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Characteristics and Prognosis of Sporadic Neoplasias Detected in Patients with Ulcerative Colitis. 在溃疡性结肠炎患者中发现的散发性肿瘤的特征和预后。
IF 3.2 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-02-28 DOI: 10.1159/000537756
Noriko Yamamoto, Ken Yamashita, Yudai Takehara, Shin Morimoto, Fumiaki Tanino, Yuki Kamigaichi, Hidenori Tanaka, Koji Arihiro, Fumio Shimamoto, Shiro Oka
{"title":"Characteristics and Prognosis of Sporadic Neoplasias Detected in Patients with Ulcerative Colitis.","authors":"Noriko Yamamoto, Ken Yamashita, Yudai Takehara, Shin Morimoto, Fumiaki Tanino, Yuki Kamigaichi, Hidenori Tanaka, Koji Arihiro, Fumio Shimamoto, Shiro Oka","doi":"10.1159/000537756","DOIUrl":"10.1159/000537756","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with ulcerative colitis (UC) develop not only UC-associated neoplasias but also sporadic neoplasias (SNs). However, few studies have described the characteristics of SNs in patients with UC. Therefore, this study aimed to evaluate the clinical features and prognosis of SNs in patients with UC.</p><p><strong>Methods: </strong>A total of 141 SNs in 59 patients with UC, detected by surveillance colonoscopy at Hiroshima University Hospital between January 1999 and December 2021, were included. SNs were diagnosed based on their location, endoscopic features, and histopathologic findings along with immunohistochemical staining for Ki67 and p53.</p><p><strong>Results: </strong>Of the SNs, 91.5% were diagnosed as adenoma and 8.5% were diagnosed as carcinoma (Tis carcinoma, 3.5%; T1 carcinoma, 5.0%). 61.0% of the SNs were located in the right colon, 31.2% were located in the left colon, and 7.8% were located in the rectum. When classified based on the site of the lesion, 70.9% of SNs occurred outside and 29.1% within the affected area. Of all SNs included, 95.7% were endoscopically resected and 4.3% were surgically resected. Among the 59 patients included, synchronous SNs occurred in 23.7% and metachronous multiple SNs occurred in 40.7% during surveillance. The 5-year cumulative incidence of metachronous multiple SNs was higher in patients with synchronous multiple SNs (54.2%) than in those without synchronous multiple SNs (46.4%).</p><p><strong>Conclusion: </strong>Patients with UC with synchronous multiple SNs are at a higher risk of developing metachronous multiple SNs and may require a closer follow-up by total colonoscopy than patients without synchronous SNs.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"213-223"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989597","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}
引用次数: 0
Closing the Gap: A Critical Examination of Adherence, Inconsistency, and Improvements in Colonoscopy Reporting Practices. 缩小差距:结肠镜检查报告实践中的坚持、不一致和改进的批判性研究》(Closing the Gap: A Critical Examination of Adherence, Inconsistency, and Improvements in Colonoscopy Reporting Practices)。
IF 3 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-03-13 DOI: 10.1159/000538113
Thomas J Lux, Katja Herold, Ioannis Kafetzis, Phillip Sodmann, Zita Sassmanshausen, Alexander Meining, Alexander Hann
{"title":"Closing the Gap: A Critical Examination of Adherence, Inconsistency, and Improvements in Colonoscopy Reporting Practices.","authors":"Thomas J Lux, Katja Herold, Ioannis Kafetzis, Phillip Sodmann, Zita Sassmanshausen, Alexander Meining, Alexander Hann","doi":"10.1159/000538113","DOIUrl":"10.1159/000538113","url":null,"abstract":"<p><strong>Introduction: </strong>Comprehensive and standardized colonoscopy reports are crucial in colorectal cancer prevention, monitoring, and research. This study investigates adherence to national and international guidelines by analyzing reporting practices among 21 endoscopists in 7 German centers, with a focus on polyp reporting.</p><p><strong>Methods: </strong>We identified and assessed German, European, American, and World Health Organization-provided statements to identify key elements in colonoscopy reporting. Board-certified gastroenterologists rated the relevance of each element and estimated their reporting frequency. Adherence to the identified report elements was evaluated for 874 polyps from 351 colonoscopy reports ranging from March 2021 to March 2022.