Journal of clinical gastroenterology最新文献

{"title":"The Lactulose Breath Test can Predict Refractory Gastroesophageal Reflux Disease by Measuring Bacterial Overgrowth in the Small Intestine.","authors":"Pelin Telli, Aynura Rustamzada, Bilger Çavuş","doi":"10.1097/MCG.0000000000002226","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002226","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Diagnostic Yield of Video Capsule Endoscopy in Celiac Disease: A Methodological Perspective.","authors":"Javier Arredondo Montero","doi":"10.1097/MCG.0000000000002225","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002225","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjunctive Incremental Pregabalin Therapy Leads to Better Pain Relief in Patients With Chronic Pancreatitis: A Double-blind Randomized Controlled Trial.","authors":"Randeep Rana, Samagra Agarwal, Sumaira Qamar, Srikanth Gopi, Renu Bhatia, Kumble Seetharama Madhusudhan, Deepak Gunjan, Anoop Saraya","doi":"10.1097/MCG.0000000000002173","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002173","url":null,"abstract":"<p><strong>Objectives: </strong>Gabapentinoids like pregabalin have been inadequately explored in patients with painful chronic pancreatitis (CP) on a long-term basis. The objective was to study the pain relief on pregabalin as an adjunct therapy for 12 weeks in painful CP.</p><p><strong>Materials and methods: </strong>In this double blind, randomized placebo-controlled trial, patients with painful CP with no ongoing inflammation(no pseudocyst/inflammatory head mass) or significant obstruction were randomized to receive either incremental doses of pregabalin or placebo for 12 weeks. The primary outcome was change in Izbicki pain score. Change in the quality of life (QoL) (SF-36 questionnaire), interference of pain with daily life [modified brief pain inventory- short form (mBPI-SF)] and patients' global impression of change (PGIC) were assessed as secondary outcomes. Tolerability and adverse effects were noted as safety outcomes. As an exploratory outcome, the role of quantitative sensory testing (QST) to predict patients' response to pregabalin was assessed.</p><p><strong>Results: </strong>Fifty-five patients with painful CP (age 29.9±10.6 y; 79% males; median illness duration 36 mo) were randomized to receive pregabalin (n=30) or placebo (n=25). Change in Izbicki pain score was significantly better in pregabalin group [pregabalin: -23.75 (IQR: -9.69 to -43.75) versus placebo: -8.75 (3.44 to -17.50); P=0.005]. Overall QoL and PGIC were also better and interference of pain with daily activities reduced in the pregabalin group [median change BPI severity pregabalin: -1.83 (-0.83 to -3.75) versus placebo: -0.67 (0.33 to -1.42); P=0.008; BPI interference pregabalin: -2.64 (-0.33 to -5.21) versus placebo: -0.43 (1.18 to -2.29); P=0.009]. Frequent adverse events included sleepiness (51.7%) and giddiness (58%) but drug discontinuation occurred in only 10.4% of patients. No QST parameters could predict pain response to pregabalin.</p><p><strong>Conclusions: </strong>Pregabalin is a useful adjunct to pain management in patients with CP.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastro-Entero-Colic Fistula After Successful EUS Guided Gastroenterostomy: Initial Lessons Learned From an International Cohort.","authors":"Antonio Mendoza Ladd, Michel Ladna, Luke Pecha, Enrique Perez Cuadrado, Kaveh Sharzehi, Meera Bhardwaj, Samuel Han, Jorge Vargas, Sumant Inamdar, Khanh Do-Cong Pham, Olaya Brewer, Christoph Schlag, Pieter Hindryckx, Tomas Hucl, Amrita Sethi, Viliam Masaryk, Harshit Khara","doi":"10.1097/MCG.0000000000002178","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002178","url":null,"abstract":"<p><strong>Background: </strong>EUS-guided gastroenterostomy (EUS-GE) is an effective option for the management of gastric outlet obstruction (GOO). Due to the poor prognosis of patients undergoing it, data on its long-term adverse events (AE) is scarce. Herein, we describe a cohort of patients with gastro-entero-colic fistula (GECF) as a late AE of previously successful EUS-GE.</p><p><strong>Methods: </strong>Patients who developed a GECF after EUS-GE from 10 high-volume centers were analyzed. Information collected included demographic characteristics, indications, clinical and technical success rates, stent type and size, fistula characteristics, management, and outcomes.</p><p><strong>Results: </strong>Sixteen cases were identified. The mean interval from index EUS-GE to the diagnosis of GECF was 4 to 8 weeks. The most common cause of GOO was pancreatic adenocarcinoma (PDAC). The transverse colon was the most common site for the GECF (14 patients). A 20×10 mm lumen apposing metal stent (LAMS) was utilized in 10 patients. Endoscopic management with a variety of modalities was successful in 13 cases. Follow-up interval after endoscopic management of the fistula averaged 2 to 4 weeks. At the time of the manuscript elaboration, 10 patients had died, 5 were alive, and 1 was lost to follow-up.</p><p><strong>Conclusions: </strong>This is the first description of a cohort of patients with GECF after EUS-GE. The exact mechanisms leading to GECF in these cases are unknown. Possible explanations include inadvertent colon puncture during the index procedure and/or entrapment of mesocolon. More data is needed to further characterize this AE.