Indian Journal of Gastroenterology最新文献

{"title":"Hyperperfusion liver injury due to a malpositioned umbilical venous catheter.","authors":"Ankur Mandelia, Moinak Sen Sarma","doi":"10.1007/s12664-024-01684-1","DOIUrl":"10.1007/s12664-024-01684-1","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"961-962"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153915","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":"Phytobezoar in a toddler.","authors":"Debalina Chakrabarti, Paresh Shukla","doi":"10.1007/s12664-024-01683-2","DOIUrl":"10.1007/s12664-024-01683-2","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"959-960"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145590","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":"High-resolution anorectal manometry profile in patients with chronic constipation versus control.","authors":"Rahul Deshmukh, Shubham Jain, Saurabh Bansal, Anuraag Jena, Jay Chudasama, Sameet Patel, Qais Contractor, Asif Bagwan, Sanjay Chandnani, Pravin Rathi","doi":"10.1007/s12664-025-01830-3","DOIUrl":"10.1007/s12664-025-01830-3","url":null,"abstract":"<p><strong>Background and aims: </strong>Studies comparing chronic constipation (CC) and asymptomatic subjects are lacking in our population. This study aimed to compare the high-resolution anorectal manometry (HRAM) profiles of patients with CC and healthy volunteers (HV), as well as patients with functional defecation disorders (FDD) and those without in the constipation group.</p><p><strong>Methods: </strong>This retrospective comparative study included patients with CC who underwent HRAM and a balloon expulsion test (BET). As historical controls, healthy volunteers were recruited. If both ARM and BET were abnormal, FDD was diagnosed using ROME-IV criteria.</p><p><strong>Results: </strong>Total 120 CC and 60 HV as controls were included. Maximum anal squeeze pressure (205 ± 62 vs. 170 ± 35 mmHg, p = 0.001), rectal sensations (1st sensation 49 vs. 40 ml, p = 0.024), desire to defecate (125 vs. 105 ml, p = 0.011) and maximum tolerable volume 171 vs. 150 ml, p = 0.018) were found to be significantly higher in CC patients as compared to controls. Median anal relaxation (15.5% [- 8.0 to 37.5] vs. 58.0% [34.0-77.0], p = 0.001), median defecation index (1.27 [0.88-1.74] vs. 2.00 [1.12-3.49], p = 0.001) and median recto-anal pressure gradient (17.50 [- 10.25 to 39.0] vs. 39.50 [7.50-69.0], p = 0.001) were significantly lower in CC patients. BET was not significant between CC and healthy volunteers (53% vs. 45%, p = 0.37). FDD was found in 57.5% of CC patients. Patients with FDD had higher anal residual pressure (95 ± 26 vs. 45 ± 21 mmHg, p = 0.001) and lower recto-anal pressure gradients than those without FDD (- 4.5 vs. 36 mmHg, p = 0.001). Rectal sensations were comparable in both FDD and non-FDD groups.</p><p><strong>Conclusion: </strong>The clinical and manometric profiles of CC and HV patients differed significantly. FDD and rectal hyposensitivity were more common in those with CC. Type-1 recto-anal dyssynergia was the most common FDD sub-type.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"910-917"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023130","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":"From pain relief to mucosal grief: A comprehensive review of NSAID enteropathy.","authors":"Harsh Srivastava, Tanisha Sehgal, Varun Mehta, Jeffrey Berinstein, Shrinivas Bishu, Manjeet Kumar Goyal","doi":"10.1007/s12664-025-01886-1","DOIUrl":"10.1007/s12664-025-01886-1","url":null,"abstract":"<p><p>Non-steroidal anti-inflammatory drugs (NSAIDs) are essential for their analgesic, anti-inflammatory and anti-pyretic properties. However, their extended use can lead to NSAID enteropathy, a frequently underdiagnosed condition of the small intestine. This pathology manifests as mucosal damage, ulcerations, strictures and increased intestinal permeability, potentially resulting in complications such as bleeding, protein loss and nutrient malabsorption. Modern diagnostic technologies, particularly capsule endoscopy, have revealed that small-bowel injury affects up to 70% of chronic NSAID users, although many patients remain asymptomatic. This comprehensive review explores the epidemiology, underlying mechanisms, clinical manifestations, diagnostic approaches and treatment strategies for NSAID enteropathy, while emphasizing the growing importance of increased clinical awareness and continued research into preventive and therapeutic interventions, especially as long-term NSAID use becomes more prevalent in our aging global population.