DDW top 10: Gallstone disease, benefits of dog ownership, alcoholic hepatitis

Here are Healio’s top 10 peer-tested articles from Digestive Disease Week 2022, which highlight research on restrictive diets, gallstone disease, dog ownership and Crohn’s disease, COVID-19 antibody response and more.

Restrictive diets offer greater symptom reduction vs. medical treatment in IBS patients

Two restrictive diets were superior in reducing symptoms compared with optimized medical treatment alone in patients with irritable bowel syndrome.

“There are several different treatment options that are effective in alleviating symptoms of IBS, and dietary treatment indeed can be encouraged as a first-line treatment option,” Sanna Nybacka, RD, PhD, of the department of molecular and clinical medicine at the University of Gothenburg in Sweden, told Healio. “Our findings support the current guidelines in treatment of IBS, where a positive diagnosis of IBS is crucial for a successful management of IBS and should be followed by general lifestyle intervention and dietary advice. Medical treatment should be guided by the patient’s symptom profile and preference as a second-line treatment option.” Read more.

Gallstone disease may be predictor of pancreatic cancer

Patients with pancreatic ductal adenocarcinoma were six times more likely to have had cholelithiasis or cholecystitis in the year before diagnosis compared with the general population.

“Pancreatic cancer is often fatal, because it is frequently not diagnosed until its later stages. What complicates the initial diagnosis is that early symptoms often mirror those associated with gallstone disease and gallbladder inflammation, both of which have been demonstrated to be risk factors for pancreatic cancer,” Teviah E. Sachs, MD, MPH, associate professor and chief of surgical oncology at Boston Medical Center, said at the DDW media briefing. “Unfortunately, there is little known about how often these conditions occur before the diagnosis of pancreatic cancer.” Read more.

Early-life dog ownership may protect against development of Crohn’s disease

Dog ownership and close interactions with these pets in early childhood could help prevent later development of Crohn’s disease.

“Our study seems to add to others that have explored the ‘hygiene hypothesis’ which suggests that the lack of exposure to microbes early in life may lead to lack of immune regulation toward environmental microbes,” Williams Turpin, PhD, research associate at Mount Sinai Hospital and the University of Toronto, said in a press release. Read more.

Unrecognized alcoholic hepatitis linked to higher mortality, hospitalization

A significant proportion of alcoholic hepatitis cases remain unrecognized and correlate with higher 30-day mortality, hospital length of stay and ICU admission.

“Whether this increased mortality is from being left untreated vs. decreased tendency in that group to seek medical care (presence of other comorbidities) remains to be determined,” Julton Tomanguillo Chumbe, MD, of the division of gastroenterology at Charleston Area Medical Center in West Virginia, and colleagues wrote. Read more.

Rectal expulsion device may predict outcomes in patients with chronic constipation

An investigational, point-of-care rectal expulsion device may help determine whether patients with chronic constipation will improve with pelvic floor physical therapy.

“The rectal expulsion device was specifically designed to simplify and pull the tertiary care paradigm of anorectal function testing downstream to any general gastroenterologists’ medical office for patients with chronic constipation,” Eric D. Shah, MD, MBA, assistant professor at Dartmouth College Geisel School of Medicine and Dartmouth-Hitchcock Medical Center in New Hampshire, told Healio. Read more.

Antibiotic use linked with an increased risk for older-onset IBD

The use of antibiotics, particularly those targeting gastrointestinal pathogens, was associated with an increased risk for older-onset inflammatory bowel disease.

“This risk is higher with each subsequent antibiotic course prescribed, in the 1-2 years following antibiotic use and with antibiotics targeting gastrointestinal pathogens,” Adam S. Faye, MD, MS, assistant professor of medicine and population health at NYU Grossman School of Medicine, told Healio. Read more.

Biologics linked to lower dementia rate in older patients with IBD

Older patients with IBD who were treated with biologics exhibited a lower incidence of dementia compared with those never treated with biologics.

“When we looked at a national database, what we found was an increased rate of dementia among IBD patients,” Ahmed Eltelbany, MD, an internist at the Cleveland Clinic, told Healio. “However, when we further stratified our study to look at the biologic use among these patient groups, we found that the group that used biologics had a decreased prevalence of dementia compared to the group that did not receive biologics.” Read more.

Debate: ‘Safety, adequacy, cost’ still favor percutaneous vs. endoscopic ultrasound biopsy

Although percutaneous liver biopsy is still the “gold standard,” advances in techniques and increased use of endoscopic ultrasound-guided biopsy may soon change that dynamic.

“There are several advantages to endoscopic ultrasound-guided liver biopsy, not the least of which is patient comfort,” David L. Diehl, MD, FASGE, of Geisinger Medical Center in Danville, Pennsylvania, told attendees. “It provides outstanding sample yields with the current techniques, and it’s possible to do bi-lobar sampling in a very simple manner, which can decrease sampling error.” Read more.

Cannabinoid use increases need for higher sedation during endoscopy

Baseline cannabinoid use associated with the need for increased sedation among patients who underwent endoscopy with endoscopist-directed conscious sedation.

“Endoscopist-directed conscious sedation, or EDCS, is widely used for routine endoscopic procedures such as gastroscopy and colonoscopy. While efficient and cost-effective, EDCS can be limited by failure to achieve sufficient levels of sedation,” Yasmin Nasser, MD, PhD, assistant professor of medicine at the University of Calgary, said. “With legalization [of cannabis] over the last decade, there has been rising use. ... Given the underlying properties of cannabinoids and their potential for interactions with the opiate and benzodiazepines frequently employed in EDCS, it is biologically plausible that baseline cannabinoid use could influence sedation requirements for endoscopy.” Read more.

Additional doses of SARS-CoV-2 vaccine heighten antibody response in patients with IBD

Seroconversion rates and antibody response significantly increased after a third dose of SARS-CoV-2 vaccine in patients with IBD.

“Third- and fourth-dose responses were significantly stronger than a two-dose regimen,” Joshua Quan, MSc, a master’s student at the University of Calgary Cumming School of Medicine, told attendees. “Also, the antibody responses decayed over time from second- to third-dose vaccination, which really highlights the need for third-dose vaccination.” Read more.