JGH Open最新文献

{"title":"Malnutrition and Associated Factors Among Patients With Cirrhosis at a Tertiary Care Center in Addis Ababa Ethiopia: An Ordinal Logistic Regression Analysis.","authors":"Metages Damtie Melaku, Aklog Almaw Yigzaw, Yoseph Gebremedhin Kassie, Mulugeta Wondmu Kedimu, Henok Bahru Wodajeneh, Binyam Melese Getahun, Denekew Tenaw Anley, Melaku Mekonen Agidew, Edgeit Abebe Zewde","doi":"10.1002/jgh3.70107","DOIUrl":"https://doi.org/10.1002/jgh3.70107","url":null,"abstract":"<p><strong>Background: </strong>Cirrhosis is an irreversible stage of liver damage that decreases the ability of the liver to store and metabolize nutrients. Malnutrition is a common problem in patients with cirrhosis and increases the risk of mortality.</p><p><strong>Aims: </strong>This study aimed to assess malnutrition and associated factors among patients with cirrhosis at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Tikur Anbessa Specialized Hospital. All patients with cirrhosis who were admitted to the hospital from August to November were included. Royal Free Hospital Global Assessment tool (RFH-GA) was used to assess nutritional status. Data were entered in Epi-data software version 4.6.0.2 and analyzed with STATA version 17/MP. Ordinal logistic regression analysis was fitted to determine factors associated with nutritional status. Statistical significance was declared at <i>p</i> value < 0.05.</p><p><strong>Results: </strong>The prevalence of moderate malnutrition and severe malnutrition were 36.67% and 14.29%, respectively. Patients with ascites were five times at a higher risk of being severely malnourished (AOR = 5.08; 95% CI = 2.66-9.67). The odds of severe malnutrition decrease by 0.35 times for patients without a history of previous hospitalization (AOR = 0.35; 95% CI = 0.18-0.68). The odds of being in the higher category of nutritional status (severe malnutrition) are 10 times higher for patients with hepatic encephalopathy (AOR = 10.43; 95% CI = 4.66-23.31). As the level of creatinine blood urea nitrogen (Cr-BUN) increases, the risk of malnutrition increases by 2.57 times (AOR = 2.57; 95% CI = 1.02-5.78).</p><p><strong>Conclusion: </strong>Malnutrition is high among cirrhotic patients at Tikur Anbessa Specialized Hospital. Ascites, history of hospitalization, Cr-BUN, and hepatic encephalopathy are significant predictors of malnutrition.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 2","pages":"e70107"},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081098","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":"Can Peritoneal Biopsy Diagnose Atypical Cases of Familial Mediterranean Fever?: A Case Report.","authors":"Yousef Alsaffaf, Ahmed Aldolly, Mahmoud Shokfa, Ahmad Alnahhas","doi":"10.1002/jgh3.70108","DOIUrl":"https://doi.org/10.1002/jgh3.70108","url":null,"abstract":"<p><strong>Background: </strong>Familial Mediterranean Fever (FMF) is a prevalent inherited monogenic autoinflammatory disease that predominantly affects populations from the Mediterranean basin. It is typically characterized by the recurrence of fever episodes and abdominal pain accompanied by recurrent short-lived inflammatory attacks that usually resolve spontaneously within 1-3 days. It is uncommon to see ascites with large amounts of peritoneal fluid as a manifestation of FMF.</p><p><strong>Case presentation: </strong>A 36-year-old Arab female presented with generalized abdominal pain and bloating. No family history of FMF. Analysis of peritoneal fluid identified low-grade ascites. A CT scan was performed, which did not reveal any suspicious lesions. Laparoscopic surgery was undertaken to rule out the differential diagnoses and obtain a peritoneal biopsy, even though the periton had a normal visual appearance. Histopathological examination of the biopsy specimens was compatible with a diagnosis of FMF, after other differential diagnoses were ruled out. The patient showed significant improvement within a month of taking colchicine. The ascites resolved progressively and completely, affirming the FMF diagnosis.