Digestion最新文献

{"title":"Clinical Evaluation of Computer-Aided Colorectal Neoplasia Detection Using a Novel Endoscopic Artificial Intelligence: A Single-Center Randomized Controlled Trial.","authors":"Hirotaka Nakashima,&nbsp;Naoko Kitazawa,&nbsp;Chika Fukuyama,&nbsp;Hiroshi Kawachi,&nbsp;Hiroshi Kawahira,&nbsp;Kumiko Momma,&nbsp;Nobuhiro Sakaki","doi":"10.1159/000528085","DOIUrl":"https://doi.org/10.1159/000528085","url":null,"abstract":"<p><strong>Introduction: </strong>Computer-aided diagnostic systems are emerging in the field of gastrointestinal endoscopy. In this study, we assessed the clinical performance of the computer-aided detection (CADe) of colonic adenomas using a new endoscopic artificial intelligence system.</p><p><strong>Methods: </strong>This was a single-center prospective randomized study including 415 participants allocated into the CADe group (n = 207) and control group (n = 208). All endoscopic examinations were performed by experienced endoscopists. The performance of the CADe was assessed based on the adenoma detection rate (ADR). Additionally, we compared the adenoma miss rate for the rectosigmoid colon (AMRrs) between the groups.</p><p><strong>Results: </strong>The basic demographic and procedural characteristics of the CADe and control groups were as follows: mean age, 54.9 and 55.9 years; male sex, 73.9% and 69.7% of participants; and mean withdrawal time, 411.8 and 399.0 s, respectively. The ADR was 59.4% in the CADe group and 47.6% in the control group (p = 0.018). The AMRrs was 11.9% in the CADe group and 26.0% in the control group (p = 0.037).</p><p><strong>Conclusion: </strong>The colonoscopy with the CADe system yielded an 11.8% higher ADR than that performed by experienced endoscopists alone. Moreover, there was no need to extend the examination time or request the assistance of additional medical staff to achieve this improved effectiveness. We believe that the novel CADe system can lead to considerable advances in colorectal cancer diagnosis.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":"104 3","pages":"193-201"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9942180","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":"Clinical Guidelines for Diagnosis and Management of Peutz-Jeghers Syndrome in Children and Adults.","authors":"Hironori Yamamoto,&nbsp;Hirotsugu Sakamoto,&nbsp;Hideki Kumagai,&nbsp;Takashi Abe,&nbsp;Shingo Ishiguro,&nbsp;Keiichi Uchida,&nbsp;Yuko Kawasaki,&nbsp;Yoshihisa Saida,&nbsp;Yasushi Sano,&nbsp;Yoji Takeuchi,&nbsp;Masahiro Tajika,&nbsp;Takeshi Nakajima,&nbsp;Kouji Banno,&nbsp;Yoko Funasaka,&nbsp;Shinichiro Hori,&nbsp;Tatsuro Yamaguchi,&nbsp;Teruhiko Yoshida,&nbsp;Hideki Ishikawa,&nbsp;Takeo Iwama,&nbsp;Yasushi Okazaki,&nbsp;Yutaka Saito,&nbsp;Nariaki Matsuura,&nbsp;Michihiro Mutoh,&nbsp;Naohiro Tomita,&nbsp;Takashi Akiyama,&nbsp;Toshiki Yamamoto,&nbsp;Hideyuki Ishida,&nbsp;Yoshiko Nakayama","doi":"10.1159/000529799","DOIUrl":"10.1159/000529799","url":null,"abstract":"<p><strong>Background: </strong>Peutz-Jeghers syndrome (PJS) is a rare disease characterized by the presence of hamartomatous polyposis throughout the gastrointestinal tract, except for the esophagus, along with characteristic mucocutaneous pigmentation. It is caused by germline pathogenic variants of the STK11 gene, which exhibit an autosomal dominant mode of inheritance. Some patients with PJS develop gastrointestinal lesions in childhood and require continuous medical care until adulthood and sometimes have serious complications that significantly reduce their quality of life. Hamartomatous polyps in the small bowel may cause bleeding, intestinal obstruction, and intussusception. Novel diagnostic and therapeutic endoscopic procedures such as small-bowel capsule endoscopy and balloon-assisted enteroscopy have been developed in recent years.