World Journal of Gastroenterology最新文献

{"title":"Unraveling the gut-liver axis in autoimmune liver disease overlap syndrome: A multi-omics perspective.","authors":"Eguono D Akpoveta, Uchenna E Okpete, Haewon Byeon","doi":"10.3748/wjg.v31.i37.112298","DOIUrl":"10.3748/wjg.v31.i37.112298","url":null,"abstract":"<p><p>Autoimmune liver disease overlap syndrome (OS) is a rare and clinically significant condition that has received limited attention in microbiome research. In their recent study, Wang <i>et al</i> combined 16S rRNA sequencing with untargeted metabolomics to characterize the gut-liver axis in OS, identifying shared features of dysbiosis in autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC), and unique signatures, including enrichment of <i>Klebsiella</i> and <i>Escherichia</i> and depletion of aromatic amino acids. In this letter, we critically appraise these findings, emphasizing that OS should be considered a distinct immunometabolic phenotype rather than a simple mixture of AIH and PBC. We discuss the potential mechanistic relevance of the <i>Fusicatenibacter</i>-tyrosine relationship, highlight the clinical implications of integrating microbiota-metabolite analyses, and outline the limitations that future studies must address.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 37","pages":"112298"},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Added value of the albumin-bilirubin score in predicting liver-related complications and mortality in metabolic-associated steatotic liver disease.","authors":"Supatsri Sethasine, Padoemwut Teerawongsakul, Witchakorn Ruamtawee, Nutachat Treerasoradaj, Huttakan Navadurong","doi":"10.3748/wjg.v31.i37.110829","DOIUrl":"10.3748/wjg.v31.i37.110829","url":null,"abstract":"<p><strong>Background: </strong>The albumin-bilirubin (ALBI) score is a marker of liver function and prognosis in hepatocellular carcinoma, with its utility being expanded to various liver conditions. However, its role in predicting long-term outcomes in patients with metabolic-associated steatotic liver disease (MASLD) remains unknown.</p><p><strong>Aim: </strong>To determine the ability of the ALBI score in predicting the 8-year liver-related complications and all-cause mortality in MASLD.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal cohort study of 1163 patients with MASLD. MASLD was defined by a controlled attenuation parameter of > 254 dB/m on transient elastography, at least one cardiometabolic risk factor, and no excessive alcohol consumption. Odds ratio regression was employed to create based-prognostic scores with and without ALBI. The predictive accuracy of both scores, the ALBI score, and fibrosis-4 (FIB-4) were assessed using area under the receiving operating characteristic curve (AUROC) analysis and compared using the DeLong test.</p><p><strong>Results: </strong>Over 8 years, 100 (8.6%) participants of liver-related complications, and 86 (7.4%) died (30.2% of prior liver complications). ALBI had greater accuracy for predicting liver-related complications [AUROC = 0.72, 95% confidence interval (CI): 0.66-0.77] compared with the based-prognostic score (AUROC = 0.67, 95%CI: 0.62-0.73) and FIB-4 (AUROC = 0.64, 95%CI: 0.58-0.70). Additionally, ALBI was superior to the based-prognostic score and FIB-4 (AUROC = 0.81, 95%CI: 0.76-0.86 <i>vs</i> AUROC = 0.78, 95%CI: 0.72-0.83 and AUROC = 0.72, 95%CI: 0.65-0.78, respectively) for predicting all-cause mortality. Incorporating ALBI improved the prognostic score's accuracy for both outcomes (liver complications: AUROC = 0.74, 95%CI: 0.68-0.79; all-cause mortality: AUROC = 0.83, 95%CI: 0.79-0.88).</p><p><strong>Conclusion: </strong>The ALBI score is a robust and independent predictor of long-term liver-related complications and all-cause mortality in patients with MASLD. ALBI may have potential clinical applications for long-term risk stratification in MASLD management.