Abstract
This narrative review summarizes a selection of clinically-important novel gastrointestinal developments, presented and discussed at the virtual Gastro Update Europe. The selected topics, fully referenced, reflect what the distinguished faculty considered of vital importance to be communicated to the astute busy gastro-hep clinician who is eager to stay abreast of important novel developments. Whenever appropriate a personal comment or addition was added to further raise the educational value of this review. Given its narrative character, statements and conclusions are largely expert opinion-based, and referencing within this summary is limited to the included slide images.
Highlights
Are there changes in the microbiome as a key driver for colonic cancer? A mega-analysis of close to 30.000 British colorectal cancers (CRC) patients, matched with 137.000 controls revealed a dose-dependent effect of oral antibiotic use, mainly targeting anaerobes, in raising the risk of colonic but not rectal cancer
All these alarming findings stress the urgent need for new risk assessment algorithms, including family history, BMI, smoking, alcohol, physical activity, fasting glucose, red meat and vegetable consumption, folate, non-steroidal anti-inflammatory drugs (NSAIDs) and antimicrobial use, etc. combined with acompilation of genetic factors
What follows is a summary of the take-home messages from those studies: – risk of intraprocedural bleeding may be as high as ~5% in low-risk endoscopies with biopsies in patients who did not omit the direct oral anticoagulants (DOACs) morning dose; – delayed bleeding does occur more often when DOAC treatment is resumed earlier than recommended in the European guidelines; – routine peri-endoscopic bridging with heparin substantially increases the risk of bleeding without providing any clinical benefit; – shortterm interruption of anticoagulation, as recommended by the European guidelines, appears to be a safe and effective strategy for containing bleeding events and minimising thromboembolic risk
Summary
This narrative review summarizes a selection of clinically-important novel gastrointestinal developments, presented and discussed at the virtual Gastro Update Europe. The selected topics, fully referenced, reflect what the distinguished faculty considered of vital importance to be communicated to the astute busy gastro-hep clinician who is eager to stay abreast of important novel developments. Материалы конференции Gastro Update Eвропа 2020, 4–5 сентября 2020 г. В данном обзоре в повествовательной форме кратко изложены клинически важные передовые исследования представленные для обсуждения на конференции Gastro Update Europe 2020. Краткое резюме докладов сопровождается личными пояснениями автора обзора. Выводы и заключения в значительной степени основаны на мнениях экспертов, а ссылки в настоящем резюме ограничиваются включенными слайд-изображениями.
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