Indian Journal of Gastroenterology最新文献

{"title":"Sex and gender differences in metabolic dysfunction-associated liver disease.","authors":"Rishitha Penmetsa, Sasha Kapil, Lisa B VanWagner","doi":"10.1007/s12664-025-01833-0","DOIUrl":"10.1007/s12664-025-01833-0","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease (NAFLD), is the most prevalent cause for chronic liver disease globally, with a rising incidence of metabolic-associated steatohepatitis (MASH) and its complications. This review examines the critical role of sex and gender in MASLD/MASH prevalence, progression and clinical outcomes. Biological sex affects MASLD significantly with males exhibiting higher rates of downstream complications such as hepatocellular carcinoma (HCC). In comparison, females tend to develop progressive disease with higher rates of MASH cirrhosis. Gender, influenced by social and cultural factors, influences disease progression through behaviors such as diet, exercise and alcohol consumption. As the prevalence of gender-fluid and gender diverse patients increases, this has additional influences on MASLD. Age-related trends demonstrate MASLD prevalence in men increases from young adulthood, whereas in women, rates rise mainly after menopause, affecting liver fibrosis and inflammation differently. Animal studies reveal sex-specific differences in steatosis, inflammatory cytokines, oxidative stress and the role of sex hormones such as estrogen and testosterone in modulating disease progression. Lifestyle behaviors linked to gender also contribute; women generally follow healthier diets and respond better to exercise in reducing liver fat. While estrogen plays a protective role in liver metabolism, its effects on MASLD progression are complex, particularly in post-menopausal women. This review also explores the emerging area of gender-affirming hormone therapy (GAHT) in transgender individuals, showing potential benefits in managing comorbid MASLD/MASH. Ultimately, understanding these sex and gender-based variations is essential for optimizing MASLD treatment strategies, highlighting the need for more research on how sexual dimorphism and gender influence the disease.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"192-201"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768599","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":"Pregnancy outcomes among women with inflammatory bowel disease: A UK tertiary centre experience.","authors":"Ruth Tunney, Eleanor Liu, Jimmy K Limdi","doi":"10.1007/s12664-024-01657-4","DOIUrl":"10.1007/s12664-024-01657-4","url":null,"abstract":"<p><strong>Background: </strong>Optimal management of inflammatory bowel disease (IBD) in pregnancy is associated with better pregnancy outcomes. We describe management of IBD during pregnancy and maternal and fetal outcomes of patients from a tertiary UK IBD centre.</p><p><strong>Methods: </strong>This is a retrospective observational cohort study of all pregnancies occurring between 2015 and 2021 in a large tertiary IBD centre in the UK. IBD activity and management prior to, during and after pregnancy were recorded along with pregnancy and neonatal outcomes. Associations between IBD-focused interventions and any adverse pregnancy outcomes, as well as the association between IBD severity and treatments and adverse maternofetal outcomes were assessed.</p><p><strong>Results: </strong>Pregnancies in 130 women with IBD were included for analysis. The mean maternal age at delivery was 30.5 (± 4.7) years. At conception, 73 women (56.2%) were in clinical remission and 24 (18.4%) were treated with a biologic agent. Active disease during pregnancy, measured by physician global assessment, was less frequent in women who were in clinical remission at conception, compared to those not in remission at conception (16/73 21.9% vs. 39/49 79.6%; data insufficient for eight women). Active IBD at conception was associated with pre-term birth (p = 0.04). Maternal corticosteroid use in any trimester was associated with low birth weight (T1 p = 0.02; T2 p = 0.005; T3 p = 0.007). Active disease (p = 0.008) and steroid use in the third trimester (p = 0.05) were both associated with neonatal infections up to six months after birth.</p><p><strong>Conclusion: </strong>Women in clinical remission at the time of conception have favorable outcomes, consistent with prospective observational studies. Our observations emphasize the importance of high quality IBD care for women pre and post-partum in line with international recommendations.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"230-239"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-specific risk factors, clinical presentation and outcome of amebic liver abscess in a tertiary care centre.","authors":"Manoj Yadav, Disha Saxena, Nadiya Mudin, Vishnu Kumar Agarwal, Ashok Jhajharia, Prachis Ashdhir, Rupesh Kumar Pokharna","doi":"10.1007/s12664-023-01491-0","DOIUrl":"10.1007/s12664-023-01491-0","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"304-305"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829619","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":"Gender disparities in gastroenterology and hepatology conferences: The journey towards equality.","authors":"Jalpa Devi, Amna Subhan Butt, Lajpat Rai, Jatin Kumar, Sadik Memon","doi":"10.1007/s12664-024-01591-5","DOIUrl":"10.1007/s12664-024-01591-5","url":null,"abstract":"<p><strong>Background: </strong>This study scrutinizes gender representation in invited faculty and conference committee leadership at key gastroenterology and hepatology conferences in Pakistan over five years, exploring the impact of the \"glass ceiling\" and \"sticky floor\" phenomena on gender diversity within academic medicine.