Gastroenterologia y hepatologia最新文献

{"title":"Proton pump inhibitor use and treatment satisfaction in Spanish patients with systemic sclerosis: Insights from a nationwide survey","authors":"Francisco Alejandro Felix-Tellez,&nbsp;Alfredo Guillen-del-Castillo,&nbsp;Ariadna Aguilar,&nbsp;Claudia Barber,&nbsp;Carolina Malagelada,&nbsp;Laura Polo Figueras,&nbsp;Laura Triginer,&nbsp;Claudia Codina-Clavaguera,&nbsp;Jordi Serra,&nbsp;Carmen Pilar Simeón-Aznar,&nbsp;Luis G. Alcalá-González","doi":"10.1016/j.gastrohep.2026.502705","DOIUrl":"10.1016/j.gastrohep.2026.502705","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate real-world patterns of proton pump inhibitor use, treatment compliance, and patient-perceived effectiveness in the control of gastroesophageal reflux symptoms and their impact on quality of life in patients with systemic sclerosis.</div></div><div><h3>Patients and methods</h3><div>We conducted a cross-sectional, patient-reported survey distributed through the Asociación Española de Esclerodermia. Participants provided sociodemographic and clinical data and completed items addressing reflux symptoms and their impact on quality of life, dosing schedule, compliance, and perceived effectiveness in controlling esophageal and extra-esophageal symptoms.</div></div><div><h3>Results</h3><div>A total of 141 patients responded (83% female; mean age 56<!--> <!-->±<!--> <!-->10 years; diffuse-subset<!--> <!-->=<!--> <!-->56, limited-subset<!--> <!-->=<!--> <!-->52). One hundred thirty (92%) reported reflux symptoms, with 54 (42%) developing reflux symptoms before being diagnosed with systemic sclerosis. Current chronic proton pump inhibitors use was reported by 116 (82%) patients, of whom 24% took the medication incorrectly. Symptom control varied by symptom type: heartburn and thoracic pain showed the highest response rates (77% and 67% patients reporting partial or complete effectiveness, respectively), whereas other symptoms, such as regurgitation, dysphonia and globus remained poorly controlled (57%, 47% and 51% mild or no effectiveness, respectively). Despite patients reporting persistent reflux symptoms on proton pump inhibitor therapy, only 37% were prescribed prokinetics and 35% were prescribed mucosal protective agents as adjuvant therapy.</div></div><div><h3>Conclusions</h3><div>Proton pump inhibitors remain the cornerstone of reflux symptom management in systemic sclerosis but demonstrate limited effectiveness and frequent errors in administration. While patient satisfaction with heartburn control is acceptable, persistent esophageal and extra-esophageal symptoms suggest additional, non-acid-related mechanisms.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 7","pages":"Article 502705"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276049","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":"Gallbladder adenocarcinoma mimicking adenomyomatosis: A case report","authors":"Antonio Pérez Serena,&nbsp;Daisy Paola Martínez Betancourt","doi":"10.1016/j.gastrohep.2025.502650","DOIUrl":"10.1016/j.gastrohep.2025.502650","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 7","pages":"Article 502650"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899626","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":"Diagnostic yield of capsule endoscopy in iron-deficiency anemia in a low-complexity hospital","authors":"Itziar Rubio de la Plaza,&nbsp;Francisco Javier Parra,&nbsp;Alba Sanz Prieto,&nbsp;Marina Gil Santana,&nbsp;Luis Alonso Castillo Herrera,&nbsp;Irene Chivato Martín-Falquina,&nbsp;Esteban Fuentes-Valenzuela,&nbsp;Alicia Bejerano Domínguez","doi":"10.1016/j.gastrohep.2026.502759","DOIUrl":"10.1016/j.gastrohep.2026.502759","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 7","pages":"Article 502759"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618310","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":"Intensive vs. moderate fluid resuscitation in acute pancreatitis: A systematic review and meta-analysis","authors":"Naomi Salcedo-Campos,&nbsp;Jose Caballero-Alvarado,&nbsp;Victor Lau-Torres,&nbsp;Carlos Zavaleta-Corvera","doi":"10.1016/j.gastrohep.2026.502715","DOIUrl":"10.1016/j.gastrohep.2026.502715","url":null,"abstract":"<div><h3>Objective</h3><div>Intravenous fluid resuscitation is central to the early management of acute pancreatitis (AP), but the optimal intensity remains uncertain. This systematic review and meta-analysis compared intensive or aggressive vs. moderate fluid resuscitation in adults with AP.