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 37","pages":"110829"},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations and clinical utility of referral pathways for early detection of liver disease in at-risk populations.","authors":"Jesse Pustjens, Willem P Brouwer, Ibrahim Ayada, Harry L A Janssen, Laurens A van Kleef","doi":"10.3748/wjg.v31.i37.107665","DOIUrl":"10.3748/wjg.v31.i37.107665","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease is the most prevalent chronic liver condition, affecting over one-third of the global population, with cirrhosis present in up to 3.3% of cases. Early detection of advanced liver disease in at-risk populations can enable timely intervention, prevent progression, and reduce complications. This review focuses on the current recommendations for early detection of advanced liver disease, evaluates the evidence for the performance of non-invasive tests in the target population for screening, and examines the multifaceted burden of screening, including economic implications and psychological impacts. Additionally, we discuss future directions, such as integrating liver health into a multidisciplinary care framework. Current guidelines recommend case-finding, targeting individuals with type 2 diabetes, metabolically complicated obesity, or persistent elevated liver enzymes. The Fibrosis-4 index is widely endorsed as a first-line non-invasive test, yet the diagnostic performance in primary care settings seems suboptimal, particularly for pre-cirrhotic disease. Sequential strategies incorporating novel non-invasive tests may improve accuracy and cost-effectiveness. Confirmation typically involves vibration-controlled transient elastography. Key challenges include a large eligible population, uncertainties in optimal screening intervals, patient adherence to follow-up, and limited real-world cost-effectiveness data. Integrating liver health assessment into cardiometabolic care pathways, reflex testing, telehealth, and patient education may enhance uptake. While challenges remain, early detection of advanced liver disease is already likely cost-effective. Ongoing advances in screening pathways and treatment options are expected to further strengthen the case for widespread implementation.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 37","pages":"107665"},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Era of metabolic dysfunction-associated steatotic liver disease and impact on the liver donor pool.","authors":"Juanita Pérez-Escobar, Aline Huerta-Álvarez, Graciela Elia Castro-Narro, María Isabel Astudillo-Delgado, Paulina Carpinteyro-Espin","doi":"10.3748/wjg.v31.i37.110164","DOIUrl":"10.3748/wjg.v31.i37.110164","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a silent epidemic having substantial clinical implications, with liver transplantation being one of the areas most impacted. The increasing prevalence of metabolic fatty liver disease has reduced the quality of available donor organs. While noninvasive methods are increasingly applied to evaluate liver steatosis in deceased donors, liver biopsy remains the gold standard. Many aspects of liver biopsies are not yet fully standardized. Macrovesicular hepatic steatosis is associated with decreased allograft quality and poorer short- and long-term transplant outcomes, especially in moderate and severe steatotic cases. Donation after cardiac arrest further exacerbates these poor outcomes. Matching marginal allografts with suitable recipients based on recipient characteristics is crucial for improving transplant outcomes. Living donor liver transplant is a feasible option for addressing organ shortages. Noninvasive evaluation is preferred for assessing liver health; however, when the results are inconclusive, a liver biopsy is recommended. Lifestyle modifications can improve graft, living donor and recipient outcomes. Analysis of the impact of MASLD on the donor pool and the implementation of new optimization strategies are essential to ensure the sustainability of transplantation as a curative treatment for advanced liver cirrhosis. The aim of this review was to summarize the effect of MASLD on the liver donor population, highlighting how to evaluate steatosis in donors, and to discuss its clinical implications as well as strategies to optimize organ allocation in the MASLD era.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 37","pages":"110164"},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in the diagnosis of celiac disease.","authors":"Zhen Wang, Qi Wu","doi":"10.3748/wjg.v31.i37.112388","DOIUrl":"10.3748/wjg.v31.i37.112388","url":null,"abstract":"<p><p>Celiac disease (CD) is a prevalent immune-mediated disorder triggered by gluten ingestion in genetically susceptible individuals. Primarily affecting the small intestine, CD can also have adverse systemic health effects. However, the majority of affected individuals remain undiagnosed because of asymptomatic or subclinical manifestations. While the diagnostic gold standard remains the combination of positive serum immunoglobulin A antibodies against tissue transglutaminase and villous atrophy on small intestinal biopsy, an evolving understanding of CD pathogenesis has elevated various serum biomarkers to increasingly important complementary diagnostic tools. This editorial aims to outline the scientific merits and potential limitations of serum biomarker assays for CD diagnosis, alongside their established and emerging clinical applications in both initial diagnosis and long-term disease monitoring.