Zeitschrift fur Gastroenterologie最新文献

{"title":"Liver failure as first manifestation of a hepatic lymphoma.","authors":"Philipp A Reuken, Martin Brauer, Jacob Hammersen, Nikolaus Gassler, Andreas Rosenwald, Julian Westphal, Rene Aschenbach, Michael Bauer, Cristina Ripoll, Alexander Zipprich, Andreas Stallmach","doi":"10.1055/a-2821-8070","DOIUrl":"https://doi.org/10.1055/a-2821-8070","url":null,"abstract":"<p><p>Acute liver failure (ALF) is a rapidly progressive and potentially fatal condition in which successful treatment depends on the prompt identification of the underlying cause. We report the case of a 66-year-old woman who presented with severe hepatitis, marked coagulopathy, hyperbilirubinemia, and bicytopenia, while common etiologies of ALF were excluded. Imaging studies and initial bone marrow diagnostics did not provide a conclusive explanation. Subsequent histopathological evaluation of liver and bone marrow biopsies ultimately revealed hepatosplenic T-cell lymphoma, a rare and diagnostically challenging entity that may initially present as ALF. Despite planned chemotherapy, the patient experienced rapid deterioration of liver function and died from progressive liver failure. This case highlights the importance of early histological assessment - particularly via transjugular liver biopsy - in patients with unexplained ALF. It also underscores that hematologic malignancies should be considered even in the absence of typical systemic manifestations and that timely diagnostic evaluation is crucial for guiding urgent therapeutic decisions.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Women in Gastroenterology - Current Status from a German Survey: Why Waiting Is Not an Option].","authors":"Sandra Nagl, Ana Dugic, Yarema Okhrin, René Barnickel, Ulrike Denzer","doi":"10.1055/a-2797-1759","DOIUrl":"https://doi.org/10.1055/a-2797-1759","url":null,"abstract":"<p><p>Despite the increasing proportion of female medical students and physicians, gender-specific disparities persist in gastroenterology and endoscopy, particularly with regard to leadership positions. The aim of this study was to analyze gender-related differences and perceived structural barriers in Germany.In February 2025, all members of the German Society for Gastroenterology (DGVS) were invited to participate in an anonymous online survey comprising 16 standardized questions. Data were collected on professional practice acitivity, training status, endoscopic practice, and continuing medical education, with a focus on gender-specific differences.A total of 685 DGVS members participated. Men were significantly more likely to hold leadership positions (15.33% vs. 5.58%, p=0.0002). Women more frequently worked part-time (43.12% vs. 15.33%, p<0.0001) and performed complex interventional endoscopic procedures less often (p<0.0001). In addition, women reported significantly higher dissatisfaction with their endoscopic training (42.38% vs. 20.92%, p<0.0001), primarily due to family responsibilities and challenges balancing work and family life.This study demonstrates persistent gender disparities in gastroenterology. Targeted structural interventions and improved models for reconciling professional and family responsibilities are needed to ensure gender equity and support women's career progression.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Utilization of colorectal cancer screening and the influence of socioeconomic factors].","authors":"Jona T Stahmeyer, Imke Meißner, Maren Dreier, Kathrin Krüger, Christian Krauth, Heiner Wedemeyer","doi":"10.1055/a-2821-7519","DOIUrl":"https://doi.org/10.1055/a-2821-7519","url":null,"abstract":"<p><p>Colorectal cancer is one of the most common oncological diseases in Germany. Although the implementation and continuous development of colorectal cancer screening has been a success story and has contributed to a reduction in morbidity and mortality, participation remains below expectations. The current analysis examined the utilization of colorectal cancer screening since the introduction of the invitation procedure and the influence of socioeconomic factors.Insured persons who reached the age of eligibility for colonoscopy for the