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Care of inflammatory bowel disease patients in remission

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Gastroenterology Report 2016年第4期4卷 261-271,I0001页

作者： Charumathi Raghu Subramanian george triadafilopoulos Internal Medicine Guthrie ClinicSayrePAUSA Division of Gastroenterology and Hepatology Stanford UniversityStanfordCAUSA

Inflammatory bowel disease(IBD)comprises two distinct conditions:ulcerative colitis and Crohn’s disease,both of which are chronic,relapsing disorders carrying significant morbidity,mortality and healthcare *** growing attention to coordinated healthcare for patients with chronic systemic diseases,this review focuses on the care of IBD patients in remission,their concerns,quality of life,follow-up,the role of primary care physicians and the IBD-specific aspects of long-term *** did an extensive PubMed search for articles pertaining to IBD patients in remission and,along with the authors’experience,formulated a comprehensive *** difficulties faced by IBD patients in remission include but are not limited to education and employment concerns,psychosocial issues,problems related to health insurance,nutrition,fertility and *** review also addresses newer treatment modalities,the debatable effects of smoking on IBD and the importance of *** in remission can be a challenge due to its multifaceted nature;however,with a coordinated approach by gastroenterologists and other involved practitioners,several of these issues can be addressed.

关键词： inflammatory bowel disease remission long-term care

Refractory gastroesophageal reflux disease

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Gastroenterology Report 2015年第1期3卷 41-53页

作者： Charumathi Raghu Subramanian george triadafilopoulos Internal Medicine Guthrie ClinicSayrePAUSA Division of Gastroenterology Stanford University School of MedicineStanfordCAUSA

Gastroesophageal reflux disease(GERD)is a condition that develops when the reflux of stomach contents into the esophagus causes troublesome symptoms,esophageal injury,and/or *** of proton pump inhibitors(PPI)remains the standard therapy for GERD and is effective in most *** whose symptoms are refractory to PPIs should be evaluated further and other treatment options should be considered,according to individual patient *** to PPIs could be total(no symptoms),partial(residual breakthrough symptoms),or absent(no change in symptoms).Patients experiencing complete response do not usually need further *** with partial response can be treated surgically or by using emerging endoscopic *** who exhibit no response to PPI need further evaluation to rule out other causes.

关键词： gastroesophageal reflux disease acid-related diseases pH monitoring endoscopy

Diagnosis and therapy of esophageal squamous cell dysplasia and early esophageal squamous cell cancer

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Gastroenterology Report 2017年第4期5卷 247-257,I0001页

作者： Charumathi Raghu Subramanian george triadafilopoulos Internal Medicine Guthrie clinicSayrePAUSA and Division of Gastroenterology and Hepatology Stanford UniversityStanfordCAUSA

Esophageal squamous cell carcinoma(ESCC)and esophageal adenocarcinoma(EAC)comprise the majority of esophageal cancers,and they differ from each other in several *** the incidence of EAC is increasing in the West,ESCC is still the predominant cancer type *** dysplasia is considered to be a premalignant lesion to ESCC;however,the exact probability and timeline of malignant transformation are not known,hence the lack of guidelines for management of such *** carries a poor prognosis if not detected early,so there has been a trend towards early detection and *** modalities include endoscopic ultrasound,white light endoscopy,non-endoscopic methods such as biomarkers,*** diagnosis can identify a subset of patients who could benefit from less invasive endoscopic eradication *** review aims to discuss the different modalities for diagnosis and treatment of early esophageal squamous lesions,including the newer endoscopic therapies,and comparison of different techniques.

