Digestive Diseases最新文献

{"title":"Metachronous Multiple Gastric Cancer Discovered as Endoscopic Curability C2 during Regular Follow-Up after Gastric Endoscopic Submucosal Dissection.","authors":"Kosuke Nomura,&nbsp;Shu Hoteya,&nbsp;Daisuke Kikuchi,&nbsp;Yusuke Kawai,&nbsp;Yorinari Ochiai,&nbsp;Takayuki Okamura,&nbsp;Yugo Suzuki,&nbsp;Junnosuke Hayasaka,&nbsp;Yutaka Mitsunaga,&nbsp;Masami Tanaka,&nbsp;Kazuhiro Fuchinoue,&nbsp;Hiroyuki Odagiri,&nbsp;Satoshi Yamashita,&nbsp;Akira Matsui","doi":"10.1159/000531002","DOIUrl":"https://doi.org/10.1159/000531002","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to clarify characteristics of metachronous endoscopic curability C2 (eCura C2) cancer during post-endoscopic submucosal dissection (ESD) follow-up.</p><p><strong>Methods: </strong>Of 4,355 gastric lesions treated by ESD at our hospital during 2005-2021, 657 were metachronous. After excluding lesions found ≥2 years since the prior examination or in the gastric remnant, the remaining 515 were analyzed. Study 1: We compared 35 eCura C2 cancers and 480 eCura A-C1 cancers. Study 2: Endoscopic findings of the 35 lesions were examined to determine why they had been missed.</p><p><strong>Results: </strong>Mean tumor size was larger (34.0 mm vs. 12.1 mm, p &lt; 0.01) and the proportions of mixed-type and poorly differentiated cancers were higher (highly:mixed:poorly, 34.3:57.1:8.6 vs. 94.2:5.0:0.8, p &lt; 0.01) in the eCura C2 group. Study 2: At the prior examination, 4 lesions were noticed but considered benign, 2 lacked sufficient imaging, 19 were detectable on imaging but missed, and 10 were not detectable on imaging. Over half the lesions that were detectable but missed at the prior examination were in the lesser curvature, many being type IIa-IIb lesions with color similar to the background mucosa. All lesions not detectable on imaging at the prior examination were mixed-type or poorly differentiated type.</p><p><strong>Discussion: </strong>Metachronous cancer detected as eCura C2 cancers was significantly larger, and a significantly higher proportion was mixed-type or poorly differentiated cancers, compared with eCura A-C1 cancers. Possible reasons why these lesions were missed include rapid progression of mixed-type and poorly differentiated cancers, and poor recognition that lesions showing only slight color changes may be present at the lesser curvature.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 5","pages":"810-818"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10160338","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":"Global Epidemiology of Cirrhosis: Changing Etiological Basis and Comparable Burden of Nonalcoholic Steatohepatitis between Males and Females.","authors":"Darren Tan, Kai En Chan, Zhen Yu Wong, Cheng Han Ng, Jieling Xiao, Wen Hui Lim, Phoebe Tay, Ansel Tang, Clarissa Elysia Fu, Mark Muthiah, Benjamin Nah, Eunice X Tan, Margaret L P Teng, Mohammad Shadab Siddiqui, Yock Young Dan, Seng Gee Lim, Rohit Loomba, Daniel Q Huang","doi":"10.1159/000533946","DOIUrl":"10.1159/000533946","url":null,"abstract":"<p><strong>Introduction: </strong>The etiology of liver diseases has changed significantly, but its impact on the comparative burden of cirrhosis between males and females is unclear. We estimated sex differences in the burden of cirrhosis across 204 countries and territories from 2010 to 2019.</p><p><strong>Methods: </strong>We analyzed temporal trends in the burden of cirrhosis using the methodology framework of the 2019 Global Burden of Disease study. We estimated annual frequencies and age-standardized rates (ASRs) of cirrhosis incidence, death, and disability-adjusted life-years (DALYs) by sex, region, country, and etiology.</p><p><strong>Results: </strong>In 2019, the frequency of incident cases, deaths, and DALYs due to cirrhosis was 1,206,125, 969,068, and 31,781,079 in males versus 845,429, 502,944, and 14,408,336 in females, respectively. From 2010 to 2019, the frequency of cirrhosis deaths increased by 9% in males and 12% in females. Incidence ASRs remained stable in males but increased in females, while death ASRs declined in both. Death ASRs for both sexes declined in all regions, except in the Americas where they remained stable. In 2019, alcohol was the leading cause of cirrhosis deaths in males, and hepatitis C in females. Death ASRs declined for all etiologies in both sexes, except in nonalcoholic steatohepatitis (NASH). The ratio of female-to-male incidence ASRs in 2019 was lowest in alcohol(0.5), and highest in NASH(1.3), while the ratio of female-to-male death ASRs was lowest in alcohol(0.3) and highest in NASH(0.8).