Arquivos de Gastroenterologia最新文献

{"title":"THE IMPACT OF OBESITY ON THE CLINICAL COURSE OF INFLAMMATORY BOWEL DISEASE.","authors":"Roberta Oliveira Raimundo Borsato, Júlio Maria Fonseca Chebli, Tarsila Campanha da Rocha Ribeiro, Luiz Henrique Silva Borsato, Marcos Paulo Moraes Sales, Maria Antônia de Lima Barra","doi":"10.1590/S0004-2803.24612025-093","DOIUrl":"10.1590/S0004-2803.24612025-093","url":null,"abstract":"<p><strong>Background: </strong>The incidence and prevalence of disorders such as obesity, metabolic syndrome (MS), and inflammatory bowel disease (IBD) have increased over recent decades. MS is a complex condition represented by a cluster of cardiovascular risk factors with a multifactorial origin-including genetic, behavioral, dietary factors, and alterations in gut microbiota. IBD reflects a complex and heterogeneous immune-mediated condition that typically, though not exclusively, affects the intestine.</p><p><strong>Objective: </strong>To evaluate the impact of obesity on the clinical course of IBD in a cohort of patients followed at a referral center for IBD.</p><p><strong>Methods: </strong>This was a retrospective longitudinal observational cohort study including patients of both sexes and all ethnicities, followed at the Inflammatory Bowel Disease Referral Center of the University Hospital of the Federal University of Juiz de Fora, between January 2019 and August 2023. A total of 404 adults aged 18 to 80 years with a diagnosis of IBD-established by clinical, endoscopic/histological, and/or imaging criteria-were included. IBD cases were classified as either Crohn's disease (CD) or ulcerative colitis (UC). To assess DII annual activity, electronic medical records were reviewed for outpatient visits and hospitalizations from 2019 to 2023. CD was considered active when the Harvey-Bradshaw Index (HBI) was ≥5, and UC was considered active when the total Mayo score was ≥3 or the partial Mayo score was ≥2.</p><p><strong>Results: </strong>The mean age at IBD diagnosis was 37.79±13.44 years, with an average disease duration of 12.50±8.3 years. Biologic therapy was used in the majority of patients (58.4%), with treatment failure occurring in 56.8% of these cases during the study period. No statistically significant differences were observed in most outcomes, except for a higher frequency of biologic use in non-obese patients with CD (P=0.028). There was a trend toward a greater number of years with active disease in obese patients with CD (P=0.062).</p><p><strong>Conclusion: </strong>IBD patients with obesity were predominantly female. Among those with CD, the phenotype was mainly non-stricturing, non-penetrating, with a clinical course characterized by greater disease activity over time, suggesting that obesity may be an unfavorable factor for disease control. This trend was not observed among patients with UC.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25093"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EFFICACY OF WATER INFUSION VERSUS AIR/CO2 INSUFFLATION FOR COLONOSCOPY: A SYSTEMATIC REVIEW AND META-ANALYSIS.","authors":"Fernando Rodriguez-Guzman, Anna Carolina Orsini Arman, Marcelo Morganti Ferreira Dias, Diego Paternostro, Bruna Haueisen Figueiredo-Zwetkoff, Otávio Micelli-Neto, José Celso Ardengh","doi":"10.1590/S0004-2803.24612025-113","DOIUrl":"10.1590/S0004-2803.24612025-113","url":null,"abstract":"<p><strong>Background: </strong>Colonoscopy is a widely used screening method for colorectal cancer, playing a crucial role in early detection and prevention by allowing visualization and removal of precancerous lesions. It also helps diagnose and manage neoplastic lesions and inflammatory bowel disease by providing direct visualization of the intestinal mucosa. However, traditional air or carbon dioxide (CO2) insufflation may limit complete visualization of the colon. Alternatively, water infusion causes local distension without elongating the colon (unlike air insufflation), while warm water reduces spasms, decreasing insertion time and patient discomfort.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to compare water infusion versus air/CO2 insufflation in terms of technical efficacy, evaluate the effect of water immersion on procedural difficulty, and determine the accuracy of water immersion colonoscopy in detecting colon adenomas.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, and Cochrane CENTRAL databases for randomized controlled trials published from inception to January 2023. Outcomes included adenoma detection rate, success rate of cecal intubation, cecal intubation time, total procedure time (from insertion to withdrawal), need for abdominal compression, and on-demand sedation rate. Thirty randomized controlled trials were included.