Journal of Digestive Diseases最新文献

{"title":"Recurrent Liver Dysfunction in Erythropoietic Protoporphyria: A Case With Compound Heterozygous FECH Mutations","authors":"Ya Jun Zhang, Shao Ping Huang, Zhi Yin Shang, Min Liu, Chuan Tao Tu","doi":"10.1111/1751-2980.70000","DOIUrl":"10.1111/1751-2980.70000","url":null,"abstract":"","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"260-263"},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLOBE Score and UK-PBC Risk Score Predict Long-Term Clinical Outcomes of Patients With Primary Biliary Cholangitis and Receiving Ursodeoxycholic Acid and Fenofibrate","authors":"Shu Xiang Li,&nbsp;Bu Er Li,&nbsp;Min Li,&nbsp;Sha Chen,&nbsp;Ting Ting Lyu,&nbsp;Qian Yi Wang,&nbsp;Xiao Ming Wang,&nbsp;Yu Wang,&nbsp;Hong Ma,&nbsp;Xiao Juan Ou,&nbsp;Yuan Yuan Kong,&nbsp;Xin Yan Zhao,&nbsp;Hong You,&nbsp;Wei Jia Duan,&nbsp;Ji Dong Jia","doi":"10.1111/1751-2980.13359","DOIUrl":"10.1111/1751-2980.13359","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Fenofibrate is widely used as add-on therapy for patients with primary biliary cholangitis (PBC) who have a suboptimal response to ursodeoxycholic acid (UDCA). We aimed to evaluate whether the UDCA biochemical response criteria, especially the GLOBE and UK-PBC risk scoring systems, could predict the long-term prognosis of PBC patients who received fenofibrate add-on therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PBC patients receiving fenofibrate add-on therapy were included in this retrospective–prospective study. We compared the utility of nine biochemical response criteria and two scoring systems to predict clinical outcomes by Kaplan–Meier plots and the receiver operating characteristic (ROC) curve analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-three patients were included in this study, of whom 11 had a poor outcome (hepatic decompensation, liver-related death, or liver transplantation) and 52 had a good outcome. After a median follow-up of 45 months, fenofibrate add-on therapy steadily decreased the serum levels of alkaline phosphatase, γ-glutamyl transferase, and alanine aminotransferase in both groups. The patients with poor outcomes had a higher GLOBE score and UK-PBC risk score than those with good outcomes after 12 months of treatment. More importantly, both scores had better predictive performance for hepatic decompensation- and transplant-free survival than the other criteria. The areas under the ROC curve of the GLOBE and UK-PBC risk scores at 12 months were 0.878 (95% confidence interval [CI] 0.751–0.955) and 0.919 (95% CI 0.803–0.978), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The GLOBE and UK-PBC risk scores outperformed the other biochemical response criteria in predicting the clinical outcomes of PBC patients with suboptimal response to UDCA and receiving fenofibrate add-on therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"250-259"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic and Clinical Characteristics of Difficult-To-Treat Crohn's Disease: Trio-Based Exome Sequencing in 24 Families","authors":"Hui Bo Wu,&nbsp;Zhao Yuan Xu,&nbsp;Wei Wang,&nbsp;Qi Zhang,&nbsp;Jue Lin,&nbsp;Yi Tong Cui,&nbsp;Jun Hu,&nbsp;Tao Liu,&nbsp;Xiang Peng,&nbsp;Jun Deng,&nbsp;Jia Yin Yao,&nbsp;Min Zhang,&nbsp;Xi Xi Chen,&nbsp;Min Zhi","doi":"10.1111/1751-2980.13358","DOIUrl":"10.1111/1751-2980.13358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Difficult-to-treat Crohn's disease (DTT-CD) represents a critical unmet need in inflammatory bowel disease (IBD) management. However, its genetic architectures remain poorly understood. We aimed to evaluate the genetic characteristics and clinical manifestations of DTT-CD cases through integrated trio-based whole exome sequencing (WES) and longitudinal phenotyping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional cohort study, DTT-CD patients who met the International Organization for the Study of Inflammatory Bowel Disease (IOIBD) criteria and their first-degree relatives underwent trio-WES analysis. Treatment persistence and remission rates were analyzed. Genetic variants were prioritized via cosegregation analysis, the American College of Medical Genetics and Genomics (ACMG) guidelines, and functional prediction algorithms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 24 patients with DTT-CD, 87.5% failed at least two biologics, 