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"838-853"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827576","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":"Interpreting fibrosis markers in psychoactive substance use disorders: Key confounders to consider.","authors":"Srikanth Kothalkar","doi":"10.1007/s12664-025-01952-8","DOIUrl":"10.1007/s12664-025-01952-8","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"957-958"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226637","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 prehabilitative gastrostomy tube feeding to bridge severely malnourished surgically unfit achalasia patients to per-oral endoscopic myotomy.","authors":"Biswa Ranjan Patra, Chetan Saner, Shubham Gupta, Yash Harwani, Sidharth Harindranath, Nitish Patwardhan, Yash Kallurwar, Ankita Singh, Arun Vaidya, Prajakta Mane, Megha Meshram, Akash Shukla","doi":"10.1007/s12664-025-01834-z","DOIUrl":"10.1007/s12664-025-01834-z","url":null,"abstract":"<p><strong>Background and aim: </strong>Achalasia cardia may be associated with a risk of severe malnutrition, causing unique challenges in nutritional and definitive management. This study aims to evaluate a novel nutrition strategy in severely malnourished, surgically unfit patients, using percutaneous endoscopic gastrostomy (PEG) tube feeding to improve nutrition followed by per-oral endoscopic myotomy (POEM).</p><p><strong>Methods: </strong>We conducted a prospective study of achalasia cardia patients from September 2023 to September 2024 at a tertiary care centre. Patients with severe malnutrition (body mass index [BMI] < 16.0 kg/m²) and hypoalbuminemia (< 3.0 g/dL) deemed surgically unfit by multidisciplinary team were included. They received PEG feeding to improve nutritional status before undergoing POEM. Serial anthropometric and biochemical parameters before PEG and before POEM were compared and technical and clinical success of both procedures was assessed.</p><p><strong>Results: </strong>Among 45 achalasia patients, eight (17.77%) met the inclusion criteria. The median Eckardt score was 10 (range 9-11), with a median symptom duration of 3.5 years (range 2-10). Six patients had type-I and two had type- II achalasia, including two with prior treatment failures. Two patients died even before PEG placement due to severe infections at presentation. The remaining six patients underwent PEG feeding, gaining an average of 11.96 (± 2.68) kg over 11.33 (± 0.94) weeks. This was associated with significant improvement in BMI (13.9 to 19.15; p < 0.00001), albumin (2.8 to 4.2; p < 0.0001), mid-arm circumference (17.27 vs. 22.64; p < 0.001), biceps skin fold thickness (2.15 vs. 3.61; p < 0.001) and triceps skin fold thickness (3.25 vs. 5.84; p < 0.001). All patients then successfully underwent POEM, achieving 100% technical and clinical success.</p><p><strong>Conclusion: </strong>Patients with severe malnutrition (based on BMI and serum albumin) with achalasia considered unfit for POEM or surgery can be managed safely and effectively by using PEG tube feeding as bridge to successful POEM treatment.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"854-863"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798972","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":"Child-Turcotte-Pugh score-based modified anti-tubercular treatment in patients with decompensated cirrhosis with tuberculosis: A two-year retrospective observational study from North India.","authors":"Juned Ahmad","doi":"10.1007/s12664-025-01860-x","DOIUrl":"10.1007/s12664-025-01860-x","url":null,"abstract":"<p><strong>Background: </strong>Management of tuberculosis in decompensated cirrhosis is challenging, as the risk of severe liver failure is markedly increased if hepatotoxicity develops secondary to anti-tubercular treatment (ATT). Child-Turcotte-Pugh (CTP) score-based ATT by Dhiman et al. proposed that the number of hepatotoxic drugs should be two, one and none in CTP scores of ≤ 7, 8-10 and ≥ 11, respectively. We present here our retrospective observational study of treating tuberculosis in patients with decompensated cirrhosis utilizing the above-mentioned CTP-based ATT regimens.</p><p><strong>Methods: </strong>A retrospective observational study utilizing electronic data search was conducted on the application-based software for the duration from April 2022 to April 2024. On the software, decompensated cirrhosis with tuberculosis patients were already tagged. The modified ATT regimens (weight-based) were as per the CTP score. With CTP score ≥ 11, no hepatotoxic drug was included: Intensive Phase -ELA (Ethambutol, Levofloxacin and Amikacin); Continuation Phase: EL. With CTP scores 8-10, 1 hepatotoxic drug (rifampicin preferred) was included; Intensive Phase: RELA, R Rifampicin; Continuation Phase: REL. CTP score ≤ 7 received two hepatotoxic drugs, Intensive Phase: HREL, H Isoniazid, Continuation Phase: HRE. The duration of ATT's continuation phase was 12-18 months.