Indian Journal of Gastroenterology最新文献

{"title":"Human epidermal growth factor receptor-2/neu expression in gallbladder cancer is significantly associated with clinicopathological parameters and survival.","authors":"Sashibhusan Dash, Prajna Anirvan, Sagarika Samantaray, Prafulla Kumar Swain, Prasant Kumar Parida, Niranjan Rout, Manoranjan Ranjit","doi":"10.1007/s12664-024-01723-x","DOIUrl":"10.1007/s12664-024-01723-x","url":null,"abstract":"<p><strong>Background: </strong>Anti-human epidermal growth factor receptor-2 (Her-2/neu) target therapy has substantially improved the disease outcome of patients with breast and gastric/gastroesophageal cancers characterized by Her-2/neu overexpression and/or amplification. Consequently, evaluating Her-2/neu expression in other cancers to predict response to Her-2/neu targeting agents emerges as a crucial approach. We aimed at investigating the positivity rate of this receptor in gallbladder cancer (GBC) and assess the relationship between Her-2/neu status, clinicopathological parameters and survival to identify patients who would benefit most from anti-Her-2/neu-targeted therapy. The Her-2/neu expression was correlated with clinicopathological parameters and survival of GBC cases.</p><p><strong>Methods: </strong>Total 235 surgically resected and histopathologically proven primary GBC cases were collected over a five-year period from January 1, 2017, to December 31, 2020. Her-2/neu expression in these cases was analyzed using immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH).</p><p><strong>Results: </strong>Employing testing algorithms (IHC scoring based on gastric cancer criteria, followed by FISH in equivocal cases), Her-2/neu positivity was identified in 43 (18.29%) GBC cases and was significantly associated with grade-I tumors, tumor stage > T2, perineural invasion, surgical margin positivity and advanced Tumor-Node-Metastasis (TNM) stage. The mean survival time for Her-2/neu-positive cases was 14 months (SE, 1.1; 95% CI, 11.7-16.06), while it was 20 months (SE, 0.69; 95%CI, 18.1-20.9) for Her-2-negative cases (p < 0.001).</p><p><strong>Conclusion: </strong>Her-2/neu is expressed in about one-fifth of GBC patients and is significantly associated with tumor behavior and patient survival. Utilizing novel targeted agents may hold the key to improving the prognosis of these patients.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"723-734"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079662","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":"Double-site rapid urease test versus histopathology for the diagnosis of Helicobacter pylori among patients with dyspepsia on proton pump inhibitors-A diagnostic accuracy study.","authors":"Ashutosh Ishan Yadav, Vaneet Jearth, Arun Kumar Sharma, Anupam Kumar Singh, Priya Chauhan, Purnima Patial, Aravind Sekar, Jimil Shah, Harshal Mandavdhare, Surinder Singh Rana, Usha Dutta","doi":"10.1007/s12664-025-01789-1","DOIUrl":"10.1007/s12664-025-01789-1","url":null,"abstract":"<p><strong>Background and aims: </strong>In real-world settings, many patients cannot or do not stop proton pump inhibitors (PPIs) due to symptoms, but guidelines do not address H. pylori testing in PPI users. We compared the rapid urease test (RUT) and histopathology (HPE) when H. pylori testing and endoscopy are indicated for patients with a recent history of PPI use.</p><p><strong>Methods: </strong>A prospective study of 164 patients who used PPIs within two weeks of endoscopy was conducted. Gastric antrum and body biopsies were used for double-site RUT and polymerase chain reaction (PCR) analyses. The updated Sydney protocol was followed for HPE. Patients with at least two out of three positive tests were considered infected with H. pylori. Fifty patients, who underwent only PCR for H. pylori diagnosis after stopping PPIs for two weeks, were enrolled as controls to assess the effect on detection rates. Additionally, an analysis utilizing PCR as the gold standard was conducted.</p><p><strong>Results: </strong>In patients on PPIs, there was no significant difference in detection rates (positivity rate) between HPE and RUT (31.7% vs. 27.4%, p = 0.3771 [McNemar]). