Digestion最新文献_第5页

Clinicopathological and Endoscopic Features of Non-Ampullary Duodenal Epithelial Tumors with Gastrointestinal Mixed Phenotype. 胃肠道混合表型非壶腹十二指肠上皮肿瘤的临床病理及内镜特征。

IF 3 3区医学

Digestion Pub Date : 2025-06-20 DOI: 10.1159/000547024

Momoko Yamamoto, Yoichi Akazawa, Nobuyuki Suzuki, Hiroya Ueyama, Shunsuke Nakamura, Yasuko Uemura, Tomoyo Iwano, Ryota Uchida, Hisanori Utsunomiya, Daiki Abe, Shotaro Oki, Atsushi Ikeda, Tsutomu Takeda, Kumiko Ueda, Mariko Hojo, Tadasuke Hashiguchi, Takashi Hashimoto, Shinji Mine, Takashi Yao, Akihito Nagahara

{"title":"Clinicopathological and Endoscopic Features of Non-Ampullary Duodenal Epithelial Tumors with Gastrointestinal Mixed Phenotype.","authors":"Momoko Yamamoto, Yoichi Akazawa, Nobuyuki Suzuki, Hiroya Ueyama, Shunsuke Nakamura, Yasuko Uemura, Tomoyo Iwano, Ryota Uchida, Hisanori Utsunomiya, Daiki Abe, Shotaro Oki, Atsushi Ikeda, Tsutomu Takeda, Kumiko Ueda, Mariko Hojo, Tadasuke Hashiguchi, Takashi Hashimoto, Shinji Mine, Takashi Yao, Akihito Nagahara","doi":"10.1159/000547024","DOIUrl":"10.1159/000547024","url":null,"abstract":"Introduction: Non-ampullary duodenal epithelial tumors with a gastrointestinal mixed phenotype (mixed-type NADETs) have not been thoroughly analyzed. We aimed to elucidate the clinicopathological and endoscopic characteristics of mixed-type NADETs.Methods: A total of 229 NADETs from 218 patients collected from February 2010 to December 2023 were analyzed. Based on immunohistochemistry for MUC5AC, MUC6, MUC2, and CD10, the NADETs were classified into gastric phenotype (GP), gastric predominant mixed phenotype (GPP), intestinal predominant mixed phenotype (IPP), and intestinal phenotype (IP).Results: Among the 229 NADETs, there were 20, 22, 69, and 118 lesions classified as GP, GPP, IPP, and IP, respectively. Tumor location (first/second/third) was GP = 13/7/0, GPP = 12/8/2, IPP = 13/52/4, and IP = 16/94/8 (p < 0.01). Mean tumor sizes of GP, GPP, IPP, and IP were 14.7/18.5/10.9/10.3 mm (p < 0.01), respectively. The ratio of category 4/5 by Vienna classification was 50.0, 68.2, 13.0, and 2.5% (p < 0.01), respectively. In the comparisons between GP vs. GPP and IP vs. IPP, white opaque substance was significantly less frequently observed in GP than in GPP (p < 0.05), the ratio of category 4/5 was significantly higher in IPP than in IP (p < 0.01), but no significant differences were observed in tumor location, coloration, macroscopic type, and endoscopic findings including magnifying endoscopy with narrow-band imaging.Conclusion: Mixed-type NADETs (GPP and IPP) exhibited similar endoscopic and clinicopathological characteristics to their predominant phenotypes, and may have a higher malignant potential than the pure phenotypes.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368691","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

Colonization of Streptococcus pyogenes Is Associated with Functional Dyspepsia and Exacerbates Functional Dyspepsia in Mice by Inhibiting the RhoA/ROCK1 Pathway through the Skin-Gut Axis. 化脓性链球菌的定植与功能性消化不良有关，并通过抑制RhoA/ROCK1途径通过皮肤-肠轴加剧小鼠功能性消化不良。

IF 3.6 3区医学

Digestion Pub Date : 2025-06-19 DOI: 10.1159/000545005

Yihan Lin, Cunze Wang, Meilin Fang, Hongyuan You, Jinglin Li, Shasha Huang, Chengyang Xu, Ling Wang

