Digestion最新文献

{"title":"Prospective Validation of Magnified Endoscopic Examination with Image-Enhanced Endoscopy as an Optical Biopsy for Differentiating Superficial Duodenal Epithelial Tumor and Non-Neoplastic Lesion in Duodenum.","authors":"Atsushi Nakayama, Yoko Kubosawa, Daisuke Minezaki, Kohei Morioka, Kentaro Iwata, Kurato Miyazaki, Teppei Masunaga, Yukie Hayashi, Mari Mizutani, Teppei Akimoto, Yusaku Takatori, Noriko Matsuura, Tomohisa Sujino, Kaoru Takabayashi, Naohisa Yahagi, Motohiko Kato","doi":"10.1159/000552784","DOIUrl":"10.1159/000552784","url":null,"abstract":"<p><strong>Introduction: </strong>Superficial duodenal epithelial tumors (SDETs) and non-neoplastic lesions (NNLs) often appear similar on conventional endoscopy, complicating real-time differentiation and leading to frequent biopsies. However, duodenal biopsy is invasive and may hinder subsequent endoscopic resection. We previously developed a diagnostic algorithm using magnified endoscopic examination with image-enhanced endoscopy (IEE-ME) to distinguish SDETs from NNLs. This study aimed to prospectively validate the diagnostic performance of this algorithm in clinical practice.</p><p><strong>Methods: </strong>In this single-center prospective observational study, we evaluated an IEE-ME-based diagnostic algorithm for esophagogastroduodenoscopy. Lesions were classified according to predefined criteria, including superficial structure, white opaque substance, demarcation line, and enlarged marginal epithelium. Endoscopic diagnoses were made immediately by 11 endoscopists with varied experience, who were blinded to the final histopathological diagnoses. The diagnostic performance was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy.</p><p><strong>Results: </strong>Among 241 lesions analyzed, 84 and 157 were histologically diagnosed as SDETs and NNLs, respectively. The diagnostic algorithm demonstrated excellent performance, with a sensitivity of 97.6% (95% confidence interval [CI]: 91.7-99.7%), specificity of 95.5% (95% CI: 91.0-98.2%), PPV of 92.1% (95% CI: 85.0-96.0%), NPV of 98.7% (95% CI: 95.0-99.7%), and overall accuracy of 96.3% (95% CI: 93.0-98.3%).</p><p><strong>Conclusion: </strong>This prospective validation showed that IEE-ME, applied through a structured algorithm, enables highly accurate and noninvasive differentiation between SDETs and NNLs. Given its excellent NPV and accuracy, this approach may serve as an optical biopsy method that reduces the need for conventional biopsies in clinical practice.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351080","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":"Accurate Imaging Diagnosis of Small Pancreatic Carcinoma/High-Grade Pancreatic Intraepithelial Neoplasia Using Combined Indirect Imaging Findings.","authors":"Ryota Sagami, Kazuhiro Mizukami, Hidefumi Nishikiori, Hiroaki Tsuji, Takao Sato, Yoshifumi Azuma, Yasuhisa Hiroshima, Koshiro Tsutsumi, Masahide Fukuda, Sotaro Ozaka, Kensuke Fukuda, Mie Arakawa, Masao Iwao, Ryo Ogawa, Yuka Hirashita, Takuro Uchida, Mizuki Endo, Masaaki Kodama, Shin-Ichiro Horiguchi, Tsutomu Daa, Tatsunori Satoh, Kazuhito Honda, Kazunari Murakami","doi":"10.1159/000552273","DOIUrl":"10.1159/000552273","url":null,"abstract":"<p><strong>Introduction: </strong>Early-stage pancreatic cancer (EPC), including high-grade pancreatic intraepithelial neoplasia (HG-PanIN) and pancreatic cancer ≤10 mm, has a favorable prognosis. Indirect imaging findings, such as main pancreatic duct (MPD) irregularities, branch pancreatic duct (BPD) dilation, and focal pancreatic parenchymal atrophy (FPPA), may aid in diagnosis. This study aimed to evaluate their diagnostic performance and assess intermodality agreement.</p><p><strong>Methods: </strong>Patients with an irregular MPD caliber were included. Indirect imaging findings, including MPD dilation/stenosis, BPD dilation, and FPPA, were evaluated. Positive findings were defined as those detected on computed tomography (CT) or magnetic resonance imaging (MRI). Concordance rates between modalities were also assessed.