JGH Open最新文献

{"title":"The Efficacy of Lubiprostone in Patients of Constipation: An Updated Systematic Review and Meta-Analysis","authors":"Umar Akram,&nbsp;Obaid Ur Rehman,&nbsp;Eeshal Fatima,&nbsp;Zain Ali Nadeem,&nbsp;Omer Usman,&nbsp;Waqas Rasheed,&nbsp;Ramsha Ali,&nbsp;Khawaja Abdul Rehman,&nbsp;Abdulqadir J. Nashwan","doi":"10.1002/jgh3.70070","DOIUrl":"10.1002/jgh3.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"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}

{"title":"Portal-Vein Compression Caused by Double-Pigtail Plastic Biliary Stent","authors":"Shinsuke Akiyama,&nbsp;Masaya Wada,&nbsp;Tetsuro Inokuma","doi":"10.1002/jgh3.70094","DOIUrl":"10.1002/jgh3.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Reports of pseudoaneurysms associated with biliary self-expandable metallic stent (SEMS) placement have been increasing. Recently, cases of hepatic pseudoaneurysm rupture caused by double pigtail plastic stents (DPS) have also been reported. The symptoms of pseudoaneurysms are often non-specific, and many cases are diagnosed only after rupture. Therefore, early detection and appropriate treatment are required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 45-year-old woman presented with obstructive jaundice caused by pancreatic head cancer, with imaging revealing common bile duct stenosis and intrahepatic bile duct dilation. Endoscopic retrograde cholangiopancreatography (ERCP) was performed to place a DPS in the left hepatic duct, relieving jaundice. However, follow-up contrast-enhanced computed tomography (CE-CT) revealed differences in arterial-phase blood flow between the liver lobes without reduction in portal vein blood flow. Therefore, the compression and stenosis of the left branch of the portal vein caused by the DPS were clearly identified using three-dimensional computed tomography (3D-CT). The DPS was replaced with a straight-type stent, preventing further complications. The patient subsequently underwent successful pancreaticoduodenectomy without any surgical complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is a case of portal vein compression caused by double-pigtail plastic biliary stent. By promptly recognizing the differences in arterial-phase blood flow between the liver lobes and replacing the DPS with a straight-type plastic stent, complications, such as portal vein pseudoaneurysm formation, rupture, embolism, or thrombosis, were successfully avoided.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013888","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":"Significance of Endoscopic Redness of Duodenum in Health Checkup","authors":"Atsushi Nakayama,&nbsp;Motohiko Kato,&nbsp;Yoshiki Sakaguchi,&nbsp;Yu Takahashi,&nbsp;Shinya Kodashima,&nbsp;Ai Fujimoto,&nbsp;Nobutake Yamamichi,&nbsp;Kazumasa Miki,&nbsp;Naohisa Yahagi","doi":"10.1002/jgh3.70096","DOIUrl":"10.1002/jgh3.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>It is important for endoscopist to diagnose the lesion redness. In this study, we focused on the redness of duodenal bulb. We objectively analyzed the changes in redness of the duodenal bulb using linked color imaging (LCI) with chromatic indicators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seven endoscopists observed the duodenal bulb with white light imaging (WLI) and LCI, and evaluated them by visual analogue scale (VAS) for the degree of redness. The difference in VAS between WLI and LCI was defined as ΔVAS. All images were quantified by the Comission Internationale de l'Eclariage-<i>L</i>*<i>a</i>*<i>b</i>* color space. Values related to color differences (Δ<i>E</i>*, Δ<i>L</i>*, Δ<i>a</i>*, and Δ<i>b</i>*) were calculated from the two images of WLI and LCI. Multiple regression analysis was performed for the factors with the health checkup correlated with ΔVAS and the correlation between ΔVAS and Δ<i>E</i>*, Δ<i>L</i>*, Δ<i>a</i>*, and Δ<i>b</i>* was also examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis prospectively included 1144 examinees. In multiple regression analysis, it revealed that sex (<i>β</i> = 0.5847, <i>p</i> &lt; 0.0001) and metabolic syndrome (<i>β</i> = 0.4138, <i>p</i> = 0.0012) were the factors independently influenced ΔVAS. And only Δ<i>a</i>*, a chromatic index for changes in