Digestive Diseases and Sciences最新文献

{"title":"Endoscopic Band Ligation Resection for Multifocal Gastric Adenocarcinoma of the Fundic Gland Type: A Rare Case Report of 8 Synchronous Lesions.","authors":"Fu-Jian Li, Xiu-Xiu Yin, Ze-Feng Liu, Feng-Yan Li, Hui-Lan Ye, Qiong-Rong Zeng, Guo Zhang, Zhang-Xiu Jiang","doi":"10.1007/s10620-025-09383-3","DOIUrl":"https://doi.org/10.1007/s10620-025-09383-3","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079869","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":"Reassessing Vonoprazan for Endoscopy-Negative Reflux Disease: A Systematic Review and Meta-Analysis.","authors":"Minahil Iqbal, Muhammad Ahsan Asif, Asma Tahir, Humza Saeed, Sufyan Shahid, Mariam Shahabi, Arfa Ahmed Assad, Muhammad Ahmad, Azeem Khalid, Hassam Ali, Douglas G Adler","doi":"10.1007/s10620-025-09399-9","DOIUrl":"https://doi.org/10.1007/s10620-025-09399-9","url":null,"abstract":"<p><strong>Background: </strong>Non-erosive reflux disease (NERD) is characterized by reflux without esophageal erosions. Vonoprazan, a potassium-competitive acid blocker, is recommended for patients with erosive esophagitis (EE). However, its role in NERD, remains limited. We conducted a systematic review and meta-analysis to assess its efficacy in patients with NERD.</p><p><strong>Methods: </strong>A systematic literature search was conducted, on MEDLINE, Embase and Cochrane Library until January 25, 2025, to identify all randomized controlled trials (RCTs) comparing Vonoprazan to placebo in patients with NERD. Binary and continuous outcomes were pooled using risk ratios (RRs), and standardized mean differences (SMDs), respectively, along with their 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Four RCTs with a total of 2540 patients (50.3% females) were included. Vonoprazan 10 mg was comparable to placebo in terms of mean proportion of days without heartburn (SMD: 0.12; 95% CI - 0.04-0.29, p = 0.14), mean severity score of heartburn (SMD: 0.01; 95% CI - 0.15-0.17, p = 0.94), treatment-related adverse events (RR: 0.93; 95% CI: 0.71-1.20, p = 0.568), and serious adverse events (RR: 1.46; 95% CI 0.23-9.23, p = 0.689). Vonoprazan 20 mg was superior to placebo in terms of mean proportion of days without heartburn (SMD: 0.13; 95% CI 0.01-0.24 p = 0.03), with comparable results for mean severity score of heartburn (SMD: - 0.03; 95% CI - 0.15-0.08 p = 0.56), treatment-related adverse events (RR: 1.11; 95% CI 0.52-2.36 p = 0.785), and serious adverse events (RR: 6.03; 95% CI 0.73-50.10 p = 0.096).</p><p><strong>Conclusion: </strong>Vonoprazan 10 mg showed no benefit over placebo in NERD. The 20 mg dose modestly increased heartburn-free days with similar safety, suggesting potential efficacy.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079956","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 Plot Thickens - Is Eosinophilic Gastritis Related to Collagenous Gastritis?","authors":"Shaun S C Ho, Andrew S Day","doi":"10.1007/s10620-025-09398-w","DOIUrl":"https://doi.org/10.1007/s10620-025-09398-w","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074627","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":"Safety and Outcomes of Colonoscopy in Cardiac Transplant Candidates with Severely Versus Non-severely Reduced Left Ventricular Function: A Single-Center Retrospective Cohort.","authors":"Noor Hassan, Mir Zulqarnain, Chase Branstetter, Ifrah Fatima, Islam Mohamed, Vinay Jahagirdar, Jagadish Koyi, Saqr Alsakarneh, Ameen Awad, Misha Gautam, Abbas Bader, Sruthi Sripada, Mohamed Ahmed, Adel Muhanna, Thomas Cunningham, Wendell Clarkston","doi":"10.1007/s10620-025-09371-7","DOIUrl":"https://doi.org/10.1007/s10620-025-09371-7","url":null,"abstract":"<p><strong>Background: </strong>Pre-cardiac transplant evaluation, including colorectal cancer screening, is vital for organ allocation. Data on colonoscopy risks in transplant candidates are limited to retrospective analyses with varying methodologies. Literature assessing colonoscopy alone without esophagogastroduodenoscopy is even more limited. We studied adverse events and clinical outcomes of pre-transplant screening colonoscopy in patients stratified by ejection fraction (EF).