Arab Journal of Gastroenterology最新文献

{"title":"Role of gut microbiota modulation in preventing and treating sarcopenia in patients with liver cirrhosis: A narrative review.","authors":"Minyuan Yang, Tianyu Liu, Yang Qin, Rui Cai, Xiaoqin Yang, Chuandong Tang","doi":"10.1016/j.ajg.2026.03.005","DOIUrl":"https://doi.org/10.1016/j.ajg.2026.03.005","url":null,"abstract":"<p><p>Sarcopenia, a common and serious complication in patients with liver cirrhosis, is associated with high morbidity and mortality. Accumulating evidence highlights the gut-liver-muscle axis as a key regulatory pathway underlying muscle wasting in cirrhosis, with disruptions in the gut microbiome taking center stage. This review systematically summarizes the mechanisms by which gut microbiota dysregulation contributes to sarcopenia in cirrhosis, examining how compromised intestinal integrity, inflammatory responses, and disrupted metabolism of key compounds, such as short-chain fatty acids, branched-chain amino acids, and bile acids, play pivotal roles in this pathological process. We also critically examine the scientific evidence supporting approaches that target gut microbiome health, aiming to provide a comprehensive and up-to-date overview for clinicians and researchers.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elastography as a diagnostic tool for assessment of liver stiffness in children with cystic fibrosis.","authors":"Noha A Yassin, Eman M Radi, Yasmine Gaber, Ayman Yosry, Shereen Abdel Alem, N Elbasha","doi":"10.1016/j.ajg.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.ajg.2026.03.004","url":null,"abstract":"<p><strong>Background and study aims: </strong>Cystic fibrosis-associated liver disease (CFLD) is a leading cause of mortality. There is no specific test for CFLD diagnosis. Elastography is a noninvasive imaging method for assessing chronic liver disease. We aim in this work to assess the degree of liver stiffness in children with CF using transient elastography (TE).</p><p><strong>Patients and methods: </strong>This cross-sectional study involved 50 children with CF during their outpatient care and 25 healthy children as a control group. Recruitment started in December 2020 until January 2021 because of the COVID-19 pandemic, then resumed from June 2021 till June 2022. The study included a clinical picture, biochemical analysis, and liver stiffness measurement (LSM) using TE (FibroScan).</p><p><strong>Results: </strong>Abnormal elastography was reported in 8% of CF children. Mean liver stiffness (LS) byTE was non significantly higher among CF cases when compared with controls (Mean ± SD: 4.9 ± 3.86 Kpa vs 3.85 ± 0.64 Kpa) (P = 0.326). LSM significantly positively correlated with age (r = 0.409; p = 0.003). AST to platelet ratio index (APRI) was significantly higher among patients with CF than control (P < 0.001). Cystic fibrosis liver disease (CFLD) was diagnosed in 8/50 patients (4%).</p><p><strong>Conclusion: </strong>Transient elastography can be used to assess liver diseases in patients with CF. AST and ALT do not correlate with LSM.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Helicobacter pylori seroprevalence among asymptomatic populations: Present findings and past evidence.","authors":"Ismail Zeb, Shabnam Ibrahim, Hadia Shaukat, Muneeba Naeem, Tajalla Ikram, Tanzil Ur Rahman, Ghulam Nabi, Ahsan Saidal, Mustajab Ghani, Majid Alhomrani, Walaa F Alsanie, Abdulhakeem S Alamri, Manal F Elkhadragy","doi":"10.1016/j.ajg.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.ajg.2026.03.001","url":null,"abstract":"<p><p>Helicobacter pylori is a gram-negative bacterium infecting >50% of the world's population and is endemic in Pakistan, however reports on asymptomatic individuals are limited. The present study investigated the prevalence and associated risk factors of H. pylori infection in asymptomatic humans of Khyber Pakhtunkhwa Province in Pakistan, and an overview of previous records in Pakistan. Asymptomatic individuals (n = 600) of age ranges 12-75 years were interviewed using a structured questionnaire, and blood samples were taken for serological assay. The overall prevalence of