Martin Floch - Academia.edu (original) (raw)
Papers by Martin Floch
Journal of clinical gastroenterology
Journal of Clinical Gastroenterology
ABSTRACT
American Journal of Clinical Nutrition
Recent theories have postulated that low fiber diets are related to colon cancer and diverticulos... more Recent theories have postulated that low fiber diets are related to colon cancer and diverticulosis, and to atherosclerosis. These theories are based on British and African diet history information. There has been no recent assessment of fiber intake in an area of high incidence of colonic disease in the United States. Using recall diet histories in subjects with no disease
American Journal of Clinical Nutrition
Page 1. 1602 TIlE AMERICAN JOURNAL OF CLINICAL NUTRITIoN \.OI. 23, NIl. 12, December, 1970, pp.16... more Page 1. 1602 TIlE AMERICAN JOURNAL OF CLINICAL NUTRITIoN \.OI. 23, NIl. 12, December, 1970, pp.1602-1607 Pi-intedin USA J ejunal Bacterial Flora in Chronic Small Bowel Disease I, Celiac Disease. II. Regional Enteritis1'2'3 ...
Journal of clinical gastroenterology
This paper describes the consensus opinion of the participants in the 4th Triennial Yale/Harvard ... more This paper describes the consensus opinion of the participants in the 4th Triennial Yale/Harvard Workshop on Probiotic Recommendations. The recommendations update those of the first 3 meetings that were published in 2006, 2008, and 2011. Recommendations for the use of probiotics in necrotizing enterocolitis, childhood diarrhea, inflammatory bowel disease, irritable bowel syndrome and Clostridium difficile diarrhea are reviewed. In addition, we have added recommendations for liver disease for the first time. As in previous publications, the recommendations are given as A, B, or C ratings.
Therapeutic advances in gastroenterology, 2013
Diverticulosis is one of the most common gastrointestinal conditions affecting the general popula... more Diverticulosis is one of the most common gastrointestinal conditions affecting the general population in the Western world. It is estimated that over 2.5 million people are affected by diverticular disease in the United States. The spectrum of clinical manifestations of diverticulosis ranges from asymptomatic diverticulosis to complicated diverticulitis. Treatment for symptomatic diverticular disease is largely based on symptoms. Traditional therapy includes fiber, bowel rest, antibiotics, pain control and surgery for selected cases. This review discusses recent advances in the medical treatment of diverticular disease such as the use of mesalamine, rifaximin and probiotics as our understanding of the disease evolves.
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
Diverticular disease is one of the most common medical conditions affecting Western populations. ... more Diverticular disease is one of the most common medical conditions affecting Western populations. Inflammatory complications are the most common manifestation of the disease and typically cause acute bouts of abdominal pain and fever. Chronic symptoms can also occur and can be mistakenly attributed to irritable bowel syndrome and rarely to inflammatory bowel disease. Alterations in peridiverticular bacterial flora are thought to play a role in the pathogenesis of diverticular inflammation. This article discusses the rationale and reviews the existing clinical data regarding the role of probiotics in the management of diverticular disease.
![Research paper thumbnail of [Diverticular disease and diverticulitis]](https://attachments.academia-assets.com/39578592/thumbnails/1.jpg)
](Deutsche medizinische Wochenschrift (1946), 2008
Diverticular disease is one of the most prevalent medical conditions to affect Western population... more Diverticular disease is one of the most prevalent medical conditions to affect Western populations. Symptomatic diverticular disease can range from mild, low-level symptomatology similar to that seen in irritable bowel syndrome to acute bouts of diverticulitis complicated by abscess or frank perforation. This review discusses the epidemiology, pathophysiology, clinical presentation, and management of the spectrum of diverticular disease, including mention of recent advances in the treatment of chronic diverticular disease with aminosalicyclates and probiotics.