</p><p><strong>Summary: </strong>Under these circumstances, there is growing concern about the management of PJS in Japan, and there are no practice guidelines available. To address this situation, the guideline committee was organized by the Research Group on Rare and Intractable Diseases granted by the Ministry of Health, Labour and Welfare with specialists from multiple academic societies. The present clinical guidelines explain the principles in the diagnosis and management of PJS together with four clinical questions and corresponding recommendations based on a careful review of the evidence and involved incorporating the concept of the Grading of Recommendations Assessment, Development and Evaluation system.</p><p><strong>Key messages: </strong>Herein, we present the English version of the clinical practice guidelines of PJS to promote seamless implementation of accurate diagnosis and appropriate management of pediatric, adolescent, and adult patients with PJS.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"335-347"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9347427","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":"Title Page / Table of Contents","authors":"","doi":"10.1159/000528241","DOIUrl":"https://doi.org/10.1159/000528241","url":null,"abstract":"","PeriodicalId":11315,"journal":{"name":"Digestion","volume":"104 1","pages":"1 - 4"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46976983","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":"Efficacy of the Castor Oil-Filled Capsule Method as Preparation for Colon Capsule Endoscopy.","authors":"Kazuhiro Mizukami,&nbsp;Yoshito Inumaru,&nbsp;Hidetoshi Akiyama,&nbsp;Kensuke Fukuda,&nbsp;Kazuhisa Okamoto,&nbsp;Toshio Fujioka,&nbsp;Tadayoshi Okimoto,&nbsp;Kazunari Murakami","doi":"10.1159/000529648","DOIUrl":"10.1159/000529648","url":null,"abstract":"<p><strong>Background: </strong>Colon capsule endoscopy (CCE) is useful as an alternative examination for patients in whom colonoscopy is difficult. The Japanese Association for Capsule Endoscopy has published a recommended regimen for CCE using castor oil, which is becoming a standard examination method for CCE in Japan. However, castor oil has an unpleasant flavor. Therefore, patient acceptance is not good.</p><p><strong>Objectives: </strong>The aims were to develop a castor oil-filled capsule and evaluate its feasibility and patient acceptance in a retrospective, comparative study.</p><p><strong>Method: </strong>A dissolution study of pig-derived gelatin capsules filled with castor oil was performed using artificial gastric juice. The CCE excretion rates within battery lifetime, CCE examination times, endoscopic colonic cleansing levels, and patient acceptability between CCE boosters with a castor oil-filled capsule and without castor oil were retrospectively compared using medical information, clinical data, and endoscopic findings at Takada Chuo Hospital from September 2016 to August 2019.</p><p><strong>Results: </strong>The castor oil-filled capsules were completely disintegrated at approximately 1-3 min in artificial gastric juice. Bowel preparation with oil-filled capsules and without castor oil was performed in 27 and 24 patients, respectively. CCE excretion rates within battery life were 100% and 91.7% (p = 0.217), small bowel transit times were 115 min and 143 min (p = 0.046), colon transit times were 168 min and 148 min (p = 0.733), and adequate colonic cleansing rates were 85.2% and 86.3% (p = 1.000) in patients using bowel preparation with and without oil-filled capsules, respectively. Regarding acceptance, the taste was not problematic in 85.2%, and tolerability for the next CCE was 96.3%.</p><p><strong>Conclusions: </strong>CCE using a castor oil-filled capsule method achieved high examination performance and sufficient patient tolerability.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"409-414"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9323237","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":"Evidence-Based Approach to the Discontinuation of Immunomodulators or Biologics in Inflammatory Bowel Disease.","authors":"Yusuke Miyatani, Taku Kobayashi","doi":"10.1159/000527776","DOIUrl":"10.1159/000527776","url":null,"abstract":"<p><strong>Background: </strong>Biologics and immunomodulators are key drugs in the long-term treatment of inflammatory bowel diseases, while they may negatively impact patients' quality of life due to concerns of adverse events, need for frequent hospital visits, and medical expenses. The basic concept of drug withdrawal should be based on the risk of relapse and the efficacy of re-treatment. Considering a number of patients may relapse even if treatment is continued, the disadvantage of discontinuation should be recognized not by all relapse after discontinuation, but by the increase in relapse.