United European Gastroenterology Journal最新文献

{"title":"Rifaximin-α in Patients With Recurrent Episodes of Hepatic Encephalopathy Due to Cirrhosis Reduces Healthcare Utilization.","authors":"Diederick J van Doorn, Kirsi M A van Eekhout, Koos de Wit, L C Baak, Michael Klemt-Kropp, Bart J Verwer, Philip Friederich, Gijs J de Bruin, Xander G Vos, Joost P H Drenth, R Bart Takkenberg","doi":"10.1002/ueg2.12767","DOIUrl":"10.1002/ueg2.12767","url":null,"abstract":"<p><strong>Background and aims: </strong>Hepatic encephalopathy is a frequent complication of cirrhosis. Rifaximin-α has been included in guidelines for secondary prevention of hepatic encephalopathy, but there are few real-world data on its efficacy and impact on healthcare utilization. In this study, we aimed to assess the effect of rifaximin-α on healthcare utilization.</p><p><strong>Method: </strong>We conducted a cohort analysis in patients from seven hospitals in the Netherlands, who received rifaximin-α as secondary prophylaxis for hepatic encephalopathy. Data were compared 6 months before and 6 months after the prescription of rifaximin-α. The primary endpoint was the effect of rifaximin-α on healthcare utilization. Secondary endpoint was the effect of rifaximin-α on healthcare costs.</p><p><strong>Results: </strong>We included 126 patients (65% male; median age 68) with a median Model for End-stage Liver Disease score of 15. The mean number of hepatic encephalopathy episodes after starting rifaximin-α was lower than before starting rifaximin-α (0.9 vs. 2.2; p < 0.001). Mean healthcare utilization decreased from 6.1 contacts in the 6 months before rifaximin-α to 3.3 contacts in the 6 months after starting rifaximin-α (p < 0.001). The mean number of hospital admissions decreased from 1.7 admissions per patient to 1.0 admissions after starting rifaximin-α (p < 0.001). The mean number of outpatient visits also decreased after starting rifaximin-α (2.4 visits per patient to 1.7; p = 0.001). Annual costs per patient before starting rifaximin-α were €13,320. This was similar to the costs after rifaximin-α was prescribed (€13,120).</p><p><strong>Conclusion: </strong>Rifaximin-α significantly reduced the number of episodes of hepatic encephalopathy, the number of hospital admissions as well as the number of outpatient and emergency department visits, contributing to a reduction in healthcare utilization. There was no reduction in overall costs.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"938-945"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984387","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":"Pancreatic Enzyme Replacement Therapy Improves Exclusive Enteral Nutrition Related Diarrhea in Crohn's Disease: A Prospective Randomized Trial.","authors":"Jian Kang, Jing Wang, Juan Su, Wei Wang, Yueyue Lu, Zhishun Tang, Liping Zou, Anning Yin, Jiao Li, Haixia Ren, Qian Zhou, Huipeng Wan, Ping An","doi":"10.1002/ueg2.70021","DOIUrl":"10.1002/ueg2.70021","url":null,"abstract":"<p><strong>Background & aims: </strong>Previous results showed that combined treatment of biologics and exclusive enteral nutrition (EEN) brought moderate-to-severe Crohn's disease patients significant improvements in clinical and endoscopic outcomes. Despite its essential role and favorable safety profile, EEN in the treatment of adult Crohn's disease is frequently underestimated because of lower compliance and several side effects, including EEN-related diarrhea (EEND).</p><p><strong>Methods: </strong>In this prospective, single-center randomized clinical trial, 147 eligible patients with actively moderate-to-severe Crohn's disease treated with biologics and concomitant 16-week EEN were included. Sixty-one patients without EEND were enrolled in the ND group (without EEN-related diarrhea), and other patients with EEND who received pancreatic enzyme replacement therapy (PERT) (43 patients) or not (43 patients) were recruited in PERT and NPERT groups, respectively. The clinical outcomes, biologic outcomes, and endoscopic outcomes were evaluated. Quality of life (QoL) and psychological status were also assessed at baseline and endpoints (week 16).</p><p><strong>Results: </strong>Bowel movements (daily frequency decreased by 5.3 times) and stool consistency (reduced watery and loose stool) were greatly improved in PERT group at week 16. At week 16, patients in the ND and PERT groups achieved similar clinical responses (93% in ND group and 94.7% in PERT group, p = 0.731) and clinical remission (86.0% in ND group and 86.8% in PERT group, p = 0.90) while patients in the NPERT group had significantly lower proportions of these clinical outcomes (67.9% clinical response and 57.1% clinical remission). No significant difference was observed in endoscopic outcomes between each group (p = 0.904). QoL and mental status including anxiety and depression in PERT group had great improvement compared with the NPERT group.