</p><p><strong>Results: </strong>adenoma detection rate, success rate of cecal intubation, cecal intubation time, and total procedure time showed no significant difference between the two methods (P>0.05). However, water infusion significantly reduced the proportion of participants requiring on-demand sedation (risk ratio 0.61, 95%CI 0.48-0.77, P=0.02) and abdominal compression (risk ratio 0.65, 95%CI 0.51-0.83, P<0.01).</p><p><strong>Conclusion: </strong>Colonoscopy with water infusion helps the colonoscope reach the cecum more easily, decreasing the need for on-demand sedation and abdominal compression.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25113"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MODULATING OXIDATIVE STRESS AND INFLAMMATION: SODIUM BUTYRATE'S THERAPEUTIC PROMISE IN EXPERIMENTAL COLITIS.","authors":"Najib Muaamer Faed Murshed, Sushma Swaroopa, Samah Saleh Ahmed Al-Awadhi, Sharmila Kameyanda Poonacha, Caren D'Souza, Kishan Prasad Hosapatna Laxminarayana","doi":"10.1590/S0004-2803.24612025-129","DOIUrl":"10.1590/S0004-2803.24612025-129","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress and excessive cytokine signalling are central to the pathogenesis of ulcerative colitis (UC). Sodium butyrate (SB) has emerged as a potential therapeutic candidate due to its antioxidant and anti-inflammatory properties.</p><p><strong>Methods: </strong>UC was induced in Swiss albino mice using dextran sulfate sodium (DSS). Experiment groups included normal control (NC), DSS, DSS + SB, and DSS + 5-ASA. Clinical severity was assessed by the disease activity index (DAI) and colon length. Oxidative stress (MDA, MPO), antioxidants (SOD, GSH), Pro-inflammatory cytokines (TNF-α, IL-6), and histopathological scoring were assessed.</p><p><strong>Results: </strong>Increased DAI and shortening of the colon length with significantly elevated TNF-α and IL-6 levels and MDA and MPO, along with reduced GSH and SOD levels, which reflect oxidative damage and inflammation induced by DSS administration. Whereas treatment with SB therapy has been shown to lower DAI, preserve colon length, minimize MDA and MPO, restore GSH and SOD activity, and ameliorate cytokine levels, with effects comparable to those of 5ASA.</p><p><strong>Conclusion: </strong>In DSS-induced colitis, the SB effectively attenuated oxidative stress and pro-inflammatory cytokine responses by restoring redox balance and preserving mucosal architecture. These findings suggest that administering SB as a supplementary treatment may be a viable option for managing UC.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25129"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SAFETY AND EFFECTIVENESS OF BLUE EYE HYPERTONIC SOLUTION VERSUS SALINE SOLUTION IN THE TREATMENT OF FLAT COLONIC LESIONS: A RANDOMIZED CLINICAL TRIAL.","authors":"Caio Colturato Coimbra, Isabela Franzon Leopize DA Gama, Roberto Luiz Kaiser Junior, Fernando Tadeu Vannucci Coimbra, Carolina Colombelli Pacca, Luiz Gustavo de Quadros","doi":"10.1590/S0004-2803.24612025-115","DOIUrl":"10.1590/S0004-2803.24612025-115","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) represents a significant global health challenge, with early detection and minimally invasive treatments playing key roles in reducing morbidity and mortality. Endoscopic mucosal resection (EMR) is widely employed for flat colonic lesions, and the quality of submucosal elevation is a decisive factor for achieving complete resections, minimizing complications, and ensuring accurate histopathological assessment. Conventional 0.9% saline with dye is the standard solution but dissipates rapidly, while viscoelastic agents such as Blue Eye may offer more durable and technically advantageous lifts.</p><p><strong>Objectives: </strong>This study aimed to compare the technical and histopathological outcomes of Blue Eye versus 0.9% saline with indigo carmine in EMR of flat colonic lesions, focusing on lateral margins, injection volume, procedural performance, and clinical safety.</p><p><strong>Methods: </strong>A prospective, single-center, triple-blind study was conducted between January and October 2024, including 14 patients undergoing 19 EMRs for Paris 0-IIa flat colonic lesions sized 20-30 mm. Patients were randomized to receive either Blue Eye or saline with indigo carmine. Baseline demographics, comorbidities, lesion features, procedural variables, and histopathological outcomes were collected. Statistical analysis included the Mann-Whitney test for continuous variables and Fisher's exact test for categorical data, adopting P<0.05 as significant.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups regarding age, sex, and comorbidities. Blue Eye demonstrated significantly larger lateral margins (2.61±1.19 mm vs 1.81±0.37 mm, P=0.047) and required lower injection volume (4.60±1.50 mL vs 10.00±7.21 mL, P=0.020). Other variables, including procedure time, en bloc resection rate, bleeding, and number of clips, did not differ significantly. Anatomical lesion distribution and unfavorable anatomical findings also showed no statistical association with the solution employed.