The American Journal of Surgery, 2008
The objective of this study was to identify risk factors for recurrent or complicated diverticuli... more The objective of this study was to identify risk factors for recurrent or complicated diverticulitis requiring colectomy. A total of 112 patients were admitted to the West Haven Veterans Affairs Medical Center with the diagnosis of colonic diverticular disease from January 1998 to December 2006. Patients' records were assessed for demographics, past medical history, and physical and biochemical features of presentation. Student t tests, analysis of variance, and chi-square analysis were used to compare binary and categoric data. The medical records of 112 patients admitted to the West Haven Veterans Affairs hospital with the diagnosis of diverticulitis were analyzed retrospectively. A total of 97.3% were male (n = 109), with a mean age of 63.3 years, and a significant smoking history greater than 30 pack-years was present in 70.5% (n = 79) of patients. Eighty-four percent (n = 94) of patients presented with localized abdominal pain and 69.6% (n = 78) had abdominal tenderness without peritoneal signs. Computed tomography was performed in 85.7% (n = 96) of cases. A total of 23.2% (n = 26) of patients proceeded to laparotomy, with free perforation being the most common indication (38.4%, n = 12) followed by a history of 2 or more antecedent attacks of diverticulitis (23.1%, n = 6). Analysis of variance showed that serum albumin levels were significantly lower in the group undergoing colectomy compared with those who did not (3.4 vs 4.1 mg/dL; P = .016). The need for colectomy owing to complicated or recurrent attacks correlated with glucocorticoid use (P < .001) and a history of chronic obstructive pulmonary disease (P < .038), but not with diabetes mellitus, collagen vascular disease, or inflammatory bowel disease. The rules regarding the treatment of diverticulitis are evolving. Comorbid conditions such as hypoalbuminemia, chronic obstructive pulmonary disease, and glucocorticoid use may predispose patients to recurrent or complicated attacks of diverticulitis requiring colectomy. Stratification and reduction of risks may reduce the overall morbidity and mortality of diverticulitis.
New England Journal of Medicine, 1969
... is caused by nitrogenous substances absorbed from the intestine and admitted directly to the ... more ... is caused by nitrogenous substances absorbed from the intestine and admitted directly to the systemic circulation by portal–systemic collateral ... Supported in part by grants from the Philips —Roxane Laboratories, Inc., NV Philips—Duphar, the Warner—Lambert Research Institute ...
Journal of Clinical Gastroenterology, 2005
To investigate the literature from 1980 to 2004 for the types of studies and organisms used as pr... more To investigate the literature from 1980 to 2004 for the types of studies and organisms used as probiotics in human studies and diseases. PubMed search for probiotic organisms used in studies from 1980 to August 2004. The data from those papers were evaluated for organisms used, dose, vehicle, frequency, and investigator's report of positive or negative results. A total of 185 manuscripts were identified. Investigators reported results of both single and multiple organisms in the same manuscript. A single organism was used in 125 reports, and multiple organisms, ranging from 2 to 9, were used in 60 reports. Positive results were reported in 239 clinical situations and negative results reported in 49 in a total of 288 clinical conclusions drawn by the respective investigators. The studies are tabulated in this review. There is a large literature available in credible journals that report benefit of probiotic administration using a wide range of doses, organisms, and clinical situations. Most of the studies are simple reports of a clinical situation and require additional evaluation.
Journal of Clinical Gastroenterology, 2004
ABSTRACT
Journal of Clinical Gastroenterology, 2004
Indeterminate colitis (IC) originally referred to those 10-15% of cases of inflammatory bowel dis... more Indeterminate colitis (IC) originally referred to those 10-15% of cases of inflammatory bowel disease (IBD) in which there was difficulty distinguishing between ulcerative colitis (UC) and Crohn's disease (CD) in the colectomy specimen. However, IC is increasingly used when a definitive diagnosis of UC or CD cannot be made at colonoscopy, in colonic biopsies or at colectomy. The diagnostic difficulties may explain the variably reported prevalence of IC. Clinically, most patients with IC evolve to a definite diagnosis of UC or CD on follow up. The role of ancillary tests in the distinction of UC from CD is reviewed. The low sensitivity of serological markers limits their usefulness. Other tests include upper endoscopy and magnetic resonance imaging. The definition of IC may not be a purely histological one derived from resected specimens, but rather a clinicopathological one. This review offers some personal observations and viewpoints, and proposes an approach to some of the relatively more esoteric combinations of findings.
