Digestive Diseases and Sciences最新文献

{"title":"Will Rogers Paradox in Gastroenterology.","authors":"Amnon Sonnenberg, Anna M Buchner","doi":"10.1007/s10620-025-09028-5","DOIUrl":"https://doi.org/10.1007/s10620-025-09028-5","url":null,"abstract":"<p><p>The use of various classifications to grade and differentiate appearances of digestive diseases has enhanced precision and provided better means for their clinical evaluation and comparison. Staging systems abound to classify erosive esophagitis, gastro-esophageal varices, upper gastrointestinal hemorrhage, histopathology of celiac disease, various types of gastrointestinal neoplasia, and colitis associated with Crohn's disease or ulcerative colitis. The present review serves to highlight how potential bias may become introduced when comparing clinical outcomes based on varying and continuously evolving staging systems of digestive diseases.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Broth Benefits: How Its Nutrients Fortify Gut Barrier in Health and Disease.","authors":"Ayah Matar, Nada Abdelnaem, Michael Camilleri","doi":"10.1007/s10620-025-08997-x","DOIUrl":"https://doi.org/10.1007/s10620-025-08997-x","url":null,"abstract":"<p><p>Bone broth is a traditional nutrient revered by different people from ancient times to the modern era as a remedy for various illnesses. This review investigates the nutritional components of bone broth, focusing primarily on the most abundant amino acids and minerals saturated in bone broth and their impact on health, particularly in the context of intestinal barrier integrity, intestinal permeability, inflammation, and their application in inflammatory bowel disease. Through comprehensive reviews of animal and human studies, this research highlights that bone broth includes amino acids (glutamine, glycine, proline, histidine, arginine), minerals (Ca, P, K, Mg, Zn) that are beneficial and not just a traditional remedy, resolving questions that have been posed for generations. The benefits documented for components in bone broth support the enhancement of gut health, alleviate inflammation in the intestinal barrier, improve intestinal barrier function in health and disease states, particularly in inflammatory bowel disease, as well as enhancing nutrient absorption. Bone broth offers a nutrient-dense option for enhancing overall health and may offer an alternative to dietary supplements with claims for enhanced gut health. We aim to foster interest in and provide evidence to substantiate claims for bone broth as a potential remedy, particularly for maintaining remission in conditions like IBD and possibly functional diarrhea and to encourage further research.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pseudoaneurysms Post-biliary Stenting: A Comprehensive Literature Review.","authors":"Erica Loon, Mohanad Awadalla, Abdellatif Ismail, Monzer Abdalla, Hazem Abosheaishaa, Shaikhoon Mohammed, Chukwunonso Ezeani, Natalie Wilson, Mohammad Bilal, Prabhleen Chahal, Mohamed Abdallah","doi":"10.1007/s10620-025-09017-8","DOIUrl":"https://doi.org/10.1007/s10620-025-09017-8","url":null,"abstract":"<p><strong>Purpose: </strong>Pseudoaneurysms (PSA) following endoscopic biliary stenting are a rare, potentially life-threatening adverse event. Incidence, diagnostic approach, treatment, and prevention of PSA remain unknown. In this comprehensive literature review, we aimed to evaluate the association of developing PSA following biliary stent placement.</p><p><strong>Methods: </strong>We conducted a comprehensive search of databases for studies that reported development of PSA after placement of a biliary stent. Full text review and data extraction were performed according to the PRISMA guidelines.</p><p><strong>Results: </strong>From 386 initial studies, 32 (n = 36 patients) met inclusion criteria. Thirty-one patients had stents placed in the common bile duct, four in the right or left hepatic ducts, and one in the cystic duct. The most common indication for stent placement was biliary obstruction from pancreatic adenocarcinoma with 69.4% of patients having primary pancreaticobiliary malignancy or metastases. 52.0% had received prior chemotherapy with or without localized radiation. Metal stents were used in 60.5% of cases and plastic stents in 37.2%. Average time to PSA presentation was 114 days, with gastrointestinal bleeding as the most common sign/symptom (75%). PSAs were most often located in the hepatic artery (55.6%), diagnosed by diagnostic angiography (55.6%), and treated with embolization (86.1%). No immediate deaths were reported and 83.3% of patients fully recovered.</p><p><strong>Conclusion: </strong>The majority of PSAs presented with gastrointestinal bleeding and developed in patients who had metal stents placed for pancreaticobiliary malignancy. Prior history of previous chemotherapy/radiation or biliary procedures was common in this population. Angiography and embolization were used to diagnose and manage most cases.