Gastroenterology最新文献

{"title":"Reply to Li","authors":"Siyan Cao, Khai M. Nguyen, Marco Colonna","doi":"10.1053/j.gastro.2025.01.007","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.01.007","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"16 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988786","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":"Physiological Data Collected from Wearable Devices Identify and Predict Inflammatory Bowel Disease Flares","authors":"Robert P. Hirten, Matteo Danieletto, Milagros Sanchez-Mayor, Jessica K. Whang, Kyung Won Lee, Kyle Landell, Micol Zweig, Drew Helmus, Thomas J. Fuchs, Zahi A. Fayad, Girish N. Nadkarni, Laurie Keefer, Mayte Suarez-Farinas, Bruce E. Sands","doi":"10.1053/j.gastro.2024.12.024","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.024","url":null,"abstract":"<h3>Background and Aims</h3>Wearable devices capture physiological signals non-invasively and passively. Many of these parameters have been linked to inflammatory bowel disease (IBD) activity. We evaluated the associative ability of several physiological metrics with IBD flares and how they change before the development of flare.<h3>Methods</h3>Participants throughout the United States answered daily disease activity surveys and wore an Apple Watch, Fitbit or Oura Ring. These devices collected longitudinal heart rate (HR), resting heart rate (RHR), heart rate variability (HRV), steps, and oxygenation (SpO2). C-reactive protein, erythrocyte sedimentation rate and fecal calprotectin were collected as standard of care. Linear mixed-effect models were implemented to analyze HR, RHR, steps, and SpO2, while cosinor mixed-effect models were applied to HRV circadian features. Mixed effect logistic regression was used to determine the predictive ability of physiological metrics.<h3>Results</h3>309 participants were enrolled across 36 states. Circadian patterns of HRV significantly differed between periods of inflammatory flare and remission, and symptomatic flare and remission. Marginal means for HR and RHR were higher during periods of inflammatory flare and symptomatic flare. There was lower daily steps during inflammatory flares. HRV, HR, and RHR differentiated whether participants with symptoms had inflammation. HRV, HR, RHR, steps, and SpO2 were significantly altered up to 7 weeks prior to inflammatory and symptomatic flares.<h3>Conclusions</h3>Longitudinally collected physiological metrics from wearable devices can identify and change prior to IBD flares, suggesting their feasibility to monitor and predict IBD activity.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"54 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986880","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":"Reply to Wang et al","authors":"Joseph J. Zhao, Raghav Sundar","doi":"10.1053/j.gastro.2025.01.005","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.01.005","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"75 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986881","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":"AGA Institute Quality Indicator Development for Irritable Bowel Syndrome","authors":"Kenneth W. Hung, David A. Leiman, Archana Kaza, Rabindra Watson, Lin Chang, Jennifer K. Maratt","doi":"10.1053/j.gastro.2024.11.003","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.11.003","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Quality Indicator Development</h2>A comprehensive PubMed search was performed for the terms “irritable bowel syndrome” or “IBS” to identify national and international guidelines, clinical practice updates, and consensus statements published between 2012 and 2022 and updated in November 2023. A total of 20,684 article titles and abstracts were reviewed. Articles in non-English languages and those that did not have clear guideline or consensus statements were excluded.Recommendation statements from 42 guidelines, clinical</section></section><section><section><h2>Quality Indicators</h2>Multiple diagnostic and therapeutic interventions were evaluated, including colonoscopy, stool-based tests, serologic tests, imaging studies, dietary therapy, probiotics, medications, and brain–gut behavior therapy. Table 1 summarizes quality indicators for diagnosis and management of IBS and the strength of recommendation by society, when available.</section></section><section><section><h2>Discussion and Future Directions</h2>The AGA Quality Committee reviewed national and international society guidelines and consensus statements on the epidemiology, diagnosis, and management of IBS and developed quality indicators based on available evidence to date. Quality indicators allow clinicians, practices, and health systems to focus on aspects of care that are evidence-based and supported by multiple professional societies to promote guideline-endorsed care and, when needed, to implement interventions with the goal of</section></section><section><section><h2>Acknowledgments</h2>The authors would like to particularly acknowledge the work of David Godzina and members of the AGA Quality Committee who participated in generating and evaluating these quality indicators. The authors are also grateful for the Rome Foundation Board for their feedback and endorsement of these quality indicators.