Digestive Diseases最新文献

{"title":"No increased risk of venous thromboembolism or infectious complications after JAK inhibitor exposure in patients with ulcerative colitis undergoing surgery.","authors":"Ine De Greef, Gabriele Bislenghi, Isabelle Terrasson, João Sabino, Marc Ferrante, André D'Hoore, Bram Verstockt, Séverine Vermeire","doi":"10.1159/000544062","DOIUrl":"https://doi.org/10.1159/000544062","url":null,"abstract":"<p><p>Introduction Total colectomy for ulcerative colitis (UC) is associated with postoperative morbidity, including venous thromboembolic events (VTE). In light of recent concerns on increased major adverse events associated with JAK inhibitor exposure, we aimed to evaluate the postoperative VTE risk as well as other complications in UC patients undergoing colectomy. Methods This single-center retrospective cohort study included all UC patients who underwent (procto)colectomy between 2013 and March 2022, and documented the 180-day postoperative non-infectious and infectious complications. Results One hundred seventy-five UC patients (43.4% women, median age 41.0 years) underwent colectomy. Forty-nine patients (28.0%) were operated in an urgent setting. In the twelve weeks prior to surgery, 53 (30.3%) patients had received anti-TNF agents, 40 (22.9%) anti-adhesion therapy, 16 (9.1%) anti-IL12/23 and 34 (19.4%) JAK inhibitors. Preoperatively, 26 patients (14.9%) received moderate to high doses of systemic corticosteroids. All except two patients received prophylactic LMWH postoperatively. During the 180-day postoperative period, 2 patients developed a thrombosis, all incidental findings on abdominal CT scan. No VTE was seen in the patients who underwent colectomy while on JAK inhibitor. Three out of 34 JAK-inhibitor treated patients (8.8%) developed a postoperative infectious complication, while the overall incidence of infectious complications was 17.1%. Conclusion Our findings suggest that the overall VTE risk in UC patients undergoing colectomy is low with adequate antithrombotic prophylaxis. JAK inhibitor use prior to surgery was not linked to increased short-term thromboembolic or infectious complications. However, the limited sample size warrants further study in larger cohorts.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-21"},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathological resection depth in cold snare polypectomy and underwater endoscopic mucosal resection for superficial nonampullary duodenal epithelial tumors.","authors":"Takayuki Nukui, Takaya Shimura, Shingo Inaguma, Naomi Sugimura, Shigeki Fukusada, Ruriko Nishigaki, Yuki Kojima, Takuya Kanno, Makiko Sasaki, Mamoru Tanaka, Keiji Ozeki, Eiji Kubota, Satoru Takahashi, Hiromi Kataoka","doi":"10.1159/000544939","DOIUrl":"https://doi.org/10.1159/000544939","url":null,"abstract":"<p><strong>Introduction: </strong>Cold snare polypectomy (CSP) and underwater endoscopic mucosal resection (UEMR) are used for small superficial nonampullary duodenal epithelial tumors (SNADETs). This study aimed to compare the resection depth of SNADETs removed by CSP versus UEMR.</p><p><strong>Methods: </strong>Data from SNADETs resected with CSP or UEMR between April 2018 and July 2023 at Nagoya City University Hospital were collected retrospectively. An independent pathologist, blinded to clinical information, evaluated the resected specimens and categorized resection depth into four groups: M (mucosa only), iMM (incomplete muscularis mucosae with defects), cMM (complete muscularis mucosae without submucosa), and SM (complete muscularis mucosae with submucosa).</p><p><strong>Results: </strong>Among 109 SNADETs, 78 were resected with CSP and 31 with UEMR. The percentages of M, iMM, cMM, and SM for CSP were 23.1%, 50.0%, 5.1%, and 21.8%, respectively, while for UEMR they were 0%, 6.5%, 6.5%, and 87.1%. The UEMR group had a higher SM resection rate and significantly greater median submucosal depth than the CSP group (783 μm [range, 0-2220] vs. 0 μm [range, 0-1226]; P < 0.001). On the multivariate analysis, UEMR was an independent and significant factor for achieving SM resection.</p><p><strong>Conclusion: </strong>UEMR achieved a significantly higher SM resection rate than CSP for all types of SNADETs. Clinically diagnosed duodenal high-grade dysplasia and adenocarcinoma should be treated with UEMR rather than CSP.