Edoardo Vespa, Alberto Barchi, Jacopo Fanizza, Rukaia Barà, Ernesto Fasulo, Sarah Bencardino, Francesca Bernardi, Ilaria Faggiani, Silvio Danese, Sandro Passaretti
{"title":"Mean Basal Esophagogastric Junction Pressure Is a Better High-resolution Manometry Predictor of Gastroesophageal Reflux Disease Than Esophagogastric Junction Contractile Integral.","authors":"Edoardo Vespa, Alberto Barchi, Jacopo Fanizza, Rukaia Barà, Ernesto Fasulo, Sarah Bencardino, Francesca Bernardi, Ilaria Faggiani, Silvio Danese, Sandro Passaretti","doi":"10.5056/jnm25029","DOIUrl":"10.5056/jnm25029","url":null,"abstract":"<p><strong>Background/aims: </strong>: Esophagogastric junction contractile integral (EGJ-CI) is a metric of EGJ barrier function assessed on high-resolution manometry (HRM). However, its clinical utility may be limited by measurement discrepancies and wide variability. Mean basal EGJ pressure (MBEP) is a novel, simple HRM metric assessing barrier function. We compared their performance to predict conclusive gastroesophageal reflux disease (GERD).</p><p><strong>Methods: </strong>: Consecutive patients undergoing esophageal function testing for known or suspected GERD were retrospectively evaluated. MBEP and EGJ-CI were manually calculated. Conclusive GERD was defined as acid exposure time > 6% or histologically confirmed Barrett's esophagus. Statistical analyses including Mann-Whitney and Kruskal-Wallis tests, receiver operating characteristic (ROC) curves, univariable and multivariable logistic regression were performed.</p><p><strong>Results: </strong>: Two hundred and twenty-six patients (mean age 52.8 ± 14.6 years, 58% males) were included. Applying Lyon 2.0 consensus criteria, 41% had conclusive GERD, 8% had borderline GERD, 8% had reflux hypersensitivity, and 43% had no GERD evidence. Patients with conclusive GERD had significantly lower MBEP compared to those without (11.8 mmHg vs 18.5 mmHg; <i>P</i> < 0.001). MBEP showed greater predictive performance for conclusive GERD (area under the ROC curve [AUROC]: 0.71; 95% CI, 0.65-0.78) than EGJ-CI (AUROC: 0.66; 95% CI, 0.59-0.74), also discriminating Lyon 2.0 subgroups (P < 0.001) and EGJ morphology types (P < 0.001). On multivariable analysis, MBEP independently predicted conclusive GERD (per 1-mmHg increase OR, 1.11; <i>P</i> = 0.022), while EGJ-CI did not (OR, 0.99; <i>P</i> = 0.207).</p><p><strong>Conclusions: </strong>: MBEP is a simple HRM metric to evaluate anti-reflux barrier function, predicting conclusive GERD and differentiating reflux phenotypes with better performance than EGJ-CI. This metric could serve as a valuable adjunctive tool in GERD diagnosis.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"35-45"},"PeriodicalIF":3.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906114","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}
Francesco Calabrese, Andrea Pasta, Edoardo V Savarino, Edoardo G Giannini, Elisa Marabotto
{"title":"Mean Nocturnal Baseline Impedance in Gastroesophageal Reflux Disease: Considerations on the Study by Lee et al.","authors":"Francesco Calabrese, Andrea Pasta, Edoardo V Savarino, Edoardo G Giannini, Elisa Marabotto","doi":"10.5056/jnm25153","DOIUrl":"10.5056/jnm25153","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"136-137"},"PeriodicalIF":3.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906132","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}
Xin Huang, Yuzhu Chen, Xiaolin Ji, Lingling Zhu, Tianzhuang Li, Zhiwei Xia, Zhijie Xu, Ying Ge, Kun Wang, Liping Duan
{"title":"Transient Gastric Pressure Elevation Synergizing With Impaired Esophagogastric Junction Barrier Function Plays a Pivotal Role in the Refractory Gastroesophageal Reflux Disease.","authors":"Xin Huang, Yuzhu Chen, Xiaolin Ji, Lingling Zhu, Tianzhuang Li, Zhiwei Xia, Zhijie Xu, Ying Ge, Kun Wang, Liping Duan","doi":"10.5056/jnm25050","DOIUrl":"10.5056/jnm25050","url":null,"abstract":"<p><strong>Background/aims: </strong>: The pathophysiology of refractory gastroesophageal reflux disease (RGERD), which differs from proton pump inhibitor dependent gastroesophageal reflux disease (DGERD), remains incompletely elucidated. This study aims to compare esophageal motility patterns, transdiaphragmatic pressure gradients (TPG), and reflux profiles between RGERD and DGERD patients, and to delineate dynamic pressure gradient-esophagogastric junction (EGJ) interactions in these patients.</p><p><strong>Methods: </strong>: In this retrospective study, 274 patients who underwent 24-hour impedance-pH monitoring and high-resolution manometry, along with an assessment of proton pump inhibitor responsiveness, were classified as RGERD (32.5%), DGERD (54.4%), or non-GERD (13.1%). Clinical characteristics, TPG, esophageal motility, and reflux metrics were compared between RGERD and DGERD patients. Subgroup analysis excluding hiatal hernia (HH) was conducted to investigate the pathophysiology of RGERD.