first time and had been invited by their health insurance were included in the study and followed up for one year. The utilization of colorectal cancer screening (stool test or colonoscopy) was recorded using specific billing numbers in the remuneration scheme.Over a one-year period, the participation rate was 11.4% (stool test 6.8%; colonoscopy 5.0%). The participation was significantly higher among women (13.8%) than among men (8.5%). Furthermore, differences in the participation rate were found according to socio-economic characteristics. For example, participation among employed persons (12.0%) was significantly higher than among citizens receiving social assistance (7.4%). A social gradient was also visible in terms of school and vocational training.The heterogeneous use of screening services shows different information needs. Actions for improvement could include awareness campaigns and group-specific, easy-to-understand, multilingual information, as well as an easier access.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life-style factors of patients with metabolic dysfunction-associated steatotic liver disease - Data from the German SLD-Registry.","authors":"Andreas Geier, Martin A Kabelitz, Monika Rau, Yvonne Serfert, Anita Pathil, Wolf P Hofmann, Manfred von der Ohe, Leopold Ludwig, Renate Heyne, Kerstin Stein, Thomas Berg, Peter Buggisch, Münevver Demir, Elke Roeb, Benjamin Maasoumy, Stefan Zeuzem, Heiner Wedemeyer, Jörn Schattenberg","doi":"10.1055/a-2814-8555","DOIUrl":"https://doi.org/10.1055/a-2814-8555","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) affects more than 18 million individuals in Germany. Life-style choices including alcohol, coffee and smoking are frequent but prospective data are rare.The German SLD-Registry aims to describe clinical characteristics and observe outcomes in secondary and tertiary care. Detailed data on life-style choices are prospectively collected.Baseline data of 903 patients were analysed. 40% (363/903) reported low grade alcohol consumption (mean 1.4 g/day). The alcohol subgroup had higher ferritin (152 vs. 205 ng/ml) but less frequently high-risk fibrosis scores (FIB-4 >2.67 8.5 vs. 15%; NFS >0.675 9.3 vs. 17%) or LS ≥9.6 kPa (25 vs. 73%; OR 0.546 [0.41-0.73], p<0.001). Smokers (current 83/544, former 136/544) had a trend towards higher CAP (326 and 314 vs. 305dB in never smokers (325/544)). No association of smoking to LS ≥9.6 kPa or cirrhosis stage could be observed (OR 0.94 [0.62-1.43], p=0.78). LS ≥9.6 kPa tended to be less frequent in coffee consumers (1-2 cups/day 229/464, 3-4 cups/day 117/464, >5 cups/day 36/464) than in non-consumers (36, 23 and 28% vs. 45%). CAP was not different between these groups. The OR for coffee consumers was reduced (0.58 [0.97-0.34]; p=0.04) with a significant dose dependency (p<0.003).Alcohol and coffee consumption are frequent among MASLD patients. Low grade alcohol and any degree coffee consumption were associated with a decreased risk of advanced liver fibrosis. Our data may confirm the beneficial effects of coffee and indicate that very low alcohol consumption may at least not exert relevant unfavourable effects.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Relationship Between Steatotic Liver Disease and Barrett's Esophagus: A Cross-Sectional Analysis of 5507 Screening Participants.","authors":"Nikolaus Götz, Andreas Völkerer, Hannah Hofer, Sarah Wernly, Franz Singhartinger, Ewald Wöll, Elmar Aigner, Maria Flamm, Christian Datz, Bernhard Wernly","doi":"10.1055/a-2763-8210","DOIUrl":"https://doi.org/10.1055/a-2763-8210","url":null,"abstract":"<p><p>Barrett's esophagus (BE) is the main precursor of esophageal adenocarcinoma (~2% prevalence in Western adults). Steatotic liver disease (SLD), affecting ~25% of adults, is linked to systemic inflammation, but its relationship with BE is unclear.In the population-based Salzburg Colon Cancer Prevention Initiative (2007-2020), we analyzed 5507 asymptomatic screening participants. SLD was diagnosed by ultrasound and classified as MASLD or MetALD; BE was confirmed endoscopically and histologically. Associations were assessed using multivariable logistic regression adjusting for