33.3% required dual targeted therapy, and drug persistence declined across treatment lines (<i>p</i> = 0.0193). Remission rates were suboptimal (clinical: 41.7%; endoscopic: 50.0%). Trio-WES analysis identified 15 likely pathogenic candidate variants across 12 genes, including the established monogenic IBD gene <i>XIAP</i> (two novel variants: p.Asp247Glufs*19, p.Ser43X; two known variants: p.Arg381X, p.Arg238X), genome-wide association studies-implicated IBD risk genes (<i>MAML2</i> and <i>PLA2R1</i>), and novel candidate variants (<i>KIZ</i>, <i>LAMA5</i>, <i>SAMD9</i>, etc.) that were potentially linked to epithelial-immune dysregulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first trio-WES study of DTT-CD that reveals a high prevalence of monogenic <i>XIAP</i> deficiency (16.7%), advocating for genetic screening in refractory cases. Novel candidate genes implicate polygenic mechanisms of therapeutic resistance. Family-based sequencing may be used to elucidate the genetic background of DTT-CD cases to guide molecular diagnosis and personalized therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"230-240"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Clinical Nomogram for Predicting Surgery in Newly Diagnosed Crohn's Disease","authors":"Chao Li,&nbsp;Xi Zhang,&nbsp;Jie Qi Zheng,&nbsp;Yi Zhe Tie,&nbsp;Zhi Rong Zeng,&nbsp;Min Hu Chen,&nbsp;Ri Rong Chen,&nbsp;Sheng Hong Zhang","doi":"10.1111/1751-2980.13357","DOIUrl":"10.1111/1751-2980.13357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To develop a nomogram with easily available parameters to predict the risk of Crohn's disease (CD)-related bowel resection in patients with newly diagnosed CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cohort study by recruiting patients with newly diagnosed CD between 2005 and 2022. The patients were divided into the training and internal test sets in a 7:3 ratio. Adjusted multivariate Cox regression and least absolute shrinkage and selection operator analyses were used for feature selection. A nomogram was developed and evaluated using 10-fold cross-validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 490 patients were included, among whom 67 (13.7%) received CD-related bowel resection during a median follow-up of 45.2 months. Stricturing or penetrating behavior, perianal involvement, and higher C-reactive protein (CRP) were independently associated with a higher risk of CD-related bowel resection, while higher white blood cell (WBC) and lymphocyte levels and hemoglobin levels were protective factors. The nomogram including disease behavior, hemoglobin, CRP, and lymphocyte and WBC counts yielded a C-statistic of 0.80 (95% confidence interval [CI] 0.74–0.86) in 10-fold cross-validation of the training set. Using the internal test set, the robust performance was verified with C-statistic, calibration slope, and calibration-in-the-large of 0.80 (95% CI 0.70–0.89), 1.10 (95% CI 0.61–1.56), and 0.28 (95% CI −0.17 to 0.67). Decision curve analyses indicated its potential clinical utility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The nomogram integrating disease behavior and laboratory data might be a promising approach for early risk stratification of CD-related bowel resection, hence facilitating personalized treatment for newly diagnosed CD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"203-211"},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Open-Label Randomized Controlled Non-Inferiority Trial of Arginine Glutamate Injection for the Treatment of Mild Hepatic Encephalopathy","authors":"Hai Bo Zhang,&nbsp;Huai Bin Zou,&nbsp;Yun Yi Gao,&nbsp;Li Wang,&nbsp;Yuan Gao,&nbsp;Ming Kong,&nbsp;Wei Wei Kang,&nbsp;Rui Zhong,&nbsp;Xian Shan Yang,&nbsp;Yan Ren,&nbsp;Li Li Feng,&nbsp;Lu Li,&nbsp;Shuang Li,&nbsp;Zhong Ping Duan,&nbsp;Yu Tao Zhan,&nbsp;Yu Chen","doi":"10.1111/1751-2980.13355","DOIUrl":"10.1111/1751-2980.13355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the efficacy and safety profile of arginine glutamate and L-ornithine-L-aspartate (LOLA) in treating mild hepatic encephalopathy (HE) and hyperammonemia in cirrhotic patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, open-label, non-inferiority, randomized controlled trial (RCT) enrolled patients aged 18–75 years with cirrhosis and mild HE. The patients were randomly allocated in the ratio of 1:1 using