</p><p><strong>Results: </strong>: The RGERD group exhibited a significantly higher proportion of chest pain compared to the DGERD group. Regarding reflux profiles, RGERD patients without HH (RGERD<sup>HH-</sup> group) experienced increased weakly acidic reflux (<i>P</i> < 0.001) and prolonged bolus exposure (<i>P</i> = 0.006) compared to their counterparts (DGERD<sup>HH-</sup> group). Mechanistically, the RGERD<sup>HH-</sup> group showed reduced lower esophageal sphincter basal pressure (<i>P</i> = 0.010) and EGJ contractile integral (<i>P</i> = 0.005). Notably, following a wet-swallow, the RGERD<sup>HH-</sup> group experienced the significant elevation in gastric pressure and TPG. Correlation analyses revealed weakly acidic reflux and bolus exposure were positively correlated with gastric pressure variation, and inversely correlated with lower esophageal sphincter basal pressure.</p><p><strong>Conclusions: </strong>: Transient gastric pressure elevation and compromised EGJ barrier function drive weakly acidic reflux and esophageal bolus exposure. This pressure gradient-barrier mismatch underpins the refractoriness of RGERD.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"32 1","pages":"71-85"},"PeriodicalIF":3.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906157","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":"The Effect of Tegoprazan on Serum Gastrin Levels and the Development of Hypergastrinemia in the Maintenance Treatment for Gastroesophageal Reflux Disease: Comparison to Lansoprazole.","authors":"Kwang Jae Lee, Da Hyun Jung, Oh Young Lee","doi":"10.5056/jnm25104","DOIUrl":"10.5056/jnm25104","url":null,"abstract":"<p><strong>Background/aims: </strong>Safety data on potassium-competitive acid blockers are limited. We aim to evaluate the effect of tegoprazan on serum gastrin levels during maintenance treatment for gastroesophageal reflux disease compared to lansoprazole.</p><p><strong>Methods: </strong>In a prospective, randomized trial, patients who underwent initial treatment with a standard dose of a proton pump inhibitor (n = 121) or tegoprazan (n = 226) were randomized to receive a half-dose of tegoprazan (n = 173) or lansoprazole (n = 174) as maintenance treatment for up to 24 weeks. Serum gastrin levels were measured immediately after initial treatment and monitored throughout the maintenance treatment period.</p><p><strong>Results: </strong>Baseline gastrin levels were similar between the tegoprazan and lansoprazole groups (<i>P</i> = 0.335). During maintenance treatment, gastrin levels were significantly lower in the tegoprazan group at week 16 (<i>P</i> = 0.001) and week 24 (<i>P</i> = 0.012) compared to the lansoprazole group. Although the proportion of hypergastrinemia (> 115 pg/mL) was similar at baseline between the tegoprazan and lansoprazole groups (<i>P</i> = 0.114), it was significantly lower in the tegoprazan group during maintenance treatment (<i>P</i> = 0.003, 0.033, and 0.039 at weeks 8, 16, and 24, respectively) than in the lansoprazole group. Multivariate analysis revealed that age, sex, baseline gastrin levels, <i>Helicobacter pylori</i> infection, and the drug group were independently associated with final gastrin levels.</p><p><strong>Conclusion: </strong>Tegoprazan has a smaller impact on increasing serum gastrin levels and the development of hypergastrinemia than lansoprazole, suggesting that tegoprazan may reduce safety concerns related to hypergastrinemia, particularly at half doses.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 4","pages":"527-533"},"PeriodicalIF":3.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280458","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}
Jung-Bin Park, Kee Wook Jung, June Hwa Bae, Kyuwon Kim, Min Hui Lee, Gyeong-Chae Bae, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Suk-Kyun Yang, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Seung-Jae Myung
{"title":"Comparison of Clinical Characteristics and Long-term Prognosis of Focal Hypoganglionosis With Adult-onset Megacolon and Chronic Intestinal Pseudo-obstruction.","authors":"Jung-Bin Park, Kee Wook Jung, June Hwa Bae, Kyuwon Kim, Min Hui Lee, Gyeong-Chae Bae, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Suk-Kyun Yang, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Chang Sik Yu, Seung-Jae Myung","doi":"10.5056/jnm24179","DOIUrl":"10.5056/jnm24179","url":null,"abstract":"<p><strong>Background/aims: </strong>Focal hypoganglionosis with adult-onset megacolon (FHAM) is marked by colon dilation proximal to a narrowed segment, with unaffected small bowel motility. Despite similar initial symptoms, FHAM may be more amenable to surgical intervention without recurrence, unlike chronic intestinal pseudo-obstruction (CIPO). The long-term outcomes of FHAM remain underexplored, prompting a comparison of its clinical features and prognosis with CIPO.