Journal of Digestive Diseases最新文献

{"title":"Clostridium perfringens Infection in a Male With Ulcerative Colitis: A Case Report.","authors":"Li Mei Shao, Rui Hang Li, Ying Ying Liu, Ling Liu","doi":"10.1111/1751-2980.70020","DOIUrl":"10.1111/1751-2980.70020","url":null,"abstract":"","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":"559-563"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549578","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":"Global Burden and Trends of Early-Onset Gastrointestinal Cancers From 1990 to 2021.","authors":"Ying Ying Wang, Xin Long Wang, Ting Hu, Kai Juan Wang","doi":"10.1111/1751-2980.70026","DOIUrl":"10.1111/1751-2980.70026","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to explore the global burden and trends of early-onset gastrointestinal (GI) cancers, defined as those diagnosed in individuals younger than 50 years of age, from 1990 to 2021 based on the Global Burden of Disease Study 2021 (GBD 2021).</p><p><strong>Methods: </strong>Data of disability-adjusted life-years (DALYs), incidence, and corresponding age-standardized rates were extracted to assess the burden and trends of early-onset GI cancers, including esophageal, gastric, liver, colorectal, pancreatic, and gallbladder and biliary tract cancers from 1990 to 2021.</p><p><strong>Results: </strong>Colorectal cancer had the highest age-standardized DALYs rate (ASDR) and incidence rate (ASIR) globally at 101.37 and 5.37 per 100 000 in 2021. Moreover, it showed the greatest ASIR growth over the past three decades, with projections indicating it would remain the leading cause by 2040. Colorectal, gastric, and liver cancers ranked the top three contributors to disease burden in 2021, with gastric cancer showing the most significant decline (average annual percentage change [AAPC] for ASDR: -2.27; for ASIR: -1.71). Elevated body mass index was the risk factor for most of these cancers, with AAPC ranging from 0.68 to 5.09. Additionally, early-onset pancreatic cancer had the greatest impact in Eastern Europe, while gallbladder and biliary tract cancer was more prevalent in Southern Latin America. East Asia had the heaviest burden of other cancers.</p><p><strong>Conclusions: </strong>Early-onset colorectal, gastric, and liver cancers were the top three contributors to disease burden in 2021. Preventing these cancers and reducing obesity should be the main priorities for public health.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":"509-517"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959544","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":"The Scope of Percutaneous Biliary Cholangioscopy: Beyond Choledocholithiasis.","authors":"Jake DiFatta, Chase Mahler, Alyssa Knight, Junaid Raja","doi":"10.1111/1751-2980.70027","DOIUrl":"10.1111/1751-2980.70027","url":null,"abstract":"<p><strong>Objective: </strong>To discuss less well-defined indications for percutaneous cholangioscopy (PC) that have been described in case reports and other studies. The role of PC is expanding in the treatment of biliary and pancreatic pathologies and presents unique advantages and drawbacks when compared to other endovascular diagnostic and therapeutic modalities. The utility of cholangioscopy in the treatment of choledocholithiasis has been well defined, and therefore here we focus on other indications.</p><p><strong>Methods: </strong>A thematic review was conducted by searching PubMed for studies reporting indications for PC since January 1, 2000. Relevant data were extracted, synthesized, and analyzed to identify trends and gaps in the use of this procedure.</p><p><strong>Results: </strong>Indications for PC include indeterminate biliary strictures, tumor evaluation and staging, primary sclerosing cholangitis (PSC), hemobilia, foreign object retrieval, and pancreatic pathologies, and so on. PC is generally used when other techniques such as endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP) are insufficient or contraindicated. Reasons for this include technical complexity, anatomic abnormalities, and cost. PC has similar rates of complication as other biliary techniques such as ERCP, albeit marginally higher rates of cholangitis, which can be successfully mitigated with antibiotics.