</p><p><strong>Methods: </strong>Charts were reviewed at Saint Luke's Hospital in Kansas City, Missouri, between 2014 and 2023. Cohorts were divided by EF: severe (EF < 30%) and non-severe (EF ≥ 30%). Demographics and clinical outcomes were compared using descriptive statistics and chi-square tests, with a p-value: < 0.05. Outcomes included adverse events and adenoma or colorectal cancer detection.</p><p><strong>Results: </strong>Among 322 patients, 231 had EF < 30% and 91 had EF ≥ 30%. Adverse events were similar in both cohorts (p > 0.05 for all). No severe events were observed during colonoscopy as classified by the American Society of Gastrointestinal Endoscopy (Cotton et al. (2010) Gastrointest Endosc. 71:446-454) Adenoma detection rate in the EF ≥ 30% group was 37.1 and 26.6% in the EF < 30% group. Analysis showed no significant differences in adenoma detection (p = 0.08).</p><p><strong>Conclusions: </strong>Our study provides new data on the safety and diagnostic performance of pre-transplant colonoscopy in patients with severe and non-severely reduced EF. While minor adverse events were commonly observed, no severe complications occurred during colonoscopy. Adverse clinical outcomes were comparable between cohorts regardless of EF severity, and severity did not appear to significantly impact detection of adenomas; however, bowel prep and colonoscopy were performed in a closely monitored, inpatient setting.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079923","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":"Safety and Efficacy of Ustekinumab and Vedolizumab Among Older Adults with Inflammatory Bowel Disease.","authors":"Moniyka Sachar, Pakdee Rojanasopondist, William Beaty, Cristina Fernandez, Olivia Delau, Alice Li, Nicole Werner, Polly Kirsch, Rebecca Minerva Ortiz, Xinyu Wang, Megan Murphy, Jordan Eric Axelrad, Simon Hong, Ariela Holmer, Shannon Chang, David Hudesman, Seymour Katz, Lisa Malter, Adam S Faye","doi":"10.1007/s10620-025-09395-z","DOIUrl":"https://doi.org/10.1007/s10620-025-09395-z","url":null,"abstract":"<p><strong>Purpose: </strong>There is a lack of safety and efficacy data for newer biologic agents among adults ≥ 60 years old with inflammatory bowel disease (IBD) given their limited inclusion in clinical trials. We conducted a retrospective cohort study comparing the safety and efficacy of ustekinumab (UST) or vedolizumab (VDZ) use in older adults as compared to younger adults with IBD.</p><p><strong>Methods: </strong>This single-center retrospective study compared individuals 18 to 59 years old to individuals ≥ 60 years old with a confirmed diagnosis of IBD who began VDZ or UST treatment between 2014 and 2022. The primary efficacy and safety outcomes were endoscopic remission and serious infection, respectively. Secondary outcomes included endoscopic response, clinical remission, and non-severe adverse events. Multivariable regression was used to identify factors independently associated with safety and efficacy.</p><p><strong>Results: </strong>Overall, 948 individuals were included, with 779 (82.2%) < 60 years-old. In total, 548 (57.8%) had Crohn's disease, 367 (38.7%) had ulcerative colitis, 33 (3.5%) had indeterminate colitis, and a total of 403 individuals (42.5%) initiated VDZ whereas 545 (57.5%) initiated UST. When assessing efficacy, younger and older individuals had comparable rates of endoscopic remission (< 60 years-old 27.5% vs 29.0% ≥ 60 years-old, p = 0.69) as well as clinical remission (< 60 years-old 26.4% vs 26.6% ≥ 60 years-old, p = 0.96). When assessing safety, serious infection rates (< 60 years-old 8.9% vs 8.9% ≥ 60 years-old, p  = 0.99) and non-severe adverse event rates (< 60 years-old 12.3% vs 8.9% ≥ 60 years-old, p = 0.21) were not significantly different. On multivariable analysis, measures of disease severity (prior advanced therapy use, prior corticosteroid use, severe disease) significantly decreased the odds of endoscopic and clinical remission. Additionally, prior advanced therapy use and the presence of comorbidities increased the odds of serious infections.