</p><p><strong>Conclusion: </strong>The occurrence of chronic ascites in a patient requires the consideration of FMF among the differential diagnoses. A diagnosis of FMF can also be suspected through a peritoneal biopsy, which may be sufficient for diagnosis without the need for genetic testing. Additionally, the patient's response to colchicine therapy can be considered for confirmation, as demonstrated in our case. Future research should focus on considering the inclusion of peritoneal biopsy among the diagnostic criteria for FMF particularly in cases with non-specific presentations.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 2","pages":"e70108"},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081059","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 Efficacy of a 6-Month Placement of a Fully Covered Self-Expanding Metallic Stent for Refractory Benign Biliary Stricture: A Multicenter Prospective Study.","authors":"Tomohisa Iwai, Mitsuhiro Kida, Kazuya Sugimori, Hiroaki Shigoka, Takaaki Matsumoto, Masashi Ijima, Haruo Miwa, Kosuke Okuwaki, Masafumi Watanabe, Kai Adachi, Akihiro Tamaki, Taro Hanaoka, Junro Ishizaki, Chika Kusano","doi":"10.1002/jgh3.70103","DOIUrl":"10.1002/jgh3.70103","url":null,"abstract":"<p><strong>Background and aim: </strong>Managing benign biliary stricture endoscopically is complicated and challenging. This study aimed to evaluate the safety and efficacy of a 6-month placement of a fully covered self-expanding metallic stent for refractory benign biliary stricture.</p><p><strong>Methods: </strong>Twenty-two patients with refractory benign biliary stricture (13 with chronic pancreatitis and 9 without) were recruited from five higher tertiary care centers. All patients received a planned 6-month fully covered self-expanding metallic stent placement. Primary outcomes included clinical success, technical success of stent removal, adverse events, and stricture recurrence.</p><p><strong>Results: </strong>Of the 21 cases (one case was excluded owing to malignant findings), fully covered self-expanding metallic stent placement was successful in all cases, with contralateral bile duct plastic stents used in three patients and stents remaining in place for 6 months in 16 of 21 patients. Distal stent migration occurred in three cases, two of which had resolved strictures. Adverse events were observed in 19.0% of patients: one case of severe cholangitis, two cases of mild cholangitis, and one case of hyperplasia formation. No stent-induced pancreatitis or cholecystitis occurred. All stents were removed successfully, and the treatment success rate was 85%. One patient experienced recurrent stricture 6.5 months post-stent removal.</p><p><strong>Conclusions: </strong>A six-month placement of a modified fully covered self-expanding metallic stent effectively improved strictures and minimized stent-induced Adverse events in patients with refractory benign biliary stricture.</p><p><strong>Trial registration: </strong>UMIN ID: UMIN000025027.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":"e70103"},"PeriodicalIF":1.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048237","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":"Elderly Onset Primary Intestinal Lymphangiectasia-A Rare Case.","authors":"Li-Han Goh, Madhavan Manoharan, Khean-Lee Goh","doi":"10.1002/jgh3.70102","DOIUrl":"10.1002/jgh3.70102","url":null,"abstract":"<p><p>Primary intestinal lymphangiectasia (PIL) is a rare protein-losing gastroenteropathy characterized by diffuse or localized ectasia of the enteric lymphatics, which can be accompanied by lymphatic abnormalities in other parts of the body. This condition results in hypoalbuminemia, hypogammaglobulinemia, and lymphopenia due to the abnormal leakage of lymphatic fluid into the gastrointestinal tract. As there are no specific serological or radiological tests available, the gold standard for diagnosing intestinal lymphangiectasia is endoscopic examination with histopathological examination of intestinal biopsy specimens. We present a rare case of primary intestinal lymphangiectasia in a 62-year-old Chinese woman who presented with a six-month history of lethargy, persistent diarrhea, and progressive weight loss. Gastroscopy and colonoscopy were performed, and biopsies revealed dilated intestinal lymphatics with broadened villi in the small intestine. Secondary causes of intestinal lymphangiectasia were ruled out, confirming the diagnosis of PIL. The patient was treated with a high-protein, low-fat diet supplemented with medium-chain triglycerides, resulting in significant clinical improvement.