the degree of redness, showed a statistically and considerably positive correlation with ΔVAS (<i>r</i> = 0.4529, <i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To evaluate the difference in the degree of redness between WLI and LCI of duodenal bulb in esophagogastroduodenoscopy may help in early detection of metabolic syndrome, which rarely has symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980207","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 Digital Rectal Examination Identify the Subtype of Dyssynergic Disorders as Well as High Resolution Anorectal Manometry?","authors":"Philippe Onana Ndong,&nbsp;Karine Baumstarck,&nbsp;Véronique Vitton","doi":"10.1002/jgh3.70097","DOIUrl":"10.1002/jgh3.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Diagnosing dyssynergic disorders (DD) often requires 3D high-definition anorectal manometry (3D-HRAM), raising concerns about cost, availability, and delayed referral. Digital rectal examination (DRE) offers a reliable, cost-effective alternative for DD diagnosis. This study aimed to assess DRE's capability to classify DD patients into the four subtypes outlined in Rao's classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective monocentric study involved patients diagnosed with DD through 3D-HRAM. After initial 3D-HRAM performed by one physician, patients underwent a clinical examination, including DRE by a second senior clinician blinded to DD subtypes. Statistical tests measured the correlation between DRE and HRAM in classifying the four DD subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 200 patients, revealing commendable overall agreement between DRE and 3D-HRAM (Kappa = 0.658). For subtype diagnosis, correlation was substantial for Subtypes I, II, and IV (0.679, 0.741, 0.649, respectively) and moderate for Subtype III (Kappa = 0.325).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>DRE demonstrates satisfactory performance in diagnosing the four subtypes of DD. Enhanced training in DRE, emphasizing functional information, has the potential to reduce reliance on additional tests, thereby mitigating economic and organizational impacts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972567","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 Impact of Circadian Preferences on Quality of Life in Patients With Gastroesophageal Reflux Disease: An Evaluation Using the SF-36","authors":"Uğur Ergün,&nbsp;Ahmet Güleç,&nbsp;Taner Buğra Tan","doi":"10.1002/jgh3.70086","DOIUrl":"10.1002/jgh3.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Aims</h3>\u0000 \u0000 <p>Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that negatively impacts individuals' quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study investigates the effect of circadian preferences on the quality of life in patients with GERD. A total of 152 participants (80 patients diagnosed with GERD and 72 healthy controls) were included in the study. Participants' circadian preferences were assessed using the morningness-eveningness questionnaire (MEQ), quality of life was evaluated with the SF-36 scale, and the severity of GERD symptoms was measured using the gastroesophageal reflux disease quality of life scale (GERD-QOL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study's findings indicate that the quality of life and circadian preferences of GERD patients differ significantly from those of the control group. Correlation analyses revealed a positive relationship between SF-36 and MEQ, but no direct relationship was found between GERD-QOL and SF-36 or MEQ. Mediation analyses demonstrated that the effect of GERD-QOL on SF-36 is entirely mediated by circadian preferences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results highlight the significant impact of circadian preferences on the quality of life in GERD patients, suggesting that individuals with an evening chronotype may have lower quality of life. Our study contributes to the literature as one of the first to suggest that circadian preferences should be considered in the management of GERD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972579","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":"Relationship Between Patient Demographics and Biologic Therapy Use in Inflammatory Bowel Disease. A Single Center Cross-Sectional Study","authors":"Mohammad Shehab,&nbsp;Abdulwahab Alsayegh,&nbsp;Munirah Alabdulhadi,&nbsp;Shahed Snober,&nbsp;Nouf Aleissa,&nbsp;Ahmad Alfadhli","doi":"10.1002/jgh3.70092","DOIUrl":"10.1002/jgh3.