</p><p><strong>Conclusions: </strong>Our prospective results provided invaluable evidence that PERT supplementation efficiently improved EEND in Crohn's disease patients with combined treatment of biologics and 16-week EEN, which had a promising effect in active Crohn's disease induction.</p><p><strong>Trial registration: </strong>ChiCTR2200058343.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"997-1011"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999611","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":"New Simple and Fast Digital Screening Method for Minimal Hepatic Encephalopathy in Cirrhotic Patients.","authors":"S Mouri, D Thabut","doi":"10.1002/ueg2.70028","DOIUrl":"10.1002/ueg2.70028","url":null,"abstract":"<p><p>Covert hepatic encephalopathy (CHE) is a subtle yet significant neurological complication of liver diseases, especially in patients with cirrhosis. Although it lacks overt clinical signs, CHE severely impacts quality of life, increases accident risks, and has serious prognostic implications. It is characterized by neurocognitive symptoms detectable only through specialized neuropsychometric tests. CHE affects 30%-80% of cirrhotic patients and represents the early stage of hepatic encephalopathy, which is a predictor of mortality. Early diagnosis is essential to improve patient outcomes. The Psychometric Hepatic Encephalopathy Score (PHES) is the gold standard for diagnosing CHE, but it is time-consuming and requires specialized training. Other tests, like the Animal Naming Test (ANT), are simpler and more practical for screening minimal hepatic encephalopathy (MHE), though they lack specificity. The Stroop test shows promise as a quicker and reliable diagnostic tool, but still has limitations. Recent innovations include a smartphone-based self-screening method developed by Dobbermann et al., combining three digital tests: the Tip Test, Number Connection Test, and Modified Stroop Test. This approach correlates well with PHES, is independent of language skills, and is accessible for a diverse patient population, including those with color vision deficiencies. This tool offers a rapid and reliable way to screen for CHE even in home settings, potentially improving early detection and intervention. In conclusion, CHE is an underrecognized but critical condition that requires greater clinical attention. Current diagnostic tools have limitations, highlighting the need for more effective, practical methods. A multidisciplinary approach involving hepatologists, neurologists, and neuropsychologists is crucial to improve the diagnosis and management of CHE, ultimately enhancing patient outcomes.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"851-852"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050231","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":"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":"855-901"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","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":"Serum Collagen Biomarkers Are Reflective of Tissue Specific Fibroblasts Associated With Ulcerative Colitis Activity and Treatment Response to Ustekinumab.","authors":"Swati Venkat, Joshua Rusbuldt, Dylan Richards, Thomas Freeman, Camilla Richmond, Joachim Hog Mortensen, Jakob Benedict Seidelin, Anja Poulsen, Brad McRae, Darren Ruane","doi":"10.1002/ueg2.70002","DOIUrl":"10.1002/ueg2.70002","url":null,"abstract":"<p><strong>Background: </strong>There is a need to identify peripheral biomarkers reflective of defined disease associated fibroblasts in Ulcerative Colitis (UC), with the aim of enabling clinical development approaches for novel-stromal-targeted therapeutics for individuals at risk for fibrostenotic complications. Additionally, longitudinal non-invasive biomarkers of tissue remodelling, fibroblast biology and pharmacodynamic measurements are needed in the clinic to facilitate risk stratification.</p><p><strong>Aim: </strong>To identify novel blood protein biomarkers associated with defined fibroblast subsets, tissue remodelling and treatment response/non-response in UC.