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":"e70102"},"PeriodicalIF":1.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029675","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":"Comparative Study of Remimazolam and Midazolam During Sedated Upper Gastrointestinal Endoscopy: A Propensity Score Matching Analysis.","authors":"Ryoji Ichijima, Hisatomo Ikehara, Tomomi Sugita, Daisuke Yamaguchi, Yasuhiko Nagata, Kanako Ogura, Mitsuru Esaki, Yosuke Minoda, Hiroyuki Ono, Yuki Maeda, Shinsuke Kiriyama, Tetsuya Sumiyoshi, Yuichi Kanmura","doi":"10.1002/jgh3.70100","DOIUrl":"10.1002/jgh3.70100","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to compare the use of remimazolam and midazolam in upper gastrointestinal endoscopy in Japan as a sub-analysis of data from an investigator-initiated clinical trial of remimazolam.</p><p><strong>Methods and results: </strong>Patients in two groups were matched using propensity score matching. We evaluated the time from the end of the gastrointestinal endoscopy until discharge, the time from the end of the procedure until awakening, and adverse events. Overall, 36 participants from the clinical trial population who underwent upper gastrointestinal endoscopy using remimazolam and 199 patients who underwent the procedure with midazolam during the same period were included in this study. Following propensity score matching, 34 patients in both groups were matched. The median time from the end of the procedure until awakening was 27.0 min (23.0-40.5 min) in the midazolam group (Group M) and 0 min (0-5.0 min) in the remimazolam group (Group R); the median time from the end of the upper gastrointestinal endoscopy until discharge was 39.0 min (35.0-52.5 min) in Group M and 5.0 min (0-5.0 min) in Group R (<i>p</i> < 0.01). Reported adverse events were hypotension and hypoxemia in one patient in Group R.</p><p><strong>Conclusion: </strong>Compared with midazolam, remimazolam significantly shortened the time to patient awakening and duration until the patient could leave the endoscopy room. <b>Trial Registration:</b> The main study (REM-IICT JP1) is registered with the Japan Registry of Clinical Trails: jRCT2031200360.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":"e70100"},"PeriodicalIF":1.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013855","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":"Effect of a Ketogenic Diet on Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Progression: A Randomized Controlled Trial.","authors":"Sakkarin Chirapongsathorn, Wiwit Rintaravitoon, Bhagawat Tangjaturonrasme, Samitti Chotsriluecha, Yanisa Pumsutas, Achariya Kanchanapradith, Sombat Treeprasertsuk","doi":"10.1002/jgh3.70099","DOIUrl":"10.1002/jgh3.70099","url":null,"abstract":"<p><strong>Background: </strong>Despite the popularity of a ketogenic diet, no randomized, controlled trials have evaluated its efficacy on metabolic dysfunction-associated steatotic liver disease (MASLD) progression.</p><p><strong>Methods: </strong>We conducted an 8-week, open-label, randomized controlled trial involving 24 patients with MASLD who were randomly assigned to either the home delivery ketogenic diet or a nutrition education program on adherence to the DASH diet. The primary outcome was a reduction in hepatic steatosis as measured by transient elastography.</p><p><strong>Results: </strong>There were no significant differences between groups in liver stiffness and steatosis measurement after interventions. Subjects on a ketogenic diet had lost more weight than subjects in the control group at 8 weeks (mean change [95% CI], -6.16 [-7.22, -5.10] vs. -2.14 [-4.49, 0.21] kg; <i>p</i> = 0.001). The decrease in waist circumference, systolic blood pressure, fat mass, and visceral fat area was significantly greater among subjects on a ketogenic diet than among those in the control group. Laboratory parameters, including AST, triglyceride, and HDL were also significantly decreased among subjects on a ketogenic diet than among those in the control group.