<section><h2>Author Contributions</h2>Kenneth W. Hung: conceptualization, drafting, review/editing. David A. Leiman: conceptualization, drafting, review/editing. Archana Kaza: conceptualization, review/editing. Rabindra</section></section></section>","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"7 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981438","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":"Critical Reflections on Tumor Microenvironmental Alterations in Peritoneal Metastases","authors":"Chenxi Wang, Huichuan Tian, Jin Shang","doi":"10.1053/j.gastro.2024.12.034","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.034","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"68 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986920","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":"Eradication Therapy to Prevent Gastric Cancer in H. pylori-positive individuals: Systematic Review and Meta-analysis of Randomized Controlled Trials and Observational Studies.","authors":"Alexander C. Ford, Yuhong Yuan, Jin Young Park, David Forman, Paul Moayyedi","doi":"10.1053/j.gastro.2024.12.033","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.033","url":null,"abstract":"<h3>Background &amp; aims</h3>Screening for, and treating, <em>Helicobacter pylori</em> (<em>H. pylori</em>) in the general population or patients with early gastric neoplasia could reduce incidence of, and mortality from, gastric cancer. We updated a meta-analysis of randomized controlled trials (RCTs) examining this issue.<h3>Methods</h3>We searched the literature through 4^th October 2024, identifying studies examining effect of eradication therapy on incidence of gastric cancer in <em>H. pylori</em>-positive adults without gastric neoplasia at baseline or <em>H. pylori</em>-positive patients with gastric neoplasia undergoing endoscopic mucosal resection (EMR) in either RCTs or observational studies. The control arm received placebo or no eradication therapy in RCTs and no eradication therapy in observational studies. Follow-up was ≥2 years. We estimated relative risks (RR) of gastric cancer incidence and mortality.<h3>Results</h3>Eleven RCTs and 13 observational studies were eligible. For RCTs, RR of gastric cancer was lower with eradication therapy in healthy <em>H. pylori</em>-positive individuals (eight RCTs: 0.64; 95% CI 0.48-0.84) and <em>H. pylori</em>-positive patients with gastric neoplasia undergoing EMR (three RCTs: 0.52; 95% CI 0.38-0.71). RR of death from gastric cancer was lower with eradication therapy in healthy <em>H. pylori</em>-positive individuals (five RCTs: 0.78; 95% CI 0.62-0.98). In observational studies, RR of future gastric cancer was lower with eradication therapy in <em>H. pylori</em>-positive subjects without gastric neoplasia at baseline (11 studies: 0.56; 95% CI 0.43-0.73) and <em>H. pylori</em>-positive patients with gastric neoplasia undergoing EMR (two studies: 0.19; 95% CI 0.06-0.61).<h3>Conclusions</h3>This meta-analysis provides further evidence that administering eradication therapy prevents gastric cancer in <em>H. pylori</em>-positive individuals, with consistency in results among studies of different design.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"37 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142986882","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":"Mechanistic implications of the Mediterranean diet in patients with newly diagnosed Crohn's disease- multi-omic results from a prospective cohort","authors":"L. Godny, S. Elial-Fatal, J. Arrouasse, T. Sharar Fischler, L. Reshef, Y. Kutukov, S. Cohen, T. Pfeffer-Gik, R. Barkan, S. Shakhman, A. Friedenberg, M.H. Pauker, K.M. Rabinowitz, E. Shaham-Barda, I. Goren, U. Gophna, H. Eran-Banai, J.E. Ollech, Y. Snir, Y. Broitman, I. Dotan","doi":"10.1053/j.gastro.2024.12.031","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.031","url":null,"abstract":"<h3>Background</h3>To decipher the mechanisms underlying the protective role of the Mediterranean diet (MED) in Crohn’s disease (CD), we explored the implications of adherence to MED on CD course, inflammatory markers, microbial and metabolite composition.<h3>Methods</h3>Patients with newly diagnosed CD were recruited and followed prospectively. MED adherence was assessed by repeated food frequency questionnaires (FFQ), using a predefined IBDMED score, alongside validated MED adherence screeners. Crohn’s disease activity index (CDAI), C-reactive protein (CRP), fecal calprotectin and microbial composition (16S-rRNA-sequencing) were assessed each visit. Baseline serum and fecal samples were analyzed for targeted quantitative metabolomics.