichannel intraluminal impedance-pH (MII-pH), proton pump inhibitors (PPIs), laparoscopic antireflux surgery (LARS), Medicine (General), R5-920
Abstract: Gastroesophageal reflux disease (GERD) is one of the most frequent gastrointestinal disorders. Proton pump inhibitors (PPIs) are effective in healing lesions and improving symptoms in most cases, although up to 40% of GERD patients do not respond adequately to PPI therapy. Refractory GERD (rGERD) is one of the most challenging problems, given its impact on the quality of life and consumption of health care resources. The definition of rGERD is a controversial topic as it has not been unequivocally established. Indeed, some patients unresponsive to PPIs who experience symptoms potentially related to GERD may not have GERD; in this case the definition could be replaced with “reflux-like PPI-refractory symptoms.” Patients with persistent reflux-like symptoms should undergo a diagnostic workup aimed at finding objective evidence of GERD through endoscopic and pH-impedance investigations. The management strategies regarding rGERD, apart from a careful check of patient's compliance with PPIs, a possible change in the timing of their administration and the choice of a PPI with a different metabolic pathway, include other pharmacologic treatments. These include histamine-2 receptor antagonists (H2RAs), alginates, antacids and mucosal protective agents, potassium competitive acid blockers (PCABs), prokinetics, gamma aminobutyric acid-B (GABA-B) receptor agonists and metabotropic glutamate receptor-5 (mGluR5) antagonists, and pain modulators. If there is no benefit from medical therapy, but there is objective evidence of GERD, invasive antireflux options should be evaluated after having carefully explained the risks and benefits to the patient. The most widely performed invasive antireflux option remains laparoscopic antireflux surgery (LARS), even if other, less invasive, interventions have been suggested in the last few decades, including endoscopic transoral incisionless fundoplication (TIF), magnetic sphincter augmentation (LINX) or radiofrequency therapy (Stretta). Due to the different mechanisms underlying rGERD, the most effective strategy can vary, and it should be tailored to each patient. The aim of this paper is to review the different management options available to successfully deal with rGERD.
Published: 2021
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3. Alteraciones de la motilidad esofágica en la manometría de alta resolución: Clasificación de Chicago versión 4.0©

Author: Rena Yadlapati, Peter J. Kahrilas, Mark R. Fox, Albert J. Bredenoord, C. Prakash Gyawali, Sabine Roman, Arash Babaei, Ravinder K. Mittal, Nathalie Rommel, Edoardo Savarino, Daniel Sifrim, André Smout, Michael F. Vaezi, Frank Zerbib, Junichi Akiyama, Shobna Bhatia, Serhat Bor, Dustin A. Carlson, Joan W. Chen, Daniel Cisternas, Charles Cock, Enrique Coss-Adame, Nicola de Bortoli, Claudia Defilippi, Ronnie Fass, Uday C. Ghoshal, Sutep Gonlachanvit, Albis Hani, Geoffrey S. Hebbard, Kee Wook Jung, Philip Katz, David A. Katzka, Abraham Khan, Geoffrey Paul Kohn, Adriana Lazarescu, Johannes Lengliner, Sumeet K. Mittal, Taher Omari, Moo In Park, Roberto Penagini, Daniel Pohl, Joel E. Richter, Jordi Serra, Rami Sweis, Jan Tack, Roger P. Tatum, Radu Tutuian, Marcelo F. Vela, Reuben K. Wong, Justin C. Wu, Yinglian Xiao, and John E. Pandolfino
Subjects: Acalasia. Espasmo esofágico. Presión de relajación integrada. Esfínter esofágico inferior. Miotomía. Endoscopia Peroral., Diseases of the digestive system. Gastroenterology, RC799-869, Internal medicine, RC31-1245
Abstract: La Clasificación de Chicago v4.0 (CCv4.0) es el esquema actualizado para clasificar las alteraciones de la motilidad esofágica utilizando la métrica de la manometría de alta resolución (HRM). Para desarrollar la CCv4.0, 52 expertos internacionales diversos separados en siete subgrupos de trabajo utilizaron una metodología formalmente validada, en un periodo de dos años. Las actualizaciones claves de la CCv4.0 consisten en un protocolo de HRM más riguroso y expansivo que incorpora las posiciones en decúbito supino y sedestación, así como pruebas provocadoras; una definición refinada de la obstrucción del flujo de salida de la unión esofagogástrica (EGJOO), criterios diagnósticos más estrictos para la motilidad esofágica inefectiva, y descripción de la métrica basal de la EGJ. Adicionalmente, la CCv4.0 se propuso definir el diagnóstico de alteración de la motilidad como conclusivo o no conclusivo con base en los síntomas asociados, los hallazgos en las pruebas provocadoras, y los resultados de los exámenes de apoyo como el esofagograma con tableta de bario y/o la prueba con sonda para imagen endoluminal funcional. Estos cambios buscan minimizar la ambigüedad presente en iteraciones previas de la Clasificación de Chicago; además proveen criterios más estandarizados y rigurosos para los patrones de alteración de la peristalsis y obstrucción de la EGJ.
Published: 2021
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4. Compliance with Gluten Free Diet Is Associated with Better Quality of Life in Celiac Disease

Author: Raphaël Enaud, Candice Tetard, Raphaël Dupuis, David Laharie, Thierry Lamireau, Frank Zerbib, Pauline Rivière, Sarah Shili-Mismoudi, and Florian Poullenot
Subjects: celiac disease, gluten free diet, compliance, quality of life, Nutrition. Foods and food supply, TX341-641
Abstract: The quality of life (QOL) of patients with celiac disease (CD) can be altered by both symptoms of the disease and by the restrictions of the gluten-free diet (GFD). The objective was to determine the factors associated with better QOL in a large cohort of CD patients. A link to an online survey was sent to the members of the French Association of Gluten Intolerant People (AFDIAG). The French-Celiac Disease Questionnaire (F-CDQ), scoring from 0 to 100, was used to measure the QOL. Other data collected were sociodemographic characteristics, information on CD, purchasing and consumption habits of gluten-free products, and a self-assessment scale (ranging from 0 to 10) to determine the compliance with the GFD. Among the 907 CD patients who returned the questionnaire, 787 were analyzed (638 women (81%); median age: 49 years; 71% with self-assessed GFD compliance > 8). Their median F-CDQ was 73 (range: 59–82). In multivariate analysis, the main factors associated with a better quality of life were the long duration of the GFD, good compliance with the GFD, and the number of follow-up visits. Compliance with and duration of the GFD are associated with a better quality of life in patients with CD. Taking this into consideration would offset its restrictive aspect and improve its adherence.
Published: 2022
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5. Pattern and Severity of Psoriasiform Eruptions in Patients with Inflammatory Bowel Diseases, Arthritis or Skin Inflammatory Disorders Treated with TNF-alpha Inhibitors

Author: Anne-Sophie Darrigade, Brigitte Milpied, Marie-Elise Truchetet, Thierry Schaeverbeke, David Laharie, Frank Zerbib, Marie Beylot-Barry, Thomas Jouary, Alain Taïeb, Khaled Ezzedine, and Julien Seneschal
Subjects: TNF-α, inhibitors, psoriasiformeruption, inflammatoryboweldisease, arthritis, psoriasis, tumournecrosisfactor, Dermatology, RL1-803
Abstract: Psoriasiform eruptions are a classical adverse skin reaction of tumour necrosis factor (TNF)-α inhibitors. The aim of this study was to identify the association between the severity or pattern of psoriasiform reactions and the underlying disease. A retrospective study was conducted between January 2012 and May 2015. Adult patients who developed psoriasiform eruptions whilst being treated with TNFα inhibitors were included. For each patient, 3 independent blinded dermatologists graded twice the severity of the lesions according to 6 clinical psoriasiform eruption types. Inter- and intra-individual kappa tests were performed to evaluate the robustness of the scoring system. The association between severity score levels or the pattern of reactions and the underlying disease was assessed. The severity scoring system showed good inter- and intra-observer reproducibility. Women patients treated with TNFα inhibitors for inflammatory bowel diseases showed a higher risk of developing severe reactions with scalp and skin-fold involvement.
Published: 2017
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6. Interferential therapy for chronic constipation in adults: The CON‐COUR randomizedcontrolled trial

Author: Veronique Vitton, François Mion, Anne‐Marie Leroi, Charlène Brochard, Benoit Coffin, Frank Zerbib, Henri Damon, Chloé Melchior, Henri Duboc, Michel Queralto, Karine Baumstarck, Assistance Publique - Hôpitaux de Marseille (APHM), Hospices Civils de Lyon (HCL), Application des ultrasons à la thérapie (LabTAU), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, Inflammation et axe Microbiote-Intestin-Cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Normandie Université (NU), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Service d'Hépato-Gastroentérologie [CHU Rouen], and Service de Colo-proctologie, Clinique des Cèdres, Cornebarrieu, France
Subjects: Oncology, [SDV]Life Sciences [q-bio], Gastroenterology
Published: 2023

7. Gastric electrical stimulation versus per‐oral pyloromyotomy for the treatment of nausea and vomiting associated with gastroparesis: An observational study of two cohorts

Author: Guillaume Gourcerol, Jean Michel Gonzalez, Bruno Bonaz, Sébastien Fontaine, Frank Zerbib, Francois Mion, Paul Basile, André Gillibert, Amélie Labonde, Heithem Soliman, Véronique Vitton, Benoit Coffin, and Jérémie Jacques
Subjects: Endocrine and Autonomic Systems, Physiology, Gastroenterology
Published: 2023

8. The tapestry of reflux syndromes

Author: Peter J. Kahrilas, Pali Hungin, Sophie Nelson, Juan Mendive, Maura Corsetti, Jesper Lagergren, Edoardo Savarino, Sabine Roman, Albert J. Bredenoord, Frank Zerbib, Foteini Anastasiou, Gastroenterology and Hepatology, and Amsterdam Gastroenterology Endocrinology Metabolism
Subjects: Patient Care Team, medicine.medical_specialty, education.field_of_study, business.industry, Stomach, Gallbladder, digestive, oral, and skin physiology, Population, Humans, Syndrome, Translating, Reflux, MEDLINE, Disease, digestive system diseases, medicine.anatomical_structure, Health care, Epidemiology, medicine, Family Practice, Intensive care medicine, business, education, Analysis
Abstract: For decades the rationale for treatment of gastro-oesophageal reflux disease (GORD) with acid suppressors, such as proton pump inhibitors (PPIs), was that symptoms were attributable to reflux of acidic stomach contents into the oesophagus. However, recent advances in the understanding of how brain–gut interactions can modulate the perception of visceral stimuli have complicated the concept of GORD.1 It is increasingly evident that altered perception of reflux is an important underlying cause of symptoms.2 A number of syndromes related to visceral hypersensitivity and central nervous system dysregulation are now recognised as ‘functional’ gastrointestinal (GI) disorders, potentially localised to the oesophagus,3 bowel, stomach, duodenum, anorectum, gallbladder, or multiple GI sites in the same patient. These functional syndromes are common; an internet-based health survey of almost 6000 adults in the US, Canada, and the UK found that 35% had symptoms compatible with some functional GI disorder and 7% met diagnostic criteria for a functional oesophageal disorder.4 This could potentially account for a large fraction of the adults with weekly reflux symptoms in population-based assessments (global prevalence ∼13%).5 However, it being impractical to investigate all of these patients, the recognition of altered perception as a major determinant of reflux symptoms has had little impact on management in general practice. To provide guidance for the management of uninvestigated reflux symptoms in primary care, a series of sponsored (Reckitt Benckiser Healthcare Ltd, UK) workshops were held among gastroenterologists, GI surgeons, and GPs. The objective was to translate recent research findings into clinical practice strategies. Epidemiological data suggest that the prevalence of GORD has increased considerably since the mid-1990s. However, wider public awareness of the link between reflux symptoms and oesophageal cancer6 has likely contributed to the increased presentation of symptomatic patients in primary care. Additionally, the more we understand the …
Published: 2021

9. Alteraciones de la motilidad esofágica en la manometría de alta resolución: Clasificación de Chicago versión 4.0©

Author: Roger P. Tatum, Peter J. Kahrilas, Nathalie Rommel, Philip O. Katz, Geoffrey P. Kohn, Mark A. Fox, Sumeet K. Mittal, Geoffrey S. Hebbard, Johannes Lengliner, Radu Tutuian, André J.P.M. Smout, Rami Sweis, Albis Hani, John E. Pandolfino, Daniel Sifrim, Uday C Ghoshal, Rena Yadlapati, Reuben K. Wong, Arash Babaei, Daniel Pohl, C. Prakash Gyawali, Marcelo F. Vela, Ronnie Fass, Albert J. Bredenoord, Sutep Gonlachanvit, C Defilippi, Frank Zerbib, Adriana Lazarescu, Roberto Penagini, Moo In Park, Nicola de Bortoli, Dustin A. Carlson, Sabine Roman, Joan W. Chen, Charles Cock, Enrique Coss-Adame, Jan Tack, Junichi Akiyama, Edoardo Savarino, David A. Katzka, Abraham Khan, Daniel Cisternas, Justin C.Y. Wu, Shobna Bhatia, Kee Wook Jung, Taher Omari, Jordi Serra, Ravinder K. Mittal, Serhat Bor, Michael F. Vaezi, Yinglian Xiao, and Joel E. Richter
Subjects: Acalasia. Espasmo esofágico. Presión de relajación integrada. Esfínter esofágico inferior. Miotomía. Endoscopia Peroral, General Chemical Engineering, RC799-869, Diseases of the digestive system. Gastroenterology, Internal medicine, RC31-1245
Abstract: La Clasificación de Chicago v4.0 (CCv4.0) es el esquema actualizado para clasificar las alteraciones de la motilidad esofágica utilizando la métrica de la manometría de alta resolución (HRM). Para desarrollar la CCv4.0, 52 expertos internacionales diversos separados en siete subgrupos de trabajo utilizaron una metodología formalmente validada, en un periodo de dos años. Las actualizaciones claves de la CCv4.0 consisten en un protocolo de HRM más riguroso y expansivo que incorpora las posiciones en decúbito supino y sedestación, así como pruebas provocadoras; una definición refinada de la obstrucción del flujo de salida de la unión esofagogástrica (EGJOO), criterios diagnósticos más estrictos para la motilidad esofágica inefectiva, y descripción de la métrica basal de la EGJ. Adicionalmente, la CCv4.0 se propuso definir el diagnóstico de alteración de la motilidad como conclusivo o no conclusivo con base en los síntomas asociados, los hallazgos en las pruebas provocadoras, y los resultados de los exámenes de apoyo como el esofagograma con tableta de bario y/o la prueba con sonda para imagen endoluminal funcional. Estos cambios buscan minimizar la ambigüedad presente en iteraciones previas de la Clasificación de Chicago; además proveen criterios más estandarizados y rigurosos para los patrones de alteración de la peristalsis y obstrucción de la EGJ.
Published: 2022

10. I-CARE, a European Prospective Cohort Study Assessing Safety and Effectiveness of Biologics in Inflammatory Bowel Disease

