Journal of clinical gastroenterology最新文献

{"title":"Comparison of the Efficacy of Dexrabeprazole and Rabeprazole in Inhibiting Intragastric and Intraesophageal Acidity in Gastroesophageal Reflux Disease.","authors":"Elvan Isik, Serhat Bor","doi":"10.1097/MCG.0000000000002449","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002449","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) are the cornerstone of gastroesophageal reflux disease (GERD) treatment, but concerns regarding their efficacy and side effects persist. Dexrabeprazole, the R(+) enantiomer of rabeprazole, may offer similar efficacy with a lower dose, potentially addressing these issues.</p><p><strong>Aim: </strong>This study aimed to compare the efficacy and safety of dexrabeprazole 10 mg and rabeprazole 20 mg in GERD patients with pathologic acid reflux.</p><p><strong>Method: </strong>A total of 48 GERD patients were included: 24 received dexrabeprazole 10 mg and 24 constituted the historical active-control group receiving rabeprazole 20 mg, once daily for 7 days. Gastric and intraesophageal acidity, GERD symptoms (heartburn, regurgitation), and adverse event frequency were assessed pre- and post-treatment.</p><p><strong>Results: </strong>Both groups showed significant improvements in esophageal and gastric acidity, acid reflux frequency, and GERD symptoms. Dexrabeprazole 10 mg significantly reduced regurgitation scores by day 1 (P=0.001), whereas rabeprazole 20 mg did not achieve similar reductions at this time point (P=0.114). In addition, the reduction in 24-hour intraesophageal pH <4 times was greater in the dexrabeprazole group (P=0.035). There were no significant differences in adverse events or laboratory findings between groups.</p><p><strong>Conclusion: </strong>Dexrabeprazole 10 mg demonstrated comparable efficacy to rabeprazole 20 mg and provided faster improvement in regurgitation and a greater reduction in intraesophageal acid exposure. These findings suggest that dexrabeprazole 10 mg may be an effective alternative to higher doses of rabeprazole in GERD management. Further studies are warranted to confirm these results and explore their long-term benefits.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228056","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 Trajectory of Gastrointestinal Symptom Experience Following Fecal Microbiota Transplant for Recurrent Clostridioides Difficile Infection.","authors":"Hijab Zehra, Nataliia Kuchma, Annie W Lin, Glen Morris, Olivia Solano, Sharon Lopez, Amanda J Kabage, Byron P Vaughn, Alexa Weingarden, Monika Fischer, Alexander Khoruts, Levi Teigen","doi":"10.1097/MCG.0000000000002424","DOIUrl":"10.1097/MCG.0000000000002424","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent Clostridioides difficile infection (rCDI) increases the risk of persistent gastrointestinal symptoms after treatment. Although fecal microbiota transplantation (FMT) effectively prevents CDI recurrence after antibiotics, the trajectory of gastrointestinal symptom severity remains poorly characterized.</p><p><strong>Methods: </strong>We tracked gastrointestinal symptom severity in a prospective, multicenter cohort study of adults with rCDI after treatment with standardized FMT products. Patients who experienced a CDI recurrence during the follow-up period were excluded. The IBS Symptom Severity Scale (IBS-SSS) was used as a measure of symptom severity, not as a diagnostic tool. Patients completed the IBS-SSS at the time of FMT, 1-week, 1-month, and 3-months post-FMT. The primary outcome was the change in IBS-SSS score after treatment. Subgroup analyses were conducted among patients with baseline IBS-SSS ≥175 (moderate/severe symptom severity) and <175 (none/mild symptom severity). Linear mixed-effects models were used to evaluate longitudinal changes and identify clinical predictors of IBS-SSS scores.</p><p><strong>Results: </strong>Among 107 patients included, median IBS-SSS scores decreased from 170 (range: 0 to 440) at baseline to 76 (range: 0 to 390) at week 1 and 54 (0 to 445) at month 3 (P<0.001). In those with baseline IBS-SSS ≥175 (n=51), 64% had none or mild symptom severity at month 3. In those with baseline IBS-SSS <175 (n=53), symptom severity was observed to remain as none or mild at month 3 in all but one patient.