Digestive Diseases and Sciences最新文献

{"title":"A Functional First - An Introduction to the DDS Citation Classic \"Inaugural Rome Foundation Research into the Epidemiology of All Disorders of Gut-Brain Interaction\".","authors":"Jonathan D Kaunitz","doi":"10.1007/s10620-026-10146-x","DOIUrl":"10.1007/s10620-026-10146-x","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"6128"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683853","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":"Randomized Placebo-Controlled Trial of Psyllium Fiber in Functional Abdominal Pain Disorders in Children.","authors":"Manjit Kaur, Ujjal Poddar, Anshu Srivastava, Moinak Sen Sarma, Prabhakar Mishra","doi":"10.1007/s10620-026-10156-9","DOIUrl":"10.1007/s10620-026-10156-9","url":null,"abstract":"<p><strong>Background: </strong>Functional abdominal pain disorders (FAPD) are common in children and there is heterogeneity in the available literature regarding the role of fibre in FAPD and none so-far in functional abdominal pain-not otherwise specified (FAP-NOS).</p><p><strong>Aim: </strong>The study aimed to evaluate the efficacy of psyllium fiber in pediatric FAPD including Irritable bowel syndrome (IBS) and FAP-NOS.</p><p><strong>Methods: </strong>In this prospective randomized placebo-controlled trial, children (5-18 years) diagnosed as FAPD based on Rome IV criteria were randomized to psyllium fiber or placebo (maltodextrin) for 12 weeks. Post-treatment improvement of pain and quality of life (QoL) from baseline was compared between the two groups. Pain assessment was done using the pain score table, which assessed duration, frequency, and intensity of pain.</p><p><strong>Results: </strong>The mean age of 109 children (FAP-NOS: 85%; psyllium fiber 57, placebo 52) was 11.8 ± 3.9 years (58% boys). There was a significant difference in pain improvement in terms of reduction in scores for intensity (5.5 vs. 3.2), frequency (6.0 vs. 3.2), duration (5.3 vs. 3.3), and QoL (4.4 vs. 2.3) between the psyllium and placebo group (P < 0.001 in all). Responders (> 50% reduction in pain) were seen in 86% of the psyllium as compared to 60% in the placebo group (P = 0.001). On multivariate analysis, use of psyllium fiber was the only factor predictive of response (OR: 5.49, 95% CI 2.05-14.72, P < 0.001). After discontinuation of psyllium fiber, 81% had sustained response over a mean follow-up of 6.7 ± 4.0 months.</p><p><strong>Conclusions: </strong>A 12-week trial of psyllium fiber improves pain in most and gives sustained relief in three-fourths of children with FAP-NOS and IBS.</p><p><strong>Clinical trial registration: </strong>Clinical Trial Registry of India ( CTRI/2023/08/056772; Website http://ctri.nic.in ).</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5801-5811"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673274","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":"Standardizing Transition of Care for Adolescents with Inflammatory Bowel Disease: The Need for a Unified Approach.","authors":"Abdullah Sultany, Amlish Gondal, Subash Ghimire, Rasmita Budhathoki","doi":"10.1007/s10620-026-10101-w","DOIUrl":"10.1007/s10620-026-10101-w","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"6129-6130"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381752","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 Single-Center Retrospective Cohort Review of Pancreatic Cysts and Malignancy in Cystic Fibrosis Lung Transplant Recipients.","authors":"Yasseen El Abdellaoui, Daniel Dong, Julia Zweifach, Grace McDevitt, Logan O Gauthier, Avinash Kambadakone, Sophia Zhao, Christopher Vélez, Yasmin G Hernandez-Barco, Isabel Neuringer","doi":"10.1007/s10620-026-10110-9","DOIUrl":"10.1007/s10620-026-10110-9","url":null,"abstract":"<p><strong>Background: </strong>Individuals with cystic fibrosis (CF) develop pancreatic cysts and cancer more frequently than the general population, particularly among lung transplant recipients due to long-term immunosuppression. CF lung transplant guidelines address many gastrointestinal malignancies including colorectal cancer, but do not provide recommendations for routine surveillance of the pancreas.