Digestive Diseases and Sciences最新文献

{"title":"Gastrointestinal Manifestations of Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders: A Mentored Review.","authors":"Abdillahi Ahmed, Bishal Paudel, Anil Sharma","doi":"10.1007/s10620-026-09958-8","DOIUrl":"10.1007/s10620-026-09958-8","url":null,"abstract":"<p><strong>Background: </strong>Hypermobile Ehlers-Danlos Syndrome (hEDS) is a connective tissue disorder that is often diagnosed after diagnostic delays due to reliance on heightened clinical suspicion. Hypermobility spectrum disorders (HSD) bridge the gap between asymptomatic joint hypermobility and hEDS. Due to overlapping features and evolving diagnostic criteria, these entities are often discussed collectively as hEDS/HSD. Patients commonly present with gastrointestinal (GI) symptoms, prompting referral for specialized care.</p><p><strong>Objectives: </strong>This review summarizes the diagnostic criteria, epidemiology, and GI manifestations of hEDS/HSD to aid gastroenterologists in recognizing common presentations and facilitating earlier diagnosis and appropriate management.</p><p><strong>Methods: </strong>We conducted a narrative review of the GI manifestations of hEDS/HSD, including associations with disorders of gut-brain interaction (DGBIs), organic GI disease, structural abnormalities, motility disorders, postural orthostatic tachycardia syndrome (POTS), and mast cell activation syndrome (MCAS).</p><p><strong>Results: </strong>The strongest GI association in hEDS/HSD is with DGBIs. Evidence suggests possible associations with organic conditions, such as celiac disease and eosinophilic esophagitis, as well as structural GI abnormalities and dysmotility. In addition, hEDS/HSD is closely linked with POTS and MCAS, which may share pathophysiologic mechanisms and have synergistic effects on symptoms.</p><p><strong>Conclusion: </strong>Gastroenterologists should maintain a high index of suspicion for hEDS/HSD, which can be readily screened for using the Beighton score. Earlier diagnosis may be therapeutic by reducing uncertainty related to multisystem symptoms. A multidisciplinary approach incorporating mental health, nutrition, and pain management may be required to optimize patient outcomes.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4474-4482"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835091","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":"The Increasing Disease Burden Among Males and the Elderly in Pancreatitis: Latest Insights from the 2021 Global Burden of Disease Study.","authors":"Jia Hu, Wei Xiao, Si Weng Chao, Nuoming Yin, Yang Fu, Binqiang Xu, Huizhen Huang, Mengyan Cui, Zerun Li, Junjie Fan, Chunlan Huang, Qixiang Mei, Yue Zeng","doi":"10.1007/s10620-026-09845-2","DOIUrl":"10.1007/s10620-026-09845-2","url":null,"abstract":"<p><strong>Aim: </strong>To develop effective prevention measures, a deep understanding of the evolution patterns and trends of pancreatitis burden is essential. Our study aims to quantify the burden related to pancreatitis in 204 countries and regions from 1990 to 2021.</p><p><strong>Methods: </strong>Data related to pancreatitis were derived from the Global Burden of Disease Study in 2021. The burden of pancreatitis was assessed using incidence, disability-adjusted life years (DALYs), deaths and their corresponding age-standardized rates (ASRs), stratified by age, sex, Sociodemographic Index (SDI) and Human Development Index (HDI). The estimated annual percentage change was used to quantify the variation in ASRs. The analysis covered the period from 1990 to 2021.</p><p><strong>Results: </strong>In 2021, there were 2,741,736 new cases of pancreatitis (95% UI 2,413,878-3,133,076), leading to 122,416 deaths (95% UI 109,848-141,362), accounting for 0.22% of global deaths, causing a loss of 4,101,154 DALYs (95% UI 3,647,631-4,684,283). The burden of pancreatitis in 2021 and its trends from 1990 to 2021 showed substantial differences based on sex, SDI quintiles and geographical regions.</p><p><strong>Conclusion: </strong>Based on our results, the burden of pancreatitis is high and increasing among males and the elderly. Countries with high levels of SDI bear a greater disease burden. Forecast analysis predicts that by 2050, the number of deaths and DALYs related to pancreatitis will continue to rise. Understanding the disease burden and future burden trends associated with pancreatitis is crucial for implementing effective interventions to alleviate the global burden.