Digestion最新文献

{"title":"Endoscopic treatment of achalasia.","authors":"Gonzalo Latorre, Robert Bechara","doi":"10.1159/000546490","DOIUrl":"https://doi.org/10.1159/000546490","url":null,"abstract":"<p><strong>Background: </strong>Achalasia is the most common major esophageal motility disorder, characterized by impaired lower esophageal sphincter (LES) relaxation and absent or ineffective peristalsis. Peroral endoscopic myotomy (POEM), pneumatic dilation (PD), and botulinum toxin injection (BTI) are the main endoscopic therapies available. This review highlights recent advances, technical variations, and updated evidence on the efficacy and safety of POEM.</p><p><strong>Summary: </strong>POEM has emerged as a highly effective and minimally invasive treatment for achalasia, with randomized controlled trials demonstrating excellent long-term clinical success and durability. Its safety profile and capacity for a tailored myotomy offer distinct advantages over alternative therapies. However, gastroesophageal reflux disease (GERD) remains a key concern. Ongoing efforts are focused on optimizing procedural techniques, including myotomy length and orientation, sling fiber preservation, and the addition of fundoplication. Additionally, training protocols, patient selection criteria, and strategies to prevent and predict GERD are critical areas of development. Future research should aim to refine follow-up strategies and define objective measures of success to enhance the safety, efficacy, and accessibility of POEM.</p><p><strong>Key messages: </strong>Endoscopic treatments of achalasia, particularly POEM, offer effective and durable outcomes. Optimizing technique, refining training, and managing GERD are essential for improving safety and long-term success.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-25"},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steatotic Liver Disease Subtypes and their Association with Colorectal Cancer Risk in Korea: A Nationwide Population-Based Study.","authors":"Sang Yi Moon, Minkook Son, Jong Yoon Lee, Yeo Wool Kang, Myeongseok Koh","doi":"10.1159/000546376","DOIUrl":"https://doi.org/10.1159/000546376","url":null,"abstract":"<p><strong>Background: </strong>A recent Delphi consensus proposed a new classification system for steatotic liver disease (SLD), replacing the previous terminology, non-alcoholic fatty liver disease (NAFLD). This study aimed to examine the association between SLD subtypes and the risk of developing colorectal cancer (CRC).</p><p><strong>Methods: </strong>We used the Korean National Health Insurance Service database to identify participants who underwent health screenings in 2009 and 2010 and retrospectively analysed their data through to 2019. The participants were grouped into four categories: no SLD, metabolic dysfunction-associated steatotic liver disease (MASLD), MASLD with increased alcohol intake (MetALD), and alcohol-related liver disease (ALD). Hepatic steatosis was defined as a fatty liver index ≥30. The primary outcome was the occurrence of newly diagnosed CRC according to the SLD classification.</p><p><strong>Results: </strong>This analysis included 242,275 participants. The adjusted hazard ratios for CRC incidence were 1.17 (95% confidence interval [CI]: 1.10-1.25) for MASLD, 1.45 (95% CI: 1.28-1.65) for MetALD, and 1.78 (95% CI: 1.48-2.14) for ALD, with no SLD as the reference group. All results were statistically significant (p < 0.001).</p><p><strong>Conclusion: </strong>Individuals in Korea with MASLD, MetALD, or ALD are at an increased risk of developing CRC.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Fat Diet-Induced Gut Microbiota Disruption Promotes Colorectal Cancer Lymphatic Metastasis via Propionate/GPR41 Signaling.","authors":"Jialei Wang, Qingying Tan, Min Ni, Feng Chen, Junlong Yang, Guoliang Wang, Xiaoyong Zhao, Xiaoli Zhang, Sen Zhang","doi":"10.1159/000545843","DOIUrl":"https://doi.org/10.1159/000545843","url":null,"abstract":"<p><strong>Objective: </strong>High-fat diets (HFD) are known to affect the gut microbiome structure and potentially promote the development and metastasis of colorectal cancer (CRC). This study aims to elucidate the molecular mechanisms through which gut microbiome dysbiosis, mediated by the propionate/GPR41 signaling pathway, promotes lymphangiogenesis and lymph node (LN) metastasis in CRC, providing new insights for CRC treatment.