<h3>Results</h3>Consecutive patients: 271 (52% males, average age- 31±12 years, B1 phenotype- 75%). FFQ collected: 636 (range 1-5 FFQ per patient). Adherence to MED was associated with a non-complicated CD course, and inversely correlated with CDAI, fecal calprotectin, CRP and microbial dysbiosis index (all <em>P</em> &lt; .05). Increasing adherence to MED over time correlated with reduced CDAI and inflammatory markers (<em>P</em> &lt; .05). Adherence to MED correlated with a microbial cluster of commensals and short-chain fatty acid producers including <em>Faecalibacterium</em>, and with plant metabolites, vitamin derivatives and amino acids. Conversely, adherence to MED inversely correlated with a cluster of oral genera, <em>Escherichia coli</em> and <em>Ruminococcus gnavus</em>, known CD-associated species, and with tryptophan metabolites, ceramides and primary bile acids (FDR &lt; .2).<h3>Conclusion</h3>Adherence to MED is associated with beneficial clinical outcomes and decreased inflammatory markers. These may be driven by lower levels of primary bile-acids and microbial dysbiosis and a beneficial microbial and metabolite composition. Randomized controlled trials are needed to evaluate the role of MED in CD management.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"51 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974801","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":"Individuals with Lynch syndrome have similar survival as the general population, but lower than family members without Lynch syndrome","authors":"Daniel Karpati, Maartje Nielsen, Anja Wagner, Sanne W. Bajwa-ten Broeke, Fonnet E. Bleeker, Monique E. van Leerdam","doi":"10.1053/j.gastro.2024.12.032","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.032","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"16 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961896","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":"Risk of colorectal cancer associated with frequency of colorectal polyp diagnosis in relatives","authors":"Yuqing Hu, Elham Kharazmi, Qunfeng Liang, Kristina Sundquist, Jan Sundquist, Mahdi Fallah","doi":"10.1053/j.gastro.2024.12.030","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.030","url":null,"abstract":"<h3>Background &amp; Aims</h3>We aimed to evaluate the association of frequency of polyp diagnosis in relatives with the risk of overall and early-onset colorectal cancer (CRC).<h3>Methods</h3>We leveraged data from nationwide Swedish family cancer datasets (1964-2018) to calculate standardized incidence ratios (SIRs) for individuals with a family history of polyp by frequency of polyp diagnosis in family members.<h3>Results</h3>We followed up 11,676,043 individuals for up to 54 years. Compared with the risk in individuals without a family history of colorectal tumor (N=142,234), the risk of overall CRC was 1.4-fold in those with 1 FDR with one-time polyp diagnosis [95%CI=1.3-1.4, N=11,035; early-onset SIR: 1.4 (1.3-1.5), N=742]. The risk was significantly higher in individuals with 1 FDR with ≥2 times (frequent) polyp diagnoses [overall CRC: 1.8 (1.8-1.9); early-onset CRC=2.3 (2.0-2.6)]. A rather similar risk was observed for individuals with ≥2 FDRs with one-time polyp diagnosis [overall CRC: 1.9 (1.7-2.1); early-onset CRC: 2.2 (1.5-2.9)]. Individuals with ≥2 FDRs with frequent polyp diagnoses had a 2.4-fold overall risk (2.2-2.7) and a 3.9-fold early-onset risk (2.8-5.3). Younger age at polyp diagnosis in FDRs was associated with an increased risk of CRC. A family history of polyp in second-degree relatives was important only when there were frequent diagnoses of polyp.<h3>Conclusions</h3>A higher frequency of colorectal polyp diagnosis in relatives is associated with a greater risk of CRC, especially early-onset CRC. This risk is independent of number of affected relatives or youngest age at polyp diagnosis. These findings underscore the need for more personalized CRC screening strategies that are tailored to individuals with a family history of polyp.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"19 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939543","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":"Postoperative Endoscopic Outcomes in the MESOCOLIC Trial Investigating Mesenteric-based surgery for Crohn's Disease","authors":"Ming Duan, Wei Liu, John Calvin Coffey, Jia Ke, Wei Zhou, Yi Li","doi":"10.1053/j.gastro.2024.12.028","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.028","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"101 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936882","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}