Indian Journal of Gastroenterology最新文献

{"title":"Utility of rotational thrombo-elastometry as an objective measure of hypercoagulability in ulcerative colitis.","authors":"P Krishna Bharadwaj, Ebby George Simon, Rutvi G Dave, Tulasi Geevar, Sukesh C Nair, Joseph Aj, Amit Kumar Dutta, Rajeeb Jaleel, Anoop John, Ajith Thomas, Amith Viswanath","doi":"10.1007/s12664-025-01759-7","DOIUrl":"https://doi.org/10.1007/s12664-025-01759-7","url":null,"abstract":"<p><strong>Background and aims: </strong>Inflammatory bowel disease (IBD) has an increased risk of venous thromboembolism (VTE), with factors such as hospitalization and surgery enhancing this risk. This study was aimed at evaluating rotational thrombo-elastometry (ROTEM) for assessing blood coagulation status in ulcerative colitis (UC) and determining its relationship with disease severity and response to treatment.</p><p><strong>Methods: </strong>This was a prospective age and sex-matched study with 60 patients each in UC and irritable bowel syndrome groups, the latter being controls. Clinical details and blood investigations, including ROTEM (clotting time [CT], clot formation time [CFT], alpha angle [AA], maximum clot firmness [MCF], maximum lysis [ML]) and D-dimer, were collected, analyzed and compared between the two groups. A hypercoagulable state was defined by Kaufmann et al. as having two or more of the following: short CT and/or CFT time, increased AA and increased MA.</p><p><strong>Results: </strong>There were 60 patients with UC (age, 38.6 ± 11.64 years; 44 males). The UC group significantly had more patients with hypercoagulable ROTEM than the control group (66.7% vs. 36.7%, p = 0.001). In UC patients with hypercoagulable ROTEM, nine patients were in remission and 31 patients had active disease. Compared to controls, CT, CFT, AA, MCF and D-dimer levels were significantly abnormal in the UC group. Among UC patients with increasing severity, only CFT, AA and D-dimer differed significantly across the groups. There were no significant differences in ROTEM values and D-dimer in patients with severe UC at admission compared to one-week post-discharge. Only hemoglobin (OR, 0.61; 95% CI, 0.38-0.98; p = 0.04) was found to be a significant independent predictor of a hypercoagulable state of active UC, on multivariate analysis.</p><p><strong>Conclusions: </strong>More patients with UC had hypercoagulable ROTEM compared to controls, which increased with disease severity. Low hemoglobin was predictive of a hypercoagulable state in active UC.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985951","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":"Bone mineral density trends in cirrhotic patients.","authors":"Joseph C Lee, Jia Wen Chong, Tony M Rahman","doi":"10.1007/s12664-025-01780-w","DOIUrl":"https://doi.org/10.1007/s12664-025-01780-w","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020231","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":"Prevalence of hepatitis B infection and its associated factors in rural South India.","authors":"Adhisakthi Rajalatchumi, Palanivel Chinnakali, Rahul Dhodapkar, Jeby Jose Olickal, Sadhana Subramanian, Sitanshu Sekhar Kar, Pazhanivel Mohan","doi":"10.1007/s12664-025-01768-6","DOIUrl":"https://doi.org/10.1007/s12664-025-01768-6","url":null,"abstract":"<p><strong>Background: </strong>Information on the burden of hepatitis B infection is required for targeted interventions and streamlining the diagnosis and treatment facilities across various healthcare levels in India. Therefore, this study was aimed at determining the prevalence of hepatitis B infection and associated factors among the adult population in a rural area of South India.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted among the rural adult population aged 18 years and above between January 2021 and April 2022. Alere Determine^TM HBsAg rapid diagnostic test kit (RDT) was used to detect hepatitis B surface antigen (HBsAg) and a Chemiluminescent immunoassay (CLIA) test was used for confirmatory diagnosis. Data on the behavioral and clinical risk factors for HbsAg and other basic socio-demographic details were captured using a pre-tested, structured questionnaire.</p><p><strong>Results: </strong>Total 5169 participants were included in the study. The mean (SD) age was 41 (15.7) years and 50% were males. About 20% reported alcohol use and 10% reported tobacco use. The prevalence of hepatitis B infection was 2.5% (95% CI = 2.05-2.91), of whom 10 (7.9%) had a known history of hepatitis B infection. Alcohol use (PR 2.8, 95% CI = 1.9 - 4.2), tobacco use (PR 2.8, 95% CI = 1.6-5.1), history of blood transfusion (PR 7.8, 95% CI = 4.7-13.0), history of dental procedures (PR 3.6, 95% CI = 2.5-5.1), tattoos (PR 3.5, 95% CI = 2.1-5.8) and having more than one sex partner (PR 6.8, 95% CI = 1.1-41.2) were significantly associated with hepatitis B infections.