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Biologic therapies treat patients with moderate to severe inflammatory bowel disease (IBD). This study aims to investigate the demographics of biologic therapy use and its association with patient characteristics, a topic that has not yet been thoroughly assessed in our region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Electronic health record data from June 1, 2021, to May 31, 2023, were collected at a tertiary care IBD center in Kuwait. The primary outcome of this single-center cross-sectional study was to assess the demographics of use of various biologic therapies among patients with IBD. The secondary outcome was to assess whether the type of biologic therapy differed based on gender, age, and IBD type.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 513 patients using biologic therapy in this study, there were 210 (40.9%) on adalimumab (ADL), 154 (30.0%) on infliximab (IFX), 112 (21.9%) on ustekinumab (UST), and 33 (6.4%) on vedolizumab (VDZ). Patients taking VDZ were more likely to have ulcerative colitis (UC) (<i>p</i> &lt; 0.001) and were more likely to be over 30 years old (<i>p</i> &lt; 0.001). In contrast, patients on UST were less likely to be over 30 (<i>p</i> = 0.011) and more likely to have Crohn's disease (CD) (<i>p</i> &lt; 0.001). In addition, patients on ADL were more likely to have Crohn's disease (<i>p</i> = 0.003), as were patients on IFX (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients taking VDZ were more likely to have UC and be over 30 years of age, while those on UST were more likely to be under 30 years of age and to have CD. Additionally, patients on ADL and IFX were more likely to have CD. This study highlighted the need for further research evaluating physicians' preferences and the effectiveness of different biological therapies in patients with IBD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972573","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":"Trend of Representation of Women in Gastroenterology, Hepatology, and Endoscopy Conferences in Asia","authors":"Jalpa Devi,&nbsp;Tanyaporn Chantarojanasiri,&nbsp;Dao Viet Hang,&nbsp;Rashid Lui,&nbsp;Raja Affendi Raja Ali,&nbsp;Amna Subhan Butt,&nbsp;Rohan Raja,&nbsp;Trinh To Tram,&nbsp;Ting Ting Chan,&nbsp;Women in GI Focus Group, Emerging Leaders Committee, Asian Pacific Association of Gastroenterology","doi":"10.1002/jgh3.70080","DOIUrl":"10.1002/jgh3.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Despite progress in promoting gender equality, gender bias remains a significant obstacle for women and hinders their academic advancement. We aim to survey and critically analyze women's representation in conferences and changes over time in various regions of Asian countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An international survey was conducted with representatives from East Asia (Hong Kong, China, and Japan), South Asia (India and Pakistan), and Southeast Asia (Vietnam and Thailand). The survey collected data on faculty members serving as chairpersons, moderators, speakers, and organizing committee members of annual scientific meetings held between 2018 and 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 33 conferences were held between 2018 and 2022: 24 in gastroenterology, 5 in hepatology, and 4 in endoscopy across East, South, and Southeast Asia, respectively. The total number of invited faculty members was 4106. Out of 4106, the number of women involved as chairperson, moderator, speakers, and organizing committee was 105, 78, 290, and 146, respectively. The representation of women faculty ranged from 3.8% to 25% in East Asia, 9.2% to 13.5% in South Asia, and 11.8% to 34.3% in Southeast Asia. Overall, the increase in women's participation was minor and statistically non-significant. However, there was an increase of women's participation as chairpersons, moderators, speakers, and organizing committee members from 14.1% in 2018 to 15.2% in 