</p><p><strong>Conclusions: </strong>A ketogenic diet produced a significantly greater weight loss (absolute difference, approximately 4%) than did the general lifestyle advice intervention for the first 8 weeks. A ketogenic diet was associated with a greater improvement in some risk factors for coronary heart disease and MASLD. However, a ketogenic diet did not reduce steatosis nor worsen MASLD progression. Longer and larger studies are required to determine the long-term safety and efficacy of the ketogenic diet. <b>Trial Registration:</b> TCTR20220426005.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":"e70099"},"PeriodicalIF":1.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013869","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 2-Mercaptoethane Sulfonate Sodium (MESNA) in the Prevention of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Randomized Open Label Trial.","authors":"Amir Sadeghi, Hesamoddin Samar, Mohammad Abbasinazari, Parvaneh Mohammadi, Ali Abazarikia, Shadi Ziaie","doi":"10.1002/jgh3.70083","DOIUrl":"10.1002/jgh3.70083","url":null,"abstract":"<p><strong>Background and aim: </strong>Oxidative stress has been considered a factor in the development of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). The present clinical trial evaluated whether adding intravenous mesna to rectal indomethacin could prevent or alleviate PEP.</p><p><strong>Methods: </strong>An open-labeled clinical trial was done on 698 participants undergoing endoscopic retrograde cholangiopancreatography (ERCP). Eligible patients received 100 mg indomethacin suppository 30 min before undergoing ERCP. Randomly, the participants received 400 mg intravenous mesna or nothing 30 min before doing the procedure. The PEP incidence and degree were measured in the patients as the main outcome.</p><p><strong>Results: </strong>The total rate of PEP was equal to 13.7%. No significant difference was seen in the rate and severity of PEP between the mesna plus indomethacin and indomethacin alone arms (14% vs. 13.4%, respectively, <i>p</i> = 0.671). In high-risk patients, PEP rate and severity were lower in the mesna plus indomethacin group compared with indomethacin alone group and the statistical analysis showed that the difference was significant (41.7% vs. 51.8%, respectively, <i>p</i> = 0.033).</p><p><strong>Conclusion: </strong>In high-risk patients undergoing ERCP, a combination of intravenous mesna plus rectal indomethacin may decrease the PEP rate and severity.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":"e70083"},"PeriodicalIF":1.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013880","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":"Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy.","authors":"Hironori Ochi, Masayuki Kurosaki, Takaaki Tanaka, Nobuharu Tamaki, Kaoru Tsuchiya, Yutaka Yasui, Hiroyuki Marusawa, Toshifumi Tada, Shinichiro Nakamura, Takehiro Akahane, Eisuke Okamoto, Haruhiko Kobashi, Hirotaka Arai, Michiko Nonogi, Namiki Izumi","doi":"10.1002/jgh3.70098","DOIUrl":"https://doi.org/10.1002/jgh3.70098","url":null,"abstract":"<p><strong>Aim: </strong>We investigated the impact of proteinuria on the therapeutic effect before lenvatinib administration as second-line treatment after atezolizumab-bevacizumab.</p><p><strong>Methods: </strong>We examined 64 patients who were administered lenvatinib as second-line treatment after discontinuation of atezolizumab and bevacizumab. Proteinuria assessed before lenvatinib administration was considered severe if the qualitative value test (QV) was 3+ or the urine protein/creatinine ratio (UPCR) was ≥ 2.0 (group A, <i>n</i> = 13) and non-severe if the UPCR was < 2.0 or the QV was ≤ 2+ (group B, <i>n</i> = 51).</p><p><strong>Results: </strong>In the entire cohort, the modified albumin-bilirubin grades were grades 1, 2a, 2b, and 3 in 12, 21, 26, and 5 patients, respectively. Regarding the Barcelona Clinic of Liver Cancer stage, 2, 22, and 40 patients had stages A, B, and C, respectively. The objective response rate (ORR) was 14.0% and the disease control rate (DCR) was 59.3%. The median survival time and progression free survival after administration of lenvatinib was 14.8 (95% confidence interval [CI], 11.3-18.4) and 5.5 (95% CI, 3.6-7.5) months, respectively. The ORR and DCR were 0% and 38.4% for group A (<i>n</i> = 13) and 17.6% and 64.7% for group B (<i>n</i> = 51), respectively. The median time to treatment failure was 2.2 months in group A and 4.2 months in group B (<i>p</i> = 0.120).