United European Gastroenterology Journal最新文献

{"title":"Dedicated Endoscopy for Barrett's Oesophagus With Higher Dysplasia Yield May Reduce Seattle Protocol Biopsies: Results From UK Multicentre Study.","authors":"Champika Gamakaranage, James Britton, Elizabeth Ratcliffe, Neeraj Prasad, Richard Keld, Mark Murgatroyd, Shanmugasundaram Balakrishnan, Nazar Aslam, Vinay Sehgal, Jenni Marsh, Daniel Plant, Matthew Johnston, Stefanos Kateroglou, Jake Baker, Hannah Morgan, Claudia Cipriano, Anjan Dhar, Shaheen Hamdy, John McLaughlin, Yeng Ang","doi":"10.1002/ueg2.70270","DOIUrl":"10.1002/ueg2.70270","url":null,"abstract":"<p><strong>Background: </strong>Dedicated service for Barrett's oesophagus (BO) surveillance may be more effective than conventional service, according to some single centre studies.</p><p><strong>Objective: </strong>To determine whether the surveillance of BO through a dedicated service can improve key performance indicators (KPIs), and dysplasia detection rate (DDR) compared with conventional service in a multi centre study.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted across 6 NHS-hospitals, capturing BO surveillance data over 8 years. Factors associated with DDR were assessed by logistic regression.</p><p><strong>Results: </strong>There were 1037 dedicated and 976 conventional surveillance procedures (N = 2013), male: female ratio = 2.2:1; mean age = 64.4 (SD ± 12.2) years; mean maximum length of BO = 4.1 cm (range: 0-18 cm). All the KPIs and DDR were significantly higher in the dedicated service (DDR = 6.9%) than in the conventional service (DDR = 2.8%), p < 0.001. The use of narrow band imaging (NBI) and acetic acid chromoendoscopy (AAC) and sedation were high, and the complication rate was significantly lower in the dedicated service. The lesion recognition was significantly associated with DDR (OR = 6.9). Surprisingly, Seattle biopsy protocol adherence showed no correlation with DDR (OR = 0.47).</p><p><strong>Conclusion: </strong>The dedicated service provides higher quality endoscopy, and a higher yield of early neoplasia. It uses more sedation, advanced imaging, and detects more lesions than conventional services. Thus, the dedicated surveillance could potentially replace time and cost consuming Seattle biopsies with targeted biopsies of visible lesions. In future, this may become easier with the use of artificial intelligence for lesion detection (CADe).</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70270"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Versus On-Demand Direct Endoscopic Necrosectomy for Necrotizing Pancreatitis: A Systematic Review and Meta-Analysis.","authors":"Rui Wang, Qingzhou Kong, Ping Hu, Yu Ma, Xiao Liang, Ning Zhong, Zhen Li","doi":"10.1002/ueg2.70290","DOIUrl":"10.1002/ueg2.70290","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing of direct endoscopic necrosectomy (DEN) for Necrotizing Pancreatitis (NP) remains unclear. This meta-analysis aimed to evaluate the efficacy and safety of immediate DEN compared with on-demand DEN.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched to identify studies. The primary outcome measure was clinical success.</p><p><strong>Results: </strong>Seven studies (4 RCTs and 3 observational studies) comprising 616 patients were included. Immediate DEN did not demonstrate a statistically significant advantage in clinical success (OR: 1.92, 95% CI 1.01-3.63). No significant differences were found in technical success (OR: 1.62, 95% CI: 0.43-6.09), total number of DEN (standardized mean difference: 0.31, 95% CI: -0.21-0.84), need for additional percutaneous drainage (OR: 0.53, 95% CI: 0.27-1.03), need for salvage surgery (OR: 0.60, 95% CI: 0.28-1.27), procedure-related adverse events were comparable between groups (OR: 0.81, 95% CI: 0.51-1.28), disease-related adverse events (OR: 0.84, 95% CI: 0.34-2.13), mortality (OR: 1.11, 95% CI: 0.47-2.59). In RCT-only analyses, these findings remained consistent. Immediate DEN lowered stent migration risk (OR: 0.31, 95% CI: 0.11-0.92), but lost significance in RCT-only analysis.</p><p><strong>Conclusion: </strong>This meta-analysis found no overall superiority of immediate DEN over on-demand DEN for patients with NP, highlighting the need to identify specific subgroups that benefit from an upfront necrosectomy strategy.