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients presenting with chronic constipation and megacolon, prospectively recruited between January 2017 and December 2023. Within this cohort, 87 patients were diagnosed with FHAM and 13 with CIPO, all of whom were included in the study. The median follow-up period was 3.0 years for patients with FHAM and 2.8 years for those with CIPO.</p><p><strong>Results: </strong>The proportion of females was greater in both groups (FHAM, 67.8%; CIPO, 53.8%). The median age at diagnosis was similar between the groups (FHAM, 54.5 years; CIPO, 45.3 years). Surgery was performed in 46.0% of patients with FHAM and 69.2% of those with CIPO. Unplanned postoperative hospitalizations and the need for reoperation due to disease recurrence were notably lower in patients with FHAM. None of the patients with FHAM required long-term total parenteral nutrition, in contrast to 46.2% of patients with CIPO. Significant inter-group differences were observed in body mass index at the last follow-up.</p><p><strong>Conclusions: </strong>Patients with FHAM exhibit a more favorable long-term prognosis and lower postoperative recurrence rates than patients with CIPO. This study underscores the importance of differentiating between these conditions and precisely selecting surgical candidates.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 4","pages":"501-511"},"PeriodicalIF":3.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280517","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":"The Need for Objective Testing in Proton Pump Inhibitor-refractory Extraesophageal Gastroesophageal Reflux Disease.","authors":"Seung Young Kim","doi":"10.5056/jnm25138","DOIUrl":"10.5056/jnm25138","url":null,"abstract":"","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 4","pages":"405-406"},"PeriodicalIF":3.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280440","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":"Treatment of Irritable Bowel Syndrome With Antispasmolytics in Taiwan, Hong Kong, and Vietnam: A Delphi Expert Consensus Statement.","authors":"Sabera Hashim, Shan Wang, Benjamin Burr, Swarali Tadwalkar, Radhika Mehta, Ankur Gupta","doi":"10.5056/jnm25035","DOIUrl":"10.5056/jnm25035","url":null,"abstract":"<p><strong>Background/aims: </strong>In Hong Kong, Taiwan and Vietnam, the burden of irritable bowel syndrome (IBS) is poorly documented, with limited evidence-based treatments and outdated guidelines. We used a modified Delphi method to reach expert consensus on different aspects of disease management and gain insights into the current clinical practice for IBS in these 3 countries, focusing on treatment with antispasmolytics.</p><p><strong>Methods: </strong>Evidence from a targeted literature review was used to draft consensus statements for a multidisciplinary 3-round Delphi survey. Consensus was defined as ≥ 70% agreement among experts from the same country (qualitative data) or a SD < 5% on rate estimates (quantitative data). Data were grouped and analyzed by expert specialty and country.</p><p><strong>Results: </strong>Thirty-six experts (12 per country; primary care physicians, n = 6; gastroenterologists, n = 4; and pharmacists, n = 2) participated in the 3 voting rounds. Consensus was reached for 17/25 (68.0%) statements. Respondents agreed that IBS diagnosis relies on symptoms and guidelines. Regarding antispasmolytics, most experts were highly satisfied with the available medications, particularly hyoscine and otilonium bromide, and agreed on a short (< 2 weeks) treatment duration. Mean 1-year relapse rate was 38.3-48.0% with antispasmolytics overall and 20.5-26.5% with otilonium bromide. In all 3 countries, consensus was reached that frequent IBS relapses affect patients' daily routine and quality of life frequently and that long-term treatment strategies addressing relapse represent a key unmet need in IBS management.</p><p><strong>Conclusions: </strong>Although antispasmolytics provide immediate symptom relief, their long-term effectiveness needs further investigations in Asian populations. Our findings may inform clinical decision-making and guideline updates.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 4","pages":"512-526"},"PeriodicalIF":3.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280443","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}
Ho-Kyoung Lee, Cheol Min Shin, Young Hoon Chang, Hyemin Jo, Jinju Choi, Yonghoon Choi, Yu Kyung Jun, Hyuk Yoon, Young Soo Park, Nayoung Kim, Dong Ho Lee