</p><p><strong>Summary: </strong>Discontinuation of immunomodulator monotherapy is associated with an increased risk of relapse. However, prolonged remission might be an indication of withdrawal, concerning the long-term adverse effect including lymphoma and nonmelanoma skin cancers. When considering discontinuation from combination therapy of anti-tumor necrosis factor (TNF) agents with immunomodulators, therapeutic drug monitoring may be useful to understand the pharmacokinetic effect. However, recent randomized controlled trials, as well as large-scale observational studies, demonstrated that discontinuation of anti-TNF agents, but not of immunomodulators, resulted in a significantly higher risk of relapse even in deep remission. Therefore, discontinuation of anti-TNF agents should be considered with caution and close monitoring combined with fecal calprotectin may be necessary. On the other hand, evidence of not only short-term relapse rate but of the true long-term influence on the patient's quality of life should be clarified by a multidimensional approach.</p><p><strong>Key messages: </strong>Discontinuation of treatment should be implemented based on shared decision-making with careful interpretation of evidence and the condition.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":"104 1","pages":"66-73"},"PeriodicalIF":3.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9843544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10548044","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":"Erratum.","authors":"","doi":"10.1159/000528659","DOIUrl":"https://doi.org/10.1159/000528659","url":null,"abstract":"","PeriodicalId":11315,"journal":{"name":"Digestion","volume":"104 2","pages":"163"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10253119","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":"Relapse and Need for Extended Immunosuppression: Novel Features of Drug-Induced Autoimmune Hepatitis.","authors":"Sabine Weber,&nbsp;Alexander L Gerbes","doi":"10.1159/000528329","DOIUrl":"https://doi.org/10.1159/000528329","url":null,"abstract":"<p><strong>Background: </strong>Drug-induced autoimmune hepatitis (DI-AIH) has been proposed as a distinct phenotype of drug-induced liver injury (DILI), and frequently has been associated with specific drugs, such as minocycline and nitrofurantoin. However, no clear definition of DI-AIH has been established thus far.</p><p><strong>Objectives: </strong>We aimed to identify features distinguishing DI-AIH from DILI and idiopathic autoimmune hepatitis (AIH) in an attempt to further define a DI-AIH phenotype.</p><p><strong>Method: </strong>A cohort of 38 previously reported DILI and AIH patients who were prospectively recruited at our tertiary centre and who received corticosteroid was analysed regarding the phenotypical presentation and outcome of DI-AIH, DILI, and AIH.</p><p><strong>Results: </strong>AIH (n = 19), DILI (n = 8), and DI-AIH (n = 11) patients presented with similar clinical features at onset, with the only difference being a higher Roussel Uclaf Causality Assessment Method (RUCAM) score in the DILI and DI-AIH patients. Post-treatment AIH scores were lower and a more rapid decrease of alanine aminotransferase in the first week of corticosteroid treatment was observed in both DILI groups when compared to AIH patients, while no significant differences were observed between DI-AIH and DILI patients. Relapse occurred in DI-AIH but not in DILI patients (36% vs. 0%) with a more frequent need for long-term immunosuppression (27% vs. 13%).</p><p><strong>Conclusions: </strong>Our data show that relapse after cessation of corticosteroids and need for further immunosuppressive treatment does occur in a substantial proportion of DI-AIH patients. However, no other phenotypical differences between DILI due to agents commonly associated with DI-AIH and DILI due to other drugs were identified.