</p><p><strong>Conclusion: </strong>Blue Eye appears to provide superior technical performance in EMR of flat colonic lesions by ensuring wider lateral margins with less injection volume, without increasing adverse outcomes. Larger multicenter studies are needed to confirm and generalize these findings.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25115"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACCURACY OF ULTRASOUND FOR SARCOPENIA ASSESSMENT IN DIGESTIVE TRACT CANCER PATIENTS.","authors":"Tassiane de Paula Sudbrack, Katia Barão, Nora Manoukian Forones","doi":"10.1590/S0004-2803.24612025-127","DOIUrl":"10.1590/S0004-2803.24612025-127","url":null,"abstract":"<p><strong>Background: </strong>Cancer is a malignant disease characterized by the accumulation of genetic alterations with uncontrolled cell growth. In 2022, approximately 20 million new cancer cases and nearly 10 million deaths occurred globally. Cancer patients are at high risk for malnutrition due to the disease and treatment. Sarcopenia can negatively affect clinical outcomes and is associated with a higher likelihood of adverse results, including falls, fractures, low physical performance, and mortality.</p><p><strong>Objective: </strong>The aim of this study was to determine whether ultrasound of the gastrocnemius muscle can be a method for detecting the risk or presence of sarcopenia in patients with digestive system cancer.</p><p><strong>Methods: </strong>This is a cross-sectional study conducted with patients diagnosed with digestive system cancer, aged 18 years or older, undergoing treatment. The 2018 EWGSOP algorithm was used to evaluate sarcopenia, and participants were classified into two groups: one group at risk for sarcopenia or sarcopenic and another group as non-sarcopenic. A portable ultrasound (BodyMetrix™ BX2000 ultrasound) was used to measure the thickness of the gastrocnemius muscle.</p><p><strong>Results: </strong>The diagnostic performance of ultrasound (US) and calf circumference (CC) in detecting sarcopenia was evaluated by the area under the ROC curve. The area under the curve for US was 0.940, with 80% sensitivity and 100% specificity, and for CC, it was 0.889, with 72% sensitivity and 95% specificity. We found a negative correlation between the measure of the gastrocnemius muscle by ultrasound (US) and Sarc-CalF, and a positive correlation between the US and calf circumference (CC).</p><p><strong>Conclusion: </strong>The evaluated method shows potential for clinical application, suggesting it could be a fast and sensitive clinical tool. However, further studies are needed to establish robust evidence base and achieve a more accurate sarcopenia diagnosis for early multidisciplinary intervention.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25127"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NON-CELIAC GLUTEN/WHEAT SENSITIVITY (NCG/WS). A BRAZILIAN CASES SERIES.","authors":"Lorete Maria da Silva Kotze, Luiz Roberto Kotze, Eloisa Medeiros Nisihara, Renato Nisihara","doi":"10.1590/S0004-2803.24612025-104","DOIUrl":"10.1590/S0004-2803.24612025-104","url":null,"abstract":"<p><strong>Background: </strong>Non-celiac gluten/wheat sensitivity (NCGWS) is a varied disorder characterized by symptoms related to gluten intake, without celiac disease (CD) or wheat allergy. In Brazil, data on patients with NCGWS remain limited. Objectives: To describe the clinical, serological, and histopathological features of Brazilian patients diagnosed with NCGWS and to compare findings between sexes.</p><p><strong>Methods: </strong>A retrospective study was conducted using medical records of 36 patients diagnosed with NCGWS between 2015 and 2025 at a gastroenterology clinic in Curitiba, Brazil. Diagnosis was based on excluding CD and wheat allergy, clinical improvement after a gluten-free diet (GFD), and normal or Marsh I duodenal histology. Serology (anti-endomysium/anti-transglutaminase antibodies) and duodenal biopsies were analyzed. Symptoms, comorbidities, and demographic data were compared by sex.</p><p><strong>Results: </strong>Most patients were women (83.3%). All had negative CD serology. Duodenal biopsies showed Marsh 0 (80% of females, 100% of males) or Marsh I changes. Gastrointestinal symptoms included flatulence, abdominal distension, and reflux; diarrhea was more common in males (P=0.0017). All patients reported symptom improvement after two months on a GFD.</p><p><strong>Conclusion: </strong>In this Brazilian cohort, NCGWS was more frequent in women. Accurate diagnosis relies on histological, serological, and especially thorough clinical evaluation. Multidisciplinary follow-up and personalized dietary guidance are vital for optimal patient outcomes.