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4270-4281"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835138","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":"Pancrelipase Improves Symptoms of Exocrine Pancreatic Insufficiency and Health-Related Quality of Life in a Real-World Population of Patients with Chronic Pancreatitis.","authors":"Mohamed O Othman, Jens J Kort, Mitchell L Ramsey, Tamas A Gonda, Luis F Lara, Saad Jazrawi, Tara Keihanian, Walter Park, Neil R Brett, Diala Harb, Moming Li, Guru Trikudanathan","doi":"10.1007/s10620-026-09952-0","DOIUrl":"10.1007/s10620-026-09952-0","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment for exocrine pancreatic insufficiency (EPI) includes pancreatic enzyme replacement therapy (PERT). Although PERT may improve symptoms, there are currently no EPI symptom measures to monitor PERT treatment. This analysis evaluated the utility of the Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q) in patients with chronic pancreatitis and EPI treated with pancrelipase.</p><p><strong>Methods: </strong>This prospective, observational study (NCT04949828) included adult patients with chronic pancreatitis and EPI who were recommended pancrelipase 72,000 lipase units per meal and 36,000 lipase units per snack by an independent physician. Outcomes included the change from baseline to 1 month and 3 months after treatment initiation in PEI-Q symptom score, PEI-Q symptom severity categories, and health-related quality of life (HRQoL) as measured by the PEI-Q impact domain score.</p><p><strong>Results: </strong>The per-protocol population included 32 and 29 patients with data at 1 and 3 months after pancrelipase initiation, respectively. A significant reduction in mean PEI-Q symptom scores was observed from baseline to 1 month (- 1.0; p < 0.001) and 3 months (- 1.1; p < 0.001). Despite all patients having moderate/severe EPI symptoms at baseline, 62.5% and 62.1% of patients reported mild/no EPI symptoms after 1 and 3 months, respectively. There was also a significant reduction in mean PEI-Q impact scores from baseline to 1 month (- 1.0; p < 0.001) and 3 months (- 1.2; p < 0.001), indicating improved HRQoL.</p><p><strong>Conclusion: </strong>Pancrelipase improved patient-reported EPI symptoms and HRQoL based on the PEI-Q, which may be a useful tool for monitoring PERT treatment in patients with chronic pancreatitis and EPI.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4318-4328"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in Clinical and Cardiometabolic Outcomes Among Patients with Alcohol-Associated Liver Disease.","authors":"Pradhan Hariharan, Majd B Aboona, Janet Foote, Leith Ghani, Amal Altaf, Pooja Rangan, Daniel Q Huang, Mark Muthiah, David O Garcia, Vincent L Chen, Donghee Kim, Juan Pablo Arab, Mazen Noureddin, Luis Antonio Diaz, Michael B Fallon, Karn Wijarnpreecha","doi":"10.1007/s10620-026-09982-8","DOIUrl":"10.1007/s10620-026-09982-8","url":null,"abstract":"<p><strong>Purpose: </strong>We assess racial disparities in the prevalence and incidence of clinical outcomes in alcohol-associated liver disease (ALD) in a diverse US population.</p><p><strong>Methods: </strong>This is a retrospective multicenter study on patients aged 18-80 years with ALD in the Banner Health System from 2012 to 2024. Patients with major adverse liver outcomes (MALO) (ascites, hepatic encephalopathy, hepatocellular carcinoma, esophageal variceal bleeding) at baseline were excluded. Primary outcomes included mortality and the incidence of MALO, cardiovascular diseases (CVD) (coronary artery disease (CAD), congestive heart failure (CHF), cerebrovascular accidents (CVA), peripheral artery disease), type II diabetes mellitus (DM), cirrhosis, major adverse cardiovascular events (MACE) (CAD, CHF, CVA, mortality), and all-cause cancer. Competing risk and Cox proportional hazard regression analyses were used for outcome modeling.</p><p><strong>Results: </strong>The cohort included 16,693 patients with ALD. The median age was 50.3 and 67.8% were male. The racial distribution was 66.7% Non-Hispanic White (NHW), 0.4% Asian/Pacific Islander, 3.2% Black, 17.9% Hispanic, and 11.8% Native American/Alaskan (NA). Compared to NHW patients, NA patients had higher mortality (aHR: 1.85, 95% CI: 1.50-2.27) and higher incidence of MALO (aHR: 1.19, 95% CI: 1.04-1.37), cirrhosis (aHR: 1.51, 95% CI: 1.28-1.79) and MACE (aHR: 1.38, 95% CI: 1.20-1.59).</p><p><strong>Conclusion: </strong>NA patients with ALD had higher mortality and incidence of adverse clinical outcomes compared to NHW. Further research is warranted to explore these disparities and develop tailored interventions to improve outcomes.