Digestive Diseases and Sciences最新文献

{"title":"Successful Endoscopic Removal of Steel Needle Resembling Fish Bone from Stomach Wall.","authors":"Zhao Mu, Liansong Ye, Jiamin Qin, Liming Wen, Yong Yan","doi":"10.1007/s10620-025-09034-7","DOIUrl":"https://doi.org/10.1007/s10620-025-09034-7","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977704","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":"Clinical Outcome of Inflammatory Bowel Disease with Clostridioides difficile Polymerase Chain Reaction Toxin-Positive/Enzyme Immunoassay Toxin-Negative: A Retrospective Cohort Study.","authors":"Junseok Park, Seulji Kim, Jong Pil Im, Hyun Jung Lee, Joo Sung Kim, Hyunsun Park, Yoo Min Han, Seong-Joon Koh","doi":"10.1007/s10620-025-09045-4","DOIUrl":"https://doi.org/10.1007/s10620-025-09045-4","url":null,"abstract":"<p><strong>Background: </strong>Clostridioides difficile infection (CDI) frequently occurs concurrently in patients with inflammatory bowel disease (IBD), and differential diagnosis from IBD flares is critical. However, clinical management of C. difficile in IBD patients with polymerase chain reaction toxin-positive (tPCR+)/enzyme immunoassay toxin-negative (tEIA-) results has not yet been investigated.</p><p><strong>Aims: </strong>We aimed to assess the clinical significance of C. difficile tPCR+/tEIA- in patients with IBD and the impact of antibiotic treatment on IBD outcomes.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study included patients with IBD with CDI test results between January 01, 2018, and August 01, 2022. First, the clinical outcomes of IBD, such as medication escalation, hospitalization, and surgery, were compared between patients with IBD with tPCR-/tEIA- and those with tPCR+/tEIA- using Cox regression and propensity score matching. Next, the clinical outcomes of IBD were assessed based on whether antibiotic treatment for CDI was administered to both groups.</p><p><strong>Results: </strong>Among 412 patients with IBD with PCR test, 71 (17.2%) showed tPCR+/tEIA- results. The tPCR+/tEIA- group showed no statistically significant difference in IBD outcomes compared to the tPCR-/tEIA- group. The antibiotic-treated tPCR+/tEIA- group showed a higher risk of drug escalation and admission than the tPCR-/tEIA- group, while the antibiotic-untreated tPCR+/tEIA- group did not. After drug escalation during the follow-up, the treated tPCR+/tEIA- group showed IBD outcomes similar to those of the tPCR-/tEIA- group.</p><p><strong>Conclusions: </strong>In patients with IBD with indeterminate CDI, the need for antibiotics should be thoroughly assessed and proper management of underlying IBD such as drug escalation may lead to favorable outcomes.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985035","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":"Pancreaticobiliary Maljunction: A Multidimensional Exploration of Pathophysiology, Diagnosis, Classification, Management and Research Prospects.","authors":"Peng Huang, Hu Yang, Houfang Kuang, Jun Yang, Xufei Duan, Hongqiang Bian, Xin Wang","doi":"10.1007/s10620-025-09057-0","DOIUrl":"https://doi.org/10.1007/s10620-025-09057-0","url":null,"abstract":"<p><p>Pancreaticobiliary maljunction is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall, usually forming a markedly long common channel, which can cause reciprocal reflux between pancreatic juice and bile. Cholangiography, endoscopic ultrasonography, surgery, and autopsy can be used to diagnose pancreaticobiliary maljunction. Elevated amylase levels in bile and extrahepatic bile duct dilatation strongly suggest the existence of pancreaticobiliary maljunction. The regurgitation may lead to the development of various hepatobiliary and pancreatic disorders such as pancreatitis and biliary carcinoma. The pathogenesis of pancreaticobiliary maljunction is the result of a series of pathophysiological changes caused by reflux. Surgery is recommended for patients diagnosed with pancreaticobiliary maljunction irrespective of the presence or absence of symptoms because of its high biliary carcinogenicity, but the treatment strategy is quite different between adult patients with and without biliary dilatation.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976719","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":"Obeticholic Acid vs Fibrates as Second-Line Therapy for Primary Biliary Cholangitis: Systematic Review and Meta-Analysis.","authors":"Eliabe S Abreu, Pedro Henrique Reginato, Jorge Ferreira Jasmineiro Pitanga, Pedro Neves Borges, Pierre-Antoine Soret, Christophe Corpechot, Guilherme Grossi Lopes Cançado","doi":"10.1007/s10620-025-09044-5","DOIUrl":"https://doi.org/10.1007/s10620-025-09044-5","url":null,"abstract":"<p><strong>Background: </strong>Around 40% of patients diagnosed with Primary Biliary Cholangitis (PBC) experience a suboptimal biochemical response to ursodeoxycholic acid (UDCA).