Digestive Diseases and Sciences最新文献

{"title":"EUS-Guided Shear Wave Elastography in a Real-World Cohort: Diagnostic Accuracy and the Impact of Measurement Variability.","authors":"Umang Arora, Shivam Khare, Shrihari Anikhindi, Ashiesh Khandelwal, Randeep Rana, Ashish Kumar, Praveen Sharma, Naresh Bansal, Munish Sachdeva, Piyush Ranjan, Mandhir Kumar, Anil Arora","doi":"10.1007/s10620-026-10139-w","DOIUrl":"10.1007/s10620-026-10139-w","url":null,"abstract":"<p><strong>Background: </strong>Liver stiffness measurement (LSM) is a non-invasive surrogate for hepatic fibrosis that informs risk stratification and management. Vibration-controlled transient elastography (VCTE; FibroScan®) is well established. Endoscopic ultrasound-guided shear wave elastography (EUS-SWE) offers the potential to assess LSM during routine EUS; however, its diagnostic performance remains uncertain.</p><p><strong>Methods: </strong>In this prospective, single-center diagnostic accuracy study, consecutive adults without biliary obstruction who were undergoing EUS additionally underwent LSM measurement from the right hepatic lobe using EUS-SWE (Olympus ME3) and same-day VCTE. VCTE thresholds defined advanced chronic liver disease (ACLD; > 15 kPa), cirrhosis (> 12 kPa), and advanced fibrosis (> 8 kPa). EUS-SWE performance was evaluated using correlation, Bland-Altman agreement, and area under the receiver-operating characteristic curve (AUROC).</p><p><strong>Results: </strong>Among 146 patients (median VCTE-LSM 6.05 kPa, range 3-53.3), 57, 41, and 31 had LSM ≥ 8, ≥ 12, and ≥ 15 kPa, respectively. EUS-SWE showed moderate correlation with VCTE (Spearman ρ = 0.65, p < 0.001) and reported higher values by 34.1% (95% limits of agreement:-64.8% to 133.1%) without proportional bias on Bland-Altman analysis. EUS-SWE showed excellent accuracy for screening relevant VCTE-LSM thresholds with AUROC (95% CI) 0.89 (0.81-0.97) for ACLD, 0.89 (0.82-0.96) for cirrhosis, and 0.85 (0.79-0.92) for advanced fibrosis. Optimal EUS-SWE threshold for VCTE-defined ACLD was 12.9 kPa (sensitivity 93%, specificity 77%), representing the optimal screening cutoff; a regression-derived threshold of 21.4 kPa (sensitivity 67%, specificity 93%) represents the mathematical equivalent EUS-SWE value to VCTE ≥ 15 kPa, appropriate for direct modality comparison. Accuracy for ACLD declined monotonously with increasing variability (IQR/LSM%): AUROC 0.97 (for < 30%), 0.86 (30-45%), 0.83 (45-60%), and 0.78 (≥ 60%).</p><p><strong>Conclusion: </strong>EUS-SWE yields LSM values approximately 34% higher than VCTE-LSM; the two modalities are not interchangeable and require modality-specific thresholds. EUS-SWE provides accurate prediction of VCTE-defined fibrosis thresholds, particularly when IQR/LSM% ≤ 45%, and represents a promising adjunct for opportunistic liver stiffness assessment during routine EUS.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5745-5753"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600407","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 Global Immune-Nutrition-Inflammation Index (GINI) in Acute Pancreatitis Severity Assessment: A Comparative Study.","authors":"Busra Turkmen, Merve Özel Yetkin, Ezgi Yenişekerci Kulak, Gulden Baskol, Mevlut Baskol","doi":"10.1007/s10620-026-10173-8","DOIUrl":"10.1007/s10620-026-10173-8","url":null,"abstract":"<p><strong>Purpose: </strong>Acute pancreatitis (AP) is a common inflammatory disease with variable clinical severity. The Global Immune-Nutrition-Inflammation Index (GINI) has shown prognostic value in oncology but has not been investigated in AP. We aimed to evaluate its value for early severity stratification in AP and to compare it with established inflammatory indices across complementary severity references.</p><p><strong>Methods: </strong>This retrospective single-center study included 152 patients with AP treated at Erciyes University Faculty of Medicine between January 2022 and December 2025 and 164 healthy controls. Demographic, clinical, and laboratory data obtained at admission were analyzed. Disease severity was assessed primarily using the 2012 Revised Atlanta Classification, with the Ranson score and the Bedside Index of Severity in Acute Pancreatitis (BISAP) as complementary early prognostic references, and etiology was recorded (biliary vs. non-biliary). The performance of GINI and other indices was evaluated using ROC analysis, DeLong comparisons, and multivariate logistic regression.