Összefoglaló közlemények / Reviews

Progress in diagnostic methods of Helicobacter pylori infection

Buzás György Miklós dr.1,2

1Ferencvárosi Egészségügyi Szolgáltató KKNP Kft., Gasztroenterológia, Budapest;
2MEDOC Egészségközpont, Gasztroenterológia, Budapest
Correspondence: drbgym@gmail.com

The diagnostic methods of Helicobacter pylori infection have continuously improved since the discovery of the bacterium. As an invasive test, endoscopy is still unavoidable for patients over 45-50 years of age with alarm symptoms or bleeding. Enhanced endoscopy methods have considerably improved the accuracy of examination, with the help of artificial intelligence. Histology has been complemented with immunohistochemistry and fluorescent in situ hybridisation. The most spectacular progress, however, has been seen with genetic methods: their accuracy surpassed those of traditional methods. The importance of urea breath test and stool antigen test has risen both in primary diagnosis and in managing eradication. For lack of an effective vaccine, a more active eradication policy is proposed including new groups (family members of infected people, immigrants, migrants) to curtail the prevalence of Helicobacter pylori infection.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2022 | VOLUME 8, ISSUE 2

Összefoglaló közlemények / Reviews

Non-surgical treatment options of difficult bile duct stones

Vincze Áron dr.

Pécsi Tudományegyetem, Klinikai Központ, I. sz. Belgyógyászati Klinika, Gasztroenterológiai Tanszék, Pécs
Correspondence: vincze.aron@pte.hu

Common bile duct stones are not removable in 10-15% of the cases with the traditional dormia basket or extraction balloon methods due to the size, shape of stone, or the anatomy of the bile duct, localization of biliary stone. Effective modalities are in these cases the papillary large balloon dilatation, the mechanical lithotripsy, the cholangioscopy assisted electrohydraulic or laser lithotripsy, and the extracorporeal shock­wave lithotripsy. Endoscopic management of difficult bile duct stones, the applicability and the efficacy of these less frequently used modalities are summarized.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2022 | VOLUME 8, ISSUE 2

Összefoglaló közlemények / Reviews

Extraintestinal manifestations of IBD with emphasis on dermatological aspects

Élthes Zsuzsa Bianka dr.1, Palatka Réka2,3, Gáspár Krisztián dr.2, Palatka Károly dr.1

1Debreceni Egyetem, Általános Orvostudományi Kar, Gasztroenterológia Klinika, Debrecen;
2Debreceni Egyetem, Általános Orvostudományi Kar, Bőrgyógyászati Klinika, Debrecen;
3Debreceni Egyetem, Általános Orvostudományi Kar, Klinikai Immunológia és Allergológia Doktori Iskola, Debrecen
Correspondence: palatka@med.unideb.hu

The prevalence of extraintestinal manifestations of chronic non-specific intestinal inflammatory disorders is around 30%. They may appear before, in parallel or after the diagnosis of IBD and have major impact on patients’ quality of life. Practically any organ can be affected, but joint, skin, hepatobiliary and eye manifestations are the most frequent. A key to successful treatment is a systematic and multidisciplinary approach.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2022 | VOLUME 8, ISSUE 2

Összefoglaló közlemények / Reviews

The role and importance of percutaneous endoscopic gastrostomy in clinical nutrition in light of several decades practice

Taller András dr.

Uzsoki Utcai Kórház, II. sz. Belgyógyászati Osztály, Budapest
Correspondence: taller@uzsoki.hu

Percutaneous endoscopic gastrostomy (PEG) is a worldwide accepted procedure of artificial enteral nutrition for patients who are unable to eat the required amount in the long run. However due to the fact that it is a safe and easy technique it might lead to use with inappropriate indications and with questionable timing. Due to PEG we know more about artificial enteral nutrition, and our mindset about indications changed as well. This publication gives any overview of the procedure and its clinical usage in light of the three decades of experience that we have.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2022 | VOLUME 8, ISSUE 2

Összefoglaló közlemények / Reviews

Non-alcoholic fatty liver disease (NAFLD) or metabolic (dysfunction)-associated fatty liver disease (MAFLD)? (Opinions vs. evidence)

Pár Alajos dr.1,2, Pár Gabriella dr.1

1Pécsi Tudományegyetem, Klinikai Központ, I. sz. Belgyógyászati Klinika, Pécs;
2Pécsi Tudományegyetem, Klinikai Központ, II. sz. Belgyógyászati Klinika és Nephrológiai, Diabetológiai Centrum, Pécs
Correspondence: par.alajos@pte.hu

The non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder worldwide, a clinicopa­thological spectrum from pure steatosis to steatohepatitis and cirrhosis. The progressive form of NAFLD is the non-alcoholic steatohepatitis (NASH) with or without fibrosis has a high risk of severe outcomes, including hepatic and extrahepatic complications. The diagnosis of NAFLD has been based on the presence of fatty liver and lack of excessive alcohol consumption and the exclusion of other causes of steatosis. Since the term NAFLD contains „negative criteria” (and alcohol in its name), during the last two decades several authors have suggested to rename the disease to a „positive” term, that should involve metabolic instead of non-alcoholic. In 2020 an international expert consensus statement has recommended a new definition of metabolic (dysfunction)-associated fatty liver disease (MAFLD) to replace NAFLD, and it was suggested how the disease should be diagnosed. The diagnosis of MAFLD should be based on the evidence of hepatic steatosis (by imaging techniques, biomarkers or biopsy), in addition to one of the following three criteria: overweight/obesity, type 2 diabetes mellitus, and metabolic dysfunction. The proposal has evoked intensive debates in the hepatology literature. A number of experts and liver societies have been supportive concerning the usefulness of the new diagnostic criteria. It was emphasized that MAFLD can help to identify those patients with steatosis who are at high risk of more advanced liver disease, in addition, the new name mirrors the metabolic nature of the disease, and is not stigmatizing. Others dis­agreed with the change, saying that it is premature, and can create rather confusion than advance in the field. This paper gives an account on the diagnostic criteria of MAFLD, overviews the experts’ opinions on MAFLD term, and discusses the implications of the name change. It can be concluded, that the debate is not over. There is a need for further researches on better understanding of the pathogenesis of the disease entity, and continue the exchange of ideas, assess the consequences of the new terminology, thus archive a true, evidence-based consensus.

ISSUE: Central European Journal of Gastroenterology and Hepatology | 2022 | VOLUME 8, ISSUE 2