{"title":"Colonization of <italic>Streptococcus pyogenes</italic> Is Associated with Functional Dyspepsia and Exacerbates Functional Dyspepsia in Mice by Inhibiting the RhoA/ROCK1 Pathway through the Skin-Gut Axis.","authors":"Yihan Lin, Cunze Wang, Meilin Fang, Hongyuan You, Jinglin Li, Shasha Huang, Chengyang Xu, Ling Wang","doi":"10.1159/000545005","DOIUrl":"10.1159/000545005","url":null,"abstract":"Introduction: We investigated the importance of skin microbiota in functional dyspepsia (FD) based on the skin-gut axis theory and revealed potential mechanisms. This study also validates recent popular FD treatments.Methods: We used mendelian randomization (MR) to analyze 418 gut bacteria and 145 skin bacteria, identifying key symbionts in FD development. Bibliometric keyword analysis was conducted on current FD therapies. Finally, we used a mouse model of FD to assess body weight, food intake, gastric residue rate, small intestine transit rate, and fecal water content after interventions with skin-gut symbionts and treatment methods. Hematoxylin-eosin staining observed gastric antrum tissue morphology. RhoA and ROCK1 protein and mRNA levels in gastric antrum tissue were detected by western blot and real-time PCR. Fluorescence immunoassay observed ROCK1 and vesicular acetylcholine transporter (VAChT) protein expression.Results: Streptococcus has a causal relationship with FD. Bibliometric analysis highlighted electroacupuncture as a research hotspot. Skin Streptococcus colonization reduced food intake, body weight, small intestine transit rate, and increased gastric residue rate in FD mice, decreasing RhoA, ROCK1, and VAChT protein and mRNA levels. Antibiotics reversed these effects. Electroacupuncture improved weight, appetite, gastrointestinal motility, and RhoA, ROCK1, and VAChT protein, and mRNA levels in FD mice.Conclusion: The study confirmed the pathogenic role of skin Streptococcus in FD and the therapeutic value of electroacupuncture at Tianshu acupoint, potentially via RhoA/ROCK1 signaling pathway regulation.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-20"},"PeriodicalIF":3.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368692","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

Timing and Predictors for Vonoprazan Dose Escalation in Refractory Gastroesophageal Reflux Disease: A Long-Term Observational Study. 难治性胃食管反流病Vonoprazan剂量增加的时间和预测因素：一项长期观察研究

IF 3 3区医学

Digestion Pub Date : 2025-06-17 DOI: 10.1159/000546992

Satoshi Shinozaki, Hirotsugu Sakamoto, Hiroyuki Osawa, Tomonori Yano, Nikolaos Lazaridis, Hironori Yamamoto

{"title":"Timing and Predictors for Vonoprazan Dose Escalation in Refractory Gastroesophageal Reflux Disease: A Long-Term Observational Study.","authors":"Satoshi Shinozaki, Hirotsugu Sakamoto, Hiroyuki Osawa, Tomonori Yano, Nikolaos Lazaridis, Hironori Yamamoto","doi":"10.1159/000546992","DOIUrl":"10.1159/000546992","url":null,"abstract":"Introduction: Vonoprazan (VPZ) therapy has become one of the standard treatments for gastroesophageal reflux disease (GERD). When GERD symptoms persist despite the maintenance dose therapy (10 mg daily), dose escalation to 20 mg daily is generally recommended. This study aims to clarify the proper timing and predictors for dose escalation of VPZ therapy in patients with refractory GERD treated with the maintenance dose.Methods: This retrospective observational study included 257 patients with symptomatic GERD. Data from medical records, including endoscopic findings and Izumo scale scores, were analyzed.Results: The mean follow-up period was 3.3 years. Throughout the follow-up period, VPZ dose escalation (from 10 to 20 mg daily) was required in 56 of 257 patients (22%). Kaplan-Meier analysis showed cumulative dose-escalation-free rates at 6 months, 1 year, and 2 years were 87%, 81%, and 78%, respectively. Predictive factors for VPZ dose escalation were analyzed using a Cox proportional-hazards regression model. Multivariate analysis revealed that pre-existing epigastric pain was a significant positive predictor for dose escalation, whereas pre-existing constipation was identified as a significant negative predictor. Kaplan-Meier analysis indicated that the 1-year dose-escalation-free rates were 69% in patients with epigastric pain compared to 88% in those without (p = 0.001). GERD symptom scores showed a significant improvement 1 month after dose escalation.Conclusion: The incidence of refractory GERD requiring VPZ dose escalation is relatively low. Epigastric pain prior to VPZ initiation independently predicts the need for dose escalation. VPZ dose escalation effectively improves GERD symptoms.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316172","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