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of double-site RUT were 89.13%, 96.61%, 91.11%, 95.80% and 94.51%, respectively, whereas HPE was 82.61%, 88.14%, 73.08%, 92.86% and 86.59%. PCR had a much greater detection rate and there was no significant difference in detection rate by the PCR method in patients on and off PPI for at least two weeks prior to testing for H. pylori (48% vs. 44%, p = 0.58). The sensitivity of double-site RUT and HPE was still comparable, albeit low, when only PCR was considered the gold standard (43.75% vs. 40%, respectively). Atrophic gastritis and intestinal metaplasia are found in approximately 9% and 5% of gastric body biopsies and 9% and 2.5% of gastric antrum biopsies, respectively.</p><p><strong>Conclusion: </strong>PPI use does not affect PCR-based testing for H. pylori. If PCR-based testing is unavailable, double-site RUT offers a cost-effective alternative for H. pylori testing in PPI users at the point of care, particularly in resource-limited settings, in comparison to HPE. The choice between biopsy using validated protocols or double RUT is also contingent upon the underlying risk factors for gastric cancer.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"706-714"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274767","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":"Altered molecular signature of the intestinal microbiota in irritable bowel syndrome patients versus healthy controls: An updated systematic review.","authors":"Zhen-Zhi Wang, Yu-Kun Chen, Xinyu Li, Li Lin, Bozhu Chen, Min Chen, Hui Zheng","doi":"10.1007/s12664-025-01845-w","DOIUrl":"10.1007/s12664-025-01845-w","url":null,"abstract":"<p><strong>Background and aims: </strong>Irritable bowel syndrome (IBS), a prevalent functional gastrointestinal disorder, poses significant challenges for both patients and medical practitioners. Recent investigations have indicated the gut microbiome as a potential therapeutic target for IBS. Nevertheless, the exact association between these microorganisms and IBS symptoms remains incompletely elucidated. This updated systematic analysis aims to assess the extant research correlating the gut microbial community with IBS.</p><p><strong>Methods: </strong>A systematic search was performed in major electronic databases including PubMed, EMBASE and Web of Science, spanning from their inception to December 2024. The objective was to identify case-control studies that examined and compared the composition of the fecal or colonic microbiota in individuals diagnosed with IBS against healthy controls.</p><p><strong>Results: </strong>Our systematic search included 44 articles, which collectively revealed that IBS patients exhibit lower intestinal microbiome diversity compared to healthy controls. Fecal microbiome analysis demonstrated an imbalance in the phyla Firmicutes and Bacteroidetes among IBS patients. Specifically, IBS with diarrhea (IBS-D) patients showed reduced levels of Butyricimonas and Proteobacteria, while IBS with constipation (IBS-C) patients exhibited decreased Firmicutes and Actinobacteria, along with increased Verrucomicrobiota and Proteobacteria. Additionally, disruptions in the gut microbiome were noted, particularly in the duodenum and jejunum, as well as changes in key bacterial populations within the colon and rectum.</p><p><strong>Conclusion: </strong>Our review confirms significant gut microbiota dysbiosis in IBS patients, characterized by reduced microbial diversity and altered abundances of Firmicutes and Bacteroidetes. These findings support the potential for microbiota-targeted therapies in IBS management, though further research is needed to establish causal mechanisms and clinical applications.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"647-665"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781181","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":"Short and long-term outcomes of anorectal biofeedback therapy in patients with functional defecation disorders: Efficacy and predictors of response.","authors":"Ayush Agarwal, Abhijith K Anil, Rajkumar Bayye, Ashish Agarwal, Ashish Chauhan, Samagra Agarwal, Ritesh Netam, Soumya Jagannath Mahapatra, Saurabh Kedia, Deepak Gunjan, Shalimar, Vineet Ahuja, Pramod Kumar Garg, Ashok Kumar Jaryal, Govind K Makharia","doi":"10.1007/s12664-026-02035-y","DOIUrl":"https://doi.org/10.1007/s12664-026-02035-y","url":null,"abstract":"<p><strong>Objectives: </strong>Functional defecation disorders (FDD), a major sub-type of chronic constipation, often exhibit limited response to pharmacotherapy. Anorectal biofeedback therapy (BFT) is the recommended therapy, but there is limited data regarding its long-term effectiveness and predictors of response. We evaluated the short and long-term effectiveness of a six-session anorectal BFT protocol in patients with FDD.