Journal of clinical gastroenterology最新文献

{"title":"Translating Real-World Evidence on Oral Sulfate Tablets for Bowel Preparation into Practice: Methodological Nuances to Consider.","authors":"Huynh Manh Tien, Vo Pham Phuong Uyen, Quach Duc Trong","doi":"10.1097/MCG.0000000000002346","DOIUrl":"10.1097/MCG.0000000000002346","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"468"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165755","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":"Is Antibiotic Prophylaxis Warranted in All Patients With Biliary Obstruction Undergoing Endoscopic Retrograde Cholangiopancreatography?: A Systematic Review and Meta-Analysis.","authors":"Eric Smith, Yizhong Wu, Colby Adamson, Alexander Grieme, Ryan Villafuerte, Shivanand Bomman, Kalee Moore, Neel Shah, Daryl Ramai, Douglas G Adler","doi":"10.1097/MCG.0000000000002229","DOIUrl":"10.1097/MCG.0000000000002229","url":null,"abstract":"<p><strong>Goals: </strong>To evaluate whether prophylactic antibiotics improve infectious complication rates after endoscopic retrograde cholangiopancreatography (ERCP).</p><p><strong>Background: </strong>Current guidelines recommend prophylactic antibiotics before ERCP only in cases of anticipated incomplete biliary drainage or severe immunosuppression. A recent randomized controlled trial (RCT) suggested a benefit regardless of drainage status. This systematic review and meta-analysis assess the impact of prophylactic antibiotics on post-ERCP infectious complications.</p><p><strong>Study: </strong>A systematic search of major databases was conducted through June 2024 for RCTs comparing ERCP outcomes with and without antibiotic prophylaxis. Pooled data were analyzed for the composite outcome of infectious complications, including cholangitis, bacteremia, and sepsis. Mortality and pancreatitis were also analyzed. Publication bias was evaluated using funnel plots and regressions for funnel plot asymmetry. Our analysis implemented a dichotomous regression model with random effects using R software.</p><p><strong>Results: </strong>Eleven RCTs with 2105 patients were included, with 1086 receiving antibiotics and 1019 serving as controls. Infectious complications were significantly lower in the antibiotic group [risk difference (RD): -0.08, 95% CI: -0.14 to -0.02, P =0.00001, I2 : 83%]. Beta-lactam and cephalosporin antibiotics had a greater effect (RD: -0.10, 95% CI: -0.17 to -0.04, P =0.00001, I2 : 85%). Bacteremia rates were also reduced (RD: -0.06, 95% CI: -0.11 to -0.01, P =0.01, I2 : 58%). No significant differences were found in cholangitis, sepsis, pancreatitis, or mortality. Sensitivity analyses confirmed robustness.</p><p><strong>Conclusions: </strong>Antibiotic prophylaxis reduces post-ERCP infectious complications and should be considered in all patients with biliary obstruction who are undergoing ERCP.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"459-467"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080609","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":"Impact of Primary Language on Early Repeat Screening Colonoscopy.","authors":"Anthony Kerbage, Sara F Haddad, Danah Al Deiri, Michel Chedid El Helou, Carole Macaron, Carol A Burke","doi":"10.1097/MCG.0000000000002251","DOIUrl":"10.1097/MCG.0000000000002251","url":null,"abstract":"<p><strong>Background: </strong>Repeat colonoscopy ≤1 year after a screening colonoscopy is recommended when bowel preparation is inadequate due to the potential of missed advanced neoplasia. Whether patients whose primary language is not English (NEPL) have a greater risk of repeat colonoscopy ≤1 year after screening colonoscopy than native English speakers (EPL) is unknown. We investigated the primary language in early repeat colonoscopy.</p><p><strong>Methods: </strong>The TriNetX Research Network database was used to compare rates of repeat colonoscopy ≤1 year between patients with NEPL and EPL. Propensity score matching (PSM) was used to adjust for factors associated with inadequate bowel preparation. Risk of repeat colonoscopy ≤1 year of baseline screening exam, colorectal polyps, and colorectal cancer (CRC) on repeat colonoscopy were expressed as odds ratios (OR) with 95% CI.</p><p><strong>Results: </strong>Among 611,149 patients undergoing screening colonoscopy (mean age 58.3 y, 63.6% white, 7.1% Hispanic), 31,118 had NEPL and 580,031 had EPL. After PSM, each cohort included 29,446 patients. NEPL patients had higher odds of undergoing repeat colonoscopy within 1 year compared with EPL patients (1.9% vs. 1.3%; OR: 1.49, 95% CI: 1.30-1.69). In the matched cohorts, the rate of polyp detection on repeat colonoscopy was similar, but NEPL patients had higher odds of CRC detection (0.8% vs. 0.6%; OR: 1.4, 95% CI: 1.1-1.7).</p><p><strong>Conclusions: </strong>NEPL patients had greater odds of early repeat colonoscopy than EPL patients. Although colorectal polyps and CRC were infrequent in both groups, NEPL patients appeared to be at higher risk of CRC detection. Language-tailored interventions may improve bowel preparation quality and reduce repeat procedures.