a randomization table to be treated with intravenous administration of arginine glutamate or LOLA for 7 days. The primary end-point was the clinical improvement of mild HE. Secondary end-points included post-treatment change in blood ammonia level and the time to complete the number connection test (NCT)-A. Adverse events and adverse drug reactions were documented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From July 2020 to June 2021, 108 cirrhotic patients with mild HE were included and randomized to receive either arginine glutamate or LOLA for 7 days. Clinical improvement was observed in 88.9% of the patients receiving arginine glutamate and 90.7% of those having LOLA (between-group difference −1.9%, 95% confidence interval −13.3% to 9.6%), indicating non-inferiority of arginine glutamate to LOLA. The two groups showed comparable reductions in blood ammonia levels and improvements in time to complete NCT-A. The rate of adverse events was similar between the two groups, with only four cases reported adverse drug reactions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both regimens effectively alleviated mild HE symptoms and reduced ammonia levels. Arginine glutamate showed non-inferiority to LOLA in terms of clinical improvement, ammonia reduction, and time to complete NCT-A, with no significant adverse events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"241-249"},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alexithymia in Functional Defecation Disorder: The Incidence and the Effect on Treatment","authors":"Sai Nan Shi,&nbsp;Bin Bin Zhu,&nbsp;Mei Feng Wang,&nbsp;Lin Lin,&nbsp;Liu Qin Jiang","doi":"10.1111/1751-2980.13356","DOIUrl":"10.1111/1751-2980.13356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to investigate the prevalence of alexithymia in patients with functional defecation disorder (FDD) and its impact on treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>FDD patients who underwent high-resolution anorectal manometry and balloon expulsion test were enrolled. Symptoms, anorectal function, and treatment efficacy were assessed at baseline and after 4-week medication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Alexithymia was present in 29.5% of all 129 FDD patients. Compared to the non-alexithymia group, the alexithymia group had higher baseline scores for the Patient Assessment of Constipation-Symptoms (PAC-SYM) (19.0 vs. 15.0, <i>p</i> = 0.03), Patient Assessment of Constipation-Quality of Life (PAC-QOL) (67.0 vs. 26.0, <i>p</i> &lt; 0.001), Zung's Self-Rating Anxiety Scale (SAS) (44.5 vs. 30.0, <i>p</i> &lt; 0.001), and Self-Rating Depression Scale (SDS) (48.0 vs. 33.0, <i>p</i> &lt; 0.001). Moreover, the improvements in post-treatment complete spontaneous bowel movements (CSBMs) (0.0 vs. 1.5, <i>p</i> = 0.041), PAC-SYM (0.0 vs. −11.5, <i>p</i> &lt; 0.001), PAC-QOL (0.0 vs. −16.0, <i>p</i> &lt; 0.001), SAS (0.0 vs. −1.0, <i>p</i> &lt; 0.001), and SDS (0.0 vs. −3.0, <i>p</i> &lt; 0.001) scores were less significant in the alexithymia group than in the non-alexithymia group. A high Toronto Alexithymia Scale-20 score was an independent risk factor for drug therapy failure in FDD patients (odds ratio 0.949, 95% confidence interval 0.919–0.980, <i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Alexithymia is prevalent in FDD patients and significantly affects symptom severity, quality of life, mental state, and treatment outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"212-220"},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Fecal Diversion in Perianal Crohn's Disease: A Systematic Review and Meta-Analysis","authors":"Imogen Hartley,&nbsp;Babak Sarraf,&nbsp;Helen Wilding,&nbsp;Jonathan P. Segal,&nbsp;Nik Sheng Ding","doi":"10.1111/1751-2980.13354","DOIUrl":"10.1111/1751-2980.13354","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Perianal fistulizing Crohn's disease (pfCD) is a severe type of inflammatory bowel disease resulting in significant patient morbidity. Despite advancements in treatments, pfCD remains challenging to manage with low healing rates. Fecal diversion (FD) has previously demonstrated clinical improvement for patients with refractory disease. Our meta-analysis aimed to explore the clinical response to FD, rates of successful restoration of bowel continuity after FD, rates of re-diversion, and factors affecting the success of FD in pfCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis was carried out of adult patients who had undergone FD for pfCD, with detailed patient outcome data. Studies were identified through a literature search of six bibliographic databases and one trial register, all run on February 28, 2025, including MEDLINE ALL, EMBASE, Emcare, APA PsycInfo, CINAHL, Cochrane Library, and Clinicaltrials.gov.