</p><p><strong>Conclusion: </strong>PC enables direct visual inspection of the biliary tree with correlative cholangiography to better appreciate and manage biliary pathology not amenable to peroral cholangioscopy, ERCP, or MRCP.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":"470-476"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952191","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":"The Prevalence of Inflammatory Bowel Disease in Juvenile Spondyloarthritis.","authors":"Ipek Ulkersoy, Umit Gul, Mehmet Yildiz, Arlin Tunc, Sevval Ozyildirim, Nergis Akay, Oguzhan Tin, Nursena Kologlu Ates, Elif Kilic Konte, Aybuke Gunalp, Esma Aslan, Ayse Kalyoncu Ucar, Sezgin Sahin, Nuray Kepil, Kenan Barut, Omer Faruk Beser, Sebuh Kurugoglu, Fugen Cullu Cokugras, Ozgur Kasapcopur","doi":"10.1111/1751-2980.70028","DOIUrl":"10.1111/1751-2980.70028","url":null,"abstract":"<p><strong>Objectives: </strong>Juvenile spondyloarthritis (JSpA) shares genetic, immunopathogenic, and environmental features with pediatric inflammatory bowel disease (IBD), placing patients at an elevated risk for IBD. We aimed to evaluate the prevalence of IBD and identify potential early markers for its recognition in children with JSpA, trying to improve its diagnostic, screening, and treatment strategies.</p><p><strong>Methods: </strong>Children diagnosed with JSpA were prospectively evaluated. Fecal calprotectin (FCP) was measured in all participants, and those with elevated FCP (> 100 μg/g) or two or more IBD-related symptoms (chronic diarrhea, weight loss/growth retardation, abdominal pain, or bloody/mucous stool) underwent ileocolonoscopy with histopathological and radiological assessment.</p><p><strong>Results: </strong>Altogether 81 children (71.6% male) with a mean age of 194 months at adimission were included, and 23 underwent endoscopic evaluation (19 for elevated FCP, 4 for two or more IBD-related symptoms). Among them, 10 (43.5%) had both macroscopic and microscopic presentation of colitis, 4 (17.4%) had microscopic appearance only, and 9 (39.1%) had normal histopathological findings. Notably, 94.7% of children with elevated FCP levels were asymptomatic for IBD. Among FCP-positive patients, 13 (68.4%) showed macroscopic and/or microscopic mucosal changes. Overall, colitis was confirmed in 14 (17.3%) patients. Sacroiliitis, as confirmed by magnetic resonance imaging, was significantly more frequent among both FCP-positive and colitis-positive patients (p < 0.001 and p = 0.008, respectively). No significant associations were found between FCP levels or intestinal inflammation and disease activity, acute-phase reactants, or treatment status.</p><p><strong>Conclusions: </strong>IBD and subclinical colitis are relatively frequent in JSpA. Elevated FCP represents a promising noninvasive biomarker for detecting silent intestinal inflammation, warranting confirmation by ileocolonoscopy.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":"518-529"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989668","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":"Comparative Effectiveness and Safety of Upadacitinib and Vedolizumab in Biologic-Experienced Patients With Ulcerative Colitis: A Retrospective Study","authors":"Neta Sror,&nbsp;Haim Leibovitzh,&nbsp;Ayal Hirsch,&nbsp;Tamar Thurm,&nbsp;Yulia Ron,&nbsp;Nitsan Maharshak,&nbsp;Nathaniel Aviv Cohen","doi":"10.1111/1751-2980.70012","DOIUrl":"10.1111/1751-2980.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Upadacitinib (UPA) and vedolizumab (VDZ) have been approved to treat moderate-to-severe ulcerative colitis (UC); however, direct comparative data between these two regimens are lacking. We aimed to compare the effectiveness and safety of UPA and VDZ among patients with moderate-to-severe UC who had previously been treated with advanced therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with moderate-to-severe UC receiving VDZ or UPA for at least 14 weeks following advanced therapy failure, including at least one anti-tumor necrosis factor (TNF) agent, between 2015 and 2024, were retrospectively recruited. Clinical response and remission were defined by the Partial Mayo Score and the Simple Clinical Colitis Activity Index. The safety profile during the treatment was also compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 66 patients treated with VDZ and 22 patients with UPA were included. The median age of the VDZ and UPA groups was 38 and 37 years, respectively. Patients receiving UPA achieved significantly higher rates of corticosteroid-free remission after 52-week therapy (75.0% vs. 25.0%; adjusted odds ratio [aOR] 5.68, 95% confidence interval [CI] 1.50–21.00, <i>p</i> = 0.011); however, these patients were more likely to experience adverse events (AEs) (40.9% vs. 9.1%; aOR 4.60, 95% CI 1.20–17.00, <i>p</i> = 0.02), although medication discontinuation due to AEs was only noted in two (3.0%) patients receiving VDZ. No patients were hospitalized during the treatment period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>UC patients receiving UPA achieved significantly higher rates of corticosteroid-free clinical remission but with more AEs, suggesting that decision-making based on disease severity and comorbidities can help guide the positioning of these therapies in UC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 9-10","pages":"428-435"},"PeriodicalIF":2.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258365","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":"Effect of Statins and PCSK9 Inhibition on Metabolic Dysfunction–Associated Steatotic Liver Disease","authors":"Eleni Theocharidou,&nbsp;Thomas Gossios","doi":"10.1111/1751-2980.70011","DOIUrl":"10.1111/1751-2980.70011","url":null,"abstract":"<p>Dyslipidemia is common in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and, along with other metabolic comorbidities, accounts for an increased cardiovascular risk. Effective treatment of dyslipidemia not only reduces such risk but may have a beneficial effect on MASLD as well. Here we reviewed published data on the efficacy and safety of available hypolipidemic treatments for MASLD. Statins are the mainstay of hypolipidemic therapy for MASLD. In patients with compensated cirrhosis, statins are safe and can improve the risks of decompensation and hepatocellular carcinoma as well as mortality. However, in those with decompensated cirrhosis, statins should not be used unless there are strong indications that outweigh the risk of adverse events. Studies on proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors acting as the second-line therapy in MASLD remain scarce. Preliminary clinical data support their protective roles in MASLD; however, preclinical data raise concerns regarding safety, in particular with complete PCSK9 inhibition due to hepatocyte lipid accumulation. While more evidence is required to elucidate the role of PCSK9 inhibitors, statins should be used for the treatment of hyperlipidemia in patients with MASLD according to their cardiovascular risk stratification.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 9-10","pages":"392-397"},"PeriodicalIF":2.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258309","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":"Stage-Specific Transcriptome Landscape of Hepatocellular Carcinoma: Insights From Super and Poor Survivors With Prognostic Signature Identification","authors":"Xiao Qian Xu,&nbsp;Hao Wang,&nbsp;Li Chen Shi,&nbsp;Cheng Huang,&nbsp;Hong You,&nbsp;Ji Dong Jia,&nbsp;You Wen He,&nbsp;Yuan Yuan Kong","doi":"10.1111/1751-2980.70010","DOIUrl":"10.1111/1751-2980.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Patient prognosis for hepatocellular carcinoma (HCC) varies significantly even when they share the same clinical stage. We aimed to characterize the stage-specific transcriptomic landscape in super survivors with HCC and develop a prognostic gene signature for the prediction of patient survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from The Cancer Genome Atlas (TCGA) among 76 age- and sex-matched super (alive at 5 years) and poor survivors (deceased within 1 year) with HCC were analyzed. Gene set enrichment analysis stratified by tumor stage was conducted, and a key prognostic gene signature was developed. The gene signature was then validated by using the whole TCGA cohort and the independent International Cancer Genome Consortium (ICGC) cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Stage-specific transcriptomic profiling revealed that stages I and II HCC cases showed