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-16"},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic ability of magnifying endoscopy compared to biopsy examination for early gastric cancer prior to endoscopic submucosal dissection.","authors":"Takuma Yoshida, Osamu Dohi, Mayuko Seya, Katsuma Yamauchi, Hayato Fukui, Hajime Miyazaki, Takeshi Yasuda, Tsugitaka Ishida, Naoto Iwai, Toshifumi Doi, Ryohei Hirose, Ken Inoue, Naohisa Yoshida, Kazuhiko Uchiyama, Takeshi Ishikawa, Tomohisa Takagi, Hideyuki Konishi, Yukiko Morinaga, Mitsuo Kishimoto, Yoshito Itoh","doi":"10.1159/000544045","DOIUrl":"https://doi.org/10.1159/000544045","url":null,"abstract":"<p><p>Background Biopsy-specimen examination is the gold standard for the preoperative histological diagnosis of early gastric cancer (EGC). However, few studies have compared the diagnostic accuracies of biopsy and magnifying endoscopy with narrow-band imaging or blue laser imaging (ME-NBI/BLI). Thus, we compared the diagnostic accuracy of biopsy specimens and ME-NBI/BLI to evaluate whether ME-NBI/BLI is a feasible preoperative diagnostic tool for EGC. Methods This retrospective single-center study enrolled 185 patients who underwent gastric endoscopic submucosal dissection (ESD) between January and December 2018. The sensitivity and positive predictive value (PPV) of the histological diagnosis of ME-NBI/BLI and biopsy were evaluated. Logistic regression analysis was used to assess the risk factors for the misdiagnosis of biopsy specimens and ME-NBI/BLI. Results In total, 158 patients with EGC were analyzed. Sensitivities of biopsy and ME-NBI/BLI were 1 and 0 for adenomas (P = 0.333), 0.693 and 0.971 for differentiated adenocarcinomas (P < 0.001), and 0.688 and 0.625 for undifferentiated adenocarcinomas (P > 0.999), respectively. PPVs of biopsy and ME-NBI/BLI were 0.077 and 0 for adenomas (P > 0.999), 0.960 and 0.958 for differentiated adenocarcinomas (P > 0.999), and 0.750 and 0.750 for undifferentiated adenocarcinomas (P > 0.999), respectively. The underdiagnosis rate for differentiated adenocarcinomas was significantly higher in biopsy examination than in ME-NBI/BLI (27.9% vs. 0%, respectively, P < 0.001). Conclusion ME-NBI/BLI had a higher sensitivity than biopsy examination for the preoperative diagnosis of differentiated adenocarcinomas. Therefore, performing ME-NBI/BLI for these lesions may be preferable regardless of their diagnosis as non-cancerous lesions from biopsy specimens.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-19"},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiome dysbiosis and inflammatory bowel disease complement each other.","authors":"Huan Zhang, Jingrong Xiang, Jie Feng, Mengting Zhang, Qinhua Xi","doi":"10.1159/000544771","DOIUrl":"https://doi.org/10.1159/000544771","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract. The worldwide increase in the incidence of IBD imposes a significant economic burden on patients and communities. Recently, numerous studies have shown that disruption of the balance between the host and microbes, known as dysbiosis, is strongly associated with the development of IBD.</p><p><strong>Summary: </strong>Dysbiosis can be influenced by diet, lifestyle rhythms, hygiene conditions, drugs, and the inflammatory state of IBD patients. In the microbiome microenvironment, dysbiosis can be influenced by the microbiome and metabolites. Gut microbiome dysbiosis in IBD patients can play a proinflammatory role by disrupting the intestinal barrier and modulating the immune system, leading to the worsening or recurrence of IBD. In future studies, the mechanisms of dysbiosis in IBD and its influencing factors should be investigated from a more macroscopic perspective to propose new valuable diagnostic and therapeutic approaches.</p><p><strong>Key messages: </strong>Gut microbiome dysbiosis can lead to the development of inflammatory bowel disease, and inflammatory bowel disease can in turn exacerbate gut microbiome dysbiosis, creating a vicious cycle.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-18"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HBV relapse after discontinuation of Tenofovir alafenamide or Entecavir in non-cirrhotic HBeAg-negative patients.","authors":"Yi-Jie Huang, Shou-Wu Lee, Chun-Fang Tung, Szu-Chia Liao, Teng-Yu Lee, Yen-Chun Peng, Chung-Hsin Chang, Jun-Sing Wang","doi":"10.1159/000544870","DOIUrl":"https://doi.org/10.1159/000544870","url":null,"abstract":"<p><p>Background &amp; Aims: This study investigated the off-therapy relapse in hepatitis B e antigen (HBeAg)-negative non-cirrhotic patients who discontinued tenofovir alafenamide (TAF) or entecavir (ETV).</p><p><strong>Methods: </strong>Non-cirrhotic HBeAg-negative patients who discontinued TAF or ETV were enrolled. The propensity score -matching method at a ratio of 1:1 and Cox proportional hazard model were performed to analyze factors associated with virological relapse and clinical relapse.