H. pylori infection was 45% (270/600), significantly higher in males (157, 58%) than females (113, 42%) (P = 0.0003), and peaked in the 31-50 year's (145, 54%), with lowest prevalence in 11-30 year's age group (43, 16%) (P = 0.0001). Marital status was significantly correlated with the infection (P = 0.0001). Higher prevalence was observed in the lower socioeconomic class (170, 63%) compared to middle (90, 33%) and upperclass (10, 4%) (P = 0.0112). Risk was high in tap water (120, 44%) and well water drinkers (105, 39%) (P < 0.0001). A non-significant association of infection was observed among the smokers (75, 28%) and non-smokers (195, 72%) (P = 0.7608). Awareness level and education showed strong association, with infection higher in illiterates (143, 53%) and the lowest prevalence was found in individuals with higher education (23, 9%) (P < 0.0001). Spatially, the infection was high in Swat (55, 20%), followed by Upper Dir, Lower Dir, and Buner (each 34, 13%), Malakand and Shangla (26, 10%), and Chitral (21, 8%) (P < 0.05). Nationally, reported prevalence varies widely from <10% in selected groups to >80% in high-risk cohorts, with high infection rates in Karachi, Quetta, Peshawar, Islamabad, and Abbottabad. Serological assays are frequently used; however, histopathology, stool antigen test, and^13C-urea breath tests are sensitive and accurate for confirming active infection across Pakistan. Preventive measures on an urgent basis should be taken by the health authorities to diagnose and treat the infection at a very early stage.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myelin-oligodendrocyte glycoprotein antibody-associated disease in Crohn's disease: an exceptional neurological manifestation.","authors":"Meriem Charifi, Adel Rechach, Mahrez Fissah, Lamia Bengherbia, Mohamed Ouamer Belkacemi, Selma Kesraoui, Ahcene Chibane","doi":"10.1016/j.ajg.2026.02.009","DOIUrl":"https://doi.org/10.1016/j.ajg.2026.02.009","url":null,"abstract":"<p><p>Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare demyelinating syndrome of the central nervous system (CNS). Its association with other autoimmune diseases is uncommon. We present a unique case of MOGAD in a 53-year-old man with Crohn's disease, highlighting significant diagnostic challenges. The patient had been diagnosed with Crohn's disease one year prior, with azathioprine treatment that was ineffective. He underwent surgery for ileal stenosis and an incidental hepatic hydatid cyst. Six weeks later, he developed bilateral optic neuritis and acute myelitis with significant neurologic deficits. After a thorough diagnostic workup and exclusion of other etiologies, including multiple sclerosis and neuromyelitis optica spectrum disorder (NMOSD), MOG-IgG seropositivity supported the diagnosis. Immediate high-dose corticosteroid therapy resulted in almost complete recovery of visual and motor functions. This case report highlights the importance of considering rare entities such as MOGAD in patients with Crohn's disease who present with severe, simultaneous bilateral optic neuritis and myelitis, a core clinical phenotype of MOGAD, even when some imaging features (e.g., orbital MRI) are atypical. Early diagnosis and appropriate management can significantly improve outcomes, as seen in this patient.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-195 mimic, a new therapeutic strategy for suppressing CDK6 expression and progression of hepatocellular carcinoma: a pilot study.","authors":"Tayyaba Wali, Saima Ejaz, Shan E Zahra, Mian Abdur Rehman Arif, Fatma Hussain, Muhammad Shahid, Muafia Baigum, Atiqa Nudrat, Fariha Naz, Saadiya Zia","doi":"10.1016/j.ajg.2026.03.003","DOIUrl":"https://doi.org/10.1016/j.ajg.2026.03.003","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC), a leading cause of death worldwide, is primarily caused by uncontrolled cellular proliferation, invasion and metastasis leading to tumor development in the liver. miR-195 regulates G1 to S phase transition in the cell cycle by targeting CDK6. In the current study, expression of miR-195 was significantly reduced while that of CDK6 was upregulated in HCC patients. The