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4340-4349"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959802","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":"Adjunctive Stenting After Esophageal ESD: Dissecting the Data Delivers Doubt.","authors":"Jacopo Fanizza, Francesco Vito Mandarino, Silvio Danese, Giuseppe Dell'Anna","doi":"10.1007/s10620-026-09916-4","DOIUrl":"10.1007/s10620-026-09916-4","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3977-3979"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697367","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":"Diagnosis of Malignant Intraductal Papillary Mucinous Neoplasm by Cholangioscopy and Probe-Based Confocal Laser Endomicroscopy.","authors":"Qiuhong Liu, Yu Feng, Fan Zhu, Qingyong Huang, Fenglan Xiao, Zhongjie Cao, Zhigang Zuo, Song Hu","doi":"10.1007/s10620-026-09937-z","DOIUrl":"10.1007/s10620-026-09937-z","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3932-3934"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765563","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":"Same-Admission Cholecystectomy Is Safe and Effective for Patients with Concurrent Choledocholithiasis and Cholangitis.","authors":"Aditya Chandrashekar, Arpita N Jajoo, Jianing Li, Romik Srivastava, Amukta Palakurthi, Sukhmanpreet Kaur Sandhu, Ivy Mannoh, Grace Rozycki, Alistair J Kent, Venkata S Akshintala","doi":"10.1007/s10620-026-09925-3","DOIUrl":"10.1007/s10620-026-09925-3","url":null,"abstract":"<p><strong>Purpose: </strong>Although guidelines recommend early cholecystectomy (CCY) after ERCP for choledocholithiasis-associated cholangitis, surgery is frequently deferred, particularly in severe disease. We evaluated real-world outcomes and decision-making between same-admission versus deferred CCY to assess the impact of surgical delay.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study on patients with choledocholithiasis-associated cholangitis from 2011 to 2022. Primary outcomes were the occurrence of ≥ 1 recurrent biliary event (RBE) within one year, and 30-day mortality and readmissions. Secondary outcomes included operative complications, length of stay, and reasons for delay. Multivariable logistic regression adjusted for age, comorbidities, sex, and severity, with subgroup analyses for Grade III cholangitis. Kaplan-Meier survival analysis evaluated time to first RBE.</p><p><strong>Results: </strong>Among 171 patients (mean [SD] age, 66.2 [19.1] years; 85 [49.7%] female), 94 (55%) had CCY deferred. Same-admission CCY was associated with lower odds of RBEs (aOR 0.01; 95% CI 0-0.08; p < 0.001) and 30-day readmission (1.3% vs. 13.8%; aOR 0.11; 95% CI 0.01-0.48; p = 0.0023), with similar complication rates and length of stay. Kaplan-Meier analysis confirmed superior RBE-free survival for same-admission CCY (log-rank p < 0.001). Among patients with Grade III cholangitis (n = 34), same-admission CCY reduced RBE rate (0% vs. 56.5%; p < 0.001) without increasing intraoperative or postoperative complications. Deferral was most often due to high surgical risk (21.3%), concurrent pathology (20.2%), or patient preference (14.9%).</p><p><strong>Conclusions: </strong>Same-admission CCY for choledocholithiasis-associated acute cholangitis reduced recurrence and 30-day readmission without increasing postoperative complications, mortality, or length of stay, including in Grade III cholangitis. These findings support same-admission CCY after clinical stabilization.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4104-4112"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765707","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":"Managing Refractory Pouchitis: Which Biologic Is Best?","authors":"Lisa Laforce-van Lierop, Frank Hoentjen","doi":"10.1007/s10620-026-09950-2","DOIUrl":"10.1007/s10620-026-09950-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"4003-4005"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811906","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":"Milking the Data: Should Dairy Be Restricted Before Colonoscopy?","authors":"Sanjeevani Tomar, Chisom Nwaneki, Harsimran Kalsi, Natalie Cosgrove","doi":"10.1007/s10620-026-09886-7","DOIUrl":"10.1007/s10620-026-09886-7","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3980-3982"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728734","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":"The Limits of Visual Size Estimation in Large Colorectal Laterally Spreading Tumours.","authors":"Tomoaki Matsumura, Kenichiro Okimoto, Jun Kato","doi":"10.1007/s10620-026-09918-2","DOIUrl":"10.1007/s10620-026-09918-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"3983-3984"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728802","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}