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25104"},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TIME-RESTRICTED EATING IN MASLD: THE IMPERATIVE TO PRESERVE MUSCLE MASS AND PREVENT WEIGHT CYCLING FOR SUSTAINABLE CLINICAL BENEFIT.","authors":"Yusuf Bünyamin Ketenci, Hakan Demiröz, Mehmet Akca","doi":"10.1590/S0004-2803.24612025-111","DOIUrl":"10.1590/S0004-2803.24612025-111","url":null,"abstract":"<p><strong>Background and objective: </strong>Time-restricted eating (TRE) and calorie restriction (CR) are effective lifestyle interventions for metabolic dysfunction-associated steatotic liver disease (MASLD). However, sarcopenia and weight cycling remain underappreciated threats that may offset their long-term benefits. This short communication reviews current evidence and clinical implications of these challenges.</p><p><strong>Methods: </strong>Sarcopenia, prevalent in MASLD, aggravates insulin resistance, systemic inflammation, and fibrosis progression. Recent randomized controlled trials, including Oh et al., reported significant muscle mass loss during TRE and CR interventions. Additionally, weight regain, affecting up to 60% of patients post-intervention, induces metabolic stress, promotes hepatic fat re-accumulation, and may accelerate disease progression.</p><p><strong>Conclusion: </strong>MASLD interventions should integrate muscle-preserving strategies-resistance exercise, adequate protein intake-and long-term weight maintenance support. Future trials must measure functional muscle outcomes, assess fibrosis progression, and evaluate sustainable behavioral strategies to prevent weight cycling.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25111"},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSOCIATED FACTORS AND CLINICAL ASPECTS OF COLECTOMY IN PATIENTS WITH ULCERATIVE COLITIS - EXPERIENCE OF A BRAZILIAN SOUTHEASTERN COHORT.","authors":"Sandro da Costa Ferreira, Rogério Serafim Parra, Gleici da Silva de Castro Perdoná, Rosamar Eulira Fontes Rezende, Lílian Rose Otoboni Aprile, Omar Féres","doi":"10.1590/S0004-2803.24612025-096","DOIUrl":"10.1590/S0004-2803.24612025-096","url":null,"abstract":"<p><strong>Background: </strong>Despite recent advances in the medical treatment of ulcerative colitis (UC) involving the use of biological agents and small molecules, a proportion of patients with UC still require surgical treatment.</p><p><strong>Objective: </strong>This study evaluated patient characteristics and factors associated with colectomy in patients with UC at a tertiary IBD center.</p><p><strong>Methods: </strong>This is a retrospective and observational study utilizing the database at our university hospital. The sample comprised 232 patients diagnosed with UC, with a mean age of 46.45±15.00 years, 60.3% of whom were women. The patients were divided into two groups depending on whether or not they had undergone colectomy between January 2001 and December 2018.</p><p><strong>Results: </strong>Of all 50 (21.6%) patients underwent colectomy. Clinical intractability (40.0%) and acute severe colitis (22%) were the main indications for colectomy. Longer disease duration (P=0.035), pancolitis (82.0% vs 6.0%; P<0.001) when compared to proctitis, higher endoscopic Mayo sub-score (Mayo 3: 22.0% vs Mayo 1: 5.5%; P<0.0001), and initial use of biological agents (14.0% vs 1.1%; P<0.001) were significantly associated with the occurrence of colectomy. There was no difference in the distribution of cases according to sex, race, smoking, previous use of corticosteroids, and extraintestinal manifestations (P>0.05).</p><p><strong>Conclusion: </strong>Our study shows that a longer disease duration, extensive disease (pancolitis), and higher severity of UC at diagnosis were associated with a poor prognosis, culminating in a higher need for surgical intervention.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25096"},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GENERATIVE AI TOWARDS A COMPARATIVE ANALYSIS OF HOSPITALIZATION RATES AMONG PATIENTS WITH ULCERATIVE COLITIS TREATED WITH INFLIXIMAB, VEDOLIZUMAB, AND TOFACITINIB IN THE PUBLIC HEALTHCARE SYSTEM IN BRAZIL: A NATIONWIDE STUDY.","authors":"Douglas Andreas Valverde, Abel Botelho Quaresma, Maria Paz Gimenez Villamil, Thyago Proença de Moraes, Paulo Gustavo Kotze","doi":"10.1590/S0004-2803.24612025-066","DOIUrl":"10.1590/S0004-2803.24612025-066","url":null,"abstract":"<p><strong>Objective: </strong>Ulcerative colitis (UC) is a chronic inflammatory bowel disease that requires advanced therapies, including infliximab, vedolizumab, and tofacitinib. Our aim is to understand the hospitalization rates and outcomes associated with these therapies in real-world scenarios, which is crucial for optimizing patient management and healthcare resource allocation.