</p><p><strong>Results: </strong>We identified numerous recommendations for colonoscopy reporting. We categorized the reasoning behind those recommendations into clinical relevance, justification, and quality control and research. Although all elements were considered relevant by the surveyed gastroenterologists, discrepancies were observed in the evaluated reports. Particularly diminutive polyps or attributes which are rarely abnormal (e.g., surface integrity) respectively rarely performed (e.g., injection) were sparsely documented. Furthermore, the white light morphology of polyps was inconsistently documented using either the Paris classification or free text. In summary, the analysis of 874 reported polyps revealed heterogeneous adherence to the recommendations, with reporting frequencies ranging from 3% to 89%.</p><p><strong>Conclusion: </strong>The inhomogeneous report practices may result from implicit reporting practices and recommendations with varying clinical relevance. Future recommendations should clearly differentiate between clinical relevance and research and quality control or explanatory purposes. Additionally, the role of computer-assisted documentation should be further evaluated to increase report frequencies of non-pathological findings and diminutive polyps.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"224-231"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119120","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}
引用次数: 0
Relationship between Helicobacter pylori Eradication and Barrett's Esophagus Elongation. 根除幽门螺杆菌与巴雷特食管伸长之间的关系
IF 3.2 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI: 10.1159/000536443
Kenta Hashigami, Yugo Iwaya, Tadanobu Nagaya, Daichi Hara, Atsuhiro Hirayama, Takuma Okamura, Taiji Akamatsu, Takeji Umemura
{"title":"Relationship between Helicobacter pylori Eradication and Barrett's Esophagus Elongation.","authors":"Kenta Hashigami, Yugo Iwaya, Tadanobu Nagaya, Daichi Hara, Atsuhiro Hirayama, Takuma Okamura, Taiji Akamatsu, Takeji Umemura","doi":"10.1159/000536443","DOIUrl":"10.1159/000536443","url":null,"abstract":"<p><strong>Introduction: </strong>Helicobacter pylori eradication therapy may worsen gastroesophageal reflux disease that is a significant risk factor for Barrett's esophagus. However, the relationship between eradication therapy and Barrett's esophagus remains controversial. This study evaluated the impact of Helicobacter pylori eradication on the lengthening of Barrett's esophagus.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of consecutive patients who successfully underwent Helicobacter pylori eradication between 2004 and 2017. Endoscopic images obtained before and after eradication therapy were compared for Barrett's esophagus length according to the Prague C&amp;M criteria and the presence of reflux esophagitis based on the Los Angeles classification.</p><p><strong>Results: </strong>A total of 340 patients were analyzed (mean age: 66.9 ± 12.9 years) for a median follow-up of 55 months (interquartile range: 29.8-89.3). At the initial endoscopic assessment, 187 patients (55%) had a hiatal hernia, and all patients had gastric atrophy (C-0 to I: 2%, C-II to III: 47%, O-I to III: 51%). Reflux esophagitis was detected in 7 patients (2%) before eradication and in 21 patients (6%) afterward, which was a significant increase (p = 0.007). Barrett's esophagus was identified in 69 patients (20%) before eradication, with a median length of C0M1. Elongation after treatment was observed in only 2 patients (0.6%). We observed no significant increase in either the prevalence (p = 0.85) or the median length (p = 0.5) of Barrett's esophagus.</p><p><strong>Conclusions: </strong>Only 0.6% of patients exhibited Barrett's esophagus lengthening after Helicobacter pylori eradication therapy, suggesting no significant impact of the treatment on the development or elongation of Barrett's esophagus.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"186-191"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641826","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}
引用次数: 0
Functional Endoscopy. 功能性内窥镜检查。
IF 3.2 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2023-11-24 DOI: 10.1159/000534831
Haruhiro Inoue, Yuto Shimamura