</p><p><strong>Methods: </strong>Microbial diversity and composition in rectal cancer were compared between CRC patients and healthy controls using 16s rRNA sequencing. Key genes related to short-chain fatty acid metabolism, HFD, and gut microbiota were identified. In vitro assays assessed CRC cell proliferation, migration, invasion, and lymphangiogenesis. A CRC mouse model on an HFD was used to measure fecal propionate levels and analyze GPR41 expression in tumors. In vivo fluorescence imaging was employed to track cancer cell migration and lymph node metastasis.</p><p><strong>Results: </strong>HFD-induced microbial dysbiosis led to a significant reduction in SCFA-producing bacteria and an increase in pro-inflammatory species. This dysbiosis contributed to the suppression of propionate's protective effects. Propionate inhibited CRC cell proliferation, migration, and invasion under HFD conditions by activating the GPR41 pathway. Silencing GPR41 reversed these inhibitory effects, highlighting the key role of GPR41 in mediating propionate's anti-tumor effects. In vivo experiments further confirmed that propionate suppressed HFD-enhanced CRC lymphatic metastasis through the GPR41 signaling pathway, linking microbial dysbiosis with the modulation of cancer progression.</p><p><strong>Conclusion: </strong>This study reveals that HFD promotes CRC lymphangiogenesis and LN metastasis through gut microbiota dysbiosis and suppression of the propionate-activated GPR41 signaling pathway. These findings highlight the therapeutic potential of targeting the propionate/GPR41 axis , offering a promising strategy for developing novel anticancer therapies.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-27"},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biodegradable stents for the treatment of refractory benign esophageal strictures: Systematic review and meta-analysis.","authors":"Daniel Tyč, Nina Vaněčková, Josef Hanuš, Iva Selke Krulichová","doi":"10.1159/000546377","DOIUrl":"https://doi.org/10.1159/000546377","url":null,"abstract":"<p><strong>Introduction: </strong>Refractory benign esophageal strictures (RBES) pose significant clinical challenges. Biodegradable (BD) stents have emerged as alternatives to traditional stenting methods, offering the possibility of reducing the need for multiple procedures. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of BD stents in the treatment of RBES.</p><p><strong>Methods: </strong>The PubMed, Web of Science, Scopus, Cochrane, and Science Direct databases were searched according to the PRISMA statement. Studies that focused on the clinical outcomes of BD stents used in adult patients with RBES were included. Data on technical success and complication rates were analyzed using random-effects models. Efficacy data were analyzed using Kaplan-Meier analysis.</p><p><strong>Results: </strong>The review included 15 studies with 241 BD stent implantations. The technical success rates were consistently high in all studies. The median time to restenosis was 21 weeks, with survival rates of 38.4% at 26 weeks and 27.0% at 52 weeks. The rate of complications requiring intervention was relatively low, but significant hyperplasia and pain occurred in 16.4% and 8.8% of the cases, respectively. Significant heterogeneity was observed in hyperplasia-related outcomes, which required a detailed subgroup analysis to investigate the underlying causes.</p><p><strong>Conclusion: </strong>BD stents provide acceptable results in terms of efficacy and safety for the treatment of RBES. However, the evidence is limited owing to the lack of randomized controlled trials and comparative studies. Future research should focus on these areas to strengthen the clinical evidence regarding BD stents.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-23"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of GALNT12 as a Novel Potential Diagnostic and Prognostic Marker for Esophageal Squamous Cell Carcinoma by Integrated Bioinformatics Analysis.","authors":"Zhaowei Chen, Lili Kang, Zhenze Yang, Yaoqing Cai, Shuyong Yu, Ping Li, Jian Song","doi":"10.1159/000546092","DOIUrl":"https://doi.org/10.1159/000546092","url":null,"abstract":"<p><strong>Background: </strong>Esophageal squamous cell carcinoma (ESCC) is a highly fatal cancer with unclear molecular underpinnings. This study utilized bioinformatics to uncover key genes and pathways associated with ESCC and to identify prognostic markers.