</p><p><strong>Conclusion: </strong>The global burden of cirrhosis is higher in males. However, incidence and death ASRs from NASH cirrhosis in females are comparable to that of males.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"900-912"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10234385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Water-Assisted Colonoscopy without Sedation in Patients with Ulcerative Colitis.","authors":"Haitao Shi,&nbsp;Hong Zeng,&nbsp;Mei Wang,&nbsp;Jiong Jiang,&nbsp;Sumei Sha,&nbsp;Fenrong Chen,&nbsp;Yan Wang,&nbsp;Yan Cheng,&nbsp;Shiyang Ma,&nbsp;Xin Liu","doi":"10.1159/000531652","DOIUrl":"https://doi.org/10.1159/000531652","url":null,"abstract":"<p><strong>Background: </strong>Studies have found that water-assisted colonoscopy (WAC) including water immersion colonoscopy (WIC) and water exchange colonoscopy (WEC) is superior to air insufflation colonoscopy (AIC) in terms of the cecal intubation rate. However, the application of WAC in ulcerative colitis (UC) has rarely been reported. This study aimed to explore the effectiveness of WAC without sedation in patients with UC.</p><p><strong>Methods: </strong>One hundred and seventy-two UC patients were randomly divided into the AIC group (n = 56), WIC group (n = 58), and WEC group (n = 58). The cecal intubation rate, abdominal pain score, operator difficulty, bowel cleanliness, insertion, and total time were compared.</p><p><strong>Results: </strong>The cecal intubation rate was higher in the WIC (91.4% vs. 75.0%; mean difference = 16.4%; 95% CI: 3.0-29.8%) and WEC (93.1% vs. 75.0%; mean difference = 18.1%; 95% CI: 5.0-31.2%) compared to the AIC group, while there was no difference between the WIC and WEC groups. The abdominal pain score and operator difficulty were lower in the WIC and WEC groups than in the AIC group, while there was no difference between the WIC and WEC groups. The bowel cleanliness during withdrawal was higher in the WIC and WEC groups than in the AIC group, while the WEC was superior to WIC. Compared with the AIC and WIC groups, the insertion time and total time were longer in the WEC group, and there was no difference in the AIC group and WIC group.</p><p><strong>Conclusion: </strong>In comparison with AIC, WAC can increase the cecal intubation rate, reduce abdominal pain scores and improve bowel cleanliness in patients with UC.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 5","pages":"737-745"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214018","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":"The Role of Fecal Microbiota Transplantation in the Induction of Remission in Ulcerative Colitis.","authors":"Adam Saleh,&nbsp;Shyon Parsa,&nbsp;Manuel Garza,&nbsp;Eamonn M M Quigley,&nbsp;Bincy P Abraham","doi":"10.1159/000529591","DOIUrl":"https://doi.org/10.1159/000529591","url":null,"abstract":"<p><strong>Background: </strong>Considerable research supports an important role for the microbiome and/or microbiome-host immune system interactions in the pathogenesis of inflammatory bowel disease (IBD). Consequently, microbiota-modulating interventions, such as fecal microbiota transplantation (FMT), have attracted interest in the management of IBD, including ulcerative colitis (UC).</p><p><strong>Summary: </strong>While the clinical response to FMT in UC has varied between different studies, results to date may offer guidance toward optimal use of FMT. Thus, increased microbiome biodiversity, the presence of short-chain fatty acid-producing bacteria, Clostridium clusters IV and XIVa, Odoribacter splanchnicus, and reduced levels of Caudovirales bacteriophages have been identified as characteristics of the donor microbiome that predict a positive response. However, inconsistency in FMT protocol between studies confounds their interpretation, so it is currently difficult to predict response and premature to recommend FMT, in general, as a treatment for UC. Additional randomized controlled trials designed based on previous findings and employing a standardized protocol are needed to define the role of FMT in the management of UC.</p><p><strong>Key messages: </strong>There is a well-developed rationale for the use of microbiome-modulating interventions in UC. Despite variations in study protocol and limitations in study design that confound their interpretation, FMT seems to benefit patients with UC, overall. Available data identify factors predicting FMT response and should lead to the development of optimal FMT study protocols.