Revista de Gastroenterologia de Mexico最新文献

{"title":"Respuesta al comentario del artículo «Recomendaciones de buena práctica clínica en la prescripción y deprescripción de inhibidores de la bomba de protones. Revisión por expertos de la AMG»","authors":"L.R. Valdovinos-García","doi":"10.1016/j.rgmx.2025.06.001","DOIUrl":"10.1016/j.rgmx.2025.06.001","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 3","pages":"Pages 505-506"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frecuencia de adenomas serrados sésiles en pacientes con antecedente de cáncer colorrectal detectados durante colonoscopias de vigilancia","authors":"J.P. Pérez-Macías,&nbsp;J.C. Sánchez-del Monte,&nbsp;A.I. Hernández-Guerrero,&nbsp;W.D. Torrecilla-Ramírez,&nbsp;B.A. Sánchez-Jiménez,&nbsp;G.M. Salgado-Castellón","doi":"10.1016/j.rgmx.2024.11.008","DOIUrl":"10.1016/j.rgmx.2024.11.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Sessile serrated adenomas (SSAs) are precursor lesions of colorectal cancer (CRC) in 15-30% of cases, but due to their subtle characteristics, their endoscopic detection is a challenge. The present work aimed to determine the frequency of SSAs in patients with a history of CRC who underwent index and surveillance colonoscopies after their cancer diagnosis.</div></div><div><h3>Material and methods</h3><div>An observational cohort study was conducted on patients diagnosed with CRC who underwent an index colonoscopy and at least two surveillance colonoscopies at the <em>Instituto Nacional de Cancerología</em> in Mexico City, between January 2015 and December 2018. Demographic and clinical variables and endoscopic findings were analyzed. SSA frequency was calculated as the number of patients with one or more SSAs divided by the total number of patients analyzed. Means were compared for the bivariate inferential analysis and the chi-square test and Fisher's exact test were used for the nominal variable analysis. Logistic regression was carried out to search for factors related to SSA.</div></div><div><h3>Results</h3><div>Four hundred patients were included; the mean patient age was 58<!--> <!-->years and 52% were women. SSA frequency was 5.25%. Thirty-three percent of the SSAs were found in the index colonoscopy and 38% in subsequent colonoscopies. SSAs had a mean size of 5.52<!--> <!-->mm, 84% were classified as Paris Is, 45% as KUDO<!--> <!-->II, and most were located in the ascending or transverse colon (21% and 20%, respectively).</div></div><div><h3>Conclusions</h3><div>SSAs are rare premalignant lesions, and their endoscopic diagnosis is a challenge. Their identification during the follow-up of patients with a history of CRC is essential for reducing the risk of metachronous progression.</div></div>","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 3","pages":"Pages 381-387"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manifestaciones gastrointestinales en amiloidosis hereditaria por transtirretina (AhTTR): reporte de caso","authors":"J.C. Peñafort-Zamora ,&nbsp;A.C. Zamora-García ,&nbsp;H. Hernández-Cortes ,&nbsp;J.A. Pérez-Ríos ,&nbsp;S. Villalon-Ávalos","doi":"10.1016/j.rgmx.2025.03.006","DOIUrl":"10.1016/j.rgmx.2025.03.006","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 3","pages":"Pages 486-488"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuevas herramientas para la clasificación y puntuación de enfermedad por reflujo gastroesofágico","authors":"S. Siboni ,&nbsp;M. Sozzi ,&nbsp;P. Visaggi ,&nbsp;R. De Maron ,&nbsp;E. Asti","doi":"10.1016/j.rgmx.2025.05.005","DOIUrl":"10.1016/j.rgmx.2025.05.005","url":null,"abstract":"<div><div>Gastroesophageal reflux disease (GERD) is a prevalent condition characterized by the retrograde flow of gastric contents into the esophagus, significantly impacting quality of life. Traditional diagnostic approaches often lack precision due to symptom overlap with other conditions. This review introduces the American Foregut Society (AFS) classification, Milan score, pHoenix score, COuGH RefluX score, and Lyon score, five novel tools designed to enhance the objectivity, reproducibility, and clinical relevance of GERD diagnosis.</div><div>The AFS classification refines the endoscopic assessment of esophagogastric junction (EGJ) integrity by incorporating measurable parameters (hiatal hernia length, hiatal aperture diameter, and flap valve), overcoming the subjectivity of the Hill classification. The Milan score, derived from high-resolution manometry, integrates four parameters (ineffective esophageal motility, EGJ-contractile integral, EGJ morphology, and straight leg raise response) to quantify anti-reflux barrier (ARB) disruption.</div><div>The pHoenix score, developed for prolonged wireless pH monitoring, weights supine AET more heavily, addressing limitations of the DeMeester score and Lyon 2.0 consensus. The COuGH RefluX score, a clinical prediction model for laryngopharyngeal symptoms, uses six parameters (cough, obesity, globus, hiatal hernia, regurgitation, male sex) to stratify GERD likelihood. Finally, the Lyon score integrates endoscopic and pH-impedance data, categorizing patients into phenotypes (from no GERD to severe GERD) and predicting treatment outcomes.