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Severe Ulcerative Colitis in the Modern Era Spotlight on Opioids, Small Molecule Therapy, and Interdisciplinary Communication.","authors":"Catalina Mulanax, Fernando S Velayos","doi":"10.1007/s10620-025-08947-7","DOIUrl":"https://doi.org/10.1007/s10620-025-08947-7","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automobile Accident Injury Leading to Cryptic Bowel Perforation.","authors":"Bangfa Xiong, Qianfeng Wei, Guangming Yang, Jiahui Wang, Qian Liu, Erqing Chai","doi":"10.1007/s10620-025-08922-2","DOIUrl":"https://doi.org/10.1007/s10620-025-08922-2","url":null,"abstract":"<p><strong>Background: </strong>Blunt abdominal trauma poses diagnostic challenges, particularly in identifying cryptic gastrointestinal perforations. This case report highlights the critical role of meticulous imaging analysis and timely surgical intervention in managing occult bowel injuries following automobile accidents.</p><p><strong>Case presentation: </strong>A 48-year-old male presented with acute abdominal discomfort, muscular rigidity, and peritoneal signs 12 hours after a nighttime traffic collision. Initial abdominal computed tomography (CT) demonstrated ileocecal contusion and ascending colon hematoma, but suboptimal window settings initially obscured evidence of perforation.</p><p><strong>Methods: </strong>Emergency laparoscopic exploration revealed turbid bloody fluid, ileocecal laceration, and extensive colonic edema, necessitating conversion to open surgery. Surgical interventions included ileocecal repair, double-barrel colostomy, saline irrigation, and drainage tube placement. Postoperative care emphasized infection control and wound management.</p><p><strong>Results: </strong>Intraoperative findings confirmed gastrointestinal perforation, corroborated by subsequent CT re-evaluation with adjusted window parameters. The patient recovered uneventfully, with discharge achieved two weeks postoperatively. Follow-up imaging indicated resolution of colonic edema and successful stoma function.</p><p><strong>Conclusion: </strong>This case underscores the diagnostic pitfalls of suboptimal CT settings in occult bowel perforation and advocates for proactive surgical exploration in equivocal trauma scenarios. Multidisciplinary collaboration, precision in imaging interpretation, and tailored surgical strategies are pivotal for favorable outcomes in blunt abdominal trauma. The findings reinforce the necessity of integrating clinical suspicion with advanced diagnostic modalities to mitigate delayed complications.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Per-oral Pancreatoscopy-Guided Lithotripsy Versus Extracorporeal Shock Wave Lithotripsy in Pancreatic Stone: A Meta-Analysis.","authors":"Noppachai Siranart, Landon Kozai, Daniel Martin Simadibrata, Nawan Pornananrat, Peerada Roongphornchai, Patavee Pajareya, Rinrada Worapongpaiboon, Somkiat Phutinart, Wichapol Dendumrongsup, Yanisa Chumpangern, Aunchalee Jaroenlapnopparat, Kornpong Vantanasiri, Kittithat Tantitanawat","doi":"10.1007/s10620-025-08952-w","DOIUrl":"https://doi.org/10.1007/s10620-025-08952-w","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic duct stones (PDS) pose a significant clinical challenge, and choosing treatment modality is crucial to achieving optimal outcomes. Extracorporeal shock wave lithotripsy (ESWL) has long been regarded as the primary intervention for PDS. However, per-oral pancreatoscopy-guided lithotripsy (POP), both electrohydraulic lithotripsy (EHL-POP) and laser lithotripsy (LL-POP), has emerged as a promising endoscopic alternative. This meta-analysis compares the efficacy and safety profiles of EHL-POP, LL-POP, and ESWL for treating PDS.</p><p><strong>Methods: </strong>A search of MEDLINE, EMBASE, and Cochrane databases until November 2023 was conducted to identify studies assessing the use of EHL-POP, LL-POP, or ESWL for the treatment of PDS. Primary outcomes were technical success and clinical success of stones. Secondary outcomes were any adverse events (AEs) and the incidence of post-intervention pancreatitis.</p><p><strong>Results: </strong>A total of 45 observational studies were included. Among the 9624 patients with PDS analyzed, 373 underwent POP (238 EHL-POP and 135 LL-POP), while 9,251 underwent ESWL. The pooled technical and clinical success rates of ESWL versus POP were 85.5% (95% CI: 79.1-90.2%) vs. 88.1% (95% CI: 75.1-94.8%) (p = 0.66) and 78.5% (95% CI: 70.9-84.5%) vs. 81.6% (95% CI: 65.1-91.4%) (p = 0.69), respectively. The pooled technical success rate of EHL-POP was 85.2% (95% CI: 68.5-93.9%, I² = 63%), which was comparable to LL-POP at 92.7% (95% CI: 64.4-98.9%, I² = 0%) (p = 0.48). The clinical success rates of EHL-POP and LL-POP were 74.4% (95% CI: 50.7-89.2%, I² = 48%) and 85.7% (95% CI: 63.9-95.3%, I² = 68%), respectively (p = 0.38). The rates of any adverse events and post-intervention pancreatitis for ESWL vs. POP were 10.1% (95% CI: 5.5-17.6%, I² = 95%) vs. 9.3% (95% CI: 4.1-19.6%, I² = 55%) (p = 0.87) and 4.3% (95% CI: 3.1-5.9%, I² = 85%) vs. 2.8% (95% CI: 1.3-6.1%, I² = 0%) (p = 0.32), respectively.</p><p><strong>Conclusion: </strong>Both EHL-POP and LL-POP, emerges as highly effective and safe alternatives for managing PDS, with safety profiles comparable to ESWL. POP could be considered as an alternative first-line option to ESWL for PDS.