JGH Open最新文献

{"title":"The Impact of Waitlisting After a Weekend on Transplant-Related Outcomes for Patients With Acute Liver Failure in the US","authors":"Melis G. Celdir,&nbsp;Qianyi Shi,&nbsp;Tomohiro Tanaka","doi":"10.1002/jgh3.70271","DOIUrl":"https://doi.org/10.1002/jgh3.70271","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Potential delays in patient care during weekends have not been studied in liver transplantation (LT) for acute liver failure (ALF). We evaluated the impact of listing after a weekend on waitlist (WL) and post-LT outcomes in ALF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a retrospective cohort study of adult ALF patients from February 2002 to May 2023 in the United Network for Organ Sharing (UNOS) database, the primary exposure was listing after a weekend. Multinomial regression and Cox models assessed WL outcomes and post-LT mortality, respectively, adjusting for potential confounders. Inverse probability censoring weighting addressed censoring bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 6600 adults listed for LT, 840 (13%) were listed after a weekend. The median number of days from admission to waitlisting was 2 (IQR1–3). Accounting for potential confounders, patients listed after a weekend had a lower likelihood of spontaneous survival (SS; relative risk ratio 0.74, 95% CI 0.61–0.90, LT as reference). Post-LT mortality at 1 year was higher in patients listed after a weekend (HR 1.25, 95% CI: 1.01–1.54). IPW cohort outcomes corroborated these findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among adults with acute liver failure, listing for liver transplantation after a weekend was associated with lower rates of spontaneous survival and higher one-year post-transplant mortality. Identifying system-level factors contributing to delays in transplant evaluation over weekends may help improve the timeliness and efficiency of care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923387","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":"Lactulose Combined With PEG for Effective and Safe Bowel Preparation Before Colonoscopy: A Meta-Analysis","authors":"Hu-Bin Xia,&nbsp;Wen-Li Ruan,&nbsp;Min Wu,&nbsp;Yi-Feng Zhou","doi":"10.1002/jgh3.70262","DOIUrl":"https://doi.org/10.1002/jgh3.70262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the efficacy of polyethylene glycol electrolyte (PEG) combined with lactulose versus PEG alone in bowel preparation quality for colonoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The protocol for this systematic review was registered with PROSPERO (CRD420251035139). Comprehensive literature searches were conducted across multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP. RevMan 5.4 software was employed to assess differences between the two groups regarding the rates of excellent bowel preparation, willingness to undergo repeat examination, incidence of adverse reactions, and adenoma detection rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen eligible studies, encompassing 2468 participants, were included in the analysis. Meta-analysis demonstrated that the combination of PEG and lactulose was significantly more effective than PEG alone in bowel cleansing (OR = 3.57, 95% CI: 2.75–4.63, <i>p</i> &lt; 0.001, <i>I</i>² = 0% for efficacy; SMD = 0.38, 95% CI: 0.26–0.50, <i>p</i> &lt; 0.001, <i>I</i>² = 45% for BBPS scores; SMD: Standard Mean Difference; BBPS: Boston Bowel Preparation Scale). This combination also led to a lower incidence of adverse events, including vomiting (OR = 0.54, 95% CI: 0.36–0.82, <i>p</i> = 0.004), abdominal pain (OR = 0.54, 95% CI: 0.36–0.80, <i>p</i> = 0.003), and abdominal bloating (OR = 0.53, 95% CI: 0.38–0.75, <i>p</i> &lt; 0.001), compared with PEG alone. Furthermore, PEG plus lactulose significantly improved the detection rate of intestinal adenomas (OR = 2.57, 95% CI: 1.74–3.79, <i>p</i> &lt; 0.001). However, no significant differences were observed in the incidence of nausea (OR = 0.69, 95% CI: 0.88–0.99, <i>p</i> = 0.05) or willingness to repeat the examination (OR = 1.31, 95% CI: 0.51–3.36, <i>p</i> = 0.58).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combination of PEG and lactulose significantly enhances bowel cleansing efficacy, increases adenoma detection rates, and reduces the incidence of adverse reactions. This regimen is recommended for bowel preparation prior to colonoscopy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144918770","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":"Newly Diagnosed Celiac Disease in a Patient With a Body Mass Index of 50.8 kg/m2","authors":"Mehak Sachdeva,&nbsp;Abdul-Rahman Diab,&nbsp;Thomas Brown","doi":"10.1002/jgh3.70210","DOIUrl":"https://doi.org/10.1002/jgh3.70210","url":null,"abstract":"<p>Celiac disease (CD) was previously known to be seen in underweight individuals, with weight loss being one of the key symptoms; however, newer data today is starting to show that most adults with celiac disease are either normal weight, overweight or obese. Here we present a 52-year-old patient with a body mass index (BMI) of 50.8 kg/m² who was diagnosed with biopsy-proven CD and her tissue transglutaminase immunoglobulin A level was 45.5 U/mL (0–15 U/mL). CD is becoming increasingly prevalent in overweight and obese individuals, making it essential for clinicians to be aware of this atypical presentation to prevent any delay in diagnosis and improve their quality of life.