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Standard therapeutic strategies used to treat gastointestinal disorders are reliant on drugs and carry with them associated adverse side effects. Apheresis, a novel extracorporeal therapy, is reported to be a rapidly acting, effective treatment option without associated serious adverse side effects. This viewpoint discusses the application of this unique process for the treatment of gastrointestinal disorders.
Direct infections of the gastrointestinal tract cause most cases of diarrhea, but diarrhea can also be caused by systemic infections or infections that affect other organ systems. The authors of this Review discuss clinically relevant infectious diseases that do not primarily affect the gastrointestinal tract but commonly cause diarrhea, and note that they should be included in the differential diagnosis and diagnostic approach to diarrhea.
Coinfection with HCV and HIV is common and an increasingly important public health problem. Management of hepatitis C in HIV-infected patients is complicated by immune suppression, potential drug interactions and toxicities, and the relative paucity of health-care providers with expertise in the management of both diseases. Data now support the safety, tolerability and efficacy of hepatitis C treatment with peginterferon plus ribavirin in HIV-infected patients.
Osteoporosis is an important problem for some patients with inflammatory bowel disease (IBD). Reports of low bone mineral density (BMD) in IBD patients buoyed widespread BMD testing for osteoporosis, but data on fracture incidence have now tempered these concerns. This Review considers the authors' approach to prevention and treatment of osteoporosis in IBD patients—a controversial subject, with advocates for more or less aggressive management.
This article highlights two cases of massive lower gastrointestinal bleeding in patients on dialysis after rejection of kidney–pancreas transplants. One patient did not have the transplanted organ removed and eventually exsanguinated, while the second patient, whose rejected pancreas was removed, survived complications and did well. The cases illustrate that arterio-enteric bleeding should be included in the differential diagnosis of patients with rejected pancreatic transplants.