</p><p><strong>Methods: </strong>This cross-sectional study was conducted between January and March of 2023. The three major national societies of gastroenterology and hepatology in Pakistan that had been established for more than 10 years and the scientific programs of their annual conferences, which were publicly accessible, were included and coded as Society 1, Society 2 and Society 3 to maintain anonymity. The scientific programs for the last five years (2018-2022) were retrieved. The roles of invited faculties were identified as invited speakers, moderators, chairs/panelists, presidents and chairs of organizing or scientific committees and the gender makeup of the faculty was compared. Regression analysis was used to evaluate the trends for female representation over time for each role.</p><p><strong>Results: </strong>Significant gender disparity was evident by an extremely lower cumulative proportion of female invited faculty compared to males (211 [11.9%] vs. 1567 [88.1%], p 0.001). The predominance of invited male faculty was observed across all societies as well as in various roles of invited faculty (p 0.01). A significant disparity has also been observed in leadership positions of all three societies (43 [95.5%] males vs. 2 [4.5%] females, p 0.001), while the trend of women's underrepresentation across all societies remained almost unchanged over time (slope = 0.08, R² =  - 0.078, p-value = 0.875).</p><p><strong>Conclusion: </strong>Our study unveils striking gender disparities in women's representation as invited speakers and other roles at the annual scientific conferences of major gastroenterology and hepatology. Additionally, male dominance remains entrenched, notably in leadership positions, necessitating a proactive, multifaceted approach to rectify gender inequities.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"278-285"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456514","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":"Hepatitis E seroprevalence in pregnancy.","authors":"Meghna Singh, Amit Goel, Manju Lata Verma, Seema Mehrotra, Pushp Lata Sankhwar","doi":"10.1007/s12664-025-01926-w","DOIUrl":"10.1007/s12664-025-01926-w","url":null,"abstract":"<p><strong>Background and objectives: </strong>The occurrence of hepatitis E virus (HEV) infection in pregnant women is a significant concern for maternal and neonatal health. Detection of HEV can be done through anti-HEV antibodies (immunoglobulin G [IgG] and immunoglobulin M [IgM]) or RNA-based tests. Robust estimates of exposure of hepatitis E among pregnant women in northern India are limited. So, this study was done to evaluate the seroprevalence of hepatitis E in pregnant females.</p><p><strong>Methods: </strong>The prospective cohort study was conducted at the department of obstetrics and gynecology for one year. The study was approved by the Institutional Ethical Committee (ECR/262/Inst/UP/2013RR-19 Ref code XV-PGTSC-IIA/P24). A 5-mL blood sample was collected from each participant's median cubital vein, centrifuged and serum/plasma separated early to prevent hemolysis of red blood cells and stored at - 20 °C for further analysis. The study used the Wantai HEV IgG ELISA diagnostic kit manufactured in Beijing, a commercially available enzyme-linked immunosorbent assay for qualitative detection of IgG antibodies to hepatitis E virus in human serum or plasma. Results were calculated by relating each specimen absorbance value to the cut-off value (C.O). All specimens fulfilled quality control criteria and the index was defined as A/C.O.</p><p><strong>Results: </strong>Of 602 pregnant patients tested, 287 patients (47.7%) were IgG HEV positive and 326 patients (52.3%) were IgG HEV negative. Seropositivity increases with an increase in age. Total 51.3% of rural area females were seropositive than 45.3% in urban population. Low body mass index (BMI) was associated with high seropositivity.</p><p><strong>Discussion: </strong>Seroprevalence of hepatitis E in the north Indian population in the present study was quite high. The result of the present study can be used in formulating the guidelines for hepatitis E vaccination in pregnant females.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"250-258"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146219696","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":"Towards equality for women in gastroenterology practice.","authors":"Ayushi Chauhan, Purnima Bhat","doi":"10.1007/s12664-026-01986-6","DOIUrl":"10.1007/s12664-026-01986-6","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"148-151"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147305398","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":"Gender disparities in liver transplantation.","authors":"Rajalakshmi Govalan, Shikhar Singh, Pratima Sharma","doi":"10.1007/s12664-025-01839-8","DOIUrl":"10.1007/s12664-025-01839-8","url":null,"abstract":"<p><p>Gender disparities significantly influence outcomes in liver transplantation (LT), impacting disease prevalence, progression, access