{"title":"How \"Sure\" Are We About Precision Medicine in IBD?","authors":"Florian Tran, Konrad Aden","doi":"10.1002/ueg2.70048","DOIUrl":"https://doi.org/10.1002/ueg2.70048","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095034","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}
Raquel Oliveira, Joana Roseira, Maria Manuela Estevinho, Helena Tavares de Sousa, Carla Rolanda, Alexander Meining, Benjamin Walter
{"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":"https://doi.org/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, I<sup>2</sup> = 98%), including pain (67.5%; CI 46.4%-85.6%; I<sup>2</sup> = 98%) and numbness (12.4%; 95% CI 6.6%-19.7%; I<sup>2</sup> = 98%) syndromes. Among pain syndromes, the most affected areas were the hand (28.2%; CI 19.2%-38.2%; I<sup>2</sup> = 99%), lower back (27.3%; CI 20.1%-35.2%; I<sup>2</sup> = 97%), thumb (27.1%; CI 18.9%-37.7%; I<sup>2</sup> = 99%) and neck (25.7%; CI 19.3%-32.7%; I<sup>2</sup> = 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%; I<sup>2</sup> = 94%), while 28.2% engaged in physical therapy (CI 18.2%-39.5%; I<sup>2</sup> = 96%). Sick leave was reported by 13.8% of endoscopists (CI 7.9%-20.9%; I<sup>2</sup> = 94%). Practice modifications to manage ERIs included adjusting monitor (45.5%, CI 22.2%-69.9%; I<sup>2</sup> = 96%) and table (32.4%, CI 14.5%-53.5%; I<sup>2</sup> = 97%) height, but also reducing the number of cases per endoscopy session (14.6%; CI 10.4%-19.4%; I<sup>2</sup> = 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":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-19","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}
Sabuhi Mammadov, Mehmet Akif Yağli, Asli Ciftcibasi Ormeci
{"title":"Pancreatic Enzyme Replacement Therapy Improves Exclusive Enteral Nutrition Related Diarrhea in Crohn's Disease: A Prospective Randomized Trial.","authors":"Sabuhi Mammadov, Mehmet Akif Yağli, Asli Ciftcibasi Ormeci","doi":"10.1002/ueg2.70049","DOIUrl":"https://doi.org/10.1002/ueg2.70049","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095058","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":"Effects of Transcutaneous Auricular Vagal Nerve Stimulation on Chronic Constipation: A Multicenter, Randomized Controlled Study.","authors":"Tangyi Liu, Zeyu Wang, Yunling Li, Xiaoyu Kang, Xiangping Wang, Gui Ren, Yong Lv, Jing Li, Yaling Liu, Shuhui Liang, Xin Wang, Xiaojun Huang, Xiaoyin Zhang, Jun Wang, Yongzhan Nie, Hui Luo, Jinbo Sun, Wei Qin, Ying Han, Yanglin Pan","doi":"10.1002/ueg2.70041","DOIUrl":"https://doi.org/10.1002/ueg2.70041","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to investigate the efficacy of transcutaneous auricular vagal nerve stimulation (taVNS) in adult patients with chronic constipation.</p><p><strong>Design: </strong>Consecutive patients who met the Rome IV criteria for chronic constipation were enrolled and randomly assigned to either the taVNS group or the sham-taVNS group. Treatment consisted of 30 min of therapy twice a day for 4 weeks. The primary outcome was the response rate at week 1-4, defined as the proportion of patients with a weekly complete spontaneous bowel movement (CSBM) of ≥ 3 and weekly excessive use of rescue medication ≤ 3 times. Secondary outcomes included spontaneous bowel movements, anxiety and depression scores, abdominal symptoms, and adverse events.</p><p><strong>Results: </strong>The study was terminated due to lack of efficacy revealed by the interim analysis. A total of 106 patients were randomized, with 52 participants in the taVNS group and 54 participants in the sham-taVNS group. After 4 weeks of treatment, the response rates were 17% (9/52) in the taVNS group and 19% (10/54) in the sham-taVNS group. There was no significant difference between the two groups in intention-to-treat (ITT) analysis (RR 0.92, 95% CI 0.30-2.80, p = 1) or in the per-protocol (PP) analysis. No serious adverse events were reported.</p><p><strong>Conclusion: </strong>Our study did not support the effectiveness of 4-week 25 Hz taVNS for the treatment of adult chronic constipation patients.</p><p><strong>Trial registration: </strong>clinicaltrials.gov number: NCT05723731.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050136","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}
Eliza Butnaru, Solène Tran Van, Franck Brazier, Clara Yzet
{"title":"Pancreatic Panniculitis Without Pancreatopathy: A Rare Complication of Splenic Vein Stenting for Portal Hypertension in Myeloproliferative Syndrome.","authors":"Eliza Butnaru, Solène Tran Van, Franck Brazier, Clara Yzet","doi":"10.1002/ueg2.70046","DOIUrl":"https://doi.org/10.1002/ueg2.70046","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036073","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}
