United European Gastroenterology Journal最新文献

{"title":"Efficacy and Safety of Vonoprazan and High-Dose Amoxicillin Dual Therapy for Rescue Treatment of Helicobacter pylori Infection: A Multicenter Randomized Controlled Trial.","authors":"Ju Zhang, Xinzhao Wang, Shujie Song, Xiaoming Zhu, Ting Lv, Lingling Wang, Lei Lei, Yuhui Wang, Yali Lei, Yating Wang, Xiaojing Zhu, Lifeng Zhang, Min Chen, Yongquan Shi","doi":"10.1002/ueg2.70070","DOIUrl":"https://doi.org/10.1002/ueg2.70070","url":null,"abstract":"<p><strong>Background: </strong>Vonoprazan and amoxicillin dual therapy has demonstrated favorable efficacy in the initial treatment of Helicobacter pylori (H. pylori) infection. This study aimed to evaluate the efficacy and safety of vonoprazan and high-dose amoxicillin (VHA) dual therapy for H. pylori rescue treatment.</p><p><strong>Methods: </strong>This was an open label, multicenter, non-inferiority, and randomized controlled clinical trial conducted at four institutions in both central and northwestern China. A total of 688 H. pylori-infected patients who had failed previous treatments were randomly assigned (1:1) to receive either VHA dual therapy or the tetracycline- and furazolidone-based bismuth-containing quadruple therapy (TFEB) for 14 days. Eradication rates, adverse event (AE) rates, and the patient compliance were compared between the two groups.</p><p><strong>Results: </strong>The eradication rates in the VHA and TFEB groups were 73.8% and 76.2% (p = 0.481), respectively, by intention-to-treat (ITT) analysis; 81.9% and 85.6% (p = 0.215), respectively, by modified ITT (MITT) analysis; and 82.1% and 85.6% (p = 0.248), respectively, by per-protocol (PP) analysis. VHA therapy remained non-inferior to TFEB in ITT, MITT, and PP analyses. The overall AE incidence in the VHA group was significantly lower compared with that in the TFEB group (13.4% vs.. 28.5%, p < 0.001). Patients' compliance was similar between the two groups. A history of multiple prior eradication failures was an independent risk factor (2 failures: OR = 0.566, p = 0.032; ≥ 3 failures: OR = 0.335, p < 0.001) reducing the efficacy of H. pylori rescue therapy.</p><p><strong>Conclusion: </strong>The 14-day VHA dual therapy was non-inferior to bismuth-containing quadruple therapy, with a lower incidence of adverse events and good compliance, and may represent an effective alternative for H.pylori rescue treatment.</p><p><strong>Trial registration: </strong>This trial was registered at ClinicalTrials.gov (No. NCT06168084).</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal and Oropharyngeal Dysphagia: Clinical Recommendations From the United European Gastroenterology and European Society for Neurogastroenterology and Motility.","authors":"Amir Mari, Francesco Calabrese, Andrea Pasta, Greta Lorenzon, Bas Weusten, Jutta Keller, Pierfrancesco Visaggi, Sabine Roman, Elisa Marabotto, Ram Dickman, Jordi Serra, Nicola De Bortoli, Paola Iovino, Daniel Pohl, Dan Dumitrascu, Mentore Ribolsi, Claudia Barber, Serhat Bor, Mark Fox, Rami Sweiss, Vicente Lorenzo-Zuniga, Filiz Akyuz, Matteo Ghisa, Altay Celebi, Fahmi Shibli, Rainer Dziewas, Ismail Hakkı Kalkan, Jan Tack, Pere Clavé, Silvia Carrion, Ivy Cheng, Noemi Tomsen, Omar Ortega, Sergio Marin Rubio, Nicole Pizzorni, Emilia Michou, Julie Regan, Shaheen Hamdy, Nathalie Rommel, Martina Scharitzer, Olle Ekberg, Antonio Schindler, Renee Speyer, Anna Gillman, Frank Zerbib, Edoardo V Savarino","doi":"10.1002/ueg2.70062","DOIUrl":"https://doi.org/10.1002/ueg2.70062","url":null,"abstract":"<p><p>Dysphagia is a prevalent symptom of the upper gastrointestinal tract causing health related consequences, impacting quality of life and is associated with global economic burden. Swallowing difficulties are classified into oropharyngeal dysphagia (OD) and esophageal dysphagia. Despite its clinical importance, dysphagia is associated with several uncertainties regarding its optimal diagnostic work-up and management, particularly, considering the progress with diagnostic modalities and technologies. A Delphi consensus was performed with experts from various disciplines who conducted a literature summary and voting process on 41 statements. Quality of evidence was evaluated using the grading of recommendations, assessment, development, and evaluation criteria. Consensus was reached for all the statements. The panel agreed with the definition and prevalence of esophageal and OD types. The role of endoscopy, high-resolution manometry, EndoFLIP, barium swallow and other imaging tests in evaluating esophageal dysphagia has reached overall strong agreement. Videofluoroscopic