Author: Laurent Peyrin-Biroulet, Jean-François Rahier, Julien Kirchgesner, Vered Abitbol, Sebastian Shaji, Alessandro Armuzzi, Konstantinos Karmiris, Javier P. Gisbert, Peter Bossuyt, Ulf Helwig, Johan Burisch, Henit Yanai, Glen A. Doherty, Fernando Magro, Tamás Molnar, Mark Löwenberg, Jonas Halfvarson, Edyta Zagorowicz, Hélène Rousseau, Cédric Baumann, Filip Baert, Laurent Beaugerie, Jean-Marc Gornet, Jean-Marie Reimund, Xavier Hebuterne, Aurélien Amiot, Franco Armelao, Pierre Blanc, Claudio Papi, Guillaume Pineton De Chambrun, Xavier Roblin, null Chu, Sohail Shariq, Nikolaos Viazis, Jimmy Limdi, Piotr Eder H, Georgios Michalopoulos, Andrew Bell, Livia Biancone, Marie Dewitte, Zia Mazhar, Denis Franchimont, Stephane Nancey, Gilles Macaigne, Maria Beatrice Principi, Mathurin Fumery, Gareth Parkes, Jean-Christophe Valats, Glen Doherty, Guillaume Bouguen, Hersin Tsai, Mohsin Gangi, Natalia Pedersen, Frédéric Heluwaert, Richard Shenderey, Sebastian Zeissig, Jeffrey Butterworth, Fabiana Castiglione, Lynsey Corless, Camille Zallot, Salil Singh, Sunil Sonwalkar, Elizabeth Clayton, Deven Vani, Guy Bellaiche, Martine De Vos, Uri Kopylov, Triana Lobaton, Christophe Locher, Gerassimos Mantzaris, George Abouda, Katie Smith, Michael Sprakes, Angeliki Theodoropoulou, Emma Wesley, Joëlle Bonnet, David Elphick, Cyrielle Gilletta, John Gordon, David Laharie, Antoine Nakad, Ambrogio Orlando, Patrick Dubois, Peter Hasselblatt, Christophe Michiels, Cathryn Preston, Anca Staicu, Lucine Vuitton, Mehdi Kaassis, Ally Speight, Deb Ghosh, Nicolas Mathieu, Anne-Laure Pelletier, Anne Phillips, Romain Altwegg, Irit Avni, null biron, Jonathon Landy, Maria Nachury, Achuth Shenoy, Caroline Trang, Georgios Bamias, Klaudia Farkas, Christian Maaser, Ariella Shitrit, Britta Siegmund, Jérôme Filippi, Colm O'morain, Laurent Costes, David Hobday, Zoltán Szepes, Emma Calabrese, Helen Dallal, Michael Fung, Arvind Ramadas, Bijay Baburajan, Konrad Koss, Christophe Barberis, Anthony Buisson, Morgane Amil, Paola Balestrieri, Matthew Johnson, Maria Tzouvala, Stéphanie Viennot, Ferenc Nagy, Nick Thompson, Laurent Alric, Sunil Samuel, Anne Bourrier, Elise Chanteloup, Emilie Del Tedesco, Marcus Harbord, Alan Lobo, Sally Myers, Richard Pollok, Tariq Ahmad, Rakesh Chaudhary, Christos Karakoidas, Ashraf Soliman, Carmen Stefanescu, Georgios Theocharis, Stijn Vanden Branden, Belén Beltran, Yoram Bouhnik, Arnaud Bourreille, Joana Branco, Ben Colleypriest, Rami Eliakim, Paul Knight, Aoibhlinn O'toole, Virgina Robles, Konstantinos Triantafyllou, Marta Maia Bosca, Guy Lambrecht, Lucia Marquez Mosquera, Simon Panter, Aikaterini Pappa, Marion Simon, Ganesh Sivaji, Christophe Bellanger, Arthur Belle, Natalia Borruel, Laurence Egan, Harald Peeters, Daniel Sharpstone, Ramesh Arasaradnam, José Manuel Benitez, Jens Frederik Dahlerup, Olga Giouleme, Miguel Minguez, Eftychia Tsironi, Angela Variola, Patrick Allen, Lucille Boivineau, Andy Cole, Nina Dib, Fernando Gomollon, Richard Johnston, Konstantinos Katsanos, Nick Kennedy, Marianne Kiszka-Kanowitz, Ignacio Marin-Jimenez, Pál Miheller, Pilar Nos, Othman Saraj, Lars Vinter-Jensen, Eran Zittan, Clotilde Baudry, Xavier Calvet, Marie-Christine Cazelles-Boudier, Jean-Louis Coenegrachts, Garret Cullen, Marco Daperno, Anjan Dhar, Romain Gerard, Nanna Jensen, Nitsan Maharshak, Mark Mcalindon, Simon Mcloughlin, Miles Parkes, Kamal Patel, Armando Peixoto, Dimitrios Polymeros, Francisco Portela, Rodolfo Rocca, Philippe Seksik, Sreedhar Subramanian, Ruth Tennenbaum, Raja Atreya, Oliver Bachmann, Arthur Berger, Renáta Bor, Maire Buckley, Daniel Carpio, María Chaparro, Francesco Costa, Eugeni Domenech, Maria Esteve, Stephen Foley, Jordi Guardiola, Ioannis Koutroubakis, Tanja Kuehbacher, Cécilia Landman, Alessandro Lavagna, Noemí Manceñido, Míriam Mañosa, Maria Dolores Martín-Arranz, Laurianne Plastaras, Maria Lia Scribano, Subhasish Sengupta, Nils Teich, My-Linh Tran-Minh, Evanthia Zampeli, Leila Amininejad, Teresa Arroyo, Alain Attar, Ann-Sofie Backman, Anita Bálint, John Beckly, Shomron Ben Horin, Sónia Bernardo, Ludovic Caillo, Bénédicte Caron, María Shanika de Silva, Anna FábiáN, Gionata Fiorino, Ana Gutierrez, Adi Lahat, Mohamed Masmoudi, Marco Mendolaro, Vinciane Muls, Florian Poullenot, Christopher Probert, Catherine Reenaers, Mariann Rutka, Zaman Sarwari, Joanne Sayer, Beatriz Sicilia, Helena Sousa, Catherine van Kemseke, Yamile Zabana, Marco Astegiano, Paul Banim, Dominik Bettenworth, Médina Boualit, Jacob Broder Brodersen, Angeliki Christidou, Rachel Cooney, João Cortez Pinto, Portugal Marília Cravo, Anneline Cremer, Silvio Danese, Antonio di Sabatino, Jan Fallingborg, Antonio Ferronato, Esther Garcia Planella, Sanjay Gupta, Eran Israeli, Samantha Kestenbaum, Lone Larsen, Elisabeth Macken, Nicoletta Mathou, Ágnes Milassin, Joanna Pofelski, Chiara Ricci, Francisco Rodriguez-Moranta, Martin Schmidt-Lauber, Ian Shaw, Marta Soares, Heithem Soliman, Christos Triantos, Konstantinos Zografos, Anurag Agrawal, Alexandre Aubourg, Manuel Barreiro-de Acosta, Jesús Barrio, Daniel Bergemalm, Fernando Bermejo, Giorgia Bodini, Johan Bohr, Dimitrios Christodoulou, Christophe Claessens, Paul Collins, Ruth de Francisco, Santiago Garcia, Sotirios Georgopoulos, Felix Goutorbe, Chrisostomos Kalantzis, Anastasia Kourikou, Vincent Mace, Georgia Malamut, Paula Ministro, Isabelle Nion Larmurier, Elena Ricart, Mélanie Serrero, Juliette Sheridan, Petra Weimers, Vibeke Andersen, Bruno Arroja, Bernd Bokemeyer, Luis Bujanda, Thibault Degand, Carl Eriksson, Cécile Garceau, Henning Glerup, Idan Goren, Lucina Jackson, Stéphane Koch, Francisco Mesonero, Ingrid Ordas, Pauline Riviere, Simone Saibeni, João Soares, Noémie Tavernier, Klaus Theede, Bella Ungar, Elke Bästlein, Antonio Gasbarrini, Andreas Protopapas, Wolfgang Reindl, Fabrizio Bossa, Ailsa Hart, Franz-Josef Heil, Anthony O'Connor, Bas Oldenburg, Luca Pastorelli, null Stephen patchett, Subramaniam Ramakrishnan, John de Caestecker, Ana Echarri, David Kevans, Jürgen Büning, Rosa Coelho, Jeroen Jansen, Benjamin Koslowski, Christopher Wells, Daniel Ceballos, Ingrid König, Hari Padmanabhan, Timi Patani, Raheel Qureshi, Matthieu Allez, Emmanouil Archavlis, Delphine Bonnet, Luisa Guidi, Deirdre Mcnamara, Piero Vernia, Michael Weidenhiller, Lang Alon, Trine Boysen, Charlotte Delattre, Richard Farrell, Rolf-Achim Krüger, Thierry Paupard, Ida Vind, Flavio Caprioli, Vladimir Gancho, Vincent Quentin, Benjamin Avidan, Geert D’Haens, Jane Mccarthy, Jonathon Snook, Konstantinos Soufleris, Frank Zerbib, Dan Carter, Annekatrien Depla, Thomas Eisenbach, Walter Fries, Nikolaos Grammatikos, Saskia Ilegems, Antonio Lopez-Sanroman, Jacques Moreau, Gabriele Riegler, Svend Rietdijk, Marta Rocha, Isabelle Rosa, Barbara Ryan, Yelena Yeremenko, Arnaud Boruchowicz, Filipe Damião, Foteini Laoudi, Andreas Lügering, Giampiero Macarri, Konstantinos Thomopoulos, Luísa Barros, Thomas Blixt, Aurélien Garros, Sam Khorrami, Harry Sokol, Andreas Sturm, Dan Livovsky, Jochen Maul, Heinrich Miks, Vasileios Papadopoulos, Carsten Schmidt, Yifat Snir, Lise Svenningsen, Wafaa Ahmed, Yelena Broitman, Emmanuel Cuillerier, Prashant Kant, Jan Leyden, Lev Lichtenstein, Susana Lopes, Chloé Martineau, Hugh Mulcahy, Axel Schweitzer, Fiona Van Schaik, Hagar Banai, Pauline Danion, Charlotte Dulery, Herma Fidder, Claire Gay, Hervé Hagege, Florence Harnois, Søren Peter Jørgensen, Jens Müller-Ziehm, Michail Oikonomou, Carolina Palmela, Jörg Schulze/Röske, Mark Smith, Tamar Thurm, Francesca Bresso, Hedia Brixi, John Jones, Padraig Macmathuna, Claire Painchart, Yulia Ron, Marianne Vester-Andersen, Gonçalo Alexandrino, Norbert Börner, Mariana Cardoso, Cristina Chagas, Axel Dignaß, Iris Dotan, Charlotte Hedin, Pantelis Karatzas, Panagiotis Kasapidis, Károly Palatka, Georgios Sakizlis, Ana Wilson, Nick Bosanko, Paulo Caldeira, Charlotte Gagniere, Louise Libier, Camille Meunier, Gero Moog, Audrey Pasquion, Roberta Pica, Ayesha Akbar, Nadia Arab, Guillaume Cadiot, João Carvalho, Claire Charpignon, Laus Fellermann, Sigal Fishman, Gerald Fraser, Nathan Gluck, Mark Hoesl, Jarosław Kierkus, Maria Klopocka, Eduardo Martin Arranz, Luis Menchen, Susanna Nikolaus, Anca Petrache, Cyriel Ponsioen, Sabino Riestra, Pilar Robledo, Cristina Rodriguez, Misheal Samer, Matthias Tischer, Joanna Wypych, Julien Baudon, Cristina Bezzio, Gilles Boschetti, Tom Creed, Maria Giulia Demarzo, Stefano Festa, Andrés Figueroa, Mette Julsgaard, Pablo Navarro, Pablo Perez-Galindo, Cléa Rouillon, Emanuele Sablich, Joan Tosca, Mathias Vidon, Marine Vidon, René-Louis Vitte, Anne Wampach, Isabelle Clerc Urmes, Marc Borie, Mathieu Uzzan, Kelly Chatten, Rimmer Peter, Iqbal Tariq, Marta Cossignani, Fiorella Cañete, Tom Holvoet, Susanne Krasz, Sandra Dias, Hadas Abalia, Aziza Abaza, Gal Abramovich, Ingrid Ackzell, Carol Adams, Catherine Addleton, Erika Alfambra, Alicia Algaba, Clare Allcock, Joanna Allison, Karine Amouriaux, Julie Anderson, Emma Anderson, Saskia Appelmans, Lisa Armstrong, Stacey Atkins, Masoumeh Attaran-Bandarabadi, Yvonne Bailey, Stephanie Bardot, Natasha Beck, Lillie Bennett, Jonathan Phil Bergfeld, Ramdane Berkane, Hanne Boey, Louise Bowlas, Joanne Bradley-Potts, Tracy Brear, Nicole Bretlander-Peters, Ellen Brown, Johanna Brown, Elizabeth Buckingham, Katrien Buellens, Rhian Bull, Maura Burke, Leighanne Burns, Julie Burton, Agness Bwalya, Karine Cabanas, Muriel Callaghan, Océane Camou, Debbie Campbell, Elvira Capoferro, Mandy Carnahan, Cornelia Carnio, Anne Carter, Concetta Casali Clack, Leïla Chedouba, Bessie Cipriano, Sophie Claeys, Manon Closset, Dilek Coban, Sara Cococcia, Carolann Coe, Helen Cole, Emilie Collet, Kayleigh Collins, Isabelle Combes, Emma Connor, Kathryn Constantin, Susan Cooke, Nathanaëlle Cornet, Estelle Corrihons, Pilar Corsino, Rosie Cortaville, Donna Cotterill, Amanda Cowton, Harriet Cox, Viktoria Cripps, Amanda Crowder, Tzufit Cukier, Amelia Daniel, Chris Dawe, Jose de Haan, Rosanna de la Croix, Evva Dejonckheere, Juan Delare Villanegro, Guillaume Delaval, Mariangela Delliponti, Aude Delommez, Emilie Detry, Melanie Dhanaratne, Laura Diez Galan, Marie Dodel, Emma Dooks, Joseph Du Cheyron, Linda Duane, Jennifer Dulling Vulgo Cochran, Simona Dyer, Harvey Dymond, Charlotte Ekblad, Kerry Elliott, Ingrid Emmerson, Irène Eugene-Jolchine, Lorna Fleming, Eve Fletcher, Sarah Ford, Greg Forshaw, Angela Foulds, Caroline Francois, Nicole Fuge, Gal Gafni, Miri Ganon, Olga Garcia Nuñez, Laura Garcia Ramirez, Sophie Gelder, Raimonda Gettkowski, Daniela Gilardi, Paolo Giuffrida, Vincent Gobert, Jo Godden, Nuala Godwin, Kay Goulden, Sharon Graham, Charlotte Green, Marie Green, Aboubakar Gueye, Tuba Guler, Ida Gustavsson, Helena Hadjisavvas, Fiona Hammonds, Christina Hantzi, Marion Hauke, Julie Haydock, Orla Hayes, Lizette Helbo Nislev, Jessica Hochstodter, Ashleigh Hogg, Manuela Hölbing, Maureen Holland, Maartje Holsbergen, Linda Howard, Aviya Hoyda, Robert Hull, Jane Irish, Wendy Jackson, Wendy Janssen, Lesley Jeffrey, Sofia Jourdan, Izabela Jutrowska, Chava Kaniel, Theofilos Karezos, Niamh Kelly, Jessica Kelly, Mary Kennedy, Una Kennedy, Joyce Kibaru, Gemma Kirkman, Janine Klaproth, Corinna Kneese, Andrea Koch, Kathleen Kokke, Martha Koppelow, Sabine Krause, Sabine Krauspe, Petra Kwakkenbos, Nunzia Labarile, Hannah Lang, Marianne Lassailly, Martine Leconte, Linda Lepczynski, Emma Levell, Nina Levhar, Kerstin Lindhort, Jessica Lisle, Beatriz Lopez Cauce, Gabriele Lorenz, Ambra Lovati, Tracey Lowry, Margareta Lund, Anne Lutz Vorderbrügge, Suzanne Maansson, Videsheka Madapathage, Maelys Cheviakoff, Alison Magness, Orla Manley, Catherine Manyoni, Ingke Marg, Antonella Marra, Carole Martins, Arianna Massella, Aurore Mathias, Danielle Mervyn, Charlotte Minsart, Sally Mitchell, Kathleen Monks, Mélanie Montero, Alson Moore, Maren Moser, Alison Moss, Angela Mullen, M. Francisca Murciano, Deanna Naylor, Ansgar Nehus, Anne Nicholson, Sarah Nöding, Sinead Nolan, Janet Nörenberg, Clare Northcott, Jim O'Connell, Alison O’Kelly, Noam Orbach-Zingboim, Judit Orobitg, Charlene Otieno, Charlotte Owen, Sarah Patch, Maor Pauker, Renate Pauli, Harriet Pearson, Falgon Peggy, Séverine Petit, Christine Petrissans, Simona Piergallini, Lucy Pippard, Laura Pitt, Gabriella Pócsik, Yoann Poher, Chloé Pomes, Lucy Pritchard, Laura Puchades, Sheena Quaid, Aleem Rana, Dana Raynard, Mykla Reilly, Sonja Reinert, Manuela Reinknecht, Baerbel Renner, Rob Reynolds, Giulia Rizzuto, Matthew Robinson, Joke Robrechts, Eva M. Rodriguez, Efrat Rosenblum, Tamlyn Russel, Ibiyemi Sadare, Noa Salama, Toos Schakel, Anja Schauer, Elisa Schiavoni, Caroline Shaw, Sarah Shelton, Virginie Sicart, Elodie Siouville, Orla Smith, Théo Soude, Sophie Stephenson, Elaine Stephenson, Marjan Steppe, An Sterkx, Jo Stickley, Kathleen Sugrue, Natalia Swietec, Charlotte Tasiaux, Bhavneet Thamu, Susane Thomas, Ogwa Tobi, Kahina Touabi, Shifra Tovi, Julie Tregonning, Laura Turchini, Julia Unkhoff, Olesya Unruh, Nurcan Uzun, Frauke Van Aert, Sandrine Vanden Bergh, Louise Vandenbroucke, Laura Vansteenkiste, Shay Vardit, Valentin Vergriete, Elaine Walker, Eleanor Warner, Olivia Watchorn, Ekaterina Watson, Marie-Claire Wauthier, Belgium Maria Weetman, Margaret Weston, Wiebke West-Petroschka, Susann Wienecke, Kerstin Wierling, Miriam Wiestler, Rebecca Wilcox, Elva Wilhelmsen, Angharad Williams, Georgina Williamson, Deborah Wilson, Kate Wistance, Nicolas Wortmann, Subie Wurie, Karin Yadgar, Gail Young, Megan Young, Julien Aucouturier, Marie- Jo Bertin, Hasnae Bougrine, Marie Coisnon, Antoine Defrance, Kati Gutierrez, Amel Harouz, Laure Jerber, Aida Khlifi, Amina Kirati, Nasaladjine Liworo, Maude Logoltat, Charlotte Mailhat, Chancely M'Bayi, Yasmina Medane, Dalal Merkhoufa, Saouda Mohamed Elhad, Bertille Monthe, Fanny Moyon, Pascaline Rabiega, Jennifer Sekela, Charlotte Thilloy, Naima Hamamouche, Frederic Partisotti, Patrick Blandin, Hocine Mokhtari, Laure Coutard, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de gastro-entérologie, Gastroenterology and hepatology, Gastroenterology and Hepatology, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
Subjects: Biological Products, Hepatology, Efficacy, Lymphoma, Tumor Necrosis Factor-alpha, Inflammatory Bowel Disease, Gastroenterology, Biologics, Crohn Disease/diagnosis, Inflammatory Bowel Diseases/chemically induced, Colitis, Ulcerative/diagnosis, Cohort Studies, Necrosis, Immunologic Factors/adverse effects, Humans, Female, 03.02. Klinikai orvostan, Prospective Studies, Safety, I-CARE, Cancer, Immunosuppressive Agents
Abstract: BACKGROUND AND AIMS: There is a need to evaluate the benefit-risk ratio of current therapies in inflammatory bowel disease (IBD) patients to provide the best quality of care. The primary objective of I-CARE (IBD Cancer and serious infections in Europe) was to assess prospectively safety concerns in IBD, with specific focus on the risk of cancer/lymphoma and serious infections in patients treated with anti-tumor necrosis factor and other biologic monotherapy as well as in combination with immunomodulators.METHODS: I-CARE was designed as a European prospective longitudinal observational multicenter cohort study to include patients with a diagnosis of Crohn's disease, ulcerative colitis, or IBD unclassified established at least 3 months prior to enrollment.RESULTS: A total of 10,206 patients were enrolled between March 2016 and April 2019, including 6169 (60.4%) patients with Crohn's disease, 3853 (37.8%) with ulcerative colitis, and 184 (1.8%) with a diagnosis of IBD unclassified. Thirty-two percent of patients were receiving azathioprine/thiopurines, 4.6% 6-mercaptopurine, and 3.2% methotrexate at study entry. At inclusion, 47.3% of patients were treated with an anti-tumor necrosis factor agent, 8.8% with vedolizumab, and 3.4% with ustekinumab. Roughly one-quarter of patients (26.8%) underwent prior IBD-related surgery. Sixty-six percent of patients had been previously treated with systemic steroids. Three percent of patients had a medical history of cancer prior to inclusion and 1.1% had a history of colonic, esophageal, or uterine cervix high-grade dysplasia.CONCLUSIONS: I-CARE is an ongoing investigator-initiated observational European prospective cohort study that will provide unique information on the long-term benefits and risks of biological therapies in IBD patients. (EudraCT, Number: 2014-004728-23; ClinicalTrials.gov, Number: NCT02377258).
Published: 2022