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":"104 3","pages":"243-248"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925818","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":"Saliva Secretion Is Significantly Lower in Female Patients with Mild Reflux Esophagitis than in Female Healthy Controls.","authors":"Eri Momma,&nbsp;Mai Koeda,&nbsp;Yoshimasa Hoshikawa,&nbsp;Tomohide Tanabe,&nbsp;Shintaro Hoshino,&nbsp;Yuichi Kitasako,&nbsp;Noriyuki Kawami,&nbsp;Katsuhiko Iwakiri","doi":"10.1159/000528863","DOIUrl":"https://doi.org/10.1159/000528863","url":null,"abstract":"<p><strong>Introduction: </strong>Saliva secretion is significantly lower in patients with mild reflux esophagitis than in healthy controls. A previous study on healthy controls showed that stimulated saliva secretion was lower in females than in males. Saliva secretion may be lower in female patients with mild reflux esophagitis than in male patients. Therefore, the present study investigated sex differences in saliva secretion in patients with mild reflux esophagitis.</p><p><strong>Methods: </strong>Twenty-five male patients with mild reflux esophagitis, 25 male healthy controls, 24 female patients with mild reflux esophagitis, and 24 female healthy controls were recruited for this case-control study. Saliva secretion was assessed as follows: each patient chewed sugar-free gum for 3 minutes prior to endoscopy, and the volume and pH of saliva before and after acid loading as an index of the acid-buffering capacity were measured.</p><p><strong>Results: </strong>No significant differences were observed in the amount of stimulated saliva secretion, salivary pH, or the acid-buffering capacity between male patients with mild reflux esophagitis and healthy controls. No significant differences were noted in salivary pH between female patients with mild reflux esophagitis and healthy controls; however, the amount of stimulated saliva secretion was significantly lower (p = 0.0023) in the former (2.5 [1.9-4.1]) than in the latter (4.6 [3.2-6.6]), while the acid-buffering capacity was slightly lower (p = 0.0578) in the former (5.9 [5.7-6.2]) than in the latter (6.2 [6.0-6.5]).</p><p><strong>Conclusion: </strong>The amount of stimulated saliva secretion was significantly lower in female patients with mild reflux esophagitis than in female healthy controls. This reduction in saliva secretion may affect the pathophysiology of mild reflux esophagitis in females.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":"104 4","pages":"299-305"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9932108","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":"Analysis of Circulating DNA to Assess Prognoses for Metastatic Colorectal Cancer Patients Treated with Regorafenib Dose-Escalation Therapy: A Retrospective, Exploratory Analysis of the RECC Trial.","authors":"Ryo Ohta,&nbsp;Takeshi Yamada,&nbsp;Masato Nakamura,&nbsp;Masanobu Enomoto,&nbsp;Makoto Takahashi,&nbsp;Hajime Yokomizo,&nbsp;Chihiro Kosugi,&nbsp;Kei Ishimaru,&nbsp;Hiromichi Sonoda,&nbsp;Hidekazu Kuramochi,&nbsp;Yoichiro Yoshida,&nbsp;Shinji Furuya,&nbsp;Keiji Hirata,&nbsp;Hiroshi Yoshida,&nbsp;Keijiro Nozawa,&nbsp;Yojiro Hashiguchi,&nbsp;Hideyuki Ishida,&nbsp;Keiji Koda,&nbsp;Kenji Katsumata,&nbsp;Kazuhiro Sakamoto","doi":"10.1159/000528283","DOIUrl":"https://doi.org/10.1159/000528283","url":null,"abstract":"<p><strong>Introduction: </strong>Regorafenib is a multi-kinase inhibitor approved for patients with metastatic colorectal cancer (mCRC) who were previously treated with standard therapies. A few reports showed the impact of KRAS mutation on therapeutic efficacy of regorafenib. Only one study reported poor prognoses for patients treated with regorafenib who had large amounts of circulating cell-free DNA (cfDNA). In the present study, we evaluated the impact of KRAS mutations in tissue or plasma and amounts of cfDNA on prognoses of mCRC patients treated with regorafenib.</p><p><strong>Method: </strong>This is a biomarker investigation of the RECC study, which evaluated efficacy of regorafenib dose-escalation therapy. Plasma samples were obtained just before initiation of treatment with regorafenib. KRAS mutations were evaluated using tissue and plasma samples. cfDNA was extracted from plasma samples and quantified.