swallow study, alongside fiber-endoscopic evaluation of swallowing, as the methods of choice for the instrumental assessment of oropharyngeal dysfunction is a strong recommendation. Regarding treatment, a weak recommendation was achieved for the use of PPIs, calcium-channel blockers, nitrates, phosphodiesterase type 5 inhibitors, antidepressants or peppermint oil for the treatment of hypercontractile esophagus. A strong recommendation exists for endoscopic and surgical treatment of achalasia, while a weak recommendation is provided for other esophageal motility disorders. Regarding OD, a weak recommendation was achieved for swallow therapy, to improve swallowing mechanics, reduce symptoms, and enhance quality of life. Swallow therapy could be more effective when using validated assessment tools, consistent treatment parameters, and considering long-term follow-up. A multinational group of European experts summarized the current state of consensus on the definition, diagnosis, and management of dysphagia.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-Omics Analysis of Ileal Mucosa and Mesentery Before and After Ileocecal Resection in Crohn's Disease.","authors":"Kai Xia, Yiran Jiao, Luoqiu Zhang, Renyuan Gao, Fangtao Wang, Yun Pan, Shuang Cui, Yin Lin, Tianqi Wu, Lin Li, Xiaocai Wu, Yu Ruan, Jing Sun, Lu Yin, Chunqiu Chen, Moubin Lin","doi":"10.1002/ueg2.70069","DOIUrl":"https://doi.org/10.1002/ueg2.70069","url":null,"abstract":"<p><p>Crohn's disease (CD), a type of inflammatory bowel disease (IBD), is a chronic disorder involving any part of the gastrointestinal tract. Ileocecal resection may serve as a more effective treatment option for early CD. However, the potential relationship and mechanisms between the ileocecum and remission induction of CD are still elusive. In this study, we conducted 16S rRNA sequencing and liquid chromatography-tandem mass spectrometry (LC-MS/MS) on 68 terminal ileal mucosa and mesentery samples from 34 patients with CD. The results showed an improvement in the microbial health of the ileal mucosa and mesentery in patients with CD after ileocecal resection. In addition, specific spatial alterations in microbiota and metabolites were observed before and after surgery. Furthermore, differentially expressed metabolites in the ileal mucosa and mesentery were subjected to Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. The findings of this study support the therapeutic value of ileocecal resection in CD from a multi-omics perspective and may guide the clinical translation of microbiome-based strategies for precise treatment of CD.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small and Stable Pancreatic Cysts Are Reassuring During Surveillance: Results From the PACYFIC Trial.","authors":"Iris J M Levink, Marloes L J A Sprij, Brechtje D M Koopmann, Jihane Meziani, Sanne Jaarsma, Priscilla A van Riet, Kasper A Overbeek, Myrte Gorris, Rogier P Voermans, Jeanin E van Hooft, Riccardo Casadei, Mariacristina Di Marco, Michael B Wallace, Sanne A Hoogenboom, Neville Azopardi, Reea Ahola, Marcin Polkowski, Pieter Honkoop, Silvia Carrara, Erik J Schoon, Niels G Venneman, Laurens A van der Waaij, Anne-Marie van Berkel, Gemma Rossi, Jilling F Bergmann, Elizabeth Pando, Georg Beyer, Matthijs P Schwartz, Frederike G I van Vilsteren, Chantal Hoge, Marianne E Smits, Rutger Quispel, Ellert J van Soest, Patrick M Vos, Robert C Verdonk, Toon Steinhauser, Eva Kouw, Adriaan C I T L Tan, Laszlo Czako, Marco J Bruno, Djuna L Cahen","doi":"10.1002/ueg2.70043","DOIUrl":"https://doi.org/10.1002/ueg2.70043","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cysts are increasingly discovered on imaging studies performed for unrelated conditions. Currently, surveillance of these lesions poses a substantial burden on patients, and health care recourses. We hypothesized that individuals with small and stable cysts have a diminutive risk of progressing to high-grade dysplasia (HGD) or pancreatic cancer (PC) that is similar to that in the general population.</p><p><strong>Methods: </strong>This nested PACYFIC-study is a collaboration among 44 centers in Europe and Northern-America, and investigates the risk of HGD and PC for different cyst sizes and growth rates in participants without baseline worrisome features (WF) or high-risk stigmata (HRS).