</p><p><strong>Methods: </strong>We performed data analysis on matched serum and tissue transcriptomics from the UNIFI trial at weeks 0 and 8 in clinical responders and non-responders. Detailed gene correlation analysis was performed on 97 colonic biopsies from 50 patients pre- and post-treatment, to construct detailed cell-type mapping associated with clinical parameters. Detailed serum-based proteomics analysis was performed using matched serum and tissue sample sets to evaluate specific correlations between defined tissue cellular subsets and unique peripheral proteins, reflective of defined tissue transcriptional subsets and clinical parameters.</p><p><strong>Results: </strong>Evaluation of the UNIFI clinical study, revealed a significant association between intestinal-inflammatory activated fibroblasts (IIAF) and various clinical parameters, including Geboes scores. These findings were unique to IIAFs and were confirmed using spatial tissue transcriptomics. Evaluation of novel peripheral proteomics revealed a significant correlation between selective serum collagen biomarkers, including Pro-Collagen 22, Collagen 1M, CTX-III, ELP-3, and the IIAF tissue module. These serum collagen biomarkers were unique to IIAFs, as other broad proteomics methodologies failed to demonstrate significant correlations with known UC serum markers. Ustekinumab endoscopic responders had a significant decrease in IIAFs, which was associated with decreases in these IIAF associated serum proteins. Furthermore, C1M and ELP-3 demonstrated predictive value to enable characterisation of UC patients with IIAF driven disease.</p><p><strong>Conclusions: </strong>These serum biomarkers were correlated with tissue levels of IIAFs, identifying unique peripheral markers of tissue associated cell types correlated with fibrosis. Given the association of IIAFs and treatment response, this highlights the utility of these triaged collagen biomarkers for anti-stromal therapeutic development and patient stratification in UC and beyond.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"982-996"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450224","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":"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":"971-981"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","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":"Ergonomics in Endoscopy-Editorial.","authors":"Keith Siau, Swati Pawa","doi":"10.1002/ueg2.70019","DOIUrl":"10.1002/ueg2.70019","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"853-854"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788946","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":"Disorders of the gut-brain interaction among European people with obesity: Prevalence and burden of compatible symptoms.","authors":"Chloé Melchior, Jóhann P Hreinsson, Jan Tack, Jutta Keller, Qasim Aziz, Olafur S Palsson, Shrikant I Bangdiwala, Ami D Sperber, Magnus Simrén, Jean-Marc Sabaté","doi":"10.1002/ueg2.12700","DOIUrl":"10.1002/ueg2.12700","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of disorders of the gut-brain interaction (DGBI) among people with obesity in the general population is unknown. Our aim was to assess the prevalence of DGBI among obese subjects in the general population in comparison with normal or overweight subjects, as well as exploring factors associated with DGBI in obesity in Europe.</p><p><strong>Methods: </strong>We included subjects who completed the internet-based survey of the Rome Foundation Global Epidemiology study in 11 European countries. Obesity was defined as a BMI>30 kg/m² and participants were divided into three classes: 1: BMI 30 to <35 kg/m², 2: BMI 35 to <40 kg/m², and 3: BMI 40 kg/m² or higher. The prevalence of symptoms compatible with DGBI was reported and compared between obese and normal or overweight (BMI between 18.5 and <30 kg/m²) participants. Factors potentially associated with DGBI and obesity including demographics, psychological distress (PHQ-4), non-GI somatic symptoms (PHQ-12), quality of life (PROMIS-10), healthcare access, medication and food consumption were assessed.</p><p><strong>Results: </strong>We included 20,117 participants in our analysis. The prevalence of obesity was 17.8% (95% CI 17.3, 18.4), with 12.6%, 3.7% and 1.6% in obesity classes 1, 2 and 3, respectively. The prevalence of any DGBI was 44.2% in the obese group versus 39.6% in the normal or overweight group (OR = 1.20 (1.12, 1.30)), with all DGBI being more prevalent in the obese versus normal or overweight group, with the exception for functional constipation where the opposite pattern was seen. Female sex, higher level of psychological distress and more severe non-GI somatic symptoms were seen in the group with DGBI associated with obesity.</p><p><strong>Conclusions: </strong>Symptoms compatible with DGBI are common among European people with obesity in the general population and are linked with certain demographic and disease-related factors. This should be acknowledged in the management of patients with obesity.