Indian Journal of Gastroenterology最新文献

{"title":"Masked hypertension in patients with irritable bowel syndrome: A direction worthy of in-depth study.","authors":"Ting-Ting Ji, Yi-Heng Yao, Liang Liu, Hai-Su Li","doi":"10.1007/s12664-025-01863-8","DOIUrl":"https://doi.org/10.1007/s12664-025-01863-8","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804006","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":"https://doi.org/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":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-08","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":"Clinical applications of hyperspectral imaging in gastroenterology and hepatology: A systematic review.","authors":"Qilang Xiang, Yanting Ao, Qian Jia, Muhan Lü","doi":"10.1007/s12664-025-01836-x","DOIUrl":"https://doi.org/10.1007/s12664-025-01836-x","url":null,"abstract":"<p><strong>Background: </strong>Hyperspectral imaging (HSI), a high-throughput, three-dimensional technology initially developed for remote sensing, has recently garnered increasing interest in applications in gastroenterology and hepatology. We focus on the aspects of HSI clinical research in gastroenterology and hepatology from a more clinically oriented perspective, discussing its prospective trajectories in this field and delving into the current challenges encountered with HSI.</p><p><strong>Methods: </strong>A comprehensive systematic search was carried out in PubMed, Embase and Web of Science, encompassing studies published up to June 30, 2024. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, a systematic review was then conducted to evaluate the identified studies. Two independent reviewers screened the retrieved articles based on pre-defined inclusion and exclusion criteria, followed by an independent data extraction process to ensure accuracy and reliability.</p><p><strong>Results: </strong>Total 63 studies met the inclusion criteria. Among the 63 included studies, HSI demonstrated significant potential in cancer diagnosis (65.1%), intra-operative monitoring (33.3%) and H. pylori detection (1.6%), with most studies integrating artificial intelligence (AI) for enhanced data analysis. Most studies integrated HSI with AI, enabling efficient analysis and processing of complex hyperspectral data. Additionally, advancements in medical devices, including hyperspectral endoscopes and hyperspectral microscopes, have enhanced the practicality and clinical utility of HSI in gastroenterology and hepatology.</p><p><strong>Discussion: </strong>HSI shows promising performance and significant potential in gastroenterology and hepatology by enhancing the detection of gastrointestinal cancers, improving intra-operative decision-making through real-time tissue characterization, and facilitating tissue assessment during surgery. HSI offers non-invasive, real-time tissue analysis, but its clinical adoption is hindered by high costs, technical complexity and lack of standardized protocols.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788855","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":"Comment on \"Overlap of 'disorders of gut-brain interaction' and their impact on quality of life and somatization in a tertiary care center\".","authors":"Yu Yan, Tingting Ji, Jingyu Zhu, Xingjie Shen","doi":"10.1007/s12664-025-01844-x","DOIUrl":"https://doi.org/10.1007/s12664-025-01844-x","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784239","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":"Clinical, economic and social impact of hepatitis A virus: Impact of gastrointestinal co-infections on disease course.","authors":"Samannay Das, Ashray Sudarshan Patel, Pratibha Kale, Ekta Gupta, Vikas Khillan, Vikrant Sood, Rajeev Khanna, Seema Alam, Bikrant Bihari Lal","doi":"10.1007/s12664-025-01846-9","DOIUrl":"https://doi.org/10.1007/s12664-025-01846-9","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784238","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":"Ways to improve the negative impact of proton pump inhibitors on biopsy-based test accuracy for Helicobacter pylori detection.","authors":"Peter Malfertheiner, Christian Schulz","doi":"10.1007/s12664-025-01841-0","DOIUrl":"https://doi.org/10.1007/s12664-025-01841-0","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784240","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-02","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":"Japanese narrow band imaging expert team classification of colorectal polyps: A validation study from India.","authors":"Kayal Vizhi Nagarajan, Amit Yelsangikar, Anupama Nagar Krishnamurthy, Hima Bindu, Arun Patted, Vinay Bhat, Tripti Kaur, Naresh Bhat","doi":"10.1007/s12664-025-01784-6","DOIUrl":"10.1007/s12664-025-01784-6","url":null,"abstract":"<p><strong>Background: </strong>Japanese narrow band imaging expert team (JNET) classification has a diagnostic accuracy above 90% in differentiating neoplastic from non-neoplastic colonic polyps as well as estimating the depth of invasion in colorectal cancer. However, its validation outside Japan is limited to expert centers and requires magnifying endoscopes.</p><p><strong>Aims and methods: </strong>This study aimed at validating the JNET classification prospectively in a real-world setting in India using magnifying endoscopes with dual focus. We analyzed consecutive patients with colonic polyps detected via these endoscopes. The JNET classification was compared with histopathology, the gold standard and its diagnostic accuracy was assessed.</p><p><strong>Results: </strong>Total 203 consecutive patients with colonic polyps underwent examination using a magnifying endoscope with dual focus. In real time, 331 polyps were identified and classified based on the JNET classification. Among them, 15 polyps could not be retrieved, leaving 316 polyps for histopathological comparison in the study. