Indian Journal of Gastroenterology最新文献

{"title":"Role of intestinal fatty acid binding protein in the non-invasive diagnosis of celiac disease in children.","authors":"Sanjeevani Kaul, Rohan Malik, Tapish Pandey, Savita Saini, Alka Singh, Prasenjit Das, Govind Makharia","doi":"10.1007/s12664-025-01796-2","DOIUrl":"https://doi.org/10.1007/s12664-025-01796-2","url":null,"abstract":"<p><strong>Objectives: </strong>Intestinal fatty acid binding protein (IFABP) is a marker of intestinal epithelial injury and has been studied as a surrogate for predicting villous atrophy. The aim of this study was to evaluate the utility of IFABP in the non-invasive diagnosis of celiac disease (CeD) in children.</p><p><strong>Methods: </strong>Symptomatic children with positive anti-tissue transglutaminase antibody underwent a duodenal biopsy and IFABP measurement. Controls were included who had both tissue transglutaminase antibody (tTG) and IFABP measured. We evaluated the performance of IFABP in the diagnosis of CeD by generating the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>Total 123 children were screened; 98 had a positive anti-tTG, 74 patients aged 8.5 ± 4.0 years were diagnosed to have CeD and 24 patients had a normal biopsy. Seventy-six children aged 8.4 ± 4.0 years were enrolled as controls. Serum IFABP was significantly higher in children with CeD; median 918 pg/mL (interquartile range [IQR] = 630-1316) as compared to controls; median 386 pg/mL (IQR = 125-581) (p < 0.001). We observed increasing serum IFABP levels with a higher Marsh grade of mucosal injury (p < 0.001). Sensitivity and specificity for diagnosis of CD were 51% and 88% at serum IFABP level > 920 pg/mL and area under the curve (AUC) of 0.79 (0.67-0.90). In children with CD and a tTG 1-10 of normal, this cut-off could make a diagnosis without biopsy in 28/34 cases.</p><p><strong>Conclusion: </strong>Serum IFABP can improve the non-invasive diagnosis of CeD in children with elevated tTG-IgA titers in a subset of patients and also has good correlation with the degree of villous atrophy.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal fatty acid-binding protein in celiac disease: Finding its place in diagnosis and monitoring.","authors":"Rishi Bolia","doi":"10.1007/s12664-025-01837-w","DOIUrl":"https://doi.org/10.1007/s12664-025-01837-w","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The road to Rome IV and beyond: Evolution, refinements and future considerations for the Rome criteria for functional gastrointestinal disorders.","authors":"Manjeet Kumar Goyal, Omesh Goyal, Ajit Sood","doi":"10.1007/s12664-025-01808-1","DOIUrl":"https://doi.org/10.1007/s12664-025-01808-1","url":null,"abstract":"<p><p>Evolution of the diagnostic criteria for functional gastrointestinal disorders (FGID) from Rome I to Rome IV in the past three decades represents a transformative shift from simplistic, symptom-based definitions to a nuanced framework that reflects the complex interplay between the gut and brain. Initial iterations, i.e. Rome-I and II criteria, established a standardized model that focused on clusters of symptoms rather than structural abnormalities, while Rome-III criteria introduced stricter symptom duration thresholds and acknowledged the influence of psychological factors. The introduction of Rome IV criteria in 2016 marked a watershed moment. FGIDs were renamed as 'disorders of gut-brain interaction' (DGBI), integrating advances in neurogastroenterology and emphasizing the pathophysiological roles of central neural processes, altered motility, immune regulation, dysbiosis, etc. These criteria redefined the diagnostic thresholds and emphasized on 'bothersome' symptoms that affect daily activities. For diagnosis of irritable bowel syndrome, abdominal pain, rather than discomfort, was essentially required and the sub-types of functional dyspepsia were more precisely defined. The Multidimensional Clinical Profile framework was added, which incorporated the sub-type, severity and psychological and physiological modifiers of DGBIs. However, the application of the Rome-IV criteria in the past eight years in clinical and research settings has faced a number of challenges, including the risk of underdiagnosing patients with milder symptoms, under-recognition of the overlaps of DGBIs and the lack of universal applicability due to socio-cultural and economic disparities in different geographical regions, Additionally, the new term, 'DGBI', while scientifically correct, can be discerned as potentially over-simplified and can itself be stigmatizing for patients who may inadvertently perceive these disorders as being primarily 'neuro-psychological'. The selective retention of the term 'functional' to name individual disorders such as functional dyspepsia and functional diarrhea remains to be justified. Advancements in neurogastroenterology research in the past decade have highlighted the significant prevalence of organic mimickers of DGBIs, most common being small intestinal bacterial overgrowth and non-celiac gluten sensitivity, which need to be ruled out, especially in 'refractory' DGBI cases. Substantial data on post-infectious DGBIs, especially post-COVID DGBIs, have been published. Importantly, multiple objective biomarkers have been proposed, which may complement and strengthen the symptom-based diagnostic criteria for DGBIs. By addressing the challenges, incorporating recent scientific advances and striking a balance between clinical practicality and global applicability, the future iterations of the Rome criteria have the potential to set new standards for the diagnosis and treatment of DGBIs.