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"418-423"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080602","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 Effects of Surgical and Endoscopic Esophageal Myotomy Versus Nonmyotomy Treatments on the Risk of Esophageal Cancer Development in Patients With Achalasia.","authors":"Noy Lapidot Alon, Bejamin Liu, Ronnie Fass","doi":"10.1097/MCG.0000000000002370","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002370","url":null,"abstract":"<p><strong>Background: </strong>Esophageal cancer is an uncommon but devastating complication of achalasia. There is very limited information in the literature about the effect of any type of treatment on the risk of cancer development in patients with achalasia. The aim of the study was to compare the effects of surgical and endoscopic myotomy (SEM) versus non-SEM on the esophageal cancer risk of patients with achalasia.</p><p><strong>Methods: </strong>We performed a population-based analysis using the TriNetX Global Collaborative Network, which provides real-time access to deidentified electronic health records (EHRs) from 146 health care organizations across the United States and 16 other countries. Adult patients (≥18 y) diagnosed with achalasia between 2004 and 2024 were included. In addition, patients with achalasia who developed esophageal cancer were identified. Patients were grouped by treatment: surgery or endoscopic myotomy versus medical or no therapy. To ensure a proper timeline, the esophageal cancer had to be documented only after the diagnosis of achalasia was established. Multivariable logistic regression was used to evaluate associations with cancer risk. Kaplan-Meier analysis compared the time from achalasia diagnosis to cancer development.</p><p><strong>Results: </strong>Among 50,365 patients with achalasia, 8015 (15.9%) underwent surgical or endoscopic myotomy (SEM). Esophageal cancer occurred in 394 patients (0.78%); of those, 46 (0.57%) were in the SEM group, and 348 (0.82%) were in the non-SEM group. SEM was independently associated with a significant reduction in the risk of esophageal cancer (OR=2.49, 95% CI: 1.93-3.26, P<0.0001) and longer time to diagnosis (586 vs. 92 d, log-rank P=0.0014; HR=0.609, 95% CI: 0.447-0.829). Male sex (OR=2.31, 95% CI: 2.00-2.78) and nicotine dependence (OR=8.77, 95% CI: 7.25-10.43) were significant predictors of increased esophageal cancer risk in patients with achalasia.</p><p><strong>Conclusions: </strong>Surgical or endoscopic myotomy treatment for achalasia is independently associated with reduced risk and delayed onset of esophageal cancer compared with non-SEM treatment, supporting a potential protective effect.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815622","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":"Comparative Outcomes After Index Myocardial Infarction in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.","authors":"Bachviet Nguyen, Stephanie Quon, Christopher Ma, Sunny Singh","doi":"10.1097/MCG.0000000000002372","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002372","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a chronic systemic inflammatory disorder associated with elevated cardiovascular risk. While prior studies have linked IBD to increased risk of myocardial infarction (MI), post-MI outcomes in this population remain poorly characterized. We aimed to evaluate post-MI outcomes in patients with IBD compared with non-IBD controls.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted following PRISMA guidelines. Five databases were searched from inception to July 2025. We included observational studies comparing post-MI outcomes in adults with and without IBD. Random-effects meta-analyses were performed using hazard ratios (HRs) and odds ratios (ORs) with 95% CIs. Heterogeneity was assessed using the I2 statistic.</p><p><strong>Results: </strong>Nine retrospective cohort studies encompassing 9.45 million patients were included. IBD was associated with significantly increased risk of MACE (HR: 1.31, 95% CI: 1.07-1.59), all-cause mortality (HR: 1.25, 95% CI: 1.12-1.39), and recurrent MI (HR: 1.22, 95% CI: 1.08-1.39) following index myocardial infarction compared with non-IBD patients. Pooled ORs showed increased odds of major bleeding (OR: 1.38, 95% CI: 1.13-1.70) and transfusion (OR: 1.41, 95% CI: 1.35-1.47), but lower odds of heart failure (OR: 0.81, 95% CI: 0.74-0.89) and no significantly increased odds of stroke.</p><p><strong>Conclusions: </strong>Patients with IBD have statistically significantly higher risks of MACE, all-cause mortality, recurrent MI, blood transfusions, and major bleeding compared with the non-IBD population. These findings emphasize the potential role for tailored cardiovascular risk stratification, bleeding risk mitigation, and longitudinal management strategies in patients with IBD.