JGH Open最新文献

{"title":"Association Between Intermittent Water Supply and Helicobacter pylori Prevalence: A Global Ecological Study","authors":"Saeed S. Graham,&nbsp;Christin Wilkinson,&nbsp;Briannae Theodore,&nbsp;Mary-Jane Williams,&nbsp;Dmitry Tumin","doi":"10.1002/jgh3.70482","DOIUrl":"https://doi.org/10.1002/jgh3.70482","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> is a major global pathogen with recognized potential for waterborne transmission. Intermittent water supply affects over one billion worldwide and may promote <i>H. pylori</i> contamination of municipal sources. Whether water supply discontinuity contributes to population-level <i>H. pylori</i> burden has not been examined globally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional ecological analysis of 79 countries with matched utility-level water infrastructure data and country-level <i>H. pylori</i> prevalence estimates from a published global meta-analysis. The primary exposure was continuity of water supply (hours/day). Secondary exposures included non-revenue water percentage (NRW %), pipe breaks per utility, and operating cost coverage ratio. Unadjusted and adjusted linear regression models with heteroscedasticity-consistent standard errors were estimated, controlling for basic sanitation coverage and log-transformed population density. A sensitivity analysis used a population-based measure of water availability on demand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Greater water supply continuity was independently associated with lower <i>H. pylori</i> prevalence in both unadjusted (<i>β</i> = −0.987, 95% CI −1.669 to −0.305, <i>p</i> = 0.005) and adjusted models (<i>β</i> = −1.125, 95% CI −1.876 to −0.375, <i>p</i> = 0.004). Higher NRW % and lower operating cost coverage were each associated with higher <i>H. pylori</i> prevalence after adjustment. Pipe breaks did not reach significance. Sensitivity analysis produced consistent findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IWS and broader water infrastructure deterioration are associated with higher <i>H. pylori</i> prevalence at the country level. These findings support the hypothesis that water infrastructure deterioration may contribute to population-level <i>H. pylori</i> burden and suggest a role for water system investment within long-term gastric cancer prevention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70482","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149205945","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":"Daikenchuto and Processed Ginger Alleviate Liver Ischemia–Reperfusion Injury by Enhancing Anti-Inflammatory Effects and HO-1 Production","authors":"Kenichi Saga,&nbsp;Yoichiro Uchida,&nbsp;Hiroshi Kawamoto,&nbsp;Hirofumi Hirao,&nbsp;Yosuke Umino,&nbsp;Masaaki Ito,&nbsp;Yuki Kidoguchi,&nbsp;Junya Kawasoe,&nbsp;Kosuke Tanaka,&nbsp;Kentaro Kadono,&nbsp;Shoichi Kageyama,&nbsp;Kojiro Taura,&nbsp;Hiroaki Terajima,&nbsp;Takeshi Watanabe,&nbsp;Etsuro Hatano","doi":"10.1002/jgh3.70478","DOIUrl":"10.1002/jgh3.70478","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Daikenchuto (DKT), a Kampo medicine, is widely used in surgical practice because of its pro-motility effects on the gastrointestinal tract. Although its anti-inflammatory effects in the gastrointestinal tract have been well documented, its role in hepatic ischemia–reperfusion injury (IRI) remains unclear. This study investigated the protective effects of DKT and its individual components against hepatic IRI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Male C57BL/6 mice were fed a diet containing 3.6% DKT or its individual herbal components for 1 week before 60 min of partial hepatic ischemia. Liver injury was evaluated based on serum liver enzyme levels, histology, and TUNEL staining. Portal venous adrenomedullin (ADM) levels and hepatic heme oxygenase-1 (HO-1) expression were also assessed. In vitro, peritoneal macrophages were stimulated with High Mobility Group Box 1 (HMGB1) to examine the effects of DKT and 6-shogaol (6SG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DKT significantly reduced serum alanine aminotransferase levels, necrotic area, and hepatocyte apoptosis compared to the control. Although single-herb doses equivalent to those in the DKT formula did not confer protection, a threefold dose of processed ginger reproduced the hepatoprotective effects of DKT. DKT did not increase portal ADM levels. In contrast, both DKT and 6SG significantly upregulated HO-1 expression in vivo and suppressed the production of inflammatory cytokines in HMGB1-stimulated macrophages in vitro.