</p><p><strong>Methods: </strong>In this ambispective cohort study (2018-2024), adult patients diagnosed with FDD by Rome-IV criteria who completed six BFT sessions were included. The primary outcome was at least 30% improvement in the Modified Cleveland Constipation (MCC) score. Secondary outcomes included changes in symptoms on visual analog scale (VAS), individual symptoms, anorectal manometry parameters and predictors of response to BFT. The patients who had completed at least one-year follow-up were contacted to assess long-term response.</p><p><strong>Results: </strong>One hundred sixty-six patients were included (median age = 40 years [IQR = 27-52]; 69.3% male). After BFT, 61.4% achieved improvement in MCC score by > 30%, with significant improvement in VAS score and individual symptoms such as incomplete evacuation, straining and manual evacuation (p < 0.001). Post biofeedback, there was significant increase in defecation index and anal relaxation (p < 0.001). Younger age was predictive of short-term response to BFT regardless of different sub-types of FDD. At long-term follow-up of 110 patients (median = 22 months, IQR = 12-28 months), 56.4% reported sustained improvement in MCC score by > 30%, with initial response to BFT being significant predictor of long-term response.</p><p><strong>Conclusions: </strong>Anorectal BFT is an effective treatment for FDD with sustained benefit over long term.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591327","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":"Association between dietary advanced glycation end products and gallstone disease: A case-control study.","authors":"Leyli Zahra Bahreini Boroujeni, Fatemeh Javaheri-Tafti, Zeinab Ghaeminejad, Danial Fotros, Mehrnaz Momenan, Azita Hekmatdoost, Moloud Ghorbani, Amir Sadeghi, Zahra Yari","doi":"10.1007/s12664-026-02034-z","DOIUrl":"https://doi.org/10.1007/s12664-026-02034-z","url":null,"abstract":"<p><strong>Background and aims: </strong>Gallstone disease is a common gastrointestinal disorder involving metabolic and inflammatory pathways. Advanced glycation end products, abundant in processed foods and generated during high-temperature cooking, promote oxidative stress and inflammation, mechanisms implicated in gallstone formation. Therefore, this study investigated the association between advanced glycation end products intake and gallstone among Iranian adults.</p><p><strong>Methods: </strong>In this case-control study, 189 newly diagnosed patients with gallstone and 342 controls were included. Dietary intake was assessed using a validated 168-item food frequency questionnaire. Dietary advanced glycation end products intake was estimated using established advanced glycation end products databases and expressed as Kilounits (Ku) per day. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) after adjustment for age, sex, body mass index, total energy intake, physical activity, smoking status and alcohol consumption.</p><p><strong>Results: </strong>Mean advanced glycation end products intake was significantly higher among gallstone cases than controls (11,027.8 ± 5903.6 vs. 9490.5 ± 4773.5 kU/day, p = 0.002). Participants in the highest quartile of advanced glycation end products had greater total energy intake and meat consumption compared with those in the lowest quartile (both p < 0.001). In the crude model, individuals in the highest quartile had twice the odds of gallstone compared with those in the lowest quartile (OR = 2.00; 95% CI = 1.20-3.34). After adjustment for potential confounders, the association remained significant (OR = 1.89; 95% CI = 1.07-3.38; p = 0.016). A significant positive trend across quartiles was observed (p for trend = 0.026).</p><p><strong>Conclusion: </strong>Higher dietary advanced glycation end products were significantly associated with greater odds of gallstone. These findings suggest that reducing dietary exposure to advanced glycation end products may represent a potential nutritional strategy for gallstone prevention. Prospective studies are warranted to confirm these findings.