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772810","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":"Mixed-Methods Development and Validation of PRO/PREM Items for Patients Undergoing Colon Polyp Surveillance.","authors":"Sidney May, Erin M Knight, Nancy Boyer, Audrey H Calderwood, Kelsey M Biddle, Amy R Marks, Jessica M Badalov, Christopher D Jensen, Theodore R Levin, Douglas J Robertson, Peter F Cronholm, Matthew D Kearney, Frances K Barg, Lee Jones, William D Edwards, Eileen O'Shea, Joann Geddes, Karen E Schifferdecker","doi":"10.1097/MCG.0000000000002386","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002386","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcomes (PROs) and experience measures (PREMs) are essential in assessing patient outcomes and experiences in comparative effectiveness research and clinical practice. While validated measures exist for colorectal cancer (CRC) screening, none address colon polyp surveillance. We aimed to develop and validate PRO/PREM items for this purpose.</p><p><strong>Study: </strong>Using a mixed-methods instrument development design, we conducted semistructured interviews with 14 older adults with a history of colon polyps and 9 primary care physicians and then tested a 16-item PRO/PREM questionnaire. We conducted exploratory factor analyses (EFAs; N=449), confirmatory factor analyses (CFAs; N=466), and test-retest reliability (N=155) to assess validity and reliability.</p><p><strong>Results: </strong>Interviews revealed 6 PRO/PREM domains: Test Satisfaction, Test Convenience, Testing Complications, Assistance Needed, Confidence in Test, and Cancer Worry. Whereas the EFA results supported a 3-factor solution, the CFA results supported a 1-factor, 4-item model of Test Experience/Satisfaction. Test-retest reliability for this composite Test Experience/Satisfaction score was good. Test-retest reliability was moderate for 12 of the individual PRO/PREM items and poor for 3 items.</p><p><strong>Conclusions: </strong>To our knowledge, this is the first study to develop and validate PRO/PREM items for adults undergoing colon polyp surveillance. Although subsequent research is required to assess the predictive validity of these items, our findings provide strong initial support for their psychometric properties, and this study represents an essential first step toward implementing PRO/PREM items for colon polyp surveillance in research and clinical settings.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772818","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 \"Real-World Management and Economic Burden of Gallbladder Polyps\".","authors":"Renren Wang, Yiheng Yao, Liang Liu","doi":"10.1097/MCG.0000000000002390","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002390","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772796","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":"Utility of Oesophagogastroduodenoscopy in Lynch Syndrome.","authors":"Douglas Tjandra, Omar Salehi, Jadon Karp, Harindra Jayasekara, Rita A Busuttil, Alex Boussioutas","doi":"10.1097/MCG.0000000000002382","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002382","url":null,"abstract":"<p><strong>Goal: </strong>This study aims to investigate the outcomes in Lynch syndrome associated with routine second-yearly oesophagogastroduodenoscopy (OGD).</p><p><strong>Background: </strong>The role of OGD for surveillance in Lynch syndrome remains contentious, with variation in guidelines. Our service runs a dedicated high-risk gastrointestinal risk management clinic where OGD is offered every second year after recruitment into surveillance.</p><p><strong>Methods: </strong>Patients with Lynch syndrome who underwent at least one OGD were retrospectively reviewed. Demographics, clinical risk factors, personal and family history of malignancy, and endoscopic/histologic findings at OGD were evaluated. Logistic regression, Kaplan-Meier and Cox regression analysis were used to evaluate factors associated with premalignant and malignant lesions.</p><p><strong>Results: </strong>A total of 296 patients were identified, with a total of 962 OGDs performed. Dysplasia was identified in 9 patients (3.0%), the majority of which were in the duodenum (66.7%). Two cases (0.7%) were diagnosed with duodenal adenocarcinoma. Premalignant lesions were seen in 20.9% (3.7% Barrett's metaplasia, 16.2% GIM, 1.0% both). Multivariable analysis did not identify predictors of dysplasia or malignancy. Tobacco smoking was associated with premalignant lesions at baseline and on follow-up.</p><p><strong>Conclusions: </strong>Our Lynch syndrome cohort demonstrated high rates of premalignant, dysplastic or malignant lesions (22.6%). High-risk lesions showed a predilection for the duodenum. This study suggests a role for routine OGD in patients with Lynch syndrome.