</div><div>These tools collectively address diagnostic challenges by standardizing assessments and improving patient stratification. By reducing diagnostic ambiguity and guiding personalized therapy, these innovations hold promise for transforming GERD management, particularly in selecting candidates for escalated medical or surgical interventions.</div></div>","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 3","pages":"Pages 412-427"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respuesta a «Trasplante de microbiota fecal en Clostridioides difficile recurrente: ¿es pertinente mayor rigor metodológico y el análisis de otras poblaciones?»","authors":"P. Núñez,&nbsp;R. Quera,&nbsp;C. von Muhlenbrock","doi":"10.1016/j.rgmx.2025.06.002","DOIUrl":"10.1016/j.rgmx.2025.06.002","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 3","pages":"Pages 507-508"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisión sistemática: efecto de los inhibidores de la bomba de protones sobre la fisiología de Helicobacter pylori","authors":"V. Blandón-Arias ,&nbsp;A.M. Ospina-Gil ,&nbsp;B.E. Salazar-Giraldo ,&nbsp;T.L. Pérez-Cala","doi":"10.1016/j.rgmx.2024.12.006","DOIUrl":"10.1016/j.rgmx.2024.12.006","url":null,"abstract":"<div><h3>Introduction and aims</h3><div><em>Helicobacter pylori</em> is a Gram-negative bacillus that colonizes the gastric mucosa and infects more than half of the world population. Treatment consists of two antibiotics and a proton pump inhibitor (PPI) that favors the replication of the bacterium and enhances the activity of the antibiotics. Despite the importance of proton pump inhibitor use in treating <em>H.</em> <em>pylori</em> infection, the precise mechanisms through which PPIs affect the physiology of the bacterium are not yet understood.</div></div><div><h3>Aim</h3><div>Our aim was to compile information pertaining to the effect of PPIs on the physiology of <em>H.</em> <em>pylori</em> and the mechanisms through which they produce alterations in the bacterium.</div></div><div><h3>Methods</h3><div>A bibliographic search was conducted, utilizing the PubMed, Science Direct, and LILACS databases, and included preclinical and clinical original articles published in any language.</div></div><div><h3>Results</h3><div>The sulfenamide form of PPIs was shown to have effects on <em>H.</em> <em>pylori,</em> including the induction of structural changes, inhibition of bacterial growth, and interference with enzymes, such as urease, ATPases, and alcohol dehydrogenase.</div></div><div><h3>Conclusions</h3><div>The binding of the sulfenamide form of PPIs to the bacterial structural and enzymatic components was the main mechanism through which <em>H.</em> <em>pylori</em> physiology was altered <em>in vitro</em>, but how they induce alterations in the bacterium was not established in the clinical studies analyzed.</div></div>","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 3","pages":"Pages 388-399"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melanosis del esófago: una entidad rara","authors":"L.M. Relvas ,&nbsp;S. Barros ,&nbsp;I. Carvalho ,&nbsp;A.J. Cadillá ,&nbsp;F. Velasco","doi":"10.1016/j.rgmx.2025.03.009","DOIUrl":"10.1016/j.rgmx.2025.03.009","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 3","pages":"Pages 489-490"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consenso mexicano sobre abordaje y tratamiento de la hemorragia variceal aguda","authors":"F. Higuera-de-la-Tijera ,&nbsp;A. Noble-Lugo ,&nbsp;J. Crespo ,&nbsp;A. Albillos ,&nbsp;A.J. Montaño-Loza ,&nbsp;A.D. Cano-Contreras ,&nbsp;G.E. Castro-Narro ,&nbsp;L.F. De Giau-Triulzi ,&nbsp;E.S. García-Jiménez ,&nbsp;N.J. Fernández-Pérez ,&nbsp;J.M. Aldana-Ledesma ,&nbsp;O.E. Trujillo-Benavides ,&nbsp;J. Cerna-Cardona ,&nbsp;Y.M. Velasco-Santiago ,&nbsp;E. Cerda-Reyes ,&nbsp;D.K. Tapia-Calderón ,&nbsp;A. Bautista-Santos ,&nbsp;J.L. Pérez-Hernández ,&nbsp;R. Moreno-Alcántar ,&nbsp;J.A. Velarde-Ruiz Velasco","doi":"10.1016/j.rgmx.2025.03.003","DOIUrl":"10.1016/j.rgmx.2025.03.003","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Portal hypertension is the main consequence of cirrhosis and the cause of most of its complications, such as ascites, variceal bleeding, and hepatic encephalopathy. The development of those complications marks the transition from compensated cirrhosis to decompensated cirrhosis, and the latter is associated with poor prognosis. Approximately 50% of cirrhotic patients have gastroesophageal varices. Acute variceal bleeding (AVB) is a medical emergency with high mortality rates ranging from 15 to 25% within 6 weeks. AVB management has evolved in recent years due to new evidence on fluid resuscitation and transfusion support, advances in endoscopic techniques, esophageal stent use, and transjugular intrahepatic portosystemic shunt (TIPS) placement. This consensus aimed to establish recommendations based on the best available evidence and expert opinion from Mexican specialists in gastroenterology for the diagnosis, management, and treatment of AVB in patients with portal hypertension. The goal was to improve clinical decision-making, reduce the associated mortality, and standardize care protocols across the different levels of medical care in Mexico.