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 4","pages":"656-665"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9809427","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":"Early MOnitoring of REsponse (MORE) to Golimumab Therapy: Results of a Multicentre, Prospective Observational Trial.","authors":"Ulf Helwig,&nbsp;Thomas Helmut Krause,&nbsp;Christian Maaser,&nbsp;Jürgen Büning,&nbsp;Attyla Drabik,&nbsp;Margit Blömacher,&nbsp;Sandra Plachta-Danielzik,&nbsp;Niels Teich,&nbsp;Annette Krummenerl,&nbsp;Andreas Sturm,&nbsp;Matthias Schwab,&nbsp;Stefan Schreiber","doi":"10.1159/000527460","DOIUrl":"https://doi.org/10.1159/000527460","url":null,"abstract":"<p><strong>Background: </strong>The therapeutic goal of clinical remission in patients with moderate to severe ulcerative colitis (UC) is achieved after biological therapy only in 16-39%. Individualization of therapeutic intervention would benefit from prediction of early response.</p><p><strong>Study objective: </strong>The primary objective of our study was to assess golimumab (GLM) trough serum level of ≥2.5 μg/mL in combination with a reduction of faecal calprotectin (FC) of ≥50% at week 6 compared to baseline to predict clinical response at week 26 after regular GLM intake.</p><p><strong>Methods: </strong>Patients with moderate to severe active UC and planned GLM treatment were recruited for a prospective, multicentre, observational study in Germany. Prediction of clinical response was assessed by FC and GLM trough level. Missing data were imputed as therapy failure according to the last observation carried forward method.</p><p><strong>Results: </strong>Fifty nine patients have been enrolled. 54% of patients were anti-TNF naïve. Clinical response at week 6 was a significant predictor for achieving clinical response at week 26 (odds ratio [OR] 10.97, confidence interval [CI], 2.96-40.68; p < 0.001). Moreover, patients with a GLM trough level of ≥2.5 μg/mL and a ≥50% reduction of FC at week 6 had an OR of 5.33 (95% CI, 0.59-47.84) to achieve clinical response at week 26.</p><p><strong>Conclusion: </strong>Clinical response at week 6 is the best predictive marker for achieving clinical response at week 26. Consideration of significant reduction of FC and trough GLM serum levels could improve prediction of response.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 2","pages":"239-249"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10835317","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":"Influence of Artificial Intelligence on the Adenoma Detection Rate throughout the Day.","authors":"Rino Richter, Johannes Bruns, Wilfried Obst, Verena Keitel-Anselmino, Jochen Weigt","doi":"10.1159/000528163","DOIUrl":"10.1159/000528163","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence systems recently demonstrated an increase in polyp and adenoma detection rate. Over the daytime, the adenoma detection rate decreases as tiredness leads to a lack of attention. It is not clear if a polyp detection system with artificial intelligence leads to constant adenoma detection over the day.</p><p><strong>Methods: </strong>We performed a database analysis of screening and surveillance colonoscopies with and without the use of AI. In both groups, patients were investigated with the same endoscopy equipment and by the same endoscopists. Only patients with good bowel preparation (BBPS &gt;6) were included. We correlated the daytime, the investigational time, day of the week, and the adenoma and polyp detection.</p><p><strong>Results: </strong>A total of 303 colonoscopies were analyzed. 163 endoscopies in the AI+ group and 140 procedures in the AI- group were included. In both groups, the total adenoma detection rate was equal (AI+ 0.39 vs. AI- 0.43). The adenoma detection rate throughout the day had a significant decreasing trend in the group without the use of AI (p = 0.015), whereas this trend was not present in the investigations that have been performed with AI (p = 0.65). The duration of investigation did not show a significant difference between the groups (8.9 min in both groups). No relevant effect was noticed in adenoma detection between single days of the working week with or without the use of AI.</p><p><strong>Conclusion: </strong>AI helps overcome the decay in adenoma detection over the daytime. This may be attributed to a constant awareness caused by the use of the AI system.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 4","pages":"615-619"},"PeriodicalIF":2.