nach oben

Current Treatment Options in Gastroenterology

Erschienen in:

19.01.2018 | Esophagus (PG Iyer, Section Editor)

Emerging Insights into the Esophageal Microbiome

verfasst von: Michael May, BA, Julian A. Abrams, MD, MS

Erschienen in: Current Treatment Options in Gastroenterology | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose of review

Analysis of the esophageal microbiome remains a relatively new field of research, and most studies to date have focused on characterizing the esophageal microbiome in states of health and disease. Microbiome alterations have been implicated in the pathogenesis of inflammatory and neoplastic conditions in the colon and elsewhere in the gastrointestinal tract. The epidemiology of various esophageal conditions including Barrett’s esophagus (BE), esophageal adenocarcinoma (EAC), esophageal squamous cell carcinoma (ESCC), and eosinophilic esophagitis (EoE) point to the microbiome as a potential co-factor in disease pathogenesis, and the possibility exists that these microbiome alterations could contribute directly to the inflammatory environments necessary for the carcinogenesis or atopy involved in these conditions.

Recent findings

The native esophageal microbiome is similar in composition to the oral microbiome, with a high relative abundance of the phylum Firmicutes and the genus Streptococcus. Limited studies to date suggest that there are certain microbiome alterations associated with esophageal diseases. Additionally, it may be possible to indirectly assess the esophageal microbiome via non-endoscopic means. This raises the possibility that non-invasive microbiome analysis could be used for disease screening and monitoring.

Summary

Further understanding of the role of the esophageal microbiome in disease pathogenesis, as well as methods for microbiome alteration, may help elucidate future targets for disease modifying therapies, or minimally invasive screening tools in patients at high risk for development of various esophageal conditions.

Pei Z, Bini EJ, Yang L, Zhou M, Francois F, Blaser MJ. Bacterial biota in the human distal esophagus. Proc Natl Acad Sci U S A. 2004;101(12):4250–5. https://doi.org/10.1073/pnas.0306398101.CrossRefPubMedPubMedCentral

• Gall A, Fero J, McCoy C, Claywell BC, Sanchez CA, Blount PL, et al. Bacterial composition of the human upper gastrointestinal tract microbiome is dynamic and associated with genomic instability in a Barrett's esophagus cohort. PLoS One. 2015;10(6):e0129055. Multiple sites sampled in the upper GI tract of BE patients, demonstrating similar microbiome along the upper GI tract within individuals. https://doi.org/10.1371/journal.pone.0129055.CrossRefPubMedPubMedCentral

Fillon SA, Harris JK, Wagner BD, Kelly CJ, Stevens MJ, Moore W, et al. Novel device to sample the esophageal microbiome--the esophageal string test. PLoS One. 2012;7(9):e42938. https://doi.org/10.1371/journal.pone.0042938.CrossRefPubMedPubMedCentral

Ross-Innes CS, Debiram-Beecham I, O'Donovan M, Walker E, Varghese S, Lao-Sirieix P, et al. Evaluation of a minimally invasive cell sampling device coupled with assessment of trefoil factor 3 expression for diagnosing Barrett's esophagus: a multi-center case-control study. PLoS Med. 2015;12(1):e1001780. https://doi.org/10.1371/journal.pmed.1001780.CrossRefPubMedPubMedCentral

Elliott DRF, Walker AW, O'Donovan M, Parkhill J, Fitzgerald RC. A non-endoscopic device to sample the oesophageal microbiota: a case-control study. Lancet. Gastroenterol Hepatol. 2017;2(1):32–42.

