Journal of Gastroenterology and Hepatology最新文献

{"title":"Methodological Considerations in Interpreting Dairy-Free Diet Efficacy in Adult Eosinophilic Oesophagitis.","authors":"Zia Ullah","doi":"10.1111/jgh.70822","DOIUrl":"https://doi.org/10.1111/jgh.70822","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181807","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":"Dietary and Microbial Determinants of Intestinal Sulfur Gas and Malodor: Mechanisms, Phenotypes, and Nutritional Mitigation.","authors":"Aziz Ullah","doi":"10.1111/jgh.70806","DOIUrl":"https://doi.org/10.1111/jgh.70806","url":null,"abstract":"<p><p>Intestinal gas and malodor are common nutrition-related concerns that may influence dietary adherence, gastrointestinal symptoms, and quality of life. Although gas volume and odor are often treated as a single outcome, they arise from partly distinct processes. Bulk intestinal gas is generated principally through swallowed air, acid-bicarbonate reactions, and microbial fermentation, whereas malodor is determined mainly by trace volatile sulfur compounds, including hydrogen sulfide, methanethiol, and dimethyl sulfide. Their production depends on dietary sulfur amino acids, sulfate, taurine, host-derived substrates, microbial cross-feeding, intestinal transit, luminal chemistry, and gas-liquid partitioning. This review integrates evidence concerning dietary determinants of intestinal gas, gut microbial sulfur metabolism, nutritional and microbiome-directed interventions, and downstream odor-control strategies. The concept of conditional sound-odor discordance is retained as a secondary framework illustrating that gas volume, acoustic intensity, and odor burden should not be considered interchangeable endpoints. Human dietary trials indicate that low-FODMAP diets and substrate-specific enzymes may reduce fermentation-related symptoms or total gas production, but they do not necessarily suppress sulfur-derived odorants. Probiotic evidence remains strain-specific and largely indirect, whereas sulfide-binding compounds and external adsorptive devices target odor-active molecules more directly. Future nutritional studies should combine controlled dietary exposure with measurements of gas volume, volatile sulfur compounds, microbial functional pathways, intestinal transit, and perceived odor.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168914","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":"Double Duty, Single Scope: Unmasking a Pancreatic Mass in Billroth II Anatomy.","authors":"Akihiko Kida, Kosuke Satomura, Fumitaka Arihara, Azusa Kawasaki, Yuji Hodo, Yukihiro Shirota, Taro Yamashita","doi":"10.1111/jgh.70804","DOIUrl":"https://doi.org/10.1111/jgh.70804","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182531","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":"Endoscopic Surveillance After Endoscopic Resection of Superficial Esophageal Squamous Cell Carcinoma for Metachronous Head and Neck Cancers.","authors":"Yuya Asada, Shunsuke Yoshii, Ryu Ishihara, Yuta Fujimoto, Yoshiaki Ando, Gentaro Tanabe, Tomoya Ueda, Daiki Kitagawa, Atsuko Kizawa, Takehiro Ninomiya, Yuki Okubo, Hitoshi Mori, Yasuhiro Tani, Minoru Kato, Satoki Shichijo, Takashi Kanesaka, Sachiko Yamamoto, Koji Higashino, Noriya Uedo, Tomoki Michida","doi":"10.1111/jgh.70805","DOIUrl":"https://doi.org/10.1111/jgh.70805","url":null,"abstract":"<p><strong>Background and aim: </strong>Patients undergoing endoscopic resection (ER) for superficial esophageal squamous cell carcinoma (ESCC) are at risk of developing metachronous head and neck cancers (HNCs). Early detection of HNCs is essential for preserving patients' quality of life. Although periodic endoscopic surveillance for metachronous ESCCs is widely recommended, the optimal strategy for detecting metachronous HNCs after esophageal ER remains unclear.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included patients who underwent ER for superficial ESCC at a tertiary cancer center between 2006 and 2017. The study endpoints were the incidence of metachronous HNCs after esophageal ER, risk factors for metachronous HNCs, and the association between detected metachronous HNCs and surveillance intervals.