Arab Journal of Gastroenterology最新文献

{"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":"10.1016/j.ajg.2025.12.003","url":null,"abstract":"<div><h3>Background and study aims</h3><div>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.</div></div><div><h3>Patients and methods</h3><div>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<em>.</em> 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.</div></div><div><h3>Results</h3><div>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 &lt; 0.01), and 74.9 % were willing to recommend the product.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"27 2","pages":"Pages 160-166"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","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}

{"title":"Elastography as a diagnostic tool for assessment of liver stiffness in children with cystic fibrosis","authors":"Noha A. Yassin ,&nbsp;Eman M. Radi ,&nbsp;Yasmine Gaber ,&nbsp;Ayman Yosry ,&nbsp;Shereen Abdel Alem ,&nbsp;N. Elbasha","doi":"10.1016/j.ajg.2026.03.004","DOIUrl":"10.1016/j.ajg.2026.03.004","url":null,"abstract":"<div><h3>Background and study aims</h3><div>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).</div></div><div><h3>Patients and Methods</h3><div>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).</div></div><div><h3>Results</h3><div>Abnormal elastography was reported in 8% of CF children. Mean liver stiffness (LS) by<!--> <!-->TE 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 &lt; 0.001). Cystic fibrosis liver disease (CFLD) was diagnosed in 8/50 patients (4%).</div></div><div><h3>Conclusion</h3><div>Transient elastography can be used to assess liver diseases in patients with CF. AST and ALT do not correlate with LSM.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"27 2","pages":"Pages 233-238"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","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 ,&nbsp;Shabnam Ibrahim ,&nbsp;Hadia Shaukat ,&nbsp;Muneeba Naeem ,&nbsp;Tajalla Ikram ,&nbsp;Tanzil Ur Rahman ,&nbsp;Ghulam Nabi ,&nbsp;Ahsan Saidal ,&nbsp;Mustajab Ghani ,&nbsp;Majid Alhomrani ,&nbsp;Walaa F Alsanie ,&nbsp;Abdulhakeem S. Alamri ,&nbsp;Manal F. Elkhadragy","doi":"10.1016/j.ajg.2026.03.001","DOIUrl":"10.1016/j.ajg.2026.03.001","url":null,"abstract":"<div><div><em>Helicobacter pylori</em> is a gram-negative bacterium infecting &gt;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 <em>H. pylori</em> 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 <em>H. pylori</em> 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 &lt; 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 &lt; 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 &lt; 0.05). Nationally, reported prevalence varies widely from &lt;10% in selected groups to &gt;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.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"27 2","pages":"Pages 205-212"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","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":"Beyond viral elimination: the emerging epidemic of metabolic dysfunction-associated steatotic liver disease (MASLD)–viral hepatitis overlap","authors":"Rahma Mohamed ,&nbsp;Aya M. Abdelmagid ,&nbsp;Amani M. Ali ,&nbsp;Ahmed M. Kamel ,&nbsp;Ahmed Cordie","doi":"10.1016/j.ajg.2026.02.001","DOIUrl":"10.1016/j.ajg.2026.02.001","url":null,"abstract":"<div><div>Egypt’s landmark success in eliminating HCV and controlling HBV proves that large-scale, coordinated public health strategies can yield transformative results. However, the rising burden of MASLD now threatens these achievements. Confronting this emerging epidemic with the same urgency, innovation, and scale will be critical to safeguarding the gains of the past decade and securing the future of global liver health.