</p><p><strong>Results: </strong>GINI showed the highest discrimination for moderately severe/severe AP (AUC 0.813, 95% CI 0.738-0.888; cut-off 3134; sensitivity 79%, specificity 77%, NPV 92%) and was significantly superior to CRP, CAR, PLR, PIV, SII and PNI (all p < 0.05). GINI was an independent predictor (OR 3.73 per SD; p < 0.001). Its performance was preserved across biliary and non-biliary etiologies (AUC 0.848 and 0.817; interaction p = 0.68). GINI also clearly separated patients from healthy controls (AUC 0.959).</p><p><strong>Conclusion: </strong>GINI outperforms most conventional inflammatory and nutritional markers for predicting AP severity, is etiology-independent, and carries a high negative predictive value. It may serve as a practical adjunct for early risk stratification; multicenter prospective validation is warranted.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5847-5857"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697280","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":"Cavitary Gastric Gastrointestinal Stromal Tumor with Distant Metastasis.","authors":"Xiaoying Zhang, Xiaoyun Zhu","doi":"10.1007/s10620-026-10154-x","DOIUrl":"10.1007/s10620-026-10154-x","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5282-5285"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663714","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":"Concise Commentary: AI-Generated GI Patient Education-High Quality, yet Readability May Limit Utility.","authors":"Ryan Francis Flanagan","doi":"10.1007/s10620-026-10152-z","DOIUrl":"10.1007/s10620-026-10152-z","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5324-5325"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648490","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":"Crohn's Like No Other, Revealed by Macrophage Activation Syndrome and Associated with Leukocytoclastic Vasculitis.","authors":"Najoua Elmoutaoukil, Mehdi Zouaoui, Soukaina Noubail, Salma Fares, Achraf Miry, Youssef Hnach, Mbarek Azouaoui, Nourdin Aqodad","doi":"10.1007/s10620-026-10075-9","DOIUrl":"10.1007/s10620-026-10075-9","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5275-5277"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469585","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":"Temporomandibular Joint Dislocation: A Rare Complication of Esophagogastroduodenoscopy.","authors":"Lana Dardari, Ahmed Nadeem, Waqqas Haroon, Akash Khurana, Bishai Adel, Claire Beveridge","doi":"10.1007/s10620-026-10148-9","DOIUrl":"10.1007/s10620-026-10148-9","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5280-5281"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618805","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":"Systematic Review: Evaluating the Prognostic Value of Granulomas in Crohn's Disease.","authors":"Julia Smith, Courtney Bartel, Lynn Warner, Jasbir Dhaliwal","doi":"10.1007/s10620-026-10080-y","DOIUrl":"10.1007/s10620-026-10080-y","url":null,"abstract":"<p><strong>Background and aims: </strong>Histological differences are among the characteristics that divide Crohn's disease (CD) from ulcerative colitis. Granulomas are one feature known to develop in a subset of patients with CD, though their exact role in prognosis is relatively limited. Therefore, there is an unmet need to further understand the features that predict patterns in disease courses for people with CD.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Databases used for the search were EMBASE, PubMed, CINAHL, Scopus, and Web of Science. Two reviewers independently reviewed abstracts and full text for inclusion. Overall, 46 studies were included for data collection and quality assessment.</p><p><strong>Results: </strong>The 46 studies included 37 cohort analyses, four systematic reviews (three with meta-analysis), four cross-sectional studies, and one case-control report. Common exposure and outcome variables included age, disease location and behavior, clinical severity, medication utilization, and surgical requirement. There was considerable risk for bias in accordance with the Critical Appraisal Skills Programme tool, with only 26 studies having met ≥ 80% of high-quality assessment criteria. Varying relationships were observed between granulomas and clinical aspects of disease such as phenotype, severity, and medication utilization.