</p><p><strong>Aims: </strong>We aim to highlight the increased risk that CF lung transplant patients face for developing pancreatic cysts and malignancy. This study may inform future multicenter studies and guideline revisions to include monitoring of the pancreas in this population.</p><p><strong>Methods: </strong>An observational, retrospective chart review of CF lung transplant recipients (N = 54) was conducted monitoring pancreatic cyst incidence and severity. Statistics and figures were generated in RStudio.</p><p><strong>Results: </strong>Twenty-two patients (40.7%) had pancreatic cystic lesions. Nearly, all patients underwent post-transplant, abdominal CT (100%), and ultrasound (98.1%), while 30 patients (55.6%) received an MRI/MRCP. Of those with cysts, 7 (31.8%) had cysts detected pre-transplant, while 15 (68.2%) had cysts detected post-transplant. Seven patients (31.8%) were diagnosed with suspected IPMNs. Seven patients (31.8%) had cysts measuring ≥ 30 mm, 4 (18.2%) exhibited main pancreatic duct dilation > 5 mm, and 8 patients (36.4%) showed a cystic growth rate ≥ 3.0 mm per year. Seven individuals (13.0%) had their cysts sampled for malignancy; two (3.7%) were diagnosed with pancreatic cancer and an additional patient experienced rapid multifocal cyst progression and underwent total pancreatectomy.</p><p><strong>Conclusion: </strong>Findings indicate a higher-than-expected pancreatic cyst and cancer prevalence, supporting the need for formal screening guidelines for CF lung transplant recipients.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5521-5531"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454919","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":"Letter to the Editor Regarding Barkan et al.'s Article, \"Randomized Trial of Intensive Nurse‑Led Follow‑up Versus Standard Care in Inflammatory Bowel Disease\".","authors":"Chung Sang Tse","doi":"10.1007/s10620-026-10160-z","DOIUrl":"10.1007/s10620-026-10160-z","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"6137-6138"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668650","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":"Outcomes of ERCP for Post-operative Bile Leaks After Cholecystectomy, Hepatectomy, and Liver Transplantation: A High-Volume Tertiary Referral Center Experience.","authors":"Azizullah Beran, AbdiGhani Ismail, Mingjun Song, Sujani Yadlapati, Itegbemie Obaitan, John M DeWitt, Mohammad Al-Haddad, Mark A Gromski, James L Watkins, Glen A Lehman, Eugene P Ceppa, Nicholas J Zyromski, Michael G House, Evan L Fogel, Jeffrey J Easler, Nasir Saleem","doi":"10.1007/s10620-026-10159-6","DOIUrl":"10.1007/s10620-026-10159-6","url":null,"abstract":"<p><strong>Background: </strong>Bile leak (BL) remains one of the major adverse events of hepatobiliary surgeries. We evaluated ERCP outcomes for postoperative BL (PBL) cholecystectomy (C-BL), hepatectomy (H-BL), and liver transplantation (LT-BL) and identified predictors of persistent leak after initial ERCP.</p><p><strong>Methods: </strong>This study includes consecutive patients who underwent ERCP for PBL at a single high-volume center (2011-2021). Leaks were graded as low-grade BL (LG-BL) or high-grade BL (HG-BL). Initial success was defined as cholangiographic and clinical resolution of BL following a single therapeutic ERCP session at the first follow-up ERCP. Final success was defined as cholangiographic and clinical resolution of the BL at the last follow-up assessment, irrespective of the number of therapeutic ERCP sessions required.</p><p><strong>Results: </strong>417 patients with PBLs were included: 348 (83.5%) C-BL, 43 (10.3%) H-BL, and 26 (6.2%) LT-BL. Initial clinical success was 80.7% overall, with the highest in LT-BL (91.7%), followed by C-BL (83.5%), and then H-BL (50%) (p < 0.001). HG-BLs had lower initial success (54.7% vs. 87.8% for LG-BL; p < 0.001). Final success was 96% overall, but lower in H-BL (84.2%) than C-BL (97.3%) and LT-BL (95.8%) (p < 0.001). Overall, HG-BL (adjusted odds ratio [aOR] 5.79) and H-BL (aOR 3.52) were independent predictors of persistent leak.