</p><p><strong>Results: </strong>Among 49 patients (22 malignant [17 with HG-PanIN]), BPD dilation adjacent to an irregular MPD and FPPA were significantly associated with malignancy (p = 0.013 and 0.002, respectively) with moderate-to-substantial interobserver agreement. MPD stenosis with FPPA and the combination of all 3 findings showed the highest specificity (85.2%). The combination of BPD dilation and FPPA achieved the highest diagnostic accuracy (77.6%), although the accuracy based on FPPA alone did not significantly differ. Intermodality agreement ranged from moderate-to-almost perfect.</p><p><strong>Conclusion: </strong>FPPA was a significant indirect imaging finding for diagnosing EPC using CT, MRI, and endoscopic retrograde pancreatography, whereas BPD dilation around an irregular MPD caliber was associated with EPC only in univariate analysis. The combination of characteristic indirect imaging findings may improve diagnostic performance, particularly specificity. This imaging-based diagnostic approach may facilitate early detection of EPC.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-12"},"PeriodicalIF":3.4,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316329","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":"Restoration of Gut Microbiota Dysbiosis by a Probiotic <i>Lactobacillus paragasseri</i> OLL2716 in Patients Being Treated with Low-Dose Aspirin and Acid-Suppressive Agents.","authors":"Erika Teramura, Shin Fujiwara, Yasuhiro Koga, Masashi Matsushima, Tsubomi Chou, Hiroyuki Ito, Shunji Hirose, Junko Nagata, Soichiro Yamamoto, Jin Imai, Katsuto Hozumi, Mariko Takeda, Katsunori Kimura, Takayoshi Suzuki","doi":"10.1159/000552916","DOIUrl":"10.1159/000552916","url":null,"abstract":"<p><strong>Introduction: </strong>Low-dose aspirin (LDA)-associated small intestinal injury has been suggested to be associated with gut microbiota dysbiosis. The probiotic Lactobacillus paragasseri OLL2716 (LG21) mitigates LDA-induced injury; however, its mechanisms of action on gut microbiota remain unclear.</p><p><strong>Methods: </strong>Participants were assigned to the control, acid-suppressive agents (ASAs)-, and ASAs+LDA-treated groups. All subjects consumed yogurt containing LG21 twice daily for 6 weeks. Ileal lavage and fecal microbiota were analyzed once (at the baseline) and twice (at the baseline and post-intervention), respectively.</p><p><strong>Results: </strong>In ileal lavage at the baseline, the family Enterobacteriaceae showed a higher abundance in the ASAs+LDA group than in the control and ASAs groups. A tendency toward increased Enterobacteriaceae abundance was also observed in the feces of the ASAs group; however, it was completely restored to the levels comparable to the control group after LG21 treatment. At the baseline in the fecal microbiota, beta diversity differed significantly between the control and ASAs groups and between the control and ASAs+LDA groups, whereas no significant differences were observed among the groups after LG21 intervention. Increased Streptococcaceae and Bacteroidaceae abundances in the ASAs-treated groups at the baseline were also restored after LG21 intervention.</p><p><strong>Conclusion: </strong>Increased Enterobacteriaceae abundance was found in both ileal lavage of the ASAs+LDA group and feces of the ASAs group. This increase in the abundance of potentially pathogenic bacteria was restored by a probiotic LG21 strain. These findings suggest that LG21 may modulate gut microbiota, particularly Enterobacteriaceae, which could be associated with its beneficial effects on LDA-induced small bowel injury.