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>DKT attenuates liver IRI via HO-1 induction and suppression of macrophage-mediated inflammation, rather than via ADM elevation. These protective effects may be mediated, at least in part, by processed ginger.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185102","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":"Halitosis and Helicobacter pylori Infection: A Systematic Review and Meta-Analysis","authors":"Yu Xia,&nbsp;Jun-Da Zhu,&nbsp;Tong Su,&nbsp;Bing-Jie Jin,&nbsp;Shu-Lei Zhao,&nbsp;Hong-Wei Xu,&nbsp;Chang-Qin Xu","doi":"10.1002/jgh3.70483","DOIUrl":"10.1002/jgh3.70483","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Halitosis, a common clinical condition, is frequently associated with <i>Helicobacter pylori</i> infection. Numerous studies have highlighted a significant reduction in halitosis following successful <i>H. pylori</i> eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This meta-analysis aimed to investigate the association between <i>H. pylori</i> infection and halitosis, as well as the effect of <i>H. pylori</i> eradication on halitosis resolution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched major databases, including PubMed, EMBASE, the Cochrane Library, and the Science Citation Index, up to March 2025. Literature screening and data extraction were conducted according to strict inclusion and exclusion criteria. Study quality was assessed using appropriate tools according to study design. Heterogeneity and risk of bias were analyzed using Stata 12.0. Subgroup analyses were performed to examine the relationship between <i>H. pylori</i> infection and halitosis, including infection prevalence, symptom incidence, and treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 154 articles screened, 24 met the inclusion criteria, involving 5872 patients. The analysis revealed a significantly higher <i>H. pylori</i> infection rate in the halitosis group compared with the non-halitosis group (OR = 3.42; 95% CI: 1.13–10.33). The prevalence of halitosis was higher in <i>H. pylori</i>-positive individuals than in <i>H. pylori</i>-negative individuals (OR = 1.91; 95% CI: 1.28–2.86). The prevalence of halitosis was lower in the successful eradication group compared with the unsuccessful eradication group (OR = 0.17; 95% CI: 0.04–0.73). Moreover, pre-eradication halitosis rates were higher than post-eradication rates (OR = 4.39; 95% CI: 1.99–9.68).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings suggest a significant observational association between <i>H. pylori</i> infection and halitosis, and eradication therapy may be associated with alleviation of halitosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168964","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":"Trends, Disparities, and Outcomes in Time to Treatment Initiation in Patients With Early-Onset Colorectal Cancer","authors":"Imran Qureshi,&nbsp;Charmi Patel,&nbsp;Muhammad Ali Ibrahim Kazi,&nbsp;Jackson Edwards,&nbsp;Hamza Khan,&nbsp;Kaveh Hajifathalian,&nbsp;Ahmed Al-Khazraji","doi":"10.1002/jgh3.70480","DOIUrl":"10.1002/jgh3.70480","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The incidence of early-onset colorectal cancer (EOCRC) is on the rise globally. It is well documented in the literature that increased time to treatment initiation (TTI) results in higher mortality rates in malignancies. We conducted this study to explore trends, disparities, and outcomes in TTI in patients with EOCRC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study using the National Cancer Database. We identified 56 333 patients less than 45 years of age who were diagnosed with colorectal cancer between 2004 and 2021 who had data on TTI. We calculated the average annual percentage change (AAPC) in TTI and assessed