</p><p><strong>Results: </strong>Of the 2369 PACYFIC participants, 975 met the inclusion criteria, with a mean age of 67 years (SD 13) and 65% being female. Of these, 438 individuals (45%) had a baseline small cyst size (< 15 mm), and 885 (91%) individuals had a slow growth rate (< 2.5 mm/year). During a median follow-up of 45 months (IQR 27), 20 individuals (2.1%) developed HGD, or PC. Individuals with small cysts had a 1.5-fold lower risk of developing WF or HRS (hazard ratio [HR] 0.7 [0.5-1.0], p = 0.03) than those with larger cysts but a similar risk of developing HGD or PC (p > 0.05). Slow growth was protective against the development of WF or HRS (HR 0.4 [0.2-0.6], p < 0.001) and HGD or PC (HR 0.04 [95% CI 0.02-0.12], p < 0.001). Individuals with small, stable sized cysts without baseline WF or HRS did not have a higher risk of HGD or PC than the general population (standardized incidence ratio [SIR] 1.13 [95% CI 0.01-6.30]).</p><p><strong>Conclusion: </strong>Cyst size < 15 mm and growth rate < 2.5 mm/year appear to be \"reassuring\" features associated with a negligible risk of developing WF or HRS and HGD or PC. For cysts with these characteristics-and without baseline WF or HRS-less intensive surveillance (than currently recommended) or even cessation may be appropriate.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Sugar and Sweetened Beverage Intake Increases Inflammatory Bowel Disease Risk: A Systematic Review and Meta-Analysis.","authors":"Isha Maniyar, Arpita Jajoo, Gala Godoy Brewer, Preetha Iyengar, Andrew Nguyen, Christina Fasulo, Jacob White, Alyssa Parian, Berkeley N Limketkai","doi":"10.1002/ueg2.70047","DOIUrl":"https://doi.org/10.1002/ueg2.70047","url":null,"abstract":"<p><strong>Background and aims: </strong>The impact of dietary sugar intake on the risk of developing inflammatory bowel disease is unclear, with inconsistent findings across studies. The aim of this systematic review and meta-analysis was to clarify how sugar consumption contributes to the risk of developing inflammatory bowel disease (IBD) using the most recently available data.</p><p><strong>Methods: </strong>A library informationist retrieved relevant articles from PubMed, EMBASE, CINAHL, Cochrane Central, Web of Science, and Scopus. Two independent reviewers screened the abstracts and full texts, yielding 45 studies for inclusion. Meta-analyses estimated odd ratios using random effect models.</p><p><strong>Results: </strong>11 prospective and 34 retrospective studies reported data on sugar intake and IBD risk. Pooled analysis showed that added sugar intake was associated with increased risk of Crohn's disease (OR 1.66; 95% Cl 1.21-2.29; n = 523,730; 14 studies) and ulcerative colitis (OR 1.59; 95% CI 1.25-2.02; n = 787,228; 18 studies). Similarly, soda/sweetened beverage intake was associated with increased risk of Crohn's disease (OR 1.58; 95% CI 1.18-2.12; n = 328,716; 12 studies) and ulcerative colitis (OR 1.72; 95% CI 1.23-2.391; n = 328,642; 13 studies).</p><p><strong>Conclusions: </strong>Sugar and soda/sweetened beverage intake were associated with an increased risk of developing both Crohn's disease and ulcerative colitis. Although additional prospective investigation is warranted, current data suggest that reduction of sugar consumption might help reduce the risk of inflammatory bowel disease.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Prevalence of Burnout in Gastroenterology and Endoscopy: A Systematic Review and Meta-Analysis.","authors":"Mohamed G Shiha, Francesca Manza, John Ong, Iago Rodríguez-Lago, Martina Müller, Reena Sidhu","doi":"10.1002/ueg2.70045","DOIUrl":"https://doi.org/10.1002/ueg2.70045","url":null,"abstract":"<p><strong>Background: </strong>Burnout is an increasingly recognised phenomenon that negatively affects physicians' well-being, patient safety and the sustainability of healthcare systems. In this systematic review and meta-analysis, we aimed to estimate the global prevalence of burnout in gastroenterology and endoscopy.</p><p><strong>Methods: </strong>We searched Medline, Embase, Scopus and PsycINFO up to November 2024 for studies reporting the prevalence of burnout in gastroenterology and endoscopy. The primary outcome was the prevalence of burnout among gastroenterologists and endoscopists. Secondary outcomes included the prevalence of emotional exhaustion, depersonalisation, low sense of personal accomplishment and gender-related differences in burnout. We used random-effects models to calculate the pooled prevalence and odds ratios (OR) with their 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of 22 studies comprising 8124 participants were included. The pooled prevalence of burnout was 45% (95% CI, 37%-54%), with significant variability observed across different geographical regions, assessment tools and definitions of burnout. The pooled prevalence of emotional exhaustion was 31% (95% CI, 22%-40%), depersonalisation was 23% (95% CI, 16%-31%), and low sense of personal accomplishment was 25% (95% CI, 10%-40%). Female gastroenterologists were more likely to experience burnout than males (OR 1.53; 95% CI, 1.16-2.01; p < 0.001).