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-13"},"PeriodicalIF":3.4,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307575","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":"Adverse Events after Colorectal Polypectomy in Patients with Amyloidosis: Risk Assessment Using Propensity Score Matching.","authors":"Hiroshi Sawaguchi, Tadanobu Nagaya, Tomoyuki Nakajima, Takuma Okamura, Mai Iwaya, Takeshi Uehara, Nagaaki Katoh, Yoshiki Sekijima, Yugo Iwaya","doi":"10.1159/000551743","DOIUrl":"https://doi.org/10.1159/000551743","url":null,"abstract":"<p><strong>Introduction: </strong>Amyloidosis may increase the risk of post-polypectomy bleeding due to mucosal and vascular fragility. We compared adverse events after colorectal polypectomy between patients with and without amyloidosis and explored risk factors for immediate post-polypectomy bleeding (IPPB).</p><p><strong>Methods: </strong>This retrospective investigation included 21 amyloidosis patients (71 polyps) and 110 non-amyloidosis patients (298 polyps) who underwent cold snare polypectomy (CSP) or endoscopic mucosal resection (EMR) between 2005 and 2024. Propensity score matching compared IPPB, delayed bleeding, and perforation. In the matched cohort, risk factors for IPPB were evaluated using generalized estimating equation (GEE) logistic regression clustered by patient ID. In the amyloidosis group, histological predictors (amyloid deposition and location) were assessed, and receiver operating characteristic (ROC) analysis evaluated polyp size.</p><p><strong>Results: </strong>IPPB occurred significantly more frequently in the amyloidosis group than in the matched non-amyloidosis group (p = 0.008). In multivariable GEE analysis, amyloidosis remained independently associated with IPPB (adjusted OR 3.20, 95% CI: 1.14-8.99; p = 0.027). In amyloidosis patients, muscularis mucosae deposition was associated with IPPB (p = 0.017); multivariate analysis suggested muscularis mucosae deposition (OR 6.55, 95% CI: 1.59-27.00; p = 0.009) and EMR (OR 8.26, 95% CI: 1.41-48.60; p = 0.020) as predictors. ROC analysis yielded an area under the ROC curve of 0.66 with a 6-mm cutoff.</p><p><strong>Conclusions: </strong>Amyloidosis was independently associated with increased IPPB risk after colorectal polypectomy. Muscularis mucosae deposition and EMR may help identify higher-risk lesions in amyloidosis, and CSP may be considered when feasible to reduce bleeding risk.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.4,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293845","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":"Prognostic Effect of MES 1 Inflammatory Extent on Remission Maintenance in Ulcerative Colitis.","authors":"Mimari Kanazawa, Keiichi Tominaga, Takanao Tanaka, Yuka Yamazaki, Shunsuke Kojimahara, Satoshi Masuyama, Shoko Watanabe, Akira Yamamiya, Takeshi Sugaya, Kenichi Goda, Yasuo Haruyama, Atsushi Irisawa","doi":"10.1159/000553050","DOIUrl":"10.1159/000553050","url":null,"abstract":"<p><strong>Introduction: </strong>Ulcerative colitis (UC) is characterized by continuous inflammation extending from the rectum. Even mild inflammation can present prognostic implications when the disease is extensive. Mayo Endoscopic Score (MES) 1 represents increased risk of relapse, hospitalization, and treatment modification, but it is based solely on inflammation intensity, incorporating consideration of neither extent nor localization.</p><p><strong>Methods: </strong>Patients with UC in clinical remission with MES 0 or 1 at the initial endoscopic assessment after induction therapy were enrolled retrospectively and were followed for 2 years. Effects of the inflammation extent on remission maintenance were analyzed retrospectively for patients evaluated as MES 1. We investigated whether all MES 1 inflammation should be treated equally.</p><p><strong>Results: </strong>For the 301 included patients, the remission maintenance rate was significantly higher in the MES 0 group than in the MES 1 group (88.9% vs. 67.3%, p < 0.001). Moreover, MES 1 patients with 1-2 inflamed segments had higher remission maintenance rates than those with 3-6 inflamed segments (78.4% vs. 45.6%, p < 0.001). A significantly higher remission maintenance rate was found for the MES 0 group than for the MES 1 group with 1-2 inflamed segments (88.9% vs. 78.4%, p = 0.037). No significant difference was found between rectal and non-rectal involvement (80.7% vs. 76.5%, p = 0.685).