</p><p><strong>Conclusion: </strong>FMT administered for prevention of rCDI was followed by a rapid (1 wk) and sustained (3 mo) reduction in gastrointestinal symptom scores in patients who did not develop CDI recurrence. These data help characterize the expected early post-FMT symptom trajectory, providing foundational evidence to better inform patient expectations and future interventions for persistent symptoms.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149193989","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":"Monoclonal Antibody Therapy in Eosinophilic Esophagitis: A Narrative Review of Effects on Dysphagia, Histologic Response, and Endoscopic Outcomes.","authors":"Nwal Hadaki, Bisher Sawaf, Kyrillos M Gerges, Hassam Cheema, Adam Alhaddad, Amr Kais, Akira Saito, Mohammad Al-Haddad","doi":"10.1097/MCG.0000000000002450","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002450","url":null,"abstract":"<p><p>Eosinophilic esophagitis (EoE) is a chronic immune-mediated inflammatory disorder characterized by esophageal eosinophilic infiltration and symptoms of esophageal dysfunction, most notably dysphagia and food impaction. The prevalence of EoE has increased substantially over the past 2 decades, and the disease is now recognized as a major cause of esophageal morbidity in both adults and adolescents. Although proton pump inhibitors, swallowed topical corticosteroids, dietary elimination strategies, and endoscopic dilation remain the cornerstone of therapy, a considerable proportion of patients experience persistent symptoms, disease recurrence, or treatment-related limitations. Advances in understanding the immunopathogenesis of EoE have identified type 2 inflammatory pathways as central drivers of disease activity, leading to the development of targeted monoclonal antibody therapies. Several monoclonal antibodies directed against interleukin-4, interleukin-5, interleukin-13, and Siglec-8 have been evaluated in randomized controlled trials, demonstrating variable effects on clinical symptoms, histologic remission, and endoscopic disease severity. This review synthesizes current evidence on monoclonal antibody therapy for EoE in adolescents and adults, with emphasis on their mechanistic rationale, clinical efficacy, and limitations. Particular attention is given to the frequently observed discordance between symptomatic improvement and histologic or endoscopic response. Current guideline recommendations, regulatory considerations, and future research directions are also discussed.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194067","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":"Trends and Projections of Esophageal Cancer Incidence and Mortality in China, 1990 to 2050: An Analysis of the Global Burden of Disease Study 2023.","authors":"Peng Su, Yanzhao Xu, Shiwang Wen, Huilai Lv, Yonggang Zhu, Huisen Wang, Ziqiang Tian","doi":"10.1097/MCG.0000000000002437","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002437","url":null,"abstract":"<p><strong>Goals: </strong>The study aims to analyze and project esophageal cancer trends in China from 1990 to 2023 using GBD 2023 data.</p><p><strong>Background: </strong>Esophageal cancer (EC) remains a major public health challenge in China. Updated evidence on long-term trends and future burden is needed to inform prevention and control strategies.</p><p><strong>Methods: </strong>We extracted EC incidence and mortality data for China from 1990 to 2023 from the Global Burden of Disease (GBD) 2023 study. Joinpoint regression was used to characterize temporal changes and estimate annual percentage change (APC) and average annual percentage change (AAPC) in age-standardized incidence and mortality rates (ASIR/ASMR). Autoregressive integrated moving average (ARIMA) models were applied to project rates through 2050.</p><p><strong>Results: </strong>From 1990 to 2023, EC ASIR declined from 28.23 to 11.45 per 100,000, with an overall AAPC of -2.56% (95% CI: -3.00 to -2.13). ASMR decreased similarly, with an AAPC of -2.94% (95% CI: -5.36 to -0.47). Joinpoint analysis identified multiple trend segments, with the steepest decline in ASIR during 2007 to 2014 (APC: -7.00%). Notably, after a prolonged decrease, ASIR rebounded significantly during 2020 to 2023 (APC: 4.86%; 95% CI: 3.01-6.73).</p><p><strong>Conclusion: </strong>Although China has markedly reduced the esophageal cancer burden since 1990, the post-2020 rebound in incidence calls for intensified surveillance and rapid evaluation of potential drivers. Priority actions include risk-stratified prevention and strengthened targeted screening for high-risk populations.