</p><p><strong>Conclusions: </strong>Almost half of gastroenterologists and endoscopists experience burnout, with females being disproportionately affected. These findings highlight the need for urgent action to address burnout and its contributing factors, including gender disparities.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbial Signatures Associated With Clinical Remission in Inflammatory Bowel Disease Treated With Biologics: A Comprehensive Multi-Cohort Analysis.","authors":"Qingyang Zheng, Yun Zhong, Haifeng Lian, Jieru Zhuang, Lichun Wang, Jianyong Chen, Huaiming Wang, Hui Wang, Xijie Ye, Zicheng Huang, Keli Yang","doi":"10.1002/ueg2.70064","DOIUrl":"https://doi.org/10.1002/ueg2.70064","url":null,"abstract":"<p><strong>Background and aims: </strong>The relationship between gut microbiota and biological treatment response in inflammatory bowel disease (IBD) remains incompletely understood. We sought to characterize microbial signatures associated with clinical remission and develop a prediction model for clinical remission.</p><p><strong>Methods: </strong>We analyzed 16 S rRNA gene sequencing data from two independent public cohorts (n = 231) treated with biologics (infliximab: n = 23; adalimumab: n = 22; ustekinumab: n = 186). Microbial diversity and taxonomic compositions were compared between the remission and non-remission groups. Random Forest algorithm was employed to construct a prediction model using differential genera and clinical features, with performance evaluated through cross-validation. The model was further validated in a local cohort (n = 29).</p><p><strong>Results: </strong>Significant differences in alpha and beta diversity were observed between the remission and non-remission groups (p < 0.05). MaAsLin2 analysis identified 25 differentially abundant genera (p < 0.05). Among these, we selected the top 10 genera with highest importance scores (Parabacteroides_B_862066, Agathobaculum, Ruminococcus_E, Sutterella, Clostridium_R_135822, Hominilimicola, Onthenecus, Butyricimonas, Bariatricus, Hominenteromicrobium) to build the Random Forest model, notably all enriched in remission patients. The model demonstrated robust predictive performance for clinical remission (AUC: 0.895), which was further validated in the local cohort (AUC: 0.750).</p><p><strong>Conclusion: </strong>There is a relationship between gut microbial signatures and biological treatment outcomes in IBD patients. A predictive model based on gut microbiota composition may help stratify patients for treatment response. Further investigation of microbiome modulation strategies may enhance therapeutic efficacy.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and Safety of Advanced Dual-Targeted Therapy in Refractory Perianal Crohn's Disease.","authors":"Nadia Fathallah, Mario Pagano, Mohamed Amine Houari, Amélie Barré, Calina Atanasiu, Edouard Chambenois, Isabelle Nion-Larmurier, Stéphane Morisset, Julien Kirchgesner, Vincent de Parades","doi":"10.1002/ueg2.70059","DOIUrl":"https://doi.org/10.1002/ueg2.70059","url":null,"abstract":"<p><strong>Introduction: </strong>Perianal Crohn's disease (CD) remains challenging to treat despite the increasing number of advanced therapies. Advanced dual-targeted therapy has emerged as a new treatment option in CD, but no data are available for perianal CD. The aim of this study was to evaluate the effectiveness and safety of advanced dual-targeted therapy for anoperineal fistulas (APFs) in CD patients.</p><p><strong>Materials and methods: </strong>We prospectively included all consecutive patients receiving an advanced dual-targeted therapy for APFs from August 2019 to December 2023 in a single tertiary perianal CD centre. The primary outcome was clinical effectiveness. Secondary outcomes were patients' treatment perception, radiological effectiveness, luminal disease effectiveness, impact on extra-intestinal manifestations, and safety. Factors associated with complete clinical remission of APFs were identified using logistic regression.</p><p><strong>Results: </strong>A total of 33 patients were included. The most frequently used advanced dual-targeted therapy was a combination of infliximab and ustekinumab (75.8%). After a median follow-up of 27.4 months, 48.5% and 97.0% of patients were in complete clinical remission and reported a perceived improvement, respectively. Complete radiological remission was achieved in 24.2% of the patients. A concomitant improvement in luminal intestinal involvement was observed in 46.1% of cases, and in extra-digestive manifestations in 45.8% of cases. Treatment tolerance was considered good or very good in 90.9% of cases. Associated anal ulcers and long-term exposure to antibiotics were associated with a lower likelihood of complete clinical remission for fistulas.