Indian Journal of Gastroenterology最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","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":"Efficacy and safety of anti-reflux mucosal ablation therapy at 12 months.","authors":"Krithi Krishna Koduri, Neeraj Singla, Rajesh Goud Maragoni, Nitin Jagtap, Aniruddha Pratap Singh, Rakesh Kalapala, D Nageshwar Reddy","doi":"10.1007/s12664-025-01761-z","DOIUrl":"https://doi.org/10.1007/s12664-025-01761-z","url":null,"abstract":"<p><strong>Background and objectives: </strong>Anti-reflux mucosal ablation (ARMA) is a minimally invasive therapy for patients with proton pump inhibitor (PPI) controlled gastro-esophageal reflux disease (GERD). This study evaluated the safety and efficacy of ARMA over 12 months.</p><p><strong>Methods: </strong>This single-center prospective study included PPI-dependent GERD patients (acid exposure time [AET] > 6% or AET > 4.2% with reflux episodes > 80 on 24-h-pH-impedance monitoring). ARMA was performed in a standardized fashion using hybrid technique (sub-mucosal lift followed by ablation). Patients were evaluated using the GERD health-related quality of life questionnaire (HRQL) at baseline, three months and 12 months, with 24-h-pH-impedance monitoring at baseline and 12 months.</p><p><strong>Results: </strong>Total 216 patients (67.1% males, mean age = 38.7 years) underwent ARMA. At baseline, 123 (56.9%) patients had Hill's grade I and 93 (43.1%) had Hill's grade II on endoscopy. Ninety (41.7%) patients had Los Angeles (LA) grade A and 2 (0.93%) had LA grade B. There was a significant improvement in GERD-HRQL score from 43.8 (12.6) at baseline to 20.6 (13.8) at three months and to 8.3 (12.3) at 12 months (p = 0.001). The mean (SD) heartburn and regurgitation scores improved from 22.9 (10.8) and 20.6 (9.4) at baseline to 11.1 (8.7) and 9.5 (8.7) at three months and 3.9 (6.9) and 3.9 (6.9) at 12 months, respectively (p = 0.001). The AET (median [IQR]) decreased from 11.9 (15.9) to 7.6 (10.8) (n = 125, p = 0.009) at 12 months and the median DeMeester score reduced from 42.4 (47.1) to 26.2 (32.3) (p = 0.001). There was also a significant decrease in number of patients with AET 4% to 6% and > 6% and reflux episodes 40-80 and > 80 and DeMeester score > 14.72, as well as an increase in patients with AET < 4% and reflux episodes < 40. There was a significant improvement in Hill's grading and endoscopic esophagitis at one year. No major adverse events were observed.</p><p><strong>Conclusion: </strong>In PPI-dependent GERD patients, ARMA resulted in sustained symptom reduction and improved quality of life at 12 months. This procedure is relatively simple, widely accessible and has a good safety profile.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov (NCT04243668).</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266078","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":"Change in liver fat content in patients following pancreatic resections.","authors":"Agestino V Antony, Manoj T Pillai, Roby Das, Ramesh Rajan, Ananthakrishna V R","doi":"10.1007/s12664-025-01777-5","DOIUrl":"https://doi.org/10.1007/s12664-025-01777-5","url":null,"abstract":"<p><strong>Objectives: </strong>Metabolic sequelae of pancreatic resections, especially hepatic steatosis, has seldom been studied in detail. This study aims to examine the change in liver fat content following pancreatic resections, specifically pancreaticoduodenectomy, distal pancreatectomy and to identify potential predictors of post-pancreatectomy hepatic steatosis.</p><p><strong>Methods: </strong>This prospective observational study was conducted from December 2022 to July 2024 and included patients who underwent pancreatic resections at a single tertiary care centre in southern India. Exclusion criteria included chronic liver disease and excessive alcohol consumption. Liver fat content was assessed using non-contrast computed tomography at baseline, six months and 12 months post-surgery. Liver fat was quantified using the liver attenuation index and liver attenuation in Hounsfield Units (HU). Liver fat content was defined as normal when liver attenuation index was more than + 5, mild to moderate (6% to 30%) when + 5 to -10 HU and severe (> 30%) when less than -10 HU.