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"27 2","pages":"Pages 155-159"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475880","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":"Dropped gallstones during laparoscopic cholecystectomy revealed by perihepatic abscess.","authors":"Myriam Ayari, Sarrah Ben Azouz, Sarra Ben Rejeb, Taieb Jomni","doi":"10.1016/j.ajg.2026.02.007","DOIUrl":"https://doi.org/10.1016/j.ajg.2026.02.007","url":null,"abstract":"","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469860","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":"Effects of gluten-free diet on metabolic syndrome components and anthropometric indices in patients with nonalcoholic fatty liver disease: An open-label randomized clinical trial","authors":"Maziar Jazayeri ,&nbsp;Rasoul Zarrin ,&nbsp;Afshin Mohammadi ,&nbsp;Mohammad Reza Pashaei ,&nbsp;Sajjad Ahmadpour","doi":"10.1016/j.ajg.2025.10.001","DOIUrl":"10.1016/j.ajg.2025.10.001","url":null,"abstract":"<div><h3>Background and study aims</h3><div>There is no approved medication to rescue fat build-up in patients with nonalcoholic fatty liver disease (NAFLD). Some medications have been used to reduce the symptoms of these patients. In the present study, we aimed to investigate the effects of a gluten-free diet (GFD) on hepatic steatosis (HS), the lipid profile, blood pressure (BP), fasting blood sugar (FBS) and anthropometric indices in patients with NAFLD within 3 months of intervention.</div></div><div><h3>Patients and Methods</h3><div>This study is an open-label, randomized clinical trial of 60 patients with NAFLD who were referred to the gastrointestinal (GI) clinic of Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran. Patients were randomly divided into two groups and classified into two groups: group I or the control group (follows lifestyle change training) and group II (follows both lifestyle change training and the GFD. The parameter variations, including body mass index (BMI), FBS, lipid profile, liver function test (LFT), waist circumference (WC), BP and grade of HS, were recorded and compared between the start of the study and 3 months after the intervention. SPSS statistics 25 software was used for data analysis, and the significance level was considered at the level of P &lt; 0.05.</div></div><div><h3>Results</h3><div>After the 3-month intervention, both groups showed significant within-group improvements in most anthropometric and metabolic measures, likely reflecting the impact of lifestyle modification. However, when comparing outcomes between groups, only the FBS and triglyceride (TG) levels were significantly lower in the GFD group than in the control group, whereas the changes in all other parameters were not significantly different between the two groups.</div></div><div><h3>Conclusion</h3><div>In this trial, incorporating a GFD alongside lifestyle change training led to significant improvements in FBS and TG levels, whereas other parameters improved similarly in both groups.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"27 1","pages":"Pages 84-90"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490689","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 factors influencing the therapeutic response and prognosis of stage IV CRC patients undergoing simultaneous resection of primary and liver metastatic lesions and subsequent adjuvant therapy---A pilot study on the prognosis of stage IV CRC","authors":"Chen Shen,&nbsp;Wen Gu,&nbsp;Xiaojun Zhou","doi":"10.1016/j.ajg.2025.09.026","DOIUrl":"10.1016/j.ajg.2025.09.026","url":null,"abstract":"<div><h3>Background</h3><div>Patients with stage IV colorectal cancer (CRC) with liver metastasis represent a specific group that can be treated with surgery. However, the influence of genomic alterations on the therapeutic response and prognosis was not clear in CRC patients underwent simultaneous surgery of primary and metastatic lesions.</div></div><div><h3>Methods</h3><div>Fifty-two patients underwent simultaneous surgery on primary and metastatic lesions were retrospectively recruited. The mutational landscape of primary lesion was established by whole-exome sequencing(WES). Non-parametric test, Fisher’s exact test, multivariate analyses, Kaplan-Meier analyses were performed to identify risk factors for response and prognosis, and a Nomogram model was established. Analyses were performed and figures were plotted using the Graphpad PRISM 5.0 and the R software.