</p><p><strong>Aims: </strong>We aimed to compare fibrates and obeticholic acid (OCA) as add-on second-line therapy and evaluate whether these drugs hold superiority over each other.</p><p><strong>Methods: </strong>We systematically searched Embase, MEDLINE, and Cochrane CENTRAL for studies comparing fibrates and OCA published by May 6, 2024. A pooled analysis was conducted to evaluate changes in liver biochemistry and response rates based on validated criteria. Data were expressed as mean difference (MD) for continuous outcomes and as Odds Ratio (OR) when binary.</p><p><strong>Results: </strong>We included 883 patients from 4 studies, 468 (53.0%) under UDCA + OCA. Follow-up time ranged from 6 to 12 months. Patients treated with fibrates have similar mean bilirubin post-intervention values (MD 0.11 × upper limit of normal [ULN]; 95% CI - 0.26 to 0.49) compared to OCA. However, fibrates demonstrated superiority over OCA for percentual reduction in ALP compared to baseline (MD 20.13%; 95% CI 11.84-28.41), ALP post-intervention values (MD - 0.59 xULN; 95% CI - 1.02 to - 0.15), and rate of ALP normalization (OR 32.34; 95% CI 14.54-71.92). Patients treated with fibrates also more frequently met Barcelona (OR 4.28; 95% CI 2.26-8.11), POISE (OR 5.48; 95% CI 2.70-11.13), and Paris II (OR 5.88; 95% CI 3.96-8.74) response criteria.</p><p><strong>Conclusion: </strong>In patients with PBC and an incomplete response to UDCA, fibrates seem to be associated with greater ALP reduction and achievement of response criteria compared to OCA.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972603","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":"A Case of Rare Primitive Neuroectodermal Tumor of the Liver.","authors":"Shuyun Wang, Binglin Lai","doi":"10.1007/s10620-025-09043-6","DOIUrl":"https://doi.org/10.1007/s10620-025-09043-6","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985823","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":"Dyspepsia-Is the Stomach Half Empty?","authors":"Eamonn M M Quigley","doi":"10.1007/s10620-025-09038-3","DOIUrl":"https://doi.org/10.1007/s10620-025-09038-3","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990751","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":"A Rare Cause of Terminal Ileal Ulcer: Beyond Tuberculosis and Crohn's Disease.","authors":"Shivam Sethi, Raghavender Puri, Harsh Prakash Jain, D K Ashwin","doi":"10.1007/s10620-025-09023-w","DOIUrl":"https://doi.org/10.1007/s10620-025-09023-w","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981619","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":"Evaluation of an Exercise Program in Patients with Inflammatory Bowel Disease: A Pilot Study.","authors":"Natasja van de Pol, Elyke H Visser, Desirée van Noord, C Janneke van der Woude, Annemarie C de Vries, Vincent de Jonge, Rachel L West","doi":"10.1007/s10620-025-09030-x","DOIUrl":"https://doi.org/10.1007/s10620-025-09030-x","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with inflammatory bowel disease (IBD) tend to be less physical active, while maintaining an active lifestyle has been associated with enhanced disease control, diminished fatigue, and improved quality of life. This study aimed to evaluate the feasibility and potential impact of an exercise program for patients with IBD.</p><p><strong>Methods: </strong>Patients with IBD participated in a 16-week personalized exercise program based on their individual fitness level. Outcome measures included body composition (BMI, muscle mass and fat percentage), physical fitness (based on the Fundamental Motor Skills), quality of life, fatigue, and disease control. For statistical analyses, a paired t test or Wilcoxon signed rank test was used.</p><p><strong>Results: </strong>In total 32 patients were included, mean age was 50.1 years (SD 12.3), 37.5% were male, and 50% had Crohn's disease. The program was completed by 75% of patients, and average rating of the program was 8.6 out of 10. The program significantly improved fatigue scores (P = 0.013). Quality of life scores improved by an average of 8 points, and disease control showed no significant difference. Additionally, muscle mass (P = 0.020), fat percentage (P = 0.003), lower body strength and coordination (P = 0.006), flexibility (P = 0.002), and speed and endurance (P < 0.001) improved significantly after the program.</p><p><strong>Conclusion: </strong>This pilot study showed that a personalized exercise program could be feasible for patients with IBD and has the potential to have a positive effect on quality of life and fatigue. These findings underline the importance of physical activity and can be used as a step toward integrating an exercise program in standard IBD care.