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen studies encompassing 714 adult pfCD patients were included. FD resulted in a 65% clinical improvement rate, yet considerable heterogeneity existed in study methodologies and outcome definitions. While 29% of patients achieved bowel restoration within a median follow-up of 58.2 months, challenges in sustaining the effects were evident, with 10% requiring repeat diversion and a 37% overall proctectomy/proctocolectomy rate. Factors associated with diversion success included the absence of rectal involvement and quiescent luminal disease, with biologic use showing no impact on outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FD offers symptom control in pfCD, although restoration rates remain low. These findings emphasize the need for individualized patient counseling. Future research should strive for uniform measures and refined approaches to enhance pfCD management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"180-192"},"PeriodicalIF":2.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening and Analysis of the Clinical Characteristics of Celiac Disease Autoimmunity in the Young Population in Northwest China","authors":"Tian Shi,&nbsp;Sheng Long Xue,&nbsp;Wei Dong Liu,&nbsp;Yan Feng,&nbsp;Ting Li,&nbsp;Na Li,&nbsp;Kuerbanjiang Aihemaijiang,&nbsp;Xiao Ling Huang,&nbsp;Wen Jia Hui,&nbsp;Qi Jiang,&nbsp;Ying Xuan Chen,&nbsp;Feng Gao","doi":"10.1111/1751-2980.13351","DOIUrl":"10.1111/1751-2980.13351","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to evaluate the prevalence of celiac disease (CeD) autoimmunity among young adult individuals in northwest China based on their relevant demographics, clinical characteristics, and laboratory data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional survey of serum CeD prevalence among young students aged 18–23 years who underwent routine physical examinations at the Xinjiang Second Medical College from September 2022 to December 2023. All subjects were tested for total serum immunoglobulin (Ig) A levels. Those with normal total IgA levels were tested for anti-tissue transglutaminase (tTG)-IgA and anti-endomysial antibody (EMA)-IgA. Individuals with IgA deficiency were tested for anti-deamidated gliadin peptide (DGP) IgG and anti-EMA-IgG. CeD autoimmunity was defined as positivity for both EMA and tTG/DGP antibodies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 1464 participants, CeD seropositivity rates were 0.41% for tTG-IgA and 0.55% for EMA-IgA, and CeD autoimmunity was prevalent in 0.34%. All seropositive patients had a normal body mass index. The incidence of seropositivity was highest in Tajiks (1.28%), followed by Kazakhs (0.97%), Hans (0.29%), and Uygurs (0.22%) (<i>p</i> &gt; 0.05). CeD was most frequently associated with elevated transaminase levels (1.87%; <i>p</i> = 0.005). Biochemical tests showed significantly higher alanine aminotransferase levels in CeD-positive patients (<i>p</i> = 0.027).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of CeD autoimmunity in the young adult population of northwest China was 0.34%. Since young individuals often lack typical clinical and laboratory features, screening for CeD in the population with gastrointestinal symptoms, related comorbidities, or atypical manifestations is essential for early diagnosis and effective management of the disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"143-149"},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Same-Day Discharge, Medical and Non-Medical Admission After Per-Oral Endoscopic Pyloromyotomy","authors":"Brittany Pass,&nbsp;Michelle Neice,&nbsp;Karan Sachdeva,&nbsp;Natalie Roppolo,&nbsp;Ahmad Alkurd,&nbsp;Farhan Mohuiddin,&nbsp;Elizabeth Armstrong,&nbsp;Ross Dies,&nbsp;Victoria Andrus,&nbsp;Ashely Deville,&nbsp;David Okuampa,&nbsp;Lena Kawji,&nbsp;Michael P. Tran,&nbsp;Omar Khan,&nbsp;Qiang Cai","doi":"10.1111/1751-2980.13353","DOIUrl":"10.1111/1751-2980.13353","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Gastric