</p><p><strong>Results: </strong>A total of 62 patients were analyzed. The cumulative rates of virological relapse at 12-month after discontinuing TAF and ETV were 80.4% and 60.0%, respectively. The respective rates of clinical relapse at 12-month were 48.7% and 21.1%. Multivariable Cox regression analysis showed that discontinuation of TAF (vs ETV, HR=2.279; p=0.005) and HBsAg levels at EOT (HR=1.540; p=0.005) were independently associated with virological relapse. Discontinuation of TAF (vs ETV, HR=3.003; p=0.011) was independently associated with clinical relapse. HBsAg levels at EOT (<3 vs. ≥ 3 log10 IU/ml) had significant interactions with the treatment regimen (TAF vs ETV) in terms of the risk of clinical relapse after treatment cessation (p for interaction <0.05).</p><p><strong>Conclusions: </strong>Patients who discontinued TAF had a higher risk of virological relapse and clinical relapse than those who discontinued ETV. HBsAg levels at EOT may be an appropriate predictor to distinguish the different risks of clinical relapse between patients who have discontinued TAF or ETV.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-15"},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STW 5-II FOR TREATMENT OF FUNCTIONAL GASTROINTESTINAL DISORDERS: MECHANISM AND CLINICAL EFFICACY.","authors":"Antonio Tursi, Beatrice Marinoni, Antonino Carlo Privitera, Lorenzo Privitera, Silvio Danese","doi":"10.1159/000544695","DOIUrl":"https://doi.org/10.1159/000544695","url":null,"abstract":"<p><strong>Background: </strong>Functional Dyspepsia (FD) is currently defined as episodic or recurrent epigastric pain or discomfort in the absence of organic diseases, lasting at least four weeks. FD is estimated to affect 7.2% of the worldwide population. Due to the underlying complex pathogenetic mechanisms, the therapy for FD is generally prescribed to treat the main symptoms experienced by the patient.</p><p><strong>Summary: </strong>Recently, a new herbal formulation has been proposed for treating FD. This plant-based preparation, called STW 5-II, is a fixed combination of six hydroethanolic herbal extracts from bitter candy tuft, peppermint leaf, chamomile flower, licorice root, caraway fruit, and melissa leaf. STW 5-II has been shown to be more effective than placebo in several controlled studies and clinical scenarios, allowing for its recent introduction into several European markets.</p><p><strong>Key messages: </strong>This review aims to describe the mechanisms of action of this herbal drug, its current and potential clinical indications, and to explore future perspectives for its use.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-11"},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Ultrasound - measurements and normal findings. What do you need to know?","authors":"Kathleen Möller, Pascal Fischer, Odd Helge Gilja, Heike Gottschall, Christian Jenssen, Alois Hollerweger, Claudia Lucius, Jennifer Meier, Gerhard Rogler, Benjamin Misselwitz, Christoph F Dietrich","doi":"10.1159/000544043","DOIUrl":"https://doi.org/10.1159/000544043","url":null,"abstract":"<p><strong>Background: </strong>A standardized examination procedure and correct bowel wall assessment are the prerequisites for correct findings and for distinguishing normal findings from pathological diagnoses. PubMed was searched for the time period from January 01, 1990 - March 29, 2024, using a Boolean search Summary: The present work provides knowledge and details of the examination of the gastrointestinal tract in transcutaneous ultrasound with examination procedure, transducer selection, transducer guidance, knowledge of the identification of anatomical structures and sonographic assessment. The sonographic reference values for the gastrointestinal tract were researched, compiled, and interpreted. In addition, citations and references of eligible studies were searched to identify further studies for inclusion.</p><p><strong>Key messages: </strong>Knowledge of the sonographic appearance of the gastrointestinal tract and the standardized examination of the healthy gastrointestinal tract, including correct measurements, must be trained. Although age, body weight and food ingestion influence the thickness of the intestinal wall, it does not normally exceed 2 mm in the duodenum, jejunum, ileum and colon on US. However, in most clinical studies 3 mm was used as cut-off for pathology. When assessing the appendix, an outer diameter of < 6 mm is considered normal. However, an increase in this diameter may also occur in healthy, asymptomatic people and should be not used as the sole criterion for diagnosing appendicitis. GIUS is now established as valid clinical method to assess patients with digestive diseases. Accordingly, there is a great need for training opportunities and supervision of young doctors who want to enhance their knowledge and skills in GIUS.