Yu G, Gail MH, Shi J, Klepac-Ceraj V, Paster BJ, Dye BA, et al. Association between upper digestive tract microbiota and cancer-predisposing states in the esophagus and stomach. Cancer Epidemiol Biomark Prev. 2014;23(5):735–41. https://doi.org/10.1158/1055-9965.EPI-13-0855.CrossRef

Zhang C, Cleveland K, Schnoll-Sussman F, McClure B, Bigg M, Thakkar P, et al. Identification of low abundance microbiome in clinical samples using whole genome sequencing. Genome Biol. 2015;16(1):265. https://doi.org/10.1186/s13059-015-0821-z.CrossRefPubMedPubMedCentral

Robinson KM, Crabtree J, Mattick JS, Anderson KE, Dunning Hotopp JC. Distinguishing potential bacteria-tumor associations from contamination in a secondary data analysis of public cancer genome sequence data. Microbiome. 2017;5(1):9. https://doi.org/10.1186/s40168-016-0224-8.CrossRefPubMedPubMedCentral

Mannell A, Plant M, Frolich J. The microflora of the oesophagus. Ann R Coll Surg Engl. 1983;65(3):152–4.PubMedPubMedCentral

10.

Snider EJ, Freedberg DE, Abrams JA. Potential role of the microbiome in Barrett's esophagus and esophageal adenocarcinoma. Dig Dis Sci. 2016;61(8):2217–25. https://doi.org/10.1007/s10620-016-4155-9.CrossRefPubMedPubMedCentral

11.

Finlay IG, Wright PA, Menzies T, McArdle CS. Microbial flora in carcinoma of oesophagus. Thorax. 1982;37(3):181–4. https://doi.org/10.1136/thx.37.3.181.CrossRefPubMedPubMedCentral

12.

Lau WF, Wong J, Lam KH, Ong GB. Oesophageal microbial flora in carcinoma of the oesophagus. Aust N Z J Surg. 1981;51(1):52–5. https://doi.org/10.1111/j.1445-2197.1981.tb05905.x.CrossRefPubMed

13.

•• Benitez AJ, Hoffmann C, Muir AB, Dods KK, Spergel JM, Bushman FD, et al. Inflammation-associated microbiota in pediatric eosinophilic esophagitis. Microbiome. 2015;3(1):23. Prospective study in EoE demonstrating the impact of elimination diet and reintroduction on the esophageal microbiome. https://doi.org/10.1186/s40168-015-0085-6.CrossRefPubMedPubMedCentral

14.

•• Amir I, Konikoff FM, Oppenheim M, Gophna U, Half EE. Gastric microbiota is altered in oesophagitis and Barrett's oesophagus and further modified by proton pump inhibitors. Environ Microbiol. 2014;16(9):2905–14. Demonstrates within-individual changes to the esophageal and gastric aspirate microbiome caused by PPI therapy. https://doi.org/10.1111/1462-2920.12285.CrossRefPubMed

15.

Harris JK, Fang R, Wagner BD, Choe HN, Kelly CJ, Schroeder S, et al. Esophageal microbiome in eosinophilic esophagitis. PLoS One. 2015;10(5):e0128346. https://doi.org/10.1371/journal.pone.0128346.CrossRefPubMedPubMedCentral

16.

Sanduleanu S, Jonkers D, De Bruine A, Hameeteman W, Stockbrugger RW. Non-helicobacter pylori bacterial flora during acid-suppressive therapy: differential findings in gastric juice and gastric mucosa. Aliment Pharmacol Ther. 2001;15(3):379–88. https://doi.org/10.1046/j.1365-2036.2001.00888.x.CrossRefPubMed

17.

Albenberg LG, GD W. Diet and the intestinal microbiome: associations, functions, and implications for health and disease. Gastroenterology. 2014;146(6):1564–72. https://doi.org/10.1053/j.gastro.2014.01.058.CrossRefPubMedPubMedCentral

18.

David LA, Maurice CF, Carmody RN, Gootenberg DB, Button JE, Wolfe BE, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505(7484):559–63. https://doi.org/10.1038/nature12820.CrossRefPubMed

19.