关键词： esophageal squamous cell carcinoma esophageal squamous cell dysplasia endoscopic resection radiofrequency ablation

Endoscopic appearance of esophageal hematomas

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World Journal of Gastroenterology 2000年第2期6卷 307-309页

作者： Rodica Ouatu-Lascar Gayatri Bharadhwaj george triadafilopoulos Gastroenterology Section Palo Alto Veterans Affairs Health Care SystemPalo AltoCalifornia and Division of GastroenterologyDepartment of MedicineStanford UniversityStanfordCaliforniaUSA

INTRODUCTIONEsophageal hematomas develop from the dissectionof the mucosa from the muscular layers of theesophageal wall and represent an uncommoncondition affecting all *** the mostcommon cause of esophageal hematomas isiatrogenic mechanical injury-induced by prolongednasogastric intubation,difficult or forcefulendoscopic intubation,or the result of

关键词： esophagus hematoma/etiology endoscopy gastrointestinal hemorrhage/diagnosis hematoma/classification wounds injuries

Neuro-regulation of lower esophageal sphincter function as treatment for gastroesophageal reflux disease

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World Journal of Gastroenterology 2008年第7期14卷 985-990页

作者： Anupender Singh Sidhu george triadafilopoulos Division of Gastroenterology and Hepatology Stanford University School of MedicineStanfordCA 94305-5187United States

The junction between the esophagus and the stomach is a specialized region, composed of lower esophageal sphincter (LES) and its adjacent anatomical structures, the gastric sling and crural diaphragm. Together these structures work in a coordinated manner to allow ingested food into the stomach while preventing reflux of gastric contents across the esophago-gastric junction (EGJ) into the esophagus. The same zone also permits retrograde passage of air and gastric contents into esophagus during belching and vomiting. The precise coordination required to execute such a complicated task is achieved by a finely-regulated high-pressure zone. This zone keeps the junction between esophagus and stomach continuously closed, but is still able to relax briefly via input from inhibitory neurons that are responsible for its innervation. Alterations of the structure and function of the EGJ and the LES may predispose to gastroesophageal reflux disease (GERD).

关键词： Gastroesophageal reflux disease Lower esophageal sphincter Esophago-gastric junction

Gastric per-oral endoscopic myotomy: Current status and future directions

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World Journal of Gastroenterology 2019年第21期25卷 2581-2590页

作者： Alexander Podboy Joo Ha Hwang Linda A Nguyen Patricia Garcia Thomas A Zikos Afrin Kamal george triadafilopoulos John O Clarke Division of Gastroenterology and Hepatology Stanford University School of Medicine

Gastroparesis, or symptomatic delayed gastric emptying in the absence of mechanical obstruction, is a challenging and increasingly identified syndrome. Medical options are limited and the only medication approved by the Food and Drug Administration for treatment of gastroparesis is metoclopramide, although other agents are frequently used off label. With this caveat, first-line treatments for gastroparesis include dietary modifications, antiemetics and promotility agents, although these therapies are limited by suboptimal efficacy and significant medication side effects. Treatment of patients that fail first-line treatments represents a significant therapeutic challenge. Recent advances in endoscopic techniques have led to the development of a promising novel endoscopic therapy for gastroparesis via endoscopic pyloromyotomy, also referred to as gastric per-oral endoscopic myotomy or per-oral endoscopic pyloromyotomy. The aim of this article is to review the technical aspects of the per-oral endoscopic myotomy procedure for the treatment of gastroparesis, provide an overview of the currently published literature, and outline potential next directions for the field.

关键词： Gastroparesis Gastric per-oral endoscopic myotomy Per-oral endoscopic pyloromyotomy Myotomy Endoscopic myotomy Peroral endoscopic myotomy Gastric emptying

Managing Barrett’s esophagus with radiofrequency ablation

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Gastroenterology Report 2013年第2期1卷 95-104页

作者： Junichi Akiyama Andrew Roorda george triadafilopoulos National Center for Global Health and Medicine 1-21-1 ToyamaShinjukuTokyo162-8655Japan El Camino GI Medical Associates Mountain ViewCA 94040USA Division of Gastroenterology Stanford University Medical CenterStanfordCA 94305USA

Barrett’s esophagus(BE)is a well-established pre-malignant lesion for esophageal adenocarcinoma,a condition that carries a dismal five-year overall survival rate of less than 15%.Among several available methods to eliminate BE,radiofrequency ablation(RFA)provides the most efficient modality,since it has been demonstrated to successfully eradicate BE with or without dysplasia with acceptable safety,efficacy and durability *** conjunction with proton pump therapy,this new technology has quickly become the standard care for patients with dysplastic ***,several technical questions remain about how to deploy RFA therapy for maximum effectiveness and long-term favorable outcomes for all stages of the *** include how to select patient for therapy,what the best protocol for RFA is,when to use other modalities,such as endoscopic mucosal resection,and what should be considered for refractory *** review addresses these questions with the perspective of the best available evidence matched with the authors’experience with the technology.