per-oral endoscopic myotomy (G-POEM) is a promising treatment for gastroparesis. Our previous pilot study has indicated that about 50% of patients could be safely discharged home on the same day as the procedure. In this study, we presented more data on this topic and divided admission into medical and non-medical admissions to assess the safety of same-day discharge after the G-POEM procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All patients who underwent G-POEM for gastroparesis at our institution from April 2022 to June 2023 were included. After undergoing G-POEM, patients who met the following four criteria would be discharged on the same day: (i) no major complications during the procedure; (ii) patient having abdominal pain scored 4 or less on a pain scale from 0 to 10, or &gt; 4 but improved after having one dose of intravenous pain medication; (iii) no vomiting after the procedure; and (iv) the patient had someone at home to help them access medical care when necessary. The admitted patients were divided into two groups: those with medical issues, and those with non-medical issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 61 consecutive patients were included in this study, among whom 40 (65.6%) were discharged on the same day. Among the 21 (34.4%) patients who were admitted to the hospital for observation, 12 were admitted for non-medical issues. The remaining nine (14.8%) patients were admitted for medical issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>After about 10 years of practice, G-POEM is a safe endoscopic therapeutic modality. This study shows that 85.2% of patients undergoing G-POEM can be discharged on the same day.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"135-142"},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Utility of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Biopsy for Rectal and Perirectal Lesions With Categorization of Their Indications","authors":"June Hwa Bae,&nbsp;Jung-Bin Park,&nbsp;Ji Eun Baek,&nbsp;Seung Wook Hong,&nbsp;Sung Wook Hwang,&nbsp;Sang Hyoung Park,&nbsp;Dong-Hoon Yang,&nbsp;Byong Duk Ye,&nbsp;Seung-Jae Myung,&nbsp;Suk-Kyun Yang,&nbsp;Jeong-Sik Byeon","doi":"10.1111/1751-2980.13352","DOIUrl":"10.1111/1751-2980.13352","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic ultrasound-guided fine-needle aspiration and/or biopsy (EUS-FNA/B) is a diagnostic tool for gastrointestinal (GI) lesions. However, its effectiveness in the lower GI tract remains underreported. In this study, we aimed to evaluate the clinical utility of EUS-FNA/B for rectal and perirectal lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-seven consecutive patients with rectal or perirectal lesions underwent EUS-FNA/B between 2009 and 2023. The histological diagnoses by EUS-FNA/B were compared with the final diagnoses to assess the former's diagnostic performance. Additionally, the therapeutic utility of EUS-FNA/B and its clinical applicability across various scenarios were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-nine of the 77 patients had rectal lesions, with gastrointestinal stromal tumor (GIST) being the most common in 15 patients. Of the 48 patients with perirectal lesions, 27 and 21 had malignant and benign lesions, respectively. EUS-FNA/B was diagnostic in 61 (79.2%) patients, with the rates of 79.3% and 79.2% for rectal and perirectal lesions. EUS-FNA/B enabled timely treatment decisions by confirming malignancy (<i>n</i> = 32) and prevented unnecessary surgeries/procedures by establishing the benign nature of the lesions (<i>n</i> = 14). A definitive diagnosis of rectal GIST was made using EUS-FNA/B, thereby facilitating the initiation of neoadjuvant chemotherapy followed by anus-saving surgery (<i>n</i> = 10). EUS-FNA/B enabled the implementation of minimally invasive interventions such as EUS-guided drainage (<i>n</i> = 5). Adverse events occurred in five (6.5%) patients, with only one requiring hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EUS-FNA/B is a valuable modality for patients with rectal or perirectal lesions, which facilitates accurate histological diagnosis, appropriate treatment, and favorable safety profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"193-202"},"PeriodicalIF":2.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}