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 37","pages":"112388"},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of anti-obesity drugs in metabolic dysfunction-associated steatotic liver disease: An updated review.","authors":"Marcio J Concepción-Zavaleta, Jenyfer M Fuentes-Mendoza, Jhean G Gonzáles-Yovera, Gemma Y Ruvalcaba-Barbosa, Leonardo D Cura-Rodríguez, Josué S González-Rodríguez, Luis A Concepción-Urteaga, Aranza I Pérez-Reyes, Juan Eduardo Quiroz-Aldave, José Paz-Ibarra","doi":"10.3748/wjg.v31.i37.111435","DOIUrl":"10.3748/wjg.v31.i37.111435","url":null,"abstract":"<p><p>Obesity is a major driver of metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH). As the global prevalence of obesity continues to rise, the burden of MASLD/MASH is increasing, posing significant challenges to healthcare systems. The use of anti-obesity medications (AOMs) in this population is complex due to altered hepatic metabolism, safety concerns, and potential hepatotoxicity. Recent advances in pharmacologic agents, such as glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs), dual GLP-1/glucose-gastric inhibitory polypeptide (GIP) agonists, and triple GLP-1/GIP/glucagon agonists, have shown promising metabolic effects in the general population. Among these, GLP-1 RAs (<i>e.g.</i>, liraglutide and semaglutide) consistently demonstrate hepatic benefits, including reductions in hepatic steatosis, improvements in liver enzyme profiles, and attenuation of fibrosis progression. Tirzepatide, a dual GLP-1/GIP agonist, has shown superior weight loss effects compared to GLP-1 receptor agonist monotherapy, with emerging but still limited data on hepatic outcomes in MASLD/MASH. Retatrutide, a triple agonist, has produced the most pronounced metabolic effects to date, although its impact on liver histology remains underexplored. Other AOMs, such as bupropion-naltrexone and phentermine-topiramate, require cautious use due to potential hepatotoxicity. Importantly, advanced MASLD may alter drug pharmacokinetics, underscoring the need for individualized therapy and close monitoring. This review provides an updated synthesis of the efficacy and safety of current and emerging AOMs in patients with MASLD/MASH and highlights the urgent need for further research to define optimal pharmacological strategies in this high-risk population.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 37","pages":"111435"},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of metabolic dysfunction-associated fatty liver disease among health check-up attendees: A retrospective study conducted in Vietnam.","authors":"Ngan Lam Lu, Huong Tu Lam, Thong Duy Vo","doi":"10.3748/wjg.v31.i37.110797","DOIUrl":"10.3748/wjg.v31.i37.110797","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated fatty liver disease (MAFLD) is a recently proposed term that highlights the role of metabolic dysfunction in hepatic steatosis. It currently affects more than one-third of adults worldwide and is associated with liver fibrosis, hepatocellular carcinoma, cardiovascular disease, and chronic kidney disease. Given its high prevalence, asymptomatic progression, and revised definition, evaluating its epidemiology and risk profile remains an important public health priority.</p><p><strong>Aim: </strong>To assess the prevalence and characteristics of MAFLD among Vietnamese individuals undergoing health check-ups.</p><p><strong>Methods: </strong>This retrospective study included 331 adults undergoing routine health check-ups at The Health Evaluation and Promotion Center, International University of Health and Welfare Center, Cho Ray Hospital, from June to October 2023. MAFLD was diagnosed based on the 2020 international expert consensus. Data collected included demographic, clinical, laboratory information, and metabolic risk factors from routine health check-up records. Descriptive statistics, <i>χ</i> ² tests, and <i>t</i>-tests/Mann-Whitney tests were applied as appropriate. Significance was defined as <i>P</i> < 0.05.