</p><p><strong>Conclusion: </strong>ERCP is effective and safe for PBL. However, initial clinical success varied by surgical etiology and leak severity. HG-BL and H-BL were associated with lower initial success and more frequently required repeated ERCP interventions for leak resolution. Further studies are needed to validate optimal treatment strategies for higher-risk bile leak subgroups.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5812-5823"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673272","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":"Gastroscopic Removal of a Duodenal Foreign Body in a 94-Year-Old Patient.","authors":"Lingyi Zhou, Xinrong Xu, Qiang Zhan, Qinglin Zhang","doi":"10.1007/s10620-026-10085-7","DOIUrl":"10.1007/s10620-026-10085-7","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5271-5272"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367254","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 Efficacy and Safety of Clip-Assisted Endoscopic Cyanoacrylate Injection for Gastric Varices: A Systematic Review and Meta-Analysis.","authors":"Mohamed Abuelazm, Yousef Hawas, Belal Mohamed Hamed, Abdelrahman Awad, EzzElDien A Ibrahim, Hatem Eltaly, Mohamed Nasser Elshabrawi, Ibrahim Gowaily, Mohamed Elgendy, Douglas G Adler","doi":"10.1007/s10620-026-10071-z","DOIUrl":"10.1007/s10620-026-10071-z","url":null,"abstract":"<p><strong>Background: </strong>Bleeding from gastric varices (GVs) is a severe complication of portal hypertension. Conventional endoscopic cyanoacrylate injection (Con-ECI) is an effective treatment, but it is associated with significant risks of rebleeding and systemic ectopic embolism. Clip-assisted ECI (Clip-ECI), where clips are deployed before glue injection, has been developed to mitigate these risks, but its efficacy remains debatable.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Embase, Web of Science, and Scopus was conducted for studies up to August 2025. The primary outcomes were all-cause rebleeding and ectopic embolism. Secondary outcomes included variceal obliteration, mortality, and procedure-related complications. Risk ratios (RR) with 95% confidence intervals (CI) were pooled from randomized and non-randomized studies using a random-effects model.</p><p><strong>Prospero id: </strong>CRD420251163015.</p><p><strong>Results: </strong>Seven studies involving 783 patients were included. Compared to Con-ECI, Clip-ECI was associated with a significantly lower risk of variceal rebleeding (RR: 0.24; 95% CI [0.12, 0.48]; P < 0.001) and ectopic embolism (RR: 0.31; 95% CI [0.13, 0.76]; P = 0.01). The pooled rates of variceal rebleeding and ectopic embolism in the Clip-ECI group were 7.1% and 2.1%, respectively. Also, Clip-ECI achieved a significantly higher rate of complete variceal obliteration (RR: 1.39; 95% CI [1.23, 1.57]; P < 0.001). There were no significant differences in all-cause mortality (P = 0.28), technical success (P = 0.35), or other adverse events.</p><p><strong>Conclusion: </strong>In patients with GVs, Clip-ECI significantly reduces the risks of rebleeding and ectopic embolism while improving variceal obliteration, without increasing adverse events, compared with Con-ECI.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5326-5345"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367241","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":"Endoscopic Sphincterotomy Plus Large Balloon Dilation Versus Endoscopic Sphincterotomy Alone for Patients with Common Bile Duct Stones: A GRADE Evaluation of Systematic Review and Meta-Analysis.","authors":"Mahmoud Mohamed Gad, Mohamed Ayman Salem, Muhammad Youssef, Yousif Ahmed Othman, Mariam A Abusalah, Woroud A L Fauomi, Mohamed Mostafa Eisa, Mahmoud Diaa Hindawi","doi":"10.1007/s10620-026-10115-4","DOIUrl":"10.1007/s10620-026-10115-4","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic sphincterotomy (ES) and endoscopic papillary balloon dilation (EPBD) are established treatments for common bile duct (CBD) stones, each with limitations. Endoscopic sphincterotomy with large-balloon dilation (ESBD) combines both techniques, but its efficacy versus ES alone remains controversial. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing ESBD with ES alone for the management of CBD stones.