Digestion最新文献

{"title":"Association between Antithrombotic Drug Management and Bleeding during High-Risk Endoscopic Procedures: A Multicenter Retrospective Observational Study.","authors":"Makoto Imai, Tomonori Aoki, Ryota Niikura, Kazuhiro Furukawa, Nobuo Toda, Yuntae Kim, Keiji Ogura, Takuma Okamura, Kenkei Hasatani, Naohiro Yoshida, Tetsuya Sumiyoshi, Tsutomu Nishida, Shu Kiyotoki, Masahiro Arai, Takaaki Ikeda, Yasuaki Motomura, Seishi Yamada, Miwa Kurasawa, Eiji Otsuka, Tomoyuki Iwata, Kazuto Komatsu, Nobumi Suzuki, Yoku Hayakawa, Mitsuhiro Fujishiro","doi":"10.1159/000552539","DOIUrl":"10.1159/000552539","url":null,"abstract":"<p><strong>Introduction: </strong>Optimal management of antithrombotic drugs (ATDs) is essential to minimize bleeding during high-risk endoscopic procedures. This study aimed to investigate periprocedural ATD strategies to reduce 30-day post-procedural bleeding.</p><p><strong>Methods: </strong>We performed a multicenter, retrospective cohort study on high-risk endoscopic procedures. The primary outcome was 30-day bleeding requiring endoscopic hemostasis. We categorized the peri-procedure management of ATDs into continuation, discontinuation, and replacement. We evaluated the risk differences in 30-day bleeding among ATD management groups, as compared to patients who did not take ATDs (nonusers).</p><p><strong>Results: </strong>High-risk upper-GI procedures included 1,365 esophageal ESDs, 788 elective EVLs, 5,391 gastric ESDs, and 2,562 PEGs; lower-GI procedures included 23,326 colonic polypectomy/EMRs and 2,769 colonic ESDs. ATD management included aspirin continuation (n = 818) and discontinuation (n = 62); thienopyridine discontinuation (n = 188) and replacement (n = 97); warfarin continuation (n = 97) and discontinuation (n = 20); DOAC discontinuation (n = 487). Thirty-day bleeding occurred in 5.89% of upper-GI and 1.22% of lower-GI procedures. Bleeding risk differed according to ATD management. In upper-GI procedures, numerically higher bleeding rates were observed in some antithrombotic management groups, particularly aspirin continuation and thienopyridine discontinuation during gastric ESD, compared with nonusers; however, the absolute risk differences were within 10%. In contrast, bleeding risk differences in lower-GI procedures were smaller overall and within 5%.</p><p><strong>Conclusion: </strong>This multicenter study describes differential bleeding risk patterns across high-risk endoscopic procedures among patients receiving antithrombotic therapy.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.4,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971401","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":"Family History and Clinical Severity of Functional Constipation: Sex-Stratified Findings from the FAMI-CON+ Multicenter Retrospective Study.","authors":"Akihiko Oka, Kazuhiro Kozuka, Koki Matsuo, Hideharu Okanobu, Ritsuo Mouri, Seiji Onogawa, Shinji Tanaka, Tomohiro Miwata, Nhu Thi Hanh Vu, Duc Trong Quach, Toshio Kuwai, Hideki Kobara, Shunji Ishihara, Shiro Oka, Toru Hiyama","doi":"10.1159/000552532","DOIUrl":"10.1159/000552532","url":null,"abstract":"<p><strong>Introduction: </strong>Functional constipation (FC) is one of the most prevalent disorders of gut-brain interaction, associated with reduced quality of life and increased morbidity and mortality. Although several studies have examined risk factors in children, research focusing on adult populations is considerably limited. The present study investigated the association between family history and the clinical phenotype of FC using an adult cohort and a standardized constipation scoring system, building on prior population-based findings suggesting familial influences on disease prevalence and severity.</p><p><strong>Methods: </strong>A retrospective multicenter study of adults diagnosed with FC according to the Rome IV criteria was conducted at 9 Japanese centers. Collected data included family history, demographic characteristics, age at symptom onset, modified Constipation Scoring System (mCSS) scores before and after treatment, and prescribed medications, with onset age and mCSS selected to evaluate potential familial associations with earlier disease onset and greater symptom severity.</p><p><strong>Results: </strong>Data from 266 patients were analyzed. A family history was present in 30.1% of patients and was more common in women (34.5%) than in men (22.1%) (OR 1.86, 95% CI: 1.04-3.31; p = 0.037). Among the women, a positive family history was associated with earlier onset (median 30 vs. 40 years, p = 0.043) and higher baseline mCSS scores (median 11 vs. 8, p = 0.039), whereas no significant associations were observed in men. Subscore analyses showed higher ratings for \"feeling of incomplete evacuation\" and \"minutes in lavatory per attempt\" in women with a family history. Although women with a family history required more medications, treatment response, as measured by improvement in mCSS, was comparable to those without such history.