Indian Journal of Gastroenterology最新文献

{"title":"Pancreatic enzyme replacement therapy for exocrine pancreatic insufficiency-Insights into prescribing practices.","authors":"Sudipta Dhar Chowdhury, Soumya Jagannath Mahapatra, Reuben Thomas Kurien, Ajith Thomas, Gauri Kumbhar, Pramod Kumar Garg","doi":"10.1007/s12664-026-02046-9","DOIUrl":"https://doi.org/10.1007/s12664-026-02046-9","url":null,"abstract":"<p><strong>Introduction: </strong>Exocrine pancreatic insufficiency (EPI) can affect individuals with a wide range of diseases. Despite the publication of multiple international guidelines, the prescribing practices vary across the globe. The present study was done with an aim to assess how doctors in India evaluate and manage EPI, focusing on usage of pancreatic exocrine replacement therapy (PERT) and barriers to its use.</p><p><strong>Methods: </strong>This was a cross-sectional questionnaire-based survey using Google forms. Doctors practicing gastroenterology were invited using email, social media networks to participate voluntarily. Trainees were excluded to ensure that the responses reflected independent clinical practice. The questionnaire was designed to assess the following domains: evaluation of EPI, use of PERT, response to therapy, strategies for non-response and perceived barriers to therapy.</p><p><strong>Results: </strong>Total 586 doctors were approached for the questionnaire survey between May 2023 and January 2024. Responses were received from 520 doctors, eight were excluded as they were still in training. Among the doctors most were gastroenterologists, in private practice with a mean age of 42.2 (SD 9.4) years. Fecal elastase-1 appeared to be the most popular test for testing EPI. The most common indication for starting PERT was symptomatic EPI. Approximately 50% of doctors reported prescribing PERT in the setting of AP. The most common indication for PERT in acute pancreatitis was acute necrotizing pancreatitis (ANP). Most doctors prescribed 25,000 lipase units with each major meal and 10,000 units with snacks. Cost of therapy appeared as the biggest limitation for therapy with PERT. A majority (86.1%) of doctors were assessed for response, relying primarily on clinical indicators. Non-response is managed by dose increase and adjunctive therapies.</p><p><strong>Discussion: </strong>This large questionnaire-based survey conducted across India suggests that while the management of EPI generally aligns with published international guidelines, there is a pressing need for India-specific recommendations, particularly to address cost-related barriers that impact access to PERT.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792268","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 non-invasive tools may better predict esophageal varices and their management.","authors":"Abhirup Chatterjee","doi":"10.1007/s12664-026-02051-y","DOIUrl":"https://doi.org/10.1007/s12664-026-02051-y","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764786","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: A valuable investigation.","authors":"Jing Zhang, Lin-Jing Wang, Jin-Feng Chi","doi":"10.1007/s12664-025-01862-9","DOIUrl":"10.1007/s12664-025-01862-9","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"780-781"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855129","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":"Video capsule endoscopic appearance of small intestinal varices causing obscure gastrointestinal bleeding.","authors":"Suprabhat Giri, Preetam Nath, Bipadabhanjan Mallick, Dibya Lochan Praharaj","doi":"10.1007/s12664-024-01594-2","DOIUrl":"10.1007/s12664-024-01594-2","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"792-793"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848838","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":"Prevention of bile duct injury - A bird's eye view.","authors":"Sadiq S Sikora, Mohammad Ibrarullah","doi":"10.1007/s12664-025-01885-2","DOIUrl":"10.1007/s12664-025-01885-2","url":null,"abstract":"<p><p>Gallstone disease is a common ailment and laparoscopic cholecystectomy (LC) is the most commonly performed surgical procedure for the treatment of symptomatic gallstones. Bile duct injury (BDI) is a serious complication reported in 0.1% to 0.2% and 0.15% to 0.36% of patients undergoing open and LC, respectively. The higher incidence of BDI following LC is a matter of grave concern that needs redressal. The cause and mechanism of BDI can be classified into gallbladder, patient or surgeon-related factors. Variable anatomy or inflammatory obliteration of the hepatocystic triangle (HCT), male sex, obese patient are some for the important causes for difficult cholecystectomy. A thorough pre-operative evaluation, delineation of anatomy in HCT to establish critical view of safety (CVS), alternative \"bailout\" techniques when CVS is not achievable, and use of intra-operative cholangiogram are considered the important strategies in performing safe cholecystectomy. Consensus guidelines have evolved in several multicentric studies to perform safe cholecystectomy with respect to prevention of BDI. The merits of CVS have been validated globally and recommended as the single most important factor in this regard. Surgeons strictly adhering to the CVS guidelines report significant reduction in the incidence of BDI. In this article, the predictors of difficult cholecystectomy, salient features of the technique of safe cholecystectomy, the bailout strategies and the role of intra-operative cholangiogram have been discussed. The suggested recommendations in this article are based on detailed review of the available literature and the guidelines suggested by several international societies.