</p><p><strong>Results: </strong>Total 37 patients were included in this study (males:16, females: 21). Mean age was 50.4 years. Adenocarcinoma was the major etiology (43%) followed by neuroendocrine tumors (21.6%) and cystic neoplasms of pancreas (18.9%). Pre-operatively, 89.2% of patients had normal liver fat content. By six months post-surgery, 54% of patients had increased liver fat, with 20% exhibiting severe steatosis. At 12 months, 51.3% showed elevated liver fat. The increase in liver fat content was statistically significant (p-value = 0.00007). Patients undergoing pancreaticoduodenectomy had a higher incidence of hepatic steatosis at six months compared to those undergoing distal pancreatectomy (p-value = 0.019).</p><p><strong>Conclusions: </strong>Post-pancreatectomy hepatic steatosis is common, particularly in patients undergoing pancreaticoduodenectomy. Metabolic dysfunction does not seem to be directly linked to factors such as diabetes, body mass index or chemotherapy. Further studies with larger cohorts and extended follow-up are needed to assess the long-term clinical significance of these changes, including progression to conditions such as non-alcoholic fatty liver disease.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266077","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":"Assessing circulating miR-1246 as a diagnostic biomarker for colorectal cancer: Insights from a meta-analysis.","authors":"Kamil Safiejko, Michal Pruc, Lukasz Szarpak","doi":"10.1007/s12664-025-01805-4","DOIUrl":"https://doi.org/10.1007/s12664-025-01805-4","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266076","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":"Navigating difficult biliary cannulation: Is pancreatic guidewire-assisted fistulotomy the preferred route?","authors":"Zaheer Nabi, D Nageshwar Reddy","doi":"10.1007/s12664-025-01797-1","DOIUrl":"https://doi.org/10.1007/s12664-025-01797-1","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247717","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":"Acute liver failure and liver transplantation.","authors":"Dinesh Jothimani, Navin Kumar Marannan, Mohamed Rela","doi":"10.1007/s12664-024-01708-w","DOIUrl":"10.1007/s12664-024-01708-w","url":null,"abstract":"<p><p>Sudden and rapid deterioration of hepatic function leading to jaundice, coagulopathy and encephalopathy defines acute liver failure (ALF). Timing of jaundice to encephalopathy classifies ALF into hyperacute, acute and sub-acute liver failure and prognosticates outcome. There exists a significant geographical heterogeneity in the etiology of ALF; paracetamol toxicity is the most common cause in the west, whereas viral hepatitis predominates Asian countries. Hepatitis A is the leading cause for ALF in India. ALF due to yellow phosphorus poisoning is observed commonly in southern India. Clinical outcomes of ALF have improved significantly over the last theee decades and attributed improvement in critical care services, better understanding of the disease and timely initiation of appropriate organ support. Thus, a majority of patients with ALF recover with medical management, in particular hyperacute liver failure. However, patients with seronegative hepatitis, non-paracetamol drug toxicity and sub-acute liver failure are more likely to require liver transplantation (LT). Patients with ALF should be managed in a higher centre with transplant set-up. Emergency LT is a life-saving procedure in ALF, but selection of patients for LT may be a challenge. Various prognostic models have been evaluated to identify those with increased chance of death in the absence of LT. King's College criteria is an extensively studied prognostic model, time tested and used widely across several centres, but has a lower sensitivity missing out on some patients who may benefit from LT. ALF-Early Dynamic (ALFED) being a dynamic model may have better predictability but needs more validation. Timely availability of cadaver organ in ALF patients waitlisted for 'supra-urgent' LT may be an issue. Lower organ donation rates in India and other Asian countries have innovated living donor liver transplantation. Auxiliary partial orthotopic liver transplantation (APOLT) is an exclusive surgical technique in selected patients with ALF allowing regeneration of native liver eliminating the need for long-term immunosuppression. One and five-year survival following LT in ALF patients is around 80% and 70%, respectively, and has significantly improved compared to previous era.