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772847","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":"Gastrostomy Tube Placement for Enteral Nutrition Among Hospitalized Patients With Cirrhosis Is Associated With Increased Mortality.","authors":"Noah Lybik, Daniel Leary, William Peng, Saad Saffo","doi":"10.1097/MCG.0000000000002384","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002384","url":null,"abstract":"<p><strong>Objective: </strong>Gastrostomy tubes may be associated with increased morbidity and mortality in patients with cirrhosis. However, as liver transplantation becomes more accessible, clarifying the feasibility of using these devices to overcome malnutrition and sarcopenia is increasingly relevant. We aim (1) to show whether gastrostomy tube placement increases mortality in patients with cirrhosis and (2) to examine which additional factors influence the odds for procedure-related complications and death.</p><p><strong>Methods: </strong>The National Inpatient Sample was queried from 2016 to 2019 for patients with cirrhosis. After collecting relevant demographic and clinical data, we used propensity score matching to address selection biases that may have impacted the decision to pursue gastrostomy tube placement. Finally, we performed logistic regression analyses for key outcome measures, including mortality and procedure-related complications.</p><p><strong>Results: </strong>The unweighted sample included 593,108 admissions, of which gastrostomy tube placement occurred in 5062. In our matched cohort, death occurred in 22% of those who received a gastrostomy tube versus 9% of those who did not. Gastrostomy tube placement was the strongest predictor of in-hospital mortality (adjusted odds ratio 2.74, 95% CI: 2.44-3.08; P<0.001). Our secondary analyses demonstrated that ascites increased the odds of both procedure-related complications and death, although other factors were also implicated.</p><p><strong>Conclusion: </strong>Gastrostomy tube placement is independently associated with increased mortality in patients with cirrhosis, and those with decompensated disease, namely ascites, and additional medical comorbidities are more likely to develop adverse events. These findings highlight the need for individualized approaches in managing malnutrition in patients with cirrhosis.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729092","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":"Urban Residency is Independently Associated With Allergic Phenotype and Inflammatory Changes in Eosinophilic Esophagitis.","authors":"Mayssan Muftah, Davis A Hartnett, Brent Hiramoto, Ryan Leung, Rama Nassri, Ryan Flanagan, Jennifer X Cai, Wai-Kit Lo, Walter W Chan","doi":"10.1097/MCG.0000000000002383","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002383","url":null,"abstract":"<p><strong>Goals: </strong>To identify clinical features associated with geographic residency in patients with eosinophilic esophagitis (EoE).</p><p><strong>Background: </strong>Prior studies on the geographic distribution of eosinophilic esophagitis (EoE) have focused on disease prevalence. Geographic and environmental factors may impact the clinical characteristics and phenotypes of EoE, although data remain limited.</p><p><strong>Study: </strong>This was a cross-sectional study of consecutive patients residing in Massachusetts with newly diagnosed EoE (≥15 eosinophils/hpf). Patients' residency settings were classified as urban or nonurban based on the 2020 US Census and residential zip codes. Clinical, endoscopic, and histologic variables were recorded. EoE patients in urban versus nonurban settings were compared using the student t test or the Fisher exact test for univariate analyses. Multivariable logistic regression was performed to identify the independent association between urban residency and comorbid atopic conditions, the inflammatory endotype, and the fibrostenotic endotype.</p><p><strong>Results: </strong>Six hundred eighty-three EoE patients were included, with 136 (20.0%) urban and 547 (80%) nonurban residents. Urban patients had higher rates of atopy (63.2% vs. 51.8%, P=0.02), severe food/environmental allergies (17.7% vs. 8.3%, P=0.002), and inflammatory findings endoscopic (43.4% vs. 27.8%, P=0.0006). On multivariable analysis, atopy (OR=1.57, CI: 1.02-2.40, P=0.04), severe food/environmental allergies (OR=1.99, CI: 1.09-3.63, P=0.02), and inflammatory findings (OR=1.90, CI: 1.22-2.94, P=0.004) remained independently associated with urban residency.</p><p><strong>Conclusions: </strong>Urban residency is independently associated with severe food/environmental allergies and inflammatory endoscopic findings at EoE diagnosis, suggesting increased allergic phenotype and active inflammation at presentation. Allergen exposure, particularly indoors, and social determinants may be contributory factors. Environmental considerations, such as geographic residency, may impact EoE disease presentation, activity, and outcome.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729157","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}