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"680-689"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145603919","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: Response to correspondence.","authors":"Rajalatchumi Poorasamy, Sadhana Subramanian, Palanivel Chinnakali","doi":"10.1007/s12664-025-01878-1","DOIUrl":"10.1007/s12664-025-01878-1","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"782-783"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039955","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":"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":"745-755"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","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}

{"title":"Abbreviated anorectal biofeedback therapy is beneficial in symptomatic improvement of functional defecatory disorder.","authors":"Stephan Benny, Noble Varghese Mathews, Ajith Thomas, Anoop John, Reuben Thomas Kurien, Sudipta Dhar Chowdhury, Amit Kumar Dutta, Ebby George Simon, A J Joseph, Rajeeb Jaleel","doi":"10.1007/s12664-025-01752-0","DOIUrl":"10.1007/s12664-025-01752-0","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"767-769"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614812","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":"Age-stratified prevalence of anti-hepatitis A virus antibodies in four metropolitan Indian cities and recent changes in Pune city.","authors":"Sanjay Lalwani, Sonali Palkar, Balasubramanian S, Gurmeet Kaur, Monjori Mitra, Rupeshkumar Deshmukh, Ruta Kulkarni, Vidya Arankalle","doi":"10.1007/s12664-025-01746-y","DOIUrl":"10.1007/s12664-025-01746-y","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pune, western India, was earlier identified as hyperendemic for hepatitis A. Subsequently, we noted age and socio-economic status-dependent reduction in hepatitis A virus (HAV) prevalence. To assess the situation in different parts of India, this multicentric, hospital-based, cross-sectional study was conducted in four metropolitan cities in the northern/southern/eastern/western regions.</p><p><strong>Methods: </strong>As per age group-anti-HAV-positivity-specific sample size calculations (1-40 years), 496 samples/centre were collected from Pune, Kolkata, Chennai and Ludhiana. All samples were tested for anti-HAV antibodies using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Overall, 44.9% of children up to five years of age were anti-HAV antibody-positive (ELISA), with a steady increase reaching 92.9% by the age of 26-40 years. Importantly, 782/1756 (44.5%) of the total population ≤ 15 years was anti-HAV negative and hence susceptible to HAV. The city-wise analysis documented similar patterns with a few differences. According to the World Health Organization (WHO) classification of HAV endemicity, Pune, Chennai and Ludhiana were classified as cities with intermediate endemicity, whereas Kolkata with lower seroprevalence had low endemicity. Compared to the 2011-2012 survey anti-HAV positivity remained unchanged in the other cities except for the rise in Chennai. Apart from age, other risk factors varied in different cities. A comparison of socio-economic-dependent, age-stratified serosurveys conducted during 1982, 1992, 1998, 2017 and 2022 in Pune documented the shift from high to intermediate endemicity in the population with high socio-economic status in 1998 and lower-middle socio-economic strata in 2017.</p><p><strong>Conclusion: </strong>The lowering of anti-HAV positivity reflects a definite improvement in sanitation and voluntary vaccination, but seems to have slowed down during recent years. Additional, well-defined efforts are necessary.</p>","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"735-744"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572319","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":"Pancreatic ductal adenocarcinoma with localized lymphangitis carcinomatosis causing gastric outlet obstruction.","authors":"Vibhu Jain, Santhosh Irrinki, Kailash Chand Kurdia, Uma Nahar, Rajender Kumar","doi":"10.1007/s12664-024-01671-6","DOIUrl":"10.1007/s12664-024-01671-6","url":null,"abstract":"","PeriodicalId":13404,"journal":{"name":"Indian Journal of Gastroenterology","volume":" ","pages":"796-798"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017379","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}