</p><p><strong>Conclusion: </strong>The remission maintenance rate decreases as the extent of MES 1 inflammation increases in patients in remission. Even mild but extensive inflammation may increase the risk of relapse. Treatment strategies should incorporate consideration of the inflammation extent.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-9"},"PeriodicalIF":3.4,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239048","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":"Cold Sensation and Gastric Accommodation in Functional Dyspepsia: An Exploratory Study of Autonomic Function.","authors":"Hideki Mori, Tatsuhiro Masaoka, Juntaro Matsuzaki, Moe Sato, Hiroko Ando, Tetsuhiro Yoshino, Takanori Kanai","doi":"10.1159/000552935","DOIUrl":"10.1159/000552935","url":null,"abstract":"<p><strong>Introduction: </strong>Functional dyspepsia (FD) is a heterogeneous disorder characterized by impaired gastric accommodation and autonomic dysfunction as key pathophysiological features. Cold sensation (Hie), a commonly recognized subjective bodily sensation in East Asia, reflects autonomic instability. However, its association with gastric accommodation in FD remains unclear.</p><p><strong>Methods: </strong>This single-center prospective observational study enrolled healthy volunteers (HVs) and patients with FD. Cold sensation was assessed using a validated questionnaire. Gastric accommodation was evaluated using a standardized nutrient drink test, with drinking time as indices of postprandial tolerance. Autonomic nervous system activity was examined using heart rate variability during the test.</p><p><strong>Results: </strong>Patients with FD had significantly shorter drinking times and lower completion rates than the HVs. In the combined cohort, cold sensation showed a weak inverse association with drinking time; however, this relationship did not reach statistical significance. In multivariable analysis adjusting for FD status and medication use, cold sensation was not independently associated with drinking time. Cold sensation was significantly inversely correlated with baseline coefficient of variation of R-R intervals, reflecting overall autonomic nervous system activity, but was not associated with nutrient load-induced autonomic responses.</p><p><strong>Conclusion: </strong>Cold sensation was more prevalent in patients with FD and was associated with reduced baseline autonomic activity. However, its association with gastric accommodation was attenuated after accounting for FD status, suggesting that cold sensation may represent a disease-related phenotype rather than an independent determinant of postprandial tolerance.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-14"},"PeriodicalIF":3.4,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224142","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":"Fully Automated Detection of Pancreaticobiliary Maljunction Based on 3D Magnetic Resonance Cholangiopancreatography Using Deep Learning.","authors":"Xiaoyu Zhang, Weizheng Liu, Ziyue Chang, Chunyan Chai, Wenping Lu","doi":"10.1159/000552759","DOIUrl":"10.1159/000552759","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreaticobiliary maljunction (PBM) is closely related to biliary tract cancer. The early detection of PBM is crucial but challenging. We aimed to develop and validate a deep learning model for fully automatically detection of PBM using magnetic resonance cholangiopancreatography (MRCP) images.</p><p><strong>Methods: </strong>Clinical and imaging data from patients who underwent MRCP examinations from January 2020 to December 2021 were retrospectively collected. A total of 200 patients (100 with confirmed PBM and 100 non-PBM controls) were enrolled. The dataset was randomly divided into training, validation, and test sets in a 6:2:2 ratio. The training and validation sets were used to train YOLOv5 and Inception-ResNetV2. The test set was used to evaluate the accuracy of the model.