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"298-310"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440765","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":"A simple four symptom-based BEDS score to predict dyssynergic defecation in patients with chronic constipation.","authors":"Mayank Jain, Vinodini Agrawal","doi":"10.1007/s12664-024-01697-w","DOIUrl":"10.1007/s12664-024-01697-w","url":null,"abstract":"<p><strong>Background and aims: </strong>Dyssynergic defecation (DD) is a disorder of anorectal function characterized by impaired relaxation or inappropriate contraction of pelvic floor muscles on attempted defecation. Based on previous Indian studies, we devised a symptom score (bleeding per rectum, excessive straining for stools, digitation, sense of incomplete evacuation/blockage-BEDS) and tried to determine if it can identify which patients with chronic constipation are more likely to have DD.</p><p><strong>Methods: </strong>This is a prospective observational cohort study in which consecutive adult patients (> 18 years) with chronic constipation who were referred to our centre for anorectal manometry (ARM) between 2019 and 2023 were included. Prior to tests, patients were asked in detail regarding their symptoms and scoring was done. ARM was done by a single observer. Diagnosis of DD was based on standard criteria. Statistical tests used were median, range and percentages, Chi-square test and Mann-Whitney U-test. The data was analyzed for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Agreement of symptom-based scoring and DD diagnosis as per criteria was calculated using Cohen's κ coefficient. A p value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>As many as 244 patients (males 140, median age 42 years) formed the study cohort. Of these, 104 (42.6%) have DD. Sense of incomplete evacuation/sense of blockage (72.1% vs. 40%, p < 0.0001), excessive straining (73.1% vs. 22.1%, p < 0.0001) and digitation (28.8% vs. 13.5%, p 0.003) were more commonly reported in patients with DD. Taking a cut-off score of > / = 2, sensitivity of 69.2%, specificity 81.4% and positive likelihood ratio of 3.73 were noted. Similarly, if the score of > / = 3 was considered, the likelihood ratio increased to 4.71 with an increase in specificity (94.29%) and fall in sensitivity (26.92%).</p><p><strong>Conclusion: </strong>Symptom-based BEDS score of > / = 2 is useful in identifying patients with DD.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"330-335"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464246","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":"EUS FNAC without rapid on-site evaluation is comparable to EUS FNB with macroscopic on-site evaluation in evaluation of intra-abdominal masses.","authors":"Mohd Rafiq Najar, Monika Jain, Gurwant Singh Lamba, Sawan Bopanna","doi":"10.1007/s12664-025-01741-3","DOIUrl":"10.1007/s12664-025-01741-3","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic ultrasound-guided tissue acquisition (EUS TA) has become the mainstay for tissue diagnosis of abdominal mass lesions. Two widely used and accepted methods for obtaining diagnostic material, namely fine needle aspiration cytology (EUS FNAC) and needle core biopsy (EUS FNB), have distinct advantages and disadvantages. We compared the diagnostic accuracy of EUS FNAC without on-site pathology and EUS FNB taken within the same endoscopic session in evaluation of intra-abdominal masses.</p><p><strong>Methods: </strong>In this prospective observational study, we included patients undergoing EUS FNAC and EUS FNB for the diagnosis of solid intra-abdominal masses. Sample size was calculated based on the available literature. Location, origin, dimensions of the intra-abdominal masses and number of passes taken were recorded. EUS-guided FNAC followed by EUS-guided FNB was done back-to-back during the same endoscopic session. FNAC smears were prepared and air dried and alcohol-fixed slides were prepared. Adequacy of the FNB specimen was judged visually. The diagnostic accuracy of FNA and FNB specimens was then calculated based on the final diagnosis and compared.