</p><p><strong>Conclusion: </strong>Family history is associated with sex-specific differences in the clinical presentation of FC. This pattern may reflect interactions between genetic susceptibility, hormonal factors, and shared familial environments.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.4,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971463","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":"Body Mass Index and Mucosal Healing in Japanese Patients with Ulcerative Colitis: A Cross-Sectional Study.","authors":"Masakazu Hanayama, Shinya Furukawa, Teruki Miyake, Osamu Yoshida, Hironubu Nakaguchi, Ayumi Kanamoto, Masumi Miyazaki, Yoshimasa Murakami, Keiichiro Horiuchi, Kazuhiro Tange, Shogo Kitahata, Tomoyuki Ninomiya, Seiyuu Suzuki, Katsuhisa Ohashi, Hideomi Tomida, Yasunori Yamamoto, Eiji Takeshita, Yoshio Ikeda, Yoichi Hiasa","doi":"10.1159/000552452","DOIUrl":"10.1159/000552452","url":null,"abstract":"<p><strong>Introduction: </strong>Ulcerative colitis (UC) is a chronic inflammatory bowel disease, and obesity is thought to exacerbate disease activity via chronic low-grade inflammation and related metabolic and cytokine dysregulation. However, evidence on the relationship between obesity and UC remains limited and inconsistent. As mucosal healing (MH) is an established therapeutic goal in UC, we aimed to investigate the association between body mass index (BMI) and MH in Japanese patients with UC.</p><p><strong>Methods: </strong>This study included 292 Japanese UC patients. One endoscopist evaluated complete MH (CMH), defined as Mayo endoscopic subscores of 0. Underweight and obesity were defined as BMI <18.5 and ≥25 kg/m2, respectively. For detailed analysis, BMI was divided into quartiles: low: <19.70 kg/m2, lower-middle: 19.70-21.82 kg/m2, upper-middle: 21.83-24.60 kg/m2, and high: ≥24.61 kg/m2. Multivariable logistic regression models were used to adjust for potential confounders and to evaluate the associations of BMI categories with MH.</p><p><strong>Results: </strong>The mean age, male ratio, CMH rate, and clinical remission rate were 50.3 years, 57.9%, 25.0%, and 59.6%, respectively. No clear association between underweight, normal weight, or obesity and CMH was observed; however, in the quartile analysis, the highest BMI was independently and positively associated with CMH in the younger group but not in the older group (adjusted odds ratios: 0.29, 95% confidence interval: 0.07-0.97).</p><p><strong>Conclusion: </strong>BMI was independently and inversely associated with CMH in Japanese younger patients with UC, but this association was not observed in older patients.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-8"},"PeriodicalIF":3.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927341","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":"Comparison of Linked Color Imaging and Narrow-Band Imaging for Detection and Miss Rates during Right-Sided Colonoscopy: A Multicenter Tandem Randomized Controlled Trial.","authors":"Shoko Ono, Naohisa Yoshida, Mio Matsumoto, Shuhei Hayasaka, Masaki Inoue, Ken Inoue, Momoko Tsuda, Reo Kobayashi, Ryo Takagi, Yusuke Nishimura, Sosuke Kato, Nobuaki Yagi, Naoya Sakamoto, Mototsugu Kato","doi":"10.1159/000552449","DOIUrl":"10.1159/000552449","url":null,"abstract":"<p><strong>Introduction: </strong>Right-sided lesions are frequently missed during colonoscopy, and the diagnostic performance of image-enhanced endoscopy (IEE) modalities remains debated. This multicenter randomized controlled trial compared linked color imaging (LCI) with second-generation narrow-band imaging (2G-NBI) for adenoma detection and miss rates in the right colon.</p><p><strong>Methods: </strong>Patients undergoing colonoscopy at six centers in Japan between November 2020 and November 2023 were randomly assigned (1:1) to primary right-colon observation with LCI or 2G-NBI, followed by secondary white-light imaging (WLI). The primary outcome was adenoma detection rate (ADR) in the right-sided colon during primary IEE observation. Secondary outcomes included polyp detection rate (PDR) and miss rates of adenomas and polyps.</p><p><strong>Results: </strong>A total of 1,528 patients were analyzed (LCI, n = 776; 2G-NBI, n = 752). ADR did not significantly differ between the LCI group and the 2G-NBI group (26.7% vs. 23.4%, p = 0.14). PDR was also comparable (32.6% vs. 28.9%, p = 0.12). However, secondary WLI identified fewer additional polyps after LCI than after 2G-NBI (12.4% vs. 16.4%, p = 0.026). Per-lesion miss rates were significantly lower with LCI for both adenomas (19.9% vs. 31.4%) and polyps (21.5% vs. 31.9%) (both p < 0.001). Multivariable analyses confirmed the association between LCI and a reduced risk of missed lesions, with more pronounced associations observed in cases of poor bowel preparation, procedures by expert endoscopists, and observation times ≤70 s.