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Participation of women in Asian annual conferences in the capacity of chairperson, moderator, speaker, and/or organizing committee member was significantly under-represented. This under-representation necessitates targeted measures to enhance women's roles in these meetings, thereby supporting their career advancement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956549","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":"Editorial: The Role of Esophageal Manometry in Diagnosing Achalasia and Esophageal Motility Disorders: Challenges and Advances","authors":"Kee Huat Chuah","doi":"10.1002/jgh3.70093","DOIUrl":"10.1002/jgh3.70093","url":null,"abstract":"&lt;p&gt;Achalasia is a condition associated with significant morbidity and mortality. Among patients with achalasia, esophageal cancer, and pneumonia have been identified as carrying high mortality risks, with hazard ratios of 8.82 and 2.28, respectively [&lt;span&gt;1&lt;/span&gt;]. Despite these risks, the diagnosis of achalasia is often overlooked. Although a German study demonstrated that the delay from symptom onset to diagnosis has shortened from 35 months to 20 months over 15 years, a diagnostic delay of nearly 2 years remains a cause for concern [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In this context, two large retrospective studies on consecutive patients undergoing esophageal manometry, conducted by Ghoshal et al. in India [&lt;span&gt;3&lt;/span&gt;] and Abbass et al. in Pakistan [&lt;span&gt;4&lt;/span&gt;], are particularly timely. The spectrum of manometric diagnoses varied across countries, but the frequency of achalasia was high: 56% in India and 55.9% in Pakistan. In Malaysia, 50.1% of patients with non-obstructive dysphagia were diagnosed with achalasia (Table 1) [&lt;span&gt;5&lt;/span&gt;]. Taken together, these findings suggest that achalasia is not uncommon in selected populations, particularly among patients presenting with dysphagia.&lt;/p&gt;&lt;p&gt;Interestingly, most patients with achalasia in India and Malaysia were classified as Type II, while those in Pakistan were predominantly Type I. Symptom duration before diagnosis averaged 18 months for patients under 60 years and 36 months for those over 60 years in India, whereas in Pakistan, it could extend as long as 8 years [&lt;span&gt;3-5&lt;/span&gt;]. This prolonged duration in Pakistan may explain the higher prevalence of Type I achalasia, as Type I represents disease progression from Type II over time.&lt;/p&gt;&lt;p&gt;These findings highlight significant gaps in the timely diagnosis of achalasia. Greater education for clinicians to improve early detection and referral to tertiary centers is essential. Equally important is encouraging patients to seek medical consultation early. In line with these goals, the Malaysian Society of Gastroenterology and Hepatology and the Malaysian Upper Gastrointestinal Surgical Society have collaborated to highlight, recommend, and standardize the approach to managing patients with achalasia and esophagogastric junction outflow obstruction [&lt;span&gt;6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Treatment options resulting in good symptom improvement for achalasia are available. With the advent of newer treatment options, including peroral endoscopic myotomy (POEM), treatment outcomes have improved further. POEM has been found to be superior to pneumatic dilation for all types of achalasia and even better than Heller's myotomy for Type III achalasia [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Studies from India [&lt;span&gt;3&lt;/span&gt;] and Malaysia also reported that ineffective esophageal motility (IEM) was the second most common diagnosis after achalasia (Table 1). IEM is commonly associated with GERD and was reported in up to 38% of patients with abnormal esophageal acid exposure [&lt;span&gt;8&lt;/spa","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956523","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":"Relationship Between Adenoma Detection Rate and Respective Withdrawal Time in Different Colon Segments: A Retrospective, Single-Center Study","authors":"Xujin Chen,&nbsp;Bingxin Xu,&nbsp;Bingni Wei,&nbsp;Lin Ji,&nbsp;Cheng Yang,&nbsp;Qiang Zhan","doi":"10.1002/jgh3.70095","DOIUrl":"10.1002/jgh3.70095","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background and Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The 6-min withdrawal time for colonoscopy is widely considered the standard of care. However, there may not be appropriate if the 6-min is equally divided into various colon segments. Since the adenoma detection in each colon segment is not the same, there may be differences with the withdrawal time in different colon segments. Our objective was to evaluate the relationships between adenoma detection rate (ADR) and respective withdrawal time in different colon segments.