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915257","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":"Multifocal Colonic Masses as a Presentation of Secondary Extramedullary Plasmacytoma in Relapsing-Refractory Multiple Myeloma: A Case Report and Review of Literature","authors":"Sirisha Gaddipati,&nbsp;Sunny Sandhu,&nbsp;Eric F. Martin","doi":"10.1002/jgh3.70239","DOIUrl":"https://doi.org/10.1002/jgh3.70239","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Multiple myeloma (MM) is a common plasma cell malignancy; however, extramedullary multiple myeloma (EMM) is an aggressive phenotype in which malignant plasma cells proliferate outside of the bone marrow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Extramedullary plasmacytomas (EMP) are uncommon and gastrointestinal involvement is exceedingly rare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>Here, we present a case of multifocal secondary colonic EMP in a patient with relapsed refractory multiple myeloma (RRMM) and review literature demonstrating other cases of secondary colonic EMP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144918694","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 and Safety of Seladelpar for Primary Biliary Cholangitis: A Systematic Review and Meta-Analysis","authors":"Mohamed Abuelazm,&nbsp;Saqr Alsakarneh,&nbsp;Mohammad Tanashat,&nbsp;AlMothana Manasrah,&nbsp;Ahmed A. Ibrahim,&nbsp;Sandesh Parajuli,&nbsp;Hatem Eltaly,&nbsp;Ahmed Mazen Amin","doi":"10.1002/jgh3.70265","DOIUrl":"https://doi.org/10.1002/jgh3.70265","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Seladelpar is an oral, once-daily medication that improves cholestasis through its selective peroxisome proliferator-activated receptor (PPAR-δ) agonism. It shows promising efficacy in treating primary biliary cholangitis (PBC) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis synthesizing evidence from randomized controlled trials (RCTs) obtained from PubMed, Cochrane, Scopus, and WOS until July 19th, 2025. Dichotomous outcomes were reported using risk ratio (RR) and continuous outcomes using mean difference (MD), with a 95% confidence interval (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three RCTs with 499 patients were included. Seladelpar was significantly associated with an increased ALP normalization (RR: 21.12 with 95% CI [4.14, 107.58], <i>p</i> &lt; 0.01), biochemical response (RR: 3.06 with 95% CI [2.00, 4.70], <i>p</i> &lt; 0.01), and decreased pruritus NRS score change (MD: −1.47 with 95% CI [−2.73, −0.21], <i>p</i> = 0.02). Seladelpar was also significantly associated with a decreased incidence of pruritus (RR: 0.54 with 95% CI [0.31, 0.94], <i>p</i> = 0.03) but with an increased incidence of headache (RR: 3.37 with 95% CI [1.11, 10.23], <i>p</i> = 0.03). However, there was no significant difference between seladelpar and placebo regarding the incidence of any adverse events (RR: 0.96 with 95% CI [0.87, 1.06], <i>p</i> = 0.43).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Seladelpar improved liver biomarkers of cholestasis and reduced pruritus in patients with PBC without significantly increasing the adverse effects. This makes seladelpar a promising addition to the treatments available for PBC.</p>\u0000 \u0000 <p><b>Trial Registration:</b> PROSPERO: CRD42024521208</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 9","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915232","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":"Impacts of Ramadan Fasting on Metabolic and Hepatic Endpoints in Individuals With Metabolic Dysfunction-Associated Fatty Liver Disease: A Systematic Review and Meta-Analysis","authors":"A. B. M. Kamrul-Hasan,&nbsp;Hamid Ashraf,&nbsp;Lakshmi Nagendra,&nbsp;Deep Dutta,&nbsp;Md. Nafis Shahriar,&nbsp;Md. Saiful Islam,&nbsp;Joseph M. Pappachan","doi":"10.1002/jgh3.70264","DOIUrl":"https://doi.org/10.1002/jgh3.70264","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Previous studies examining the impact of Ramadan fasting on patients with metabolic dysfunction-associated fatty liver disease (MAFLD) have yielded mixed results. Therefore, assessing the health benefits of such fasting in patients with MAFLD through a systematic review and meta-analysis (SR/MA) is important.