</p><p><strong>Conclusion: </strong>These findings suggest that advanced dual-targeted therapy is a valid option with a good safety profile for the treatment of refractory APFs. Larger studies are required to identify the most effective combination.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse-Administered Gut-Directed Hypnotherapy for Irritable Bowel Syndrome: A Two-Year Follow-Up Study.","authors":"Jenny Lövdahl, Michaela Blomqvist-Storm, Olafur S Palsson, Gisela Ringström, Hans Törnblom, Magnus Simrén, Inês A Trindade","doi":"10.1002/ueg2.70060","DOIUrl":"https://doi.org/10.1002/ueg2.70060","url":null,"abstract":"<p><strong>Background: </strong>Gut-directed hypnotherapy is effective for irritable bowel syndrome (IBS) and a few studies have reported long-lasting therapeutic effects following intervention. No previous studies have evaluated the long-term effects of nurse-administered hypnotherapy.</p><p><strong>Aims: </strong>We aimed to investigate the long-term effects of nurse-administered gut-directed hypnotherapy for IBS and identify factors associated with symptom improvement. Furthermore, we aimed to compare treatment effects between individual and group hypnotherapy.</p><p><strong>Methods: </strong>A 2-year follow-up study including 289 patients with IBS who had completed a 12-week hypnotherapy program (individually or in groups) was conducted. Data were collected at baseline, and at 6-month-, 1-year- and 2-year follow-ups. Irritable bowel syndrome and extracolonic symptom severity (IBS-SSS), gastrointestinal-specific anxiety (VSI), and anxiety and depressive symptoms (HADS) were assessed. Patients reporting a reduction ≥ 50 points (IBS-SSS) were classified as treatment responders.</p><p><strong>Results: </strong>The 2-year follow-up was completed by 207 patients. The proportion of responders at post-treatment was 64.3%, 62.8% at the 6-month follow-up, 64.7% at the 1-year follow-up, and 61.8% at the 2-year follow-up. The severity of IBS symptoms, extracolonic and psychological symptoms were all reduced post-treatment, and this effect lasted over the 2-year follow-up period (p < 0.001). Younger age, individual hypnotherapy, and severe irritable bowel syndrome symptoms at baseline predicted a better response to treatment (R² = 0.16).</p><p><strong>Conclusions: </strong>Nurse-administered gut-directed hypnotherapy is an effective treatment for IBS with long-lasting symptom improvements. Younger age, severe irritable bowel syndrome symptoms, and individual treatment might be important factors associated with effectiveness (ClinicalTrials.gov study protocol IDs: NCT06167018, NCT03432078).</p><p><strong>Trial registration: </strong>ClinicalTrials.gov study protocol IDs: NCT06167018, NCT03432078.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sphingosine-1-Phosphate Receptor Modulators for the Treatment of Ulcerative Colitis: A Narrative Review Focusing on Safety.","authors":"Massimo C Fantini, Diego Centonze, Giovanni Giacobazzi, Silvia Benemei, Emanuele Romeo","doi":"10.1002/ueg2.70026","DOIUrl":"https://doi.org/10.1002/ueg2.70026","url":null,"abstract":"<p><p>Ulcerative colitis is a chronic immune-mediated inflammatory disease of the colon that causes considerable morbidity and increases the risk of colorectal cancer. Several targeted therapies have been developed for moderate-to-severe ulcerative colitis, significantly improving its management. Ozanimod and etrasimod, oral small-molecule drugs, are the latest addition. They belong to the class of sphingosine-1-phosphate receptor (S1PR) modulators and are the first members of this class to be granted approval for ulcerative colitis. They act by blocking lymphocyte trafficking from lymph nodes to inflamed tissues without impairing other immune system functions. This narrative review summarizes current knowledge of sphingosine-1-phosphate receptor modulators, focusing on safety. Safety data from the field of multiple sclerosis (MS) will be discussed because the first S1PR modulator to reach the market, fingolimod, was used extensively for relapsing-remitting MS. Indications for the safe use of ozanimod and etrasimod in ulcerative colitis patients will be provided.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}