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmet Healthcare Needs Among People with Inflammatory Bowel Disease: A Canadian Cross-Sectional Population-Representative Study.","authors":"Gemma Postill, James H B Im, Furong Tang, Eric I Benchimol, M Ellen Kuenzig","doi":"10.1007/s10620-025-09015-w","DOIUrl":"https://doi.org/10.1007/s10620-025-09015-w","url":null,"abstract":"<p><strong>Purpose: </strong>Despite current standards of care, many people with inflammatory bowel disease (IBD) experience significant disease complications and gaps in care. To better understand and address unmet healthcare needs, we need population-level evidence on perceived unmet healthcare needs in people with IBD. Our objective was to compare self-reported unmet healthcare needs among individuals with and without IBD and determine whether accessing medical care attenuates such need.</p><p><strong>Methods: </strong>We used the 2014 Canadian Community Health Survey, a population-representative cross-sectional survey with a multi-stage cluster randomized design. We compared perceived unmet healthcare needs among individuals with and without IBD using multilevel logistic regression, clustering by respondents' health regions and accounting for sociodemographic variables and non-IBD chronic conditions. In a second model, we additionally controlled for access to medical care (family physician, specialists, and psychologists).</p><p><strong>Results: </strong>Eighteen percent of people with IBD (n = 114/632) reported an unmet healthcare need within the preceding 12 months, compared with 11% (n = 5446/53,333) of those without IBD (SMD: 0.18). Those with IBD were more likely to have an unmet healthcare need (adjusted OR: 1.84, 95% CI 1.19-1.85). Additionally adjusting for respondent-reported recent access to medical care slightly attenuated the association between IBD and unmet healthcare needs (adjusted OR: 1.38, 95% CI 1.10-1.72).</p><p><strong>Conclusion: </strong>We provide a population-level perspective on unmet healthcare needs, demonstrating the extent and prominence of gaps in the healthcare provided to individuals living with IBD. Our findings underscore the need for improved access to multidisciplinary healthcare teams, and enhanced patient-physician dialog surrounding perceived healthcare needs.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Machine Learning Methods to Develop Diagnostic and Prognostic mRNA Signatures for Pancreatic Cancer in Plasma Small Extracellular Vesicles.","authors":"Zhen Liu, Shengnan Jia, Liping Cao","doi":"10.1007/s10620-025-08867-6","DOIUrl":"https://doi.org/10.1007/s10620-025-08867-6","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic ductal adenocarcinoma (PDAC) is frequently diagnosed in advanced stage due to the absence of effective diagnostic biomarkers. Small extracellular vesicles (sEVs) have recently emerged as potential clinical biomarkers in liquid biopsy. Our study aimed to explore sEV mRNA biomarkers for PDAC diagnosis and identify relevant markers that could guide the prognosis of PDAC patients.</p><p><strong>Methods: </strong>We analyzed mRNA sequencing of plasma sEVs from 100 participants and employed four machine learning techniques to create and assess the diagnostic models. Partial plasma sEV mRNAs were identified by all four feature extraction methods and used to construct diagnostic model. We also evaluated the predictive value of the model for the survival prognosis of PDAC patients.</p><p><strong>Results: </strong>Combined with carbohydrate antigen 19-9 (CA19-9), the 4 sEV mRNAs diagnostic signature (d-signature) could well differentiate PDAC patients from non-PDAC individuals, healthy control individuals, and benign pancreatic disease patients with an area under the curve (AUC) of 0.902, 0.971, and 0.845 in training cohort and AUC of 0.803, 0.938, and 0.762 in validation cohort. Furthermore, Cox regression analysis indicated that the score constructed based on the sEV mRNA signature was an independent adverse prognostic factor for survival prognosis of PDAC.</p><p><strong>Conclusions: </strong>Our study demonstrated the potential utility of the sEV mRNA d-signature in the diagnosis of PDAC via machine learning methods. Simultaneously, the score from this diagnostic model exhibited a significant correlation with adverse outcome in PDAC patients. This provided a novel non-invasive sEV mRNA signature for clinical diagnosis and prognostic evaluation of PDAC patients.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatocellular Carcinoma in Acute Porphyria: Incidence and Risk Factors.","authors":"Ashwani K Singal","doi":"10.1007/s10620-025-09003-0","DOIUrl":"https://doi.org/10.1007/s10620-025-09003-0","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constipation in the Elderly: Is it Age, Slow Colonic Transit, Defecatory Dysfunction, or All of the Above?","authors":"Leila Neshatian, George Triadafilopoulos","doi":"10.1007/s10620-025-09001-2","DOIUrl":"https://doi.org/10.1007/s10620-025-09001-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}