{"title":"Functional Endoscopy.","authors":"Haruhiro Inoue, Yuto Shimamura","doi":"10.1159/000534831","DOIUrl":"10.1159/000534831","url":null,"abstract":"<p><strong>Background: </strong>Functional endoscopy signifies a significant advancement in gastrointestinal examination, integrating motor function assessments alongside routine endoscopy findings. Traditional gastrointestinal endoscopy primarily focuses on the detection of early-stage cancer by identifying morphological changes within the gastrointestinal tract. These alterations include modifications in lumen structure, color tone, and surface patterns, which can be diagnosed using endoscopic images that assess these morphological changes. In contrast, functional endoscopy aims to dynamically evaluate the peristaltic movements of the digestive tract and the presence or movement of reflux of digestive fluids during the endoscopic procedure. It also seeks to identify morphological changes such as hiatal hernias, as observed in conventional endoscopy. Consequently, relying solely on endoscopic images proves inadequate for diagnosis, necessitating continuous observation of these dynamic movements.</p><p><strong>Summary: </strong>The endoscopic pressure study integrated system (EPSIS) serves as an exemplar of functional endoscopy. It incorporates a stress test to assess the functionality of the lower esophageal sphincter (LES) through intragastric insufflation. A crucial element of EPSIS evaluation is the identification of the scope holding sign (SHS), which signifies LES contraction. EPSIS also encompasses the observation of esophageal peristaltic waves and the auditory detection of burping, providing a comprehensive diagnostic approach while observing the sphincter from a retroflex view on the stomach side. By integrating these dynamic findings, functional endoscopy offers an efficient method for diagnosing functional gastrointestinal diseases, such as gastroesophageal reflux disease (GERD).</p><p><strong>Key messages: </strong>Functional endoscopy combines motor function assessments with traditional endoscopy, enhancing the diagnostic capabilities of gastrointestinal examinations. Traditional endoscopy focuses on identifying morphological changes, while functional endoscopy evaluates dynamic movements, reflux, and sphincter functionality. EPSIS exemplifies functional endoscopy, featuring a stress test and the SHS for LES contraction assessment. EPSIS provides a comprehensive approach to diagnose GERD by integrating dynamic observations.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"58-61"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10777710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440501","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}
引用次数: 0
Modulation of Intestinal Motility in an Adolescent Rat Model of Irritable Bowel Syndrome. 青春期肠易激综合征大鼠模型肠运动的调节。
IF 4.3 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2023-11-14 DOI: 10.1159/000534732
Reiko Kyodo, Takahiro Kudo, Natsuki Ito, Kazuhide Tokita, Nobuyasu Arai, Masamichi Sato, Tamaki Ikuse, Keisuke Jimbo, Yoshikazu Ohtsuka, Toshiaki Shimizu
{"title":"Modulation of Intestinal Motility in an Adolescent Rat Model of Irritable Bowel Syndrome.","authors":"Reiko Kyodo, Takahiro Kudo, Natsuki Ito, Kazuhide Tokita, Nobuyasu Arai, Masamichi Sato, Tamaki Ikuse, Keisuke Jimbo, Yoshikazu Ohtsuka, Toshiaki Shimizu","doi":"10.1159/000534732","DOIUrl":"10.1159/000534732","url":null,"abstract":"<p><strong>Introduction: </strong>The pathophysiology of irritable bowel syndrome (IBS) remains unknown. This study aimed to evaluate colonic motility and serotonin system response to restraint stress (RS) among adolescent rats who underwent neonatal maternal separation (NMS) to clarify the features of pathogenesis in adolescents with IBS.</p><p><strong>Methods: </strong>Male rats were exposed to NMS as chronic stress, and a normally handled (NH) group was used as control. Four groups were created by adding RS as acute stress treatment to the NMS and NH groups. To realize the RS treatment, the subjects were restrained for 1 h at the age of 5 weeks, and hourly fecal pellet discharge was determined. After euthanization and proximal colon intestinal tissue collection, 5-hydroxytryptamine (5-HT) and 5-hydroxytryptamine receptor 3 (5-HT3R) concentrations, enterochromaffin (EC) cell density, and the expression of mRNA-encoding slc6a4 were examined.