JGH Open最新文献

{"title":"Cannabidiol Use in Inflammatory Bowel Disease: Insights From a Gastroenterology Outpatient Population","authors":"Karina Fatakhova,&nbsp;Muhammad Jahanzaib Khan,&nbsp;Royce Perera,&nbsp;Sapphire Perera,&nbsp;Benjamin Glazebnik,&nbsp;Lindsey Donnelly,&nbsp;Pratik Patel,&nbsp;Emily Glazer,&nbsp;Greg Haggerty,&nbsp;Hassam Ali,&nbsp;Ramona Rajapakse","doi":"10.1002/jgh3.70402","DOIUrl":"10.1002/jgh3.70402","url":null,"abstract":"<p>Cannabidiol (CBD) is increasingly used for symptom relief in chronic conditions, yet its role in inflammatory bowel disease (IBD) remains underexplored. We surveyed 229 IBD patients and found that 10.5% used CBD, primarily for anxiety (54.2%), insomnia (41.7%), and pain (41.7%). Among users, 87.5% perceived benefit. Most users were female, and one-third were on biologics. These findings highlight the growing interest in alternative therapies and the need for further research on CBD's safety, efficacy, and clinical guidance in IBD care.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646806","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":"Advances in Crohn's Disease: A Comprehensive Review of Pathophysiology, Diagnosis, and Emerging Therapeutics","authors":"Yoon-Kyo An,&nbsp;Robert Gilmore,&nbsp;Graham Radford-Smith,&nbsp;Jakob Begun","doi":"10.1002/jgh3.70394","DOIUrl":"10.1002/jgh3.70394","url":null,"abstract":"<p>Crohn's disease (CD) is a chronic inflammatory condition of the bowel with a rising global incidence. Its complex etiology involves genetic susceptibility, environmental factors, and alterations in the gut microbiota, leading to dysregulated immune responses. Prompt diagnosis and personalized treatment are essential to prevent disease flares and complications. This review provides a comprehensive overview of CD, including its epidemiology, pathophysiology, diagnosis, management, treatment goals, and prospects. Treatment goals in CD have evolved beyond symptomatic control to achieving mucosal healing to prevent disease related complications. Advances in biologic therapies including the use of anti-TNF agents, vedolizumab, and ustekinumab in CD have improved outcomes, but challenges such as immunogenicity and accessibility remain. A ‘treat-to-target’ approach based on biomarkers such as C-reactive protein and fecal calprotectin allows for objective disease monitoring and adjustment of treatment as needed to achieve these targets. Promising new drug classes including Janus kinase inhibitors and anti-interleukin-23 antibodies are emerging as potential therapies. Personalized medicine is evolving as a vital approach to tailor treatment based on individual genomic, clinical, and environmental factors. Future research to refine CD management should focus on predictive biomarkers, treatment algorithms, and head-to-head trials. Overall to improve outcomes and quality of life for those living with CD, management requires a multifaceted approach that considers disease severity, individualized patient characteristics, and the evolving therapeutic landscape.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634786","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":"Therapeutic Decisions in Inflammatory Bowel Disease: ChatGPT-4.0 Compared to Medical Expertise","authors":"Helena Loncour,&nbsp;Jennifer Aoun,&nbsp;Alice Hoyois,&nbsp;Vinciane Muls","doi":"10.1002/jgh3.70386","DOIUrl":"10.1002/jgh3.70386","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>With the increasing prevalence of inflammatory bowel disease (IBD) and its complex management, evaluating innovative approaches became essential. Large language models (LLM), such as ChatGPT-4.0, have remarkably advanced, yet their application in IBD management remains unexplored. This study compares therapeutic recommendations generated by ChatGPT-4.0 with those made by IBD specialists, evaluating its potential and limitations in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This prospective observational study, conducted between September 2024 and March 2025, included 47 cases of IBD patients requiring initiation or modification of biologic therapy. Standardized clinical vignettes were presented to both IBD specialists and ChatGPT-4.0. For each case, three sequential questions were addressed: the choice of the therapeutic class of the treatment, the specific molecule in this class, and if the proposition is a monotherapy or combination therapy. Agreement was measured using the percentage concordance and Cohen's kappa coefficient (<i>κ</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The agreement between the IBD specialists and ChatGPT-4.0 was 76.6% (<i>κ</i> = 0.677) for the therapeutic class and 44.7% (<i>κ</i> = 0.352) for specific molecule selection. Therapeutic class discordance occurred in 11 cases (23.4%); all were reviewed and deemed acceptable by the gastroenterologists. Notably, seven of ChatGPT-4.0's second-line suggestions matched with the IBD specialists' treatment decisions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights a promising area of ChatGPT-4.0 application in the therapeutic management of IBD. However, it is not suitable as a standalone or fully reliable resource for decision-making in healthcare. Future