</p><p><strong>Methods: </strong>This nationwide retrospective observational study analyzed real-world data (RWD) from Brazil's public healthcare system (SUS) between January 2021 and December 2023. Data on hospitalizations, length of stay, mortality, costs, and non-IBD-related hospital admissions were extracted and analyzed using the Techtrials TT Disease Explorer and TT RWE Generator, leveraging generative artificial intelligence (GenAI) for data integration and analysis.</p><p><strong>Results: </strong>A total of 1,313 patients required hospitalization, with 1,434 hospitalizations recorded. The hospitalization rate per 100 patients was highest for tofacitinib (262.5), followed by infliximab (212.88) and vedolizumab (191.67). Patients treated with infliximab had the shortest hospital stay (Median 3.0 days [0-68]) and lowest costs (Median 510.83 BRL [23.45 - 111,594.14]), whilst vedolizumab had the highest hospitalization costs. Surgical intervention rates were highest among tofacitinib users. Non-IBD-related hospitalizations suggested potential adverse drug events, including gastrointestinal disorders, infections, and anemia.</p><p><strong>Conclusion: </strong>This study represents the first AI-assisted RWE analysis of UC hospitalizations in Brazil. The findings highlight the varying hospitalization burdens across advanced therapies, with tofacitinib associated with higher hospitalization rates and infliximab linked to shorter hospital stays and lower costs. These insights can inform clinical decision-making and healthcare policy. Future studies should further explore AI's role in optimizing RWE research and UC management.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25066"},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IS THERE A RELATIONSHIP BETWEEN INTESTINAL FRUCTOSE MALABSORPTION, GASTROINTESTINAL SYMPTOMS AFTER FRUCTOSE OVERLOAD, AND BODY ADIPOSITY IN ADOLESCENTS?","authors":"Dayane Pêdra Batista de Faria, Ana Paula Bidutte Cortez, Ricardo Palmero Oliveira, Maria Sylvia de Souza Vitalle, Patrícia da Graça Leite Speridião, Mauro Batista de Morais","doi":"10.1590/S0004-2803.24612025-078","DOIUrl":"10.1590/S0004-2803.24612025-078","url":null,"abstract":"<p><strong>Background: </strong>Over the past several decades, dietary fructose intake has increased significantly, along with the prevalence of obesity. Fructose malabsorption is associated with gastrointestinal symptoms and may lead to fructose intolerance. Evidence suggests a probable association between intestinal fructose malabsorption and increased body adiposity.</p><p><strong>Objective: </strong>To analyze the prevalence of intestinal fructose malabsorption and intolerance in asymptomatic adolescents and to investigate their relationship with fructose intake, body adiposity, systemic metabolic indicators, and intestinal permeability.</p><p><strong>Methods: </strong>This cross-sectional observational study included 37 adolescents without gastrointestinal symptoms. Fructose malabsorption was investigated using the hydrogen breath test along with the lactulose breath test. Food intake was evaluated using a habitual food survey. Nutritional status was assessed by measuring weight, height, skin folds, abdominal circumference, and via Bioelectrical Impedance Analysis (BIA). Systemic metabolic indicators and serum zonulin levels were also evaluated to determine intestinal permeability.</p><p><strong>Results: </strong>Of the 37 adolescents tested 16 (43.2%) exhibited fructose malabsorption. Gastrointestinal symptoms compatible with fructose intolerance were reported by 8 (50.0%) of the 16 adolescents with fructose malabsorption, and by 5 (23.8%) of the 21 adolescents without fructose malabsorption (P=0.095). Fructose intake among adolescents with and without fructose malabsorption was 7.5 and 7.9 g/day, respectively (P=0.807). Body adiposity was comparable across groups in both females (34.2% and 33.2%; P=0.738) and males (21.0% and 22.2%; P=0.731). Metabolic indicators and zonulin levels were similar, except for urea, which was significantly higher in the malabsorption group (31.7±6.3 mg/dL) compared to those without fructose malabsorption (24.5±÷7.8 md/dL; P=0.012).</p><p><strong>Conclusion: </strong>Intestinal fructose malabsorption is common in asymptomatic adolescents and is not associated with adiposity, biochemical changes, or increased intestinal permeability. However, it correlates with elevated fermentation in the lactulose breath test. Fructose intolerance is linked to presence gastrointestinal symptoms following lactulose ingestion.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"63 ","pages":"e25078"},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}