demographic, metabolic, and clinical factors.SLD was present in 2550 participants and clustered with diabetes and metabolic syndrome. BE was found in 62 individuals (1.0% without SLD, 1.5% with MASLD, 1.1% with MetALD; P = 0.28). After adjustment, MASLD (OR 1.28; 95% CI 0.74-2.21) and MetALD (OR 0.66; 95% CI 0.16-2.85) were not significantly associated with BE. Female sex was protective (OR 0.26; 95% CI 0.13-0.50), while hiatal hernia increased BE risk (OR 2.05; 95% CI 1.16-3.60).In this population-based cohort, MASLD and MetALD were not clearly associated with BE. Current data do not support incorporating SLD status into BE screening algorithms, although modest risk increases cannot be ruled out.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Endogenous Alcohol Production in the Human Micro- and Mycobiome: Auto-Brewery Syndrome].","authors":"Martin Raithel, Vasiliki Zlatou, Igor Kremenevski, Alexander F Hagel, Peter Konturek","doi":"10.1055/a-2772-7942","DOIUrl":"https://doi.org/10.1055/a-2772-7942","url":null,"abstract":"<p><p>Pathological changes in the human microbiome and mycobiome can lead to endogenous production of toxic metabolites, including alcohol. Auto-brewery syndrome (ABS) is characterized by endogenous alcohol formation after high-carbohydrate intake in cases of dysbiosis or underlying disease.Cases described since 1948 were analyzed up to May 2025 via selective literature review regarding symptoms, pathophysiology, diagnostics, and therapy. Syndromes not clearly attributable to endogenous alcohol (e.g., autointoxication, intestinal fermentation syndrome) were excluded.Around 30 cases show variable clinical features with neuropsychiatric, gastrointestinal, and hepatological symptoms, sometimes causing emergencies or accidents. Alcohol is produced by microbial or mycotic overgrowth (e.g., E. coli, Klebsiella, Saccharomyces, Candida) following carbohydrate intake. Diagnosis requires detailed personal and external history, exclusion of other causes, and, if needed, monitored carbohydrate challenge with alcohol measurement. Treatment focuses on carbohydrate reduction, antibiotics or antifungals, and management of underlying conditions.ABS is rare but causes endogenous alcohol-related symptoms that must be considered in medical and legal evaluation of unexplained symptoms or incidents.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"64 3","pages":"270-276"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Results of a survey on additional qualification in nutritional medicine - need for action recognisable].","authors":"Elisabeth Blüthner, Jamal Ali","doi":"10.1055/a-2737-2113","DOIUrl":"10.1055/a-2737-2113","url":null,"abstract":"<p><p>Nutritional medicine is an important area of gastroenterology. It requires trained medical personnel who have qualified through additional training in nutritional medicine.In fall 2023, a survey was conducted among young gastroenterologists (JUGA) of the DGVS. Demographic data, the institutional and personal importance of nutritional medicine, and additional training were surveyed using Likert scales (rating scale 1 to 10), single-choice, and multiple-choice questions. The influence of gender, age, position, and institution was also examined.The personal importance of nutritional medicine among the 225 participants was 8 (7-10) on average, while its importance in the institution where they worked was 5 (3-7). This was rated significantly (p=0.012) higher in university hospitals than in non-university institutions. Obstacles cited include an unclear process for additional training, availability of case seminars and courses, and a lack of support at the management level.The importance of nutritional medicine at clinical institutions is lower than the personal interest in nutritional medicine and additional training, but this is currently associated with significant obstacles. Structural improvements and greater recognition are needed to keep additional training attractive and to meet the growing demand gap.