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"917-928"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804007","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":"How to Survive and Succeed in the Design and Execution of a Collaborative Randomized Controlled Trial.","authors":"Enrique de-Madaria","doi":"10.1002/ueg2.12726","DOIUrl":"10.1002/ueg2.12726","url":null,"abstract":"<p><p>This article guides the design and execution of successful collaborative randomized controlled trials (RCTs). Aimed at researchers looking to impact clinical practice, it highlights the advantages of RCTs over observational studies in driving clinical advancements. The article details essential steps in trial development, starting with assembling a core team of a principal investigator, experienced collaborator, methodologist, patient representative, and coordinator. Critical strategies for defining impactful research questions, selecting adequate primary endpoints, and developing a robust protocol are discussed. Additional emphasis is placed on patient-centered outcomes and data integrity, supported by carefully designed electronic case report forms. The article also covers strategies for recruiting collaborators, and managing ethical approvals across multiple centers. Ultimately, it offers insights from the author's experience, encouraging new researchers to overcome challenges in launching their first RCT and reinforcing the role of high-quality, multicentric research in enhancing patient care and clinical outcomes.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"911-916"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999409","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":"Endoscopy-Related Musculoskeletal Injuries: A Systematic Review and Meta-Analysis on Prevalence, Risk Factors and Prevention.","authors":"Raquel Oliveira, Joana Roseira, Maria Manuela Estevinho, Helena Tavares de Sousa, Carla Rolanda, Alexander Meining, Benjamin Walter","doi":"10.1002/ueg2.70042","DOIUrl":"10.1002/ueg2.70042","url":null,"abstract":"<p><strong>Background: </strong>Endoscopy-related musculoskeletal injuries (ERIs) are a major occupational hazard, impacting career longevity and personal well-being.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to update and expand on previous findings by assessing prevalence, risk factors and management of ERIs among endoscopists.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we systematically searched MEDLINE, Web of Science and Scopus for relevant studies published since the last comprehensive review. A manual search of the references of relevant manuscripts was also performed. Outcomes of interest included the prevalence of ERIs, common pain syndromes, risk factors, and preventive or treatment strategies. Studies' quality was assessed using the National Institutes of Health (NIH) Quality Assessment Tool.</p><p><strong>Results: </strong>Thirty studies were included, incorporating data from 7646 gastrointestinal endoscopists. The pooled career-long prevalence of overall ERI was 62.5% (CI 52.6-71.8, I² = 98%), including pain (67.5%; CI 46.4%-85.6%; I² = 98%) and numbness (12.4%; 95% CI 6.6%-19.7%; I² = 98%) syndromes. Among pain syndromes, the most affected areas were the hand (28.2%; CI 19.2%-38.2%; I² = 99%), lower back (27.3%; CI 20.1%-35.2%; I² = 97%), thumb (27.1%; CI 18.9%-37.7%; I² = 99%) and neck (25.7%; CI 19.3%-32.7%; I² = 98%). Higher procedural volume, years in practice and female gender were consistently reported as risk factors for ERIs. Concerning therapy, 41.8% of endoscopists used medications (CI 31.2%-52.8%; I² = 94%), while 28.2% engaged in physical therapy (CI 18.2%-39.5%; I² = 96%). Sick leave was reported by 13.8% of endoscopists (CI 7.9%-20.9%; I² = 94%). Practice modifications to manage ERIs included adjusting monitor (45.5%, CI 22.2%-69.9%; I² = 96%) and table (32.4%, CI 14.5%-53.5%; I² = 97%) height, but also reducing the number of cases per endoscopy session (14.6%; CI 10.4%-19.4%; I² = 72%).</p><p><strong>Conclusion: </strong>ERIs are highly prevalent among international gastrointestinal endoscopists, and are linked to procedural volume, years in practice, and gender. Ergonomic training and workplace adaptations are essential to mitigate risks and support career sustainability.</p><p><strong>Trial registration: </strong>PROSPERO Registration: CRD42024534349.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1012-1030"},"PeriodicalIF":5.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095019","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}