11. AGA Clinical Practice Update on Functional Heartburn: Expert Review

Author: Ronnie Fass, C. Prakash Gyawali, and Frank Zerbib
Subjects: Complementary Therapies, medicine.medical_specialty, Tegaserod, medicine.drug_class, Nerd, Proton-pump inhibitor, Endoscopy, Gastrointestinal, Gastrointestinal Agents, Heartburn, Internal medicine, otorhinolaryngologic diseases, Acupuncture, medicine, Humans, Healthy Lifestyle, Esophagus, Digestive System Surgical Procedures, Evidence-Based Medicine, Hepatology, business.industry, digestive, oral, and skin physiology, Gastroenterology, medicine.disease, humanities, digestive system diseases, Esophageal Ulcer, Psychotherapy, Benchmarking, Treatment Outcome, medicine.anatomical_structure, Gastroesophageal Reflux, GERD, medicine.symptom, business, Risk Reduction Behavior, medicine.drug
Abstract: BEST PRACTICE ADVICE 1: A diagnosis of functional heartburn should be considered when retrosternal burning pain or discomfort persists despite maximal (double-dose) proton pump inhibitor (PPI) therapy taken appropriately before meals during a 3-month period. BEST PRACTICE ADVICE 2: A diagnosis of functional heartburn requires upper endoscopy with esophageal biopsies to rule out anatomic and mucosal abnormalities, esophageal high-resolution manometry to rule out major motor disorders, and pH monitoring off PPI therapy (or pH-impedance monitoring on therapy in patients with proven gastroesophageal reflux disease [GERD]), to document physiologic levels of esophageal acid exposure in the distal esophagus with absence of reflux-symptom association (ie, negative symptom index and symptom association probability). BEST PRACTICE ADVICE 3: Overlap of functional heartburn with proven GERD is diagnosed according to Rome IV criteria when heartburn persists despite maximal PPI therapy in patients with history of proven GERD (ie, positive pH study, erosive esophagitis, Barrett's esophagus, or esophageal ulcer), and pH impedance testing on PPI therapy demonstrates physiologic acid exposure without reflux-symptom association (ie, negative symptom index and symptom association probability). BEST PRACTICE ADVICE 4: PPIs have no therapeutic value in functional heartburn, the exception being proven GERD that overlaps with functional heartburn. BEST PRACTICE ADVICE 5: Neuromodulators, including tricyclic antidepressants, selective serotonin reuptake inhibitors, tegaserod, and histamine-2 receptor antagonists have benefit as either primary therapy in functional heartburn or as add-on therapy in functional heartburn that overlaps with proven GERD. BEST PRACTICE ADVICE 6: Based on available evidence, acupuncture and hypnotherapy may have benefit as monotherapy in functional heartburn, or as adjunctive therapy combined with other therapeutic modalities. BEST PRACTICE ADVICE 7: Based on available evidence, anti-reflux surgery and endoscopic GERD treatment modalities have no therapeutic benefit in functional heartburn and should not be recommended.
Published: 2020

12. Role of Rapid Drink Challenge During Esophageal High-resolution Manometry in Predicting Outcome of Peroral Endoscopic Myotomy in Patients With Achalasia

Author: Edouard Chabrun, Jérôme Rivory, François Mion, Mathieu Pioche, Thierry Ponchon, Frank Zerbib, Sabine Roman, and Hélène Foisy
Subjects: Myotomy, medicine.medical_specialty, Manometry, medicine.medical_treatment, Esophageal achalasia, Achalasia, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Pathological, High resolution manometry, medicine.diagnostic_test, business.industry, Reflux, medicine.disease, Endoscopy, Log-rank test, Gastroesophageal reflux, 030220 oncology & carcinogenesis, GERD, Original Article, 030211 gastroenterology & hepatology, Neurology (clinical), business
Abstract: Background/Aims Peroral endoscopy myotomy (POEM) is effective to treat achalasia. We aim to determine POEM effect on esophageal function and search for predictive factors of response to POEM and co-occurrence of gastroesophageal reflux disease (GERD). Methods A total of 64 untreated achalasia patients who underwent high-resolution manometry (HRM) before and 3 months after POEM were retrospectively included. Response to treatment was defined as an Eckardt score < 3. Reflux symptoms and patient’s satisfaction were evaluated. Data were compared using paired t test, Chi-square test or log rank test. Results The 2-year success rate in response to POEM was 90%. All responders reported being satisfied while only 33% of non-responders did (P < 0.001) and 64% of patients with reflux symptoms were satisfied versus 96% of those without (P = 0.009). On HRM, the integrated relaxation pressure and the contractile pattern changed significantly after POEM but were not predictive of response. Between pre and post POEM HRM, a decrease in maximal esophageal pressurization during rapid drink challenge (RDC) was associated with a better response rate than an increase of pressurization (91% vs 50%, P = 0.004). As evidenced by pH monitoring performed after POEM, GERD was pathological or borderline in 50% of patients (18/36) while only 19% (11/59) reported clinically significant reflux symptoms. On post POEM HRM, maximal esophageal pressurization during RDC was lower in patients with pathological or borderline GERD compared to those without (P = 0.054). Conclusions Esophageal HRM parameters changed significantly after POEM. Maximal esophageal pressurization during RDC may be useful to predict outcome. (J Neurogastroenterol Motil 2020;26:204-214)
Published: 2020

13. Refractory Gastroesophageal Reflux Disease: A Management Update

Author: Frank Zerbib, Michele Campigotto, Nicola de Bortoli, Massimo Bellini, Ginevra Berti, Christian Lambiase, Francesco Rettura, Santino Marchi, Edoardo Savarino, Francesco Bronzini, and Andrea Pancetti
Subjects: medicine.medical_specialty, Medicine (General), Psychological intervention, Disease, Review, 24-h multichannel intraluminal impedance-pH (MII-pH), gastroesophageal reflux disease (GERD), R5-920, Refractory, Medicine, proton pump inhibitors (PPIs), refractory GERD (rGERD), Intensive care medicine, Antireflux surgery, business.industry, Reflux, General Medicine, medicine.disease, laparoscopic antireflux surgery (LARS), digestive system diseases, Protective Agents, Transoral incisionless fundoplication, GERD, business
Abstract: Gastroesophageal reflux disease (GERD) is one of the most frequent gastrointestinal disorders. Proton pump inhibitors (PPIs) are effective in healing lesions and improving symptoms in most cases, although up to 40% of GERD patients do not respond adequately to PPI therapy. Refractory GERD (rGERD) is one of the most challenging problems, given its impact on the quality of life and consumption of health care resources. The definition of rGERD is a controversial topic as it has not been unequivocally established. Indeed, some patients unresponsive to PPIs who experience symptoms potentially related to GERD may not have GERD; in this case the definition could be replaced with “reflux-like PPI-refractory symptoms.” Patients with persistent reflux-like symptoms should undergo a diagnostic workup aimed at finding objective evidence of GERD through endoscopic and pH-impedance investigations. The management strategies regarding rGERD, apart from a careful check of patient's compliance with PPIs, a possible change in the timing of their administration and the choice of a PPI with a different metabolic pathway, include other pharmacologic treatments. These include histamine-2 receptor antagonists (H2RAs), alginates, antacids and mucosal protective agents, potassium competitive acid blockers (PCABs), prokinetics, gamma aminobutyric acid-B (GABA-B) receptor agonists and metabotropic glutamate receptor-5 (mGluR5) antagonists, and pain modulators. If there is no benefit from medical therapy, but there is objective evidence of GERD, invasive antireflux options should be evaluated after having carefully explained the risks and benefits to the patient. The most widely performed invasive antireflux option remains laparoscopic antireflux surgery (LARS), even if other, less invasive, interventions have been suggested in the last few decades, including endoscopic transoral incisionless fundoplication (TIF), magnetic sphincter augmentation (LINX) or radiofrequency therapy (Stretta). Due to the different mechanisms underlying rGERD, the most effective strategy can vary, and it should be tailored to each patient. The aim of this paper is to review the different management options available to successfully deal with rGERD.
Published: 2021
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14. Patterns of quadruple therapy use including bismuth for Helicobacter pylori eradication: A cohort study in the French national claims database

Author: Francis Mégraud, Nicholas Moore, Régis Lassalle, Magali Rouyer, Cécile Droz-Perroteau, François Tison, Bertrand Diquet, Abdelilah Abouelfath, E. Guiard, Patrick Blin, and Frank Zerbib
Subjects: medicine.medical_specialty, Index date, medicine.drug_class, Proton-pump inhibitor, 030226 pharmacology & pharmacy, Helicobacter Infections, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, Pharmacology (medical), Claims database, Omeprazole, Helicobacter pylori, biology, business.industry, Pharmacoepidemiology, biology.organism_classification, 3. Good health, Metronidazole, Treatment Outcome, surgical procedures, operative, Drug Therapy, Combination, business, Bismuth, Cohort study, medicine.drug
Abstract: Summary Background Quadruple therapy using a single capsule formulation of bismuth, metronidazole and tetracycline (BMT; Pylera®), associated with omeprazole for the eradication of Helicobacter pylori, represents the reintroduction of bismuth in France after 40 years. Objective To describe the real-life patterns of use of BMT following a request from the French health authorities. Methods Patients with a first BMT dispensing (index date, ID), with one year of data before and after ID, were identified in the French nationwide claims database 1/97 sample. Misuse of BMT was defined as dispensing >1 pack of BMT at ID or absence of a diagnostic test in the preceding year. Results In total, 540 patients were included. Prescribers were gastroenterologists (n = 243; 45%) and general practitioners (n = 160; 30%). A proton pump inhibitor was co-dispensed to 504 patients (96%). Ten patients (2%) had contraindications to BMT. Fifty-nine patients (11%) met the misuse criteria: ten (2%) were dispensed > 1 pack of BMT and 49 (9%) had not had a diagnostic test for H. pylori in the previous year. During follow-up, 27 patients (5%) required retreatment (treatment failure). Conclusion In this real-life study, most patients were dispensed only one pack of BMT, consistent with recommendations. Misuse related principally to the absence of prior diagnostic test for H. pylori.
Published: 2021

15. COVID-19 pandemic and lockdown stress consequences in people with and without Irritable Bowel Syndrome

Author: François Mion, Jean-Jacques Raynaud, Suzelle Façon, Michel Bouchoucha, Jean-Marc Sabate, Chloé Melchior, Frank Zerbib, David Deutsch, Pauline Jouet, Alexandre Entremont, Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Physiopathologie et Pharmacologie Clinique de la Douleur (LPPD), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], and Hôpital Ambroise Paré [AP-HP]
Subjects: Quality of life, Coping (psychology), Multivariate analysis, Stress, 0603 philosophy, ethics and religion, 03 medical and health sciences, 0302 clinical medicine, Pandemic, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], 030212 general & internal medicine, Irritable bowel syndrome, Depression (differential diagnoses), ComputingMilieux_MISCELLANEOUS, Univariate analysis, business.industry, Health Policy, COVID-19, 06 humanities and the arts, medicine.disease, Anxiety, Original Article, 060301 applied ethics, medicine.symptom, business, Clinical psychology
Abstract: Summary Background While all resources have been mobilized to fight COVID-19, this study aimed to analyze the consequences of lockdown and pandemic stress in participants with and without Irritable Bowel Syndrome (IBS). Methodology An online survey was proposed to people with or without IBS during the exponential phase of the pandemic in France. The questionnaire included questions about socio-demographic data, conditions of confinement , activities carried out, IBS characteristics, measurement of stress level, consequences on sleep, fatigue, anxiety and depression, and quality of life (both perceived non-specific and specific for IBS). Results/Discussion From March 31 to April 15, 2020, 304 participants, 232 with IBS and 72 without were included in the survey (mean age: 46.8 ± 16.8 years, female gender: 75.3%). Age, level of education, financial resources, living space per person and activities performed during confinement were identical in both groups. Stress linked to fear of COVID-19, lockdown and financial worries was at the same level in both groups, but the psychological consequences and deterioration of quality of life (QOL) were both higher in IBS participants. In a univariate analysis , teleworking, solitary confinement, and low household resources had a variable impact on the scores of depression, anxiety, fatigue and non-specific perceived QOL, but in a multivariate analysis , the only factor explaining a deterioration of non-specific QOL was the fact of suffering from IBS. Conclusion/Perspectives Stress linked to the COVID-19 pandemic and confinement is high and equivalent in both IBS and non-IBS participants, with higher psychological and QOL consequences in IBS patients who have altered coping capacities.
Published: 2021

16. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis

Author: George Karamanolis, Trygve Hausken, A. Sheptulin, A Papathanasopoulos, Jan Tack, Daniel Keszthelyi, M. Corsetti, T. Milosavljevic, Frank Zerbib, M. Storr, Dan L. Dumitrascu, A. Stengel, Hans Törnblom, Tim Vanuytsel, Giovanni Sarnelli, C. Malagelada, H. De Schepper, Lucas Wauters, Daniel Pohl, Agata Mulak, Ram Dickman, Goran Hauser, D. Rumyantseva, Giovanni Barbara, Jordi Serra, N. Zarate, C. O'Morain, Benoit Coffin, Guillaume Gourcerol, Anne Farmer, Serhat Bor, Vasile Drug, M. Velosa, Annemieke Smet, Edoardo Savarino, Jolien Schol, Paul Enck, M. Waluga, Anna Accarino, O. Storonova, Sarnelli, G., Schol J., Wauters L., Dickman R., Drug V., Mulak A., Serra J., Enck P., Tack J., Barbara G., Interne Geneeskunde, RS: NUTRIM - R2 - Liver and digestive health, and MUMC+: MA Maag Darm Lever (9)
Subjects: Serotonin 5-HT4 Receptor Antagonists, Gastroparesis, gastroparesi, Delphi Technique, Physiology, consensus, endoscopy, gastric emptying, gastroparesis, guideline, prokinetic, Gastroenterology, Endoscopy, Gastrointestinal, 0302 clinical medicine, Quality of life, Risk Factors, QUALITY-OF-LIFE, Epidemiology, Endoscopy, Digestive System, Societies, Medical, DIABETIC GASTROPARESIS, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, Nutritional Support, Nausea, Neurogastroenterology, Postprandial Period, Serotonin Receptor Agonists, Europe, Dopamine D2 Receptor Antagonists, Oncology, Neurology, 030220 oncology & carcinogenesis, Vomiting, 030211 gastroenterology & hepatology, medicine.symptom, Symptom Assessment, HEALTH-CARE UTILIZATION, Life Sciences & Biomedicine, Human, medicine.medical_specialty, GASTRIC ELECTRICAL-STIMULATION, Consensus, THERAPY IMPROVES SYMPTOMS, LONG-TERM, IDIOPATHIC GASTROPARESIS, Consensu, 03 medical and health sciences, Dopamine D2 Receptor Antagonist, Internal medicine, medicine, Humans, Dyspepsia, Intensive care medicine, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine, TERM-FOLLOW-UP, GASTROINTESTINAL SYMPTOMS, Science & Technology, Gastric emptying, Gastroenterology & Hepatology, Endocrine and Autonomic Systems, business.industry, Risk Factor, Guideline, medicine.disease, Gastric Emptying, Serotonin Receptor Agonist, Quality of Life, FUNCTIONAL DYSPEPSIA, business, Diet Therapy
Abstract: BACKGROUND: Gastroparesis is a condition characterized by epigastric symptoms and delayed gastric emptying (GE) rate in the absence of any mechanical obstruction. The condition is challenging in clinical practice by the lack of guidance concerning diagnosis and management of gastroparesis. METHODS: A Delphi consensus was undertaken by 40 experts from 19 European countries who conducted a literature summary and voting process on 89 statements. Quality of evidence was evaluated using grading of recommendations assessment, development, and evaluation criteria. Consensus (defined as ≥80% agreement) was reached for 25 statements. RESULTS: The European consensus defined gastroparesis as the presence of symptoms associated with delayed GE in the absence of mechanical obstruction. Nausea and vomiting were identified as cardinal symptoms, with often coexisting postprandial distress syndrome symptoms of dyspepsia. The true epidemiology of gastroparesis is not known in detail, but diabetes, gastric surgery, certain neurological and connective tissue diseases, and the use of certain drugs recognized as risk factors. While the panel agreed that severely impaired gastric motor function is present in these patients, there was no consensus on underlying pathophysiology. The panel agreed that an upper endoscopy and a GE test are required for diagnosis. Only dietary therapy, dopamine-2 antagonists and 5-HT4 receptor agonists were considered appropriate therapies, in addition to nutritional support in case of severe weight loss. No consensus was reached on the use of proton pump inhibitors, other classes of antiemetics or prokinetics, neuromodulators, complimentary, psychological, or more invasive therapies. Finally, there was consensus that gastroparesis adversely impacts on quality of life and healthcare costs and that the long-term prognosis of gastroparesis depends on the cause. CONCLUSIONS AND INFERENCES: A multinational group of European experts summarized the current state of consensus on definition, symptom characteristics, pathophysiology, diagnosis, and management of gastroparesis. ispartof: UNITED EUROPEAN GASTROENTEROLOGY JOURNAL vol:9 issue:3 pages:287-306 ispartof: location:England status: published
Published: 2021