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9743401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Accuracy of a Simplified, Practical Algorithm in Differentiating Crohn's Disease from Intestinal Tuberculosis.","authors":"Ida Normiha Hilmi,&nbsp;Nik Arsyad Nik Muhammad Affendi,&nbsp;Shahreedhan Shahrani,&nbsp;Abdul Malik Thalha,&nbsp;Hwong-Ruey Leow,&nbsp;Xin-Hui Khoo","doi":"10.1159/000529238","DOIUrl":"https://doi.org/10.1159/000529238","url":null,"abstract":"<p><strong>Background: </strong>The differentiation between intestinal tuberculosis (ITB) and Crohn's disease (CD) remains a challenge, particularly in areas where tuberculosis is highly prevalent. Previous studies have identified features that favour one diagnosis over the other. The aim of the study was to determine the accuracy of a standardized protocol in the initial diagnosis of CD versus ITB.</p><p><strong>Methods: </strong>All patients with suspected ITB or CD were prospectively recruited. A standardized protocol was applied, and the diagnosis was made accordingly. The protocol consists of history and examination, ileocolonoscopy with biopsies, and tuberculosis workup. The diagnosis of probable ITB was made based on at least one positive finding. All other patients were diagnosed as probable CD. Patients were treated either with anti-tubercular therapy or steroids. Reassessment was then carried out clinically, biochemically, and endoscopically. In patients with suboptimal response, the treatment was either switched or escalated depending on the reassessment.</p><p><strong>Results: </strong>164 patients were recruited with final diagnosis of 30 (18.3%) ITB and 134 (81.7%) CD. 1 (3.3%) out of 30 patients with ITB was initially treated as CD. 16 (11.9%) out of 134 patients with CD were initially treated as ITB. The initial overall accuracy for the protocol was 147/164 (89.6%). All patients received the correct diagnosis by 12 weeks after reassessment.</p><p><strong>Conclusion: </strong>In our population, most patients had CD rather than ITB. The standardized protocol had a high accuracy in differentiating CD from ITB.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 4","pages":"581-588"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9753733","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":"Endoscopic Ultrasound Gastro-Enteroanastomosis for Benign Gastric Outlet Obstruction due to Large Duodenal Diverticula.","authors":"Francesco Auriemma,&nbsp;Alessandro De Marco,&nbsp;Alessandro Repici,&nbsp;Benedetto Mangiavillano","doi":"10.1159/000528885","DOIUrl":"https://doi.org/10.1159/000528885","url":null,"abstract":"<p><p>Gastric outlet obstruction is a condition characterized by inadequate gastric emptying due to benign or malignant conditions inducing an inadequate oral intake. In recent years, a novel therapeutic treatment for this condition is given by the use of electrocautery lumen-apposing metal stents. In this case report, we want to present an example of a benign condition treated by endoscopic ultrasound-guided gastroenterostomy with the bi-flanged SpaxusTM stent (Taewoong Medical Co.) mounted on electrocautery catheter.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 5","pages":"819-821"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10159274","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":"Quality Assessment of Ultrasound and Magnetic Resonance Imaging for Hepatocellular Carcinoma Surveillance: A Systematic Review and Meta-Analysis.","authors":"Jingxuan Quek,&nbsp;Darren Jun Hao Tan,&nbsp;Kai En Chan,&nbsp;Wen Hui Lim,&nbsp;Cheng Han Ng,&nbsp;Yi Ping Ren,&nbsp;Teng Kiat Koh,&nbsp;Readon Teh,&nbsp;Jieling Xiao,&nbsp;Clarissa Fu,&nbsp;Nicholas Syn,&nbsp;Margaret Teng,&nbsp;Mark Muthiah,&nbsp;Kathryn Fowler,&nbsp;Claude B Sirlin,&nbsp;Rohit Loomba,&nbsp;Daniel Q Huang","doi":"10.1159/000531016","DOIUrl":"https://doi.org/10.1159/000531016","url":null,"abstract":"<p><strong>Introduction: </strong>To achieve early detection and curative treatment options, surveillance imaging for hepatocellular carcinoma (HCC) must remain of quality and without substantial limitations in liver visualization. However, the prevalence of limited liver visualization during HCC surveillance imaging has not been systematically assessed. Utilizing a systematic review and meta-analytic approach, we aimed to determine the prevalence of limited liver visualization during HCC surveillance imaging.