Indian Journal of Gastroenterology最新文献

{"title":"A comprehensive clinical and microbiological study on the diagnosis and management of cholangitis in patients with biliary atresia undergoing kasai portoenterostomy.","authors":"Merna Adel Aziz, Hala Mohsen Abdullatif, May S Soliman, Sawsan Okasha, Nevian Nabil, Mariam Mahmoud Balah, Hanaa El-Karaksy","doi":"10.1007/s12664-024-01721-z","DOIUrl":"10.1007/s12664-024-01721-z","url":null,"abstract":"<p><strong>Background and objectives: </strong>Kasai-portoenterostomy (KPE) is the initial attempt to restore the bile flow and salvage the native liver in biliary atresia (BA) patients. Cholangitis is a frequent complication after KPE and adequate treatment impacts the long-term outcome. The aim of our study is to assess the severity of cholangitis episodes in a cohort of BA patients post KPE, identify the causative agents, using several diagnostic methods, as well as to assess the tolerability and efficacy of our antimicrobial protocol.</p><p><strong>Methods: </strong>This analytical retrospective observational study, conducted at Pediatric Hepatology Unit, Cairo University Pediatric Hospital, included infants and children with cholangitis post-KPE enrolled over 30 months. Clinical data collection, basic laboratory investigations inflammatory markers, B-D glucan, blood culture, 16SrDNA, 18SrDNA were performed in all enrolled patients. Cholangitis episodes were treated with intravenous antibiotics according to our antimicrobial protocol that has been implemented in conjunction with the antimicrobial stewardship committee.</p><p><strong>Results: </strong>This study included 30 post-KPE patients, who experienced 47 episodes of cholangitis. Twenty-five episodes of cholangitis were culture positive cholangitis (positive blood culture and/or PCR results and/or liver biopsy). Klebsiella Variicola and Klebsiella pneumoniae were the most prevalent pathogens in 13 and seven cultures, respectively. Meropenem was the most successful antibiotic in the eradication of infection in 11(23.4%) episodes. Culture positive cholangitis showed increased incidence of sepsis and worse outcome in comparison to culture negative cholangitis. The severity of cholangitis was classified into 16 patients (34%) with infection, 28 (60%) sepsis, one (2%) severe sepsis and two (4%) septic shock.</p><p><strong>Conclusion: </strong>Almost half of cholangitis episodes were culture-positive; the commonest pathogen was Klebsiella, showing more severe sepsis and worse outcome.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"506-516"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614810","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":"Opium addiction is associated with increased risk of ERCP-related complications: A matched case-control study.","authors":"Amir Sadeghi, Ehsan Bahrami Hezaveh, Erfan Arabpour, Parya Mozafari Komesh Tape, Reyhaneh Rastegar, Mohammad Reza Zali","doi":"10.1007/s12664-025-01771-x","DOIUrl":"10.1007/s12664-025-01771-x","url":null,"abstract":"<p><strong>Objective: </strong>The potential impact of opium addiction on medical procedures has not been thoroughly investigated. In the present study, we aimed at investigating the potential association between opium addiction and the outcomes of endoscopic retrograde cholangiopancreatography (ERCP).</p><p><strong>Methods: </strong>In this retrospective case-control study, patients who underwent ERCP between July 2021 and October 2023 at a tertiary care center were screened and patients with opium addiction were matched with non-addict patients based on age, sex, ERCP indication and the cannulation approach at 1:1 ratio. The analysis compared the ERCP findings and post-ERCP complications between the two groups.</p><p><strong>Results: </strong>Overall, 276 patients with and without opium addiction were included (n = 138 for each group). The overall complication rate in the opium group was 10.1%, significantly higher than the control group (1.4%) (p = 0.003). Post-ERCP pancreatitis (5.8% vs. 1.4%, p = 0.046), bleeding (2.9% vs. 0%, p = 0.044) and perforation (1.4% vs. 0%, p = 0.156) were more common in the opium group. The procedural success rate of ERCP was 79.0% in opium group, while patients without opium addiction had a success rate of 85.5%, but it was not statistically significant (p = 0.207).</p><p><strong>Conclusion: </strong>ERCP could be associated with higher rate of complications in opium-addict patients. Accurate procedural techniques and appropriate prophylaxis should be considered to reduce the risk of complications.