</p><p><strong>Conclusion: </strong>This systematic review aimed to centralize the current literature and provide insight into the possible prognostic value of granulomas in CD. Several studies suggested clinical relevance; however, larger studies that adjust for confounders are needed to truly elucidate the underlying pathophysiology and significance of granulomatous CD.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5604-5614"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497348","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":"Impact of GLP-1 Analogue Therapy on Gastrointestinal Outcomes in Patients with Irritable Bowel Syndrome: A Real-World TriNetX Analysis.","authors":"Sajjad Ahmed Khan, Anurag Marasini, Alisha Shrestha, Hareesha Rishab Bharadwaj, Rahman Hameed Mohammed Abdul, Arkadeep Dhali, Saqr Alsakarneh, Ashish Sharma, Hassam Ali, Dushyant Singh Dahiya","doi":"10.1007/s10620-026-10171-w","DOIUrl":"10.1007/s10620-026-10171-w","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 (GLP-1) receptor agonists are increasingly prescribed for diabetes and obesity, conditions that frequently coexist with irritable bowel syndrome (IBS). Their effects on gastrointestinal motility and visceral sensitivity raise the possibility of therapeutic benefit in IBS, but real-world evidence remains limited. This study evaluated the association between GLP-1 receptor agonist initiation and subsequent gastrointestinal outcomes in patients with IBS using a large federated electronic health records network.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX Research Network. Patients with IBS (ICD-10 K58) who initiated GLP-1 receptor agonists (semaglutide, liraglutide, dulaglutide, exenatide, or tirzepatide) within 30 or 90 days after IBS diagnosis (GLP-1 group) were propensity score matched to IBS patients who did not receive GLP-1 therapy (non-GLP-1 group). Analyses were performed for the overall IBS cohort and stratified by subtype (IBS-D [K58.0] and IBS-C [K58.1]). Outcomes included coded chronic diarrhea, chronic constipation, abdominal pain, malabsorption, and abdominal bloating/distension. Incident outcomes were assessed using risk ratios, hazard ratios from Kaplan-Meier survival analysis, and log-rank tests.</p><p><strong>Results: </strong>After matching, the 30-day landmark cohort included 4,668 patients per group and the 90-day landmark cohort included 6,665 patients per group. In the 90-day analysis, GLP-1 use was associated with significantly lower rates of chronic diarrhea (8.9% vs. 10.6%), chronic constipation (19.8% vs. 22.0%), abdominal pain (31.6% vs. 35.8%), and abdominal bloating/distension (8.3% vs. 10.9%) compared with non-GLP-1 controls (all p < 0.001). Similar reductions were observed in IBS-D and IBS-C subtypes, particularly for abdominal pain and bloating/distension. Differences in outcome recurrence (number of instances) were smaller than differences in incidence.</p><p><strong>Conclusions: </strong>Initiation of GLP-1 receptor agonists was associated with significantly lower rates of several coded gastrointestinal symptoms in patients with IBS across multiple landmark periods and subtypes. While these observational findings are hypothesis-generating and require confirmation in prospective studies, they suggest potential benefit of GLP-1 therapies on IBS-related outcomes.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5858-5868"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697274","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":"Does Quality of Life and Symptom Severity Correlate with Celiac Disease Serology in Adolescents?","authors":"Priyanka V Chugh, Lydia Ramharack, Kat Adams, Lynne Allen-Taylor, Patricia Bierly, Kara Feigenbaum, Janel Steinhoff, Ritu Verma, Arunjot Singh, Lisa M Fahey","doi":"10.1007/s10620-026-10128-z","DOIUrl":"10.1007/s10620-026-10128-z","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescents with a new diagnosis of celiac disease (CeD) face challenges navigating social relationships while also managing symptoms and the gluten-free diet. The purpose of this study is to evaluate the relationship between quality of life (QoL), symptoms, and CeD serology in adolescents with CeD.