17. Mo1542: COMPARED EFFICACY OF USTEKINUMAB AND ANTI-TNF AGENTS AS FIRST-LINE BIOLOGICAL THERAPY IN LUMINAL CROHN’S DISEASE: A TWO-CENTER RETROSPECTIVE STUDY

Author: Pauline Rivière, Caitlyn Kanters, Alexander Ni, Gauthier Pellet, Marianne Hupé, Nesrine Aboulhamid, Florian Poullenot, Alain Bitton, Frank Zerbib, Peter L. Lakatos, Waqqas Afif, David Laharie, and Talat Bessissow
Subjects: Hepatology, Gastroenterology
Published: 2022

18. Sa1192: MANAGEMENT OF REFRACTORY GERD SYMPTOMS IN EUROPE: EXPERT OPINION IN A CASE-BASED DELPHI APPROACH

Author: Karlien Raymenants, Emidio Scarpellini, Lukas M. Balsiger, Serhat Bor, Arjan Bredenoord, Michele Cicala, José M. Conchillo, Ram Dickman, Vasile Drug, Mark Fox, Jan Gunnar Hatlebakk, Goran Hauser, Jutta Keller, Sébastien Kindt, Agata Mulak, Sabine Roman, Edoardo V. Savarino, Jolien Schol, Jordi Serra, Daniel Sifrim, Rami Sweis, Tim Vanuytsel, Frank Zerbib, and Jan F. Tack
Subjects: Hepatology, Gastroenterology
Published: 2022

19. Mo1481: CHANGES IN COLECTOMY FOR ULCERATIVE COLITIS DURING THE LAST TWO DECADES: AN IN-DEPTH RETROSPECTIVE ANALYSIS

Author: Guillaume Le Cosquer, Lena Capirchio, Pauline Rivière, Nicolas de Suray, Florian Poullenot, Bénédicte De Vroey, Arthur Berger, Marie Armelle Denis, Frank Zerbib, Radu Bachmann, Christophe Remue, Bertrand Celerier, Daniel Leonard, Quentin Denost, Alex Kartheuser, David Laharie, and Olivier Dewit
Subjects: Hepatology, Gastroenterology
Published: 2022

20. MANagement gUidelinEs for Low Anterior Resection Syndrome the MANUEL project

Author: Eloy Espin-Basany, Harald R. Rosen, Peter Christensen, Coen Im Baeten, Jacopo Martellucci, Frank Zerbib, Karen Nugent, Gianluca Pellino, Christensen, Peter, Im Baeten, Coen, Espín-Basany, Eloy, Martellucci, Jacopo, Nugent, Karen P, Zerbib, Frank, Pellino, Gianluca, and Rosen, Harald
Subjects: complications, Conference call, complication, LARS, Poor quality, Postoperative Complications, Nursing, rectal surgery, consensu, Humans, Medicine, Rectal surgery, Low Anterior Resection, Health professionals, business.industry, Rectal Neoplasms, Consensus Statement, Gastroenterology, Rectal Disease, SPECIAL SECTION ARTICLES: Special edition on functional outcomes after cancer surgery, Syndrome, Rectal Diseases, low anterior resection syndrome, consensus, colorectal surgery, Postoperative Complication, business, Working group, guidance, Human
Abstract: Aim: Little is known about the pathophysiology of low anterior resection syndrome (LARS), and evidence concerning the management of patients diagnosed with this condition is scarce. The aim of the LARS Expert Advisory Panel was to develop practical guidance for healthcare professionals dealing with LARS. Method: The ‘Management guidelines for low anterior resection syndrome’ (MANUEL) project was promoted by a team of eight experts in the assessment and management of patients with LARS. After a face-to-face meeting, a strategy was agreed to create a comprehensive, practical guide covering all aspects that were felt to be clinically relevant. Eight themes were decided upon and working groups established. Each working group generated a draft; these were collated by another collaborator into a manuscript, after a conference call. This was circulated among the collaborators, and it was revised following the comments received. A lay patient revised the manuscript, and contributed to a section containing a patient's perspective. The manuscript was again circulated and finalized. A final teleconference was held at the end of the project. Results: The guidance covers all aspects of LARS management, from pathophysiology, to assessment and management. Given the lack of sound evidence and the often poor quality of the studies, most of the recommendations and conclusions are based on the opinions of the experts. Conclusions: The MANUEL project provides an up-to-date practical summary of the available evidence concerning LARS, with useful directions for healthcare professional and patients suffering from this debilitating condition.
Published: 2021

21. Esophagogastric junction morphology and contractile integral on high-resolution manometry in asymptomatic healthy volunteers: An international multicenter study

Author: José María Remes-Troche, Dustin A. Carlson, Salvatore Tolone, Jamal Hayat, Albis Hani, Sutep Gonlachanvit, Ana Maria Leguizamo, Daniel Sifrim, Arvind Rengarajan, Jordi Serra, Zhiqin Wong, Sabine Roman, Benjamin D. Rogers, Yeung Yeh Lee, Rosa I. Ramos, Frank Zerbib, Osamu Kawamura, Shobna Bhatia, Ans Pauwels, John E. Pandolfino, Serhat Bor, Edoardo Savarino, Luiz J. Abrahao, Julio Perez de la Serna, Daniel Cisternas, C. Prakash Gyawali, Ege Üniversitesi, Rogers, Benjamin D, Rengarajan, Arvind, Abrahao, Luiz, Bhatia, Shobna, Bor, Serhat, Carlson, Dustin A, Cisternas, Daniel, Gonlachanvit, Sutep, Hani, Albi, Hayat, Jamal, Kawamura, Osamu, Lee, Yeung Yeh, Leguizamo, Ana Maria, Pauwels, An, Perez de la Serna, Julio, Ramos, Rosa I, Remes-Troche, Jose Maria, Roman, Sabine, Savarino, Edoardo, Serra, Jordi, Sifrim, Daniel, Tolone, Salvatore, Wong, Zhiqin, Zerbib, Frank, Pandolfino, John, and Gyawali, C Prakash
Subjects: Adult, Male, Aging, medicine.medical_specialty, Percentile, Adolescent, Manometry, Physiology, lower esophageal sphincter pressure, Asymptomatic, Article, barrier function, esophagogastric junction, Cohort Studies, Young Adult, 03 medical and health sciences, Lower esophageal sphincter pressure, 0302 clinical medicine, Reference Values, Internal medicine, Healthy volunteers, medicine, Humans, Esophagogastric junction, High resolution manometry, Aged, Sex Characteristics, Endocrine and Autonomic Systems, business.industry, Gastroenterology, Middle Aged, Healthy Volunteers, Multicenter study, 030220 oncology & carcinogenesis, Cohort, Gastroesophageal Reflux, Respiratory Mechanics, Cardiology, Female, 030211 gastroenterology & hepatology, medicine.symptom, business, Software, Muscle Contraction
Abstract: Background Esophagogastric junction contractile integral (EGJ-CI) and EGJ morphology are high-resolution manometry (HRM) metrics that assess EGJ barrier function. Normative data standardized across world regions and HRM manufacturers are limited. Methods Our aim was to determine normative EGJ metrics in a large international cohort of healthy volunteers undergoing HRM (Medtronic, Laborie, and Diversatek software) acquired from 16 countries in four world regions. EGJ-CI was calculated by the same two investigators using a distal contractile integral-like measurement across the EGJ for three respiratory cycles and corrected for respiration (mm Hg cm), using manufacturer-specific software tools. EGJ morphology was designated according to Chicago Classification v3.0. Median EGJ-CI values were calculated across age, genders, HRM systems, and regions. Results Of 484 studies (28.0 years, 56.2% F, 60.7% Medtronic studies, 26.0% Laborie, and 13.2% Diversatek), EGJ morphology was type 1 in 97.1%. Median EGJ-CI was similar between Medtronic (37.0 mm Hg cm, IQR 23.6-53.7 mm Hg cm) and Diversatek (34.9 mm Hg cm, IQR 22.1-56.1 mm Hg cm, P = 0.87), but was significantly higher using Laborie equipment (56.5 mm Hg cm, IQR 35.0-75.3 mm Hg cm, P < 0.001). 5(th) percentile EGJ-CI values ranged from 6.9 to 12.1 mm Hg cm. EGJ-CI values were consistent across world regions, but different between manufacturers even within the same world region (P = 0.3) but higher in women (P < 0.001). Conclusions EGJ morphology is predominantly type 1 in healthy adults. EGJ-CI varies widely in health, with significant gender influence, but is consistent within each HRM system. Manufacturer-specific normative values should be utilized for clinical HRM interpretation.
Published: 2021

22. Value of pH Impedance Monitoring While on Twice-Daily Proton Pump Inhibitor Therapy to Identify Need for Escalation of Reflux Management

Author: Marcelo F. Vela, Radu Tutuian, Daniel Sifrim, Sabine Roman, C. Prakash Gyawali, Benjamin D. Rogers, Nicola de Bortoli, Frank Zerbib, Marzio Frazzoni, and Edoardo Savarino
Subjects: Adult, Male, medicine.medical_specialty, Esophageal pH Monitoring, Time Factors, Proton Pump Inhibitor, medicine.drug_class, Proton-pump inhibitor, Gastroenterology, Drug Administration Schedule, Gastroesophageal Reflux Disease, Young Adult, Heartburn, Interquartile range, Predictive Value of Tests, Internal medicine, Electric Impedance, Medicine, Humans, pH Impedance Monitoring, High resolution manometry, Retrospective Studies, Acid Exposure Time, Reflux Episodes, Hepatology, Receiver operating characteristic, business.industry, Reflux, Proton Pump Inhibitors, Middle Aged, medicine.disease, digestive system diseases, United States, Europe, Treatment Outcome, Cohort, GERD, Gastroesophageal Reflux, Female, medicine.symptom, Drug Monitoring, business
Abstract: Background and Aims Acid exposure time (AET) and reflux episode thresholds from the Lyon Consensus may not apply for pH impedance studies performed while on proton pump inhibitor (PPI) therapy. We aimed to determine metrics from “on PPI” pH impedance studies predicting need for escalation of therapy. Methods De-identified pH impedance studies performed while on twice-daily PPI (Diversatek, Boulder, CO) in healthy volunteers (n = 66, median age 37.5 years, 43.9% female), and patients with proven gastroesophageal reflux disease (GERD) (European heartburn-predominant cohort: n = 43, median age 57.0 years, 55.8% female; North American regurgitation-predominant cohort: n = 42, median age 41.6 years, 42.9% female) were analyzed. Median values and interquartile ranges for pH impedance metrics in healthy volunteers were compared with proven GERD patients with and without 50% symptom improvement on validated measures. Receiver operating characteristic (ROC) analyses identified optimal thresholds predicting symptom response. Results Both conventional and novel reflux metrics were similar between PPI responders and nonresponders (P ≥ .1 for each) despite differences from healthy volunteers. Combinations of metrics associated with conclusively abnormal reflux burden (AET >4%, >80 reflux episodes) were seen in 32.6% and 40.5% of heartburn and regurgitation-predominant patients, respectively, 57.1% and 82.4% of whom reported nonresponse; and 85% with these metrics improved with invasive GERD management. On ROC analysis, AET threshold of 0.5% modestly predicted nonresponse (sensitivity, 0.62; specificity, 0.51; P = .22), and 40 reflux episodes had better performance characteristics (sensitivity, 0.80; specificity, 0.51; P = .002); 79% with these metrics improved with invasive GERD management. Conclusion Combinations of abnormal “on PPI” pH impedance metrics are associated with PPI nonresponse in proven GERD patients, and can be targeted for treatment escalation, including surgery, particularly in regurgitation-predominant GERD.
Published: 2021

23. Normal values and regional differences in oesophageal impedance-pH metrics: a consensus analysis of impedance-pH studies from around the world

Author: Yeong Yeh Lee, Miguel A. Valdovinos, Katsuhiko Iwakiri, Radu Tutuian, Nicola de Bortoli, Sutep Gonlachanvit, Alastair M Sammon, Julio Perez de la Serna, José María Remes-Troche, Michele Cicala, C. Prakash Gyawali, Tanisa Patcharatraku, Anne Lund Krarup, Marzio Frazzoni, Donald O. Castell, Serhat Bor, Chai Soon Ngiu, Magnus Simren, Yinglian Xiao, Osamu Kawamura, Mentore Ribolsi, Daniel Sifrim, Edoardo Savarino, Sabine Roman, E. J. Ndebia, Rosa I. Ramos, Albert J. Bredenoord, Frank Zerbib, Ans Pauwels, Jan Tack, Ege Üniversitesi, Gastroenterology and Hepatology, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
Subjects: Impedance–pH monitoring, medicine.medical_specialty, Normal values, Behavioural disorders, Audiology, Agreement, Intraobserver, 03 medical and health sciences, 0302 clinical medicine, post reflux swallow-induced peristaltic wave, Medicine, Disease, Baseline impedance, acid exposure time, impedance-pH monitoring, reflux episodes, Variability, Children, Interobserver, business.industry, Gastroenterology, Healthy subjects, Small sample, Multichannel Intraluminal Impedance, Reproducibility, Consensus analysis, 030220 oncology & carcinogenesis, Gastroesophageal-Reflux, 030211 gastroenterology & hepatology, Base-Line Impedance, business, Regional differences
Abstract: Objective Limitations of existing impedance-pH thresholds include small sample size of normative studies, inclusion of artefactual pH drops and incorrect identification of impedance reflux events. We aimed to obtain new impedance-pH thresholds from expert consensus analysis of tracings from a large number of healthy subjects. Design Of 541 studies performed worldwide using two different systems (Diversatek, USA, and Laborie, Netherlands), 150 tracings with oesophageal diagnoses, behavioural disorders and study-related artefacts were excluded. The remainder studies were subject to two reviewer consensus analysis, in-person or through video conference, consisting of editing meals and pH drops, identification of impedance reflux and postreflux swallow-induced peristaltic wave (PSPW) using strict pre-established criteria and measurement of distal mean nocturnal baseline impedance (MNBI). Results Consensus analysis was performed in 391 tracings (age 32.7 years, range 18-71, 54.2% female). Normative thresholds were significantly different between Diversatek and Laborie (total acid exposure time: 2.8% and 5%; reflux episodes: 55 and 78; MNBI at 3 cm: 1400 and 1500 ohms, at 5 cm: 1400 and 1800 ohms). Males had higher acid exposure, more reflux episodes and lower MNBI. Significant regional differences were identified, including higher PSPW scores in Western countries, and higher MNBI in Asia using Diversatek, and higher acid exposure in the Netherlands, higher MNBI in Asia and South Africa, and lower MNBI in Turkey using Laborie. Conclusion Normal impedance-pH monitoring thresholds have regional and system-related differences. Clinical interpretation needs to use normal thresholds valid for the system used and world region, following careful editing of the tracings., Queen Mary University of London, UK [DDCH1A3R], The study was conducted with financial support from Research Grant DDCH1A3R, Queen Mary University of London, UK.
Published: 2021

24. Evolution of Endoscopic Lesions in Steroid-Refractory Acute Severe Ulcerative Colitis Responding to Infliximab or Cyclosporine