</p><p><strong>Methods: </strong>We identified the differentially expressed genes (DEGs) using three datasets (GSE53625, GSE67269, and GSE23400-GPL96). Meanwhile, Weighted gene co-expression network analysis (WGCNA) constructed gene co-expression networks based on the GSE23400-GLP97 dataset. Machine-learning algorithms further identified the most critical genes. Additionally, we validated the expression and diagnostic potential of the hub genes using the GSE161533 and GSE38129 datasets. Survival analysis and Gene Set Enrichment Analysis (GSEA) revealed the prognostic value and potential functions of the hub genes, respectively.</p><p><strong>Results: </strong>The study identified 240 DGEs (103 upregulated and 137 downregulated). Concurrently, WGCNA pinpointed 209 genes associated with ESCC. Subsequently, machine-learning algorithms identify four hub genes, including KIF14, GALNT12, MGLL, and EMP1. Moreover, their expression differences and potential as diagnostic biomarkers for ESCC were validated. Survival analysis indicated that elevated GALNT12 expression was associated with a poor prognosis of ESCC patients. GSEA delineated the involvement of GALNT12 in critical biological pathways.</p><p><strong>Conclusions: </strong>Our results identified GALNT12 as a novel potential diagnostic and prognostic marker for ESCC.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-18"},"PeriodicalIF":3.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metagenomics study suggests the role of vitamins and gut microbiome in autism spectrum disorder.","authors":"Ez Sadoon Mahdi, Majid Komijani, Anita Alaghmand","doi":"10.1159/000545483","DOIUrl":"https://doi.org/10.1159/000545483","url":null,"abstract":"<p><strong>Introduction: </strong>Autism is a neurological disability that often appears after the age of three in children, also known as an Autism Spectrum Disorder (ASD). Several studies have examined the influence of some environmental factors, and many parameters related to the behavior of autistic patients have been measured in order to find ways to reduce ASD. This study investigates the relationship between ASD and serum levels of vitamin D3, B12, folic acid, and the gut microbiome.</p><p><strong>Methods: </strong>The serum levels of vitamin D3, B12, and folic acid in ASD patients were measured by the ELISA method and compared to healthy groups. DNA was extracted from stool samples of ASD patients and the control group, and then the gut microbiome was investigated via a metagenomics approach. Metagenomics sequencing was performed to analyze the 16S rRNA gene sequencing for phylum and sub phylum level microbiome.</p><p><strong>Result: </strong>The result showed no significant change in the VitD3 and folate levels of ASD patients compared to the control group (p=0.157 and p=0.0505, respectively). There was a significant difference in the VitB12 level between control healthy individuals and ASD patients, in which the serum VitB12 concentration was significantly lower than the control group (p=0.0001). Our results regarding gut metagenomics showed that the abundance of the Actinobacteria by the phylum level were significantly higher in the ASD patients compared to the control group (p=0.0013). The abundance of the Firmicutes by the phylum level were significantly lower in the ASD patients compared to the control group (p=0.0016).The abundance of Bifidobacteriaceae, and Ruminococcaceae by the family level were significantly higher in the ASD patients compared to the control group (p=0.0004. and p=0.0489, respectively).Our results indicated less species richness in the ASD patients compared to the control group.</p><p><strong>Conclusion: </strong>Patients with ASD have lower serum levels of vitamin B12 and different gut microbiome compared to healthy controls. Low vitamin B12 levels and altered gut microbiome are significantly associated with ASD in this study. However, further research is needed to determine whether these factors could serve as predictors of severe outcomes in ASD.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-20"},"PeriodicalIF":3.