</p><p><strong>Results: </strong>Forty-five patients were enrolled in this biomarker study. Median progression-free survival (PFS) and overall survival (OS) of patients without KRAS mutations in tissues were 1.9 months (95% confidence interval [CI] 1.7-2.0) and 8.9 months (95% CI: 6.5-11.2), and those of patients with KRAS mutations were 1.4 months (95% CI: 1.3-1.5) and 6.8 months (95% CI: 5.0-8.5). Median PFS and OS of patients with plasma KRAS mutations were 1.9 months (95% CI: 1.8-1.9) and 7.0 months (95% CI: 5.3-8.7), respectively. Median PFS and OS of patients without plasma KRAS mutations were 1.7 months (95% CI: 1.1-2.3) and 8.9 months (95% CI: 6.7-11.2), respectively. Prior to administration of regorafenib, KRAS mutations were detected in 6 of 16 (37.5%) patients who had no tissue KRAS mutations. Median OS of patients with high cfDNA concentration (>median) was significantly poorer than that of patients with low cfDNA.</p><p><strong>Conclusion: </strong>KRAS mutations in the tissue or plasma have no impact on efficacy of regorafenib. KRAS emerging mutations were observed in quite a few patients. Large amounts of cfDNA may indicate poorer prognoses for patients receiving late-line regorafenib chemotherapy.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":"104 3","pages":"233-242"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9942187","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":"Gastrointestinal Angiodysplasia in Patients with Severe Aortic Stenosis: The Endoscopic Features of Heyde's Syndrome.","authors":"Satoshi Sugino, Ken Inoue, Kan Zen, Masaki Yashige, Reo Kobayashi, Kazuaki Takamatsu, Nobuyasu Ito, Naoto Iwai, Ryohei Hirose, Toshifumi Doi, Osamu Dohi, Naohisa Yoshida, Kazuhiko Uchiyama, Tomohisa Takagi, Takeshi Ishikawa, Hideyuki Konishi, Satoaki Matoba, Yoshito Itoh","doi":"10.1159/000533237","DOIUrl":"10.1159/000533237","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic stenosis (AS) is sometimes associated with gastrointestinal bleeding, and this phenomenon is known as Heyde's syndrome. Such bleeding is most often considered to originate from gastrointestinal angiodysplasias, but the frequency and endoscopic features of such bleeding remain unclear. This study aimed to determine the frequency and endoscopic features of gastrointestinal angiodysplasia in patients with severe AS.</p><p><strong>Patients and methods: </strong>In this multicenter, retrospective study, we evaluated consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with severe AS from May 2016 to December 2019. We extracted the data on the clinicopathological features according to the status of anemia, the proportion of patients who underwent gastrointestinal endoscopic examinations and demonstrated gastrointestinal angiodysplasia, and identified the endoscopic features associated with such patients.</p><p><strong>Results: </strong>In 325 patients, the rates of moderate/severe anemia (hemoglobin &lt; 11 g/dL) were 52%. Regarding medicine, there were no significant differences between the patients with and without moderate/severe anemia. Patients were examined by esophagogastroduodenoscopy (21%), colonoscopy (12%), and balloon-assisted enteroscopy or small bowel capsule endoscopy (1.5%). Patients with moderate/severe anemia had significantly more angiodysplasia (38.3% vs. 7.7%; p &lt; 0.0001) and active bleeding (23.4% vs. 0%; p &lt; 0.01). Angiodysplasia was detected in 21 patients (stomach, n = 9; small intestine, n = 5, and colon, n = 10).</p><p><strong>Conclusions: </strong>The results suggest, for the first time, that patients with severe AS who underwent TAVI and moderate/severe anemia frequently had gastrointestinal angiodysplasia and active bleeding throughout the entire gastrointestinal tract.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"468-479"},"PeriodicalIF":3.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10711774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10068781","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}