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse filiform polyposis in a patient with ulcerative colitis.","authors":"Arshia Bhardwaj, Arshdeep Singh, Aminder Singh, Ajit Sood","doi":"10.1007/s12664-025-01829-w","DOIUrl":"https://doi.org/10.1007/s12664-025-01829-w","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of endoscopic findings, histopathological features and Helicobacter pylori infection in adult dyspeptic patients from the cold desert tribal region of Spiti Valley, Himachal Pradesh.","authors":"Neetu Sharma, Vishal Bodh, Dinesh Kumar, Brij Sharma, Anchana Gulati, Rajesh Sharma, Ashish Chauhan, Amit Sachdeva, Keshu Jindal, Tenzin Norbu, Sidhant Sharma","doi":"10.1007/s12664-025-01816-1","DOIUrl":"https://doi.org/10.1007/s12664-025-01816-1","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, 20% of the populations have dyspeptic symptoms with an extensive differential diagnosis. Endoscopy is a gold standard investigation for finding the etiology of dyspepsia but can miss mucosal lesions in 15% to 30% of cases. The study aims to determine the endoscopic findings, histopathological features and H. pylori infection in adult dyspeptic patients from the tribal area of Himachal Pradesh (H.P.), India.</p><p><strong>Methods: </strong>This cross-sectional observational study retrospectively analyzed the data collected during a health camp in the remote Spiti Valley of H.P. Patients aged 18 years and above were included and data of 106 dyspepsia patients who underwent endoscopic examination was analyzed. Endoscopic gastric biopsies taken in each patient were subjected to rapid urease testing (RUT) and histopathological examination. Data analyzed included basic socio-demographic features, endoscopic and histopathological features.</p><p><strong>Results: </strong>Total 106 patients of dyspepsia were included with a mean age of 46.9 ± 13.4 years and a male to female ratio of 1.4:1. The most common endoscopic abnormality was erosive gastritis followed by peptic ulcer disease. The most common histopathological finding was chronic active gastritis with H. pylori (83.0%). Gastric intestinal metaplasia (GIM) was seen in 48.1%. While endoscopy demonstrated high sensitivity (76.5%), specificity (75.0%) and positive predictive value (PPV, 98.7%) for identifying histopathological abnormalities in gastric biopsy, its negative predictive value (NPV, 11.1%) remained low. The correlation between RUT and histopathological examination for H. pylori was statistically significant.</p><p><strong>Conclusion: </strong>Erosive gastritis and peptic ulcer disease are prevalent endoscopic findings among adult dyspeptic patients from the tribal region of Spiti Valley in Himachal Pradesh. Histopathologically, H. pylori-related chronic active gastritis and gastric intestinal metaplasia are commonly observed abnormalities. Although endoscopy exhibits high sensitivity, specificity and PPV for detecting histopathological changes in gastric biopsies, its NPV is notably low.</p><p><strong>Clinical trial registry number: </strong>NA.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of infected pancreatic necrosis: A review of the role of blood biomarkers.","authors":"Niharika Dutta, Pankaj Gupta, Amit Rawat, Saroj K Sinha","doi":"10.1007/s12664-025-01820-5","DOIUrl":"https://doi.org/10.1007/s12664-025-01820-5","url":null,"abstract":"<p><p>Infected pancreatic necrosis (IPN) is a serious and critical complication of acute pancreatitis (AP), often arising in the later stages of the disease. Early detection of high-risk individuals with IPN is essential because it may enable clinicians to implement more efficient management strategies. This review explores the key biomarkers currently used to predict and diagnose IPN. Established markers such as procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) play a vital role in detecting infection and inflammation. Non-invasive markers, including corticosteroid-binding globulin (CBG), neutrophil CD64 index (nCD64), soluble PD-L1 (sPD-L1) and human leukocytes antigen-DR (HLA-DR), further contribute to identifying immune suppression and infection risks. While these tools show promise, no single biomarker has proven to be sufficiently accurate. A combination of clinical assessment, imaging and multiple biomarkers is essential for a comprehensive diagnosis. This review emphasizes the need for further research to refine and validate these markers, making them more accessible and reliable for routine clinical use. By advancing our ability to identify IPN early, we can improve patient outcomes and reduce the severe impacts of this complication in individuals suffering from AP.