</p><p><strong>Conclusion: </strong>Although ADR did not differ significantly between modalities, lower miss rates in the right-sided colon were observed with LCI. The Japan Registry of Clinical Trials (jRCT1012200007).</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-10"},"PeriodicalIF":3.4,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873741","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":"Increased Extracolonic Cancer Incidence and Mortality in Patients with Serrated Polyposis Syndrome with a History of Colorectal Cancer: A Comparative Cohort Study.","authors":"Yasutsugu Shimohara, Hidehiko Takigawa, Yuji Urabe, Yoshihiro Kishida, Akinori Nagao, Yuki Kitadai, Yukiko Sako, Hidenori Tanaka, Ken Yamashita, Yuichi Hiyama, Toshio Kuwai, Shiro Oka","doi":"10.1159/000552448","DOIUrl":"10.1159/000552448","url":null,"abstract":"<p><strong>Introduction: </strong>Serrated polyposis syndrome (SPS) is a high-risk factor for colorectal cancer (CRC); however, prognostic differences based on patient characteristics are poorly understood. This exploratory study investigated the impact of concomitant or a history of CRC at the time of SPS diagnosis on long-term prognosis.</p><p><strong>Methods: </strong>Of the 70 patients diagnosed with SPS between 2009 and 2023, 55 with a 1-year follow-up were included in this single-center retrospective cohort study. Patients with a history of CRC were assigned to the CRC (+) (n = 16) group and those without a history of CRC were assigned to the CRC (-) group (n = 39). We compared the baseline characteristics, surveillance findings, and long-term outcomes, including new extracolonic cancer incidence and overall survival, between the groups.</p><p><strong>Results: </strong>The CRC (+) group had a significantly higher prevalence of personal history of other cancers (38% vs. 10%, p = 0.024) and family history of cancer (69% vs. 38%, p = 0.048). The incidence of new extracolonic cancers during follow-up after the diagnosis of SPS was significantly higher in the CRC (+) group (25%; 4/16) than in the CRC (-) group (3%; 1/39) (p = 0.012). Overall survival was also significantly poorer in the CRC (+) group (two deaths, 13%) than in the CRC (-) group (p = 0.044).</p><p><strong>Conclusion: </strong>A history of CRC in patients with SPS is associated with a higher incidence of new extracolonic cancer and poorer overall survival. These findings suggest that management strategies should extend beyond standard colorectal surveillance to comprehensive systemic monitoring. Therefore, the validation of these results in larger prospective cohorts is warranted.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-9"},"PeriodicalIF":3.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834983","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":"Impact of Constipation on Quality of Life, Work Productivity, and Treatment Practices: Findings from the CONNECT Web-Based Survey.","authors":"Tomohisa Takagi, Tadashi Shin, Shinji Yoneda, Masaaki Higashikawa, Yusuke Shimada, Minami Umeyama, Masato Ueno","doi":"10.1159/000552237","DOIUrl":"10.1159/000552237","url":null,"abstract":"<p><strong>Introduction: </strong>Constipation is a common gastrointestinal disorder that negatively affects quality of life (QOL), work productivity, and long-term prognosis. The aim of this study was to examine the associations between constipation severity and Short Form-8 Health Survey (SF-8) and Work Productivity and Activity Impairment Questionnaire (WPAI) scores, as well as treatment status and patient preferences, through a large-scale survey of the general population.</p><p><strong>Methods: </strong>A web-based questionnaire was administered to 2,300 Japanese adults with constipation symptoms using a large survey panel. The survey assessed the Constipation Scoring System (CSS), Bristol Stool Form Scale (BSFS), SF-8, WPAI, treatment status, and preferences for treatment methods.</p><p><strong>Results: </strong>CSS scores showed significant negative correlations with the SF-8 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores and significant positive correlations with WPAI scores (p < 0.05). Both SF-8 and WPAI scores differed significantly across BSFS categories, with normal stool forms associated with better outcomes (p < 0.05). Only 22.0% of participants received prescription medication for constipation. The most common reason for not seeking medical care was \"inconvenience of visiting a medical institution\" (65.6%). Regarding treatment preferences, 80.8% preferred tablet formulations, and once-daily administration at bedtime was the most favored dosing schedule (56.7%), followed by before breakfast (30.0%).