</div></div><div><h3>Results</h3><div>Several top mutated genes were identified from the mutational landscape of primary lesions, including APC, TP53, KRAS and TTN, and many co-mutations, mutually exclusive mutations and aberrant functions or pathways were revealed. KRAS(P = 0.047) and TTN(P &lt; 0.001) exhibited significant differences in tumor mutational burden(TMB) between mutant and wild-type groups. TP53(P = 0.045), MUC12(P = 0.012) and CEL(P = 0.032) mutational status significantly stratified the patient therapeutic response, in which MUT12 was an independent risk factor(P = 0.02). CRC location(P = 0.014), patient therapeutic response(P &lt; 0.001), and the mutational status of ANKRD20A4(P = 0.006), EVC(P = 0.05), FHOD3(P = 0.05), MYO15A(P = 0.008) and POTEE(P &lt; 0.001) showed significant stratification on patient prognosis, in which cancer location, response to therapy and ANKRD20A4 and EVC mutational status were independent risk factors. These factors were used to establish a Nomogram model to predict the individual patient prognosis. Internal and external validation verified the effectiveness of the model.</div></div><div><h3>Conclusions</h3><div>Independent risk factors including cancer location, response to therapy and ANKRD20A4 and EVC mutational status were identified and were used in the establishment of a Nomogram model for patient prognosis prediction.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"27 1","pages":"Pages 74-83"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472265","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":"Role of 3D printing in prevention of COVID 19 transmission during high-risk medical procedures: patient worn personal protective equipment","authors":"Mirella Sherif ,&nbsp;Ahmed Khairy ,&nbsp;Mostafa Abdelaziz ,&nbsp;Yasmine Gaber","doi":"10.1016/j.ajg.2025.12.004","DOIUrl":"10.1016/j.ajg.2025.12.004","url":null,"abstract":"","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"27 1","pages":"Page 1"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067980","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":"Assessment of diverse proton pump inhibitor combined with bismuth quadruple regimens and risk factors for Helicobacter pylori eradication in China: A retrospective single-center study","authors":"Xiaolin Zhao,&nbsp;Chanjuan Fan,&nbsp;Mengyuan Yang,&nbsp;Yang Liu,&nbsp;Yaqiong Zhang,&nbsp;Jianping Cheng","doi":"10.1016/j.ajg.2025.12.002","DOIUrl":"10.1016/j.ajg.2025.12.002","url":null,"abstract":"<div><h3>Background and study aims</h3><div>Falling eradication rates of <em>Helicobacter pylori</em> (<em>H. Pylori</em>) have prompted changes in the first-line bismuth-containing quadruple therapy. This study aimed to assess the effectiveness of different proton-pump inhibitor (PPI) based quadruple regimens for <em>H. pylori</em> eradication.</div></div><div><h3>Patients and methods</h3><div>Electronic records were examined to acquire information on <em>H. pylori</em>-positive patients treated with a 14-day bismuth-containing quadruple regimen (PPIs, amoxicillin, clarithromycin, and bismuth). Patient demographics and eradication regimen data were also analyzed. Four groups were formed based on the different PPIs: ilaprazole, esomeprazole, omeprazole, and rabeprazole groups. Eradication rates were calculated, and the effectiveness of the treatment regimens was compared.</div></div><div><h3>Results</h3><div>A total of 2637 patients were included, comprising 1469 males and 1168 females. Of these, 22.4 % (n = 590) were treated with an ilaprazole-based quadruple regimen, 33.8 % (n = 892) with an esomeprazole-based regimen, 16.6 % (n = 439) with an omeprazole-based regimen, and 27.2 % (n = 716) with a rabeprazole-based regimen. Eradication rates were significantly higher in the esomeprazole-based regimen than in the ilaprazole-, omeprazole-, and rabeprazole-based regimens (75.2 % vs. 65.8 % vs. 65.4 % vs. 70.9 %, <em>P</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>The eradication rates across various PPI-based quadruple regimens were comparable; however, the regimen comprising amoxicillin and clarithromycin demonstrated low efficacy and is not advised in settings with high clarithromycin resistance. Among the effective therapeutic regimens, the esomeprazole-based regimen exhibited a slightly higher eradication rate.</div></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":"27 1","pages":"Pages 123-127"},"PeriodicalIF":1.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067972","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}