results of expression analysis were supported by the Pearson correlation coefficient indicating a moderate negative (r = -0.459, p = 0.02) relation between miR-195 and CDK6. However, the association of miR-195 and CDK6 with age and sex was not statistically significant. The predicted secondary and tertiary structures of miR-195 showed the presence of loops, stems, and flanking regions. Further, in silico analysis identified potential amino acid residues in CDK6, CDK4 and Cyclin D1 proteins interacting with the miR-195. We designed a mimic RNA of miR-195 by mutagenesis at 4 points. The mimic RNA_3 of miR-195 presented a well-defined stable structure showing strong binding interactions with CDK4 and Cyclin D1 and comparable interactions with CDK6. In conclusion, our study has demonstrated the potential of using miR-195 mimic RNA as a therapeutic strategy to target the CDK6 gene in HCC with reduced miR-195 expression.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence on \"A. Changes in liver stiffness and non-invasive markers in chronic hepatitis C virus patients with and without HIV co-infection following interferon-free antiviral treatment\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1016/j.ajg.2026.02.004","DOIUrl":"https://doi.org/10.1016/j.ajg.2026.02.004","url":null,"abstract":"","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mutational and transcriptional status of RYR in CRC and its indication for prognosis.","authors":"Jiangping Hu, Minxuan Peng, Qi Ou, Yi Zhou","doi":"10.1016/j.ajg.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.ajg.2026.03.002","url":null,"abstract":"<p><p>Aberrant calcium signaling, particularly the ryanodine receptor (RYR) signaling, is linked to cancer development. Currently, little is known about the status of RYR in colorectal cancer (CRC), and the correlation of RYR with CRC phenotypes remains unclear. We analyzed genetic alterations in RYRs using data from 587 patients with CRC in the TCGA database. Mutations were spread across RYR channels without identified hotspot mutations. RYR2 exhibited the highest mutation frequency (59%), with mutually exclusive mutations between RYR2 and RYR1/RYR3. RYR2 revealed significantly elevated transcription in CRC tissues, while RYR1 and RYR3 revealed decreased transcription. Patients with RYR mutations had higher tumor mutational burden (TMB). Stage-related differences in RYR1 and RYR2 transcription were detected. Although age was correlated with RYR1 mutation status, no significant differences in age or BMI were found between patients with low and high RYR transcription. Age, clinical stage, and tumor location were identified as prognostic factors, with age, clinical stage, and location being independent risk factors. In conclusion, RYRs exhibited variable mutational and transcriptional profiles in CRC, with RYR2 revealing unique patterns. Age, clinical stage, and tumor location represent independent risk factors in CRC with RYR mutations.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatitis due to afferent loop syndrome: A case report and a brief review of the literature.","authors":"Diğdem Özer Etik, Selçuk Dişibeyaz, Enis Hikmet Özmert","doi":"10.1016/j.ajg.2026.02.003","DOIUrl":"https://doi.org/10.1016/j.ajg.2026.02.003","url":null,"abstract":"<p><p>Afferent loop syndrome (ALS) should be a part of the differential diagnosis in a patient with acute pancreatitis with a history of gastric surgery. Although it is a rare clinical entity, association of ALS with acute pancreatitis can lead to poor clinical outcomes. Herein, we report the case of a 41-year-old man with a history of subtotal gastrectomy and Roux-en-Y gastric bypass who presented with abdominal pain and tenderness. Treatment of choice in this case was purely medical. A brief review of similar cases in the literature highlights the wide array of etiologies of acute pancreatitis due to ALS and reveals a broad spectrum of treatment options from medical to surgical.