Author: Arnaud Bourreille, Julien Branche, Laurent Beaugerie, Yoram Bouhnik, Stéphane Nahon, Mathurin Fumery, Benoit Coffin, Philippe Marteau, Matthieu Allez, Guillaume Savoye, Javier P. Gisbert, Martine De Vos, Jean-Yves Mary, Jacques Moreau, Elena Ricart, Laurent Peyrin-Biroulet, Xavier Roblin, Jérôme Filippi, Franck Carbonnel, Maria Esteve, Olivier Dewit, Aurelien Amiot, David Laharie, Martti Färkkilä, Lucine Vuitton, Anthony Buisson, Antonio López-Sanromán, Gert Van Assche, Frank Zerbib, CHU Bordeaux [Bordeaux], CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Haut-Lévêque [CHU Bordeaux], Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Hôtel-Dieu de Nantes, Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Claude Huriez [Lille], CHU Lille, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Hôpital Beaujon [AP-HP], Centre Hospitalier Universitaire de Nice (CHU Nice), Hôpital l'Archet, Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Hôpital Charles Nicolle [Rouen], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital JeanMinjoz, CHU Toulouse [Toulouse], Hôpital Henri Mondor, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Gastroentérologie et nutrition [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBERehd), Liver Unit, Clínica Universitaria, CIBER-EHD, Université Catholique de Louvain = Catholic University of Louvain (UCL), Hospital Universitario Ramón y Cajal [Madrid], Universidad de Alcalá - University of Alcalá (UAH), CHU Amiens-Picardie, Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Service d'Hépato-gastro-entérologie [APHP Kremlin-Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Université Paris-Sud - Paris 11 (UP11), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] (3IHP ), Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, Hôpital Louis Mourier - AP-HP [Colombes], Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Hôpital Nord (Saint Etienne), University Hospitals Leuven [Leuven], University of Helsinki, CHU Tenon [AP-HP], Sorbonne Université (SU), Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Ghent University Hospital, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Equipe 2 : ECSTRA - Epidémiologie Clinique, STatistique, pour la Recherche en Santé (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre of Excellence in Complex Disease Genetics, HUS Abdominal Center, Department of Medicine, Gastroenterologian yksikkö, Helsinki University Hospital Area, Hôpital Archet 2 [Nice] (CHU), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Service de Gastro-Entérologie [CHRU Besançon], Service de Gastro-entérologie et Nutrition[Rangueil], CHU Toulouse [Toulouse]-Hôpital de Rangueil, Service de gastro-entérologie [Henri Mondor AP-HP, Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Hospital Clínic de Barcelona, Cliniques Universitaires Saint-Luc [Bruxelles], Service d'Hépato Gastroenterologie [CHU Amiens-Picardie], Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie-Institut National de l'Environnement Industriel et des Risques, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service d'Hépato-gastroentérologie [CHU Saint-Etienne], Hospital Universitario Mutua de Terrassa, Helsinki University Central Hospital [Finland] (HUCH), Universidad Autonoma de Madrid (UAM), Hospital Universitario de la Princesa, Service d'Hépato-gastro-entérologie [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Hépato-gastro-entérologie [CHRU Nancy], Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Association Francois Aupetit, CHU Rouen, Pôle Maladies de l'appareil digestif [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Hépatologie Gastro-entérologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), DESSAIVRE, Louise, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, MAINTENANCE THERAPY, UCEIS, [SDV]Life Sciences [q-bio], Gastroenterology, Severity of Illness Index, Mucosal Healing, law.invention, Vedolizumab, 03 medical and health sciences, 0302 clinical medicine, Maintenance therapy, Randomized controlled trial, law, Interquartile range, VEDOLIZUMAB, Internal medicine, medicine, Humans, Prospective Studies, Prospective cohort study, INDEX, OUTCOMES, Hepatology, business.industry, ulcerative Colitis, INDUCTION, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, REMISSION, medicine.disease, Ulcerative colitis, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Infliximab, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, 3121 General medicine, internal medicine and other clinical medicine, Cyclosporine, 030211 gastroenterology & hepatology, Colitis, Ulcerative, Steroids, business, Steroid refractory, medicine.drug
Abstract: International audience; BACKGROUND/AIMS: Few data on the evolution of endoscopic findings are available in patients with acute severe ulcerative colitis (ASUC). The aim of this study was to describe this evolution in a prospective cohort. METHODS: Patients admitted for a steroid-refractory ASUC and included in a randomized trial comparing infliximab and cyclosporine were eligible if they achieved steroid-free clinical remission at day 98. Flexible sigmoidoscopies were performed at baseline, days 7, 42 and 98. Ulcerative colitis endoscopic index of severity (UCEIS) and its sub-scores - vascular pattern, bleeding and ulceration/erosion - were post-hoc calculated. Global endoscopic remission was defined by a UCEIS of 0, and partial endoscopic remission by any UCEIS sub-score of 0. RESULTS: Among the 55 patients analyzed (29 infliximab and 26 cyclosporine), 49 (83%) had UCEIS >= 6 at baseline at baseline. Partial endoscopic remission rates were higher for bleeding than for vascular pattern and for ulcerations/erosions at day 7 (20% vs. 4% and 5% (n = 55); p
Published: 2021

25. ESOPHAGEAL MOTILITY DISORDERS ON HIGH RESOLUTION MANOMETRY: CHICAGO CLASSIFICATION VERSION 4.0(©)

Author: Joel E. Richter, André J.P.M. Smout, Philip O. Katz, Mark A. Fox, Sumeet K. Mittal, Geoffrey P. Kohn, Jordi Serra, Rami Sweis, Edoardo Savarino, C. Prakash Gyawali, Dustin A. Carlson, Arash Babaei, Roger P. Tatum, Junichi Akiyama, David A. Katzka, Albis Hani, Abraham Khan, Charles Cock, Daniel Pohl, Yinglian Xiao, Taher Omari, Kee Wook Jung, Peter J. Kahrilas, Justin C.Y. Wu, Ravinder K. Mittal, Sutep Gonlachanvit, C Defilippi, Serhat Bor, Marcelo F. Vela, Rena Yadlapati, Ronnie Fass, John E. Pandolfino, Roberto Penagini, Uday C Ghoshal, Moo In Park, Nathalie Rommel, Daniel Cisternas, Adriana Lazarescu, Joan W. Chen, Geoffrey S. Hebbard, Johannes Lengliner, Michael F. Vaezi, Enrique Coss-Adame, Jan Tack, Shobna Bhatia, Radu Tutuian, Daniel Sifrim, Reuben K. Wong, Sabine Roman, Albert J. Bredenoord, Frank Zerbib, Nicola de Bortoli, Ege Üniversitesi, Gastroenterology and Hepatology, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
Subjects: breathing, Physiology, Achalasia, gastroesophageal junction, 0302 clinical medicine, achalasia, esophageal spasm, integrated relaxation pressure, lower esophageal sphincter, peroral endoscopic myotomy, Esophageal Achalasia, Esophageal Motility Disorders, Esophageal Spasm, Diffuse, Esophagogastric Junction, Humans, Manometry, Esophagogastric junction, Medical diagnosis, 610 Medicine & health, High resolution manometry, pathophysiology, gastroesophageal junction outflow obstruction, esophagus motility, Gastroenterology, Diffuse, priority journal, classification, Esophageal motility disorder, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Radiology, Esophageal motility, medicine.medical_specialty, disease classification, barium, Article, 03 medical and health sciences, medicine, esophagus spasm, controlled study, human, procedures, Endocrine and Autonomic Systems, business.industry, esophagus achalasia, esophagus function disorder, medicine.disease, esophagus disease, Esophageal spasm, business, Expansive
Abstract: Chicago Classification v4.0 (CCv4.0) is the updated classification scheme for esophageal motility disorders using metrics from high-resolution manometry (HRM). Fifty-two diverse international experts separated into seven working subgroups utilized formal validated methodologies over two-years to develop CCv4.0. Key updates in CCv.4.0 consist of a more rigorous and expansive HRM protocol that incorporates supine and upright test positions as well as provocative testing, a refined definition of esophagogastric junction (EGJ) outflow obstruction (EGJOO), more stringent diagnostic criteria for ineffective esophageal motility and description of baseline EGJ metrics. Further, the CCv4.0 sought to define motility disorder diagnoses as conclusive and inconclusive based on associated symptoms, and findings on provocative testing as well as supportive testing with barium esophagram with tablet and/or functional lumen imaging probe. These changes attempt to minimize ambiguity in prior iterations of Chicago Classification and provide more standardized and rigorous criteria for patterns of disorders of peristalsis and obstruction at the EGJ. © 2020 John Wiley & Sons Ltd, National Institute of Diabetes and Digestive and Kidney Diseases, NIDDK: P01 DK092217, National Institute of Diabetes and Digestive and Kidney Diseases, Grant/Award Number: P01 DK092217
Published: 2021

26. Impact of gastric electrical stimulation on economic burden of refractory vomiting: a French nationwide multicentre study

Author: Guillaume Gourcerol, Benoit Coffin, Bruno Bonaz, Hélène Hanaire, Stanislas Bruley Des Varannes, Frank Zerbib, Robert Caiazzo, Jean Charles Grimaud, François Mion, Samy Hadjadj, Paul Valensi, Lucine Vuitton, Guillaume Charpentier, Alain Ropert, Romain Altwegg, Philippe Pouderoux, Etienne Dorval, Michel Dapoigny, Henri Duboc, Pierre Yves Benhamou, Aurélie Schmidt, Nathalie Donnadieu, Philippe Ducrotte, Bruno Guerci, Helene Hanaire, Stanislas Bruley des Varannes, Francois Mion, Aurelie Schmidt, Nathalie Donadieu, Philippe Ducrotté, Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], CHU Rouen, Normandie Université (NU)-Hôpital Charles Nicolle [Rouen], UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Toulouse [Toulouse], Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Bordeaux [Bordeaux], Centre Hospitalier Universitaire de Lille (CHU de Lille), Centre d'Investigation Clinique [Hôpital de la Conception - APHM] (CIC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), CHU de Lyon, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Sud Francilien [Corbeil-Essonnes] (CH Sud Francilien), Centre Hospitalier Universitaire de Rennes (CHU Rennes), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, STEVE CONSULTANTS 69600 OULLINS., Service d'Hépato-Gastroentérologie [CHU Rouen], Normandie Université (NU), Centre Hospitalier Universitaire de Nancy (CHU Nancy), Enterra Research Group, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Hôpital Charles Nicolle [Rouen], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Gastric electrical stimulation, medicine.medical_specialty, Gastroparesis, Cost effectiveness, Nausea, Vomiting, Electric Stimulation Therapy, Financial Stress, 03 medical and health sciences, 0302 clinical medicine, Refractory, Internal medicine, Medicine, Humans, Adverse effect, ComputingMilieux_MISCELLANEOUS, 2. Zero hunger, Hepatology, business.industry, Gastroenterology, Nutritional status, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Electric Stimulation, 3. Good health, Treatment Outcome, Gastric Emptying, 030220 oncology & carcinogenesis, Quality of Life, 030211 gastroenterology & hepatology, medicine.symptom, business, Body mass index
Abstract: Medico-economic data of patients suffering from chronic nausea and vomiting are lacking. In these patients, gastric electrical stimulation (GES) is an effective, but costly treatment. The aim of this study was to assess the efficacy, safety and medico-economic impact of Enterra therapy in patients with chronic medically refractory nausea and vomiting.Data were collected prospectively from patients with medically refractory nausea and/or vomiting, implanted with an Enterra device and followed for two years. Gastrointestinal quality of life index (GIQLI) score, vomiting frequency, nutritional status and safety were evaluated. Direct and indirect expenditure data were prospectively collected in diaries.Complete clinical data were available for142 patients (60 diabetic, 82 non-diabetic) and medico-economic data were available for 96 patients (36 diabetic, 60 non-diabetic), 24 months after implantation. GIQLI score increased by 12.1 ± 25.0 points (p.001), with a more significant improvement in non-diabetic than in diabetic patients (+15.8 ± 25.0 points, p.001 versus 7.3 ± 24.5 points, p = .027, respectively). The proportion of patients vomiting less than once per month increased by 25.5% (p.001). Hospitalisations, time off work and transport were the main sources of costs. Enterra therapy decreased mean overall healthcare costs from 8873 US$ to 5525 US$ /patient/year (p = .001), representing a saving of 3348 US$ per patient and per year. Savings were greater for diabetic patients (4096 US$ /patient/year) than for non-diabetic patients (2900 US$ /patient/year).Enterra therapy is an effective, safe and cost-effective option for patients with refractory nausea and vomiting.gov Identifier: NCT00903799.
Published: 2020

27. Randomised clinical trial: oesophageal radiofrequency energy delivery versus sham for PPI-refractory heartburn

Author: Marc Le Rhun, Maxime Leroy, Michel Robaszkiewicz, Stanislas Bruley des Varannes, Jean Paul Galmiche, François Mion, Chloé Melchior, Thierry Ponchon, S Sacher-Huvelin, Alberto Zalar, Frank Zerbib, Edouard Chabrun, Emmanuel Coron, Caroline Gorbatchef, Benoit Coffin, Franck Cholet, Fabienne Vavasseur, CHU Bordeaux [Bordeaux], CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Neuropathies du système nerveux entérique et pathologies digestives, implication des cellules gliales entériques, Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), CHRU Brest - Service d'Hématologie (CHU-Brest-Hemato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, douville, sabine, and Hôpital Charles Nicolle [Rouen]-CHU Rouen
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Drug Resistance, Gastroenterology, Severity of Illness Index, Placebos, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Symptom relief, Refractory, Double-Blind Method, Heartburn, Internal medicine, Clinical endpoint, Medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Treatment Failure, Adverse effect, ComputingMilieux_MISCELLANEOUS, Aged, Hepatology, business.industry, Reflux, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Proton Pump Inhibitors, Middle Aged, Radiofrequency Therapy, Combined Modality Therapy, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Clinical trial, Gastroesophageal Reflux, 030211 gastroenterology & hepatology, Female, France, medicine.symptom, business, Radiofrequency energy
Abstract: Background Oesophageal radiofrequency reduces use of proton pump inhibitors (PPIs) in patients with gastro-oesophageal reflux disease responding to PPIs. Aim To determine the efficacy of oesophageal radiofrequency in patients with PPI-refractory heartburn. Methods A randomised, double-blind, sham-controlled multicentre study was designed to assess the efficacy of oesophageal radiofrequency in PPI non-responding patients with heartburn. Patients had moderate-to-severe heartburn defined by at least 3 occurrences a week, and not improved by continuous PPI treatment. The primary endpoint was clinical success at week 24, defined by intake of less than 7 PPI doses over the 2 preceding weeks and adequate symptom control determined by the patient. Results Sixty two patients were randomised, 29 to the oesophageal radiofrequency group and 33 to the sham group. Intention-to-treat analysis showed that 1/29 (3.4%) and 5/33 (15.1%) achieved the primary endpoint in the oesophageal radiofrequency and sham groups, respectively (NS). There was no significant difference between oesophageal radiofrequency and sham regarding the number of days without heartburn, days with PPI consumption in the last 2 weeks, and patients not taking PPIs. No pH-impedance parameter was associated with clinical response. The occurrence of adverse events was similar in both groups. Conclusion This sham-controlled, randomised study did not demonstrate any efficacy of oesophageal radiofrequency for the treatment of PPI-refractory heartburn regarding symptom relief or consumption of PPIs. ClinicalTrials.gov NCT01682265.
Published: 2020

28. Gastric Electrical Stimulation Reduces Refractory Vomiting in a Randomized Crossover Trial

Author: Romain Altwegg, Pierre Mathieu, Henri Duboc, Maud Robert, Aurelie Schmidt, Lucine Vuitton, Emmanuel Huet, Alain Ropert, Daniela Calabrese, Fabienne Vavasseur, Pierre-Yves Benhamou, Emmanuel Disse, Sebastien Fontaine, Benoit Coffin, François Mion, Jean Charles Grimaud, Philippe Ducrotté, Guillaume Gourcerol, Sophie Borot, Frederic Borie, Frank Zerbib, Hélène Hanaire, Quentin Denost, Pierre Fontaine, Philippe Pouderoux, Nathalie Donnadieu, Robert Caiazzo, Fabian Reche, Nathalie Jeandidier, Etienne Dorval, Guillaume Charpentier, Michel Dapoigny, Samy Hadjadj, Gaëtan Prévost, Bruno Bonaz, Anne Marie Leroi, Nicolas Mathieu, Stanislas Bruley des Varannes, Benjamin Castel, Paul Valensi, Eric Letessier, Alfred Penfornis, Bruno Guerci, Service d'Hépato-Gastroentérologie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre d'Investigation Clinique [CHU Rouen] (CIC Rouen), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), CHU Louis Mourrier, CHU Grenoble, CHU Toulouse [Toulouse], Neuropathies du système nerveux entérique et pathologies digestives, implication des cellules gliales entériques, Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Recherche translationnelle sur le diabète - U 1190 (RTD), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Marseille, Hospices Civils de Lyon (HCL), Hôpital Edouard Herriot [CHU - HCL], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre d’Études et de Conservation des Œufs et du Sperme [CHU Jean Verdier] (CECOS), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital de Corbeil, Service des explorations fonctionnelles, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes], CHU Pontchaillou [Rennes], Hépato-gastro-entérologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Tours, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, Centre Hospitalier Universitaire [Grenoble] (CHU), Steve Consultants, Oullins, France., Service de physiologie digestive, urinaire, respiratoire et de l'exercice [CHU Rouen], CHU Rouen, Normandie Université (NU)-Hôpital Charles Nicolle [Rouen], Faculté de Médecine [Nancy], Université de Lorraine (UL), Enterra Research Group, Service d'Hépato-Gastroentérologie [Rouen], Centre d'Investigation Clinique [Rouen] (CIC Rouen), Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Rouen, Groupe d'Etude du Stress et des Interactions Neuro-Digestives (GESIND), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, University Hospital Grenoble-Alpes, BP 217, 38043 Grenoble Cedex 9, France. 8, Recherche translationelle sur le diabète (EGID), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut Européen de Génomique du Diabète - EGID, AP-HP Hôpital Jean-Verdier [Bondy], Centre Hospitalier Universitaire de Besançon (CHU Besançon), Centre Hospitalier Universitaire de Nîmes (CHU de Nîmes), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Département Sciences pour l'Action et le Développement (DEPT SAD), Institut National de la Recherche Agronomique (INRA), Service de physiologie digestive, urinaire, respiratoire et de l'exercice [Rouen], Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Charles Nicolle [Rouen], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Service des explorations fonctionnelles [CHU Rennes]
Subjects: Adult, Male, 0301 basic medicine, Gastroparesis, Vomiting, Nausea, Electric Stimulation Therapy, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Refractory, Diabetes mellitus, Humans, Medicine, Prospective Studies, ComputingMilieux_MISCELLANEOUS, 2. Zero hunger, Cross-Over Studies, Intention-to-treat analysis, Hepatology, Gastric emptying, business.industry, Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, medicine.disease, Crossover study, Electrodes, Implanted, 3. Good health, Treatment Outcome, 030104 developmental biology, Gastric Emptying, Anesthesia, Quality of Life, Female, 030211 gastroenterology & hepatology, medicine.symptom, business
Abstract: There have been conflicting results from trials of gastric electrical stimulation (GES) for treatment of refractory vomiting, associated or not with gastroparesis. We performed a large, multicenter, randomized, double-blind trial with crossover to study the efficacy of GES in patients with refractory vomiting, with or without gastroparesis.For 4 months, we assessed symptoms in 172 patients (66% women; mean age ± standard deviation, 45 ± 12 years; 133 with gastroparesis) with chronic (12 months) of refractory vomiting (idiopathic, associated with a type 1 or 2 diabetes, or postsurgical). A GES device was implanted and left unactivated until patients were randomly assigned, in a double-blind manner, to groups that received 4 months of stimulation parameters (14 Hz, 5 mA, pulses of 330 μs) or no stimulation (control); 149 patients then crossed over to the other group for 4 months. Patients were examined at the end of each 4-month period (at 5 and 9 months after implantation). Primary endpoints were vomiting score, ranging from 0 (daily vomiting) to 4 (no vomiting), and the quality of life, assessed by the Gastrointestinal Quality of Life Index scoring system. Secondary endpoints were changes in other digestive symptoms, nutritional status, gastric emptying, and control of diabetes.During both phases of the crossover study, vomiting scores were higher in the group with the device on (median score, 2) than the control group (median score, 1; P.001), in diabetic and nondiabetic patients. Vomiting scores increased significantly when the device was ON in patients with delayed (P.01) or normal gastric emptying (P = .05). Gastric emptying was not accelerated during the ON period compared with the OFF period. Having the GES turned on was not associated with increased quality of life.In a randomized crossover study, we found that GES reduced the frequency of refractory vomiting in patients with and without diabetes, although it did not accelerate gastric emptying or increase of quality of life. Clinicaltrials.gov, Number: NCT00903799.
Published: 2020