</div></div><div><h3>Patients and methods</h3><div>This systematic review and meta-analysis followed PRISMA 2020 and was registered in PROSPERO (CRD42024626152). PubMed, Scopus, Web of Science, and Embase were searched from inception to February 15, 2024 for Randomized Controlled Trials (RCT) enrolling adults with acute pancreatitis and comparing intensive/aggressive vs. moderate fluid resuscitation. The primary outcome was in-hospital mortality; secondary outcomes were length of hospital stay, persistence of systemic inflammatory response syndrome (SIRS), fluid-overload complications, and early clinical improvement (≤36<!--> <!-->h). Risk of bias was assessed with RoB 2.0. Pooled relative risks (RR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using fixed- or random-effects models according to heterogeneity (<em>I</em>²). Analyses were performed in RevMan 5.4.1.</div></div><div><h3>Results</h3><div>Seven RCTs were included. IFR was associated with higher mortality than MFR (RR 2.60; 95% CI 1.48–4.57; <em>I</em>² <!-->=<!--> <!-->0%). IFR did not reduce LOS (MD 1.21 days; 95% CI 0.72–1.69; <em>I</em>² <!-->=<!--> <!-->65%) or SIRS persistence (RR 0.87; 95% CI 0.50–1.52; <em>I</em>² <!-->=<!--> <!-->26%). Fluid-overload complications were more frequent with IFR (RR 3.34; 95% CI 1.60–6.98; <em>I</em>² <!-->=<!--> <!-->0%). Early clinical improvement did not differ (RR 1.20; 95% CI 0.63–2.29; <em>I</em>² <!-->=<!--> <!-->72%). Risk of bias was generally low.</div></div><div><h3>Conclusions</h3><div>Across randomized evidence, intensive hydration offers no clinical benefit over moderate regimens and is associated with higher mortality and greater risk of fluid overload. Findings support moderate, goal-directed, individualized fluid therapy in acute pancreatitis and highlight the need for large multicenter RCTs to refine fluid targets and monitoring endpoints.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 7","pages":"Article 502715"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443379","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":"Recomendaciones sobre el diagnóstico de pacientes con el virus de la hepatitis delta (VHD) en España","authors":"María Buti,&nbsp;Antonio Aguilera,&nbsp;José Luis Calleja,&nbsp;José María Molero,&nbsp;Pablo Ryan,&nbsp;José Joaquín Antón,&nbsp;Raquel Domínguez-Hernández,&nbsp;Alberto de la Cuadra-Grande,&nbsp;Federico García","doi":"10.1016/j.gastrohep.2026.502768","DOIUrl":"10.1016/j.gastrohep.2026.502768","url":null,"abstract":"<div><div>The hepatitis delta virus (HDV), whose infection depends on the presence of the hepatitis B virus (HBV), is associated with one of the chronic viral hepatitis that most rapidly progresses to advanced liver disease, including liver cirrhosis and/or hepatocellular carcinoma. In this context, screening for HBV/HDV infection is key to the early diagnosis of hepatitis D, improving the prognosis of infected individuals through a strategy that has proven to be effective and efficient. This document reviews the epidemiology and current situation of hepatitis D in Spain, including the main barriers to its detection and diagnosis. The aim is to define recommendations for the diagnosis of hepatitis D, determined by a multidisciplinary experts panel. Regarding screening, recommendations are established in relation to: 1) settings and populations where screening is indicated; 2) optimization of HDV detection (reflex testing and point-of-care testing); and 3) the frequency for the test to be repeated. Regarding diagnosis, the following aspects are addressed: 1) how to diagnose HDV infection (double reflex test); 2) what characteristics are present in the tests currently available to determine HDV-RNA; and 3) possible solutions to overcome the current barriers in the diagnosis of the infection. These recommendations contribute to improving the prognosis for hepatitis D and, additionally, represent a step toward eliminating viral hepatitis by 2030, a goal set by the World Health Organization.