• Schulz MD, Atay C, Heringer J, Romrig FK, Schwitalla S, Aydin B, et al. High-fat-diet-mediated dysbiosis promotes intestinal carcinogenesis independently of obesity. Nature. 2014;514(7523):508–12. Demonstrates that diet-induced microbiome alterations are capable of promoting intestinal cancer in mice. https://doi.org/10.1038/nature13398.CrossRefPubMedPubMedCentral

20.

Kaakoush NO, Lecomte V, Maloney CA, Morris MJ. Cross-talk among metabolic parameters, esophageal microbiota, and host gene expression following chronic exposure to an obesogenic diet. Sci Rep. 2017;7:45753. https://doi.org/10.1038/srep45753.CrossRefPubMedPubMedCentral

21.

O'Keefe SJ, Li JV, Lahti L, Ou J, Carbonero F, Mohammed K, et al. Fat, fibre and cancer risk in African Americans and rural Africans. Nat Commun. 2015;6:6342. https://doi.org/10.1038/ncomms7342.CrossRefPubMedPubMedCentral

22.

• Mehta RS, Nishihara R, Cao Y, Song M, Mima K, Qian ZR, et al. Association of Dietary Patterns with Risk of colorectal cancer subtypes classified by fusobacterium nucleatum in tumor tissue. JAMA Oncol. 2017;3(7):921–7. Demonstrates that the effects of diet on colon cancer risk are mediated in part by the microbiome. https://doi.org/10.1001/jamaoncol.2016.6374.PubMed

23.

Nobel Y, Snider EJ, Compres G, Freedberg DE, Toussaint N, Abrams JA. Dietary fiber intake is associated with a significantly altered human esophageal microbiome. Gastroenterology. 2017;152(5):S632. https://doi.org/10.1016/S0016-5085(17)32241-2.CrossRef

24.

Brown LM, Devesa SS, Chow WH. Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age. J Natl Cancer Inst. 2008;100(16):1184–7. https://doi.org/10.1093/jnci/djn211.CrossRefPubMedPubMedCentral

25.

Hur C, Miller M, Yin Kong C, Dowling E, Nattinger K, Dunn M, et al. Trends in esophageal adenocarcinoma incidence and mortality. Cancer. 2013;6(119):1149–58.CrossRef

26.

Abrams JA, Sharaiha RZ, Gonsalves L, Lightdale CJ, Neugut AI. Dating the rise of esophageal adenocarcinoma: analysis of Connecticut tumor registry data, 1940-2007. Cancer Epidemiol Biomark Prev. 2011;20(1):183–6. https://doi.org/10.1158/1055-9965.EPI-10-0802.CrossRef

27.

Engel LS, Chow WH, Vaughan TL, Gammon MD, Risch HA, Stanford JL, et al. Population attributable risks of esophageal and gastric cancers. J Natl Cancer Inst. 2003;95(18):1404–13. https://doi.org/10.1093/jnci/djg047.CrossRefPubMed

28.

Kong CY, Nattinger KJ, Hayeck TJ, Omer ZB, Wang YC, Spechler SJ, et al. The impact of obesity on the rise in esophageal adenocarcinoma incidence: estimates from a disease simulation model. Cancer Epidemiol Biomark Prev. 2011;20(11):2450–6. https://doi.org/10.1158/1055-9965.EPI-11-0547.CrossRef

29.

Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960-1994. Int J Obes Relat Metab Disord. 1998;22(1):39–47. https://doi.org/10.1038/sj.ijo.0800541.CrossRefPubMed

30.

Giovino GA. Epidemiology of tobacco use in the United States. Oncogene. 2002;21(48):7326–40. https://doi.org/10.1038/sj.onc.1205808.CrossRefPubMed

31.

el-Serag HB, Sonnenberg A. Opposing time trends of peptic ulcer and reflux disease. Gut. 1998;43(3):327–33. https://doi.org/10.1136/gut.43.3.327.CrossRefPubMedPubMedCentral

32.

El-Serag HB. Time trends of gastroesophageal reflux disease: a systematic review. Clin Gastroenterol Hepatol. 2007;5(1):17–26. https://doi.org/10.1016/j.cgh.2006.09.016.CrossRefPubMed

33.