29. Implementation of infliximab standardized doses after pharmacokinetic modelization in a cohort of patients with Crohn’s disease

Author: Aude Berroneau, S Djabarouti, F Xuereb, Florian Poullenot, Lucie Sauvaget, Julien Ollivier, D Breilh, David Laharie, Pauline Rivière, Frank Zerbib, Département d'hépatologie et de gastroentérologie [CHU Bordeaux], Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Travaux et recherches archéologiques sur les cultures, les espaces et les sociétés (TRACES), École des hautes études en sciences sociales (EHESS)-Université Toulouse - Jean Jaurès (UT2J)-Ministère de la Culture et de la Communication (MCC)-Centre National de la Recherche Scientifique (CNRS), Bibliothèque Sainte-Geneviève (BSG), Université Sorbonne Nouvelle - Paris 3, Université de Bordeaux (UB), Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Département de pharmacocinétique et pharmacologie clinique, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CCSD, Accord Elsevier, and Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, Crohn’s disease, medicine.medical_specialty, medicine.medical_treatment, Dose banding, Pharmacokinetic, Monte-Carlo simulation, Drug Costs, Modelling, 03 medical and health sciences, 0302 clinical medicine, Maintenance therapy, Pharmacokinetics, Crohn Disease, Gastrointestinal Agents, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Cost Savings, Internal medicine, Article CLINIQUE, Medicine, Humans, Drug Dosage Calculations, Prospective Studies, Prospective cohort study, Infusions, Intravenous, Retrospective Studies, Crohn's disease, Chemotherapy, Hepatology, Dose-Response Relationship, Drug, business.industry, Significant difference, Gastroenterology, medicine.disease, Infliximab, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Hospitalization, 030220 oncology & carcinogenesis, Cohort, 030211 gastroenterology & hepatology, Female, France, business, Monte Carlo Method, medicine.drug
Abstract: International audience; BACKGROUND:According to infliximab (IFX) license in Crohn's disease (CD), infusion doses are based on patient's body-weight. Dose banding providing standardized doses (SD) has been implemented in parenteral chemotherapy in order to optimize aseptic unit capacity and reduce drug expenditure, duration of hospital stay and costs without decreasing efficacy.MATERIAL AND METHOD:The first part was a single-center retrospective analysis of consecutive CD patients receiving IFX maintenance therapy to determine standardized doses covering more than 50% of infusions. The second part was a prospective cohort study assessing the impact of SD compared to body-weight doses (BWD) on admission duration and costs.RESULTS:Six IFX SD covering more than 90% of infusion doses were implemented for dose banding. According to the Monte-Carlo simulation, there was no significant difference between IFX SD and BWD maintenance regimens. When assessed prospectively in 116 patients (75 patients treated with SD and 41 with BWD) corresponding to 128 infusions, hospitalization duration was shortened by 70 min per patient (p
Published: 2019

30. Extraesophageal Symptoms and Diseases Attributed to GERD: Where is the Pendulum Swinging Now?

Author: Michael F. Vaezi, Frank Zerbib, and David A. Katzka
Subjects: medicine.medical_specialty, Hepatology, Diagnostic Tests, Routine, business.industry, Gastroenterology, Reflux, Disease, medicine.disease, Hiatal hernia, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Gastroesophageal Reflux, medicine, GERD, Etiology, Humans, 030211 gastroenterology & hepatology, Esophagus, Intensive care medicine, business, Esophagitis, Empiric therapy
Abstract: The purpose of this review is to outline the recent developments in the field of extraesophageal reflux disease and provide clinically relevant recommendations. The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed and EMbase. The Clinical Practice Updates Committee of the American Gastroenterological Association proposes the following recommendations: Best Practice Advice 1: The role of a gastroenterologist in patients referred for evaluation of suspected extra esophageal symptom is to assess for gastroesophageal etiologies that could contribute to the presenting symptoms. Best Practice Advice 2: Non-GI evaluations by ENT, pulmonary and/or allergy are essential and often should be performed initially in most patients as the cause of the extraesophageal symptom is commonly multifactorial or not esophageal in origin. Best Practice Advice 3: Empiric therapy with aggressive acid suppression for 6-8 weeks with special focus on response of the extraesophageal symptoms can help in assessing association between reflux and extraesophageal symptoms. Best Practice Advice 4: No single testing methodology exists to definitively identify reflux as the etiology for the suspected extra esophageal symptoms. Best Practice Advice 5: Constellation of patient presentation, diagnostic test results and response to therapy should be employed in the determination of reflux as a possible etiology in extra esophageal symptoms. Best Practice Advice 6: Testing may need to be off or on proton pump inhibitor (PPI) therapy depending on patients' presenting demographics and symptoms in assessing the likelihood of abnormal gastroesophageal reflux. A. On therapy testing may be considered in those with high probability of baseline reflux (those with previous esophagitis, Barrett's esophagus or abnormal pH). B. Off therapy testing may be considered in those with low probability of baseline reflux with the goal of identifying moderate to severe reflux at baseline. Best Practice Advice 7: Lack of response to aggressive acid suppressive therapy combined with normal pH testing off therapy or impedance-pH testing on therapy significantly reduces the likelihood that reflux is a contributing etiology in presenting extraesophageal symptoms. Best Practice Advice 8: Surgical fundoplication is discouraged in those with extra esophageal reflux symptoms unresponsive to aggressive PPI therapy. Best Practice Advice 9: Fundoplication should only be considered in those with a mechanical defect (e.g., hiatal hernia), moderate to severe reflux at baseline off PPI therapy who have continued reflux despite PPI therapy and have failed more conservative non-GI treatments.
Published: 2018

31. A reduced esophageal epithelial integrity in a subgroup of healthy individuals increases with proton pump inhibitor therapy

Author: Tim Vanuytsel, Silvia Cocca, Sabine Roman, Nicolas A. Pardon, Ricard Farré, Charlotte Broers, Ans Pauwels, Frank Zerbib, and Jan Tack
Subjects: medicine.medical_specialty, Ussing chamber, business.industry, medicine.drug_class, Gastroenterology, Reflux, Proton-pump inhibitor, Original Articles, Esomeprazole, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Internal medicine, Healthy individuals, medicine, 030211 gastroenterology & hepatology, Proton pump inhibitor therapy, Esophagus, business, Intracellular, medicine.drug
Abstract: Approximately 30% of healthy volunteers (HVs) show dilated intercellular spaces in the esophageal epithelium suggesting a functionally reduced epithelial integrity. We aimed to evaluate the presence of an altered epithelial integrity in HVs and whether physiological acid could explain such a difference.Biopsies for Ussing chamber experiments were taken between 3 cm and 5 cm proximal to the gastroesophageal junction. Twenty-four-hour impedance-pH (MII-pH) monitoring was performed in the same 15 HVs. MII-pH tracings from 24 HVs before and after treatment with esomeprazole (40 mg b.i.d., two weeks), a proton pump inhibitor, were analyzed. Reflux parameters and impedance baseline (IB) at different levels of the esophagus were calculated.Epithelial integrity in the distal esophagus presents a large variability in vivo and in vitro (transepithelial electrical resistance 196.9 ± 16.27Ω. cmA subgroup of HVs presents a low epithelial integrity in the distal esophagus probably due to the increased presence of physiological acid reflux. Whether these individuals have a higher chance to develop gastroesophageal reflux disease is unknown. The role of epithelial integrity in symptom perception needs to be further explored.
Published: 2018

32. Modern diagnosis of GERD: the Lyon Consensus

Author: André J.P.M. Smout, Daniel Sifrim, Edoardo Savarino, Sabine Roman, Marcelo F. Vela, John E. Pandolfino, Mark A. Fox, Jan Tack, Peter J. Kahrilas, Michael F. Vaezi, François Mion, Albert J. Bredenoord, Frank Zerbib, Radu Tutuian, C. Prakash Gyawali, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and Gastroenterology and Hepatology
Subjects: BASE-LINE IMPEDANCE, medicine.medical_specialty, Esophageal pH Monitoring, ESOPHAGOGASTRIC JUNCTION CONTRACTILITY, Manometry, gastroesophageal reflux disease, Peptic, GASTROESOPHAGEAL-REFLUX DISEASE, Gastroenterology, PROTON-PUMP INHIBITORS, Impedance-pG, GERD, Manometry, 03 medical and health sciences, 0302 clinical medicine, Clinical history, Internal medicine, Recent Advances in Clinical Practice, medicine, Humans, Erosive oesophagitis, SYMPTOM ASSOCIATION ANALYSIS, Science & Technology, Gastroenterology & Hepatology, DILATED INTERCELLULAR SPACES, medicine.diagnostic_test, business.industry, PH monitoring, Reflux, Endoscopy, GERD, medicine.disease, 24-HOUR PH-IMPEDANCE, digestive system diseases, Questionnaire data, HIGH-RESOLUTION MANOMETRY, MULTIPLE RAPID SWALLOWS, INEFFECTIVE ESOPHAGEAL MOTILITY, 030220 oncology & carcinogenesis, Ambulatory, Gastroesophageal Reflux, Impedance-pG, 030211 gastroenterology & hepatology, business, Life Sciences & Biomedicine
Abstract: Clinical history, questionnaire data and response to antisecretory therapy are insufficient to make a conclusive diagnosis of GERD in isolation, but are of value in determining need for further investigation. Conclusive evidence for reflux on oesophageal testing include advanced grade erosive oesophagitis (LA grades C and D), long-segment Barrett's mucosa or peptic strictures on endoscopy or distal oesophageal acid exposure time (AET) >6% on ambulatory pH or pH-impedance monitoring. A normal endoscopy does not exclude GERD, but provides supportive evidence refuting GERD in conjunction with distal AET
Published: 2018

33. Irritable bowel syndrome diagnosis and management: A simplified algorithm for clinical practice

Author: Anton Emmanuel, Viola Andresen, Peter Layer, Maura Corsetti, Giovanni Barbara, Fermín Mearin, Frank Zerbib, Peter J. Whorwell, A Pali S Hungin, Jan Tack, Vincenzo Stanghellini, Fernando Azpiroz, Paul Moayyedi, Moayyedi, Paul, Mearin, Fermín, Azpiroz, Fernando, Andresen, Viola, Barbara, Giovanni, Corsetti, Maura, Emmanuel, Anton, Hungin, A Pali S, Layer, Peter, Stanghellini, Vincenzo, Whorwell, Peter, Zerbib, Frank, and Tack, Jan
Subjects: treatment, business.industry, Gastroenterology, Patient characteristics, Diagnostic test, medicine.disease, Clinical Practice, diagnosi, Irritable bowel syndrome, 03 medical and health sciences, 0302 clinical medicine, Oncology, Functional gastrointestinal disorder, medicine, 030211 gastroenterology & hepatology, 030212 general & internal medicine, business, Review Articles, Algorithm, management
Abstract: Background: Effective management of irritable bowel syndrome (IBS), a common functional gastrointestinal disorder, can be challenging for physicians because of the lack of simple diagnostic tests and the wide variety of treatment approaches available. Objective: The objective of this article is to outline a simple algorithm for day-to-day clinical practice to help physicians navigate key stages to reaching a positive IBS diagnosis and guidance on how to prioritise the use of specific management strategies. Methods: This algorithm was based on the opinion of an expert panel evaluating current evidence. Results: The key principles forming the foundation of this evidence-supported algorithm are: confidently naming and explaining an IBS diagnosis for the patient, followed by assessment of key patient characteristics likely to influence the choice of therapy, such as predominant symptoms, and exploring the patient agenda and preferences. Consultation should always include education and reassurance with an explanatory model of IBS tailored to the patient. Individualised lifestyle changes, dietary modifications, pharmacological therapies, psychological strategies or a combination of interventions may be used to optimise treatment for each patient. Conclusion: The simple visual tools developed here navigate the key stages to reaching a positive diagnosis of IBS, and provide a stepwise approach to patient-centred management targeted towards the most bothersome symptoms. Establishing a strong patient-physician relationship is central to all stages of the patient journey from diagnosis to effective management.
Published: 2017

34. Sa152 THRESHOLDS FOR REFLUX METRICS ON PH-IMPEDANCE MONITORING PERFORMED 'ON’ BID PROTON PUMP INHIBITOR (PPI) THERAPY: MULTICENTER INTERNATIONAL COLLABORATIVE STUDY

Author: Radu Tutuian, Daniel Sifrim, Sabine Roman, Nicola de Bortoli, Marcelo F. Vela, Edoardo Savarino, Frank Zerbib, Benjamin D. Rogers, and C. Prakash Gyawali
Subjects: medicine.medical_specialty, Hepatology, business.industry, medicine.drug_class, Gastroenterology, Urology, Reflux, Medicine, Proton-pump inhibitor, business, Electrical impedance
Published: 2021

35. Frequency of and Factors Associated With Sexual Dysfunction in Patients With Inflammatory Bowel Disease

Author: Pauline Rivière, D. Laharie, Frank Zerbib, Laurent Peyrin-Biroulet, Camille Zallot, J. Vergniol, P. Desobry, Jean-Marc Sabate, and Florian Poullenot
Subjects: Adult, Male, medicine.medical_specialty, Urology, Inflammatory bowel disease, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Erectile Dysfunction, Surveys and Questionnaires, Internal medicine, Humans, Medicine, Depression (differential diagnoses), Irritable bowel syndrome, Crohn's disease, business.industry, Gastroenterology, General Medicine, Middle Aged, Inflammatory Bowel Diseases, medicine.disease, Ulcerative colitis, digestive system diseases, Sexual Dysfunction, Physiological, Cross-Sectional Studies, Sexual dysfunction, Erectile dysfunction, Case-Control Studies, 030220 oncology & carcinogenesis, Colitis, Ulcerative, Female, 030211 gastroenterology & hepatology, medicine.symptom, business, Sexual function
Abstract: Background Improvement of quality of life is a main objective in inflammatory bowel disease [IBD] management. Data on sexual dysfunction [SD] in IBD are scarce. This study compared rates of SD between IBD patients and healthy controls [HC], and searched for predictors of SD. Methods All consecutive IBD patients seen in two tertiary centres during 2 months were invited to fill an anonymous validated questionnaire on their sexual function [Female Sexual Index Function and International Index of Erectile Function]. The same questionnaires were filled by HC and by patients with irritable bowel syndrome [IBS] enrolled as a second comparative group. Results In all, 358 IBD patients filled the questionnaire [192 women]-including 238 with Crohn's disease and 120 with ulcerative colitis-and 110 HC [54 women] and 107 IBS patients [54 women]. In women, SD rates were 53.6% in IBD vs 28% in HC [p < 0.01] and 77.5% in IBS [p = 0.10] patients; in men, figures were 16.9% in IBD, 7.4% in HC [p = 0.64], and 26.4% in IBS [p = 0.60]. An erectile dysfunction [ED] was reported by 43% of IBD patients, 13% of HC [p < 0.01] and 55% of IBS patients [p = 0.60 vs IBD]. Predictors of SD and ED were social and emotional functioning, anxiety in women and depression in men. IBD activity was not associated with SD. Conclusions In IBD, 54% of women have an SD and 43% of men an ED. These rates are significantly higher than in HC, mostly driven by psychological factors, and independent from disease severity.
Published: 2017

36. Bismuth Concentrations in Patients Treated in Real-Life Practice with a Bismuth Subcitrate-Metronidazole-Tetracycline Preparation: The SAPHARY Study