Texture and Colour Enhancement Imaging versus White Light Endoscopy for Detection of Dysplasia within Barrett's Oesophagus: A Pilot Study. 纹理和彩色增强成像（TXI）与白光内窥镜检测Barrett食管内发育不良：一项初步研究。

IF 3.6 3区医学

Digestion Pub Date : 2025-06-16 DOI: 10.1159/000546637

Edward Young, Hamish Philpott, Rajvinder Singh

{"title":"Texture and Colour Enhancement Imaging versus White Light Endoscopy for Detection of Dysplasia within Barrett's Oesophagus: A Pilot Study.","authors":"Edward Young, Hamish Philpott, Rajvinder Singh","doi":"10.1159/000546637","DOIUrl":"10.1159/000546637","url":null,"abstract":"Introduction: Oesophageal cancer is a leading global health issue, with increasing prevalence of oesophageal adenocarcinoma and its precursor lesion, Barrett's oesophagus (BE). Despite the opportunity to treat dysplasia prior to adenocarcinoma development, rates of missed advanced dysplasia at BE surveillance remain high. This pilot study aimed to assess whether Texture and Colour Enhancement Imaging (TXI), a new advanced mucosal imaging modality, improves dysplasia detection during BE surveillance compared to white light endoscopy (WLE).Methods: Patients undergoing endoscopy for BE assessment or surveillance at a single centre were included for analysis. Patients were randomized in a 1:1 ratio to examination with WLE then TXI or vice versa, followed by narrow-band imaging (NBI). Targeted biopsies were taken from any suspicious areas and 4-quadrant surveillance biopsies were taken at 1 cm intervals in the entire BE segment.Results: A total of 50 patients were included in the study, with 27 suspicious lesions seen in 22 patients. A total 93.3% (n = 14/15) of high-grade dysplasia or early adenocarcinoma was detected as endoscopically visible lesions on TXI and NBI. However, 4 such lesions were not detected on WLE. On per-patient analysis, the sensitivity and NPV of TXI in combination with magnified NBI were both 100% with specificity of 84.6%, surpassing all PIVI thresholds for dysplasia diagnosis in BE.Conclusion: This pilot study demonstrates the feasibility of TXI as a potential addition to the armamentarium of advanced mucosal imaging available to proceduralists surveilling BE. Further large multi-centre studies would be required to make statistical comparisons with existing imaging modalities.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-9"},"PeriodicalIF":3.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309642","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

Role of Endoscopy in Achalasia. 内镜在贲门失弛缓症中的作用。

IF 3 3区医学

Digestion Pub Date : 2025-06-16 DOI: 10.1159/000546952

Noriyuki Kawami, Yoshimasa Hoshikawa, Eri Momma, Shintaro Hoshino, Katsuhiko Iwakiri

{"title":"Role of Endoscopy in Achalasia.","authors":"Noriyuki Kawami, Yoshimasa Hoshikawa, Eri Momma, Shintaro Hoshino, Katsuhiko Iwakiri","doi":"10.1159/000546952","DOIUrl":"10.1159/000546952","url":null,"abstract":"Background: Esophagogastroduodenoscopy is often performed as an initial examination in patients with symptoms such as dysphagia or chest pain, which may suggest esophageal motility disorders. However, its current role is largely limited to ruling out organic diseases.Summary: High-resolution manometry (the gold standard for diagnosing primary esophageal motility disorders such as achalasia) along with esophagography is extremely useful for diagnosis. In recent years, however, several new endoscopic findings - esophageal rosette, gingko leaf sign, champagne glass sign, corona appearance, and pinstripe pattern - have been reported, making it increasingly possible to strongly suspect achalasia through endoscopy. Additionally, the presence of multiple annular contractions, spiral (corkscrew) contractions, or narrowing (poor distensibility) in the esophageal body during endoscopy may suggest abnormal motility of the esophageal body.Key messages: When performing endoscopic examinations in patients with symptoms such as dysphagia or chest pain, it is important to consider the possibility of esophageal motility disorders. Careful endoscopic observation may allow for the suspicion of such disorders during the examination itself.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309641","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

