United European Gastroenterology Journal最新文献

{"title":"Transcutaneous Auricular Vagal Nerve Stimulation to Treat Chronic Constipation: Another Therapeutic Failure?","authors":"Gabrio Bassotti, Danilo Consalvo","doi":"10.1002/ueg2.70065","DOIUrl":"10.1002/ueg2.70065","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1354-1355"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249824","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":"The Early Bird May Not Always Catch the Worm: Reframing Anti-TNF Timing.","authors":"Gurtej Singh, Jonathan P Segal","doi":"10.1002/ueg2.70087","DOIUrl":"10.1002/ueg2.70087","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1352-1353"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718713","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":"The Pitfalls of Measuring Burnout Prevalence: μετά the Meta-Analysis, What Then?","authors":"Romain Brisson","doi":"10.1002/ueg2.70094","DOIUrl":"10.1002/ueg2.70094","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1356-1357"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769114","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":"The Growing Burden of Obesity: Addressing a Global Public Health Challenge.","authors":"Patrizia Burra, Elvira Verduci, Jorge Amil Dias, Maria Buti, Anna Carboni, Coskun Ozer Demirtas, Pierluigi Fracasso, Daniel Hartman, Andrea Laghi, Patrick Michl, Shira Zelber-Sagi","doi":"10.1002/ueg2.70020","DOIUrl":"10.1002/ueg2.70020","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1343-1347"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017376","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":"Minimal Hepatic Encephalopathy in Cirrhotic Patients: A New Simple and Fast Digital Screening Method.","authors":"Henrike Dobbermann, Raffael Schlüter, Yevgeniy Lyubchenko, Johanna Beder, Sven Danneberg, Katharina Mitzlaff, Iris Engelbart, Jakob Jessberger, Felix Braun, Thomas Becker, Christian Labenz, Monique Janneck, Denys Matthies, Friedhelm Sayk, Jens U Marquardt","doi":"10.1002/ueg2.70004","DOIUrl":"10.1002/ueg2.70004","url":null,"abstract":"<p><strong>Backround: </strong>Minimal hepatic encephalopathy is a common and prognostically severe complication of cirrhosis with a significant impact on the quality of life. Detailed diagnostic work-up of minimal hepatic encephalopathy is time-consuming and difficult to integrate into daily clinical routine.</p><p><strong>Objective: </strong>We aimed to develop a new, simple, and easy-applicable smartphone-based self-assessment method for screening of minimal hepatic encephalopathy.</p><p><strong>Methods: </strong>92 patients with cirrhosis and 20 healthy controls were recruited to perform 3 different short digital tests on smartphones (Tip test (TT), number connection test (dNCT) and modified Stroop test (ST)). Results were correlated with the Psychometric Hepatic Encephalopathy Score (PHES) as the presumed gold standard for minimal hepatic encephalopathy. The impact of age, gender, education, CHILD and MELD scores was further investigated.</p><p><strong>Results: </strong>All 3 digital tests showed good correlation with PHES (TT r = -0.76, dNCT r = -0.58, and ST r = -0.65; all p < 0.001). Digital tests were performed significantly faster (TT median 41s (IQR 36-51s); dNCT median 21s (IQR 8-16s); ST median 76s (IQR 55-99s) than PHES (median 322s; IQR 261-434s); There were significant differences between age groups and different levels of education (p < 0.05). AUC for TT was 0.835 (95% confidence interval 0.747-0.922, p < 0.001) and highest among all digital tests.</p><p><strong>Conclusion: </strong>All 3 digital tests proved to be suitable for screening of minimal hepatic encephalopathy. TT showed the highest correlation with reference PHES and was not affected by language skills or color blindness, and, thus, might represent a new and fast method for minimal hepatic encephalopathy detection. Intra-individually adjusted smartphone-based thresholds might further eliminate the influence of age, gender, educational level or training, to refine early app-based alerts in case of cognitive deterioration in cirrhotic patients.