</div></div><div><h3>Material and methods</h3><div>Seventeen national and 3 international experts were divided into five working groups to address five thematic areas: 1) initial evaluation, 2) fluid resuscitation and initial pharmacologic therapy, 3) the role of endoscopy, 4) strategies for managing failed bleeding control, and 5) secondary prophylaxis recommendations. The consensus was developed utilizing the RAND/UCLA process, with a modified Delphi method.</div></div><div><h3>Results</h3><div>A total of 28 statements were produced, with specific recommendations on initial fluid resuscitation and transfusion strategy, and highlighting the importance of vasopressor use, the role of endoscopy, and AVB prophylaxis.</div></div><div><h3>Conclusions</h3><div>This first Mexican Consensus on Acute Variceal Bleeding establishes practical recommendations for standardizing AVB management in patients with cirrhosis in Mexico, from the initial evaluation to secondary prophylaxis, emphasizing the importance of specific strategies and laying the groundwork for future research.</div></div>","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 3","pages":"Pages 451-473"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comentario al artículo «Recomendaciones de buena práctica clínica en la prescripción y deprescripción de inhibidores de la bomba de protones. Revisión por expertos de la AMG»","authors":"I.J. Salvador ,&nbsp;B.I. Rivera","doi":"10.1016/j.rgmx.2025.04.005","DOIUrl":"10.1016/j.rgmx.2025.04.005","url":null,"abstract":"","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 3","pages":"Pages 503-504"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumores neuroendocrinos gastroenteropancreáticos: un estudio retrospectivo en el suroccidente colombiano","authors":"J.C. Bravo-Ocaña ,&nbsp;N. López-Moreno ,&nbsp;E.D. Salazar-Cardona ,&nbsp;A.F. Mejía-Hurtado ,&nbsp;V. Gutiérrez-Aragón ,&nbsp;M. Gonzáles-Hurtado ,&nbsp;L.A. Satizabal-Mayor ,&nbsp;J.F. Lbasseauny-Morales ,&nbsp;N. Rojas-Rojas ,&nbsp;C.A. Rojas-Rodríguez","doi":"10.1016/j.rgmx.2024.11.006","DOIUrl":"10.1016/j.rgmx.2024.11.006","url":null,"abstract":"<div><h3>Introduction and aim</h3><div>Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare neoplasms originating in neuroendocrine cells from the gastric mucosa and submucosa, small intestine, large intestine, rectum, and pancreas. Our aim was to describe their histopathologic, endoscopic, and clinical characteristics and the experience with these tumors at a tertiary care hospital center in the Colombian Southwest.</div></div><div><h3>Materials and methods</h3><div>A retrospective, analytic, observational, and descriptive study included 93 patients diagnosed with GEP-NETs, within the time frame of 2018 and 2022. Their clinical histories were reviewed to collect the sociodemographic, clinical, endoscopic, pathologic, treatment, follow-up, and survival data.</div></div><div><h3>Results</h3><div>Median patient age was 55.8<!--> <!-->years, and 60.2% were women. A total of 78.5% of the patients presented with symptoms, the most common of which was abdominal pain (78.1%). The tumors were mainly located in the stomach (32.3%) and small intestine (23.7%). Histopathologically, 53.8% of the tumors were grade<!--> <!-->1, 30.1% were grade<!--> <!-->2, 9.68% were grade<!--> <!-->3, and 7.52% were carcinomas. Tumor location was significantly related to stage; the majority of tumors in stage<!--> <!-->I were in the stomach, whereas the stage<!--> <!-->IV tumors were in the small intestine. At the last evaluation, 40.9% of the patients were disease-free, disease was stable in 24.7% and progressive in 11.8%, and 18.3% of the patients died.</div></div><div><h3>Conclusions</h3><div>GEP-NETs are clinically heterogeneous, and their early diagnosis is dependent on the recognition of lesions in endoscopic and imaging studies. Early tumors are mainly located in the stomach and advanced tumors in the small intestine, with metastases in the liver and regional lymph nodes. The present study suggests the importance of disease awareness in the early detection of GEP-NETs; said factor, combined with timely interdisciplinary management, could significantly impact patient outcomes.</div></div>","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 3","pages":"Pages 357-365"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}