</p><p><strong>Results: </strong>The amount of fecal pellet discharge during RS increased significantly in the RS and NMS+RS groups compared with that in the NH and NMS groups, respectively. The 5-HT concentration in the intestinal tissue of rats in the RS and NMS groups increased significantly compared with that of rats in the NH group. EC cell density also increased significantly in the NMS and NMS+RS groups compared with that in the NH and RS groups. However, combined stress did not result in any significant differences in the expression of 5-HT3R and mRNA-encoding slc6a4.</p><p><strong>Conclusions: </strong>The combination of juvenile and acute stress effectively induced increased 5-HT concentration or EC cell density via the 5-HT pathway in the proximal colon of adolescent rats.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"99-106"},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107590528","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}
引用次数: 0
A Novel Method to Localize Patency Capsule by Ileocolonoscopy Facilitates Endoscopic Assessment of the Small and Large Intestine in Patients with Crohn's Disease. 通过回肠结肠镜定位通畅囊的新方法有助于对克罗恩病患者的小肠和大肠进行内镜评估。
IF 3 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-06-10 DOI: 10.1159/000539682
Akira Sonoda, Kazuhiro Mizukami, Soh Okano, Takanori Nishiguchi, Dai Yamazaki, Yoshimasa Horie, Tsubasa Tateishi, Yuichi Saito, Yuki Hirose, Hirohito Sano, Satoshi Saito, Masakazu Takazoe, Shiho Iwamoto, Minako Sako, Masayuki Fukata
{"title":"A Novel Method to Localize Patency Capsule by Ileocolonoscopy Facilitates Endoscopic Assessment of the Small and Large Intestine in Patients with Crohn's Disease.","authors":"Akira Sonoda, Kazuhiro Mizukami, Soh Okano, Takanori Nishiguchi, Dai Yamazaki, Yoshimasa Horie, Tsubasa Tateishi, Yuichi Saito, Yuki Hirose, Hirohito Sano, Satoshi Saito, Masakazu Takazoe, Shiho Iwamoto, Minako Sako, Masayuki Fukata","doi":"10.1159/000539682","DOIUrl":"10.1159/000539682","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with Crohn's disease (CD) require an assessment of small bowel lesions, while difficulties exist in performing small intestinal examinations, especially in small-sized medical offices. Small bowel capsule endoscopy (SBCE) is handy and can be performed in most clinical settings. The only drawback of SBCE is a requirement of patency testing prior to the exam because it sometimes requires CT scanning to localize the ingested patency capsule (PC), which may be a substantial burden for the patient. We have developed a novel PC detection system named PICS (patency capsule, ileocolonoscopy, and small bowel capsule endoscopy) method by which we can avoid CT scanning. In the PICS method, ileocolonoscopy (ICS) is performed after 30-33 h of PC ingestion and the PC can be localized by ICS in patients who have not excreted the PC, and the entire intestine can be examined in combination with subsequent SBCE without additional bowel preparation. The aim of this study was to assess the usefulness and safety of the PICS method for CD patients.</p><p><strong>Methods: </strong>CD patients who underwent PICS method from April 2021 to March 2023 were reviewed for clinical data, outcome of PICS method including the rates of PC detection by ICS, the number of patients underwent SBCE, and adverse events. Lewis score was used to assess SBCE results.</p><p><strong>Results: </strong>The PICS method was performed in 54 patients. The median age of patients was 28.5 years old, and 64.8% of them were ileocolic type. The median disease duration was 10.5 months and 24.1% had history of small bowel resection. Five cases (9.3%) confirmed gastrointestinal patency by ICS, and none of the cases required CT scanning. One patient who could not be confirmed patency by ICS, and the other patient who excreted PC but was found ileal stenosis by ICS did not undergo SBCE. Remaining 52 patients received SBCE, and the median Lewis score of them was 0 (IQR 0, 450). There were no adverse events including small bowel obstruction by PC and SBCE retention in this series.</p><p><strong>Conclusion: </strong>The PICS method is not only feasible and safe but also convenient to assess disease extent in patients with CD. By localizing PC with ICS, additional CT scanning could be unnecessary for SBCE, which benefits both physicians and CD patients.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"373-379"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300358","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}
