Colonic Diverticular disease is the fifth most financially burdensome of digestive illness in the US. Inflammation is thought to be the primary cause of symptoms of SUDD. Probiotics have been shown to have an important role in the treatment of SUDD. The aim of this study is to assess the efficacy of Probiotics in patients with SUDD through a systematic review and meta-analysis.

of DD during a long-term follow-up.Patients and Methods: We reviewed 311 patients suffer from recent episode of AUD and undergoing to mesalazine treatment: 207 (group A, 105 males, median age 63 years, range 47-74 years) were treated with mesalazine 1.6 grams for 10 days each month, whilst 104 (group B, 55 males, median age 65 years, range 50-72 years) were treated with mesalazine 1.6 grams every day.Patients were followed-up every 6 months (median 7.5 months, range 5-13 months).Results: Patients were followed-up for a mean time of 3 years (range 12-72 months).Overall, occurrence of complication recurred more frequently in group A than in group B (p=0.030, log-rank test).Acute diverticulitis recurred in 17 (8.2%)patients in group A and in 3 (2.9%) in group B; diverticular bleeding occurred in 4 (1.9%) patients in group A and in 1 (0.96%) patient in group B; surgery was required in 3 (1.4%)patients in group A and in no (0%) patient in group B. Conclusions: This is the first study showing that long-term mesalazine treatment is significantly better that intermittent mesalazine treatment in preventing occurrence of DD complications after an attack of acute diverticulitis.

that some metabolites strongly drive microbial community structure.Conclusions: The strong interconnectivity between the metabolome and microbiome suggests that: (a) mucosal metabolites are primarily of microbial origin; (b) metabolites should be more deeply interrogated as direct mediators of microbial-associated disease activity; and (c) metabolites may be a direct target for monitoring and therapeutically manipulating microbial community function in IBD and other microbiome-associated intestinal diseases.

Chronic pancreatitis pain is difficult to manage due to the wide variance amongst etiologies and associated therapies available. Surgery and endotherapy are the most commonly used treatment modalities. Recent data has shown the viability and possible 1st line use of endotherapy over surgery due to less invasive nature and fewer reported complications. This study analyzes the stent related complications of endotherapy (i.e. stent migration and stent occlusion) in relationship to definitive stent duration.

The management of Chronic pancreatitis pain(CPP) is difficult and challenging. Surgery and endotherapy are the most commonly used treatment modalities. Endotherapy is a less invasive modality with fewer reported complications. This study analyzes the stent related complications of endotherapy (i.e. stent migration and stent occlusion) and their relationship to stent exchange rates, more specifically on-demand (OD) vs. scheduled exchange (SE) periods.

Endotherapy is important in the management of chronic pancreatitis pain. However, its use is controversial due to limited available data. The aim of this study was to assess the efficacy of endotherapy for alleviating pain in patients with chronic pancreatitis through a systemic review and meta-analysis. A search of Medline, Pubmed, and Embase databases between 1988 to August 2010 for studies that analyzed the use of endotherapy for pain relief in chronic pancreatitis. We included large prospective blinded studies, randomized controlled trials (RCT) and retrospective analyses. Exclusion criteria included: studies not in English or those with less than 10 patients, case series/reports and the studies that enrolled patients in alternate therapies such as surgery or celiac plexus neurolysis. In addition, a subgroup analysis was conducted on studies that included only patients with pancreatic duct strictures. A model of meta-analysis was developed and the data on pain relief was subsequently extracted, pooled, and analyzed. The Chi-square tests of homogeneity of estimate across studies showed significant heterogeneity (p<0.001 for both immediate and late response). The results were calculated and based on logits with inverse-variance weights and back-transformed normal-theory confidence intervals. Our final analysis included sixteen studies; comprising 1498 patients. Eleven studies included data for immediate relief of pain after endotherapy while twelve studies had data available for both immediate and sustained pain relief on follow-up. The compiled result of the sixteen studies for immediate pain relief is 75.7% (95% NT CI[67.0%, 82.7%]). Similarly, on long term follow up the result is 76.1% (95% NT CI[67.2%, 83.1%]). The data is displayed in the form of forest plots (Table 1, Table 2). In the subgroup analysis, we included nine studies, comprising 536 patients. Seven studies included data for immediate pain relief and eight studies had data available for sustained pain relief on follow up. The compiled results for the immediate pain relief is 74.7 % (95 NT CI [62.4%, 84.0%] while the results for sustained pain relief is 67.5% (95 NT CI [51.5%, 80.2%]).Table 2shows Forest Plot denoting sensitivity of studies with Sustained relief of pain on follow up following Endotherapy.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Endotherapy is beneficial in the immediate and long term relief of pain due to chronic pancreatitis. A slightly greater percentage of patients showed long term benefit in pain relief in comparison to immediate pain relief (76.1% vs.75.7% respectively). In contrast, patients with pancreatic strictures had a better immediate response rather than on follow up (74.7% to 67.5%). In this subset of patients, endotherapy may not be as beneficial for sustained pain relief. Large prospective multicenter trials are warranted to further evaluate the benefit of endotherapy for managing chronic pancreatitis pain and decreasing the heterogeneity of currently published data.

Results:Sweat chloride performance parameters are shown (table); differences between the 2 clinical settings are due to differences in CF frequency in each population.Borderline sweat tests have a much greater predictability for CF in a GI-CF clinic patient population than in population screening.Sweat chloride ≥60mmol/L was diagnostic of CF in both settings.Conclusion: Sweat testing should be performed in PANC patients to diagnose CF (≥60mmol/ L) and identify patients with an equivocal result (40-59mmol/L) who require further evaluation for CF.