</p><p><strong>Methods: </strong>Cross-sectional survey study of adolescent patients (13-18 years old) within one year of biopsy-proven diagnosis of symptomatic CeD. Participants completed the PedsQL questionnaire, a health-related QoL assessment, and the Celiac Symptom Index (CSI), a measure of CeD-related symptoms. Tissue transglutaminase IgA (tTG-IgA) was used as a measure of disease activity. Means, mean difference, t test, and point biserial correlations were computed to assess the association of tTG-IgA with CSI and PedsQL scores.</p><p><strong>Results: </strong>Fifty-four adolescents and parents/guardians were surveyed. Thirty-seven had abnormal tTG-IgA and were compared to those with normal tTG-IgA. There were significant differences in overall PedsQL scores (84.75 vs 77.03, r = -0.28, p = 0.05), social subscores (95.42 vs 88.59, r = 0.24, p = 0.02), emotional subscores (80.83 vs 66.62, r =- 0.31, p = 0.03), and school functioning subscores (81.25 vs 68.89, r =- 0.36, p = 0.01). There was no significant relationship between tTG-IgA and the physical subscore or CSI score. Females report higher CSI scores and lower PedsQL scores. Older age at diagnosis was associated with lower PedsQL scores.</p><p><strong>Discussion: </strong>Adolescents with abnormal tTG-IgA serology had lower QoL scores that were unrelated to measures of physical symptoms (CSI and physical subscore of PedsQL). This suggests more complex drivers of QoL that are not related to physical symptoms but are still associated with persistently elevated serology.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5691-5698"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548203","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":"Improvement of Obesity-Related Comorbidities After Bariatric Procedures: A Network Meta-Analysis of Endoscopic Versus Surgical Interventions.","authors":"Noppachai Siranart, Panisara Fangsaard, Patavee Pajareya, Daniel Martin Simadibrata, Peenaprapa Tangpradubkiat, Somkiat Phutinart, Yanisa Chumpangern, Tanattida Kassels, Sireenada Sattawatthamrong, Premkamol Patraithikul, Kittithat Tantitanawat","doi":"10.1007/s10620-026-10079-5","DOIUrl":"10.1007/s10620-026-10079-5","url":null,"abstract":"<p><strong>Background: </strong>Recent advances in bariatric interventions have introduced innovative surgical and endoscopic techniques aimed at promoting weight loss and improving obesity-related comorbidities. This study compares the effectiveness of various bariatric procedures in managing metabolic conditions and optimizing clinical outcomes.</p><p><strong>Method: </strong>A systematic literature search through January 2025 identified comparative studies, including 16 randomized controlled trials (RCTs) and 39 observational studies (follow-up range: 6-120 months), evaluating diabetes mellitus (DM), hypertension (HTN), dyslipidemia (DLP), and obstructive sleep apnea (OSA) outcomes following bariatric surgery. Secondary outcomes included de novo gastroesophageal reflux disease (GERD) incidence and GERD improvement.</p><p><strong>Results: </strong>Fifty-five studies involving 61,154 patients were analyzed. For DM improvement, one-anastomosis gastric bypass (OAGB) was significantly superior to both Roux-en-Y gastric bypass (RYGB) (OR: 1.92; 95% CI: 1.18-3.13) and sleeve gastrectomy (SG) (OR: 2.47; 95% CI: 1.49-4.09). OAGB and RYGB also showed significantly greater HTN improvement compared to SG (OR: 1.84; 95% CI: 1.20-2.84 and OR: 1.30; 95% CI: 1.14-1.49, respectively). For de novo GERD, ESG (OR: 0.08; 95% CI: 0.01-0.72) and RYGB (OR: 0.29; 95% CI: 0.18-0.48) showed significantly lower odds than SG. For GERD improvement, OAGB (OR: 5.48; 95% CI: 1.52-19.76) and RYGB (OR: 3.82; 95% CI: 2.09-6.97) significantly outperformed SG. P-score rankings placed SADI highest for DM (0.932), OAGB for HTN (0.769) and DLP (0.731), and SASI for both de novo GERD (0.803) and GERD improvement (0.900).</p><p><strong>Conclusion: </strong>OAGB, SASI, SADI, and ESG demonstrate superior efficacy in improving obesity-related comorbidities and GERD outcomes, supporting their consideration as leading options in individualized bariatric care. However, evidence is limited with outcomes heterogenously defined across studies. Future RCTs are needed to provide comparative efficacy between these interventions.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5434-5448"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410718","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}