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110343","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":"Patient Satisfaction and Perceived Stress in Digestive Endoscopy: A Multicenter Cross-sectional Study in Italian Outpatient Units.","authors":"Daniele Napolitano, Fabio Grilli, Arianna Povoli, Giuseppe Romeo, Chiara Massari, Arianna Parella, Antonio Fabio Sacco, Mirko Gaggiotti, Maria Luigia Candela","doi":"10.1097/MCG.0000000000002441","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002441","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate patient satisfaction and perceived stress among adults undergoing diagnostic digestive endoscopy in Italy and to examine their associations with sociodemographic, clinical, and procedural factors.</p><p><strong>Background: </strong>Patient satisfaction is a key indicator of endoscopy quality and complements technical performance measures. Perceived stress may influence the patient experience, but multicenter evidence combining satisfaction and stress in routine Italian outpatient endoscopy remains limited.</p><p><strong>Methods: </strong>A multicenter cross-sectional study was conducted in 5 Italian endoscopy units. Adult outpatients undergoing diagnostic digestive endoscopy completed the Endoscopy Customer Satisfaction Questionnaire (ECSQ) and the 10-item Perceived Stress Scale (PSS-10). Sociodemographic, clinical, and procedural data were collected using standardized forms. Satisfaction scores were summarized as medians and interquartile ranges. Group differences were assessed using Mann-Whitney U and Kruskal-Wallis tests, and Spearman rank correlation was used to examine associations among satisfaction, perceived stress, and age.</p><p><strong>Results: </strong>Among 517 patients, overall satisfaction was high across centers and procedure types. Satisfaction was highest before the examination, decreased during the procedure, and increased afterward. Higher perceived stress showed weak but significant negative correlations with satisfaction during the procedure (ρ = -0.09) and after the procedure (ρ = -0.12). No significant associations were found with age, sex, education, smoking habits, symptoms, or type of endoscopy. Lower satisfaction was observed among first-time patients and among those examined in the afternoon versus the morning.</p><p><strong>Conclusions: </strong>Italian digestive endoscopy services achieved high patient satisfaction, reflecting strong clinical and organizational performance. The modest inverse association between preprocedural perceived stress and satisfaction indicates that patients reporting higher perceived stress also tended to report slightly lower satisfaction. However, this association should not be interpreted as causal because of the cross-sectional study design and the timing of the measurements. First-time and afternoon patients may benefit from enhanced preparation, supportive communication, and targeted interventions.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110333","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":"Gap in Care: Follow-up of Incidental Hepatic Steatosis in an Urban Safety-net Hospital.","authors":"Venkata Sunkesula, Rishi Chowdhary, Thai Hau Koo, Ronnie Fass, Bolin Niu","doi":"10.1097/MCG.0000000000002446","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002446","url":null,"abstract":"<p><strong>Goals: </strong>This study evaluated the follow-up rates for incidental hepatic steatosis detected via imaging at an urban safety-net hospital.</p><p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease and liver transplantation. Despite its growing prevalence, incidental hepatic steatosis identified by imaging is frequently overlooked in clinical practice.</p><p><strong>Study: </strong>We retrospectively reviewed 300 adult patients diagnosed with incidental hepatic steatosis between 2019 and 2020. Comorbidities and follow-up actions such as LFTs, hepatology referral, transient elastography, insurance, and demographic information were extracted by manual chart review. Comparisons were made between patients diagnosed in the emergency department (ED) and outpatient settings.