Gastroenterology最新文献

{"title":"Elsewhere in the AGA Journals (Preview Section)","authors":"","doi":"10.1053/S0016-5085(25)00782-6","DOIUrl":"10.1053/S0016-5085(25)00782-6","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"169 1","pages":"Pages A25-A27"},"PeriodicalIF":25.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out-of-Pocket Costs for Colonoscopy Prep Persist Despite ACA Mandate: Insights from a Large Real-World Dataset","authors":"Eric D. Shah, Audrey H. Calderwood, Kaitlyn McBride, Paul Sharaf, Daniel L. Halberg","doi":"10.1053/j.gastro.2025.05.025","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.05.025","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"70 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exam 1: Recurrent Acute Pancreatitis: Many Faces (/Facets) of a Challenging Disease","authors":"","doi":"10.1053/j.gastro.2025.05.001","DOIUrl":"10.1053/j.gastro.2025.05.001","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"169 1","pages":"Pages e12-e14"},"PeriodicalIF":25.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Senescence, aging and disease throughout the gastrointestinal system","authors":"Sofia Ferreira-Gonzalez, Tomotoro Matsumoto, Eiji Hara, Stuart J. Forbes","doi":"10.1053/j.gastro.2025.06.010","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.06.010","url":null,"abstract":"Senescence is an irreversible cell cycle arrest -characterized by morphological alterations, genomic instability and secretome changes- that profoundly affects the tissue structure and function.Accumulating evidence indicates that senescence plays a relevant role in gastrointestinal pathologies: senescence contributes to salivary gland hypofunction, is instrumental in the development of oral sub-mucous fibrosis, drives age-dependent hepatic steatosis and regulates the clinical progression of steatotic liver disease. Senescence in the biliary tract develops in response to ischemic injury in biliary complications and is characteristic of biliary conditions such as biliary atresia, primary sclerosing cholangitis and primary biliary cirrhosis. Senescence also contributes to acute pancreatitis and plays a major role in the dysfunction of pancreatic beta cells. Moreover, senescence is a hallmark of a number of gastrointestinal conditions such as inflammatory bowel disease and colorectal cancer. These examples illustrate the widespread effect of cellular senescence in the gastrointestinal tract, not just as a consequence of the disease, but as a driver of pathology and a potential therapeutic target.In this review we describe the mechanisms, hallmarks and consequences of cellular senescence, as well as the therapeutic potential of senescence-targeting interventions. We aim to highlight the importance of understanding the molecular basis of senescence in gastroenterology, whilst connecting the worlds of research and clinical practice.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"22 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144305173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole food diet induces remission in children and young adults with mild-moderate Crohn's disease and is more tolerable than exclusive enteral nutrition: a randomized controlled trial","authors":"Yonat Aharoni Frutkoff, Luba Plotkin, Daniel Pollak, Jessica Livovsky, Gili Focht, Raffi Lev-Tzion, Oren Ledder, Amit Assa, Dotan Yogev, Esther Orlanski-Meyer, Efrat Broide, Jarosław Kierkuś, Ben Kang, Batia Weiss, Marina Aloi, Tobias Schwerd, Dror S. Shouval, Matteo Bramuzzo, Anne M. Griffiths, Moran Yassour, Dan Turner","doi":"10.1053/j.gastro.2025.06.011","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.06.011","url":null,"abstract":"<h3>Background</h3>Tasty&amp;Healthy (T&amp;H) is a whole-food diet for Crohn’s disease (CD), which excludes processed food, gluten, red meat, and dairy, without requiring formula or mandatory ingredients. TASTI-MM was a clinician-blinded, randomized-controlled trial comparing tolerability and effectiveness of T&amp;H vs. exclusive enteral nutrition (EEN).<h3>Methods</h3>Patients with biologic-naive mild-moderate CD aged 6–25 years were randomized to either T&amp;H or EEN for 8 weeks, receiving weekly dietary support. Tolerability was evaluated by weekly interviews, questionnaires and intake diaries. Other outcomes included symptomatic remission, Mucosal-Inflammation Non-Invasive (MINI) index, calprotectin, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Fecal microbiome was analyzed by metagenomics at baseline, week-4 and week-8. Data were analyzed by the intention-to-treat approach unless specified otherwise.<h3>Results</h3>Among 83 included patients (41 T&amp;H, 42 EEN; mean age 14.5±3.7 years), 88% tolerated T&amp;H vs. 52% for EEN (aOR 7.7 [95%CI 2.4-25]; p&lt;0.001). Calprotectin, CRP and ESR decreased significantly in both groups, with no between-group differences. Symptomatic remission was achieved in 56% of T&amp;H group vs. 38% of the EEN group (aOR 2.5 [0.98-6.3], p=0.1; per-protocol: 67% vs. 76%; p=0.47). Calprotectin &lt;250μg/g was achieved in 34% vs. 33% (aOR 0.97 [0.37-2.6], p=0.84) and MINI&lt;8 in 44% vs. 31% (aOR 1.8 [0.7-4.5]; p=0.33). Microbiome <em>α</em>-diversity improved in the T&amp;H arm and declined in the EEN arm, showing superior species richness at both week-4 and week-8. Species associated with bowel inflammation, such as <em>Ruminococcus gnavus,</em> decreased in T&amp;H and increased in EEN (q&lt;0.001).