</p><p><strong>Results: </strong>Of 155 patients with decompensated cirrhosis, 21 (13.5%) had concomitant tuberculosis. CTP score-based modified ATT was administered to all 21 during the Intensive phase. Drug-induced hepatotoxicity developed in four patients (19.1%) during the intensive phase. After the intensive phase, two patients were lost to follow-up. Out of 19 patients who completed the continuation phase, 15 (78.9%) had a resolution of tuberculosis and four (21.1%) died. The cause for death in all four patients was related to cirrhosis.</p><p><strong>Conclusion: </strong>As per our study, patients with decompensated cirrhosis tolerated the CTP-score-based modified ATT and almost 80% had a resolution of tuberculosis.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"891-897"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952586","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":"Response to Comment on \"Asian-Pacific consensus on small intestinal bacterial overgrowth in gastrointestinal disorders\".","authors":"Sanjeev Sachdeva, Nitesh Pratap, Uday C Ghoshal","doi":"10.1007/s12664-026-01969-7","DOIUrl":"10.1007/s12664-026-01969-7","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"945-946"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156989","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":"Non-selective beta blockers in pregnancy: Are we there yet?","authors":"Ashish Chauhan, Srikanth Gopi, Randeep Rana, Ashish Agarwal","doi":"10.1007/s12664-025-01959-1","DOIUrl":"10.1007/s12664-025-01959-1","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"953-954"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201424","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":"Evaluation of artificial intelligence-based patient education models for irritable bowel syndrome.","authors":"Anand Kumar Raghavendran, Balaji Musunuri, Siddheesh Rajpurohit, Ganesh Pai C, Shiran Shetty, Pretty Kumari, Rakshand Shetty, Athish Shetty, Ganesh Bhat","doi":"10.1007/s12664-025-01872-7","DOIUrl":"10.1007/s12664-025-01872-7","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder with a significant psycho-social burden. Despite medical advancements, patient education on IBS remains inadequate. This study compared two large language models (LLMs)-ChatGPT-4 and Gemini-1-for their performance in addressing IBS-related patient queries.</p><p><strong>Methods: </strong>Thirty-nine IBS-related frequently asked questions (FAQs) from IBS organizations and hospital websites were categorized into six domains: general understanding, symptoms and diagnosis, causes, dietary considerations, treatment and lifestyle factors. Responses from ChatGPT-4 and Gemini-1 were evaluated by two independent gastroenterologists for comprehensiveness and accuracy, with a third reviewer resolving disagreements. Readability was measured using five standardized indices (Flesch Reading Ease [FRE], Simple Measure of Gobbledygook [SMOG], Gunning Fog Index [GFI], Automated Readability Index [ARI], Reading Level Consensus [ARC]) and empathy was rated on a 4-point Likert scale by three reviewers.</p><p><strong>Results: </strong>Gemini produced comprehensive and accurate answers for 94.9% (37/39) of questions, with two rated as mixed (vague/outdated). ChatGPT achieved 89.7% (35/39) comprehensive responses, with four rated mixed. Domain-wise, both models performed best in \"symptoms and diagnosis\" and \"treatment\", while mixed responses were most frequent in \"general understanding\" and \"lifestyle\". There was no significant difference in comprehensiveness (p = 0.67). Readability analysis showed both LLMs generated difficult-to-read content: Gemini's FRE score was 35.83 ± 3.31 vs. ChatGPT's 32.33 ± 5.57 (p = 0.21), corresponding to college-level proficiency. ChatGPT's responses were more empathetic, with all responses rated moderately empathetic; Gemini was mostly rated minimally empathetic (66.7%).</p><p><strong>Conclusion: </strong>While ChatGPT and Gemini provided extensive information, their limitations-such as complex language and occasional inaccuracies-must be addressed. Future improvements should focus on enhancing readability, contextual relevance and accuracy to better meet the diverse needs of patients and clinicians.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"918-925"},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091638","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}