predictors of treatment delay and the degree to which they are associated with delays using logistic and linear regression, respectively. A Cox proportional hazards model was fit for each stage to assess 5-year, 10-year, and overall mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall AAPC was 1.50% (95% CI: 1.40–1.60, <i>p</i> &lt; 0.001), with all variables showing positive AAPCs, but these varied significantly by sociodemographic factors. Sex, race, ethnicity, education, insurance, and comorbidity burden were predictors of treatment delay. There was increased overall mortality in Stage 2 (aHR = 1.48, 95% CI: 1.30–1.69, <i>p</i> &lt; 0.001) and Stage 3 disease (aHR = 1.12, 95% CI: 1.03–1.21, <i>p</i> = 0.007) and decreased overall mortality in Stage 4 disease (aHR = 0.84, 95% CI: 0.79–0.88, <i>p</i> &lt; 0.001) in patients who experienced treatment delays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Treatment delays are increasingly common and strongly associated with insurance status, socioeconomic disadvantage, and race, with clinically meaningful delays of several days, while patients with advanced disease are prioritized for faster treatment. These provide public health stakeholders with important insights into inequities in the treatment of EOCRC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138671","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":"Intragastric Pressure Required to Achieve Strong Extension of the Gastric Wall for Invasion Depth Assessment in Early Gastric Cancer: A Single-Center Prospective Observational Study","authors":"Kentaro Imamura,&nbsp;Takao Kanemitsu,&nbsp;Kenshi Yao,&nbsp;Noriya Uedo,&nbsp;Masaki Miyaoka,&nbsp;Keigo Matsuda,&nbsp;Yoichiro Ono,&nbsp;Michiko Nakashima,&nbsp;Hiroshi Tanabe,&nbsp;Satoshi Nimura,&nbsp;Tsuneyoshi Yao,&nbsp;Takashi Hisabe","doi":"10.1002/jgh3.70481","DOIUrl":"10.1002/jgh3.70481","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Previously, we developed a simple and accurate method to measure intragastric pressure (IP) using upper gastrointestinal endoscopy. This study prospectively characterized the IP at the first point of visually defined strong extension of the gastric wall and evaluated the diagnostic performance of the non-extension sign (NES) for assessing invasion depth in early gastric cancer (EGC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a single-center prospective study. Consecutive patients with EGC scheduled for upper gastrointestinal endoscopy were enrolled. The patients underwent continued air insufflation until strong extension of the gastric wall occurred, at which point the IP was measured. Endoscopic assessment of invasion depth was then performed using the NES.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-six patients were enrolled; however, three were excluded, resulting in 43 patients included in the analysis. IP at the first point of strong extension of the gastric wall ranged from 5 to 20 mmHg; therefore, strong extension was achieved at an IP of 20 mmHg or less in all 43 patients. For the endoscopic diagnosis of the depth of invasion in EGC using the NES, this yielded a sensitivity of 80% (95% confidence interval (CI), 37.6%–96.4%), a specificity of 100% (95% CI, 90.8%–100%), and a diagnostic accuracy of 98% (95% CI, 87.9–99.6). No procedure-related adverse events were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IP at the first point of visually defined strong extension of the gastric wall ranged from 5 to 20 mmHg among technically evaluable patients. NES assessment showed high specificity and diagnostic accuracy, with no adverse events observed.