Islami F, Kamangar F. Helicobacter pylori and esophageal cancer risk: a meta-analysis. Cancer Prev Res (Phila). 2008;1(5):329–38. https://doi.org/10.1158/1940-6207.CAPR-08-0109.CrossRef

34.

Banatvala N, Mayo K, Megraud F, Jennings R, Deeks JJ, Feldman RA. The cohort effect and helicobacter pylori. J Infect Dis. 1993;168(1):219–21. https://doi.org/10.1093/infdis/168.1.219.CrossRefPubMed

35.

Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3–21. https://doi.org/10.1111/j.1753-4887.2011.00456.x.CrossRefPubMedPubMedCentral

36.

Yang L, Lu X, Nossa CW, Francois F, Peek RM, Pei Z. Inflammation and intestinal metaplasia of the distal esophagus are associated with alterations in the microbiome. Gastroenterology. 2009;137(2):588–97. https://doi.org/10.1053/j.gastro.2009.04.046.CrossRefPubMedPubMedCentral

37.

Macfarlane S, Furrie E, Macfarlane GT, Dillon JF. Microbial colonization of the upper gastrointestinal tract in patients with Barrett's esophagus. Clin Infect Dis. 2007;45(1):29–38. https://doi.org/10.1086/518578.CrossRefPubMed

38.

Arthur JC, Gharaibeh RZ, Muhlbauer M, Perez-Chanona E, Uronis JM, McCafferty J, et al. Microbial genomic analysis reveals the essential role of inflammation in bacteria-induced colorectal cancer. Nat Commun. 2014;5:4724. https://doi.org/10.1038/ncomms5724.CrossRefPubMedPubMedCentral

39.

Blackett KL, Siddhi SS, Cleary S, Steed H, Miller MH, Macfarlane S, et al. Oesophageal bacterial biofilm changes in gastro-oesophageal reflux disease, Barrett's and oesophageal carcinoma: association or causality? Aliment Pharmacol Ther. 2013;37(11):1084–92. https://doi.org/10.1111/apt.12317.CrossRefPubMed

40.

Zaidi AH, Kelly LA, Kreft RE, Barlek M, Omstead AN, Matsui D, et al. Associations of microbiota and toll-like receptor signaling pathway in esophageal adenocarcinoma. BMC Cancer. 2016;16(1):52. https://doi.org/10.1186/s12885-016-2093-8.CrossRefPubMedPubMedCentral

41.

Yang L, Francois F, Pei Z. Molecular pathways: pathogenesis and clinical implications of microbiome alteration in esophagitis and Barrett esophagus. Clin Cancer Res. 2012;18(8):2138–44. https://doi.org/10.1158/1078-0432.CCR-11-0934.CrossRefPubMedPubMedCentral

42.

Potter L, Angove H, Richardson D, Cole J. Nitrate reduction in the periplasm of gram-negative bacteria. Adv Microb Physiol. 2001;45:51–112. https://doi.org/10.1016/S0065-2911(01)45002-8.CrossRefPubMed

43.

Suzuki H, Iijima K, Scobie G, Fyfe V, McColl KE. Nitrate and nitrosative chemistry within Barrett's oesophagus during acid reflux. Gut. 2005;54(11):1527–35. https://doi.org/10.1136/gut.2005.066043.CrossRefPubMedPubMedCentral

44.

Kostic AD, Chun E, Robertson L, Glickman JN, Gallini CA, Michaud M, et al. Fusobacterium nucleatum potentiates intestinal tumorigenesis and modulates the tumor-immune microenvironment. Cell Host Microbe. 2013;14(2):207–15. https://doi.org/10.1016/j.chom.2013.07.007.CrossRefPubMedPubMedCentral

45.