</p><p><strong>Conclusion: </strong>Nearly three out of 100 individuals had hepatitis B infection in rural areas. Efforts to address hepatitis B transmission prevention holistically and with a public health approach must be enhanced.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984770","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":"Gastric cancer with limited peritoneal metastasis: Role of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.","authors":"Suchita Chowdhury, Abhishek Aggarwal, Shaifali Goel, Varun Goel, Vineet Talwar, Shivendra Singh","doi":"10.1007/s12664-025-01766-8","DOIUrl":"https://doi.org/10.1007/s12664-025-01766-8","url":null,"abstract":"<p><strong>Background and objectives: </strong>Peritoneal metastasis in gastric cancer is associated with a very poor prognosis with a median overall survival of seven to 15 months if treated with systemic chemotherapy only. Studies have shown improved survival with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in selected group of patients, when compared to systemic chemotherapy alone. In spite of promising results, this is not the standard of care till date. The aim of our study was to evaluate the long-term outcome for the patients of gastric cancer with peritoneal metastases undergoing cytoreductive surgery and HIPEC at our institute.</p><p><strong>Methods: </strong>Retrospective analysis of prospectively maintained data of all patients, who underwent cytoreductive surgery and HIPEC during the period of 2015-2023, was performed. All relevant pre-operative, peri-operative, post-operative and histopathological data was analyzed and overall survival and disease-free survival calculated.</p><p><strong>Results: </strong>Twenty-three patients of gastric cancer with peritoneal metastasis (PCI < / = 7) underwent cytoreductive surgery and HIPEC during the study period. At a median follow-up of 12 months, median disease-free survival (DFS) and overall survival (OS) were 12 months and 35 months, respectively. One-year and three-year DFS were 48.5% and 23%, respectively. One-year and three-year OS was 85% and 45.4%, respectively.</p><p><strong>Conclusion: </strong>Cytoreductive surgery and HIPEC can be considered to be safe and effective treatment strategy in a select group of gastric cancer patients with peritoneal metastasis leading to a meaningful survival as compared to palliative systemic chemotherapy.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018289","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":"Impacts of microplastics on gut health: Current status and future directions.","authors":"Khaiwal Ravindra, Manpreet Kaur, Suman Mor","doi":"10.1007/s12664-025-01744-0","DOIUrl":"https://doi.org/10.1007/s12664-025-01744-0","url":null,"abstract":"<p><strong>Background and objectives: </strong>Microplastics are pervasive environmental pollutants, attracting significant concern due to their potential adverse effects on ecosystems and human health. This study hypothesizes that microplastics may significantly impact gastrointestinal (GI) health through various mechanisms. The objective of this systematic review is to explore the effects of microplastics on GI health, focusing on animal models such as mice, fish and earthworms.</p><p><strong>Methods: </strong>A systematic review approach was employed, analyzing studies that investigate the impact of microplastics on the gut microbiota, gut barrier integrity and GI inflammation. The review includes a synthesis of findings from multiple animal models.</p><p><strong>Results: </strong>The review reveals consistent evidence that microplastics can disrupt the gut microbiota, impair the gut barrier, and induce inflammatory responses in the GI tract. Statistical analysis shows a significant correlation between microplastic exposure and GI health deterioration across various animal models.</p><p><strong>Conclusions: </strong>The findings underscore the harmful effects of microplastics on GI health, emphasizing the urgent need for policy interventions to reduce plastic pollution. Implementing measures to limit the production and usage of disposable plastics is crucial for mitigating the risks posed by microplastic contamination to promote environmental sustainability and safeguard human well-being.