</p>\u0000 \u0000 <p><b>Trial Registration:</b> UMIN 000046904</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138721","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":"ISG Task Force on Upper Gastrointestinal Bleeding (UGIB)—Comparison of Risk Scores in Nonvariceal Bleeding—A Prospective Multicenter Study","authors":"Manoj K. Sahu,&nbsp;Avinash Balekuduru,&nbsp;Saroj K. Sinha,&nbsp;Varghese Thomas,&nbsp;Manu Tandan,&nbsp;Shrikant Mukewar,&nbsp;Mahesh K. Goenka,&nbsp;Bailuru V. Tantry,&nbsp;Bonthala S. Satyaprakash,&nbsp;Rakesh Kochhar,&nbsp;Rajkumar P. Wadhwa,&nbsp;Philip Augustine,&nbsp;Sujoy Pal,&nbsp;Ebby George Simon,&nbsp;Mathew Philips,&nbsp;V. G. Mohan Prasad,&nbsp;Pravin Rathi,&nbsp;Manas K. Panigrahi,&nbsp;Sri P. Misra,&nbsp;Ajay K. Jain,&nbsp;Vinod K. Mishra,&nbsp;Sanjeev S. Khanna,&nbsp;Kanishka Uthansingh,&nbsp;Govind K. Makharia,&nbsp;Sandeep Nijhawan,&nbsp;Harsh Udawat,&nbsp;Bhabadev Goswami,&nbsp;Krishnadas Devadas,&nbsp;Gautam Ray,&nbsp;Satheesh Rao,&nbsp;Rajiv Baijal,&nbsp;Robert P. Panakkal,&nbsp;Dipak Shah,&nbsp;Abhinav Sharma,&nbsp;Mukesh Agarwala,&nbsp;Sanjay Kumar,&nbsp;Shivaram P. Singh","doi":"10.1002/jgh3.70463","DOIUrl":"10.1002/jgh3.70463","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To compare the performance of the Glasgow Blatchford score (GBS) to the Total Rockall score (TRS) in predicting clinical interventions in Indian patients with acute nonvariceal upper gastrointestinal bleeding (ANVUGIB).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We prospectively studied ANVUGIB in 93 hospitals in India from October 2014 to September 2018. The etiological, clinical, and investigational details were recorded on a uniform structured proforma. The GBS and TRS were prospectively calculated for all patients. Clinical interventions were defined as blood transfusion, rebleed, and mortality with 30-day follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 6450 patients with ANVUGIB were identified, followed up for 30 days and selected for analysis. Almost 5176 (80%) of the patients were male, and the mean age 50.7 ± 16.8 years (2–98 years). Blood transfusion was considered clinically necessary in 115 (1.7%) of the patients. Surgery and interventional radiology were required as rescue therapy in only 20 patients (0.3%) and 22 (0.3%) patients, respectively. The 30-day rebleeding and mortality occurred in 92 (1.4%) and in 184 (2.8%) patients, respectively. GBS was similar to TRS in predicting mortality (AUC 0.687 vs. 0.663) with cutoff values of 10.5 and 3.5 and predicting rebleeding with (AUC 0.637 vs. 0.630) cutoff values of 11.5 and 3.5, respectively. Outcomes were defined as 30-day mortality and rebleeding. Interventions were defined as transfusions, repeat endoscopy, surgery, or interventional radiology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GBS was more accurate and had more desirable clinical characteristics in predicting the need for a transfusion for hospitalized patients than TRS. However, both GBS and TRS have poor to modest predictive capability for 30-day mortality and rebleeding. They do not, then, appear to be useful as screening tools to identify people at risk for those two outcomes in a hospital setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116408","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 Fermented Brown Rice by Aspergillus oryzae (FBRA) in Ulcerative Colitis: A Double-Blind Randomized Trial","authors":"Hideki Ishikawa,&nbsp;Yoshinari Onishi,&nbsp;Keiko Kataoka,&nbsp;Yoshitaka Murakami,&nbsp;Michihiro Mutoh,&nbsp;Hiroshi Kobayashi","doi":"10.1002/jgh3.70476","DOIUrl":"10.1002/jgh3.70476","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ulcerative colitis (UC) is a diffuse, nonspecific inflammation of the colon of unknown cause. Basic and clinical studies suggest that UC may be ameliorated by dietary fiber intake. Fermented brown rice by <i>Aspergillus oryzae</i> (FBRA) is produced by fermenting brown rice and bran with <i>A. oryzae</i>. We aimed to evaluate the efficacy of FBRA in patients with UC by a double-blind, randomized crossover trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients were divided into two groups: Group A (administered FBRA for 14 weeks, followed by a washout period, and then administered nonfunctional foods (NF) for 14 weeks) and Group B (NF and then FBRA). The primary endpoint is the presence or absence of improvement in clinical activity index (CAI) scores before and after the intervention. The secondary endpoints are the pre- and postintervention changes in blood data indicating inflammation (e.g., high-sensitivity C-reactive protein (CRP)) and nutritional status (e.g., serum proteins), and the adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-six patients consented to participate: 19 in Group A