</p><p><strong>Results: </strong>The PBM group had a higher proportion of females (62% vs. 42%, p = 0.01) and biliary tract cancer (11% vs. 3%, p = 0.03) than controls. The optimal model achieved a mean absolute error of 6.2% and an F1 score of 93.0%, with sensitivity, specificity, positive predictive value, and negative predictive value of 95.0%, 92.5%, 92.7%, and 94.9%, respectively.</p><p><strong>Conclusion: </strong>The proposed deep learning model demonstrates high accuracy in automated PBM detection on MRCP images, offering potential to improve diagnostic efficiency and reduce interobserver variability.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-10"},"PeriodicalIF":3.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210494","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":"Comparative Effectiveness of Hangeshashinto and Ramosetron for the Treatment of Irritable Bowel Syndrome with Diarrhea.","authors":"Koji Nishida, Yuki Hirata, Mitsuyuki Murano, Hideaki Mitooka, Suzune Sugishima, Kei Nakazawa, Ryoji Koshiba, Kazuki Kakimoto, Takako Miyazaki, Shiro Nakamura, Hiroki Nishikawa","doi":"10.1159/000552817","DOIUrl":"10.1159/000552817","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence-based pharmacological options for irritable bowel syndrome with diarrhea (IBS-D) remain limited, and complementary approaches are of interest. We evaluated the real-world effectiveness of hangeshashinto (TJ-14), ramosetron, and their combination in patients with IBS-D or mixed-type IBS (IBS-M).</p><p><strong>Methods: </strong>This retrospective observational pilot study included 56 patients with IBS-D/IBS-M treated for 4 weeks with ramosetron (n = 12), hangeshashinto (n = 31), or combination therapy (n = 13). Symptoms were assessed at baseline and week 4 using the Izumo scale. Within-group changes were examined using nonparametric tests. To address baseline imbalances, pairwise propensity score analyses were performed using Average Treatment effect on the Treated (ATT) weighting with weighted outcome regression adjusting for pretreatment Izumo scores and prespecified covariates.</p><p><strong>Results: </strong>All groups showed improvement in Izumo symptom scores over 4 weeks. In ATT-weighted analyses, follow-up Izumo scores were comparable between hangeshashinto and ramosetron (adjusted mean difference [Hangeshashinto - Ramosetron] -0.269, 95% CI: -1.402 to 0.863). Combination therapy was associated with lower follow-up scores than ramosetron alone (adjusted mean difference [Combination - Ramosetron] -1.849, 95% CI: -3.571 to -0.127), while the comparison with hangeshashinto alone did not reach statistical significance (adjusted mean difference [Combination - Hangeshashinto] -0.845, 95% CI: -1.763 to 0.074). Higher pretreatment Izumo scores were independently associated with greater improvement.</p><p><strong>Conclusion: </strong>In this exploratory real-world analysis, hangeshashinto showed short-term symptom improvement similar to ramosetron, and combination therapy was associated with lower follow-up symptom scores than ramosetron monotherapy in propensity score-adjusted analyses. However, given the retrospective design, small sample size, and inconsistent findings across analytical approaches, these results should be interpreted cautiously and warrant confirmation in larger prospective studies.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148143063","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":"Association between Maternal and Paternal History of Chronic Constipation and Its Development: A Brief Report.","authors":"Nhu Thi Hanh Vu, Duc Trong Quach, Shunsuke Miyauchi, Naoki Ishiuchi, Atsuo Yoshino, Yoshie Miyake, Yuri Okamoto, Toshio Kuwai, Shiro Oka, Toru Hiyama","doi":"10.1159/000552818","DOIUrl":"10.1159/000552818","url":null,"abstract":"<p><strong>Introduction: </strong>A family history of chronic constipation (CC) is considered an important predisposing factor for developing CC. This study aimed to compare the associations of maternal and paternal histories of CC with constipation in offspring.