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011006","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":"Overlap of 'disorders of gut-brain interaction' and their impact on quality of life and somatization in a tertiary care center- A cross-sectional study.","authors":"Omesh Goyal, Prerna Goyal, Manjeet Kumar Goyal, Khushi Jain, Vandana Midha, Ajit Sood","doi":"10.1007/s12664-025-01770-y","DOIUrl":"https://doi.org/10.1007/s12664-025-01770-y","url":null,"abstract":"<p><strong>Background: </strong>Disorders of gut-brain interaction (DGBIs) constitute a global health challenge. Overlapping DGBIs amplify the clinical severity and have a profound impact on health-related quality of life (HRQoL) and somatization. Data on the prevalence and overlap of all individual DGBIs and their clinical ramifications remains limited. This study sought to elucidate these aspects within a northern Indian tertiary healthcare setting.</p><p><strong>Methods: </strong>This prospective cross-sectional study enrolled patients meeting Rome IV criteria for DGBIs and healthy controls (HC). Participants underwent elaborative assessments, including socio-demographic profiling, HRQoL evaluation (PROMIS Global-10) and somatization quantification (PHQ-12). Statistical analyses compared prevalence rates, overlap patterns and associated clinical outcomes between various groups.</p><p><strong>Results: </strong>Of the 2538 patients screened, 1044 (41.1%) with DGBIs (age 41.7 ± 12.6 years, 51.9% males) were enrolled; along with 1021 age and gender-matched HCs. Most common gastrointestinal region involved was gastroduodenal (49.9%), followed by bowel (39.7%) and esophageal (33.3%). Most common DGBIs were functional dyspepsia (FD; 44.4%), functional esophageal disorders (FEsD;32.4%), functional constipation (FC;18%), irritable bowel syndrome (IBS;16.1%). Overlapping DGBIs were present in 40.3% patients, with FD-FEsD (23.9%) and FD-FC(22.1%) and FD-IBS (52;12.4%) overlaps being the most common. Compared to HC, DGBI patients had significantly poorer HRQoL scores (19.1 ± 0.7 vs. 13.52 ± 3.39; p < 0.001) and significantly increased somatization scores (2.5 ± 1.7 vs. 18.5 ± 0.7; p < 0.001). Further, patients with overlapping DGBIs had significantly poorer HRQoL and significantly increased somatization scores compared to non-overlapping counterparts.</p><p><strong>Conclusions: </strong>This study provides novel data on the clinical burden and the entire spectrum of overlapping and non-overlapping DGBIs, while studying their impact on HRQoL and somatization. DGBI patients had significantly poorer HRQoL and heightened somatization compared to HCs; with further detriments observed in those with overlapping DGBIs. These findings emphasize the need for an integrated multidisciplinary approach for the evaluation of possible overlaps and for assessment of HRQoL in all patients with DGBIs to improve clinical outcomes.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019950","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":"Impact of bariatric surgery on gut microbiota in obese patients: A systematic review.","authors":"Nima Mohammadzadeh, Shabnam Razavi, Mahla Shahriari, Gholamhossein Ebrahimipour","doi":"10.1007/s12664-025-01763-x","DOIUrl":"https://doi.org/10.1007/s12664-025-01763-x","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a multi-factorial disease linked to various metabolic disorders, including insulin resistance, type-2 diabetes (T2D) and cardiovascular diseases. Traditional treatments often show limited long-term success, while bariatric surgery has emerged as the most effective intervention for sustained weight loss and comorbidity improvement. Alterations in gut microbiota may significantly contribute to these metabolic improvements.</p><p><strong>Objective: </strong>This systematic review was aimed at evaluating changes in gut microbiota composition before and after bariatric surgery and their association with clinical outcomes, including weight loss, insulin sensitivity and lipid metabolism.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of PubMed, Scopus, Web of Science and clinicaltrials.gov databases was conducted for studies published between 2004 and 2024. Keywords included \"bariatric surgery,\" \"gut microbiota\" and \"obesity.\" Inclusion criteria focused on human studies with pre and post-surgical microbiota analysis. Non-human studies, pediatric populations and studies without microbiota assessment were excluded. Data extraction covered microbiota profiles, metabolic outcomes and clinical markers.