</p><p><strong>Results: </strong>Among 644 patients, 137 metachronous HNC lesions were identified in 89 patients over a median follow-up of 63.0 months. The 10-year cumulative incidence of metachronous HNCs was 25.4%. Multivariate analysis identified male sex, esophageal grade C Lugol-voiding lesions, and metachronous ESCC within 1 year after ER as independent risk factors for metachronous HNCs. Surveillance intervals (≥ 7 months) were independently associated with the detection of larger HNCs (≥ 20 mm), but no statistically significant association was observed with the need for invasive treatment, including surgery, radiotherapy, or chemoradiotherapy. Tumor location in the postcricoid area or on the posterior wall of the hypopharynx was significantly associated with the need for invasive treatment.</p><p><strong>Conclusions: </strong>Metachronous HNCs frequently occur after esophageal ER, particularly in high-risk patients. Post-ER endoscopic surveillance should be performed not only to detect metachronous ESCCs but also to identify metachronous HNCs.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182541","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":"14-Day Keverprazan-Amoxicillin Dual Therapy Versus Bismuth-Containing Quadruple Therapy as First-Line Treatment for Helicobacter pylori Eradication: A Prospective, Single-Center, Randomized Controlled Trial.","authors":"Yue Yu, Qiang She, Yan-Bing Ding, Min Zhang, Yao-Yao Li, Zhuo-Qi Liu, Jing-Wen Fang, Li Chen, Zhen-Bin Yang, Chun-Hua Liu, Ben-Gang Zhou, Xin Jiang","doi":"10.1111/jgh.70808","DOIUrl":"https://doi.org/10.1111/jgh.70808","url":null,"abstract":"<p><strong>Background: </strong>Keverprazan, a novel potassium-competitive acid blocker (P-CAB), provides stronger and more sustained gastric acid suppression than proton pump inhibitors (PPIs). However, direct comparisons between 14-day keverprazan-amoxicillin (KA) dual therapy and 14-day bismuth-containing quadruple therapy (BQT) for Helicobacter pylori (H. pylori) eradication remain limited.</p><p><strong>Objective: </strong>This study compared the efficacy and safety of the 14-day KA dual therapy versus BQT as a first-line therapy for H. pylori eradication.</p><p><strong>Methods: </strong>This randomized controlled trial (RCT) recruited 316 treatment-naive, H. pylori-infected patients. Participants were randomly assigned to receive either the KA group (keverprazan 20 mg twice daily + amoxicillin 1000 mg three times daily) or the BQT group (esomeprazole 20 mg twice daily + amoxicillin 1000 mg twice daily + clarithromycin 500 mg twice daily + colloidal bismuth pectin 300 mg twice daily). H. pylori eradication rate was the primary outcome. Adverse events and compliance were considered as secondary outcomes.</p><p><strong>Results: </strong>KA dual therapy was noninferior to BQT in eradication rates across intention-to-treat (ITT) analysis (85.4% vs. 82.9%, noninferiority p = 0.001), modified intention-to-treat (MITT) analysis (92.5% vs. 92.9%, noninferiority p < 0.001), and per-protocol (PP) analysis (93.7% vs. 93.5%, noninferiority p < 0.001). Adverse events were significantly lower in the KA group (19.0%) than in the BQT group (28.5%), p = 0.047.</p><p><strong>Conclusion: </strong>The trial suggested KA dual therapy was a promising first-line therapy, achieving a 93.7% eradication rate in the PP analysis, with favorable safety and similar compliance compared to BQT.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry: ChiCTR2400089303.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182549","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":"From Mitochondrial Targeting to Mechanistic Dependency in Nanoparticle Therapy for Ulcerative Colitis.","authors":"Kaan Zıkşahna, Murat Ihlamur","doi":"10.1111/jgh.70809","DOIUrl":"https://doi.org/10.1111/jgh.70809","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166140","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":"Can a Non-VCTE HCC Prediction Model Be Validated Exclusively in VCTE-Assessed Patients?","authors":"Serdar Hıra","doi":"10.1111/jgh.70812","DOIUrl":"https://doi.org/10.1111/jgh.70812","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168008","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":"Heterogeneous Response Patterns to Multispecies Probiotics in Patients With Constipation During Pregnancy: An Exploratory Analysis of a Phase 2 Clinical Trial.","authors":"Xu Zhiyue, Zhou Le, Ding Shengjie, Feng Ling, Wang Zhengping, Liu Guocheng, Cai Qinghua, Chen Hongbo, Zhao Xinling, Liu Yan, Gao Lili, Hou Xiaohua, Bai Tao, Liu Xinghui","doi":"10.1111/jgh.70746","DOIUrl":"https://doi.org/10.1111/jgh.70746","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the efficacy and safety of multispecies probiotics in patients with constipation during pregnancy.