Clinical Gastroenterology and Hepatology最新文献

{"title":"The Assessment of Gastrointestinal Transit by the Atmo Capsule: A Comparison With the SmartPill Capsule.","authors":"Braden Kuo, Allen A Lee, Thomas Abell, Ashok Attaluri, Michael Cline, William Hasler, Vincent Ho, Anthony J Lembo, Amir Masoud, Richard McCallum, Baharak Moshiree, Eamonn M M Quigley, Satish S C Rao, Abigail Stocker, Mayra Sanchez, Irene Sarosiek, Brian Surjanhata, Jerry Zhou, William D Chey","doi":"10.1016/j.cgh.2024.12.013","DOIUrl":"10.1016/j.cgh.2024.12.013","url":null,"abstract":"<p><strong>Background & aims: </strong>Wireless motility capsules (WMCs) can be used to assess gastrointestinal transit time to facilitate diagnosis and treatment of motility disorders. The Atmo Capsule is a novel WMC that measures gases (H₂, CO₂, O₂) and temperature. We aimed to compare and evaluate the performance characteristics of the Atmo Capsule and the SmartPill Capsule (discontinued reference standard WMC) for measurement of gastric emptying time (GET) and colonic transit time (CTT) in patients with confirmed or suspected disordered gastrointestinal transit.</p><p><strong>Methods: </strong>Patients with symptoms indicative of an upper and/or lower gastrointestinal motility disorder ingested the 2 WMCs in a random order. Gastrointestinal transit times were assessed using Spearman correlation and Bland-Altman analysis. Device agreement was assessed for delayed GET (≥5 hours) and CTT (≥59 hours).</p><p><strong>Results: </strong>There were 213 participants from 12 sites, yielding 177 paired GET and 147 paired CTT measurements. The measurements for GET and CTT with the Atmo Capsule and SmartPill Capsule were strongly correlated (GET, R = 0.74, P < .01; CTT, R = 0.69, P < .01), and their observed biases were within 10% of the delayed transit margin. Both delayed GET (68/177) and CTT (56/147) were identified in 38% of participants, with 84% agreement for identification of both delayed GET (sensitivity 68%, specificity 91%) and CTT (sensitivity 83%, specificity 85%). No serious adverse device effects were reported.</p><p><strong>Conclusions: </strong>The performance characteristics of the Atmo Capsule for measurements of GET and CTT were equivalent to the reference standard WMC with a strong correlation and good device agreement. These results demonstrate that the Atmo Capsule is a valid method for evaluating gastrointestinal transit.</p><p><strong>Clinicaltrials: </strong>gov number, NCT05718505.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Julia L Gauci, Anthony Whitfield, Michael J Bourke","doi":"10.1016/j.cgh.2024.12.012","DOIUrl":"10.1016/j.cgh.2024.12.012","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Clinical Effectiveness of GLP1 Receptor Agonists in Inflammatory Bowel Disease Patients.","authors":"Priya Sehgal, James D Lewis, Octavia Pickett-Blakely, Neilanjan Nandi, Meena Bewtra, Gary R Lichtenstein","doi":"10.1016/j.cgh.2024.12.017","DOIUrl":"10.1016/j.cgh.2024.12.017","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Machine Learning Model Score Predicts Advanced Fibrosis and Cirrhosis in Indeterminate FIB-4 Patients.","authors":"Sebastian Niezen, Timothy R Morgan, Heather M Patton, Jasmohan S Bajaj, Elliot B Tapper, Shari S Rogal","doi":"10.1016/j.cgh.2024.12.020","DOIUrl":"10.1016/j.cgh.2024.12.020","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-17A Inhibitor-induced Pouchitis.","authors":"Hiroki Kiyohara, Yohei Mikami, Takanori Kanai","doi":"10.1016/j.cgh.2024.12.015","DOIUrl":"10.1016/j.cgh.2024.12.015","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of Retrograde Cricopharyngeus Dysfunction Using High Resolution Impedance Manometry and Comparison With Control Subjects.","authors":"Karlien Raymenants, Friedel Vulsteke, Tim Vanuytsel, Nathalie Rommel, Filip Baert, Kathelijne Delsupehe, Alexandre Bohyn, Jan Tack, Joris Arts","doi":"10.1016/j.cgh.2024.12.014","DOIUrl":"10.1016/j.cgh.2024.12.014","url":null,"abstract":"<p><strong>Background & aims: </strong>Retrograde cricopharyngeal dysfunction (R-CPD) or inability to belch has been linked to ineffective relaxation of the upper esophageal sphincter (UES) during gastroesophageal gas reflux, and botulinum toxin (BT) injection into the UES has demonstrated success in case series. However, the diagnosis is often overlooked. High resolution impedance manometry (HRiM) with belch provocation was recently suggested as diagnostic tool. Our aim was to confirm manometric findings in patients with R-CPD before and after BT treatment and to compare with control patients and healthy volunteers.</p><p><strong>Methods: </strong>Retrospective analysis of HRiM with belch provocation was performed between May 2021 and April 2024. Gas reflux episodes were counted and analyzed for UES relaxation, air clearance, air entrapment, or oscillatory movements of air in the esophagus, among others.</p><p><strong>Results: </strong>Fifty-five patients with symptoms suggestive of R-CPD, 30 control patients, and 15 healthy volunteers were included (n = 100). Twenty-nine patients had a repeat measurement after treatment with BT (n = 29). Median esophageal contractility was lower in R-CPD versus control patients and healthy volunteers (distal contractile integral: 146, 577, and 316 mmHg.cm.s, P_adj = .0109). During belching, we saw higher UES pressures in R-CPD patients vs controls, leading to incomplete air clearance and air oscillating in the esophagus (P < .0001). After BT injection, median UES pressures during belching decreased (56 vs 3 mmHg), and air clearance improved (P < .0001). A maximum UES pressure during belching >31 mmHg adequately discriminated patients from controls.</p><p><strong>Conclusions: </strong>Rapid drinking challenge with sparkling water can serve as belch provocation test during HRiM, with higher UES pressures during gas reflux and oscillations discriminating R-CPD patients from controls.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in Female Patients With Chronic Liver Disease Undergoing Infertility Treatment.","authors":"Meera Garriga, Marcelle Cedars, Monika Sarkar","doi":"10.1016/j.cgh.2024.12.019","DOIUrl":"10.1016/j.cgh.2024.12.019","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guarding the Gate: The Sentinel Role of Endosonography in Precluding Unwarranted ERCP.","authors":"Gregory A Coté, Michael L Kochman, Nikhil R Thiruvengadam","doi":"10.1016/j.cgh.2024.12.016","DOIUrl":"10.1016/j.cgh.2024.12.016","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melting the Celiac Iceberg to Improve Outcomes in Celiac Disease: Two Tales of Success.","authors":"Alberto Rubio-Tapia","doi":"10.1016/j.cgh.2024.11.021","DOIUrl":"10.1016/j.cgh.2024.11.021","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse Esophageal Adenocarcinoma.","authors":"Huijie Wu, Xiaolu Lin, Wanyin Deng","doi":"10.1016/j.cgh.2024.12.021","DOIUrl":"https://doi.org/10.1016/j.cgh.2024.12.021","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}