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted on MEDLINE, Scopus, Web of Science, Google Scholar, and ClinicalTrials.gov from their inception to March 5, 2025, to identify relevant studies involving adults with MAFLD fasting during Ramadan. The primary outcome was liver-related parameters, while additional outcomes included changes in anthropometric and metabolic parameters during the peri-Ramadan period. Statistical analysis was performed using R software, and the results were presented as mean differences (MD) with 95% confidence intervals (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight studies (10 reports), mostly with serious risk of bias, involving 603 subjects revealed that Ramadan fasting was associated with reductions in alanine transaminase (ALT [MD −4.11 U/L]), aspartate transaminase (AST [MD −4.24 U/L]), FIB4 index (MD −0.09), and nonalcoholic fatty liver disease fibrosis score (MD −0.22) from baseline in fasting individuals. However, the changes in ALT and AST were similar in studies comparing fasting and non-fasting groups. Fasting individuals experienced significantly greater weight loss (MD −1.44 kg), as well as reductions in body mass index (MD −0.66 kg/m²) and waist circumference (MD −0.91 cm), compared to those who did not fast. Individuals who fasted experienced a glycemic benefit characterized by a reduction in glycated hemoglobin (MD −0.4%). However, changes in mean body fat percentage and HOMA-IR were similar in both the fasting and non-fasting groups. Individuals who fasted experienced reductions in both systolic and diastolic blood pressure, along with improved lipid parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This SR/MA of small existing data suggests that fasting during Ramadan improves certain MAFLD-related outcomes. Larger, multinational studies with wider global representation are needed to improve clinical practice decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894372","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":"Prospective Questionnaire Survey on Adherence to Oral 5-Aminosalicylic Acid in Patients With Ulcerative Colitis","authors":"Tsuyoshi Beppu,&nbsp;Fumihito Hirai,&nbsp;Kensei Ohtsu,&nbsp;Masahiro Kishi,&nbsp;Teruyuki Takeda,&nbsp;Shigeyoshi Yasukawa,&nbsp;Noritaka Takatsu,&nbsp;Takashi Hisabe,&nbsp;Toshiharu Ueki,&nbsp;Kenshi Yao","doi":"10.1002/jgh3.70259","DOIUrl":"https://doi.org/10.1002/jgh3.70259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adherence to 5-aminosalicylic acid (5-ASA), an anchor drug for ulcerative colitis (UC), affects remission maintenance. This study aimed to investigate the current status of adherence to 5-ASA and identify the factors associated with adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled UC patients whose primary maintenance therapy was oral 5-ASA at our hospital between January 2017 and December 2018. The adherence status was examined using a questionnaire survey. Various factors, including patient background and disease activity, were also analyzed to identify those related to adherence. A second questionnaire with the same content was performed 1 year after the initial survey for comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 297 patients with UC answered the first questionnaire, of which 278 answered the second questionnaire. Complete adherence rates at the time of the first and second questionnaires were 49.8% (148/297) and 55.8% (155/278), respectively. Full-time employment (<i>p</i> = 0.00893), eating one or two meals per day (<i>p</i> = 0.00641), and multiple daily doses (<i>p</i> = 0.0153) were significantly associated with lower adherence. The 119 patients who fully adhered to both the primary and secondary questionnaires had a significantly higher cumulative non-relapse rate at 1 year than those 159 who were not (85.7% vs. 76.1%, <i>p</i> = 0.0207).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>UC patients with high adherence to 5-ASA showed a high rate of remission maintenance, so adherence should be improved by considering factors such as the number of medications taken, work status, and dietary habits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881089","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":"Causal Relationship Between Mitochondrial Characteristics and Inflammatory Bowel Disease and Its Subtypes: Evidence for Mendelian Randomization","authors":"Yichen Cai,&nbsp;Hancheng Fan,&nbsp;Jianmin Zhao,&nbsp;Guoxiang Fu","doi":"10.1002/jgh3.70257","DOIUrl":"https://doi.org/10.1002/jgh3.70257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The research was designed to explore the causal relationship between the changing landscape of 63 mitochondrial proteins and inflammatory bowel disease (IBD) by Mendelian randomization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Use SNPs significantly associated with IBD and their subtypes as instrumental variables. Various methods were utilized to assess the causal relation between mitochondrial function and the onset of IBD and their subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results after FDR on <i>p</i> values indicated that Peptide chain release factor 1-like was a causative factor for IBD. NADH dehydrogenase [ubiquinone] flavoprotein 2, hydroxymethylglutaryl-CoA synthase 9, pyruvate carboxylase, apoptosis-inducing factor 1, and transmembrane