Takeshi Ogura, Saori Ueno, Akitoshi Hakoda, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Jun Matsuno, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Taro Iwatsubo, Toshifumi Yamaguchi, Ahmad F Aboelezz, Hiroki Nishikawa
{"title":"Balloon Catheter Versus Drill Dilator for EUS-Guided Hepaticogastrostomy Stent Placement: A Randomized Clinical Trial.","authors":"Takeshi Ogura, Saori Ueno, Akitoshi Hakoda, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Jun Matsuno, Yuki Uba, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Kimi Bessho, Taro Iwatsubo, Toshifumi Yamaguchi, Ahmad F Aboelezz, Hiroki Nishikawa","doi":"10.1002/ueg2.70044","DOIUrl":"https://doi.org/10.1002/ueg2.70044","url":null,"abstract":"<p><strong>Objectives: </strong>A novel partially self-expandable metal stent (PCSEMS) with an anti-migration system has recently become available during Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) but requires tract dilation. No previous study has compared the performance of dilation devices during EUS-HGS. The aim of this randomized controlled trial was to evaluate the technical success rate of tract dilation between a balloon catheter and drill dilator technique during EUS-HGS prior to insertion of SEMS with an anti-migration system.</p><p><strong>Methods: </strong>A single-center, randomized controlled trial comparing the balloon dilation and drill dilator techniques for first-line tract dilation during EUS-HGS. The primary outcome was the initial technical success rate of tract dilation for each technique during EUS-HGS. The secondary outcome was adverse events associated with the procedures.</p><p><strong>Results: </strong>Of 54 randomized patients who underwent EUS-HGS at our center, there were 27 in the balloon dilation group and 27 in the drill dilation group. The initial technical success rate was 92.6% (25/27) in the balloon dilation group and 100% (27/27) in the drill dilation group (p = 0.1495). The technical success rate of stent delivery system insertion was significantly higher in the balloon dilation group (88%, 22/25) than in the drill dilation group (45%, 13/27; p = 0.0013). Procedure time was significantly shorter in the balloon dilation group (mean, 9.7 min) than in the drill dilation group (mean, 14.0 min; p = 0.047). Adverse events were more frequent in the drill dilation group (7.4% vs. 29.6%, p = 0.038).</p><p><strong>Conclusions: </strong>Balloon dilation appears more suitable than drill dilation for PCSEMS with 8.5 Fr stent delivery system deployment.</p><p><strong>Clinical trial registration number: </strong>University Hospital Medical Information Network 000049550.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050297","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":"Dissecting Microscopic Colitis Immunopathophysiology: Insights From Basic Research.","authors":"Andreas Münch, Celia Escudero-Hernández","doi":"10.1002/ueg2.70024","DOIUrl":"https://doi.org/10.1002/ueg2.70024","url":null,"abstract":"<p><p>Microscopic colitis is an inflammatory bowel disease (IBD) comprising two clinically undiscernible entities: collagenous colitis and lymphocytic colitis. Collagenous colitis associates with HLA genes and displays a Th1/Tc1-Th17/Tc17 profile with pericryptal myofibroblast activity, water malabsorption and secondary fluid loss due to altered osmoregulation. Conversely, lymphocytic colitis lacks genetic associations and displays a Th1/Th2 profile and paracellular/transcellular permeability. Lymphocytic colitis subclassifies into channelopathic lymphocytic colitis due to unique alteration of ion and organic acid transport that could result from drug exposure, and inflammatory lymphocytic colitis due to the involvement of moderate immune responses compared to collagenous colitis. As microscopic colitis mucosa remains intact and immune cells seem to stay inactive, microscopic colitis is an ideal model to explore early stages of IBD if collagenous colitis and lymphocytic colitis are studied as distinct entities. Exploiting multiomic approaches and established biobanks will ensure validation of microscopic colitis patient stratification, and deepening into pathomechanisms which could enable precision medicine.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040108","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":"https://doi.org/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":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-02","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":"Editorial: Striking the Right Balance for Eligibility Criteria for Clinical Trials in Inflammatory Bowel Disease.","authors":"Virginia Solitano, Vipul Jairath, Silvio Danese","doi":"10.1002/ueg2.12749","DOIUrl":"10.1002/ueg2.12749","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"512-514"},"PeriodicalIF":5.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932819","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}