</p><p><strong>Results: </strong>Among 300 patients with incidentally identified hepatic steatosis, demographic factors (age, race, BMI) and frequency of abnormal LFT were similar between ED and outpatient cohorts. While hypertension and hyperlipidemia were more prevalent in outpatients, ED patients predominantly presented with mild steatosis (95.3%) compared with higher rates of moderate-to-severe disease in the outpatient group (P <0.001). Overall, 41% of the cohort received no follow-up, and follow-up rates did not significantly differ by age, race, or insurance type. Notably, outpatients were associated with significantly higher utilization of transient elastography (10.2% vs. 2.8%, P=0.02) and a trend toward more frequent hepatology referral compared with ED patients.</p><p><strong>Conclusion: </strong>Most patients with incidental hepatic steatosis did not undergo an appropriate evaluation. Greater awareness among ED and primary care providers is required to address this growing public health issue.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110396","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 Organisation Practice Guidelines.","authors":"Alice U Lee, Martin Brand, Maria C Cabrera, Naranjargal Dashdorj, Mohamed El-Kassas, Saeed Hamid, Kathy Jackson, Joseph K Lim, C Wendy Spearman, Fu-Sheng Wang, Suna Yapali, Nancy Reau, Calvin Q Pan","doi":"10.1097/MCG.0000000000002440","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002440","url":null,"abstract":"<p><p>Significant progress on hepatitis B treatment pathways has been made since the last World Gastroenterology Organisation (WGO) guidelines in 2015. Global elimination targets have been set, prioritizing the prevention of new infections and optimizing screening and linkage to care in resource-limited settings. This has been led by the World Health Organization (WHO), which first published hepatitis B treatment and care guidelines in 2015 and updated its recommendations in 2024. The critical importance of preventing new infections was supported in 2020 by the WHO policy brief guidelines on antiviral prophylaxis for the purpose of preventing mother-to-child transmission of hepatitis B. A commitment by the global community to support maternal and infant health with the goal of triple elimination of HIV, HBV, and syphilis was established with the first WHO country guidance in 2025. Updated regional liver society guidelines [American (AASLD), European (EASL), Latin American (ALEH), and Asia Pacific (APASL)] have supported application of HBV management to regional contexts, with a focus on simplification and expansion of treatment eligibility. However, consensus on a clear roadmap for HBV guidance that may be broadly adopted in global, resource-limited settings remains elusive. The WGO guidelines are unique in their global lens with evidence-based recommendations, and where evidence is limited, expert opinions have been sought from leaders with broader global representation. Cascade-of-care algorithms ensure optimal access to hepatitis care. The opportunity to consider a test-and-treat approach is also discussed when access to the diagnostic assessment tools is unavailable (particularly in high-burden settings). The main purpose of this document is to provide a simple, easy-to-follow framework for global hepatitis B care pathways, particularly in lower-resource settings. Broadening treatment eligibility, using simplified tools, and, where required, delivering care in a decentralized model with limited test results is encouraged. Key statements that address the main issues at hand were prepared based on prevention, testing, treatment, and monitoring. Invited panel members were asked to grade recommendation statements with adjustments made on repeat voting until concordance was reached. Seminal papers for review are referenced, and supportive tool kits for implementation.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110390","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":"An Umbrella Review of Systematic Reviews on the Utility of Antibiotics in Patients With Acute Uncomplicated Diverticulitis.","authors":"Sameh H Emile, Michal Perets, Noam Kahana, Anjelli Wignakumar, Marylise Boutros","doi":"10.1097/MCG.0000000000002445","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002445","url":null,"abstract":"<p><strong>Background: </strong>The role of antibiotics in acute uncomplicated diverticulitis (AUD) has been debated, as recent trials suggest antibiotics may not add benefit in mild AUD. Conclusions from systematic reviews on this subject have been inconsistent. This umbrella review aimed to synthesize and critically appraise the evidence from systematic reviews regarding the role of antibiotics in AUD.