</p><p><strong>Conclusion: </strong>The use of UST and VDZ had similar efficacy and safety outcomes in older adults as compared to younger individuals with IBD. Decisions to utilize these biologics should be driven by overall disease burden and comorbidities, and not be deferred due to advanced chronological age alone.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069328","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 \"After Hours\" Effect and Role of Endoscopy Setting on Outcomes in Patients with Esophageal Food Impaction.","authors":"Neha Wadhavkar, Breton Roussel, Joao Filipe Monteiro, Kanwal Bains, Kuntal Bhowmick, Mouhand Mohamed, Markos Kalligeros, Sean Fine","doi":"10.1007/s10620-025-09389-x","DOIUrl":"https://doi.org/10.1007/s10620-025-09389-x","url":null,"abstract":"<p><strong>Background and aims: </strong>Esophageal food impaction (EFI) resulting in obstruction is a gastrointestinal emergency requiring disimpaction by upper endoscopy. Current guidelines recommend emergent intervention within 24 h to reduce risk of complications. However, limited data exist regarding specific factors affecting practice patterns, including timing and setting of endoscopic intervention for EFI.</p><p><strong>Methods: </strong>We conducted a retrospective review of 684 patients who presented with EFI to the emergency department (ED) at three hospitals from 2015-2021. 447 patients met inclusion criteria. We compared hospitalization rates, ED triage-to-endoscopy time, sedation type, endoscopy setting [ED/intensive care unit (ICU), operating room (OR), or endoscopy unit (EU)], and complications for \"business hours\" (between 8AM and 5PM) and \"after hours\" procedures (weekends or before 8AM/after 5PM).</p><p><strong>Results: </strong>Among 509 EFI cases, 67.2% were performed \"after hours,\" and 56.2% occurred in the EU. \"After hours\" endoscopies were over fourfold more likely to involve moderate sedation (OR 4.35 [1.64-11.54]). Mean ED triage-to-endoscopy time was significantly longer for \"business hours\" cases (11.3 ± 21.2 h versus 5.4 ± 10.3 h, adjusted p-value = 0.0002). Patients undergoing endoscopy \"after hours\" were 74% less likely to be hospitalized (0.26 [0.13-0.55]). Although not statistically significant, \"after hours\" cases had lower complication rates (2.3 versus 4.8%) and in-hospital mortality (0.0% vs 1.2%) compared to \"business hours\" (p-value ≤ 0.1367 and ≤ 0.1072, respectively).</p><p><strong>Conclusions: </strong>We found that \"after hours\" endoscopic disimpactions for EFI did not have increased hospitalizations or increased complications relative to \"business hours,\" contrary to current literature. Our findings underscore the safety, efficacy, and feasibility of \"after hours\" endoscopic intervention for EFI, which may help shape resource allocation and hospital protocols to improve patient outcomes in the future.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069000","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":"Hot on the TRAIL: Targeting SPHK1 in Colorectal Cancer: Therapeutic Potential of PF-543.","authors":"Zilu Chen, Xuejun Sun","doi":"10.1007/s10620-025-09384-2","DOIUrl":"https://doi.org/10.1007/s10620-025-09384-2","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058319","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":"Is Inflammatory Bowel Disease a Risk Factor for Perforation During Diagnostic Colonoscopy? A Systematic Review and Meta-Analysis.","authors":"Bachviet Nguyen, Stephanie Quon","doi":"10.1007/s10620-025-09392-2","DOIUrl":"https://doi.org/10.1007/s10620-025-09392-2","url":null,"abstract":"<p><strong>Purpose: </strong>Inflammatory bowel disease (IBD) may predispose patients to complications during colonoscopy, including colonic perforation. This systematic review and meta-analysis aimed to determine whether IBD is associated with an increased risk of colonic perforation compared to non-IBD patients during colonoscopy.