</p><p><strong>Methods: </strong>Students at Hiroshima University completed a web-based health checkup questionnaire between April and June 2025. Data included baseline characteristics, lifestyle factors, family history of CC, Beck Depression Inventory (BDI), Eating Attitudes Test (EAT)-26, and Bulimic Investigatory Test (BITE). CC was diagnosed using the Rome IV criteria. Multivariate logistic regression analysis was performed to identify associated factors.</p><p><strong>Results: </strong>Among 5,518 participants, both maternal and paternal histories of CC were significantly associated with CC, showing similar strength of association (maternal: odds ratio [OR] = 3.47, 95% confidence interval [CI] = 2.82-4.27; paternal: OR = 3.41, 95% CI = 2.16-5.40; both p < 0.001). Other significant factors included higher EAT-26 score (OR: 4.27, 95% CI: 2.31-7.87, p < 0.004), female sex (OR: 2.74, 95% CI: 2.28-3.28, p < 0.001), lack of physical exercise (OR: 1.67, 95% CI: 1.40-1.98, p < 0.001), and short sleep duration (OR: 1.45, 95% CI: 1.22-1.71, p = 0.001).</p><p><strong>Conclusion: </strong>Both maternal and paternal histories of CC were similarly associated with CC. However, this association may be largely driven by unmeasured shared environmental factors and should be interpreted cautiously.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-6"},"PeriodicalIF":3.4,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053462","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 Comprehensive Analysis of Prevalence, Risk Stratification, and Early Post-Procedure Predictive Scoring for Post-Endoscopic Submucosal Dissection Coagulation Syndrome.","authors":"Elsayed Ghoneem, Naohisa Yoshida, Ryohei Hirose, Reo Kobayashi, Naoto Iwai, Ken Inoue, Osamu Dohi, Hideyuki Konishi, Yoshito Itoh, Yoshikazu Inagaki, Yutaka Inada, Yukiko Morinaga, Motohiro Kojima","doi":"10.1159/000552645","DOIUrl":"10.1159/000552645","url":null,"abstract":"<p><strong>Introduction: </strong>Post-endoscopic submucosal dissection (ESD) coagulation syndrome (PECS) is defined as abdominal pain with inflammatory responses, requiring careful differentiation from delayed perforation (DP). This study aimed to evaluate clinical and biochemical characteristics associated with PECS and DP following ESD and to develop a scoring system for predicting PECS.</p><p><strong>Methods: </strong>We retrospectively analyzed 318 consecutive patients who underwent colorectal ESD at our institution between January 2022 and June 2024. Patients were classified into three groups: PECS (n = 32), DP (n = 7), and no-PECS/no-DP (NPD) (n = 279). Multivariate analysis was performed to identify predictors of PECS for clinical factors and values such as C-reactive protein (CRP), white blood cell (WBC) count, and body temperature. Based on significant predictors, we constructed a five-variable PECS-predictive scoring system (FPSS) for early post-procedure prediction of PECS.</p><p><strong>Results: </strong>Among 318 patients, the incidence of PECS and DP was 10.1% and 2.2%, respectively. DP cases demonstrated greater CRP elevation (p < 0.001) and higher leukocytosis (p = 0.011) compared with PECS, while PECS cases showed significantly higher WBC (p < 0.001) and CRP (p < 0.001) than the NPD group. Multivariate analysis identified five independent predictors of PECS: right colon (odds ratio [OR] = 3.54; p = 0.004), female gender (OR = 2.10; p = 0.018), body temperature ≥37.6°C (OR = 16.70; p < 0.001), WBC >8,000/µL on day 1 (OR = 13.78; p < 0.001), and lesion size >24 mm (OR = 3.03; p = 0.003). The FPSS (range 0-9) achieved an area under the receiver operating characteristic curve of 0.881, with high negative predictive value (97.4%).</p><p><strong>Conclusion: </strong>The characteristics of PECS were clarified in comparison with NPD and DP, and the newly developed FPSS demonstrated excellent diagnostic performance of PECS.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-14"},"PeriodicalIF":3.4,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986877","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}