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1194-1204"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997518","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":"Long-Term Efficacy and Safety of Digital-Single-Operator-Video-Pancreatoscopy Guided Lithotripsy for Pancreatic Duct Stones.","authors":"Claudio C Conrad, Mark Ellrichmann, Michiel Bronswijk, Schalk van der Merwe, Tobias Dertmann, Hadil Layka, Radhika Chavan, Sanjay Rajput, Pieter Jan de Jonge, Peter D Siersema, Marianne Udd, Leena Kylanpaa, Philip Grunert, Gilbert Rahe, Christoph Schramm, Jassin Rashidi-Alavijeh, Marco J Bruno, Torsten Beyna, Christian Gerges","doi":"10.1002/ueg2.70063","DOIUrl":"10.1002/ueg2.70063","url":null,"abstract":"<p><strong>Introduction: </strong>Ductal decompression has become the main approach for treating patients with symptomatic chronic calcifying pancreatitis and signs of ductal hypertension. Digital single operator video pancreatoscopy (dSOVP) has shown high success rates when compared with more established techniques such as extracorporeal shock wave lithotripsy. However, there is still limited evidence on long-term clinical success and quality of life.</p><p><strong>Methods: </strong>Patients with chronic calcifying pancreatitis who underwent digital single operator video pancreatoscopy guided electrohydraulic lithotripsy (EHL) of pancreatic duct stones with initial technical and clinical success were recruited for this retrospective, multicenter cohort study. Persistence of clinical success (defined as pain reduction > 50% in numerical rating scale [NRS]) as well as postinterventional quality of life (QOL) were retrospectively evaluated by database analysis and with QOL using the Mental and Physical Condition Scores (MCS, PCS).</p><p><strong>Results: </strong>A total of 58 patients were included in the long-term follow-up conducted over 24 months. Significant and sustained pain relief was reported in 70.7% of patients (n = 41) at month 3; this effect persisted until month 24. MCS decreased from 50.36 ± 13.3 at baseline to 49.75 ± 11.1 at month 12 with no statistically significant difference (data available for 42 patients, p = 0.15). Similarly, the PCS showed no significant improvement, remaining constant at 44.9 ± 9.8 at baseline and 44.9 ± 10.8 at month 12 (p = 0.1). The overall adverse event rate was 26% (11 patients), primarily consisting of mild to moderate pancreatitis (n = 9, 22%).</p><p><strong>Conclusions: </strong>Digital single operator video pancreatoscopy guided lithotripsy was shown to be safe and effective in a long-term follow-up regarding pain control but had no significant influence on QOL. Complete stone removal seems to be the key point for long-term clinical success.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1127-1132"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249822","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":"Volumetric Changes in Perianal Fistulizing Crohn's Disease Measured by Magnetic Resonance Is Feasible and Could Be a Potential Biomarker to Predict Clinical Outcomes.","authors":"Berta Caballol, Ingrid Ordás, Carolina Saavedra, Julia Saidman, Maria Carmen Masamunt, Marta Gallego, Rebeca Barastegui, Agnès Fernández-Clotet, Alex Menys, Julian Panés, Elena Ricart, Jordi Rimola","doi":"10.1002/ueg2.70003","DOIUrl":"10.1002/ueg2.70003","url":null,"abstract":"<p><strong>Background and aim: </strong>Changes in 3D volumetry of perianal fistulas in patients with Crohn's disease (CD) measured by MRI could be an imaging biomarker of interest. The objective of the study was to determine the value of volumetric changes in CD perianal fistulas after medical treatment to predict outcomes.</p><p><strong>Methods: </strong>This is a retrospective single-center pilot study evaluating CD patients with active perianal fistulas who started biological therapy between 2012 and 2021. Eligible patients were those who had both pre- and post-treatment pelvic MRI and clinical follow-up of 2-5 years. Patients were categorized as clinically active or in remission based on fistula drainage. Using specific software, we calculated the 3D volume of the fistulas, and their active and fibrotic components. We evaluated MRI volumetric changes between assessments and analyzed their predictive value for clinical remission.</p><p><strong>Results: </strong>We included 24 patients (83.3% with complex fistulas), of which 13 were in clinical remission at the last follow-up. Logistic regression analysis identified the percentage of relative change in the volumetric active component as an independent predictor of clinical remission (OR 0.92 [0.86-0.98] p = 0.013). The area under receiver operating characteristic (ROC) curve was 85.3% (p < 0.0001). A reduction of ≥ 16% in the volumetric percentage of the active component has a sensitivity of 84.6 and specificity of 81% in predicting clinical remission during follow-up.