Kostic AD, Gevers D, Pedamallu CS, Michaud M, Duke F, Earl AM, et al. Genomic analysis identifies association of fusobacterium with colorectal carcinoma. Genome Res. 2012;22(2):292–8. https://doi.org/10.1101/gr.126573.111.CrossRefPubMedPubMedCentral

46.

Kapatral V, Anderson I, Ivanova N, Reznik G, Los T, Lykidis A, et al. Genome sequence and analysis of the oral bacterium fusobacterium nucleatum strain ATCC 25586. J Bacteriol. 2002;184(7):2005–18. https://doi.org/10.1128/JB.184.7.2005-2018.2002.CrossRefPubMedPubMedCentral

47.

Rubinstein MR, Wang X, Liu W, Hao Y, Cai G, Han YW. Fusobacterium nucleatum promotes colorectal carcinogenesis by modulating E-cadherin/beta-catenin signaling via its FadA adhesin. Cell Host Microbe. 2013;14(2):195–206. https://doi.org/10.1016/j.chom.2013.07.012.CrossRefPubMedPubMedCentral

48.

Ito M, Kanno S, Nosho K, Sukawa Y, Mitsuhashi K, Kurihara H, et al. Association of Fusobacterium nucleatum with clinical and molecular features in colorectal serrated pathway. Int J Cancer. 2015;137(6):1258–68. https://doi.org/10.1002/ijc.29488.CrossRefPubMed

49.

Islami F, Pourshams A, Nasrollahzadeh D, Kamangar F, Fahimi S, Shakeri R, et al. Tea drinking habits and oesophageal cancer in a high risk area in northern Iran: population based case-control study. BMJ. 2009;338(mar26 2):b929. https://doi.org/10.1136/bmj.b929.CrossRefPubMedPubMedCentral

50.

Cook-Mozaffari PJ, Azordegan F, Day NE, Ressicaud A, Sabai C, Aramesh B. Oesophageal cancer studies in the Caspian littoral of Iran: results of a case-control study. Br J Cancer. 1979;39(3):293–309. https://doi.org/10.1038/bjc.1979.54.CrossRefPubMedPubMedCentral

51.

Cook MB, Chow WH, Devesa SS. Oesophageal cancer incidence in the United States by race, sex, and histologic type, 1977-2005. Br J Cancer. 2009;101(5):855–9. https://doi.org/10.1038/sj.bjc.6605246.CrossRefPubMedPubMedCentral

52.

•• Yamamura K, Baba Y, Nakagawa S, Mima K, Miyake K, Nakamura K, et al. Human microbiome fusobacterium Nucleatum in esophageal cancer tissue is associated with prognosis. Clin Cancer Res. 2016;22(22):5574–81. Demonstrates that F. nucleatum, which may have a causative role in colon cancer, is associated with ESCC outcomes. https://doi.org/10.1158/1078-0432.CCR-16-1786.CrossRefPubMed

53.

Nasrollahzadeh D, Malekzadeh R, Ploner A, Shakeri R, Sotoudeh M, Fahimi S, et al. Variations of gastric corpus microbiota are associated with early esophageal squamous cell carcinoma and squamous dysplasia. Sci Rep. 2015;5(1):8820. https://doi.org/10.1038/srep08820.CrossRefPubMedPubMedCentral

54.

Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128(1):3–20 e6; quiz 21-2. https://doi.org/10.1016/j.jaci.2011.02.040.CrossRefPubMed

55.

Sgouros SN, Bergele C, Mantides A. Eosinophilic esophagitis in adults: a systematic review. Eur J Gastroenterol Hepatol. 2006;18(2):211–7. https://doi.org/10.1097/00042737-200602000-00015.CrossRefPubMed

56.

Straumann A, Bauer M, Fischer B, Blaser K, Simon HU. Idiopathic eosinophilic esophagitis is associated with a T(H)2-type allergic inflammatory response. J Allergy Clin Immunol. 2001;108(6):954–61. https://doi.org/10.1067/mai.2001.119917.CrossRefPubMed

57.