and 21 in Group B completed the trial. Improvement in the CAI scores was not observed with FBRA. In the ITT analysis of the blood data, however, high-sensitivity CRP, erythrocyte sedimentation rate hourly, white blood cell count, serum protein level, and serum albumin level all tended to be improved from the preintervention level (improvement ratio 1.70; 95% CI 0.97–2.98). No serious adverse event was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is an expectation that FBRA may be effective in improving inflammation in patients with UC. Therefore, a large-scale validation study should be conducted in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116251","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":"Outcomes of Screening Colonoscopy in Older Adults: A Large Propensity-Matched Real-World Cohort Study","authors":"Taha Shakarchi,&nbsp;Muneeb Khawar,&nbsp;Mohammad Azeem Malik,&nbsp;Anuhya Jamandlamudi,&nbsp;Ihsan Noushad Karuppan Veettil,&nbsp;Aqsa Komel,&nbsp;Mirza Muhammad Hadeed Khawar,&nbsp;Naima Agha,&nbsp;Muhammad Habib,&nbsp;Ishtiaq Ahmad,&nbsp;Ban Al-Abayechi,&nbsp;Ahmed Al-Khazraji","doi":"10.1002/jgh3.70479","DOIUrl":"10.1002/jgh3.70479","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The benefits and harms of screening colonoscopy after age 75 remain uncertain. Guidelines endorse individualized decisions given competing risks, but comparative data are limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the TriNetX US Collaborative Network, adults aged 75–90 years with a colorectal cancer screening encounter were matched 1:1 by colonoscopy within 3 months. Outcomes were assessed at 30 days, 1 year, and 5 years. Sensitivity analyses excluded pre-index anemia and, separately, fecal abnormalities and alarm symptoms; subsequent colonoscopy was counted through 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Matched cohorts comprised 58 315 pairs at 30 days, 61 497 at 1 year, and 69 821 at 5 years. Colonoscopy increased polyp detection (HR 4.43 [95% CI 4.15–4.73] at 30 days; 1.88 [1.82–1.95] at 5 years) and colorectal cancer detection (4.56 [3.62–5.74]; 1.78 [1.59–1.98]; all <i>p</i> ≤ 0.003). Five-year all-cause mortality was unchanged (HR 1.01 [0.97–1.05]; <i>p</i> = 0.741). Perforation rose at 5 years (HR 1.29 [1.02–1.63]; <i>p</i> = 0.033); gastrointestinal bleeding fell at 1 year (HR 0.90 [0.84–0.97]; <i>p</i> = 0.004). After exclusion of pre-index anemia (70 399 pairs), 5-year HRs remained 1.72 for polyps and 1.52 for cancer. In an indication-restricted cohort also excluding fecal abnormalities, weight loss, abdominal pain, and change in bowel habit (54 300 pairs), the 5-year HRs were 1.59 and 1.32. Subsequent colonoscopy from day 31 to year 5 was not more frequent after index screening (5.8% vs. 6.2%; HR 0.93).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Screening colonoscopy improved polyp and cancer detection but did not reduce 5-year all-cause mortality. The late perforation signal was not explained by more subsequent or therapeutic colonoscopy. Decisions after age 75 should be individualized.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116378","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":"A Multicenter, Prospective Real-World Study of Simethicone–Activated Charcoal in Patients With Persistent Dyspeptic Symptoms Despite Acid Suppression (SIMAC Study)","authors":"Ashish Kumar,&nbsp;D. V. Sreenivas,&nbsp;Sambit Kumar Behera,&nbsp;Guduru Raghavendra Srinivas Rao,&nbsp;G. S. Sameer Kumar,&nbsp;Jaya Ghosh Chatterjee,&nbsp;Nalini Kant Choudhary,&nbsp;Ravi Shankar Bagepally,&nbsp;Shekhar Puri,&nbsp;S. M. A. Rizvi,&nbsp;Rahul Pathak,&nbsp;Shruti Pal","doi":"10.1002/jgh3.70475","DOIUrl":"10.1002/jgh3.70475","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Persistent gas-predominant dyspeptic symptoms affect many patients despite adequate proton pump inhibitor (PPI) therapy, reflecting mechanisms beyond acid secretion. We evaluated the real-world effectiveness and safety of simethicone (80 mg) plus activated charcoal (250 mg) in adults with persistent symptoms despite prior PPI therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective, multicenter observational study across nine Indian