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Helicobacter pylori Infection Status and Clarithromycin-resistant Strains in Patients With Gastric Mucosa-associated Lymphoid Tissue Lymphoma Using Real-time Polymerase Chain Reaction: A Single-center Korean Study.","authors":"Joo Yeon Koo, Nah Ihm Kim, Sung Sun Kim, Ji Young Lee, Jae-Hyuk Lee, Sook In Jung, Tae Mi Yoon, Jong-Hwan Park, Wan-Sik Lee, Sung-Bum Cho, Kyung-Hwa Lee","doi":"10.1097/MCG.0000000000002182","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002182","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori (HP) is a well-known risk factor for gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, the prevalence of clarithromycin-resistant (CLR) HP strains in patients with gastric MALT lymphoma compared with the general population is largely unknown.</p><p><strong>Materials and methods: </strong>HP test was performed on samples from 4686 patients who underwent gastric biopsy, including 89 patients who were diagnosed with gastric MALT lymphoma. HP infection and resistant strains (A2142G and A2143G) were investigated using real-time polymerase chain reaction.</p><p><strong>Results: </strong>HP was detected in 1964 out of 4597 cases in the non-MALT control group (42.7%), while HP infection was present in 51 out of 89 cases (57.3%) in the gastric MALT lymphoma group (P=0.006). The frequency of CLR strains was 39.2% (20 out of 51 cases) in the gastric MALT lymphoma group, which was significantly higher than the rate of 26.8% (527 out of 1964 cases) in the non-MALT control patient group (P=0.049). The proportion of the resistant strain A2142G was higher in the gastric MALT lymphoma group (20.0%, 4/20) than in the non-MALT control patient group (11.0%, 58/527), with marginal statistical significance (P=0.093).</p><p><strong>Conclusions: </strong>The significantly higher infection rate of CLR HP in patients with gastric MALT lymphoma suggests a reduced likelihood of successful tumor regression using clarithromycin-based first-line eradication therapy.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lean Metabolic Dysfunction-Associated Steatotic Liver Disease is a Confusing Definition. Comment on \"Lean Metabolic Dysfunction-Associated Steatotic Liver Disease: A Comparative Analysis of Hepatic and Oncological Outcomes\".","authors":"Enzo Emanuele, Piercarlo Minoretti","doi":"10.1097/MCG.0000000000002191","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002191","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition and Opioid Use Disorder Are Associated With Higher 30-day Readmission Rates in Patients Admitted for Ulcerative Colitis.","authors":"Tarek Odah, Pedro Palacios, Marianny Sulbaran, Daniela Fluxa, Jami Kinnucan, Michael F Picco, Jana G Hashash, Francis A Farraye","doi":"10.1097/MCG.0000000000002189","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002189","url":null,"abstract":"<p><strong>Background and goals: </strong>Ulcerative colitis (UC) readmissions to the hospital pose a burden to patients and health care systems. Preventing readmissions is important for the quality of care and quality of life of patients with UC. We aimed to identify the incidence of 30 and 90-day readmissions and its predictors in patients with UC.</p><p><strong>Study: </strong>Retrospective review of the 2018 National Readmission Database (NRD) of adult patients readmitted after an index admission (IA) of UC. ICD-10CM/PCS codes were used to identify patients with UC, other comorbidities, and procedures. We identified the most common causes for readmission and independent risk factors for readmission were identified using Cox regression analysis.</p><p><strong>Results: </strong>The 30 and 90-day readmission rates for UC in 2018 were 16.6% and 28.3%. In-hospital mortality and mean length of stay were higher in patients readmitted within both 30 and 90 days. Independent predictors of 30-day readmission were higher Charlson Comorbidity Index (CCI), undergoing ileostomy, increasing length of stay, malnutrition and opioid use disorder at IA. In the 90-day readmission cohort, independent predictors were CCI score of 2 or ≥3, developing shock, admission to large bed size hospitals, undergoing colectomy, increasing length of stay and opioid use disorder at IA. The number one readmission cause at 30 and 90 days was sepsis of unspecified organism.</p><p><strong>Conclusion: </strong>Readmission is associated with higher mortality and is associated with risk factors such as malnutrition, undergoing ileostomy during IA and opioid use disorder. Readmissions in UC continue to pose a high burden to patients and our health care system.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal Immunochemical Tests for Colorectal Cancer Screening: Mailed Outreach Outperforms In-Clinic Outreach With Phone Calls Being the Most Effective Reminder Strategy.","authors":"Kanika Malani, Gabriel Dayanim, Jennifer Ouellette, Yetunde Shittu, Theresetta Myers, Yousef Elfanagely, Kirsten Loscalzo, Kittichai Promrat","doi":"10.1097/MCG.0000000000002183","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002183","url":null,"abstract":"<p><strong>Goals: </strong>This study aimed to (1) compare colorectal cancer (CRC) screening rates among patients receiving mailed fecal immunochemical testing (FIT) versus in-clinic FIT and (2) assess the impact of various reminder interventions versus no extra reminder on mailed FIT completion.