</p><p><strong>Methods: </strong>This was a PRISMA-compliant systematic review on the outcome of nonantibiotic conservative management compared to standard antibiotic therapy for AUD. PubMed, Scopus, Cochrane Library, and Google Scholar were searched through October 2025 for systematic reviews with meta-analyses. The main outcome measures were disease recurrence, complications, need for surgery, mortality, readmission, and hospital stay.</p><p><strong>Results: </strong>Fourteen systematic reviews with a median of 2487 patients per review were included. All reviews, except one, reported a similar likelihood of recurrence of AD between the 2 groups. The odds ratio of recurrence varied across the reviews from 0.66 to 1.01, and the risk ratio varied from 0.82 to 1.02. The likelihood of progression to complicated diverticulitis, perforation, abscess, mortality, and need for any surgical intervention was also similar between the 2 groups. Six reviews reported no difference in readmission, but one found higher readmission with antibiotics, and conversely another reported lower readmission with antibiotics. Five of 7 reviews reported shorter hospital stays with nonantibiotic management, with mean differences ranging across reviews from -1.18 to 0.19 days. Most reviews were of low or critically low quality.</p><p><strong>Conclusions: </strong>On the basis of low-certainty evidence, omitting antibiotics in AUD appears safe, with similar clinical outcomes to standard antibiotic therapy and a possible shorter hospital stay. High-quality trials remain needed to strengthen these findings.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080947","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":"Evaluating Hepatocellular Carcinoma Detection Scores: Moving Beyond the Receiver Operating Characteristic Curve.","authors":"Lu Xing, Mingying Leng, Xue Deng","doi":"10.1097/MCG.0000000000002444","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002444","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061459","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":"Orthostatic Intolerance in Patients With Disorders of Gut-Brain Interaction: A Systematic Review and Meta-Analysis.","authors":"Kana Ayaki, Ayesha Shah, Thomas Fairlie, Dmitrii Kulin, Kyle Staller, Samuel Nurko, Laurie Keefer, Qasim Aziz, Douglas A Drossman, Michael P Jones, Gerald Holtmann","doi":"10.1097/MCG.0000000000002443","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002443","url":null,"abstract":"<p><strong>Background: </strong>Patients with severe manifestations of disorders of gut-brain interaction (DGBI) have higher rates of concomitant Orthostatic Intolerance (OI) and Postural Orthostatic Tachycardia Syndrome (POTS). These conditions diminish quality of life and increase health care use. We conducted a systematic review to assess OI and POTS prevalence in patients with DGBI.</p><p><strong>Methods: </strong>Databases were searched through January 2026 for articles reporting the prevalence of OI and POTS among patients with DGBI. Pooled prevalence rates, odds ratios (ORs), and confidence intervals (CIs) were calculated using a random-effects model.</p><p><strong>Key results: </strong>Thirteen studies included 869 patients with DGBI and 1951 controls. OI prevalence in DGBI patients was DGBI (PP=50.0%, 95% CI: 35.0-64.9). The odds of OI in patients with DGBI were significantly higher compared with controls (OR=5.17, 95% CI: 1.73-15.50, P=0.003). Pediatric patients with DGBI had a higher prevalence of OI (59.7%, 95% CI: 36.4-79.3) than adults (32.5%, 95% CI: 19.3-49.4). The prevalence of OI in patients with DGBI was significantly higher when diagnosed using the Rome IV criteria (66.1%, 95% CI: 43.3-83.3) compared with the Rome III criteria (30.6%, 95% CI: 21.4-41.6). The prevalence of OI in DGBI was higher with questionnaire-based diagnosis (54.5%, 95% CI: 9.7-93.0) compared with physician-based diagnosis (48.8%, 95% CI: 35.2-62.7). Finally, POTS was prevalent in 31.5% (95% CI: 17.3-50.2) of patients with DGBI.</p><p><strong>Conclusions: </strong>OI is more prevalent in patients with DGBI as compared with controls without DGBI. POTS occurs in over one-third of patients with DGBI. While OI and DGBI are associated, clinical heterogeneity suggests low-quality evidence, warranting cautious interpretation.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061452","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}