</p><p><strong>Conclusion: </strong>Constipation severity and stool form are associated with QOL and work productivity, underscoring the importance of appropriate treatment strategies. Patient preference should also be considered when selecting therapeutic options.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812263","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":"Comparative Assessment of Diagnostic Accuracy and Puncture Duration of Two Endoscopic Ultrasound Biopsy Needles (22G Franseen versus 20G Antegrade Core Trap) in Patients with Solid Pancreatic Lesions.","authors":"Golo Petzold, Linda S Huhnold, Richard F Knoop, Dirk Raddatz, André Sasse, Thomas R Heiduk, Jovan Todorovic, Felix Bremmer, Philipp Stroebel, Volker Ellenrieder, Albrecht Neesse, Ahmad Amanzada","doi":"10.1159/000551930","DOIUrl":"10.1159/000551930","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic ultrasound with fine needle biopsy (EUS-FNB) is the clinical standard for histological confirmation of solid pancreatic lesions. Various types of needles are available. Current guidelines cannot provide recommendations on the type of needle to be used. The aim of the study was to compare the diagnostic accuracy and puncture duration of two EUS-FNB needles (22G Franseen vs. 20G antegrade core trap) in solid pancreatic tumors.</p><p><strong>Methods: </strong>Between 09/2023 and 02/2025, patients with solid pancreatic masses and indication for histological confirmation by EUS-FNB underwent two puncture procedures at a tertiary hospital, one with a 22G FNB needle and one with a 20G FNB needle. The diagnostic accuracy and puncture duration of both needles were compared.</p><p><strong>Results: </strong>Fifty patients were prospectively included. The mean diameter of the solid lesion was 29.43 mm (±8.69). The final diagnosis was pancreatic adenocarcinoma in 47 patients, neuroendocrine tumor in 2 patients, and pseudotumor in 1 patient. In 86% of cases (43/50), the diagnosis was made with the 22G needle, and in 66% (33/50) with the 20G needle. This difference was statistically significant (p = 0.019). When both needles were used in combination, the diagnostic accuracy was 90% (45/50). The average puncture time with the 22G needle was 166 s (±73) and with the 20G needle 212 s (±93). The difference was significant (p = 0.007).</p><p><strong>Conclusion: </strong>The 22G FNB needle was superior to the 20G needle in terms of both diagnostic accuracy and puncture time. The study contributes to improving the available data for selecting the most suitable EUS needle types.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-7"},"PeriodicalIF":3.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765445","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":"An Epidemiological Study on the Relationship between Gastric Mucosal Atrophy, Exhaled Hydrogen Concentration, and Gut Microbiota.","authors":"Satoshi Sato, Daisuke Chinda, Keita Mikami, Masakazu Tobinai, Nao Ishidoya, Keisuke Furusawa, Kaede Miyashiro, Kenta Yoshida, Chikara Iino, Kaori Sawada, Tatsuya Mikami, Shigeyuki Nakaji, Koichi Murashita, Hirotake Sakuraba","doi":"10.1159/000552238","DOIUrl":"10.1159/000552238","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to conduct an epidemiological investigation of the relationship between gastric mucosal atrophy and exhaled hydrogen gas concentration, including gut microbiota, in residents who participated in health checkups.</p><p><strong>Methods: </strong>Based on pepsinogen I <70 ng/mL and PG I/PG II <3 as cutoff values, the participants were divided into a control (n = 903) and atrophy (n = 63) groups. The exhaled hydrogen gas concentrations and gut microbiota were compared in 212 participants from the control group and 53 participants from the atrophy group, selected through propensity score matching. Furthermore, participants were categorized as non-infection, persistent infection, or post-eradication groups based on their Helicobacter pylori (H. pylori) infection status.</p><p><strong>Results: </strong>In the atrophy group, 66.0% were persistent H. pylori carriers, whereas 39.6% of the control group had undergone H. pylori eradication. The atrophy group showed lower exhaled hydrogen concentration than those of the control group. In the gut microbiota of the atrophy group, an increase in Streptococcus, and a decrease in Blautia were observed. Among H. pylori infection statuses, persistent infection group showed reduced exhaled hydrogen gas concentration and increased gut Streptococcus compared to the non-infection group, but no association was observed with the post-eradication group.</p><p><strong>Conclusions: </strong>Most individuals infected with H. pylori showed evidence of gastric mucosal atrophy, accompanied by decreased breath hydrogen concentrations and alterations in the gut microbiota. Eradication of H. pylori may ameliorate gastric mucosal atrophy, which could subsequently normalize the gut microbial composition and lead to increased levels of exhaled hydrogen.