引用次数: 0
Nutritional Status Indicators Predict Tolerability to Adjuvant Chemotherapy in Patients with Stage II/III Rectal Cancer Undergoing Neoadjuvant Chemoradiotherapy. 营养状况指标可预测接受新辅助化放疗的II/III期直肠癌患者对辅助化疗的耐受性。
IF 3 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-05-29 DOI: 10.1159/000539211
Shinya Abe, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Hiroyuki Matsuzaki, Yuzo Nagai, Takahide Shinagawa, Hirofumi Sonoda, Soichiro Ishihara
{"title":"Nutritional Status Indicators Predict Tolerability to Adjuvant Chemotherapy in Patients with Stage II/III Rectal Cancer Undergoing Neoadjuvant Chemoradiotherapy.","authors":"Shinya Abe, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Hiroyuki Matsuzaki, Yuzo Nagai, Takahide Shinagawa, Hirofumi Sonoda, Soichiro Ishihara","doi":"10.1159/000539211","DOIUrl":"10.1159/000539211","url":null,"abstract":"<p><strong>Introduction: </strong>Adjuvant chemotherapy (AC) after radical surgery following preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC) is now the standard of care. The identification of risk factors for the discontinuation of AC is important for further improvements in survival. We herein examined the prognostic impact of chemotherapy compliance and its relationship with the prognostic nutritional index (PNI) before surgery.</p><p><strong>Methods: </strong>A total of 335 stage II-III LARC patients who underwent preoperative CRT between 2003 and 2022 at the University of Tokyo Hospital were retrospectively reviewed. We excluded patients with recurrence during AC and those who had not received AC. The relationship between AC and long-term outcomes and that between PNI values and the duration of AC were examined.</p><p><strong>Results: </strong>Thirty-one patients discontinued AC and 62 continued AC. Recurrence-free survival (RFS) was significantly shorter in patients who discontinued AC (p = 0.0056). The discontinuation of AC was identified as an independent risk factor for RFS (hazard ratio [HR]: 2.24, p = 0.0233). Twenty-one patients were classified as having low PNI (less than 40), which correlated with an older age, low body mass index, and incomplete AC. Low PNI was an independent risk factor for a shorter duration of AC (HR: 2.53, p = 0.0123).</p><p><strong>Conclusion: </strong>The discontinuation of AC was related to poor RFS in patients with LARC undergoing preoperative CRT. Furthermore, a low PNI value was identified as a risk factor for a shorter duration of AC.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"345-358"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174942","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}
引用次数: 0
Current Treatment Practices for Adult Patients with Constipation in Japan. 日本成人便秘患者的当前治疗方法。
IF 3.2 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2023-09-11 DOI: 10.1159/000533548
Takaomi Kessoku, Noboru Misawa, Hidenori Ohkubo, Atsushi Nakajima
{"title":"Current Treatment Practices for Adult Patients with Constipation in Japan.","authors":"Takaomi Kessoku, Noboru Misawa, Hidenori Ohkubo, Atsushi Nakajima","doi":"10.1159/000533548","DOIUrl":"10.1159/000533548","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of constipation in Japan is estimated to be 2-5%. Constipation is a disease found in older adults. In particular, Japan is an aging society, with 65% of men and 80.5% of women aged 65 years or older accounting for the majority of its population. Chronic constipation may be associated with survival, cardiovascular events, decreased quality of life, and death. This study summarizes the recent findings regarding constipation treatment practice in Japan.</p><p><strong>Summary: </strong>Until recently, the diagnosis of constipation was mainly based on medical interviews; however, with the recent development of handheld ultrasound devices, both physicians and nurses can easily and objectively diagnose fecal retention. Magnesium oxide and stimulant laxatives have been the mainstay treatments; however, since 2012, more than five new drugs for treating constipation have become available in Japan.</p><p><strong>Key messages: </strong>Magnesium oxide is less effective in patients who use acid-secretion inhibitors and patients who have undergone total gastrectomy and should be cared for hypermagnesemia. In addition, regular use of stimulant laxatives may lead to colonic inertia and decreased bowel movements; therefore, they should be used only occasionally. The following is an overview of the different uses of conventional and newer laxatives for treating constipation.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"40-48"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10777713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10213364","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}