</p><p><strong>Results: </strong>MAFLD was identified in 97 of 331 individuals (29.31%). Prevalence was significantly higher in men than women (44.51% <i>vs</i> 14.37%; <i>P</i> < 0.001). In females, prevalence increased sharply after age 50 (<i>P</i> = 0.008). According to body mass index groups, prevalence was 0% (underweight), 9.27% (normal), and 48.26% (overweight/obese). The MAFLD group had significantly higher rates of hypertension (19.59% <i>vs</i> 2.99%), dyslipidemia (98.96% <i>vs</i> 89.32%), prediabetes/diabetes (65.98% <i>vs</i> 28.20%), hyperuricemia (64.95% <i>vs</i> 31.19%), and metabolic syndrome (54.64% <i>vs</i> 7.69%) compared to the non-MAFLD group (all <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>MAFLD is prevalent in Vietnamese adults undergoing health screening. It is strongly associated with sex, age, body mass index, and metabolic disorders, indicating the importance of early detection and integrated management.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 37","pages":"110797"},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of key factors and explainability analysis for surgical decision-making in hepatic alveolar echinococcosis assisted by machine learning.","authors":"Da-Long Zhu, Alimu Tulahong, Chang Liu, Ayinuer Aierken, Wei Tan, Rexiati Ruze, Zhong-Dian Yuan, Lei Yin, Tie-Min Jiang, Ren-Yong Lin, Ying-Mei Shao, Tuerganaili Aji","doi":"10.3748/wjg.v31.i37.111038","DOIUrl":"10.3748/wjg.v31.i37.111038","url":null,"abstract":"<p><strong>Background: </strong>Echinococcosis, caused by Echinococcus parasites, includes alveolar echinococcosis (AE), the most lethal form, primarily affecting the liver with a 90% mortality rate without prompt treatment. While radical surgery combined with antiparasitic therapy is ideal, many patients present late, missing hepatectomy opportunities. <i>Ex vivo</i> liver resection and autotransplantation (ELRA) offers hope for such patients. Traditional surgical decision-making, relying on clinical experience, is prone to bias. Machine learning can enhance decision-making by identifying key factors influencing surgical choices. This study innovatively employs multiple machine learning methods by integrating various feature selection techniques and SHapley Additive exPlanations (SHAP) interpretive analysis to deeply explore the key decision factors influencing surgical strategies.</p><p><strong>Aim: </strong>To determine the key preoperative factors influencing surgical decision-making in hepatic AE (HAE) using machine learning.</p><p><strong>Methods: </strong>This was a retrospective cohort study at the First Affiliated Hospital of Xinjiang Medical University (July 2010 to August 2024). There were 710 HAE patients (545 hepatectomy and 165 ELRA) with complete clinical data. Data included demographics, laboratory indicators, imaging, and pathology. Feature selection was performed using recursive feature elimination, minimum redundancy maximum relevance, and least absolute shrinkage and selection operator regression, with the intersection of these methods yielding 10 critical features. Eleven machine-learning algorithms were compared, with eXtreme Gradient Boosting (XGBoost) optimized using Bayesian optimization. Model interpretability was assessed using SHAP analysis.</p><p><strong>Results: </strong>The XGBoost model achieved an area under the curve of 0.935 in the training set and 0.734 in the validation set. The optimal threshold (0.28) yielded sensitivity of 93.6% and specificity of 90.9%. SHAP analysis identified type of vascular invasion as the most important feature, followed by platelet count and prothrombin time. Lesions invading the hepatic vein, inferior vena cava, or multiple vessels significantly increased the likelihood of ELRA. Calibration curves showed good agreement between predicted and observed probabilities (0.2-0.7 range). The model demonstrated high net clinical benefit in Decision Curve Analysis, with accuracy of 0.837, recall of 0.745, and F1 score of 0.788.</p><p><strong>Conclusion: </strong>Vascular invasion is the dominant factor influencing the choice of surgical approach in HAE. Machine-learning models, particularly XGBoost, can provide transparent and data-driven support for personalized decision-making.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 37","pages":"111038"},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic delays in alcoholic cirrhosis: A cross-sectional study of contributing factors.","authors":"Zhong-Shang Dai, Zhi Gao, Bo He, Yong-Fang Jiang","doi":"10.3748/wjg.v31.i37.110786","DOIUrl":"10.3748/wjg.v31.i37.110786","url":null,"abstract":"<p><strong>Background: </strong>Studies investigating diagnostic delays and their effects on patients with alcoholic cirrhosis.</p><p><strong>Aim: </strong>To investigate the current status and associated factors influencing diagnostic delays in 401 patients with alcoholic cirrhosis.