Journal of Clinical Gastroenterology, 2003
Journal of Clinical Gastroenterology, 2008
The degree of nutrition training in gastrointestinal (GI) fellowship programs has not been report... more The degree of nutrition training in gastrointestinal (GI) fellowship programs has not been reported previously, but it is thought to be inadequate. The aim of this study was to determine GI fellows' exposure to nutrition and to assess nutrition knowledge and practice behaviors before and after completing a live nutrition course. This course was geared specifically for GI fellows. Nineteen faculty members from the United States and Canada participated. Electronic surveys were sent to each fellow before and after the course. The curriculum consisted of 20 hours of live education. Curriculum was revised when the precourse survey identified a gap in medical knowledge or practice behavior. Knowledge change was assessed by a 20-question survey before and after the course. Fifty-three fellows participated. Seventy percent reported no inpatient nutrition rotation. Seventy percent had never written a total parenteral nutrition or total enteral nutrition orders, and 12% had treated a home enteral or parenteral patient. Ninety percent had no outpatient nutrition or obesity rotation experience, and 59% had no core nutrition lecture series at their program. Eighty-seven percent had never been assessed for competency in nutrition, and 9% had completed a nutrition research project. Too few mentors, poor exposure, and a predominant focus on endoscopy were reasons cited for not pursing nutrition training. Knowledge change after the course was assessed; the mean correct response rates were 58% before and 88% postcourse. There is a considerable deficiency in nutrition training in GI programs. The established American Gastroenterological Association nutrition curriculum guidelines and core competencies are not being fulfilled in most programs. The curriculum of this course resulted in increased knowledge and improved nutrition practice behavior. There is a need for more nutrition training for our GI fellows.
Journal of Clinical Gastroenterology, 2008
Journal of Clinical Gastroenterology, 2008
Journal of clinical gastroenterology
Journal of Clinical Gastroenterology
ABSTRACT
American Journal of Clinical Nutrition
Recent theories have postulated that low fiber diets are related to colon cancer and diverticulos... more Recent theories have postulated that low fiber diets are related to colon cancer and diverticulosis, and to atherosclerosis. These theories are based on British and African diet history information. There has been no recent assessment of fiber intake in an area of high incidence of colonic disease in the United States. Using recall diet histories in subjects with no disease
American Journal of Clinical Nutrition
Page 1. 1602 TIlE AMERICAN JOURNAL OF CLINICAL NUTRITIoN \.OI. 23, NIl. 12, December, 1970, pp.16... more Page 1. 1602 TIlE AMERICAN JOURNAL OF CLINICAL NUTRITIoN \.OI. 23, NIl. 12, December, 1970, pp.1602-1607 Pi-intedin USA J ejunal Bacterial Flora in Chronic Small Bowel Disease I, Celiac Disease. II. Regional Enteritis1'2'3 ...
Journal of clinical gastroenterology
This paper describes the consensus opinion of the participants in the 4th Triennial Yale/Harvard ... more This paper describes the consensus opinion of the participants in the 4th Triennial Yale/Harvard Workshop on Probiotic Recommendations. The recommendations update those of the first 3 meetings that were published in 2006, 2008, and 2011. Recommendations for the use of probiotics in necrotizing enterocolitis, childhood diarrhea, inflammatory bowel disease, irritable bowel syndrome and Clostridium difficile diarrhea are reviewed. In addition, we have added recommendations for liver disease for the first time. As in previous publications, the recommendations are given as A, B, or C ratings.
