Journal of clinical gastroenterology最新文献

{"title":"Wearable Technology and Remote Physiological Monitoring in Inflammatory Bowel Disease: Erratum.","authors":"Harris T Feldman, Joseph Tejan, Rosetti Victoria, Abbas Rupawala, Apurv Soni","doi":"10.1097/MCG.0000000000002436","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002436","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":"60 10","pages":"946"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147364","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 \"Cold Versus Hot Endoscopic Mucosal Resection for ≥15 mm Large Nonpedunculated Colorectal Polyps: A Cost-Effectiveness Analysis\".","authors":"Yiheng Yao, Qingxin Dou, Liang Liu","doi":"10.1097/MCG.0000000000002347","DOIUrl":"10.1097/MCG.0000000000002347","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"948-949"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276492","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":"The July Effect on Mortality, Hospital Length of Stay, and Time to Colonoscopy Among Patients Presenting to Teaching Hospitals With LGIB in the United States.","authors":"Eugene Annor, Chima Amadi, Joseph Atarere, Nneoma Ubah, Oluwatayo J Awolumate, Adedeji Adenusi, Geraldine Nabiryo Nabeta, Darrell Downs, Ayokunle T Abegunde","doi":"10.1097/MCG.0000000000002159","DOIUrl":"10.1097/MCG.0000000000002159","url":null,"abstract":"<p><strong>Background and aim: </strong>The \"July effect\" refers to increased morbidity and mortality observed when new medical trainees start at teaching hospitals in July. This phenomenon has been noted in various conditions but has not been extensively studied in lower gastrointestinal bleeding (LGIB). LGIB accounts for 20% to 30% of major gastrointestinal bleeding admissions, with a mortality rate of 2% to 4%. This study aimed to assess the impact of the \"July effect\" on clinical outcomes for patients with LGIB admitted to teaching hospitals in the United States from 2016 to 2020.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from the Nationwide Inpatient Sample (2016 to 2020). The primary outcomes were inpatient mortality, hospital length of stay (LOS), and delays in early colonoscopy, defined as more than 24 hours from admission. The key variable was the month of admission, categorized into pre-July (May and June) and July effect (July and August) periods. Survey-weighted multivariable logistic and Poisson regression models were used to evaluate the month of admission's impact on outcomes.</p><p><strong>Results: </strong>The study included 27,425 admissions, with 13,746 (50.1%) in May and June and 13,679 (49.9%) in July and August. Less than two-thirds (59.2%) of LGIB admissions received a colonoscopy during hospitalization. Among the 15,708 patients who underwent colonoscopy within 7 days of admission, 40.8% had an early colonoscopy (within 24 h). The overall mean hospital LOS was 4.4 days, with an in-hospital mortality rate of 1%. There was no significant \"July effect\" on delays in early colonoscopy [adjusted odds ratio (aOR) 1.06, 95% CI (0.99, 1.13)], hospital LOS [adjusted incidence rate ratio (aIRR) 1.02, 95% CI (1.00, 1.04)], or in-hospital mortality [aOR 1.17, 95% CI (0.91, 1.50)].</p><p><strong>Conclusion: </strong>The study found no evidence of a \"July effect\" on in-hospital mortality, LOS, or delays in early colonoscopy for LGIB patients. Despite the influx of new trainees in July, patient care for LGIB in teaching hospitals seems consistent, indicating that current protocols and supervision effectively mitigate risks. Further research is needed to explore other factors influencing LGIB outcomes and overall patient care during this period.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"898-903"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501267","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":"The Management of Irritable Bowel Syndrome: A Position Paper of the Neurogastroenterology and Motility Section of the Israeli Gastroenterology Association.","authors":"Fahmi Shibli, Roy Dekel, Ron Yishai, Joseph Lysy, Ami Sperber, Nir Bar, Ronnie Baruch, Sigal Frishman, Anat Nevo Shor, Tiberiu Hershkovici, Tamar Thurm, Amir Mari, Dan Carter, Rita Brun, Yuval Ishay, Ram Dickman","doi":"10.1097/MCG.0000000000002388","DOIUrl":"10.1097/MCG.0000000000002388","url":null,"abstract":"<p><p>Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction with symptoms including abdominal pain associated with a change in stool form or frequency. IBS global prevalence is around 4% and its impact on patient's quality of life and social functioning is substantial. Multidisciplinary working teams of the Israeli Society of Neurogastroenterology and Motility evaluated all validated approaches to IBS management. The aim was to develop a national, evidence-based position document on IBS management for general practitioners and adult and pediatric gastroenterologists. This position document comprehensively reviewed therapeutic options, including patient education (including specific national communities), dietary modifications (particularly the low FODMAP diet), antispasmodic drugs, probiotics, antibiotics (eg, rifaximin), secretagogues (eg, linaclotide), neuromodulators, psychological therapies (including cognitive behavioral therapy and gut-directed hypnotherapy), and complementary medicine approaches. The importance of establishing a positive physician-patient communication with a therapeutic partnership, including an empathic approach and implementation of the bio-psycho-social model, was also strongly emphasized. A structured treatment algorithm incorporating multiple therapeutic tools that are locally available was developed as well. We hope that this position paper will provide a practical and updated tool for the management of IBS in Israel and in other countries as well.