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Recognition Areas by Explainable AI for Colonoscopy Images of Irritable Bowel Syndrome.","authors":"Hiroshi Mihara, Shun Kuraishi, Haruka Fujinami, Takayuki Ando, Ichiro Yasuda","doi":"10.1159/000546183","DOIUrl":"https://doi.org/10.1159/000546183","url":null,"abstract":"<p><strong>Introduction and aim: </strong>Irritable Bowel Syndrome (IBS) is a condition in which gastroenterological endoscopists cannot detect anomalies using colonoscopy, yet an artificial intelligence (AI) developed for IBS colonoscopy images has been able to distinguish between IBS and healthy individuals with high accuracy. However, it was unclear in which areas the AI identified as abnormal. The aim of this study was to elucidate how AI identifies regions typical of IBS by constructing an additional Explainable AI (XAI).</p><p><strong>Methods: </strong>Colonoscopy images of healthy individuals, patients with constipation-predominant IBS, and patients with diarrhea-predominant IBS, which are available in a repository (https://doi.org/10.5061/dryad.9s4mw6mkp), were used. After setting up a Python environment on a local PC, the XAI models for the three groups were developed. Images not used in the AI construction were then evaluated using XAI. XAI-generated images were independently assessed by two evaluators, HM and KS, to record and reconcile the characteristic differences among the three groups.</p><p><strong>Results: </strong>Images correctly identified as those of healthy individuals by XAI were evaluated as characteristics over the entire image. By contrast, for IBS, only parts of the images were evaluated as characteristic regions. For diarrhea-predominant IBS, regions characterized by clear vascular boundaries, homogeneity or erythematous tones, or narrow and somewhat dark-appearing sections of the intestinal tract were identified. For constipation-predominant IBS, regions characterized by unclear vascular boundaries, faded tones, or dark sections where the end was not visible were identified.</p><p><strong>Conclusion: </strong>An XAI for IBS was collaboratively developed by endoscopists and clinical engineers, enabling the visualization of regions characteristic of IBS and healthy individuals. The real-time display of XAI is expected to further advance the elucidation of IBS pathophysiology.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and verification of B4GALNT2 as an epigenetic marker in ulcerative colitis.","authors":"Yi Zhu, Yuan Zhou, Honggang Jiang, Zhiheng Chen, Bohao Lu, Jiaming Wu","doi":"10.1159/000545944","DOIUrl":"https://doi.org/10.1159/000545944","url":null,"abstract":"<p><strong>Background: </strong>Ulcerative colitis represents an inflammatory bowel disease characterized with a multifaceted pathogenesis, which may be attributed to influenced by genetic factors. This study aimed to identify and validate novelmarkers associated with ulcerative colitis, with a specific focuc on their regulation through DNA methylation.</p><p><strong>Methods: </strong>Gene expression and DNA methylation profiling of intestinal mucosal tissues from ulcerative colitis and healthy controls was retrieved from the GEO repository. Differentially expressed and methylated genes were examined in ulcerative colitis. Subsequently, overlapped analyses were performed to identify highly expressed and hypomethylated genes, as well as lowly expressed and hypermethylated genes. Functional annotation, transcription factor-mRNA network analysis and protein-protein interaction (PPI) network analysis were conducted for above genes. DSS-induced LOVO and Caco-2 cells were established to stimulate ulcerative colitis injury. The expression and methylation of B4GALNT2 was verified by RT-qPCR and MSP. CCK-8, flow cytometry, western blot, and ELISA were used to measure cell survival, apoptosis, and cytokine levels after B4GALNT2 overexpression.</p><p><strong>Results: </strong>Our study screened 1 down-regulated and hypermethylated gene (B4GALNT2) and 114 up-regulated and hypomethylated genes in ulcerative colitis. They were markedly associated with immune response. Totally, 10 potential transcription factors were predicted. The PPI network revealed their complex interactions. B4GALNT2 was confirmed to be down-regulated and hypermethylated in DSS-induced intestinal epithelial cells. B4GALNT2 overexpression enhanced cell viability and weakened apoptosis and cytokine production and release of DSS-induced intestinal epithelial cells.