Therapeutic advances in gastroenterology, 2013
Diverticulosis is one of the most common gastrointestinal conditions affecting the general popula... more Diverticulosis is one of the most common gastrointestinal conditions affecting the general population in the Western world. It is estimated that over 2.5 million people are affected by diverticular disease in the United States. The spectrum of clinical manifestations of diverticulosis ranges from asymptomatic diverticulosis to complicated diverticulitis. Treatment for symptomatic diverticular disease is largely based on symptoms. Traditional therapy includes fiber, bowel rest, antibiotics, pain control and surgery for selected cases. This review discusses recent advances in the medical treatment of diverticular disease such as the use of mesalamine, rifaximin and probiotics as our understanding of the disease evolves.
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
Diverticular disease is one of the most common medical conditions affecting Western populations. ... more Diverticular disease is one of the most common medical conditions affecting Western populations. Inflammatory complications are the most common manifestation of the disease and typically cause acute bouts of abdominal pain and fever. Chronic symptoms can also occur and can be mistakenly attributed to irritable bowel syndrome and rarely to inflammatory bowel disease. Alterations in peridiverticular bacterial flora are thought to play a role in the pathogenesis of diverticular inflammation. This article discusses the rationale and reviews the existing clinical data regarding the role of probiotics in the management of diverticular disease.
Deutsche medizinische Wochenschrift (1946), 2008
Diverticular disease is one of the most prevalent medical conditions to affect Western population... more Diverticular disease is one of the most prevalent medical conditions to affect Western populations. Symptomatic diverticular disease can range from mild, low-level symptomatology similar to that seen in irritable bowel syndrome to acute bouts of diverticulitis complicated by abscess or frank perforation. This review discusses the epidemiology, pathophysiology, clinical presentation, and management of the spectrum of diverticular disease, including mention of recent advances in the treatment of chronic diverticular disease with aminosalicyclates and probiotics.
The American Journal of Surgery, 2008
The objective of this study was to identify risk factors for recurrent or complicated diverticuli... more The objective of this study was to identify risk factors for recurrent or complicated diverticulitis requiring colectomy. A total of 112 patients were admitted to the West Haven Veterans Affairs Medical Center with the diagnosis of colonic diverticular disease from January 1998 to December 2006. Patients' records were assessed for demographics, past medical history, and physical and biochemical features of presentation. Student t tests, analysis of variance, and chi-square analysis were used to compare binary and categoric data. The medical records of 112 patients admitted to the West Haven Veterans Affairs hospital with the diagnosis of diverticulitis were analyzed retrospectively. A total of 97.3% were male (n = 109), with a mean age of 63.3 years, and a significant smoking history greater than 30 pack-years was present in 70.5% (n = 79) of patients. Eighty-four percent (n = 94) of patients presented with localized abdominal pain and 69.6% (n = 78) had abdominal tenderness without peritoneal signs. Computed tomography was performed in 85.7% (n = 96) of cases. A total of 23.2% (n = 26) of patients proceeded to laparotomy, with free perforation being the most common indication (38.4%, n = 12) followed by a history of 2 or more antecedent attacks of diverticulitis (23.1%, n = 6). Analysis of variance showed that serum albumin levels were significantly lower in the group undergoing colectomy compared with those who did not (3.4 vs 4.1 mg/dL; P = .016). The need for colectomy owing to complicated or recurrent attacks correlated with glucocorticoid use (P < .001) and a history of chronic obstructive pulmonary disease (P < .038), but not with diabetes mellitus, collagen vascular disease, or inflammatory bowel disease. The rules regarding the treatment of diverticulitis are evolving. Comorbid conditions such as hypoalbuminemia, chronic obstructive pulmonary disease, and glucocorticoid use may predispose patients to recurrent or complicated attacks of diverticulitis requiring colectomy. Stratification and reduction of risks may reduce the overall morbidity and mortality of diverticulitis.
New England Journal of Medicine, 1969
... is caused by nitrogenous substances absorbed from the intestine and admitted directly to the ... more ... is caused by nitrogenous substances absorbed from the intestine and admitted directly to the systemic circulation by portal–systemic collateral ... Supported in part by grants from the Philips —Roxane Laboratories, Inc., NV Philips—Duphar, the Warner—Lambert Research Institute ...