Roy-Ghanta S, Larosa DF, Katzka DA. Atopic characteristics of adult patients with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2008;6(5):531–5. https://doi.org/10.1016/j.cgh.2007.12.045.CrossRefPubMed

58.

Orenstein SR, Shalaby TM, Di Lorenzo C, Putnam PE, Sigurdsson L, Mousa H, et al. The spectrum of pediatric eosinophilic esophagitis beyond infancy: a clinical series of 30 children. Am J Gastroenterol. 2000;95(6):1422–30. https://doi.org/10.1111/j.1572-0241.2000.02073.x.CrossRefPubMed

59.

Kelley ML Jr, Frazer JP. Symptomatic mid-esophageal webs. JAMA. 1966;197(2):143–6. https://doi.org/10.1001/jama.1966.03110020131047.CrossRefPubMed

60.

Attwood SE, Furuta GT. Eosinophilic esophagitis: historical perspective on an evolving disease. Gastroenterol Clin N Am. 2014;43(2):185–99. https://doi.org/10.1016/j.gtc.2014.02.010.CrossRef

61.

Hruz P, Straumann A, Bussmann C, Heer P, Simon HU, Zwahlen M, et al. Escalating incidence of eosinophilic esophagitis: a 20-year prospective, population-based study in Olten County, Switzerland. J Allergy Clin Immunol. 2011;128(6):1349–1350 e5. https://doi.org/10.1016/j.jaci.2011.09.013.CrossRefPubMed

62.

Prasad GA, Alexander JA, Schleck CD, Zinsmeister AR, Smyrk TC, Elias RM, et al. Epidemiology of eosinophilic esophagitis over three decades in Olmsted County, Minnesota. Clin Gastroenterol Hepatol. 2009;7(10):1055–61. https://doi.org/10.1016/j.cgh.2009.06.023.CrossRefPubMedPubMedCentral

63.

Dellon ES. Epidemiology of eosinophilic esophagitis. Gastroenterol Clin N Am. 2014;43(2):201–18. https://doi.org/10.1016/j.gtc.2014.02.002.CrossRef

64.

Dellon ES, Jensen ET, Martin CF, Shaheen NJ, Kappelman MD. Prevalence of eosinophilic esophagitis in the United States. Clin Gastroenterol Hepatol. 2014;12(4):589–96 e1. https://doi.org/10.1016/j.cgh.2013.09.008.CrossRefPubMed

65.

Dellon ES, Peery AF, Shaheen NJ, Morgan DR, Hurrell JM, Lash RH, et al. Inverse association of esophageal eosinophilia with helicobacter pylori based on analysis of a US pathology database. Gastroenterology. 2011;141(5):1586–92. https://doi.org/10.1053/j.gastro.2011.06.081.CrossRefPubMedPubMedCentral

66.

Ronkainen J, Talley NJ, Aro P, Storskrubb T, Johansson SE, Lind T, et al. Prevalence of oesophageal eosinophils and eosinophilic oesophagitis in adults: the population-based Kalixanda study. Gut. 2007;56(5):615–20. https://doi.org/10.1136/gut.2006.107714.CrossRefPubMed

67.

• Chen X, Winckler B, Lu M, Cheng H, Yuan Z, Yang Y, et al. Oral microbiota and risk for esophageal squamous cell carcinoma in a high-risk area of China. PLoS One. 2015;10(12):e0143603. Suggests that specific alterations to the oral microbiome may be a useful marker to screen for ESCC. https://doi.org/10.1371/journal.pone.0143603.CrossRefPubMedPubMedCentral

68.

Farrell JJ, Zhang L, Zhou H, Chia D, Elashoff D, Akin D, et al. Variations of oral microbiota are associated with pancreatic diseases including pancreatic cancer. Gut. 2012;61(4):582–8. https://doi.org/10.1136/gutjnl-2011-300784.CrossRefPubMed

69.