positive enrichment in immune response pathways, while stage III tumor exhibited enhanced catabolic activities but reduced glycolysis. Across all tumor stages, cell cycle biological processes were less active in super survivors. A 19-gene signature, incorporating immune-, metabolism-, and cell cycle-related genes, accurately distinguished super survivors from poor survivors with 90.8% accuracy. The gene signature reliably predicted overall survival in both the verification cohort (area under the receiver operating characteristic curve [AUROC] for 1-, 3-, and 5-year survival: 0.82, 0.80, and 0.78) and the independent validation cohort (AUROC for 1- and 3-year survival: 0.80 and 0.83). Consistent AUROC was observed across tumor stages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 19-gene signature, considering the dynamic shift during HCC progression, may accurately predict survival outcomes in HCC patients as a potential tool for personalized prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 7-8","pages":"371-384"},"PeriodicalIF":2.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131206","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":"The Diagnostic and Prognostic Utility of Transabdominal Ultrasound in Crohn's Disease: A Clinical Study","authors":"Chen Xie,&nbsp;Xin Wang,&nbsp;Jie Gu,&nbsp;Xue Qin Pang,&nbsp;Qin Hua Xi,&nbsp;Lan Xiang Zhu,&nbsp;Jun Sun,&nbsp;Wei Chang Chen","doi":"10.1111/1751-2980.70009","DOIUrl":"10.1111/1751-2980.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>In this retrospective study we aimed to assess the diagnostic, monitoring, and prognostic utility of transabdominal ultrasound (TBUS) in patients with Crohn's disease in China and evaluate the utility of 16-week bowel wall thickness (BWT) reduction as a predictor of long-term outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with CD, either newly or previously diagnosed, who received biologic therapy for the first time and underwent baseline TBUS and endoscopy between June 2022 and September 2023 were included, with follow-up TBUS performed at Weeks 16 and 52 after the initiation of biologic therapy; clinical, ultrasound, laboratory, and disease activity data were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 60 patients, TBUS identified bowel wall thickening in 55 patients, with an average thickness of 7.36 ± 2.56 mm. The Limberg score of vascularization in the affected segments was ≥ 3 in 58.3% of the patients. Ascites, lymphadenopathy, and mesenteric fat hypertrophy were observed in 23.3%, 41.7%, and 41.7% of the patients, respectively. Significant correlations were found between baseline SES-CD or CDAI and BWT (<i>r</i> = 0.650 for SES-CD and 0.331 for CDAI) and the Limberg score (<i>r</i> = 0.538 for SES-CD and 0.387 for CDAI). The receiver operating characteristic (ROC) curve analysis revealed high diagnostic accuracy for BWT (area under the ROC curve [AUROC] 0.973) and the Limberg score (AUROC 0.927). Follow-up TBUS at Weeks 16 and 52 showed significant reductions in BWT and Limberg score. BWT reduction at Week 16 was significantly associated with CD clinical remission at Week 52 (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TBUS, particularly BWT and Limberg score, may serve as a useful noninvasive tool for diagnosis, monitoring, and prognosis in CD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 7-8","pages":"359-370"},"PeriodicalIF":2.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080764","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":"Efficacy and Safety of Linaclotide as an Adjunct to Polyethylene Glycol in Bowel Preparation: A Meta-Analysis","authors":"Muhammad Shahzil,&nbsp;Fariha Hasan,&nbsp;Ali Akram Qureshi,&nbsp;Zainab Jamil,&nbsp;Talha Kashif,&nbsp;Muhammad Saad Faisal,&nbsp;Taha Bin Arif,&nbsp;Ammad Javaid Chaudhary,&nbsp;Umer Farooq,&nbsp;Hassam Ali,&nbsp;John M. Levenick","doi":"10.1111/1751-2980.70008","DOIUrl":"10.1111/1751-2980.