关键词： Barrett’s esophagus radiofrequency ablation esophageal cancer adenocarcinoma intestinal metaplasia dysplasia

Functional lumen imaging probe use in a high-volume practice:Practical and technical implications

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World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 396-405页

作者： Yan Jiang Raul Vazquez-Reyes Afrin Kamal Thomas Zikos george triadafilopoulos John O Clarke Division of Gastroenterology and Hepatology Stanford University School of MedicineRedwoodCA 94063United States

BACKGROUND The functional lumen imaging probe(FLIP)is a Food and Drug Administration approved tool to aid the diagnosis and management of esophageal ***,widespread adoption of FLIP remains limited and its utility in highvolume practices remains *** To analyze large sample data on clinical use of FLIP and provide insight on several technical aspects when performing *** We conducted a retrospective comparative and descriptive analysis of FLIP procedures performed by a single provider at an academic medical *** was a total of 398 FLIP procedures *** medical records were reviewed and data regarding demographics and procedural details were *** tests,including chi-squared,t-test,and multivariable logistic and linear regression,were *** There was an increase in FLIP cases with each successive time period of 13 months(n=68,146,184,respectively)with notable rises specifically for indications of dysphagia and gastroesophageal reflux *** was a shift toward use of the longer FLIP balloon catheter for diagnostic purposes(overall 70.4%vs 29.6%,P<0.01).Many cases(42.8%)were performed in conjunction with other diagnostics/interventions,such as dilation and wireless pH probe *** were nearly equally performed with anesthesia vs moderate sedation(51.4%anesthesia),with no major *** who had anesthesia were less likely to have recurrent antegrade contractions[odds ratio(OR)=0.4,95%CI:0.3-0.8]and were also more likely to have absent contractility(OR=2.4,95%CI:1.3-CONCLUSION FLIP cases have increased in our practice with expanding indications for its *** limited normative data,providers should be aware of several potential technical issues,including the possible impact of sedation choice when assessing esophageal motility patterns.

关键词： Gastroenterology Endoscopy Functional lumen imaging probe Esophagus Motility

对质子泵抑制剂有效的胃食管反流病患者的症状控制，腹腔镜抗反流手术和奥美拉唑具有相似的疗效

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英国医学杂志中文版 2012年第4期15卷 243-244页

作者： george triadafilopoulos 王君(译) 陈国卫杨尹默(校) 卫茂玲(校) Division of Gastroenterology and Hepatology Stanford University StanfordCalifornia USA 北京大学第一医院普通外科四川大学华西医院中国循证医学中心

背景胃食管反流病（GERD）以反酸、烧心为主要表现，呈慢性反复发作，对患者日常生活质量有不良影响。目前主要有两种治疗方法分别为使用质子泵抑制剂（PPIs）内科治疗和实施腹腔镜抗反流手术（LARS）。两种方法都有各自的优缺点并且始... 详细信息

背景胃食管反流病（GERD）以反酸、烧心为主要表现，呈慢性反复发作，对患者日常生活质量有不良影响。目前主要有两种治疗方法分别为使用质子泵抑制剂（PPIs）内科治疗和实施腹腔镜抗反流手术（LARS）。两种方法都有各自的优缺点并且始终存在争议。一方面，采用内科治疗可能仍存在残余反流，并且长期使用会带来某些潜在的不良反应（如骨质疏松性骨折、药物间的相互作用等）。另一方面，腹腔镜抗反流术可能会导致手术失败相关问题、吞咽困难及腹胀等。

关键词：胃食管反流病质子泵抑制剂抗反流手术腹腔镜症状控制奥美拉唑患者骨质疏松性骨折