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 7","pages":"Article 502768"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814190","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":"Incontinencia fecal y disinergia defecatoria tras reservorio ileoanal en colitis ulcerosa: complicaciones frecuentemente infradiagnosticadas","authors":"Anna Calm,&nbsp;Antonio Marín,&nbsp;Iria Bastón-Rey,&nbsp;Lucía Madero,&nbsp;Eduard Brunet-Mas,&nbsp;Margalida Calafat,&nbsp;Grupo Joven de GETECCU","doi":"10.1016/j.gastrohep.2026.502777","DOIUrl":"10.1016/j.gastrohep.2026.502777","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 7","pages":"Article 502777"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959707","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":"Gastric tuberculosis","authors":"Yunpeng Zhang,&nbsp;Xianjie He,&nbsp;Tao Yin","doi":"10.1016/j.gastrohep.2026.502710","DOIUrl":"10.1016/j.gastrohep.2026.502710","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 7","pages":"Article 502710"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147304912","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":"Improving quality in IBD – Evaluation of corticosteroid excess prescription trends and its predictive role in disease-related outcomes","authors":"José Damasceno,&nbsp;Tânia Carvalho,&nbsp;Bruno Arroja,&nbsp;João Soares,&nbsp;Sofia Mendes,&nbsp;Bruno Gonçalves,&nbsp;Ana Rebelo,&nbsp;Raquel Gonçalves,&nbsp;Tiago Leal","doi":"10.1016/j.gastrohep.2026.502716","DOIUrl":"10.1016/j.gastrohep.2026.502716","url":null,"abstract":"<div><h3>Objective</h3><div>Corticosteroids (CS) are effective in the induction of remission in inflammatory bowel disease (IBD), but have an unfavorable side effect profile. A CS sparing strategy is frequently recommended, but its consequences in IBD outcomes have been scarcely studied. Our primary aim was to evaluate current CS use and excess in IBD patients, comparing them with a historic cohort. Our secondary aims were to identify predictors of CS excess and compare outcomes (surgery, hospitalization, new CS cycle, structural damage and a composite outcome) at 12 months between three prescription groups (no CS use, standard CS use, and excess CS use).</div></div><div><h3>Patients and methods</h3><div>A retrospective study, including adult IBD outpatients from two trimesters (one in 2014 and one in 2023). CS prescription trends were compared between groups. The latter was used to identify predictors of CS excess and compare outcomes between prescription groups.</div></div><div><h3>Results</h3><div>A total of 1131 outpatients with IBD were included, 374 in 2014 and 757 in 2023. CS use was 3.2 times lower in 2023 (6.5% vs. 20.6%, <em>p</em> <!-->&lt;<!--> <!-->0.001), and CS excess was 5.5 times lower (12.0% vs. 2.2%, <em>p</em> <!-->&lt;<!--> <!-->0.001). Crohn's disease, extraintestinal manifestations, absence of medication, clinical activity and hospitalization in the previous 12 months were independent predictors of CS excess. CS excess prescription was an independent predictor of hospitalization (HR 15.225, 95% CI 2.189–105.913, <em>p</em> <!-->=<!--> <!-->0.006), new CS cycle (HR 38.392, 95% CI 13.866–106.299, <em>p</em> <!-->&lt;<!--> <!-->0.001) and the composite outcome (HR 32.253, 95% CI 13.260–78.452, <em>p</em> <!-->&lt;<!--> <!-->0.001) at 12 months.</div></div><div><h3>Conclusions</h3><div>CS prescription rate has significantly decreased in our center. CS excess was associated with negative outcomes, namely hospitalization and new CS cycles. Improving quality-of-care in IBD should focus on avoiding excess CS prescription.</div></div>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 7","pages":"Article 502716"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456670","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":"PEComa hepático: un desafío diagnóstico y terapéutico","authors":"Isabel Company Ricart,&nbsp;María José Naharro Gascón,&nbsp;Manuel Bellver Oliver,&nbsp;Carlos Domingo del Pozo","doi":"10.1016/j.gastrohep.2026.502769","DOIUrl":"10.1016/j.gastrohep.2026.502769","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":"49 7","pages":"Article 502769"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814119","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":"Esophageal motility disorders in patients with a history of repaired esophageal atresia: a series of clinical cases.","authors":"Ana Lancho Muñoz, José Francisco Suárez Crespo, Blanca Serrano Falcón","doi":"10.1016/j.gastrohep.2026.502834","DOIUrl":"10.1016/j.gastrohep.2026.502834","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502834"},"PeriodicalIF":2.0,"publicationDate":"2026-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430328","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}