</p><p><strong>Methods: </strong>We systematically searched MEDLINE, PubMed, and Embase from inception to June 2025 for studies comparing rates of colonic perforation during diagnostic, screening, or surveillance colonoscopy in IBD versus non-IBD patients. A random-effects meta-analysis was conducted to calculate pooled odds ratios (ORs), with between-study heterogeneity assessed using I² statistics. Risk of bias was evaluated using the ROBINS-E tool.</p><p><strong>Results: </strong>Across eight retrospective cohort studies comprising over 9 million patients (686,258 with IBD), the pooled OR for colonic perforation in IBD patients during colonoscopy was 1.22 (95% CI 0.89-1.68; p = 0.2199), which did not reach statistical significance. Heterogeneity was high (I² = 82.1%). Subgroup analysis for ulcerative colitis and Crohn's disease demonstrated a pooled OR of 1.05 (95% CI 0.32-3.40) and OR 1.16 (95% CI 0.71-1.92) respectively. Only one study was judged to have a low risk of bias across all domains.</p><p><strong>Conclusion: </strong>A diagnosis of IBD (either ulcerative colitis or Crohn's disease) is not significantly associated with an increased risk of colonic perforation during colonoscopy. Subgroup differences, study heterogeneity, and methodological limitations suggest a need for further research to better quantify this risk and guide procedural planning in IBD patients.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058383","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":"Severe Primary Epstein-Barr Virus Infection in a Young Female with Crohn's Disease Treated with Upadacitinib.","authors":"Piotr Kucha, Tomasz Rawa, Jakub Kiljan, Edyta Zagórowicz","doi":"10.1007/s10620-025-09391-3","DOIUrl":"https://doi.org/10.1007/s10620-025-09391-3","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052467","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":"Hypertriglyceridemia Screening in Acute Pancreatitis: Diagnostic Blind Spot in Clinical Routine.","authors":"Mohamad Amer Nashtar, Jan Kempener, Uttban Gohman, Jasmin Weninger, Eda Kaya, Obayda Azizy, Paul Manka, Mustafa Özcürümez, Polykarpos Christos Patsalis, Ali Canbay, Martin Steinmetz","doi":"10.1007/s10620-025-09366-4","DOIUrl":"https://doi.org/10.1007/s10620-025-09366-4","url":null,"abstract":"<p><strong>Background: </strong>Hypertriglyceridemia (HTG) is the third most common cause of acute pancreatitis (AP) after gallstones and alcohol abuse. Early determination of the triglyceride (TG) level in patients with acute abdominal pain, particularly in cases of AP, is crucial, as an acute increase can be followed by a rapid decrease within 2 days. HTG as a cause of acute abdominal pain and AP is often overlooked in clinical practice. In addition, manifest HTG is often underdiagnosed and inadequately treated.</p><p><strong>Methods: </strong>We investigated 1279 cases of acute abdominal pain, including 226 cases of AP, to assess the frequency and timing of TG level measurement. Additionally, we studied 237 patients with HTG levels above 500 mg/dL to determine the frequency of HTG-related symptoms and the rate of initiation of adequate therapy, considering the specialty in which the elevated TG levels were identified.</p><p><strong>Results: </strong>Triglycerides were determined in 22% of patients with acute abdominal pain and 55% with AP; fewer than 15% of all patients received a determination at the first contact with the physician. TG levels were measured at a median of 24 h (1-54) in patients with acute abdominal pain and 48 h (24-95) in those with AP after admission. Less than half of patients with HTG received TG-lowering therapy. Only 5 of 226 cases with AP was identified as HTG-induced, while 13.5% of all cases with HTG above 500 mg/dL had a history of AP.</p><p><strong>Conclusions: </strong>Our findings support the assumption that HTG and its complications are often underestimated in clinical practice and require more attention. Furthermore, early initiation of appropriate therapy is crucial.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058342","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}