development of tailored healthcare GPT integrating European guidelines and experts' feedback may further improve LLM performance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634787","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":"Predictors of True Early Recurrence in Patients Undergoing Radiofrequency Ablation for Hepatocellular Carcinoma","authors":"Yi-Hao Yen,&nbsp;Kwong-Ming Kee,&nbsp;Chao-Hung Hung,&nbsp;Chien-Hung Chen,&nbsp;Tsung-Hui Hu,&nbsp;Jing-Houng Wang,&nbsp;Sheng-Nan Lu","doi":"10.1002/jgh3.70400","DOIUrl":"10.1002/jgh3.70400","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To analyze risk factors of true early recurrence in patients undergoing radiofrequency ablation (RFA) for early-stage hepatocellular carcinoma (HCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We enrolled 791 patients with newly diagnosed early-stage HCC (i.e., within Milan criteria) and Child–Pugh class A liver disease undergoing percutaneous RFA. Survival analysis was performed using the Kaplan–Meier method with the log-rank test. Cox proportional hazards analysis was used to identify prognostic factors associated with early recurrence (i.e., recurrence within 2 years after RFA). Early recurrence was identified in 270 (34.1%) patients. After excluding 33 patients with local tumor progression (LTP) within 2 years of initial RFA, 237 patients were classified as showing true early recurrence. Multivariate analyses showed that multiple tumors (hazard ratio [HR] = 1.526; 95% confidence interval [CI] = 1.143–2.039), alpha-fetoprotein (AFP) level of ≥ 10 ng/mL (HR = 1.533; 95% CI = 1.163–2.021), tumor size per 10 mm increase (HR = 1.019; 95% CI = 1.002–1.036), model for end-stage liver disease (MELD) score per one increase (HR = 1.024; 95% CI = 0.999–1.049), anti-hepatitis C virus (anti-HCV) positivity (HR = 1.635; 95% CI = 1.187–2.252), and being treated with antiviral therapy for HCV (HR = 0.614; 95% CI = 0.434–0.869) were associated with inferior 2-year recurrence-free survival (RFS). We constructed a predictive model with these variables. This model provided three risk strata for 2-year RFS, low risk, medium risk, and high risk, with 2-year RFS of 75%, 58%, and 35%, respectively (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We developed a risk prediction model to predict true early recurrence in patients undergoing RFA for early-stage HCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634732","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":"Rifaximin Use Is Associated With Prognosis and Recurrence Patterns in Spontaneous Bacterial Peritonitis: Exploratory Insights Into the Oral–Gut–Hepatic Axis","authors":"Yoshihito Uchida,&nbsp;Naoto Soma,&nbsp;Shunsuke Yamada,&nbsp;Shohei Tsuji,&nbsp;Satsuki Ando,&nbsp;Kayoko Sugawara,&nbsp;Masamitsu Nakao,&nbsp;Nobuaki Nakayama,&nbsp;Yukinori Imai,&nbsp;Suguru Mizuno,&nbsp;Satoshi Mochida","doi":"10.1002/jgh3.70391","DOIUrl":"10.1002/jgh3.70391","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Spontaneous bacterial peritonitis (SBP) remains a life-threatening complication in cirrhotic patients with refractory ascites. Evidence for rifaximin (RFX) in SBP prevention and prognosis is lacking in Japan. We investigated the effect of RFX on prognosis and recurrence of SBP and evaluated the prognostic role of oral health within the oral–gut–hepatic axis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective study included 142 patients with a first SBP episode. Patients were stratified into an RFX-treated group and a non-RFX group. Outcomes included 90-day survival, SBP recurrence, and cirrhosis-related complications. Oral health status and acid-suppressive therapy were also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-seven patients received RFX. Ascitic culture positivity was comparable between groups, but RFX-treated patients had fewer enteric bacteria and more oral flora (<i>p</i> = 0.0033). Ninety-day survival was significantly higher with RFX (85.1% vs. 60.0%, <i>p</i> = 0.0023). The 12-month recurrence rate was markedly lower in the RFX-treated group (10.4% vs. 63.2%; HR 0.19, 95% CI 0.09–0.40). Oral contamination independently predicted overt hepatic encephalopathy (HR 2.56) and variceal rupture (HR 6.72). Denture use was an independent predictor of mortality (HR 2.04, 95% CI 1.23–3.38).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Rifaximin use was associated with higher short-term survival and lower SBP recurrence in cirrhotic patients with refractory ascites. Oral contamination and denture use were associated with adverse outcomes, providing novel clinical evidence for the oral–gut–hepatic axis. Integration of RFX therapy with oral hygiene interventions may offer a comprehensive strategy to improve prognosis in cirrhosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623973","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":"ChatGPT-Assisted Image Interpretation for Inflammatory Bowel Diseases: Ulcerative Colitis and Crohn's Disease","authors":"Hiroki Uekado,&nbsp;Daisuke Watanabe,&nbsp;Yuichiro Aoyama,&nbsp;Hina Kawase,&nbsp;Sayaka Ikeda,&nbsp;Aya Shiraki,&nbsp;Jessica Pajimna,&nbsp;Misaki Agawa,&nbsp;Hirotaka Nakamura,&nbsp;Yuki Ito,&nbsp;Norihiro