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470376","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":"Exploration of the referral pathway of IBS patients: A knowledge, attitude, practice-based study on factors influencing tertiary care referrals.","authors":"Sahil Rahul Jain, Kartik Mehta, Aastha Gupta, Venkatesh Vaithiyam, Ashok Dalal, Sanjeev Sachdeva","doi":"10.1007/s12664-026-02043-y","DOIUrl":"https://doi.org/10.1007/s12664-026-02043-y","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470405","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":"Pancreaticoduodenectomy without venous reconstruction in locally advanced pancreatic cancer with non-reconstructible mesenteric venous anatomy: Role of collateral circulation.","authors":"Harjeet Singh, Kedar Pathak, Shikhar Verma, Harish Bhujade, Thakur Deen Yadav","doi":"10.1007/s12664-026-02042-z","DOIUrl":"https://doi.org/10.1007/s12664-026-02042-z","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404643","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":"Burdick's technique: Correcting the false tract to facilitate biliary cannulation.","authors":"Venkatesh Vaithiyam, Ashok Dalal, Sanjeev Sachdeva, Siddharth Srivastava","doi":"10.1007/s12664-026-02039-8","DOIUrl":"https://doi.org/10.1007/s12664-026-02039-8","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404639","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":"Home-prepared prednisolone enema in ulcerative colitis: Outcomes from a real-world case series.","authors":"Mridul Mahajan, Himanshu Narang, Rohit Garg, Govind Makharia, Saurabh Kedia, Vineet Ahuja","doi":"10.1007/s12664-026-02038-9","DOIUrl":"https://doi.org/10.1007/s12664-026-02038-9","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390806","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":"Albumin-bilirubin grade and sarcopenia as predictors of prognosis in patients with unresectable intermediate and advanced-stage hepatocellular carcinoma.","authors":"Biswajit Sahoo, Jagabandhu Hembram, Manas Kumar Panigrahi, Sourav Kumar Mishra, Sandip Kumar Barik, Saroj Kumar Das Majumdar, Hemanta Kumar Nayak, Manoj Kumar Nayak, Phanindra Kumar Swain, Arunprakash Pitchaimuthu, Suprava Naik, Dillip Kumar Muduly, Kiran Ygl, Shilpy Jha, Priyadip Maiti, Subhabrata Biswal","doi":"10.1007/s12664-026-02016-1","DOIUrl":"https://doi.org/10.1007/s12664-026-02016-1","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy of the albumin-bilirubin (ALBI) grade, easy albumin-bilirubin (EZ-ALBI) grade and sarcopenia in predicting the prognosis of patients with unresectable hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) as monotherapy or in combination with Lenvatinib.</p><p><strong>Methods: </strong>Thirty-eight patients with Barcelona Clinic Liver Cancer (BCLC) stage B and 36 patients with stage C HCC received TACE and TACE with Lenvatinib, respectively. Tumor response was assessed according to the modified RECIST (mRECIST) criteria. ALBI, EZ-ALBI grades and sarcopenia were measured both prior to TACE and during follow-up. Prognostic outcomes were determined based on objective response rate (ORR), progression rate and progression-free survival (PFS). Appropriate statistical analyses were used; p < 0.05 was considered significant.</p><p><strong>Results: </strong>In stage B, ORR, tumor progression and PFS showed significant variation with ALBI grades (p = 0.004, p = 0.001, p < 0.001), but not with sarcopenia (p = 0.090, p = 0.310, p = 0.114). ORR exhibited no significant difference across EZ-ALBI grades (p = 0.055), whereas tumor progression and PFS demonstrated significant differences (p = 0.025, p = 0.004). In stage C, ORR, tumor progression and PFS varied significantly according to ALBI grades (p = 0.011, p = 0.002, p < 0.001) and were worse in patients with sarcopenia (p = 0.006, p = 0.039, p = 0.012). Although ORR did not differ significantly across EZ-ALBI grades (p = 0.158), tumor progression and PFS showed significant differences (p = 0.033 and p < 0.001).</p><p><strong>Conclusions: </strong>ALBI and EZ-ALBI grades demonstrated significant prognostic value for patients with intermediate-stage HCC undergoing TACE, as well as for those with advanced-stage HCC receiving TACE in combination with Lenvatinib. The presence of sarcopenia correlated with a poorer prognosis and diminished response in patients with advanced HCC treated with TACE and Lenvatinib; however, no definitive association was identified in patients classified as BCLC stage B following TACE.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396528","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}