<h3>Conclusions</h3>T&amp;H demonstrated better tolerability than EEN for inducing remission in mild-to-moderate CD, while positively affecting the microbiome (TASTI-MM, NCT#04239248).","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"145 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial transcriptomics of Hirschsprung disease resection margins marks differential gene expression in myenteric plexus","authors":"Isabelle A.M. van Thiel, Joris J.T.H. Roelofs, Ramon R. Gorter, L.W. Ernest van Heurn, Wouter J. de Jonge, Joep P.M. Derikx","doi":"10.1053/j.gastro.2025.06.012","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.06.012","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"28 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Professional Networking For Career Advancement - Tips for Early Career Faculty","authors":"Joseph Sleiman, Laura S. Chiu, James Connolly, Shifa Umar","doi":"10.1053/j.gastro.2025.06.008","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.06.008","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"8 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential and challenges of glepaglutide for SBS-IF","authors":"Shiyu Yang, Ying Lu","doi":"10.1053/j.gastro.2025.04.039","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.04.039","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"37 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Pancreatectomy and Islet Auto Transplant for Chronic Pancreatitis","authors":"Guru Trikudanathan, Anne Eaton, Martin L. Freeman, Vikesh K. Singh, Sarah J. Schwarzenberg, Jaimie D. Nathan, Gregory J. Beilman, Maisam Abu-El-Haija, David Adams, Syed A. Ahmad, Srinath Chinnakotla, Elissa M. Downs, Mayha Faghih, Timothy B. Gardner, Luis F. Lara, Katherine Morgan, Sri Prakash Mokshagundam, Bashoo Naziruddin, Andrew Posselt, Timothy L. Pruett, Melena D. Bellin","doi":"10.1053/j.gastro.2025.04.040","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.04.040","url":null,"abstract":"<h3>Background and Aims</h3>Total pancreatectomy with islet autotransplantation (TPIAT) is an emerging but controversial therapy for patients with intractably painful chronic pancreatitis (CP) and recurrent acute pancreatitis (RAP). Outcomes of TPIAT have not been validated in multicenter studies.<h3>Methods</h3>384 participants (mean age 30 (SD 17) years, 34% pediatric, 62% female) with painful CP and/or RAP undergoing TPIAT were prospectively enrolled at 12 centers. Numeric pain scores, opioid use, and health-related QOL, including physical component summary (PCS) and mental component summary (MCS), were collected at baseline and at 6 months and 1 year post TPIAT. Predictors of outcomes were evaluated with regression modeling.<h3>Results</h3>Opioid use, assessed over a 14 day interval, decreased from 61% before to 24% at 1 year after TPIAT (p&lt;0.001). Daily abdominal pain decreased from 65% to 23%, while the mean (SD) pain score decreased from 4.9 (2.3) to 2.3 (2.5) (both p&lt;0.001). In a multivariable model, opioid use at 1 year was associated with older age and opioid use pre-TPIAT (odds ratio 9.21 [95% confidence interval 3.93-25.7]). PCS and MCS score improved by ≥10 points in 58% and 35% respectively. Higher QOL scores at 1 year were associated with higher scores pre-surgery and younger age. Mean (SD) HbA1c was 7 (1.9%) with 20% insulin independent at 1 year. Duration of disease, pancreas morphology, and etiology did not predict response to TPIAT.<h3>Conclusion</h3>In this prospective multicenter study of patients with intractably painful CP or RAP, TPIAT significantly reduced pain burden and improved QOL. While young age predicted better outcomes, duration and etiology of disease did not.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"13 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Adenoma Detection Rate and Prevalent Colorectal Cancer Detection Rate in a National Colonoscopy Registry Subtitle: Association Between Adenoma and Colorectal Cancer Detection","authors":"Jason A. Dominitz, Uri Ladabaum, Jennifer L. Holub, Rachel B. Issaka, Cynthia W. Ko, Douglas J. Robertson","doi":"10.1053/j.gastro.2025.06.009","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.06.009","url":null,"abstract":"<h3>BACKGROUND</h3>While the adenoma detection rate (ADR) is associated with post-colonoscopy colorectal cancer (PCCRC) risk, it is unknown to what extent this reflects missed colorectal cancer (CRC) versus missed pre-cancerous lesions. We evaluated the association between physician ADR and prevalent CRC detection during colonoscopy.<h3>METHODS</h3>We used cross-sectional 2019-2022 GI Quality Improvement Consortium (GIQuIC) data for &gt;1.73 million colonoscopies performed by 3567 endoscopists for screening or abnormal fecal test (AFT) follow-up from 683 US endoscopy units. Endoscopist ADR and sessile serrated lesion detection rate (SSLDR) were determined based on screening exams.<h3>RESULTS</h3>CRC was detected in 0.3% of screening and 1.5% of follow-up colonoscopies. From lowest to highest endoscopist ADR quintile, CRC detection increased from 26.6 (95% confidence interval (CI) 24.4-27.9) to 33.1 (95%CI 29.7-33.7), and from 107.8 (95%CI 96.2–129.4) to 164.7 (95% CI 140.8–188.6) per 10,000 screening and AFT follow-up colonoscopies, respectively. In multivariable models with lowest ADR quintile as reference, the odds ratios (ORs) of CRC detection in the highest ADR quintile were 1.27 (95% CI 1.14-1.41) for screening and 1.50 (95% CI 1.16-1.93) for AFT follow-up colonoscopies. Compared to high-ADR/high-SSLDR endoscopists, the ORs of CRC detection were lower for low-ADR endoscopists irrespective of SSLDR (high-SSLDR, 0.87, 95% CI 0.80-0.96; low-SSLDR 0.92, 95% CI 0.85-0.98), but similar for high-ADR/low-SSLDR endoscopists.<h3>CONCLUSIONS</h3>ADR reflects prevalent CRC detection as well as detection and removal of CRC precursors. Our findings suggest that PCCRC is not uncommonly due to missed CRC, especially among endoscopists with low ADR.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"90 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}