Okamoto,&nbsp;Haruka Miyazaki,&nbsp;Yuna Ku,&nbsp;Makoto Ooi,&nbsp;Namiko Hoshi,&nbsp;Yuzo Kodama","doi":"10.1002/jgh3.70396","DOIUrl":"10.1002/jgh3.70396","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Differentiating ulcerative colitis (UC) from Crohn's disease (CD) is challenging, particularly for nonexperts. Although artificial-intelligence-based image analysis has advanced endoscopic diagnosis, large language models of inflammatory bowel disease (IBD) require clinical validation. We evaluated the ability of ChatGPT to distinguish UC from CD using colonoscopy (CS) images with and without clinical information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 386 and 161 patients with UC and CD, respectively, with active disease who underwent CS between April 2001 and May 2025. A representative endoscopic image showing severe activity at the initial flare was selected by a nonspecialist. Data were collected on lesion continuity and perianal disease. ChatGPT was asked to (1) classify UC or CD and (2) estimate UC probability using images alone or images plus clinical information. The IBD specialists performed task (1) under the same conditions. Their diagnostic performance was compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age of the patients was 36.5 and 28 years in the UC and CD groups, respectively. The diagnostic accuracy without clinical information was 75.6% for ChatGPT and 84.9% for specialists, which increased to 87.4% and 88.7% with clinical information, respectively. The odds ratios for correct diagnosis markedly increased when clinical data were used. Receiver operator curve analysis of ChatGPT showed area under the curves of 0.750 without clinical information and 0.948 with clinical information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ChatGPT accurately discriminated between UC and CD, with diagnostic accuracy markedly increased via the integration of clinical information, suggesting applicability in clinical practice despite being less accurate than IBD specialists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623970","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":"Nurse-Led Clinic for Patients With Decompensated Liver Cirrhosis","authors":"Elsebeth E. Kelstrup,&nbsp;Sara H. Andersen,&nbsp;Tine L. Poulsen,&nbsp;Karen L. Thomsen,&nbsp;Konstantin Kazankov,&nbsp;Palle Bager","doi":"10.1002/jgh3.70393","DOIUrl":"10.1002/jgh3.70393","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Prognosis for patients with decompensated liver cirrhosis is poor and readmissions are frequent. Closer and more structured follow-up by nurses may prevent readmissions and stabilize liver-related complications. We aimed to test the hypothesis that establishing a nurse-led clinic for patients with decompensated liver cirrhosis could prevent hospital admissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A quasi-experimental study including complex patients with decompensated cirrhosis and complications. The intervention was a patient-centered and nurse-led clinic. Contacts to the participants were mainly by phone or face-to-face visits in the main outpatient clinic. In addition, the whole cohort of patients with cirrhosis followed in the department was monitored prior to, during, and after the intervention. Data was evaluated using interrupted time series.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 55 patients were enrolled in the clinic between January 2022 and February 2024. Most (55%) became able to self-manage and were discharged from the clinic hereafter. They were characterized by having lower clinical scores and having fewer mental problems. In contrast, 18% were unable to benefit from the clinic. Data on cohort-level showed decreases in outpatient visits (<i>p</i> &lt; 0.05) and admissions (<i>p</i> &lt; 0.005) while the clinic was active.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Establishing a nurse-led clinic for patients with decompensated cirrhosis is feasible and followed by reduced in- and outpatient contacts while the clinic was active.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624010","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":"Real-World Effectiveness of Tolvaptan for Hyponatremia in Cirrhosis Across Global Regions: A Target Trial Emulation","authors":"Kazuya Okushin,&nbsp;Ryosuke Tateishi,&nbsp;Mitsuhiro Fujishiro,&nbsp;Takeya Tsutsumi,&nbsp;Kazuhiko Koike,&nbsp;Tomohiro Tanaka","doi":"10.1002/jgh3.70395","DOIUrl":"10.1002/jgh3.70395","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tolvaptan promotes electrolyte-free water excretion and is widely used in Asia for ascites, but in Western countries its use is limited to hyponatremia because of hepatotoxicity concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cohort study using the TriNetX Research Network, emulating a target trial of cirrhotic patients with hyponatremia in global regions. Patients receiving tolvaptan plus sodium supplementation were compared with those receiving sodium supplementation alone. The primary outcome was 30-day all-cause mortality; secondary outcomes included correction of hyponatremia, changes in liver and renal function, and initiation of hemodialysis. Survival was analyzed