“
“Dysphagia, difficulty or delay in preparation and/or passage of a liquid or solid bolus is a common problem in our population. The optimal evaluation of the patient with dysphagia requires an understanding of the pathogenesis, the ability to use the history to differentiate between oropharyngeal and esophageal dysphagia and appropriate use of diagnostic testing. This chapter reviews the key components of the history and reviews in detail the optimal use of imaging studies, upper GI endoscopy, and esophageal function testing in the evaluation of these

complex cases. An algorithm for evaluation and treatment is presented. “
“Focusing on TNFSF15 instead of NOD2, we set out to evaluate whether combining serologic and genetic markers could distinguish between Crohn’s disease (CD) and ulcerative colitis (UC), and whether they could be used Pifithrin-�� chemical structure to stratify the disease behavior of Taiwanese CD patients. Clinical information, serum isolation, and DNA were collected after obtaining informed consent. The serological

markers were analyzed by ELISA kits and the genetic analysis for TNFSF15 single-nucleotide polymorphisms (SNPs) by Sequenom. Statistic analyses were conducted by SAS 9.2 (Cary, NC, USA). This study included 108 patients (55 CD, 53 UC) and 60 healthy controls. An initial low positive rate and low sensitivity for the serological markers led LY2157299 us to reset the cut-off values. This reset cut-off for ASCA IgA yielded a sensitivity of 0.291 and specificity of 0.925 for differentiating CD from UC patients. The reset cut-off value for p-ANCA (anti-MPO) had a sensitivity of 0.461 and a specificity of 0.817 for differentiating inflammatory bowel disease patients from healthy controls. Among the TNFSF15 SNPs, rs4263839 associated PDK4 with CD in Taiwan (P = 0.005), haplotype analysis did not increase the association. Combining the genetic marker TNFSF15 (rs4263839) and serological marker ASCA IgA increased the area under the curve from 0.61 to 0.70 for predicting stenosis/perforating phenotype, compared to ASCA IgA alone. Serological markers need to be tested and tailored to different countries/ethnicities. Combining the genetic

marker TNFSF15 with ASCA IgA increased the power of predicting stenosis/perforating phenotype in CD patients with TNFSF15 but not with a NOD2 genetic background. “
“Background and Aim:  We aimed to prospectively determine patient burden and patient preference for magnetic resonance enteroclysis, capsule endoscopy and balloon-assisted enteroscopy in patients with suspected or known Crohn’s disease (CD) or occult gastrointestinal bleeding (OGIB). Methods:  Consecutive consenting patients with CD or OGIB underwent magnetic resonance enteroclysis, capsule endoscopy and balloon-assisted enteroscopy. Capsule endoscopy was only performed if magnetic resonance enteroclysis showed no high-grade small bowel stenosis. Patient preference and burden was evaluated by means of standardized questionnaires at five moments in time.