</p><p><strong>Conclusion: </strong>Changes in the 3D MRI volumetry of perianal fistulas might have value in predicting clinical remission. Specifically, the reduction in the volumetry of the active component emerges as a promising biomarker for assessing therapeutic response.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1217-1225"},"PeriodicalIF":6.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664062","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":"European Consensus on Functional Bloating and Abdominal Distension-An ESNM/UEG Recommendations for Clinical Management.","authors":"Chloé Melchior, Heinz Hammer, Serhat Bor, Elizabeth Barba, Indira Benjak Horvat, Altay Celebi, Vasile Drug, Dan Dumitrascu, Ismail Hakki Kalkan, Goran Hauser, Christos Lionis, Dan Livovsky, Amir Mari, Agata Mulak, Teodora Surdea-Blaga, Jan Tack, Tim Vanuytsel, Edoardo Vincenzo Savarino, Natalia Zarate-Lopez, Johann Hammer, Ram Dickman","doi":"10.1002/ueg2.70098","DOIUrl":"10.1002/ueg2.70098","url":null,"abstract":"<p><strong>Introduction: </strong>Abdominal distension is an objective visible sign of increased abdominal girth. Bloating is a feeling of abdominal fullness and discomfort. Bloating may be associated or not with abdominal distension. Bloating and abdominal distension are among the most commonly reported gastrointestinal symptoms and may be associated with both organic and functional disorders. Nevertheless, specific consensus and recommendations on diagnosis, underlying mechanisms, assessment and management of functional bloating and abdominal distension are still lacking. The aim of this European consensus, then, is to provide expert opinions and recommendations on the epidemiology, diagnosis, pathophysiology and treatment of functional bloating and abdominal distension.</p><p><strong>Methods: </strong>A multidisciplinary team of experts in the field, including European specialists and national societies, participated in the development of this consensus. Relevant questions were formulated and addressed through a literature review and statements were developed and voted using a Delphi process.</p><p><strong>Results: </strong>Functional bloating and abdominal distension are common and frequently overlap with other disorders of gut-brain interaction. Diagnosis is made according to the Rome IV criteria after the exclusion of organic disease, based on the physical examination and assessment of the patient's medical history and alarming signs. In the absence of alarming signs or any relevant finding, clinical laboratory, imaging or endoscopic tests are unnecessary. The pathophysiology of functional bloating and abdominal distension is multifactorial and involves visceral hypersensitivity, abdomino-phrenic dyssynergia, intestinal dysmotility and dysbiosis. Treatment may include dietary modifications (e.g. lactose-limiting diet and low FODMAP diet), probiotics, antispasmodics (e.g., otilonium bromide, peppermint oil), rifaximin, secretagogues (e.g., linaclotide), neuromodulators (e.g., serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, buspirone), and plethysmography-based biofeedback. Moreover, cognitive behaviour therapy and hypnotherapy can be used in case of functional bloating associated with irritable bowel syndrome.</p><p><strong>Conclusion: </strong>This consensus provides an evidence-based framework for the evaluation and treatment of patients with functional bloating and abdominal distension.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970890","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":"Environmental and Inflammatory Factors Drive Perinuclear-Antineutrophil Cytoplasmic Antibodies (pANCA) in Ulcerative Colitis: A European Twin Study.","authors":"Daniel Bergemalm, Karin Amcoff, Marie J Pierik, Jean-Frederic Colombel, Severine Vermeire, Lennart Bodin, Marie Carlson, Jonas Halfvarson","doi":"10.1002/ueg2.70101","DOIUrl":"https://doi.org/10.1002/ueg2.70101","url":null,"abstract":"<p><strong>Background: </strong>Perinuclear-antineutrophil cytoplasmic antibodies (pANCA) have been identified in familial ulcerative colitis (UC), but the mechanism underlying their expression remains elusive. We assessed the role of genetic predisposition, environmental factors and systemic subclinical inflammation in the development of pANCA in a twin cohort with UC.