Esophageal Hypervigilance and Visceral Anxiety Are Involved in Esophageal Symptom Perception in Patients with Systemic Sclerosis. 食管高警觉性和内脏焦虑参与系统性硬化症患者的食管症状感知。

IF 3 3区医学

Digestion Pub Date : 2025-06-14 DOI: 10.1159/000546892

Yoshimasa Hoshikawa, Mikito Suzuki, Eri Momma, Shintaro Hoshino, Noriyuki Kawami, Masataka Kuwana, Katsuhiko Iwakiri, Masanori Atsukawa

{"title":"Esophageal Hypervigilance and Visceral Anxiety Are Involved in Esophageal Symptom Perception in Patients with Systemic Sclerosis.","authors":"Yoshimasa Hoshikawa, Mikito Suzuki, Eri Momma, Shintaro Hoshino, Noriyuki Kawami, Masataka Kuwana, Katsuhiko Iwakiri, Masanori Atsukawa","doi":"10.1159/000546892","DOIUrl":"10.1159/000546892","url":null,"abstract":"Introduction: Systemic sclerosis (SSc) causes esophageal motility disorders. However, esophageal symptom severity often does not correlate with the physiological findings of high-resolution manometry (HRM) in patients with SSc. Esophageal hypervigilance and visceral anxiety play a relevant role in symptom perception in patients with gastroesophageal reflux disease and esophageal motility disorders. Therefore, the present study examined the effects of anxiety and hypervigilance, along with HRM findings, on esophageal symptom severity in patients with SSc.Methods: We reviewed the clinical data of consecutive patients with SSc who underwent HRM and were assessed using the esophageal hypervigilance and anxiety scale (EHAS) at our hospital between January 2022 and February 2025. Predictors for the Eckardt symptom score (ESS) and gastroesophageal reflux disease questionnaire (GerdQ) were investigated.Results: This study included 51 patients with SSc. Significant differences were observed in EHAS scores between patients with ESS >3 and those with ESS ≤3 (34.0 [24.0-42.0] vs. 13.0 [1.0-24.0], p = 0.003), but not in HRM findings. The EHAS score accounted for 38.2% of the variance in the ESS score. Significant differences were also observed in the EHAS score between patients with GerdQ ≥8 and those with GerdQ <8 (26.0 [14.3-32.5] vs. 13.0 [0-22.0], p = 0.011). The combined factors of the EHAS score and absent contractility accounted for 17.3% of the variance in the GerdQ score.Conclusion: Esophageal hypervigilance and anxiety may be involved in esophageal symptom severity, particularly dysphagia severity, in patients with SSc. Further studies involving interventions targeting these conditions, such as cognitive behavioral therapy, are warranted.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-9"},"PeriodicalIF":3.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301362","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

Cost-Effective Endoscopic Screening Strategies for Asymptomatic Gastric Cancer. 无症状胃癌的低成本内镜筛查策略。

IF 3 3区医学

Digestion Pub Date : 2025-06-05 DOI: 10.1159/000546835

Fumiaki Ishibashi, Kosuke Okusa

{"title":"Cost-Effective Endoscopic Screening Strategies for Asymptomatic Gastric Cancer.","authors":"Fumiaki Ishibashi, Kosuke Okusa","doi":"10.1159/000546835","DOIUrl":"10.1159/000546835","url":null,"abstract":"Background: In Japan, biennial esophagogastroduodenoscopy (EGD) screening for gastric cancer (GC) has been implemented for adults aged ≥50 years as part of a population-based screening program. This approach has facilitated early GC detection and demonstrated individual-level benefits. However, due to a generational decline in Helicobacter pylori infection, a reduction in the long-term effectiveness of this strategy is anticipated. Given the allocation of national resources, a cost-effectiveness evaluation is essential.Summary: As GC prevalence declines in the target population, the cost-effectiveness of existing screening practices may diminish. Mathematical simulation models are commonly employed to assess the comparative effectiveness and cost-effectiveness of various cancer screening strategies. Microsimulation models, which track individual-level outcomes, are utilized to evaluate person-level effects. By contrast, macrosimulation models - such as Markov and decision tree models - are used to assess population-level outcomes.Key messages: Nine studies have compared different EGD screening strategies. These studies support the effectiveness of biennial screening in high-risk countries. In low- to intermediate-risk countries - and among lower risk populations within high-risk countries - extending the screening interval to ≥3 years appears reasonable. Additionally, strategies incorporating risk stratification using alternative modalities, such as serological tests, are more cost-effective. Continued discussion is necessary to optimize the EGD screening approach.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-8"},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233423","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