</p><p><strong>Methods: </strong>MEDLINE and Embase electronic databases were searched to identify published data on liver visualization limitations of HCC surveillance imaging. An analysis of proportions was pooled using a generalized linear mixed model with Clopper-Pearson intervals. Risk factors were analysed using a generalized mixed model with a logit link and inverse variance weightage.</p><p><strong>Results: </strong>Of 683 records, 10 studies (7,131 patients) met inclusion criteria. Seven studies provided data on liver visualization limitations on ultrasound (US) surveillance exams: prevalence of limited liver visualization was 48.9% (95% CI: 23.5-74.9%) in the overall analysis and 59.2% (95% CI: 24.2-86.9%) in a sensitivity analysis for cirrhotic patients. Meta-regression determined that non-alcoholic fatty liver disease was associated with limited liver visualization on US. Four studies provided data for liver visualization limitations in abbreviated magnetic resonance imaging (aMRI), with inadequate visualization ranging from 5.8% to 19.0%. One study provided data for complete MRI and none for computed tomography.</p><p><strong>Conclusion: </strong>A substantial proportion of US exams performed for HCC surveillance provide limited liver visualization, especially in cirrhosis, which may hinder detection of small observations. Alternative surveillance strategies including aMRI may be appropriate for patients with limited US visualization.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 5","pages":"757-766"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10159864","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":"Significant Differences in IBD Care and Education across Europe: Results of the Pan-European VIPER Survey.","authors":"Jan Kral,&nbsp;Radislav Nakov,&nbsp;Vera Lanska,&nbsp;Brigida Barberio,&nbsp;Nicolas Benech,&nbsp;Andreas Blesl,&nbsp;Eduard Brunet,&nbsp;Tiago Capela,&nbsp;Lauranne Derikx,&nbsp;Gabriele Dragoni,&nbsp;Aileen Eek,&nbsp;Catarina Frias-Gomes,&nbsp;Georgiana-Emmanuela Gîlcă-Blanariu,&nbsp;Leah Gilroy,&nbsp;Philip Harvey,&nbsp;Anna Kagramanova,&nbsp;Haluk Kani,&nbsp;Tom Konikoff,&nbsp;Matthias Lessing,&nbsp;Gorm Madsen,&nbsp;Vaidota Maksimaityte,&nbsp;Maria Miasnikova,&nbsp;Ivana Mikolašević,&nbsp;Vladimir Milivojevic,&nbsp;Daniele Noviello,&nbsp;Dmytro Oliinyk,&nbsp;Arpad Patai,&nbsp;Anthea Pisani,&nbsp;Adonis Protopapas,&nbsp;Iago Rodríguez-Lago,&nbsp;Philipp Schreiner,&nbsp;Vita Skuja,&nbsp;Florian Tran,&nbsp;Marie Truyens,&nbsp;Marcin Włodarczyk,&nbsp;Hubert Zatorski,&nbsp;Bram Verstockt,&nbsp;Jonathan Philip Segal","doi":"10.1159/000528070","DOIUrl":"https://doi.org/10.1159/000528070","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) care and education might differ around Europe. Therefore, we conducted this European Variation In IBD PracticE suRvey (VIPER) to investigate potential differences between countries.</p><p><strong>Methods: </strong>This trainee-initiated survey, run through SurveyMonkey®, consisted of 47 questions inquiring basic demographics, IBD training, and clinical care. Results were compared according to gross domestic product (GDP) per capita, for which countries were divided into 2 groups (low/high income, according to the World Bank).</p><p><strong>Results: </strong>The online survey was completed by 1,285 participants from 40 European countries, with a majority of specialists (65.3%) working in academic institutions (50.4%). Significant differences in IBD-specific training (55.9% vs. 38.4%), as well as availability of IBD units (58.4% vs. 39.7%) and multidisciplinary meetings (73.2% vs. 40.1%), were observed between respondees from high and low GDP countries (p < 0.0001). In high GDP countries, IBD nurses are more common (85.9% vs. 36.0%), also mirrored by more nurse-led IBD clinics (40.6% vs. 13.7%; p < 0.0001). IBD dieticians (33.4% vs. 16.5%) and psychologists (16.8% vs. 7.5%) are mainly present in high GDP countries (p < 0.0001). In the current COVID era, telemedicine is available in 73.2% versus 54.1% of the high/low GDP countries, respectively (p < 0.0001). Treat-to-target approaches are implemented everywhere (85.0%), though access to biologicals and small molecules differs significantly.</p><p><strong>Conclusion: </strong>Much variability in IBD practice exists across Europe, with marked differences between high and low GDP countries. Further work is required to help address some of these inequalities, aiming to improve and standardize IBD care and training across Europe.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 3","pages":"387-395"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9549267","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}