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted at a tertiary hospital in China from June 2020 to December 2023. Data were collected through telephone follow-ups and questionnaires. The Wilcoxon and Kruskal-Wallis <i>H</i> tests were used to compare diagnostic delays across various characteristics. Multivariate linear regression was employed to identify factors associated with diagnostic delays.</p><p><strong>Results: </strong>The median diagnostic delay was 5 months, with an interquartile range of 2-11 months. The proportions of patients with alcoholic cirrhosis who initially visited tertiary, secondary, and primary hospitals were 38.9%, 37.91%, and 23.19%, respectively. Furthermore, the rates of patients undergoing liver computed tomography (CT) during their first visit at tertiary, secondary, and primary hospitals were 92.95%, 13.82%, and 1.08%, respectively (<i>P</i> < 0.001). Significant differences were observed in diagnostic delay-related characteristics, including residence, resident type, initial diagnosis, medical insurance, liver CT, and liver ultrasound during the first visit, age, years of education, family size, marital status, annual family income, years of drinking, daily alcohol consumption, and type of alcohol consumed (<i>P</i> < 0.01). Furthermore, diagnostic delays were variably associated with daily alcohol consumption and other characteristics (<i>i.e.</i> residence, years of drinking, medical insurance, years of education, annual family income, liver CT and ultrasound during the first visit). Significant predictors of diagnostic delay identified on multivariate linear regression analysis included years of education, daily alcohol consumption, annual family income and blood ammonia levels (<i>P</i> < 0.01). Patients with alcoholic cirrhosis experience varying degrees of diagnostic delays, necessitating interventions targeting potential contributing factors.</p><p><strong>Conclusion: </strong>Our study indicates that patients with alcoholic cirrhosis may experience varying degrees of diagnostic delay. Interventions targeting potential factors contributing to diagnostic delay are necessary.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 37","pages":"110786"},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of dyspepsia and esophagogastroduodenoscopic findings in the era of <i>Helicobacter pylori</i> eradication.","authors":"Suguo Suzuki, Takeshi Kanno, Tomoyuki Koike, Takashi Chiba, Kiyotaka Asanuma, Katsuaki Kato, Yutaka Hatayama, Yohei Ogata, Masahiro Saito, Waku Hatta, Kaname Uno, Akira Imatani, Atsushi Masamune","doi":"10.3748/wjg.v31.i37.110942","DOIUrl":"10.3748/wjg.v31.i37.110942","url":null,"abstract":"<p><strong>Background: </strong>Since Japanese national insurance coverage was expanded to include <i>Helicobacter pylori</i> (<i>H. pylori</i>) gastritis in 2013, approximately 1.5 million patients have received eradication therapy annually. However, the prevalence and clinical features of uninvestigated dyspepsia in the post-eradication era remain unclear.</p><p><strong>Aim: </strong>To evaluate the prevalence of dyspepsia and related endoscopic findings in the general population.</p><p><strong>Methods: </strong>We analyzed data from a gastric cancer screening program using esophagogastroduodenoscopy in Sendai city between 2019 and 2021. Data regarding endoscopic findings, upper gastrointestinal symptoms, and history of <i>H. pylori</i> eradication were collected. Dyspepsia was defined as the presence of upper abdominal pain, bloating, or both. Multivariate logistic regression was used to identify independent factors associated with dyspepsia.</p><p><strong>Results: </strong>Among 23250 participants, overall dyspepsia prevalence was 28.0%. It was 28.7% in the non-infected and post-eradication cohorts, and lower (25.8%, <i>P</i> < 0.05) in the currently infected or naturally eradicated cohort. In addition, 23.1% of participants reported heartburn. The following were independently associated with dyspepsia: Age < 60 years, female sex, gastric ulcers, duodenal ulcers, erosive esophagitis, a history of gastric surgery, and successful <i>H. pylori</i> eradication. Gastric or esophageal cancer showed no association.</p><p><strong>Conclusion: </strong>Uninvestigated dyspepsia remains common even after successful <i>H. pylori</i> eradication. Dyspepsia was not considered a reliable indicator of gastric or esophageal cancer.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 37","pages":"110942"},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}