Skip to main content
Volume 6, No 3 - Summer 2006

Volume 6, No 3 - Summer 2006

Table of Contents

Endoscopic Approach to Acute Pancreatitis Treatment Update
This review focuses on the use of endoscopic techniques in the diagnosis and management of pancreatic disorders. Endoscopic retrograde cholangiopancreatography (ERCP) has been used primarily to evaluate and treat disorders of the biliary tree. Recently, endoscopic techniques have been adapted for pancreatic sphincterotomy, stenting, stricture dilation, treatment of duct leaks, drainage of fluid collections, and stone extraction via the major and minor papillae. In patients with acute and recurrent pancreatitis, ERCP carries a higher than average risk of post-ERCP pancreatitis. This risk can be reduced with the placement of a prophylactic pancreatic stent. Magnetic resonance cholangiopancreatography (MRCP) can establish the anatomy of the biliary and pancreatic ducts, identify pancreas divisum or pancreatic ductal strictures, depict bile duct stones, and demonstrate pancreatic or biliary duct dilation. Endoscopic ultrasound (EUS) provides a safer, less invasive, and often more sensitive measure for evaluating the pancreas and biliary tree, and allows some options for therapy. In acute and recurrent pancreatitis, EUS and MRCP can be used to establish a diagnosis; ERCP can be reserved for therapy. [Rev Gastroenterol Disord. 2006;6(3):119–135]
Gastroesophageal Reflux Disease Symptoms on Antisecretory Therapy: Acid, State-of-the-Art Review
A clinically important subset of patients with erosive esophagitis will not attain adequate symptom relief and healing on once-a-day proton pump inhibitor therapy. This is especially true in patients with frequent and nocturnal heartburn and in those with Los Angeles Grades C and D erosive esophagitis. The approach to evaluation and management of cases of refractory or difficult gastroesophageal reflux disease is the subject of this stateof- the-art review. [Rev Gastroenterol Disord. 2006;6(3):136-145]
MMX™ Mesalamine New Drug Review
Most current drug delivery systems in the treatment of ulcerative colitis and Crohn’s disease release the active drug at the least effective location for treatment. The pharmaceutical industry has been developing different delivery systems for Multi-Matrix System™ (MMX) mesalamine for the treatment of Crohn’s disease and ulcerative colitis. The new oral mesalamine formulation is a once-daily MMX tablet that delivers the mesalamine to the colon, making it most useful in the treatment of ulcerative colitis. The MMX coating matrix and coating system begin dissolution in the final portion of the ileum. This type of oral formulation may make MMX a preferred agent over other oral mesalamine and mesalamine-prodrug formulations that release the drug proximally in the gastrointestinal tract. Unlike previous formulations, it can be administered once daily for the treatment of ulcerative colitis. [Rev Gastroenterol Disord. 2006;6(3):146-152]
Best of DDW 2006 Meeting Review
Highlights from the 2006 Digestive Disease Week May 20-25, 2006, Los Angeles, CA [Rev Gastroenterol Disord. 2006;6(3):153-189]
Colorectal Disease Reviewing the Literature