</p><p><strong>Conclusion: </strong>Collectively, this study integrally analyzed DNA methylation and gene expression in ulcerative colitis as well as identified and verified B4GALNT2 as a key epigenetic marker.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Anti-Parietal Cell Antibody Titer Measurement Kit for Diagnosis of Autoimmune Gastritis.","authors":"Masanori Ito, Yasuhiko Maruyama, Shuichi Terao, Kimaru Okubo, Kaori Hidaka, Tomotaka Sakamoto, Ken Haruma","doi":"10.1159/000545454","DOIUrl":"10.1159/000545454","url":null,"abstract":"<p><strong>Introduction: </strong>Recent findings revealed that autoimmune gastritis (AIG) is not rare in Japan. Therefore, the accurate diagnosis of AIG is essential in upper gastrointestinal practice. Diagnostic criteria for AIG were established in 2023; however, the conventional fluorescent antibody (FA) method for anti-parietal cell antibody (APCA) titer measurements has low accuracy and is clinically problematic.</p><p><strong>Methods: </strong>We developed a latex agglutination (LA) method using a new human-derived antigen. Samples subjected to measurements were sera from AIG cases (127 cases, 49 males, average age 65.9 years) and control cases (129 cases, 81 males, average age 66.1 years) provided by the main facility and three affiliated facilities in Japan. APCA in whole serum was measured using the FA and LA methods.</p><p><strong>Results: </strong>The diagnostic ability of AIG using the FA method was as follows: sensitivity of 99.2%, specificity of 41.1%, and an overall agreement rate of 69.9%, with low specificity previously being reported. On the other hand, the new LA method had good diagnostic performance with a sensitivity of 93.7%, a specificity of 95.4%, and an overall agreement rate of 94.5%.</p><p><strong>Conclusion: </strong>We developed a new APCA measurement system that will contribute to the accurate diagnosis of AIG. The use of this measurement system in clinical practice will facilitate the diagnosis and treatment of AIG.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Contributing to the Efficacy of Fecal Microbiota Transplantation for Diarrhea-Dominant Functional Bowel Disorders.","authors":"Tsuyoshi Yamane, Tatsuhiro Masaoka, Chiharu Ishii, Hiroaki Masuoka, Wataru Suda, Shunya Kurokawa, Taishiro Kishimoto, Yohei Mikami, Shinji Fukuda, Takanori Kanai","doi":"10.1159/000545183","DOIUrl":"10.1159/000545183","url":null,"abstract":"<p><strong>Introduction: </strong>In cases of effective fecal microbiota transplantation (FMT) for irritable bowel syndrome (IBS), donor feces have been observed to be enriched in Bifidobacterium spp. Moreover, FMT for functional bowel disease can improve psychiatric symptoms. Although intestinal dysbiosis has received attention as one of the pathophysiologies of IBS, the efficacy of FMT for IBS has not yet been established. In this study, we performed a post hoc analysis of the efficacy of FMT, focusing on metabolites in donor feces.</p><p><strong>Methods: </strong>FMT was performed in 12 patients, 8 with refractory diarrhea-predominant IBS and 4 with functional diarrhea (FDr), who were refractory to medical therapy. The donors were family members within a second degree of kinship and differed for each transplant. Fecal characteristics were evaluated before and 12 weeks after transplantation using the Bristol stool scale (BS). BS scores of 3-5 at 12 weeks after transplantation were considered to indicate responders, while BS scores of 6 and 7 indicated nonresponders. Metagenomic and metabolomic analyses of all 12 donor fecal samples were performed to compare the responder and nonresponder groups.</p><p><strong>Results: </strong>Before transplantation, all patients had BS scores of 6-7, but 12 weeks after transplantation, 6 were considered responders and 6 were nonresponders. Metagenomic analysis showed that effective donor feces contained significantly higher levels of Prevotella than did the ineffective donor feces. Metabolomic analysis showed that effective donor feces contained significantly higher levels of propionate and butyrate and significantly lower lactate levels than did ineffective donor feces.</p><p><strong>Conclusion: </strong>Propionate-, butyrate-, or Prevotella-rich donor feces may contribute to successful FMT in patients with diarrhea-dominant functional gastrointestinal disorders.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}