to transplantation and post-transplant outcomes. This review synthesizes current knowledge on prevalence, biological, physiological, psychosocial and systemic factors contributing to these disparities. Epidemiological studies consistently demonstrate gender-based differences in liver disease etiology and progression, influenced by hormonal, genetic and lifestyle factors. Women experience specific challenges such as higher risks associated with alcohol metabolism and increased susceptibility to autoimmune and metabolic liver diseases. Despite higher disease severity and increasing prevalence, women face substantial barriers in accessing LT, primarily due to inherent biases within allocation systems such as the model for end-stage liver disease (MELD) scoring method and donor-recipient size matching protocols. Psycho-social factors, including healthcare provider biases, caregiving responsibilities and socio-economic constraints, further compound these inequities. Ethical considerations highlight the necessity for transparent, equitable practices in LT. This article underscores the importance of evidence-based policy reforms such as revised MELD scoring, standardized patient evaluations and advocacy initiatives. Addressing gender disparities through multidisciplinary research, targeted policy interventions and community engagement is critical to achieving equitable and improved outcomes for liver transplant patients across genders.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"202-210"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753223","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":"Challenges in the management of vascular liver disorders in women in the reproductive period.","authors":"Sagnik Biswas, Kumble S Madhusudhan, Shalimar","doi":"10.1007/s12664-025-01899-w","DOIUrl":"10.1007/s12664-025-01899-w","url":null,"abstract":"<p><p>Vascular liver diseases (VLD) are a heterogeneous cohort of uncommon hepatic diseases which affect individuals particularly in the reproductive age group. They are typically associated with inherited or acquired thrombophilia. These diseases may influence reproductive health in women through alteration of the menstrual cycle and impact fertility. Pregnancy in this patient group may be complicated by exacerbation of portal hypertension, maternal and fetal complications due to underlying liver disease or drugs used for its management. This review focuses on the known risk factors of VLD in women, along with their prevalence and management. Special situations such as impact and use of anti-coagulants in pregnancy, management of portal hypertension and variceal bleeding, safe contraceptive use in this patient group and safety and risk of in-vitro fertilization are also discussed.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"178-191"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989088","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":"Gastrointestinal symptoms and disorders of gut-brain interaction in pregnancy.","authors":"Abhinav Jain, Shraddha Ramchandani, Shobna Bhatia","doi":"10.1007/s12664-024-01705-z","DOIUrl":"10.1007/s12664-024-01705-z","url":null,"abstract":"<p><p>Gastrointestinal (GI) symptoms occur frequently in pregnant women, resulting in poor quality of life. These patients frequently require co-management with the obstetrician and a physician/GI specialist. The causation is complex and multifactorial. It is a result of a combination of maternal changes in pregnancy and feto-placental hormonal effects on the GI tract (the feto-placental-gut axis). Additional factors such as the gut-brain interaction, genetics, immune response and effects of maternal supplements during pregnancy also contribute to the causation of symptoms. The most common of these symptoms include nausea and vomiting followed by heartburn. The common lower GI symptoms include constipation and hemorrhoids. Irritable bowel syndrome (IBS) is also common in a pregnant patient. But there is a paucity of literature and high-quality studies concerning the management of IBS. This review addresses the pathophysiology and clinical and laboratory evaluation of the common upper GI and lower GI symptoms and their management. A majority of symptoms are mild and lifestyle modifications with non-pharmacological measures should be the first-line management, whereas drugs should be used judiciously in case of non-response or severe symptoms. The nutritional status of the mother and the fetus needs close monitoring. Drugs that are routinely used in pregnancy are discussed with regard to the safety of the mother and the fetus. GI endoscopy may be needed in select patients and the indications for endoscopy and colonoscopy in pregnancy along with special pregnancy-related precautions are discussed. Most symptoms improve to pre-pregnancy state after delivery.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"165-177"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926983","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":"Dr. Pramod Kumar Garg: President, Indian Society of Gastroenterology- 2026.","authors":"Usha Dutta","doi":"10.1007/s12664-026-01992-8","DOIUrl":"10.1007/s12664-026-01992-8","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"133-135"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354876","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}