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-95"},"PeriodicalIF":2.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helicobacter pylori infection and metabolic-dysfunction-associated steatotic liver disease.","authors":"Stergios A Polyzos, Nikoletta Pyrrou, Jannis Kountouras","doi":"10.1159/000544122","DOIUrl":"https://doi.org/10.1159/000544122","url":null,"abstract":"","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding the Gut-Brain Axis: A Journey Towards Targeted Interventions for Disorders-of-Gut-Brain Interaction.","authors":"Gerald Holtmann, M D Moniruzzaman, Ayesha Shah","doi":"10.1159/000543845","DOIUrl":"https://doi.org/10.1159/000543845","url":null,"abstract":"<p><strong>Background: </strong>The gut-brain axis is a bidirectional communication pathway connecting the gastrointestinal tract and the brain. Disorders of Gut-Brain Interaction (DGBI) manifest as highly prevalent gastrointestinal disorders such as irritable bowel syndrome (IBS) or Functional Dyspepsia (FD).</p><p><strong>Summary: </strong>The initial focus of DGBI research was on the effects of psychological stress on digestive functions like gastrointestinal motility, or secretion of gastric acid and pancreatic enzymes. Concepts related to DGBI have expanded in recent decades. Activation of mucosal or systemic immune functions has been observed in DGBI, and it is established that the gastrointestinal microbiome can alter mucosal integrity and permeability, leading to proinflammatory cytokine release that affects brain function. Pharmacologic treatments (e.g., tricyclic antidepressants), and non-pharmacologic interventions (e.g., cognitive behavioral therapy), are now standard for DGBI patients. Advances in culture-independent methods to study gastrointestinal microbes reveal new insights into DGBI and gut microbiota appear to play a crucial role in modulating the gut-brain axis and regulating various bodily functions.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-14"},"PeriodicalIF":2.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Useful Bowel Preparation with Ultralow-Volume (500 mL) Polyethylene Glycol for Colonoscopy: A Retrospective Study.","authors":"Yusuke Mizuno, Takaya Shimura, Takayuki Nukui, Konomu Uno, Ruriko Nishigaki, Yuki Kojima, Takuya Kanno, Makiko Sasaki, Shigeki Fukusada, Naomi Sugimura, Mamoru Tanaka, Keiji Ozeki, Eiji Kubota, Hiromi Kataoka","doi":"10.1159/000543858","DOIUrl":"10.1159/000543858","url":null,"abstract":"<p><strong>Introduction: </strong>Adequate bowel preparation is indispensable for high-quality colonoscopy. We have developed an ultralow-volume (500 mL) polyethylene glycol (PEG) combined with other laxatives (sennoside, sodium picosulfate, and lactulose) and applied this regimen clinically to all patients with colonoscopy for 3 decades. This study aimed to assess the effectiveness of this ultralow-volume bowel preparation regimen.</p><p><strong>Methods: </strong>This single-center, retrospective study analyzed data from consecutive outpatients who underwent colonoscopy between January 2022 and December 2022. All the patients took sennoside (24 mg) two nights before, sodium picosulfate (75 mg) one night before, and 500 mL of PEG with lactulose (58.5 g) on the day of examination. Cleaning efficacy was evaluated using the Boston Bowel Preparation Scale (BBPS). Adequate bowel preparation was defined as a total BBPS score ≥6, with all colon segments scoring ≥2.</p><p><strong>Results: </strong>Out of 862 patients with colonoscopy, 773 were eligible for this study, and the median age was 66 years. The adequate bowel preparation rate was 91.8% (710/773). Notably, the BBPS full score \"9\" was observed in 50.5% (390/773). The median cecal intubation time and examination time were 8 and 20 min, respectively. Only 3 patients vomited as a side effect. In the multivariate analysis, age ≥70 years, diabetes mellitus, and diverticula were significantly independent risk factors for inadequate bowel preparation.</p><p><strong>Conclusions: </strong>Our established ultralow-volume (500 mL) PEG is safe and useful as a bowel preparation method.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}