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70290"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Meckel's Diverticulum Mimicking Crohn's Disease: Double-Stricture Deception.","authors":"Yongli Li, Tian He, Ping Wan, Xiangji Li","doi":"10.1002/ueg2.70273","DOIUrl":"10.1002/ueg2.70273","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70273"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13426024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterising the Economic Burden of Functional Dyspepsia: A Cost-of-Illness Study of Direct and Indirect Costs.","authors":"Daan H C A Bosch, Brigitte A B Essers, Abraham B Beckers, Johanna T W Snijkers, Bjorn Winkens, Ad A M Masclee, Daniel Keszthelyi","doi":"10.1002/ueg2.70257","DOIUrl":"10.1002/ueg2.70257","url":null,"abstract":"<p><strong>Background: </strong>Functional dyspepsia (FD) is a prevalent disorder of gut-brain interaction (DGBI) and is associated with substantial impact on health care utilisation. However, analyses examining patient-specific characteristics that contribute to this burden remain limited. This study assessed the economic burden of patients with FD and examined patient-specific characteristics related to costs.</p><p><strong>Methods: </strong>Patients who had been recruited for a randomised controlled trial completed several questionnaires. Health care utilisation and productivity losses were measured using the iMTA Medical Consumption Questionnaire and Productivity Cost Questionnaire. Participants also completed the EuroQol 5-Dimension 5-Level, Nepean Dyspepsia Index, Generalised Anxiety Disorder-7, and Patient Health Questionnaire-9. Non-parametric bootstrapping was applied to calculate the mean annual costs. Multivariable linear regression was used to identify patient-specific characteristics associated with costs.</p><p><strong>Results: </strong>Data were obtained from 73 participants (median age 39 years; 75% female). Mean annual total costs accounted for €12,192 (2.5th to 97.5th percentiles, €1125 to €36,369), of which €10,240 (2.5th to 97.5th percentiles, €0 to €34,771) were indirect costs. Higher disease-specific quality of life (QoL) was associated with lower annual total costs (regression slope = -€4726 per 0.1-point increase in QoL; 95% CI, -€7636 to -€1815; p = 0.002), while symptom severity, generic health-related QoL or scores for anxiety or depression were not significantly associated.</p><p><strong>Conclusion: </strong>Patients with poorer disease-specific QoL, but not necessarily those with more severe symptoms or higher scores for anxiety and depression, are particularly likely to incur higher annual costs. Understanding the nature of costs and associated patient characteristics is essential for enabling more targeted strategies.</p><p><strong>Trial registration: </strong>The TENDER trial was registered on Clinicaltrials.gov under NCT03652571 on August 17, 2018.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70257"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotyping Increased Urge to Defecate in Irritable Bowel Syndrome: Analysis of Symptom, Sensory, and Psychological Profiles.","authors":"Sylvester R Groen, Lisa Vork, Zsa Zsa R M Weerts, Zlatan Mujagić, José M Conchillo, Ad A M Masclee, Daisy M A E Jonkers, Daniel Keszthelyi","doi":"10.1002/ueg2.70287","DOIUrl":"10.1002/ueg2.70287","url":null,"abstract":"<p><strong>Introduction: </strong>Visceral hypersensitivity (VHS) is considered a hallmark of irritable bowel syndrome (IBS) characterized by altered thresholds for rectal pain and discomfort during rectal distention. Rectal distention can also elicit the urge to defecate, a normal physical sensation that is, reported more often in IBS and may involve mechanisms distinct from pain and discomfort. This study investigates clinical, psychological, and physiological correlates of increased urge to defecate in IBS compared with healthy controls (HC), including sex-based differences.</p><p><strong>Methods: </strong>Patients with IBS (Rome III criteria) and HC underwent rectal balloon-distension and completed questionnaires on demographics, lifestyle, gastrointestinal (GI) and psychological symptoms, and health-related quality of life (HrQoL). Latent clusters were identified using finite-mixture modeling, and associated determinants were evaluated using multivariable logistic regression analyses.</p><p><strong>Results: </strong>Among 322 participants (220 IBS, 102 HC), the occurrence of the urge to defecate was more frequent in IBS than in HC (80.9% vs. 51.9%; p < 0.001) and often co-occurred with rectal pain and discomfort, particularly in patients with VHS. Latent class analysis identified three clusters, primarily distinguished by rectal symptom-distribution, with the most symptomatic cluster showing greater GI-symptom severity, higher psychological burden, and lower HrQoL (all p < 0.001). Regression analyses confirmed associations of urge with GI symptom severity, depressive symptom scores, and co-occurrence of pain/discomfort, but no association was found based on IBS subtype or sex.</p><p><strong>Conclusion: </strong>Increased urge to defecate is highly prevalent in IBS, strongly associated with rectal pain, rectal discomfort, psychological burden, and reduced HrQoL, but not in the IBS subtype, suggesting shared or overlapping mechanisms, particularly in the context of VHS. These findings underscore its clinical and pathophysiological relevance, supporting its value for patient-phenotyping and tailored management.