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":" ","pages":"277-282"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A rare cause of recurrent bleeding in the ileum].","authors":"Al Hossain Al Nour","doi":"10.1055/a-2592-7747","DOIUrl":"https://doi.org/10.1055/a-2592-7747","url":null,"abstract":"","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"64 3","pages":"255-256"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive analysis of the circRNA, miRNA, and mRNA networks reveals prognostic biomarkers for gastric cancer.","authors":"Jun Wen, Yaqin He, Zijian Liu, Ruyi Li, Cao Zhang","doi":"10.1055/a-2681-2278","DOIUrl":"https://doi.org/10.1055/a-2681-2278","url":null,"abstract":"<p><p>Gastric cancer (GC) remains a leading cause of cancer-related deaths worldwide. Circular RNAs (circRNAs) have been increasingly recognized for their role in GC progression, particularly by acting as competing endogenous RNAs (ceRNAs) that regulate miRNA activity. This study aimed to elucidate the regulatory mechanisms of circRNAs in GC.Differentially expressed circRNAs, miRNAs, and mRNAs were identified from Gene Expression Omnibus datasets. Functional enrichment analysis of differentially expressed genes was performed using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis. A circRNA-miRNA-mRNA regulatory network was constructed based on predicted interactions. The PT-qPCR was used to detect the expression level of circRNAs in GC specimens and cell lines. The effects of hsa_circ_004228 on the GC cell functions were detected by CCK-8, Colony formation, and Transwell assay.The ceRNA network consisted of 9 core circRNAs, 10 core miRNAs, and 23 core mRNAs. Pathway analysis revealed that these mRNAs were primarily enriched in cancer-related pathways, including PI3K-Akt signaling, p53 signaling, and ECM-receptor interaction. Prognostic analysis indicated that high IER5L expression correlated with better survival, whereas high FNDC1, HTRA1, IFIT2, NDUFA4L2, and SERPINE1 expression correlated with poorer prognosis. A ceRNA prognostic subnetwork was established, incorporating 5 circRNAs (hsa_circ_0007094, hsa_circ_0007613, hsa_circ_0008768, hsa_circ_0006089, and hsa_circ_004228) and 4 miRNAs (hsa-miR-765, hsa-miR-198, hsa-miR-125a-3p, and hsa-miR-486-5p) associated with these prognostic mRNAs. The expression levels of hsa_circ_0007094, hsa_circ_0004228, hsa_circ_0007613, hsa_circ_0008768, and hsa_circ_0006089 were significantly upregulated in gastric cancer tissues. Knockdown of hsa_circ_0004228 significantly inhibits the activity, proliferation, migration, and invasion of HGC27 and AGS cells.In conclusion, we identified key circRNAs, miRNAs, and mRNAs involved in GC progression and prognosis, constructing a ceRNA network that provides novel insights into GC pathogenesis. These findings may aid in identifying potential biomarkers for GC diagnosis and prognosis.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"64 3","pages":"257-269"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Obesity meets Inflammatory Bowel Disease - a Double Whammy? A narrative Review].","authors":"Jürgen Stein, Oliver Schroeder, Lea Tessmer, Elisa Müller, Axel Dignass","doi":"10.1055/a-2778-5748","DOIUrl":"https://doi.org/10.1055/a-2778-5748","url":null,"abstract":"<p><p>Obesity is increasingly recognised as an important factor influencing disease course and treatment outcomes in inflammatory bowel disease (IBD). Despite growing evidence that obesity is associated with complications of IBD, weight management strategies are not yet adequately addressed in clinical guidelines. Current research underlines the role of obesity as a chronic inflammatory condition that may contribute to the pathogenesis of IBD, exacerbate disease progression and negatively impact response to therapy. Increased visceral adiposity is associated with a poorer prognosis, emphasising the need for structured approaches to weight control in therapeutic management of IBD. A staged approach is recommended for the treatment of overweight and obesity in patients with IBD, including lifestyle changes, pharmacotherapy with glucagon-like peptide-1 agonists, endoscopic bariatric therapies and, in selected cases, obesity surgery.</p>","PeriodicalId":23853,"journal":{"name":"Zeitschrift fur Gastroenterologie","volume":"64 3","pages":"283-299"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}