</p><p><strong>Results: </strong>Total 27 articles and 28 clinical trials met the inclusion criteria. Pre-surgery, obese patients exhibited dysbiosis characterized by reduced microbial diversity and imbalances in key bacterial phyla. Post-surgery, especially after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), patients showed increased microbial diversity, reduced Firmicutes and elevated beneficial bacteria such as Akkermansia muciniphila and short-chain fatty acid (SCFA) producing bacteria. These microbiota changes were correlated with significant improvements in weight loss, insulin sensitivity and lipid profiles. However, some studies reported inconsistent or modest microbiota changes.</p><p><strong>Conclusion: </strong>Bariatric surgery leads to significant gut microbiota alterations that are closely linked to metabolic improvements, including enhanced glucose control and lipid metabolism. However, the long-term sustainability of these microbial changes remains unclear. Longitudinal studies are essential to determine whether these alterations persist over time and how they continuously impact metabolic health. Further research should explore targeted microbiota interventions to maintain beneficial microbial profiles post-surgery.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977901","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":"Precut fistulotomy made easy!","authors":"Venkatesh Vaithiyam, Sanjeev Sachdeva, Ashok Dalal","doi":"10.1007/s12664-025-01772-w","DOIUrl":"https://doi.org/10.1007/s12664-025-01772-w","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788076","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 \"Abbreviated anorectal biofeedback therapy is beneficial in symptomatic improvement of functional defecatory disorder\".","authors":"Mayank Jain","doi":"10.1007/s12664-025-01776-6","DOIUrl":"https://doi.org/10.1007/s12664-025-01776-6","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788074","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":"Impact of sleeve gastrectomy on the course of metabolic associated fatty liver disease.","authors":"Ragaey Ahmad Eid, Dina Attia, Asmaa Srour Soliman, Eman Ahmed Abd Elmaogod, Eman Mohammed AbdelSalam, Ahmed Mohamed Rashad, Ahmed Safaa Ahmed Sayed, Tamer Mohamed Nabil","doi":"10.1007/s12664-025-01757-9","DOIUrl":"https://doi.org/10.1007/s12664-025-01757-9","url":null,"abstract":"<p><strong>Background and aim: </strong>Metabolic associated fatty liver disease (MAFLD) is now a leading cause for chronic liver disease worldwide. Bariatric surgery has a beneficial effect on morbid obesity. We aimed at evaluating the impact of sleeve gastrectomy on the course of metabolic associated fatty liver disease.</p><p><strong>Methods: </strong>An observational prospective cohort study from February 2021 to March 2023 included 66 morbidly obese patients diagnosed with MAFLD. Sleeve gastrectomy was done, where intra-operative liver biopsy was obtained. Baseline values of anthropometric measures, full metabolic profile and liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) using the XL probe were compared with three and six-months post-operatively.</p><p><strong>Results: </strong>Prevalence of MAFLD was histologically diagnosed in 75%. There was a significant decrease in body mass index, circumference, systolic and diastolic blood pressures in the low-density lipoprotein (LDL), triglycerides (TG), cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), LSM by transient elastography measurements in kilo Pascals (TE-kPa) and CAP level from baseline to three and six months post-operatively. Also, the AST/platelets ratio (APRI), NAFLD fibrosis score (NFS), fibrosis-4 (FIB-4) and atheroscelerosis cardiovascular risk score (ASCVD) scores decreased significantly from baseline to six months of follow-up. In MAFLD patients, there was a significant positive linear correlation between the CAP score and TE, between the CAP and AST, ALT, ASCVD score, but a negative correlation with high density lipoprotein (HDL). Also, there was a significant positive correlation between the percentage of decline TE and APRI scores and percentage of decline of CAP, glycated hemoglobin (HbA1c) and homeostasis model assessment for insulin resistance (HOMA-IR).</p><p><strong>Conclusion: </strong>There was a very high prevalence of steatosis and steatohepatitis in asymptomatic morbidly obese patients. Sleeve gastrectomy has a beneficial effect on MAFLD and its associated comorbidities.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763613","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}