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of each JNET classification type, along with their 95% confidence intervals, are as follows. For Type-1 JNET classification, the values are 78% (69-86), 97% (94-99), 92% (84-97), 92% (87-95) and 92% (88-94), respectively. Type-2 A JNET classification has corresponding values of 92% (86-96), 84% (78-89), 82% (75-88), 93% (88-97) and 88% (84-91). For Type-2B JNET classification, the values are 45% (24-68), 97% (95-99), 56% (31-78), 96% (93-98) and 93% (90-96). Lastly, Type-3 JNET classification has values of 95% (87-99), 98% (96-100), 94% (85-98), 99% (97-100) and 98% (96-99), respectively.</p><p><strong>Conclusions: </strong>The JNET classification has good accuracy in characterizing colonic polyps using magnifying endoscopes with dual focus. Large-volume, multicentric data is necessary to validate the findings in our study.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"525-532"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110580","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 systematic review of fully circumferential inlet patches (heterotopic gastric mucosa): More complicated than regular inlet patches.","authors":"Daniel L Cohen, Anton Bermont, Haim Shirin","doi":"10.1007/s12664-025-01738-y","DOIUrl":"10.1007/s12664-025-01738-y","url":null,"abstract":"<p><strong>Background and objectives: </strong>Inlet patches (IP) are usually small islands of ectopic gastric mucosa found in the proximal esophagus, but rare cases of large, fully circumferential IP (FCIP) have been reported. To better understand the clinical course of patients with FCIP, we sought to perform a systematic review of all published cases.</p><p><strong>Methods: </strong>A systematic review of cases of FCIP was performed according to Preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines after thorough searches of PubMed and journal databases for appropriate cases. No restrictions were placed as to article type, country of origin or publication year.</p><p><strong>Results: </strong>Total 30 cases of FCIP from 27 articles were identified. These included patients from 10 different countries published between 1985 and 2024. The mean age was 55.7 with 82.1% men and a mean circumferential IP length of 3.4 cm. A majority of patients were symptomatic with dysphagia and/or a history of food impactions (72.4%). Most cases involved complications from the IP, including a benign stricture/ring/web (20, 66.7%), adenocarcinoma (4, 13.3%) or ulcers/erosions (2, 6.7%). The benign strictures were usually treated by dilation together with anti-secretory medication (10, 50%) or just dilation or medication. The adenocarcinoma cases were treated by surgery (two cases) or endoscopic resection (two cases), while the ulcer cases were treated medically. All cases with follow-up reported a good clinical outcome.</p><p><strong>Conclusions: </strong>Patients with FCIP are frequently symptomatic with dysphagia or food impactions and often have complications, including a stricture/ring or cancer. Despite this, they have good clinical outcomes. Given the risk of malignancy, endoscopic surveillance may be warranted.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"443-456"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12274265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752473","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":"Masked hypertension in patients with irritable bowel syndrome.","authors":"Görkem Yıldız, Gürbey Söğüt","doi":"10.1007/s12664-025-01745-z","DOIUrl":"10.1007/s12664-025-01745-z","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiology of irritable bowel syndrome (IBS) and masked hypertension (mHT) exhibits shared characteristics, including factors such as anxiety and stress. Consequently, the aim of this study was to investigate the frequency of mHT in patients with IBS.</p><p><strong>Method: </strong>Patients diagnosed with IBS in 2020-2023 were re-evaluated using the Rome IV criteria. Patients who did not have sustained HT, as evidenced by repeated in-office blood pressure (BP) measurements and who did not meet the exclusion criteria (chronic renal failure, heart failure, diabetes, cerebrovascular events, pregnancy or puerperium) were included in the study group. A control group was also constituted with the same number of age and gender-matched healthy individuals. The participants were connected to a 24-hour ambulatory BP monitor and the results were analyzed.</p><p><strong>Results: </strong>Total 128 participants, including 64 IBS patients and 64 healthy individuals, were included in our study. The age (36.9 ± 7.3 years; 37.3 ± 7.7 years) and gender (62.5% female; 62.5% female) distributions and the baseline clinical characteristics of the study and control groups were similar. The in-office systolic BP measurements of the IBS patients were significantly higher than those of the control group (124.7 ± 5.4 mmHg compared to 121.8 ± 5.2 mmHg, p = 0.02). The IBS patients also had a higher frequency of mHT (n = 21, 32.8% compared to n = 10, 15.6%, p = 0.02), higher 24-hour daytime systolic BP (127.5 ± 7.6 mmHg compared to 124.8 ± 5.22 mmHg, p = 0.02) and higher nighttime diastolic BP (62.2 ± 7.5 mmHg compared to 59.6 ± 6.1 mmHg, p = 0.03) than the control group. The study group included all four sub-types of IBS: diarrhea-dominant (IBS-D), constipation-dominant (IBS-C), mixed type (IBS-M) and unclassified (IBS-U). It was determined that 57.9% of the IBS-C patients, 27.8% of the IBS-M patients, 23.5% of the IBS-D patients and 10% of the IBS-U patients in the study group had mHT.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first study demonstrating a relationship between IBS and mHT. The frequency of mHT was higher among patients with IBS compared to healthy controls (p = 0.02). Studies on larger patient groups are needed to evaluate the frequency of mHT for the IBS sub-types.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"489-495"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700290","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}