</p><p><strong>Results: </strong>Of the 58 patients included, 50% of patients were females with a mean age of 53.91 ± 17.16 years. Nineteen pancreatic masses (32.7%), three gastric mass lesions (5.1%), one adrenal mass (1.7%), one liver mass (1.7%), three gallbladder masses (5.1%) and 31 lymph nodal masses (53.4%) were sampled. With EUS FNB, malignancy was diagnosed in 38/58 (65.5%), benign diseases in 19/58 (32.7%) and 1/58 (1.7%) was inconclusive. Number of passes was more in the EUS FNAC group compared to EUS FNB, but not statistically significant. Sensitivity and specificity of EUS FNAC without rapid on-site evaluation (ROSE) were found to be 92.4% and 100%, respectively. Diagnostic accuracy of EUS FNAC was 93.1% and when compared with EUS FNB with macroscopic on-site evaluation (MOSE), no statistically significant difference was noted.</p><p><strong>Conclusion: </strong>EUS FNAC and EUS FNB are comparable for the diagnosis of intra-abdominal masses in terms of diagnostic accuracy, sample adequacy, number of passes and safety. In resource-constraint settings, either EUS FNAC or EUS FNB alone may be sufficient for diagnosis with EUS FNB being preferred in select cases where maintained tissue architecture is needed.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"371-377"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448935","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":"Low risk of malignancies with thiopurines in an Indian cohort of patients with Inflammatory bowel disease.","authors":"Arshdeep Singh, Vandana Midha, Ajit Sood","doi":"10.1007/s12664-024-01615-0","DOIUrl":"10.1007/s12664-024-01615-0","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"390-391"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317060","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":"Eating behaviors and mental health among celiac patients, case-control study.","authors":"Mohammad Taleb Abed, Qusay Abdo, Mohammed Motasem Jaber, Aya Abdalraziq Qatanani, Abeer Omar Raba'a, Ghalia Faris Rabba, Shatha Waleed Deeb, Samar Jallad, Manal Badrasawi","doi":"10.1007/s12664-024-01732-w","DOIUrl":"10.1007/s12664-024-01732-w","url":null,"abstract":"<p><strong>Background: </strong>Celiac disease (CD) is an autoimmune disorder affecting genetically predisposed individuals, causing abnormal immune responses against gluten-containing grains. Celiac disease patients are at risk for health-related problems that affect their nutrition status, mental health and eating behavior. The focus of this study was on mental health aspects, including anxiety, stress and depression as well as eating behaviors among celiac disease patients in Palestine.</p><p><strong>Methods: </strong>This case-control study compared eating behaviors and psychological status among 226 celiac disease patients and healthy controls. Data was collected using an online questionnaire administrated via Google forms. We used the Eating Behaviors Reference for Adults to assess eating behaviors and the Depression Anxiety and Stress Scale (DASS 21) to assess psychological status. We measured nutritional status using variables such as body mass index (BMI), unintentional weight loss and eating that had stopped or nearly stopped for more than five days.</p><p><strong>Results: </strong>The study indicated that the case group had a higher mean psychological level as compared to the control group; the mean depression score for the case was 12.94 ± 5.30 for the control (11.35 ± 3.95), p < 0.05. Anxiety levels were higher in the case group (13.72 ± 5.38) compared to the control group (12.25 ± 4.09) (p < 0.05). The case had a higher stress level (15.83 ± 5.58) than the control group (14.23 ± 4.24) (p < 0.05). Results highlighted that mental health association with eating behaviors was found to be significant in the case group, as depression, anxiety and stress were significantly associated with satisfaction responses (r = -.319) (p value ≤ 0.01), (r = .439) (p value ≤ 0.05) and (r = .381) (p value ≤ 0.01) but not in hunger, emotional eating or picky eating. Additionally, with stress was found to be more significant in slow eating (r = .186) (p value ≤ 0.05).</p><p><strong>Conclusion: </strong>Celiac disease impacts mental health, including depression, stress and anxiety. It also affects eating behaviors such as slow eating, enjoyment and satiety responsiveness. In celiac disease patients, mental health influences eating behaviors such as slow eating and satiety responses.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"363-370"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364598","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}