Journal of Clinical Gastroenterology, 2005
To investigate the literature from 1980 to 2004 for the types of studies and organisms used as pr... more To investigate the literature from 1980 to 2004 for the types of studies and organisms used as probiotics in human studies and diseases. PubMed search for probiotic organisms used in studies from 1980 to August 2004. The data from those papers were evaluated for organisms used, dose, vehicle, frequency, and investigator's report of positive or negative results. A total of 185 manuscripts were identified. Investigators reported results of both single and multiple organisms in the same manuscript. A single organism was used in 125 reports, and multiple organisms, ranging from 2 to 9, were used in 60 reports. Positive results were reported in 239 clinical situations and negative results reported in 49 in a total of 288 clinical conclusions drawn by the respective investigators. The studies are tabulated in this review. There is a large literature available in credible journals that report benefit of probiotic administration using a wide range of doses, organisms, and clinical situations. Most of the studies are simple reports of a clinical situation and require additional evaluation.
Journal of Clinical Gastroenterology, 2004
ABSTRACT
Journal of Clinical Gastroenterology, 2004
Indeterminate colitis (IC) originally referred to those 10-15% of cases of inflammatory bowel dis... more Indeterminate colitis (IC) originally referred to those 10-15% of cases of inflammatory bowel disease (IBD) in which there was difficulty distinguishing between ulcerative colitis (UC) and Crohn's disease (CD) in the colectomy specimen. However, IC is increasingly used when a definitive diagnosis of UC or CD cannot be made at colonoscopy, in colonic biopsies or at colectomy. The diagnostic difficulties may explain the variably reported prevalence of IC. Clinically, most patients with IC evolve to a definite diagnosis of UC or CD on follow up. The role of ancillary tests in the distinction of UC from CD is reviewed. The low sensitivity of serological markers limits their usefulness. Other tests include upper endoscopy and magnetic resonance imaging. The definition of IC may not be a purely histological one derived from resected specimens, but rather a clinicopathological one. This review offers some personal observations and viewpoints, and proposes an approach to some of the relatively more esoteric combinations of findings.
Journal of Clinical Gastroenterology, 2003
Journal of Clinical Gastroenterology, 2008
The degree of nutrition training in gastrointestinal (GI) fellowship programs has not been report... more The degree of nutrition training in gastrointestinal (GI) fellowship programs has not been reported previously, but it is thought to be inadequate. The aim of this study was to determine GI fellows' exposure to nutrition and to assess nutrition knowledge and practice behaviors before and after completing a live nutrition course. This course was geared specifically for GI fellows. Nineteen faculty members from the United States and Canada participated. Electronic surveys were sent to each fellow before and after the course. The curriculum consisted of 20 hours of live education. Curriculum was revised when the precourse survey identified a gap in medical knowledge or practice behavior. Knowledge change was assessed by a 20-question survey before and after the course. Fifty-three fellows participated. Seventy percent reported no inpatient nutrition rotation. Seventy percent had never written a total parenteral nutrition or total enteral nutrition orders, and 12% had treated a home enteral or parenteral patient. Ninety percent had no outpatient nutrition or obesity rotation experience, and 59% had no core nutrition lecture series at their program. Eighty-seven percent had never been assessed for competency in nutrition, and 9% had completed a nutrition research project. Too few mentors, poor exposure, and a predominant focus on endoscopy were reasons cited for not pursing nutrition training. Knowledge change after the course was assessed; the mean correct response rates were 58% before and 88% postcourse. There is a considerable deficiency in nutrition training in GI programs. The established American Gastroenterological Association nutrition curriculum guidelines and core competencies are not being fulfilled in most programs. The curriculum of this course resulted in increased knowledge and improved nutrition practice behavior. There is a need for more nutrition training for our GI fellows.
Journal of Clinical Gastroenterology, 2008
Journal of Clinical Gastroenterology, 2008