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-barreled drug-induced liver injury and the unmasking of latent primary biliary cholangitis: A case of amoxicillin-clavulanate and warfarin interaction.","authors":"Omkolsoum Alhaddad, Maha Elsabaawy, Manar Samara, Karim Wagdy, Hala Elsisy, Nermine Ehsan, Hanaa Badran, Imam Waked","doi":"10.1016/j.ajg.2026.02.006","DOIUrl":"https://doi.org/10.1016/j.ajg.2026.02.006","url":null,"abstract":"<p><strong>Background: </strong>Drug-induced liver injury (DILI) remains a diagnostic challenge, particularly in the setting of polypharmacy. Amoxicillin-clavulanate is the most frequent cause of idiosyncratic DILI worldwide, typically producing a delayed cholestatic pattern. Warfarin-associated hepatotoxicity is rare but recognized, and coadministration of potentially hepatotoxic or interacting agents may exacerbate hepatic injury or coagulopathy.</p><p><strong>Case presentation: </strong>A 60-year-old woman with atrial fibrillation on long-term warfarin therapy presented with progressive jaundice two weeks after completing a 10-day course of amoxicillin-clavulanate for otitis media. Laboratory tests revealed marked hepatocellular injury (ALT 2023 U/L [ULN 45], AST 2194 U/L [ULN 40], bilirubin 6 mg/dL [ULN 1.2], INR 7). Viral hepatitis serologies, including hepatitis E, were negative. Autoimmune testing showed ANA 1:640, AMA 1:80, ASMA 1:80, and elevated IgG (3000 mg/dL). Liver biopsy demonstrated features of resolving hepatocellular and canalicular damage on a background of early primary biliary cholangitis (PBC). Warfarin withdrawal and vitamin K administration normalized INR and improved liver enzymes.</p><p><strong>Conclusion: </strong>This case illustrates a multifactorial liver injury wherein amoxicillin-clavulanate served as the primary hepatotoxin, with possible warfarin-related hepatotoxicity and coagulopathy superimposed on latent PBC. It emphasizes the need for vigilance when prescribing interacting with or hepatotoxic agents to patients on chronic anticoagulation. The case further demonstrates the supportive-but not definitive-role of RUCAM in polypharmacy-related DILI assessment, reinforcing the primacy of comprehensive clinical judgment.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of senna-based laxatives' candies: A cross-sectional study on constipation management.","authors":"Simrah Malik","doi":"10.1016/j.ajg.2025.12.003","DOIUrl":"https://doi.org/10.1016/j.ajg.2025.12.003","url":null,"abstract":"<p><strong>Background and study aims: </strong>Constipation is the most common gastrointestinal disorder, significantly imposing a substantial economic burden and impacting quality of life. The prevalence of constipation in Pakistan is 16.1%, indicating increased need of management within the Pakistani population. Therefore, this study aimed to develop a herbal candy and to evaluate the awareness, practices, usage patterns, and sensory perception of laxative for constipation management.</p><p><strong>Patients and methods: </strong>An observational cross-sectional study was conducted from 2024 to 2026. A total of 386 participants were selected for the study to determine the efficacy of laxative candy in relieving constipation. Approval for the study was granted by the Local Research Ethics Committee of the University. However, appropriate statistical tests were used to analyze the data collected.</p><p><strong>Results: </strong>The study results revealed that 57.4 % of participants took treatment measures for constipation. For one month, 34.6 % used sennative and 59.4 % experienced constipation relief for 3-4 days. For its taste and effectiveness the product was positively rated. A total of 70 % participants found laxative candies more effective than previous treatments. However, 19.9 % participants reported side effects having abdominal pain and cramps. Whereas, 79.8 % reported the product safe. Further, the correlation analysis revealed strong associations laxatives (r = 1.000, p < 0.01), and 74.9 % were willing to recommend the product.</p><p><strong>Conclusion: </strong>For relieving constipation, sennative observed to be an effective and well-tolerated option. Further, research is needed to evaluate efficacy in broader populations and long-term safety.</p>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}