Author: Frank Zerbib, Francis Mégraud, Nicholas Moore, Magali Rouyer, Cécile Droz-Perroteau, François Tison, Régis Lassalle, Patrick Blin, E. Bignon, Bertrand Diquet, Bénédicte Lelièvre, E. Guiard, Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP), Université d'Angers (UA), Département de Pharmacologie-Toxicologie [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques (ICAT), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Laboratoire de Bactériologie, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service de Neurologie, Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux]-CHU Bordeaux [Bordeaux], Chemometrics and Theoretical Chemistry - Chimiométrie et chimie théorique, Institut des Sciences Analytiques (ISA), Institut de Chimie du CNRS (INC)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC - Bordeaux, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Encephalopathy, chemistry.chemical_element, Toxicology, 030226 pharmacology & pharmacy, Gastroenterology, Helicobacter Infections, Bismuth, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Metronidazole, Internal medicine, Organometallic Compounds, medicine, Humans, Pharmacology (medical), Treatment Failure, 030212 general & internal medicine, Adverse effect, ComputingMilieux_MISCELLANEOUS, Aged, Pharmacology, Helicobacter pylori, biology, business.industry, Middle Aged, Tetracycline, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, biology.organism_classification, medicine.disease, Confidence interval, 3. Good health, Drug Combinations, chemistry, Bismuth Subcitrate, Toxicity, Female, Neurotoxicity Syndromes, business, medicine.drug
Abstract: A fixed-dose association of bismuth subcitrate, metronidazole and tetracycline (BMT) (Pylera®, Allergan, NJ, USA) was made available in France in 2013 for the eradication of Helicobacter pylori. Due to a historical issue of bismuth encephalopathy, the French Health Authorities requested a study of blood and plasma bismuth concentrations with BMT in daily practice. The aim of the study was to measure eventual bismuth accumulation and neurological toxicity in patients prescribed BMT. Patients initiating BMT for H. pylori between March 2014 and December 2015 were included. A blood sample was taken before first BMT intake and 24 h after the last intake, for assay of bismuth. A concentration > 50 μg/L was considered abnormal. Neurological complaints were assessed at inclusion, at the end of the 10-day treatment course, and 28 days later. 202 patients were included, of whom 190 took at least one dose of BMT, and 167 provided both required blood samples. Mean blood bismuth concentrations after the BMT course were 16.9 μg/L (95% confidence interval 15.6–18.3). Concentrations were > 50 μg/L (56.0 μg/L and 50.9 μg/L) in two elderly patients, one of whom presented mild, transient memory impairment during treatment. Non-serious neurological symptoms occurred in 20% of all patients and treatment failure was documented in 5% of patients. In this study measuring blood bismuth concentrations in real-life practice, in 50 μg/L. No serious neurological adverse events were observed. EU-PAS register EUPAS3142 at www.encepp.eu ; ENCePP study seal.
Published: 2019

37. Between GERD and NERD: the relevance of weakly acidic reflux

Author: Andrea Ottonello, Edoardo Savarino, Daniel Sifrim, Nicola de Bortoli, Frank Zerbib, and C. Prakash Gyawali
Subjects: medicine.medical_specialty, Nerd, Disease, Gastroenterology, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, History and Philosophy of Science, Refractory, Internal medicine, medicine, Esophagus, medicine.diagnostic_test, Chemistry, General Neuroscience, digestive, oral, and skin physiology, Reflux, Heartburn, medicine.disease, digestive system diseases, Endoscopy, medicine.anatomical_structure, 030220 oncology & carcinogenesis, GERD, 030211 gastroenterology & hepatology, medicine.symptom
Abstract: Nonerosive reflux disease (NERD) is a common condition and the most frequent phenotype of gastroesophageal reflux disease (GERD). NERD is extremely heterogeneous and includes patients with negative endoscopy but abnormal esophageal acid exposure and/or positive reflux-symptom association analysis (hypersensitive esophagus). This segregation is only possible owing to the use of impedance-pH monitoring. Indeed, weakly acidic reflux represents one of the most common causes of refractory symptoms in patients evaluated off antisecretory therapy and, more importantly, during antisecretory drug treatment. Patients with heartburn who do not have any type of reflux underlying their symptoms (functional heartburn) must be excluded from the category of GERD. The drawbacks of impedance-pH are mainly due to the day-to-day variability of the test and the fact that the accuracy of the symptom-reflux correlation scores is often far from perfect. Some histopathological characteristics, such as dilated intercellular spaces, can be helpful in distinguishing patients with NERD through esophageal biopsies. Patients with NERD in whom acid is the main pathogenetic factor respond successfully to proton pump inhibitor therapy, while those with hypersensitive esophagus to weakly acidic reflux could be treated with reflux inhibitors or surgery, although further controlled studies are required.
Published: 2016

38. Infliximab Reduces Endoscopic, but Not Clinical, Recurrence of Crohn’s Disease After Ileocolonic Resection

Author: Silvio Danese, V. Yajnik, P. Gionchetti, Brian G. Feagan, Richard N. Fedorak, O. Dewit, D. Sorrentino, V. F. Annese, W J Sandborn, Michael Chiorean, G. Radford-Smith, S Plevy, I. Lawrance, Jane E. Onken, Simon Campbell, Jewel Johanns, Peter L. Lakatos, G R D’Haens, Denis Franchimont, J. C. Preiss, Giovanni Terrosu, Áron Vincze, Torsten Kucharzik, Charles Randall, I. Stein, Edward V. Loftus, L. Sauberman, X. Li, I. Oikonomou, Frank Zerbib, H. G. Lamprecht, R. Kottoor, J. Vecchio, Severine Vermeire, Daniel Rachmilewitz, J. R. Lachance, J.L. Dupas, W. H. Holderman, Michael Safdi, T. Haas, J.-F. Colombel, Richard B. Gearry, Russell S. Walmsley, R. P. Phillips, Miguel Regueiro, A. B. Hawthorne, David T. Rubin, J. W. Hamilton, G. D'Haens, M Parkes, Jean-Marie Reimund, Fabrizio Bossa, Walter Reinisch, K. A. Peterson, M. Ropeleski, S. Fishman, Marc Chevrier, Hans H Herfarth, Stephen B. Hanauer, Timothy H. Florin, Walter Fries, D. J. Hetzel, D. E. Elliott, János Banai, B. W. Behm, S. Sedghi, Remo Panaccione, Peter D.R. Higgins, Jean-Paul Achkar, Ziad Younes, Raja Atreya, Harald Vogelsang, M. Noar, S. S. Dhalla, U. Boecker, Raymond Bourdages, Ellen Scherl, Eran Goldin, T. Ritter, S. Gassner, Stefanie Howaldt, M. Ricci, Paolo Gionchetti, B. I. Leman, Marion Blank, D. Grunkmeier, Livia Biancone, J. Mudter, N. Chiba, Paolo Usai, R. Hardi, I. P. Beales, István Altorjay, W. J S Devilliers, J. Hill, Daniel C. Baumgart, Jason M. Swoger, Charles A. Sninsky, B. Singh Salh, L. D. Wruble, G. Bramkamp, Dario Sorrentino, Paul Rutgeerts, Stephen J. Bickston, S. Schreiber, D. J. Helper, Eric Lerebours, Jaroslaw Regula, M. D. Kreines, M. Strasser, C. Antoni, Giovanni Maconi, Freddy Cornillie, Laurent Peyrin-Biroulet, J. S. Hanson, Ewa Małecka-Panas, David Rowbotham, Jean-Charles Grimaud, Gerald Fraser, Ursula Seidler, C. Bünning, C. Berg, G. Reicht, Martin Lukas, John W. Popp, Edouard Louis, D. Laharie, Xavier Hébuterne, K. J. Brown, Márta Varga, L. Paradowski, Robert Ehehalt, Sandro Ardizzone, Stephanie Viennot, S. B. Hanauer, Charles N. Bernstein, Milan Lukas, H. Debinski, R. P. Schwarz, Simon Travis, D. I. Weinberg, D. Wallace, R. S. Stubbs, Bin Zou, A. Sloss, John Wyeth, Irit Avni-Biron, Peter Bossuyt, Ira Shafran, Matthieu Allez, Pierre Desreumaux, Michael Schultz, W. Reinisch, William J. Sandborn, APH - Amsterdam Public Health, 10 Public Health & Methodologie, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, AII - Amsterdam institute for Infection and Immunity, Intensive Care Medicine, UCL - SSS/IREC-Institut de recherche expérimentale et clinique, UCL - SSS/IREC/GAEN-Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Service de gastro-entérologie, Regueiro, M, Feagan, Bg, Zou, B, Johanns, J, Blank, Ma, Chevrier, M, Plevy, S, Popp, J, Cornillie, Fj, Lukas, M, Danese, S, Gionchetti, P, Hanauer, Sb, Reinisch, W, Sandborn, Wj, Sorrentino, D, Rutgeerts, P, Regueiro, Miguel, Feagan, Brian G., Zou, Bin, Johanns, Jewel, Blank, Marion A., Chevrier, Marc, Plevy, Scott, Popp, John, Cornillie, Freddy J., Lukas, Milan, Danese, Silvio, Gionchetti, Paolo, Hanauer, Stephen B., Reinisch, Walter, Sandborn, William J., Sorrentino, Dario, Rutgeerts, Paul, Debinski, H., Florin, T., Hetzel, D., Lawrance, I., Radford Smith, G., Sloss, A., Sorrentino, D., Gassner, S., Haas, T., Reicht, G., Reinisch, W., Strasser, M., Vogelsang, H., Bossuyt, P., Dewit, O., D'Haens, G., Franchimont, D., Louis, E., Vermeire, S., Bernstein, C. N., Bourdages, R., Chiba, N., Dhalla, S. S., Feagan, B. G., Fedorak, R. N., Lachance, J. R., Panaccione, R., Ropeleski, M., Singh Salh, B., Lukas, M., Colombel, J. F., Allez, M., Desreumaux, P., Dupas, J. L., Grimaud, J. C., Hebuterne, X., Laharie, D., Lerebours, E., Peyrin Biroulet, L., Reimund, J. M., Viennot, S., Zerbib, F., Antoni, C., Atreya, R., Baumgart, D. C., Berg, C., Boecker, U., Bramkamp, G., Bünning, C., Ehehalt, R., Howaldt, S., Kucharzik, T., Lamprecht, H. G., Mudter, J., Preiss, J. C., Schreiber, S., Seidler, U., Altorjay, I., Banai, J., Lakatos, P. L., Varga, M., Vincze, A., Avni Biron, I., Fishman, S., Fraser, G. M., Goldin, E., Rachmilewitz, D., Annese, V., Ardizzone, S., Biancone, L., Bossa, F., Danese, S., Fries, W., Gionchetti, P., Maconi, G., Terrosu, G., Usai, P., D'Haens, G. R., Gearry, R. B., Hill, J., Rowbotham, D. S., Schultz, M., Stubbs, R. S., Wallace, D., Walmsley, R. S., Wyeth, J., Malecka Panas, E., Paradowski, L., Regula, J., Beales, I. P., Campbell, S., Hawthorne, A. B., Parkes, M., Travis, S. P., Achkar, J. P., Behm, B. W., Bickston, S. J., Brown, K. J., Chiorean, M. V., Devilliers, W. J. S., Elliott, D. E., Grunkmeier, D., Hamilton, J. W., Hanauer, S. B., Hanson, J. S., Hardi, R., Helper, D. J., Herfarth, H., Higgins, P. D. R., Holderman, W. H., Kottoor, R., Kreines, M. D., Leman, B. I., Li, X., Loftus, E. V., Noar, M., Oikonomou, I., Onken, J., Peterson, K. A., Phillips, R. P., Randall, C. W., Ricci, M., Ritter, T., Rubin, D. T., Safdi, M., Sandborn, W. J., Sauberman, L., Scherl, E., Schwarz, R. P., Sedghi, S., Shafran, I., Sninsky, C. A., Stein, I., Swoger, J., Vecchio, J., Weinberg, D. I., Wruble, L. D., Yajnik, V., and Younes, Z.
Subjects: Adult, Male, musculoskeletal diseases, medicine.medical_specialty, Colon, medicine.medical_treatment, Colonoscopy, Klinikai orvostudományok, Placebo, law.invention, Anti-TNF, 03 medical and health sciences, 0302 clinical medicine, Crohn Disease, Double-Blind Method, Gastrointestinal Agents, Randomized controlled trial, Ileum, Recurrence, law, CDAI, Inflammatory Bowel Disease, PREVENT, Gastroenterology, Secondary Prevention, medicine, Clinical endpoint, Humans, Postoperative Period, Colectomy, Gastrointestinal agent, Hepatology, medicine.diagnostic_test, business.industry, Orvostudományok, Middle Aged, Crohn's Disease Activity Index, Infliximab, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract: Background & Aims Most patients with Crohn's disease (CD) eventually require an intestinal resection. However, CD frequently recurs after resection. We performed a randomized trial to compare the ability of infliximab vs placebo to prevent CD recurrence. Methods We evaluated the efficacy of infliximab in preventing postoperative recurrence of CD in 297 patients at 104 sites worldwide from November 2010 through May 2012. All study patients had undergone ileocolonic resection within 45 days before randomization. Patients were randomly assigned (1:1) to groups given infliximab (5 mg/kg) or placebo every 8 weeks for 200 weeks. The primary end point was clinical recurrence, defined as a composite outcome consisting of a CD Activity Index score >200 and a ≥70-point increase from baseline, and endoscopic recurrence (Rutgeerts score ≥i2, determined by a central reader) or development of a new or re-draining fistula or abscess, before or at week 76. Endoscopic recurrence was a major secondary end point. Results A smaller proportion of patients in the infliximab group had a clinical recurrence before or at week 76 compared with the placebo group, but this difference was not statistically significant (12.9% vs 20.0%; absolute risk reduction [ARR] with infliximab, 7.1%; 95% confidence interval: -1.3% to 15.5%; P =.097). A significantly smaller proportion of patients in the infliximab group had endoscopic recurrence compared with the placebo group (30.6% vs 60.0%; ARR with infliximab, 29.4%; 95% confidence interval: 18.6% to 40.2%; P
Published: 2016

39. Esophageal Disorders

Author: Chandra Prakash Gyawali, Qasim Aziz, Ronnie Fass, John E. Pandolfino, Frank Zerbib, and Hiroto Miwa
Subjects: medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, Heartburn, Achalasia, Esophageal Disorder, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Esophageal motility disorder, 030220 oncology & carcinogenesis, Internal medicine, medicine, GERD, 030211 gastroenterology & hepatology, Esophageal spasm, Esophagus, medicine.symptom, Eosinophilic esophagitis, business
Abstract: Functional esophageal disorders consist of a disease category that present with esophageal symptoms (heartburn, chest pain, dysphagia, globus) not explained by mechanical obstruction (stricture, tumor, eosinophilic esophagitis), major motor disorders (achalasia, EGJ outflow obstruction, absent contractility, distal esophageal spasm, jackhammer esophagus), or gastroesophageal reflux disease (GERD). While mechanisms responsible are unclear, it is theorized that visceral hypersensitivity and hypervigilance play an important role in symptom generation, in the context of normal or borderline function. Treatments directed at improving borderline motor dysfunction or reducing reflux burden to sub-normal levels have limited success in symptom improvement. In contrast, strategies focused on modulating peripheral triggering and central perception are mechanistically viable and clinically meaningful. However, outcome data from these treatment options are limited. Future research needs to focus on understanding mechanisms underlying visceral hypersensitivity and hypervigilance so that appropriate targets and therapies can be developed.
Published: 2016

40. Su1904 CAN WE PREDICT THE PRESENCE OF DEEP ULCERS BY NON-INVASIVE MEASURES IN PATIENTS WITH ULCERATIVE COLITIS?

Author: Frank Zerbib, Quentin Denost, Anne Rullier, Pauline Rivière, Marion Marty, Florian Poullenot, Anne Le Chevillier, Bruno Lapuyade, and David Laharie
Subjects: medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Non invasive, Gastroenterology, Medicine, In patient, business, medicine.disease, Ulcerative colitis
Published: 2020