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, Embase, Ovid, Web of Science, and Cochrane Library for RCTs comparing ESBD versus ES alone in adults with CBD stones. Primary outcomes were total and first-session stone clearance and mechanical lithotripsy (ML) use. Secondary outcomes included procedure time and complications. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using fixed or random effect models based on heterogeneity. Subgroup analysis was performed based on stone size and balloon dilation time. Risk of bias was assessed using the Cochrane ROB-2 tool, and the certainty of evidence was evaluated using the GRADE approach.</p><p><strong>Results: </strong>Seventeen RCTs with 2671 patients were included. ESBD significantly improved first-session stone clearance (RR 1.11; 95% CI: 1.04 to 1.17; P = 0.001), reduced ML use (RR 0.47; 95% CI: 0.34-0.65; P < 0.0001), and shortened procedure time (MD - 3.44 min; 95% CI: - 5.71 to - 1.17; P = 0.003) compared with ES alone. Total stone clearance was similar between groups. ESBD significantly reduced postoperative hemorrhage (RR 0.55; 95% CI 0.34 to 0.90; P = 0.02) and stone recurrence (RR 0.53; 95% CI 0.32 to 0.87; P = 0.01), with no difference in pancreatitis or other complications. ESBD significantly increases first-session stone removal and decreases ML use in both small- and large-stone-sized groups.</p><p><strong>Conclusion: </strong>Current low- to very-low-certainty evidence suggests possible procedural advantages of ESBD over ES alone, including higher first-session stone clearance, reduced mechanical lithotripsy use, shorter procedure time, and lower rates of bleeding and stone recurrence, across both large and small CBD stones. These findings are hypothesis-generating and should not be considered practice-changing until confirmed by high-quality randomized controlled trials (RCTs).</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5615-5635"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497230","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":"Impact of Diet and Body Mass Index on the Development of Pouchitis in the First Year After Ileal Pouch-Anal Anastomosis.","authors":"Sophia Goldbeck, Chelsea Anderson, Jennifer Barr, Jordan Axelrad, Millie D Long, Hans H Herfarth, Edward Barnes","doi":"10.1007/s10620-026-10102-9","DOIUrl":"10.1007/s10620-026-10102-9","url":null,"abstract":"<p><strong>Background: </strong>Although pouchitis is the most common complication after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC), the influence of diet on pouchitis is poorly understood. Thus, evidence-based dietary recommendations after IPAA are limited.</p><p><strong>Aims: </strong>We evaluated dietary intake in the period after the final stage of IPAA for UC and Body Mass Index (BMI) to identify potential associations with pouchitis.</p><p><strong>Methods: </strong>We used the Dietary Screener Questionnaire (DSQ) to assess dietary intake among patients in a prospective cohort enrolled within 2 weeks of the final stage of IPAA for UC. We compared food group and fiber intake of those who developed pouchitis within 12 months of the final stage of IPAA with those who did not. These were also compared to the United States Department of Agriculture (USDA) recommended daily goals.</p><p><strong>Results: </strong>Among 89 patients, there was no significant difference in individual fiber intake when comparing those who developed pouchitis and those who did not. In comparison with USDA guidelines, both groups (pouchitis and no pouchitis) exhibited decreased intake of several food groups, such as fruits, vegetables, fiber, and dairy. Patients who developed pouchitis had a significantly higher median body mass index (BMI) at the time of surgery compared to patients who did not develop pouchitis (median 29.2 vs. 24.8, P = 0.022).</p><p><strong>Conclusions: </strong>In a prospective cohort, we identified no association between dietary intake and development of pouchitis within the first year after IPAA. However, elevated BMI may represent a unique target for intervention to prevent pouchitis occurrence.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5473-5479"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419488","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}