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Outpatients, age range 18–75 years, undertaking complete colonoscopy were enrolled in this study from November 2019 to November 2020 in the digestive endoscopy center. The entire colon was divided into four different segments: ascending colon, transverse colon, descending colon and rectosigmoid colon. The respective withdrawal time and ADR in each colon segment were recorded respectively.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 586 outpatients (279 males, 307 females) enrolled in this study and the general ADR was 38.2%. The positive withdrawal time (adenomas detected) was longer than negative withdrawal time (non-adenomas detected) (334.04 ± 24.21 s vs. 303.65 ± 5.20 s, t = 1.26, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). ADR in ascending colon, transverse colon, descending colon and rectosigmoid colon were respectively 30.5%, 2.9%, 3.1% and 7.5%. While all of their positive withdrawal time were longer than negative withdrawal time (94.34 ± 33.76 s vs. 70.40 ± 41.84 s, &lt;i&gt;t&lt;/i&gt; = 3.31, &lt;i&gt;p&lt;/i&gt; = 0.001; 85.40 ± 49.76 s vs. 71.66 ± 36.87 s, &lt;i&gt;t&lt;/i&gt; = 1.95, &lt;i&gt;p&lt;/i&gt; = 0.025; 80.29 ± 39.85 s vs. 69.73 ± 35.96 s, &lt;i&gt;t&lt;/i&gt; = 1.40, &lt;i&gt;p&lt;/i&gt; = 0.016;100.95 ± 55.92 s vs. 80.96 ± 42.87 s, &lt;i&gt;t&lt;/i&gt; = 3.61; &lt;i&gt;p&lt;/i&gt; &lt; 0.001, respectively). The withdrawal time threshold in the ascending colon, transverse colon, descending colon, rectosigmoid colon determined by receiver operating characteristic (ROC) curve were 77, 61, 56 and 109 s, respectively. In the ascending colon, ADR was significantly higher (47.0% vs. 33.1%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) when the colonoscopy withdrawal time was ≥ 77 s. When the withdrawal time was ≥ 61 s in the transverse colon (42.7% vs. 32.7%, &lt;i&gt;p&lt;/i&gt; = 0.013), ≥ 59 s in the descending colon (42.3% vs. 29.9%, &lt;i&gt;p&lt;/i&gt; = 0.004) and ≥ 109 s in rectosigmoid colon (52.2% vs. 33.9%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), ADR was also significantly higher. After adjusting for age, sex and BMI, Logistic regression analysis showed that withdrawal time ≥ 77 s in the ascending colon (OR, 1.796; 95% CI, 1.273–2.532; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), ≥ 61 s in the transverse colon (OR, 1.535; 95% CI, 1.094–2.155; &lt;i&gt;p&lt;/i&gt;","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956528","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":"Intensified and Accelerated Rescue Infliximab Therapy for Acute Severe Ulcerative Colitis in Pregnancy: A Case Report","authors":"Saiumaeswar Yogakanthi,&nbsp;Timothy Phan,&nbsp;Emma Flanagan,&nbsp;Linda Yang,&nbsp;Chamara Basnayake,&nbsp;Iniyaval Thevathasan,&nbsp;Julien Schulberg","doi":"10.1002/jgh3.70091","DOIUrl":"10.1002/jgh3.70091","url":null,"abstract":"<p>Acute severe ulcerative colitis (ASUC) in pregnancy poses a clinical challenge with significant risk to both mother and fetus. Anti-TNF alpha therapy is known to be safe in pregnancy, however, data surrounding outcomes in ASUC is limited. In this report, we present the case of a pregnant patient of 10 weeks' gestation with ASUC successfully managed with intensified and accelerated infliximab therapy for a total dose of 35 mg/kg during a single admission. This case highlights the use of this therapeutic strategy, as a part of a multidisciplinary approach, to avoid the need for a high-risk colectomy.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956527","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}