protein 70 with inflammatory bowel disease were identified as protective factors. Peptide chain release factor 1-like and NADH dehydrogenase [ubiquinone] flavoprotein 2 were identified as causal and protective factors for IBD, respectively. In addition, GrpE protein homolog 1, 39S ribosomal protein L33, and tRNA pseudouridine synthase A are pathogenic in Crohn's disease, and Hydroxymethylglutaryl-CoA synthase and Pyruvate carboxylase are protective factors. The MR-presso method rejected outlier SNPs. The relative stability of the outcome data was assessed and validated at multiple levels by various statistical tests including pleiotropy test, heterogeneity test, and Steiger test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study established a causal relationship between mitochondrial biological function and IBD, including its subtypes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70257","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869165","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":"Elobixibat Improves Stool/Gas Distribution and Fecal Bile Acids in Older Adults With Chronic Constipation","authors":"Noriaki Manabe,&nbsp;Emiko Bukeo,&nbsp;Takako Konishi,&nbsp;Maki Ayaki,&nbsp;Minoru Fujita,&nbsp;Ken Haruma","doi":"10.1002/jgh3.70223","DOIUrl":"https://doi.org/10.1002/jgh3.70223","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bowel stool and/or gas distribution is an important indicator of bowel function. The mean colonic transverse diameter of the colon and rectum (constipation index) is a stool and/or gas distribution parameter assessed via transabdominal ultrasonography and an indirect indicator of colonic transit time. Elobixibat, an ileal bile acid transporter inhibitor, increases the number of bowel movements in chronic constipation (CC) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To determine whether the constipation index changes following treatment with elobixibat and evaluate the relationship between changes in the constipation index and fecal bile acid concentration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective, randomized, double-blind, placebo-controlled trial in 17 CC patients aged ≥ 60 years who were administered elobixibat or placebo daily for 1 week. Changes in stool and/or gas distribution and stool bile acid concentrations were analyzed before and after treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Elobixibat, but not placebo, significantly reduced the constipation index. A significant negative correlation was found between the change in the constipation index and the change in total fecal bile acid concentration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elobixibat increases the total fecal bile acid concentration of CC patients, which results in shortened colonic transit time.</p>\u0000 \u0000 <p><b>Trial Registration:</b> JRCT ID: jRCTs061200030; https://rctportal.niph.go.jp/en/detail?trial_id=jRCTs061200030</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861583","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 Clinical Trial to Evaluate the Safety and Efficacy of Centella asiatica for Ulcerative Colitis","authors":"Xiangning Guo,&nbsp;Hirosumi Suzuki,&nbsp;Taku Sawafuji,&nbsp;Satoshi Fukuda,&nbsp;Takeshi Yamada,&nbsp;Mariko Kobayashi,&nbsp;Hideo Suzuki,&nbsp;Shintaro Akiyama,&nbsp;Bryan J. Mathis,&nbsp;Hitomi Kawai,&nbsp;Daisuke Matsubara,&nbsp;Kiichiro Tsuchiya","doi":"10.1002/jgh3.70258","DOIUrl":"https://doi.org/10.1002/jgh3.70258","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We previously reported that telomerase activator <i>Centella asiatica</i> (CA) can normalize the crypt structure of human colonic organoids in an ulcerative colitis (UC) model. Therefore, we aimed to evaluate the safety and efficacy of CA for UC in a clinical trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>Ten patients with mild UC were recruited. Patients received 500 mg of oral CA extract tablets once daily for 12 weeks. Safety and efficacy were monitored based on clinical manifestations, biomarkers, endoscopic findings, histopathological findings, and telomere length. Among 10 patients, one patient withdrew due to the relapse of UC. No adverse events were identified during the medication in the remaining nine patients. One patient showed a Partial Mayo Score (pMayo) decrease from 1 to 0, while the remaining eight pMayo scores remained at 0 before and after treatment. CRP, ESR, and leucine-rich alpha 2 glycoprotein (LRG) levels remained unchanged throughout treatment. Two patients showed endoscopic improvement. The other two patients showed histological improvement. Among five patients, relative telomere length of the rectum remained unchanged by treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CA is safe for patients with UC. Longer treatment durations and larger participant pools are required to assess CA efficacy on histological healing in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861584","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}