</p><p><strong>Methods: </strong>This Phase 2, randomized, double-blind, placebo-controlled trial was conducted across 10 hospitals in China. One hundred and twenty-two pregnant females with constipation were randomly assigned in a 2:1 ratio to receive either multispecies probiotics or placebo for 8 weeks. The primary efficacy endpoint was the proportion of patients who achieved a mean CSBM frequency of ≥ 3 per week across the entire 8-week treatment period, together with an increase of ≥ 1 CSBM per week from the baseline weekly average.</p><p><strong>Results: </strong>The overall response rate did not differ significantly between probiotics (22.78%) and placebo groups (20.51%) (p = 0.779). Weekly response rates showed different temporal patterns between groups (P for interaction = 0.024); however, this did not result in a significant between-group difference at Week 8. In post hoc exploratory subgroup analyses, for patients with baseline SBM < 3/week, baseline straining score ≤ 2, baseline stool consistency score ≤ 2 (Type 1 or 2), and gestational weeks > 20 weeks, the weekly response rate in probiotics increased faster during the treatment period. The probiotic treatment was well tolerated, with no serious adverse events observed.</p><p><strong>Conclusions: </strong>Multispecies probiotics were safe and well tolerated during pregnancy but did not significantly improve the prespecified primary endpoint within an 8-week treatment period. Post hoc subgroup analyses suggested potentially heterogeneous response trajectories according to baseline bowel frequency, straining severity, stool consistency, and gestational age; however, these findings should be interpreted with caution.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168587","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":"Protocol-Publication Discordance and Missing-Outcome Handling in Probiotic Consolidation Therapy for Rifaximin-Responsive IBS-D.","authors":"Muhammad Shoaib Khan","doi":"10.1111/jgh.70801","DOIUrl":"https://doi.org/10.1111/jgh.70801","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170152","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":"Cold Snare Polypectomy Versus Cold Snare Polypectomy With Submucosal Injection for 3-9 mm Colorectal Polyps: A Randomized Controlled Trial.","authors":"Sukit Pattarajierapan, Ponpapat Surapat, Supaphat Kongsupapsiri, Papanun Methakittrakoon, Naruemon Wisedopas, Natcha Wanpiyarat, Nathawadee Lerttanatum, Supakij Khomvilai","doi":"10.1111/jgh.70799","DOIUrl":"https://doi.org/10.1111/jgh.70799","url":null,"abstract":"<p><strong>Background and aim: </strong>Incomplete resection after cold snare polypectomy (CSP) remains a concern. CSP may sometimes require a forcible pull (\"forced CSP\"), which increases the incomplete resection rate (IRR). Submucosal injection before CSP (SI-CSP) may facilitate resection and reduce IRR. We compared SI-CSP with CSP for 3-9 mm polyps using an approach avoiding forced CSP.</p><p><strong>Methods: </strong>This randomized controlled trial enrolled patients aged 40-79 years undergoing screening or surveillance colonoscopy with at least one 3-9 mm adenomatous or sessile serrated lesion. They were randomized in a 1:1 ratio into the SI-CSP and CSP groups. If resection without forced CSP was not feasible, the procedure was converted to endoscopic mucosal resection (EMR). The primary outcome was the IRR, assessed by additional biopsies of the margins.</p><p><strong>Results: </strong>Overall, 340 polyps from 340 patients were analyzed. Baseline characteristics were comparable between the groups. In the intention-to-treat analysis, the IRRs were low and similar between the SI-CSP and CSP groups (0% vs. 1%, p = 1). SI-CSP was associated with a lower EMR conversion rate (1% vs. 12%, p < 0.001), but median procedural time was longer (77 s vs. 54 s, p < 0.001). EMR conversion occurred exclusively for 6-9 mm polyps.</p><p><strong>Conclusions: </strong>Avoiding forced CSP, with conversion to EMR when necessary, results in very low IRRs for SI-CSP and CSP in 3-9 mm colorectal polyps. Compared with CSP, SI-CSP does not reduce the IRR but reduces conversion to EMR. However, SI-CSP requires a longer procedural time and additional resources for submucosal injection.</p><p><strong>Trial registration: </strong>Thai Clinical Trials Registry TCTR20240805001.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147855","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}