sites, adults with persistent gas-related symptoms despite ≥ 2 weeks of standard-dose PPI therapy received the combination thrice daily for 28 days. Severity across 11 gastrointestinal domains was assessed using a modified Visual Analog Severity scale at baseline, Day-14, and 28. The primary outcome was change in symptom severity from baseline to Day 28, analyzed using Friedman testing with Bonferroni-adjusted Wilcoxon post hoc comparisons. A global symptom score (mean of all 11 domains) was used for exploratory subgroup analyses; secondary outcomes included adherence and safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All 183 participants completed follow-up, with significant reductions across all 11 symptoms (all <i>p</i> &lt; 0.001). Belching decreased from 46.3 ± 26.4 to 10.9 ± 19.5, epigastric burning from 48.1 ± 27.3 to 10.7 ± 17.9, and bloating from 44.2 ± 29.1 to 12.9 ± 18.6. Improvements were evident by Day-14 and sustained to Day-28. The median global symptom score reduction was 25.0 units (95% CI: 22.7–27.3), with consistent improvement across demographic and clinical subgroups. Full adherence was 87.1% at Day 14 and 83.6% at Day 28, with no serious clinical events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with persistent gas-predominant dyspepsia despite PPI therapy, simethicone–activated charcoal was associated with significant short-term symptomatic improvement. Controlled trials are warranted to confirm treatment effect.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116290","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":"Inverse Association Between Regional Availability of Board-Certified Fellows of the Japan Gastroenterological Endoscopy Society and Colorectal Cancer Mortality in Japan: An Ecological Analysis","authors":"Kazuya Inoki,&nbsp;Mahbubur Rahman,&nbsp;Sayaka Mizuno,&nbsp;Norihiro Suzuki,&nbsp;Shinya Nakatani,&nbsp;Kazuo Kikuchi,&nbsp;Atsushi Katagiri,&nbsp;Hitoshi Yoshida,&nbsp;Naomi Kakushima","doi":"10.1002/jgh3.70477","DOIUrl":"10.1002/jgh3.70477","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We investigated the association between prefecture-level colorectal cancer (CRC) mortality and contributing factors, including the regional availability of Board-Certified Fellows of the Japan Gastroenterological Endoscopy Society (BCFJGES), using publicly available data from all 47 Japanese prefectures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>This prefecture-level ecological cross-sectional study used publicly available national data from e-Stat, Cancer Statistics by the Japan National Cancer Center, and JGES records. The dependent variable was the CRC-specific age-standardized mortality rate (AMR) among individuals aged &lt; 75 years in 2021. Independent variables (2010–2016) included CRC screening and follow-up rates, smoking, alcohol consumption, obesity, physical activity, diabetes prevalence, red meat consumption, mean income, gastroenterologist and BCFJGES density per 10 000 population, CRC stage distribution, and regional classification. Simple linear regression showed that smoking, alcohol consumption, and obesity were significantly associated with higher CRC AMR, whereas physical activity, income, and BCFJGES density were associated with lower AMR. Multiple linear regression confirmed independent associations for smoking (regression coefficient [<i>b</i>] = 0.213, <i>p</i> = 0.011), alcohol consumption (<i>b</i> = 0.045, <i>p</i> = 0.003), physical activity (<i>b</i> = −0.087, <i>p</i> = 0.024), and BCFJGES density (<i>b</i> = −1.339, <i>p</i> &lt; 0.001). The Pearson correlation coefficient between AMR and BCFJGES density was −0.482 (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher prefecture-level smoking and alcohol consumption were associated with higher CRC mortality, while higher physical activity and higher BCFJGES density were associated with lower mortality. Regional disparities in BCFJGES distribution across Japan may contribute to CRC mortality and warrant continued surveillance and policy attention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 10","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116411","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}