{"title":"Predictors of Treatment Response to Fecal Microbiota Transplantation in Irritable Bowel Syndrome: A Pilot Study.","authors":"Ho-Kyoung Lee, Cheol Min Shin, Young Hoon Chang, Hyemin Jo, Jinju Choi, Yonghoon Choi, Yu Kyung Jun, Hyuk Yoon, Young Soo Park, Nayoung Kim, Dong Ho Lee","doi":"10.5056/jnm24183","DOIUrl":"10.5056/jnm24183","url":null,"abstract":"<p><strong>Background/aims: </strong>We aim to investigate the effectiveness, safety, and predictors of treatment response to fecal microbiota transplantation (FMT) in Korean irritable bowel syndrome (IBS) patients.</p><p><strong>Methods: </strong>Patients with moderate to severe diarrhea-predominant IBS (IBS-D) or mixed-type IBS (IBS-M) received FMT from one healthy donor via esophagogastroduodenoscopy. IBS-symptom severity score (IBS-SSS), Bristol stool form scale (BSFS), IBS Quality of Life (IBS-QoL) questionnaires, Hospital Anxiety and Depression Scale (HADS), and gut microbiome profiles were assessed at baseline, 4 weeks and 12 weeks post-FMT.</p><p><strong>Results: </strong>Among the 46 enrolled IBS patients, 37 patients (IBS-D:IBS-M = 28:9) completed a 12-week follow-up. Significant improvements were observed in IBS-SSS, IBS-QoL, and BSFS after 12 weeks. FMT led to increased microbial diversity and a sustained increase in beneficial bacterial genera, including <i>Holdemanella, Ruminococcus</i>, and <i>Faecalibacterium</i>. In terms of β-diversity, the distance between the patient's gut microbiome and that of the donor decreased after FMT; greater reduction in distance to donor microbiota was associated with greater symptom improvement (Unweighted UniFrac distance, <i>P</i> < 0.05). Responders (IBS-SSS reduction > 50 points) exhibited lower baseline relative abundances of <i>Roseburia</i> and <i>Subdoligranulum</i>, and more profound microbiome shifts toward the donor profile after FMT.</p><p><strong>Conclusions: </strong>FMT appears to be a potentially effective treatment for moderate to severe IBS, with significant symptom relief and gut microbiota changes. Lower baseline abundances of <i>Roseburia</i> and <i>Subdoligranulum</i> and greater shifts of gut microbiome profile toward donor microbiota after FMT may predict favorable FMT response. Long-term follow-up is on the way to assessing the durability of these effects.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 4","pages":"462-476"},"PeriodicalIF":3.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280495","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}
Sungchan Ha, Nayoung Kim, Soo In Choi, Ryoung Hee Nam, Jae Young Jang, Eun Hye Kim, Chin-Hee Song, Hee Young Na, Won Kim
{"title":"Age- and Sex-dependent Effects of High-fructose, High-fat Diets on Small Bowel Inflammation and Hepatic Steatosis in F344 Rats.","authors":"Sungchan Ha, Nayoung Kim, Soo In Choi, Ryoung Hee Nam, Jae Young Jang, Eun Hye Kim, Chin-Hee Song, Hee Young Na, Won Kim","doi":"10.5056/jnm24155","DOIUrl":"10.5056/jnm24155","url":null,"abstract":"<p><strong>Background/aims: </strong>The liver and small bowel are closely interrelated, and their diet-induced metabolic dysfunction-associated steatotic liver disease (MASLD) may also be influenced by age and sex. Therefore, this study aims to investigate the effects of age and sex on hepatic steatosis and small bowel inflammation induced by a high-fructose and high-fat diet (HFHFD) in rats.</p><p><strong>Methods: </strong>Male and female rats, aged 6 weeks (young) and 2 years (aged), were used. The HFHFD groups were provided with a high-fat diet and high-fructose water for 8 weeks. Liver and small bowel tissues were histologically analyzed. Tight junction protein expression in jejunal mucosa was analyzed, and immunohistochemistry was performed to detect claudin-2 (<i>Cldn-2</i>).</p><p><strong>Results: </strong>The histological inflammation scores of the old control groups were higher than those of the young control groups, regardless of sex. The jejunal villus/crypt ratio in the young rats was decreased in the male HFHFD group (<i>P</i> = 0.045). In contrast, in aged rats, the villus/crypt ratio decreased in the female HFHFD group (<i>P</i> = 0.076). Hepatic steatosis was higher for the male HFHFD groups (young, <i>P</i> = 0.003; aged, <i>P</i> = 0.005) and in the aged female HFHFD groups (<i>P</i> = 0.003). The correlation of jejunal inflammation scores with hepatic steatosis (<i>P</i> < 0.001) and <i>Cldn-2</i> mRNA expression (<i>P</i> = 0.047) was significant, with the highest expression observed in aged female HFHFD rats.</p><p><strong>Conclusion: </strong>MASLD may be associated with HFHFD-induced jejunal damage. In addition, the upregulation of <i>Cldn-2</i> may contribute to MASLD in aged female rats.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 4","pages":"477-490"},"PeriodicalIF":3.3,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280501","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}