</p><p><strong>Methods: </strong>A total of 48 twin pairs (Leuven, Belgium n = 4, Maastricht, The Netherlands n = 6 and Örebro, Sweden n = 38) with UC were included. Among these, 18 were monozygotic (3 concordant and 15 discordant for UC) and 30 were dizygotic (1 concordant and 29 discordant for UC). P-ANCA was detected through standardised ELISA, an indirect immunofluorescence assay and DNase treatment. In addition to high sensitivity C-reactive protein (hs-CRP), 92 inflammatory protein markers were measured in serum by proximity extension assay.</p><p><strong>Result: </strong>Perinuclear-ANCA was present in 15/52 (29%) of UC twins vs. 4/44 (9%) healthy twin siblings (p = 0.02). No agreement in the presence of pANCA or their levels was observed between twin siblings in monozygotic pairs discordant for UC [intraclass correlation coefficient (ICC) = 0.09] or dizygotic pairs (ICC = -0.20). Female sex was associated with an increased likelihood of pANCA (odds ratio, OR 5.25; 95% confidence interval, CI 1.36-20.30) and higher ANCA levels (ratio of geometric means 1.86; 95% CI 1.18-2.93). Active smoking was associated with lower concentrations of ANCA (ratio of geometric means 0.31; 95% CI 0.14-0.68) and potentially reduced the likelihood of pANCA (OR 0.20; 95% CI 0.03-1.34) in twins with UC but not in their healthy siblings. In healthy twin siblings, significant correlations between ANCA levels and hs-CRP, CDCP1, IL17 A, CXCL9 and IL5 (correlation coefficients 0.36-0.41, p-values < 0.05) were observed.</p><p><strong>Conclusion: </strong>Female sex and tobacco smoking outweighed genetics regarding the generation and levels of pANCA and ANCA antibodies. The correlations between ANCA levels and inflammatory markers in healthy twin siblings suggest that pANCA may result from subclinical inflammation.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970857","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":"Incidence and Long-Term Outcomes of Pouchitis in Ulcerative Colitis Patients.","authors":"Rosalina Bergstrøm, Bobby Lo, Eva Toft, Sebastian Schmidt, Stephan Kaiser, Robert Kudernatsch, Orhan Bulut, Flemming Bendtsen, Johan Burisch","doi":"10.1002/ueg2.70089","DOIUrl":"https://doi.org/10.1002/ueg2.70089","url":null,"abstract":"<p><strong>Background: </strong>Ileal pouch-anal anastomosis (IPAA) is the preferred intervention for ulcerative colitis (UC) patients whose medical treatment fails. Acute severe ulcerative colitis (ASUC) can precipitate the need for urgent surgery, potentially influencing post-IPAA outcomes.</p><p><strong>Objective: </strong>This study details the incidence, disease course, and treatment of pouchitis and pouch failure in a population-based cohort of UC patients following IPAA construction.</p><p><strong>Methods: </strong>We included all UC patients who underwent IPAA construction within two administrative regions in Denmark between November 1993 and April 2021 in a population-based cohort. Data spanning from diagnosis to January 2023 were manually extracted from electronic patient records and analyzed.</p><p><strong>Results: </strong>Among 233 patients, 118 (50.6%) experienced 519 pouchitis events. 437 (84.2%) had intermittent pouchitis, 60 (11.6%) had chronic antibiotic-dependent pouchitis, and 22 (4.2%) had chronic antibiotic-refractory pouchitis. There was no significant difference in the incidence of pouchitis between patients who underwent urgent surgery due to ASUC and those who underwent non-urgent surgery. Antibiotics were used in 89.6% of cases, with ciprofloxacin and metronidazole being the most common treatment. Thirty-two (13.7%) patients experienced 36 pouch failures, 6.9% experienced permanent pouch failure, with 8.3% of failures attributed to pouchitis.</p><p><strong>Conclusion: </strong>Half of the patients with IPAA experienced at least one episode of pouchitis. ASUC did not appear to increase the risk of pouchitis. The overall incidence of pouch failure was low, with pouchitis contributing to a minority of failures.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859677","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}