</p><p><strong>Background: </strong>FIT is a first-line method for CRC screening. However, no research has compared screening completion in patients receiving FIT through mail (mailed FIT) versus patients receiving FIT from a provider in a clinic setting (in-clinic FIT), both of which have significantly different workflows. Furthermore, limited research has compared whether varying reminder strategies improve mailed FIT completion.</p><p><strong>Study: </strong>This quality improvement prospective cohort study conducted at the Providence Veterans Affairs Medical Center included patients due for average-risk CRC screening. Sixteen hundred patients were mailed FIT, and if FIT was not returned within 1 month they were randomized to the following reminders: no extra reminder, personal phone call, personal voicemail, mailed postcard. Simultaneously, 1769 patients received in-clinic FIT. Three-month return and result rates were compared between mailed versus in-clinic FIT, as well as across the different mailed FIT reminder interventions.</p><p><strong>Results: </strong>Mailed FIT return (36%) and result (34%) rates were significantly higher than in-clinic FIT return (28%) and result (24%) rates (both P<0.0001). Phone calls were the most effective mailed FIT reminder (29% return rate), significantly outperforming the no extra reminder group (21% return rate, P=0.02).</p><p><strong>Conclusions: </strong>Mailed FIT demonstrated higher efficacy and should be implemented in conjunction with in-clinic FIT. Phone call reminders should be incorporated into the mailed FIT workflow.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Pancreatic Cancer and Precancerous Lesions in Patients With Chronic Pancreatitis: A Systematic Review and Meta-Analysis.","authors":"Aaron Wen, Si Yuan Pan, Kayla Dadgar, Mohammad Yaghoobi","doi":"10.1097/MCG.0000000000002187","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002187","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic cancer (PC) is the third leading cause of cancer-related death in Canada. Risk factors for the development of PC are not well defined and there is limited data on the role of pancreatitis as a risk factor for PC. Here we aimed at evaluating this relationship in a meta-analysis.</p><p><strong>Methods: </strong>A comprehensive search was performed by 2 reviewers using MEDLINE, EMBASE, CENTRAL, and Web of Science databases from inception to September 2024 for case-control studies reporting prevalence of acute or chronic pancreatitis in adult patients with PC or precancerous lesions, including pancreatic ductal adenocarcinomas (PDACs), intraductal papillary mucinous neoplasms (IPMNs), and others, as compared with controls. Data screening and extraction and risk of bias (using the ROBINS-E assessment tool) were performed independently by 2 authors. Outcomes of interest included the number of patients with a history of pancreatitis, characteristics of pancreatitis, treatments, complications, comorbidities, and prevalence of other cancers. Bayesian random effect meta-analysis was used to calculate hazard ratios for the development of PC in acute and chronic pancreatitis, along with their 95% CIs.</p><p><strong>Results: </strong>A total of 28 studies included 432,588 patients: 59,151 cases of PC, 1201 cases of IPMN, and 372,236 controls. Risk of developing PC in patients previously diagnosed with acute or chronic pancreatitis was greater than those without (HR: 5.69, 95% CI: 4.41-7.36), with the risk from chronic pancreatitis (HR: 7.82, 95% CI: 5.25-11.65) being double that of acute pancreatitis (HR: 3.54, 95% CI: 1.84-6.80). Studies examining PDAC patients (n=8) presented similar findings (HR: 6.57, 95% CI: 5.31-8.14), although studies with IPMN patients (n=2) seemed to find a greater association (HR: 17.19, 95% CI: 8.83-33.46), but with limited study power and possible sampling bias. A total of 15 studies did not specify PC type but demonstrated a similar association (HR: 4.68, 95% CI: 2.75-7.94). Sensitivity analyses by age, gender, and risk of bias confirmed the results. Most studies were graded as \"some concerns\" when assessing for risk of bias, mainly due to unavailable protocols.</p><p><strong>Conclusions: </strong>This study showed a statistically significant increase in risk of developing PC in patients with a history of pancreatitis. Further cost-effective analyses may be required to determine the best screening modalities in this population.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"Meta-analysis of Endoscopic Full-thickness Resection Versus Endoscopic Submucosal Dissection for Complex Colorectal Lesions\".","authors":"Simin Ye, Xiu Chen","doi":"10.1097/MCG.0000000000002181","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002181","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}