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"496-505"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173691","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":"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":"457-477"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","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":"Endoscopic stricturotomy for inflammatory bowel disease strictures in anatomically challenging locations (deep small bowel, duodenum, anal canal and pouch): A case series with technical review (with videos).","authors":"Partha Pal, Zaheer Nabi, Mohan Ramchandani, Kanapuram Pooja, Rajesh Gupta, Manu Tandan, D Nageshwar Reddy","doi":"10.1007/s12664-025-01754-y","DOIUrl":"10.1007/s12664-025-01754-y","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"543-546"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624370","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":"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":"478-488"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","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":"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":"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":"517-524"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","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":"Anemia in inflammatory bowel disease-A comprehensive review.","authors":"Amit Kumar Dutta, Hemanth Chinthala, John Titus George, David Mathew Thomas, Anjilivelil Joseph Joseph","doi":"10.1007/s12664-024-01735-7","DOIUrl":"10.1007/s12664-024-01735-7","url":null,"abstract":"<p><p>Anemia is a frequent complication in inflammatory bowel disease (IBD) patients. The etiology is multifactorial, with iron deficiency and anemia of chronic disease being the main reasons. Other causes include vitamin B₁₂ and folate deficiency, hemolytic anemia and medications such as azathioprine and sulfasalazine. Apart from physical symptoms, it is associated with several negative outcomes, including poor quality of life, increased risk of hospital admission, increased risk of surgery and higher treatment costs. Diagnostic evaluation aims to identify the underlying cause and severity to determine the appropriate therapeutic strategy. Investigations include a complete blood count, iron indices, inflammatory markers and vitamin B₁₂ and folate levels. Patients with iron deficiency need adequate replacement therapy to improve hemoglobin and replenish iron stores. Those with moderate to severe anemia and/or active disease need intravenous iron, while mild anemia can be treated with oral iron. Multiple parenteral iron formulations are available which differ in dose and frequency of administration. Traditional oral iron supplements are available in ferrous forms, which, although effective, are associated with gastrointestinal side effects. Newer oral iron formulations have helped reduce these adverse effects but are expensive. Anemia of chronic disease is mainly driven by the effects of inflammatory mediators on iron metabolism and erythropoiesis and treatment requires control of disease activity. Relapse of anemia after therapy is frequent; hence, patients need to be closely followed up for early detection and appropriate management. Significant advances have been made in understanding the pathophysiology of anemia in IBD and better and safer iron formulations are available. However, a significant proportion of IBD patients with anemia go undetected or untreated and there is a need for improved recognition and better management practices. This review discusses various aspects of anemia in IBD and the current approach to diagnosis and management.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"430-442"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424847","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, Shikar Singh, Pratima Sharma","doi":"10.1007/s12664-025-01839-8","DOIUrl":"https://doi.org/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":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","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":"Differentiating perianal fistulizing Crohn's disease from cryptoglandular fistulae: Moving towards early and accurate diagnosis.","authors":"Easan Anand, Phil Tozer, Phillip Lung, Ailsa Hart","doi":"10.1007/s12664-025-01828-x","DOIUrl":"https://doi.org/10.1007/s12664-025-01828-x","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730094","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":"Frequency of dermatological manifestations in patients with chronic hepatitis C infections.","authors":"Sayan Malakar, Saurabh Mishra, Sumit Rungta, Arvind Kumar, Amar Deep","doi":"10.1007/s12664-025-01843-y","DOIUrl":"https://doi.org/10.1007/s12664-025-01843-y","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730095","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}