using Kaplan–Meier curves with the log-rank test and Cox proportional hazards models. Propensity score matching was applied to balance baseline covariates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 188 707 eligible patients, 2130 received tolvaptan. After 1:1 matching, 1983 patients were analyzed in each group. Baseline characteristics were balanced, although serum sodium remained slightly lower in the tolvaptan group. Thirty-day mortality was 14.4% in the tolvaptan group and 16.1% in the control group (HR 0.87, 95% CI 0.74–1.02; log-rank <i>p</i> = 0.09). By the end of the follow-up, serum sodium levels were significantly lower in the tolvaptan group. Changes in renal and liver function were comparable between groups, with no signal of excess hepatotoxicity. Rates of hemodialysis initiation did not differ significantly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this large real-world target trial emulation across global regions with ethnic diversity, in the context of longstanding safety concerns in cirrhosis, tolvaptan was not associated with excess short-term mortality, with point estimates consistently favoring its use. Further studies are warranted to clarify its safety and effectiveness in diverse clinical settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624030","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":"Using Evidence to Get the Most Out of Dietary Interventions in Irritable Bowel Syndrome","authors":"Amy T. Woods,&nbsp;Alexander C. Ford","doi":"10.1002/jgh3.70392","DOIUrl":"10.1002/jgh3.70392","url":null,"abstract":"<p>Irritable bowel syndrome (IBS) is a chronic disorder of gut–brain interaction characterized by abdominal pain and abnormal stool form or frequency. IBS symptoms often commence after, or are exacerbated by, eating. People with IBS are, therefore, increasingly interested in the role of food or dietary constituents in triggering their symptoms and often express a preference for dietary management over drug therapy. Partly as a result, there has been an explosion in interest around dietary interventions in IBS over the last 20 years. This article discusses how the quality of randomized controlled trials (RCTs) is judged conventionally and how this can “shortchange” whole dietary intervention trials in IBS. The design of trials of active whole dietary interventions in IBS, including the selection of a comparator or a credible control intervention, is described. Finally, the article summarizes the evidence for fiber supplementation and whole dietary interventions in IBS, focusing on the results of RCTs and meta-analyses, with more recent developments also reported.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70392","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585267","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":"Oral Microbiome and Constipation: A Causal Link Revealed by Mendelian Randomization.","authors":"Ziyi Zhao, Jinlian Ling, Jiashu Chen","doi":"10.1002/jgh3.70390","DOIUrl":"https://doi.org/10.1002/jgh3.70390","url":null,"abstract":"<p><strong>Background: </strong>Constipation affects approximately 15.3% of the global population. While the gut microbiome's role in constipation has been studied, the causal relationship between the oral microbiome and constipation remains unexplored.</p><p><strong>Methods: </strong>We utilized Mendelian randomization (MR) and large-scale GWAS data to investigate the causal relationship between the oral microbiome and constipation. Oral microbiome data were sourced from a metagenome-wide association study (mgGWAS) on 2984 individuals, while constipation GWAS data came from 176 629 samples in the Japan Biobank. Statistical methods included inverse variance-weighted (IVW) analysis, weighted median, and MR-Egger regression.</p><p><strong>Results: </strong>The MR analysis revealed significant associations between specific oral microbiome and constipation. <i>Treponema denticola</i>, found in saliva, was positively associated with an increased risk of constipation (OR = 3.961, 95% CI = 1.085-14.453, <i>p</i> = 0.037). Conversely, certain bacteria like <i>Pauljensenia</i> sp000308055 showed protective effects (OR = 0.409, 95% CI = 0.167-0.999, <i>p</i> = 0.0496). In the tongue coating, <i>Neisseria sicca</i> exhibited a significant positive association with constipation (OR = 4.864, 95% CI = 1.293-18.302, <i>p</i> = 0.019), while <i>Aggregatibacter segnis</i> demonstrated a protective effect (OR = 0.400, 95% CI = 0.188-0.854, <i>p</i> = 0.018).</p><p><strong>Conclusion: </strong>This study is the first to explore the potential causal relationship between oral microbiome and constipation. The findings suggest that specific oral bacteria may influence the risk of constipation, highlighting the need for further research to validate these relationships and understand the mechanisms involved. Moreover, the study underscores the importance of considering both oral and gut microbiome in the context of gastrointestinal health and disease management.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 3","pages":"e70390"},"PeriodicalIF":1.5,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784939","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}