41. The 2018 ISDE achalasia guidelines

Author: Giovanni Sarnelli, Tim Vanuytsel, Blair A. Jobe, Cathy Bennett, David I. Watson, Piero M. Fisichella, Ivan Cecconello, Ulysses Ribeiro, Richard H. Holloway, D. Liu, M. Y. A. van Herwaarden-Lindeboom, Edoardo Savarino, Rubens Antonio Aissar Sallum, Daniel Sifrim, David A. Katzka, Eric S. Hungness, John E. Pandolfino, Fernando A. M. Herbella, Silvana Perretta, Roger P. Tatum, Lee L. Swanstrom, Guy E. Boeckxstaens, Chandra Prakash Gyawali, Richard Ricachenevsky Gurski, Marco G. Patti, L. Faccio, George Triadafilopoulos, Nathaniel J. Soper, D. Inama, M. F. Vaezi, Frank Zerbib, Sheraz R. Markar, Joel E. Richter, An Moonen, S. Vermigli, Pankaj J. Pasricha, Ines Gockel, Nelson Adami Andreollo, Guido Costamagna, Peter J. Kahrilas, Francisco Schlottmann, Giovanni Zaninotto, Mark K. Ferguson, M. F. Vela, Stuart Gittens, Karl-Hermann Fuchs, Renato Salvador, Donald E. Low, C. Pontillo, J. R. M. Da Rocha, Jan Tack, Mario Costantini, Roberto Penagini, Kulwinder S. Dua, Michio Hongo, Ary Nasi, Zaninotto, G, Bennett, C, Boeckxstaens, G, Costantini, M, Ferguson, M K, Pandolfino, J E, Patti, M G, Ribeiro, U, Richter, J, Swanstrom, L, Tack, J, Triadafilopoulos, G, Markar, S R, Salvador, R, Faccio, L, Andreollo, N A, Cecconello, I, Costamagna, G, da Rocha, J R M, Hungness, E S, Fisichella, P M, Fuchs, K H, Gockel, I, Gurski, R, Gyawali, C P, Herbella, F A M, Holloway, R H, Hongo, M, Jobe, B A, Kahrilas, P J, Katzka, D A, Dua, K S, Liu, D, Moonen, A, Nasi, A, Pasricha, P J, Penagini, R, Perretta, S, Sallum, R A A, Sarnelli, G, Savarino, E, Schlottmann, F, Sifrim, D, Soper, N, Tatum, R P, Vaezi, M F, van Herwaarden-Lindeboom, M, Vanuytsel, T, Vela, M F, Watson, D I, Zerbib, F, Gittens, S, Pontillo, C, Vermigli, S, Inama, D, and Low, D E
Subjects: Adult, Male, Myotomy, Chagas disease, medicine.medical_specialty, Botulinum Toxins, medicine.medical_treatment, Achalasia, Esophageal Disorder, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Severity of illness, otorhinolaryngologic diseases, medicine, Humans, Disease management (health), Child, Evidence-Based Medicine, DIRETRIZES PARA A PRÁTICA CLÍNICA, business.industry, General surgery, Gastroenterology, Disease Management, achalaisa, guidelines, General Medicine, Evidence-based medicine, Guideline, medicine.disease, Dilatation, Dysphagia, Esophageal Achalasia, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Esophagoscopy, Symptom Assessment, medicine.symptom, business
Abstract: Achalasia is a relatively rare primary motor esophageal disorder, characterized by absence of relaxations of the lower esophageal sphincter and of peristalsis along the esophageal body. As a result, patients typically present with dysphagia, regurgitation and occasionally chest pain, pulmonary complication and malnutrition. New diagnostic methodologies and therapeutic techniques have been recently added to the armamentarium for treating achalasia. With the aim to offer clinicians and patients an up-to-date framework for making informed decisions on the management of this disease, the International Society for Diseases of the Esophagus Guidelines proposed and endorsed the Esophageal Achalasia Guidelines (I-GOAL). The guidelines were prepared according the Appraisal of Guidelines for Research and Evaluation (AGREE-REX) tool, accredited for guideline production by NICE UK. A systematic literature search was performed and the quality of evidence and the strength of recommendations were graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Given the relative rarity of this disease and the paucity of high-level evidence in the literature, this process was integrated with a three-step process of anonymous voting on each statement (DELPHI). Only statements with an approval rate >80% were accepted in the guidelines. Fifty-one experts from 11 countries and 3 representatives from patient support associations participated to the preparations of the guidelines. These guidelines deal specifically with the following achalasia issues: Diagnostic workup, Definition of the disease, Severity of presentation, Medical treatment, Botulinum Toxin injection, Pneumatic dilatation, POEM, Other endoscopic treatments, Laparoscopic myotomy, Definition of recurrence, Follow up and risk of cancer, Management of end stage achalasia, Treatment options for failure, Achalasia in children, Achalasia secondary to Chagas' disease.
Published: 2018

42. P539 Impact of a multi-disciplinary team meeting for managing inflammatory bowel disease patients: professional practice analysis based on 869 cases

Author: H Del Arco, Florian Poullenot, Pauline Rivière, D. Laharie, and Frank Zerbib
Subjects: Nursing, business.industry, Gastroenterology, Medicine, Professional practice, General Medicine, business, Multidisciplinary team, medicine.disease, Inflammatory bowel disease
Published: 2019

43. Pattern and Severity of Psoriasiform Eruptions in Patients with Inflammatory Bowel Diseases, Arthritis or Skin Inflammatory Disorders Treated with TNF-alpha Inhibitors

Author: Marie-Elise Truchetet, Julien Seneschal, Thierry Schaeverbeke, Frank Zerbib, David Laharie, Brigitte Milpied, Khaled Ezzedine, Alain Taïeb, Thomas Jouary, Anne-Sophie Darrigade, and Marie Beylot-Barry
Subjects: Male, Necrosis, Time Factors, Anti-Inflammatory Agents, Arthritis, Dermatitis, Severity of Illness Index, 030207 dermatology & venereal diseases, 0302 clinical medicine, Risk Factors, inhibitors, 030212 general & internal medicine, Young adult, Skin, Observer Variation, tumournecrosisfactor, integumentary system, Inflammatory Bowel Diseases, General Medicine, Middle Aged, medicine.anatomical_structure, Treatment Outcome, RL1-803, Tumor necrosis factor alpha, Female, Drug Eruptions, medicine.symptom, Adult, medicine.medical_specialty, Adolescent, Dermatology, 03 medical and health sciences, Young Adult, Sex Factors, Severity of illness, medicine, Humans, Psoriasis, inflammatoryboweldisease, Aged, Retrospective Studies, psoriasiformeruption, business.industry, Tumor Necrosis Factor-alpha, Reproducibility of Results, Retrospective cohort study, medicine.disease, Scalp Dermatoses, Scalp, TNF-α, business
Abstract: Psoriasiform eruptions are a classical adverse skin reaction of tumour necrosis factor (TNF)-α inhibitors. The aim of this study was to identify the association between the severity or pattern of psoriasiform reactions and the underlying disease. A retrospective study was conducted between January 2012 and May 2015. Adult patients who developed psoriasiform eruptions whilst being treated with TNFα inhibitors were included. For each patient, 3 independent blinded dermatologists graded twice the severity of the lesions according to 6 clinical psoriasiform eruption types. Inter- and intra-individual kappa tests were performed to evaluate the robustness of the scoring system. The association between severity score levels or the pattern of reactions and the underlying disease was assessed. The severity scoring system showed good inter- and intra-observer reproducibility. Women patients treated with TNFα inhibitors for inflammatory bowel diseases showed a higher risk of developing severe reactions with scalp and skin-fold involvement.
Published: 2017

44. P455 Spacing of infliximab infusions over 8 weeks in patients with inflammatory bowel diseases in clinical remission: Final results of a retrospective multicentre French national cohort

Author: Frank Zerbib, Stephanie Viennot, Florian Poullenot, Pierre Blanc, Aurelien Amiot, L Caillo, G Pineton de Chambrun, Benjamin Pariente, Gaspard Dufour, Maria Nachury, P. Pouderoux, L Peyrin-Biroulet, Stéphane Nancey, and Romain Altwegg
Subjects: medicine.medical_specialty, Crohn's disease, business.industry, medicine.medical_treatment, Gastroenterology, Inflammatory Bowel Diseases, General Medicine, Bowel resection, medicine.disease, Inflammatory bowel disease, Ulcerative colitis, Infliximab, 03 medical and health sciences, Intestine Resection, 0302 clinical medicine, 030220 oncology & carcinogenesis, Internal medicine, medicine, 030211 gastroenterology & hepatology, In patient, business, medicine.drug
Published: 2018

45. Tu1227 – Efficacy of Per-Oral Endoscopic Myotomy for the Treatment of Non-Achalasia Esophageal Motor Disorders

Author: Jean-Michel Gonzalez, Thierry Ponchon, Frank Zerbib, Edouard Chabrun, Julien Vergniol, Stanislas Chaussade, Marc Barthet, Timothée Wallenhorst, Lucie Bernardot, Maximilien Barret, Véronique Vitton, Mathieu Pioche, Sabine Roman, and Frédéric Prat
Subjects: medicine.medical_specialty, Hepatology, business.industry, Per-oral endoscopic myotomy, Gastroenterology, medicine, Achalasia, medicine.disease, business, Surgery
Published: 2019

46. Pharyngeal pH alone is not reliable for the detection of pharyngeal reflux events: A study with oesophageal and pharyngeal pH‐impedance monitoring

Author: Frank Zerbib, Guillaume Gourcerol, Alain Ropert, François Mion, Benoit Coffin, Marie Desjardin, Stanislas Bruley des Varannes, and Sabine Roman
Subjects: medicine.medical_specialty, Pharyngeal reflux, business.industry, digestive, oral, and skin physiology, Gastroenterology, Healthy subjects, Reflux, Original Articles, medicine.disease, digestive system diseases, Laryngopharyngeal reflux, Oncology, Internal medicine, medicine, business
Abstract: Background: Pharyngeal pH probes and pH-impedance catheters have been developed for the diagnosis of laryngopharyngeal reflux. Objective: To determine the reliability of pharyngeal pH alone for the detection of pharyngeal reflux events. Methods: 24-h pH-impedance recordings performed in 45 healthy subjects with a bifurcated probe for detection of pharyngeal and oesophageal reflux events were reviewed. Pharyngeal pH drops to below 4 and 5 were analysed for the simultaneous occurrence of pharyngeal reflux, gastro-oesophageal reflux, and swallows, according to impedance patterns. Results: Only 7.0% of pharyngeal pH drops to below 5 identified with impedance corresponded to pharyngeal reflux, while 92.6% were related to swallows and 10.2 and 13.3% were associated with proximal and distal gastro-oesophageal reflux events, respectively. Of pharyngeal pH drops to below 4, 13.2% were related to pharyngeal reflux, 87.5% were related to swallows, and 18.1 and 21.5% were associated with proximal and distal gastro-oesophageal reflux events, respectively. Conclusions: This study demonstrates that pharyngeal pH alone is not reliable for the detection of pharyngeal reflux and that adding distal oesophageal pH analysis is not helpful. The only reliable analysis should take into account impedance patterns demonstrating the presence of pharyngeal reflux event preceded by a distal and proximal reflux event within the oesophagus.
Published: 2013

47. Quality of Sex Life in Patients with Inflammatory Bowel Disease

Author: David Laharie, Pauline Rivière, Florian Poullenot, and Frank Zerbib
Subjects: Adult, Male, medicine.medical_specialty, Sexual Behavior, Inflammatory bowel disease, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Internal medicine, medicine, Humans, Immunology and Allergy, In patient, Reproductive health, business.industry, Gastroenterologists, Perspective (graphical), Middle Aged, Inflammatory Bowel Diseases, Prognosis, medicine.disease, Sexual behavior, 030220 oncology & carcinogenesis, Sex life, Quality of Life, Female, 030211 gastroenterology & hepatology, Sexual Health, business
Published: 2017

48. Treatment of GORD: Three decades of progress and disappointments

Author: Stanislas Bruley des Varannes, Jean Paul Galmiche, and Frank Zerbib
Subjects: Antireflux surgery, medicine.medical_specialty, business.industry, Open surgery, Gastroenterology, Alternative medicine, digestive system diseases, humanities, Surgery, Oncology, otorhinolaryngologic diseases, Medicine, business, Intensive care medicine, Review Articles, Medical therapy
Abstract: The treatment of GORD has been revolutionized by the introduction, in the 1980s, of proton-pump inhibitors as the mainstay of medical therapy and by the development of laparoscopic antireflux surgery which has definitively replaced open surgery. However, despite these major advances, many unmet therapeutic needs still persist and justify novel therapeutic approaches. The aim of this historical review is to recall the main discoveries in the treatment of GORD that have occurred during the last three decades and to discuss why some initially promising drugs or techniques have not translated into clinical applications. A careful analysis of these previous disappointing experiences should help to identify high priorities and better research programmes on the management of GORD.
Published: 2013

49. Normal Values of Pharyngeal and Esophageal 24-Hour pH Impedance in Individuals on and off Therapy and Interobserver Reproducibility

Author: Guillaume Gourcerol, Patricia Lepicard, Alain Ropert, Sabine Roman, Benoit Coffin, Frank Zerbib, Stanislas Bruley des Varannes, and François Mion
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, medicine.drug_class, Proton-pump inhibitor, Gastroenterology, Esomeprazole, Young Adult, Laryngopharyngeal reflux, Esophagus, Reference Values, Interquartile range, Internal medicine, Electric Impedance, Humans, Medicine, Aged, Observer Variation, Hepatology, business.industry, Pharynx, Reflux, Reproducibility of Results, Hydrogen-Ion Concentration, Middle Aged, Anti-Ulcer Agents, medicine.disease, digestive system diseases, Human Experimentation, medicine.anatomical_structure, Ambulatory, GERD, Female, business, medicine.drug
Abstract: Background & Aims Combined pH and impedance monitoring can detect all types of reflux episodes within the esophageal lumen and the pharynx. We performed a multicenter study to establish normal values of pharyngeal and esophageal pH-impedance monitoring in individuals on and off therapy and to determine the interobserver reproducibility of this technique. Methods We collected ambulatory 24-hour pH-impedance recordings from 46 healthy subjects by using a bifurcated probe that allowed for detection of reflux events in the distal and proximal esophagus and pharynx. Data were collected when subjects had not received any medicine (off therapy) and after receiving 40 mg esomeprazole twice daily for 14 days (on therapy). The interobserver agreement for the detection of reflux events was determined in 20 subjects off and on therapy. Results were expressed as median (interquartile range). Results Off therapy, subjects had a median of 32 reflux events (17–45) in the distal esophagus and 3 (1–6) in the proximal esophagus; they had none in the pharynx. On therapy, subjects had a median number of 21 reflux events (6–37) in the distal esophagus and 2 (0–5) in the proximal esophagus; again, there were none in the pharynx. Interobserver agreement was good for esophageal reflux events but poor for pharyngeal events. Conclusions We determined normal values of pharyngeal and gastroesophageal reflux events by 24-hour pH-impedance monitoring of subjects receiving or not receiving esomeprazole therapy. Analyses of esophageal events were reproducible, but analyses of pharyngeal events were not; this limitation should be taken into account in further studies. Eudract.ema.europa.eu, Number: 2010-022845-48.
Published: 2013

50. Faecal microbiota transplantation in recurrent Clostridium difficile infection: Recommendations from the French Group of Faecal microbiota Transplantation

Author: Harry Sokol, Tatiana Galperine, Nathalie Kapel, Pierre Bourlioux, Philippe Seksik, Frederic Barbut, Julien Scanzi, François Chast, Rui Batista, Francisca Joly, Anne-Christine Joly, Anne Collignon, Benoit Guery, Laurent Beaugerie, Laurent Alric, Jean-Paul Aucouturier, Aurelien Amiot, Pascale Bemer, Robert Benamouzig, Nicolas Benech, Claire Billioud, Gille Boschetti, Nour Boubaddi, Guillaume Bouguen, Arnaud Bourreille, Franck Carbonnel, Elodie Cesbron-Metivier, Benoit Coffin, Michael Collins, Benjamin Davido, Thierry Davion, Aurelilen Dinh, Henri Duboc, Philippe Ducrotte, Thibaut Fraisse, Bertrand Gachot, Marielle Guillet, B. Heyman, Elodie Metivier, Frederic Mille, Alexis Mosca, Biba Nebbad, Gabriel Perlemuter, Thierry Piche, Jean-Marie Reimund, Matthieu Revest, Jean-Marc Sabate, Iradj Sobhani, Stephane Schneider, Caroline Trang, Stephanie Viennot, Maurice Viala, Cosmin Voican, Frank Zerbib, CHU Saint-Antoine [APHP], French group of faecal microbotia transplantation (FGFT), Infectious diseases department, CHRU Claude Huriez, Ecosystème intestinal, probiotiques, antibiotiques (EA 4065), Université Paris Descartes - Paris 5 (UPD5), CHU Pitié-Salpêtrière [APHP], Pharmacy academy - Paris, Microbiology department, Université Paris-Sud - Paris 11 (UP11), Gastro-enterology department, CHU Clermont-Ferrand, Clinical pharmacy department, APHP, AP-HP Hôpital Beaujon, Écosystème Microbien Digestif et Santé, Institut National de la Recherche Agronomique (INRA)-Université Paris-Sud - Paris 11 (UP11), Gastroenterology and nutrition department, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -CHU Saint-Antoine [APHP], French group of faecal microbotia transplantation ( FGFT ), Ecosystème intestinal, probiotiques, antibiotiques ( EA 4065 ), Université Paris Descartes - Paris 5 ( UPD5 ), Functional coprology laboratory, Université Paris-Sud - Paris 11 ( UP11 ), C. difficile Nationale reference laboratory, Pharmacy department, Institut National de la Recherche Agronomique ( INRA ) -Université Paris-Sud - Paris 11 ( UP11 ), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Beaujon [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: 0301 basic medicine, medicine.medical_specialty, 030106 microbiology, Pharmacy, Faecal microbiota transplantation, Donor Selection, Microbiology, 03 medical and health sciences, 0302 clinical medicine, fluids and secretions, Recurrence, medicine, Humans, Intensive care medicine, faecal microbiota transplantation, Enterocolitis, Pseudomembranous, Hepatology, Clostridioides difficile, Donor selection, business.industry, Patient Selection, Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Clostridium difficile, Fecal Microbiota Transplantation, 3. Good health, Clinical Practice, Clinical trial, Infectious disease (medical specialty), recommendations, Clostridium Infections, 030211 gastroenterology & hepatology, [ SDV.MHEP.HEG ] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, France, Specimen preparation, business
Abstract: International audience; Faecal microbiota transplantation is effective for treating recurrent forms of Clostridium difficile infection and its use in this indication is recommended in the most recent European and North American guidelines. In this context, faecal microbiota transplantation is beginning to be performed in France in clinical practice, while the rules governing this procedure have been defined in France only for clinical trials. To unify, secure, and evaluate practice in this field in France, the French Group of Faecal microbiota Transplantation (FGFT) was created in October 2014 with the support of the French National Society of Gastroenterology, the French Infectious Disease Society, and the National Academy of Pharmacy. We present here the deliberations of this group regarding the use of faecal microbiota transplantation for recurrent Clostridium difficile infection. The issues addressed are the indications, therapeutic sequence, delivery procedures, donor selection, methods and conditions of specimen preparation, and traceability.
Published: 2016

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