Ahn J, Chen CY, Hayes RB. Oral microbiome and oral and gastrointestinal cancer risk. Cancer Causes Control. 2012;23(3):399–404. https://doi.org/10.1007/s10552-011-9892-7.CrossRefPubMedPubMedCentral

70.

Snider EJ, Nobel YR, Compres G, Freedberg DE, Toussaint NC, Abrams JA. Shifts in the microbiome associated with Barrett’s esophagus and progression to dysplasia and adenocarcinoma. Gastroenterology (DDW Abstract). 2017;152(5):S1011–2. https://doi.org/10.1016/S0016-5085(17)33430-3.CrossRef

71.

Sawada A, Fujiwara Y, Nagami Y, Tanaka F, Yamagami H, Tanigawa T, et al. Alteration of esophageal microbiome by antibiotic treatment does not affect incidence of rat esophageal adenocarcinoma. Dig Dis Sci. 2016;61(11):3161–8. https://doi.org/10.1007/s10620-016-4263-6.CrossRefPubMed

72.

Holvoet S, Doucet-Ladeveze R, Perrot M, Barretto C, Nutten S, Blanchard C. Beneficial effect of Lactococcus lactis NCC 2287 in a murine model of eosinophilic esophagitis. Allergy. 2016;71(12):1753–61. https://doi.org/10.1111/all.12951.CrossRefPubMed

Titel: Emerging Insights into the Esophageal Microbiome
verfasst von: Michael May, BA
Julian A. Abrams, MD, MS
Publikationsdatum: 19.01.2018
Verlag: Springer US
Erschienen in: Current Treatment Options in Gastroenterology / Ausgabe 1/2018
Print ISSN: 1092-8472
Elektronische ISSN: 1534-309X
DOI: https://doi.org/10.1007/s11938-018-0171-5

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Alphablocker schützt vor Miktionsproblemen nach der Biopsie

16.05.2024 alpha-1-Rezeptorantagonisten Nachrichten

Nach einer Prostatabiopsie treten häufig Probleme beim Wasserlassen auf. Ob sich das durch den periinterventionellen Einsatz von Alphablockern verhindern lässt, haben australische Mediziner im Zuge einer Metaanalyse untersucht.

Eingreifen von Umstehenden rettet vor Erstickungstod!

15.05.2024 Fremdkörperaspiration Nachrichten

Wer sich an einem Essensrest verschluckt und um Luft ringt, benötigt vor allem rasche Hilfe. Dass Umstehende nur in jedem zweiten Erstickungsnotfall bereit waren, diese zu leisten, ist das ernüchternde Ergebnis einer Beobachtungsstudie aus Japan. Doch es gibt auch eine gute Nachricht.

Neue S3-Leitlinie zur unkomplizierten Zystitis: Auf Antibiotika verzichten?

15.05.2024 Harnwegsinfektionen Nachrichten

Welche Antibiotika darf man bei unkomplizierter Zystitis verwenden und wovon sollte man die Finger lassen? Welche pflanzlichen Präparate können helfen? Was taugt der zugelassene Impfstoff? Antworten vom Koordinator der frisch überarbeiteten S3-Leitlinie, Prof. Florian Wagenlehner.

Schadet Ärger den Gefäßen?

14.05.2024 Arteriosklerose Nachrichten

In einer Studie aus New York wirkte sich Ärger kurzfristig deutlich negativ auf die Endothelfunktion gesunder Probanden aus. Möglicherweise hat dies Einfluss auf die kardiovaskuläre Gesundheit.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose of review

Recent findings

Summary

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2018

Updates on Women’s Health Issues in Patients with Inflammatory Bowel Disease

Novel Therapies and Treatment Strategies for Patients with Inflammatory Bowel Disease

Expanding Role of Third Space Endoscopy in the Management of Esophageal Diseases

Biosimilars in the Treatment of Inflammatory Bowel Disease: Supporting Evidence in 2017

New Developments in the Diagnosis, Therapy, and Monitoring of Eosinophilic Esophagitis