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984965","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":"Comparative Effectiveness of Bile Acid Sequestrants and Antibiotics in the Management of Acute Pouchitis: A Matched Cohort Study from the United States.","authors":"Saqr Alsakarneh, Michael Camilleri, Francis A Farraye, Jana G Hashash","doi":"10.1007/s10620-025-09039-2","DOIUrl":"https://doi.org/10.1007/s10620-025-09039-2","url":null,"abstract":"<p><strong>Background and aims: </strong>Bile acid sequestrants (BAS) are an emerging option for treatment of pouchitis. We aimed to compare BAS monotherapy, antibiotics, and combination therapy with both in the treatment of pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the US-Collaborative TriNetX database to identify patients with acute pouchitis and UC. Treatment groups were divided into BAS (cholestyramine, colesevelam, colestipol), antibiotics (ciprofloxacin and/or metronidazole), and combination therapy of both BAS and antibiotics. Primary outcomes were failure of initial therapy (early relapse or nonresponse) and the development of recurrent pouchitis in the first 12 months after an initial episode of pouchitis.</p><p><strong>Results: </strong>Our analysis included 1,136 patients (mean age: 37.8 ± 15.4 years, and 45.9% female) of whom 727 (64%) were diagnosed with recurrent pouchitis. After adjusting for confounders by propensity-score matching, there was no significant difference in the odds of early relapse or nonresponse with BAS compared with antibiotic monotherapy (aOR: 0.74; 95% CI: 0.40-1.38; p = 0.34) or combination therapy (aOR: 0.94; 95% CI: 0.47-1.88; p = 0.86). Patients treated with BAS had a statistically significant lower recurrent pouchitis rate (aHR: 0.57; 95% CI: 0.42-0.79; p < 0.001) compared with patients treated with antibiotics. Patients treated with BAS had a statistically significant longer time (median: 225 days) to recurrent pouchitis (p < 0.001) compared to antibiotics (median: 99 days).</p><p><strong>Conclusion: </strong>Using real-world evidence regarding treatment of pouchitis compared to standard antibiotic therapy, BAS monotherapy was not inferior for initial treatment response and significantly prolonged time to recurrent pouchitis.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988378","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":"Efficacy of Home-Based Versus Hospital-Based Disimpaction with Polyethylene Glycol in Pediatric Functional Constipation: A Randomized Control Study.","authors":"Srinivas Srinidhi Vadlapudi, Ujjal Poddar, Anshu Srivastava, Moinak Sen Sarma","doi":"10.1007/s10620-025-09048-1","DOIUrl":"https://doi.org/10.1007/s10620-025-09048-1","url":null,"abstract":"<p><strong>Background/aims: </strong>Functional constipation (FC) is the most common cause of childhood constipation. Children with FC and fecal impaction need to undergo disimpaction. Polyethylene glycol (PEG) is commonly used for disimpaction either in a hospital setting as a continuous lavage or in a home-based setting over 3-6 days. Randomized control trials comparing the two regimens are not available. The study objectives were to compare the efficacy, side effects, cost-effectiveness, and parental satisfaction of home- and hospital-based disimpaction.</p><p><strong>Methods: </strong>Consecutive children attending our hospital (age: 1-18 years) and diagnosed to have FC as per ROME IV and requiring disimpaction were enrolled. Fecal impaction was established clinically (per-abdomen or per-rectal examination) or radiologically (X-ray abdomen- Barr criteria). Stratified block randomization was done. PEG was administered accordingly in a hospital-based or a home-based setting. The side effects, patient acceptability as per the treatment satisfaction questionnaire for medications (TSQM) and cost incurred were noted.</p><p><strong>Results: </strong>One hundred and fifteen children (hospital-based [n = 58], home-based [n = 57]) were enrolled. Successful disimpaction in hospital- and home-based disimpaction arm was 100% and 94.7%, respectively (p = 0.12). Vomiting (27.6% vs 5.3%, p = 0.001) and abdominal distension (31% vs 3.5%, p < 0.001) were higher in patients undergoing hospital-based disimpaction. Cost of treatment was higher in hospital-based disimpaction arm (INR 6,250 [2,228-15,585] vs INR 3,355 [850-18,350], p = < 0.001). Parental satisfaction was greater in home-based disimpaction.</p><p><strong>Conclusions: </strong>Home-based disimpaction using PEG is as effective as hospital-based disimpaction. Disimpaction in a friendlier home environment, at a lower cost and with fewer side effects makes home-based disimpaction preferable in children.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969946","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}