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-14"},"PeriodicalIF":3.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765742","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":"Endoscopic Management of Pancreatobiliary Diseases in Patients with Surgically Altered Anatomy: A Perspective from Single-Balloon Enteroscopy.","authors":"Yuki Tanisaka, Shomei Ryozawa, Masafumi Mizuide, Akashi Fujita, Suguru Ito, Ryuichi Watanabe, Ryosuke Hamamura, Yoshiki Matsuno","doi":"10.1159/000552310","DOIUrl":"10.1159/000552310","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) has long been established as a standard procedure with a high success rate and an acceptable incidence of adverse events. However, performing ERCP in patients with surgically altered anatomy remains technically challenging, not only because of the difficulty in accessing the target site but also in performing subsequent therapeutic interventions. To address these challenges, balloon enteroscopy (BE)-assisted ERCP has been introduced into clinical practice and has demonstrated both efficacy and safety. More recently, the short-type single-balloon enteroscopy (short SBE), with a working length of 152 cm and a 3.2-mm working channel, has been widely adopted, enhancing procedural efficiency. The short SBE allows the use of a wider range of accessories in various therapeutic interventions, such as stone extraction and self-expandable metallic stent placement.</p><p><strong>Summary: </strong>This review provides a comprehensive overview of SBE-assisted ERCP, with a particular focus on short SBE. It summarizes reported procedural success and adverse event rates from previous studies and discusses factors associated with procedural failure. In addition, it highlights key technical tips, various procedural approaches using short SBE-assisted ERCP, and recent advances in relevant technologies and devices.</p><p><strong>Key messages: </strong>Despite these advancements, multiple technical challenges still need to be overcome to successfully complete the procedure. Proficiency in alternative treatments, such as endoscopic ultrasound-guided biliary drainage (EUS-BD), is also essential. The decision between BE-assisted ERCP and EUS-BD should be individualized according to the type of postoperative reconstruction, the patient's clinical status, and, importantly, the endoscopist's experience level.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-12"},"PeriodicalIF":3.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765525","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":"IL-22 Associates with Venous Thromboembolism in Inflammatory Bowel Disease: A Hypothesis-Generating Study.","authors":"Rahel Cola, Gerhard Rogler, Luc Biedermann, Fritz Murray, Reto Krapf, Juerg H Beer","doi":"10.1159/000552011","DOIUrl":"10.1159/000552011","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with inflammatory bowel disease (IBD) are at significantly increased risk for venous thromboembolism (VTE). We hypothesized that (i) the increased risk is associated with elevated levels of typical pro-inflammatory cytokines and (ii) that elevated concentrations of specific cytokines could possibly predict a thromboembolic event.</p><p><strong>Methods: </strong>We examined 226 well-characterized patients of the Swiss IBD cohort study (SIBDCS); we analyzed serum samples from IBD patients with documented VTE (n = 78) and compared them 2:1 with age- and sex-matched controls without VTE of the same cohort (n = 148). An array of 12 typical proinflammatory cytokines (IL2, IL17a, IL12p70, IL8, IL1b, IL4, IL5, IFN-γ, IL6, IL22, TNF-α, and IL-10) was quantified. Detailed disease characteristics - such as activity (mild, moderate, and quiescent) as well as age at visit, sex, and the time interval between thrombosis and blood collection were statistically analyzed.</p><p><strong>Results: </strong>IL2, IL17a, IL12p70, IL8, IL1b, IL4, IL5, IFN-γ, IL6, TNF-α, and IL-10 showed no statistical difference between the thrombosis and control group. In contrast, IL-22 levels (0.709 vs. 0.542 pg/mL, p < 0.05) were significantly higher in the VTE group.</p><p><strong>Conclusions: </strong>IL-22, may associate with an increased risk of VTE in IBD in this hypothesis-generating study, whereas the other inflammatory parameters measured were not associated. This marker appears to be independent of disease activity, as the other cytokines, which are considered markers of disease activity, did not show a significant difference in comparison. Further targeted and serial measurements will have to confirm our findings.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-10"},"PeriodicalIF":3.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765474","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}