引用次数: 0
Long-Term Monitoring and Clinical Implications of Small Bowel Capsule Endoscopy in Patients with Crohn's Disease with Small Bowel Lesions: A Retrospective Analysis. 小肠胶囊内镜对克罗恩病患者小肠病变的长期监测和临床意义:回顾性分析
IF 3 3区 医学
Digestion Pub Date : 2024-01-01 Epub Date: 2024-06-10 DOI: 10.1159/000539745
Masanao Nakamura, Takeshi Yamamura, Keiko Maeda, Tsunaki Sawada, Eri Ishikawa, Kentaro Murate, Kazuhiro Furukawa, Takashi Hirose, Kota Uetsuki, Tadashi Iida, Yasuyuki Mizutani, Kentaro Yamao, Yoji Ishizu, Takuya Ishikawa, Takashi Honda, Hiroki Kawashima
{"title":"Long-Term Monitoring and Clinical Implications of Small Bowel Capsule Endoscopy in Patients with Crohn's Disease with Small Bowel Lesions: A Retrospective Analysis.","authors":"Masanao Nakamura, Takeshi Yamamura, Keiko Maeda, Tsunaki Sawada, Eri Ishikawa, Kentaro Murate, Kazuhiro Furukawa, Takashi Hirose, Kota Uetsuki, Tadashi Iida, Yasuyuki Mizutani, Kentaro Yamao, Yoji Ishizu, Takuya Ishikawa, Takashi Honda, Hiroki Kawashima","doi":"10.1159/000539745","DOIUrl":"10.1159/000539745","url":null,"abstract":"<p><strong>Introduction: </strong>Crohn's disease (CD) induces persistent inflammation throughout the gastrointestinal (GI) tract, potentially resulting in complications such as intestinal stenosis and fistulas, particularly in the small bowel. Small bowel capsule endoscopy (SBCE) is recommended for monitoring CD, especially when GI tract patency is maintained. This study aimed to retrospectively assess patients with CD who underwent SBCE to determine the timing of clinical changes and address the current lack of evidence regarding GI tract patency loss during CD treatment.</p><p><strong>Methods: </strong>Of the 166 consecutive patients who underwent SBCE at our institution, 120 were followed up and included in this study. Forty-six patients were excluded due to colitis type or immediate treatment changes post-SBCE. This study focused on the primary and secondary endpoints, including the cumulative stricture-free rate of the GI tract, emergency hospitalization post-SBCE, and post-SBCE treatment strategies, at the discretion of the attending physicians.</p><p><strong>Results: </strong>Demographic data revealed that the mean age of the study population was 43 years and that there was a male predominance (75%). The median disease duration was 12 years and the mean Crohn's Disease Activity Index was 98. During a 1,486-day observation period, 37% of patients experienced treatment changes. A Lewis score of &gt;264 and perianal lesions were identified as independent risk factors for additional treatment needs. Emergency hospitalization occurred in 6% of patients and GI patency failure in 11%. Female sex and Lewis score&gt;264 were associated with higher risks. GI patency rate declined 2 years after SBCE.</p><p><strong>Conclusions: </strong>For patients who experienced no treatment changes based on SBCE results, it is recommended to undergo SBCE monitoring at intervals of no longer than 2 years.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"380-388"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300359","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}
引用次数: 0
Prelims 预赛
IF 3.2 3区 医学
Digestion Pub Date : 2024-01-01 DOI: 10.1159/000535126
Its Concept, Pathogenesis Naito, Y. Kyoto
{"title":"Prelims","authors":"Its Concept, Pathogenesis Naito, Y. Kyoto","doi":"10.1159/000535126","DOIUrl":"https://doi.org/10.1159/000535126","url":null,"abstract":"","PeriodicalId":11315,"journal":{"name":"Digestion","volume":"96 14","pages":"1 - 4"},"PeriodicalIF":3.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139454238","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}
引用次数: 0
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