</p><p><strong>Conclusions: </strong>Severe proteinuria before lenvatinib as a second-line therapy after atezolizumab-bevacizumab treatment may affect the duration of lenvatinib administration and treatment efficacy.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":"e70098"},"PeriodicalIF":1.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013875","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":"Review of Methods for Detection <i>Helicobacter pylori</i> in Kazakhstan.","authors":"Lavrinenko Alyona, Seisenbekova Aizhan, Turemuratova Aidana, Shkreba Alexey, Yukhnevich Yekaterina","doi":"10.1002/jgh3.70101","DOIUrl":"10.1002/jgh3.70101","url":null,"abstract":"<p><p><i>Helicobacter pylori</i> (<i>H. pylori</i>) infection can cause a wide range of gastrointestinal disorders, including chronic nonatrophic gastritis, multifocal atrophic gastritis, peptic ulcer disease, gastric adenocarcinoma, and extra-nodal B-cell lymphoma. Although the prevalence of <i>H. pylori</i> infection has decreased among adults, it is still very common. Approximately 90% of gastric adenocarcinomas are associated with <i>H. pylori</i> infection. Despite the established link between <i>H. pylori</i> infection and noncardiac gastric cancer, and the increasing incidence of gastric cancer in Kazakhstan, there are limited data on the prevalence of <i>H. pylori</i> in the country. This may be due to the difficulty of detecting <i>H. pylori</i> and the unavailability of diagnostic methods. This review presents the current data of diagnostic tests for the detection of <i>H. pylori</i> in Kazakhstan with a focus on limitations and practical significance.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":"e70101"},"PeriodicalIF":1.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012576","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":"The Efficacy of Lubiprostone in Patients of Constipation: An Updated Systematic Review and Meta-Analysis.","authors":"Umar Akram, Obaid Ur Rehman, Eeshal Fatima, Zain Ali Nadeem, Omer Usman, Waqas Rasheed, Ramsha Ali, Khawaja Abdul Rehman, Abdulqadir J Nashwan","doi":"10.1002/jgh3.70070","DOIUrl":"10.1002/jgh3.70070","url":null,"abstract":"<p><strong>Background and aim: </strong>Lubiprostone increases chloride and water secretion in the intestines, and several studies have demonstrated the efficacy of lubiprostone in treating functional constipation. Several new clinical trials have emerged since the previous meta-analysis conducted in 2020. We conducted this updated meta-analysis to assess clinical efficacy of lubiprostone in these patients.</p><p><strong>Methods: </strong>A systematic search was conducted on MEDLINE, Cochrane, and Scopus. Randomized controlled trials published between July 2019 and June 2024 were selected. Cochrane's RoB 2 tool was used to assess the risk of bias. A meta-analysis was performed and findings were presented using forest plots.</p><p><strong>Results: </strong>A total of 14 studies, comprising 4550 patients, were included in the review. Only 12 studies were pooled in the meta-analysis. Lubiprostone was associated with greater spontaneous bowel movements (SBM) per week (RR 1.454, 95% CI 1.193-1.771) and SBM within 24 h (RR 1.790, 95% CI 1.491-2.150) in patients with chronic idiopathic constipation (CIC). However, it was not associated with abdominal pain in either arm (RR 1.415, 95% CI 0.873-2.294). In opioid-induced constipation (OIC), lubiprostone increased SBM within 24 h (RR 1.277, 95% CI 1.105-1.475) but did not significantly affect abdominal pain (RR 4.321, 95% CI 0.624-29.941). Lubiprostone improved all selected SBM-related and abdominal pain outcomes in patients with irritable bowel syndrome with constipation (IBS-C).</p><p><strong>Conclusion: </strong>Lubiprostone significantly improves all SBM-related outcomes. Owing to its good safety and efficacy profile, lubiprostone can be used in the combination regimens for management of CIC, IBS-C, and OIC.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":"e70070"},"PeriodicalIF":1.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012973","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}