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overlap of 'disorders of gut-brain interaction': A type of diseases that require special attention.","authors":"Yi-Heng Yao, Guo-Lei Shi, Ming Qi, Liang Liu","doi":"10.1007/s12664-025-01840-1","DOIUrl":"https://doi.org/10.1007/s12664-025-01840-1","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of clips, devices and sprays in endoscopic hemostasis: An update (with videos).","authors":"Nikhil Sonthalia, Rajesh Puri, Shivam Sethi","doi":"10.1007/s12664-025-01815-2","DOIUrl":"https://doi.org/10.1007/s12664-025-01815-2","url":null,"abstract":"<p><p>Clips, devices and sprays are important tools in the armamentarium of interventional endoscopists which are needed to tackle challenging clinical scenarios. There has been a revolutionary change in the design and features of modern-day endoscopic clips that has greatly increased its applicability. Both through-the-scope clip (TTS clip) and over-the-scope clips (OTSC) have their role in day-to-day clinical practice with each having some advantages and disadvantages. Sprays have been an important adjunct to clips which can be extremely useful in difficult clinical scenarios where clips may not work. There has been growing evidence with regard to its use in literature. Many different types of TTS clips are available that have combination of different properties such as size, tail length, rotatability, re-openability and tensile strength. Two types of OTSC are available which differs according to their design and mechanism of application. Though TTS clips are still most used clips in day-to-day practice, we recommend that OTSCs should be used as a primary modality in patients who are at high risk of rebleeding such as patients on dual anti-platelets, those requiring to restart anticoagulation early, patients with chronic kidney disease and in large (> 1.5 cm) fibrotic ulcer bleeds. Herein, we describe technical and clinical aspects, types, applications and optimal usage techniques of different clips, devices and sprays commonly used in endoscopy.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exocrine pancreatic insufficiency and pancreatic enzyme supplementation after gastric resection-A scoping review.","authors":"Suprabhat Giri, Prasanna Gore, Gaurav Khatana, Sridhar Sundaram, Vaishali Bhardwaj","doi":"10.1007/s12664-025-01806-3","DOIUrl":"https://doi.org/10.1007/s12664-025-01806-3","url":null,"abstract":"<p><p>Exocrine pancreatic insufficiency (EPI) frequently occurs following gastric resection, although it remains underdiagnosed and insufficiently managed. While pancreatic enzyme supplementation (PES) is the cornerstone of the management of EPI, substantial evidence endorsing its application post-gastric surgery is scarce. This scoping review assesses the occurrence of EPI following gastric resection and the influence of PES in managing these patient populations. All relevant studies related to EPI and PES in patients with gastric resection were reviewed until November 2024. Patient demographics, clinical profiles, method of assessment and prevalence of EPI and the effect of PES were analyzed. Total 14 studies reported EPI after gastric resection and three analyzed the outcome of PES after gastric resection. There was considerable variability in the methodologies employed to evaluate EPI following gastric resection. Earlier studies employed direct tests; however, newer studies have utilized indirect tests, predominantly the fecal elastase test. Both studies employing direct tests indicated an EPI prevalence rate of 100%, whereas those utilizing indirect tests revealed a prevalence rate between 26.8% and 100% (26.8% to 63.8% with fecal elastase). Only four studies reported on the severity of EPI following stomach resection, with significant variability. Lastly, there was a lack of high-quality evidence indicating the benefits of PES following gastric resection. Future studies are needed to develop criteria that facilitate the diagnosis of EPI in individuals who have undergone gastrectomy. Robust clinical trials are necessary to provide definitive proof of PES's efficacy in enhancing patient outcomes.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to comment on \"EUS FNAC without rapid on site evaluation (ROSE) is comparable to EUS FNB with macroscopic on site evaluation (MOSE) in evaluation of intra-abdominal masses\".","authors":"Mohd Rafiq Najar, Monika Jain, Gurwant Singh Lamba, Sawan Bopanna","doi":"10.1007/s12664-025-01824-1","DOIUrl":"https://doi.org/10.1007/s12664-025-01824-1","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}