</p><p><strong>Trial registration: </strong>The Maastricht Irritable Bowel Syndrome (MIBS) cohort study was registered under the registration number NCT00775060.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70287"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Barrett's Surveillance When Surveillance Is Most Questioned: Can Dedicated Lists Be Part of the Answer?","authors":"Guiomar Moral-Villarejo, Jacobo Ortiz-Fernandez-Sordo","doi":"10.1002/ueg2.70286","DOIUrl":"10.1002/ueg2.70286","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70286"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Endoscopic and Histologic Assessment of Eosinophilic Esophagitis in Europe and Evolution of the Diagnostic Delay: Data From the EUREOS EoE CONNECT Registry.","authors":"E Grueso-Navarro, E Dilaghi, J Fernández-Pacheco, E Amorena, E V Savarino, L Blas-Jhon, I Pérez-Martínez, A Granja-Navacerrada, D Guagnozzi, L Martín-Asenjo, G Pellegatta, M Coletta, C García-Suárez, S de la Riva, L de la Peña-Negro, E Betoré, A L Krarup, J Barrio, M Votto, L Bujanda, S Fernández-Fernández, J E Naves, A González-Almeida, R Honrubia-López, S Carrión, S Oliva, C Caño-Cerdán, M L Masiques-Mas, S Espina-Cadena, J González-Cervera, S Casabona-Francés, J Nicolay-Maneru, V Úbeda-Vargas, M Ghisa, P Romo-de Arriba, C Donado, A Benagues, V Martín-Domínguez, O Nantes-Castillejo, L Arias-González, D Maniero, H Moreira-González, I Maray, J Barrio-Torres, M T Pérez-Fernández, M Ostiz-Llanos, L Rodríguez-Alcolado, A M Cabrera-Martínez, E J Laserna-Mendieta, C Santander, A J Lucendo","doi":"10.1002/ueg2.70271","DOIUrl":"10.1002/ueg2.70271","url":null,"abstract":"<p><strong>Background: </strong>Endoscopy with histopathological assessment of esophageal biopsies is the cornerstone for the diagnosis and phenotypic characterization of eosinophilic esophagitis (EoE).</p><p><strong>Objective: </strong>To evaluate temporal trends in endoscopic assessment and biopsy sampling practices for EoE in a large European cohort and their association with temporal trends in diagnostic delay (DD).</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using multicenter data from the EoE CONNECT registry. Endoscopic findings and biopsy data at diagnosis were analyzed. Temporal trends in biopsy strategies, EREFS implementation, and DD were assessed. Diagnostic sensitivity of individual esophageal segments and their combinations was evaluated in patients undergoing multi-segment sampling. Associations between guideline publication and biopsy practices were analyzed using logistic regression models.</p><p><strong>Results: </strong>A total of 3298 patients were included. Biopsies were obtained from one esophageal segment in 12.6% of patients, two segments in 63.6%, and three segments in 23.8%. Adherence to guideline-recommended biopsy strategies improved over time, with reduced single-segment sampling and increased use of ≥ 2 segments. Distal esophageal biopsies provided the highest diagnostic sensitivity, and sampling that included the distal segment achieved sensitivity above 97%, particularly when combined with middle esophageal biopsies. EREFS reporting increased from 88-90% to over 98% in recent years. DD decreased significantly over time (approximately 0.7 years per calendar year), accompanied by a shift from mixed/stricturing to inflammatory phenotypes.</p><p><strong>Conclusion: </strong>Increased alignment with international guidelines, reflected by standardized endoscopic reporting and multi-segment biopsy protocols, was associated with improved diagnostic sensitivity, reduced DD, and fewer fibrostricturing presentations.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70271"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Food Bolus Impaction Secondary to a Fully Circumferential Inlet Patch.","authors":"Giorgi Kiladze, Wei On, Vivek Goodoory, Björn Rembacken, Peter Ellery","doi":"10.1002/ueg2.70274","DOIUrl":"10.1002/ueg2.70274","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70274"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are ROME Criteria for IBS Useful in Primary Care Practice?","authors":"Niek J de Wit, A Pali S Hungin","doi":"10.1002/ueg2.70289","DOIUrl":"10.1002/ueg2.70289","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70289"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blisters Don't Lie: Celiac Disease in the Skin.","authors":"Jonas F Ludvigsson, Philip Curman","doi":"10.1002/ueg2.70284","DOIUrl":"10.1002/ueg2.70284","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":"14 7","pages":"e70284"},"PeriodicalIF":6.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}