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"867-884"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"Efficacy and Safety of Low Volume Bowel Preparation for Colonoscopy in Hospitalized Patients\": A Randomized Noninferiority Trial.","authors":"Liping Li, Chaofan Li, Xingxing Yuan","doi":"10.1097/MCG.0000000000002330","DOIUrl":"10.1097/MCG.0000000000002330","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"947-948"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018720","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":"Diagnostic Accuracy of Biopsy-Sparing Approaches in Adult Celiac Disease.","authors":"Yasemin Kaldirim Armutcuoglu, Haluk Tarik Kani","doi":"10.1097/MCG.0000000000002348","DOIUrl":"10.1097/MCG.0000000000002348","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"948"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146258012","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":"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":"904-910"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","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":"Efficacy of a CBT Self-Help App (Zemedy) Versus an Education, Relaxation, and Mindfulness App for IBS: Results from Post-Treatment, 3-Month, and 6-Month Follow-Up.","authors":"Melissa Hunt, Anika Dalvie, Simay Ipek, Sophia Glinski, Riley Macks","doi":"10.1097/MCG.0000000000002164","DOIUrl":"10.1097/MCG.0000000000002164","url":null,"abstract":"<p><strong>Goals: </strong>To test the efficacy of a self-help cognitive behavioral therapy (CBT) for irritable bowel syndrome (IBS) app compared with an active control app.</p><p><strong>Background: </strong>IBS is a disorder of gut-brain interaction that can result in significant distress, disability, and psychiatric co-morbidity. CBT is an effective treatment for IBS. Self-help CBT apps can increase accessibility but should be tested against active controls.</p><p><strong>Methods: </strong>This randomized controlled trial (NCT04665271) compared a CBT for IBS self-help app (Zemedy) to an active education, lifestyle management, relaxation, and mindfulness control app. A total of 453 individuals were screened in and offered allocation to treatment. Participants who actually downloaded their assigned app (N=267) were evenly split between the CBT app (N=136) and the active control (N=131). Follow-up data (CBT N=74, control N=82) were collected immediately post-treatment, at which point the control group was offered crossover to CBT. Follow-up data were collected at 3 (N=65) and 6 (N=32) months. Primary outcomes included IBS symptom severity and IBS quality of life. Secondary outcomes included catastrophizing, visceral anxiety, fear of food, and depression.</p><p><strong>Results: </strong>At post-treatment, the CBT group improved significantly across all outcomes. The control group also improved on all outcomes except fear of food. In the intent-to-treat analysis the CBT group improved significantly more than the control group on both primary and secondary outcomes except depression. Gains were maintained at 3 and 6 months, although attrition was considerable.</p><p><strong>Conclusion: </strong>Self-help CBT for IBS may be effective and can be delivered successfully through apps, although we did not have data on engagement. Psychoeducation about symptom management strategies, relaxation, and mindfulness are active treatment components, but CBT is better at addressing underlying maintaining factors like catastrophizing, visceral anxiety, and fear of food.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"911-921"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605150","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":"World Gastroenterology Organization (WGO) News and Events.","authors":"Lizzie Murphy","doi":"10.1097/MCG.0000000000002447","DOIUrl":"10.1097/MCG.0000000000002447","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"i"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017030","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":"Endoscopic Resection of Duodenal Neuroendocrine Tumors in a Western Cohort.","authors":"Isaac L Jaben, Garrett G Cole, Gregory A Cote, Brenda Hoffman, B Joseph Elmunzer","doi":"10.1097/MCG.0000000000002318","DOIUrl":"10.1097/MCG.0000000000002318","url":null,"abstract":"<p><strong>Background: </strong>The incidence of duodenal neuroendocrine tumors (D-NETs) has been steadily rising. Endoscopic resection has become the preferred treatment option for smaller, localized lesions. We aimed to corroborate the efficacy and safety of endoscopic resection of D-NETs in a Western population and to evaluate treatment durability and disease course by examining long-term outcomes after resection.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients who underwent endoscopic resection of a nonampullary D-NET from 2012 through 2020 at a single institution in the United States. Demographic, clinical, and procedural data were abstracted in duplicate and independent fashion. Outcomes were assessed through medical records review and follow-up phone calls.</p><p><strong>Results: </strong>Over the study period, 58 patients underwent endoscopic resection of 59 D-NETs. Follow-up data were available in 85% of patients with a median follow-up duration of 23 months. Almost all D-NETs were located in the duodenal bulb, and all were biologically indolent. The mean size 6.6 mm (range: 1 to 27 mm). The most common resection technique was cap- or band-assisted endoscopic mucosal resection (73%). Negative resection margins were achieved in 78% of the sample. Delayed hemorrhage and perforation occurred in 5 and 6 patients, respectively; all but one were managed endoscopically. The presence of residual or recurrent neoplasm was identified at follow-up endoscopy in 10 patients and did not appear to be associated with resection margin status or endoscopic removal technique. No patients required surgical resection of a NET, were diagnosed with metastatic NET, or died as the result of their neuroendocrine tumor during follow-up.</p><p><strong>Conclusion: </strong>Endoscopic resection appears to be reasonably safe and durably effective in treating localized duodenal neuroendocrine tumors, but attention to endoscopic rescue of adverse events and to follow-up is necessary.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"893-897"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959489","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}