Regulation of Colonic Motility by Cystathionine γ-Lyase Neuron Remodeling. 半胱硫氨酸-γ-裂解酶神经元重塑对结肠运动的调节。

IF 3 3区医学

Digestion Pub Date : 2025-05-30 DOI: 10.1159/000546390

Shiwei Liang, Haicheng Fang, Guoqiang Jia, Ying Liu

{"title":"Regulation of Colonic Motility by Cystathionine γ-Lyase Neuron Remodeling.","authors":"Shiwei Liang, Haicheng Fang, Guoqiang Jia, Ying Liu","doi":"10.1159/000546390","DOIUrl":"10.1159/000546390","url":null,"abstract":"Introduction: Colitis is a colonic inflammatory reaction induced by various factors, such as pathogenic microorganisms, physical and chemical factors, and food allergens. At present, the mechanism of colonic motility disorder in colitis remains unclear. The aim of the present study was to investigate the relationship between the expression of cystathionine γ-lyase (CSE) in neurons from colonic tissue and colonic motility disorders in colitis.Methods: A model of colitis was established in rats. The disease activity index (DAI) was determined in the colitis model and control rats, and the number of fecal droppings was recorded for 7 days. Organ bath recordings, immunohistochemistry, immunocytochemistry, and Western blotting were performed on rat colonic samples and in neurons of the myenteric plexus of the enteric nervous system (ENS) in order to investigate the relationship between the expression of CSE and colonic motility disorder in colitis.Results: In the colitis model, colonic motility and the number of fecal pellets were reduced. In addition, treatment with acetylcholine increased the contractile activity of colonic strips in both groups. Treatment with inhibitors of hydrogen sulfide (H2S)-producing enzymes significantly increased the area under the curve of longitudinal muscle strips in the colitis group. CSE was expressed in the mucosa, submucosa, circular muscle, longitudinal muscle cells, and myenteric plexus. The expression of CSE in neurons of the myenteric plexus of the ENS was upregulated in the colitis group.Conclusion: These findings suggest that upregulation of endogenous H2S synthetase and increased H2S production may account for decreased colonic motility.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198529","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

Endoscopic Treatment of Achalasia. 贲门失弛缓症的内镜治疗。

IF 3 3区医学

Digestion Pub Date : 2025-05-28 DOI: 10.1159/000546490

Gonzalo Latorre, Robert Bechara

{"title":"Endoscopic Treatment of Achalasia.","authors":"Gonzalo Latorre, Robert Bechara","doi":"10.1159/000546490","DOIUrl":"10.1159/000546490","url":null,"abstract":"Background: Achalasia is the most common major esophageal motility disorder, characterized by impaired lower esophageal sphincter relaxation and absent or ineffective peristalsis. Peroral endoscopic myotomy (POEM), pneumatic dilation, and botulinum toxin injection are the main endoscopic therapies available. This review highlights recent advances, technical variations, and updated evidence on the efficacy and safety of POEM.Summary: 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.Key messages: 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.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-13"},"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}

引用次数: 0

Steatotic Liver Disease Subtypes and Their Association with Colorectal Cancer Risk in Korea: A Nationwide Population-Based Study. 韩国脂肪变性肝病亚型及其与结直肠癌风险的关系：一项基于全国人群的研究

IF 3 3区医学

Digestion Pub Date : 2025-05-28 DOI: 10.1159/000546376

Sang Yi Moon, Minkook Son, Jong Yoon Lee, Yeo Wool Kang, Myeongseok Koh

{"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":"10.1159/000546376","url":null,"abstract":"Introduction: A recent Delphi consensus proposed a new classification system for steatotic liver disease (SLD), replacing the previous terminology, non-alcoholic fatty liver disease. This study aimed to examine the association between SLD subtypes and the risk of developing colorectal cancer (CRC).Methods: We used the Korean National Health Insurance Service database to identify participants who underwent health screenings in 2009 and 2010 and retrospectively analyzed their data through to 2019. The participants were grouped into four categories: no SLD, metabolic dysfunction-associated SLD (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.Results: 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).Conclusion: Individuals in Korea with MASLD, MetALD, or ALD are at an increased risk of developing CRC.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-13"},"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}

引用次数: 0