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Linaclotide, a guanylyl cyclase-C agonist, may enhance efficacy and tolerability when combined with polyethylene glycol (PEG) for bowel preparation. This meta-analysis evaluated linaclotide plus PEG versus PEG alone for bowel preparation prior to colonoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Randomized controlled trials (RCTs) including adults undergoing colonoscopy that compared linaclotide plus PEG with PEG alone for bowel preparation were identified via database search up to March 2024. Statistical analysis was performed in RevMan Web using random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven RCTs were analyzed. Adequate bowel preparation rate was comparable (risk ratio [RR] 1.01, 95% confidence interval [CI] 0.98–1.04; <i>I</i>² = 23%), as was cecal intubation rate (RR 1.01, 95% CI 1.00–1.01). Subgroup analyses showed that compared with 3-L PEG alone, 2-L PEG plus linaclotide was non-inferior, while 3-L PEG plus linaclotide was superior regarding bowel preparation adequacy (RR 1.11, 95% CI 1.01–1.23) and total Boston Bowel Preparation Scale (BBPS) score (mean difference 0.44, 95% CI 0.04–0.85). Right and left colon BBPS scores were also higher with linaclotide. Polyp detection rate improved significantly in the 3-L PEG plus linaclotide subgroup (RR 1.78, 95% CI 1.32–2.40), whereas adenoma detection rate and withdrawal time were comparable. Linaclotide reduced abdominal pain, bloating, nausea, and sleep disturbance, and increased willingness to repeat colonoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Linaclotide with PEG provides comparable overall bowel cleansing to PEG alone while reducing adverse events and improving patient acceptance. Importantly, 2-L PEG plus linaclotide was non-inferior compared with 3-L PEG, whereas 3-L PEG plus linaclotide showed superiority over 3-L PEG alone, supporting its use in low-volume bowel preparation strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 7-8","pages":"318-333"},"PeriodicalIF":2.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069631","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":"Dynamic Relevance Between Reflux Events and Esophageal Motility in Patients With Proton Pump Inhibitor-Refractory Gastroesophageal Reflux Disease","authors":"Si Hui Lin,&nbsp;Zhi Feng Wang,&nbsp;Hua Li,&nbsp;Xiao Hong Sun,&nbsp;Xiao Qing Li,&nbsp;Gui Jun Fei,&nbsp;Wei Guang Chen,&nbsp;Tao Guo,&nbsp;Mei Yun Ke,&nbsp;Xiu Cai Fang","doi":"10.1111/1751-2980.70007","DOIUrl":"10.1111/1751-2980.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The association between reflux events and esophageal motility abnormality is unclear. We aimed to determine the relevance between reflux events and esophageal motility in proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with PPI-refractory or PPI-responsive GERD were enrolled. Ambulatory 24-h esophageal pH–impedance–pressure monitoring was performed. Reflux symptoms, reflux events, and esophageal motility during acid reflux episodes were recorded and compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty patients with PPI-refractory GERD and 18 with PPI-responsive GERD were included, all of whom had pathological gastroesophageal reflux. There were no significant differences in the major acid reflux parameters (DeMeester score and proportion of patients with acid exposure time &gt; 6%) between the two groups. However, the number of long acid reflux episodes and the time length of the longest reflux episodes were significantly higher in the PPI-refractory GERD group than in the PPI-responsive GERD group (both <i>p</i> &lt; 0.05). Moreover, patients with PPI-refractory GERD had higher rates of ineffective primary (62.0% vs. 36.0%, <i>p</i> &lt; 0.001) and secondary peristalsis (83.5% vs. 57.0%, <i>p</i> = 0.001) during long acid exposure (LAE) than those with PPI-responsive GERD. Patients with PPI-refractory GERD having LAE had a significantly lower frequency of primary and secondary peristalsis per minute and required a longer time to initiate secondary peristalsis than those without during their longest acid reflux period in the upright position (all <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Longer acid reflux episodes in patients with PPI-refractory GERD might result from frequent ineffective primary esophageal peristalsis and delayed initiation of effective secondary peristalsis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"221-229"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956569","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}