The American Journal of Gastroenterology最新文献

{"title":"Dupilumab for Eosinophilic Esophagitis in Adolescents and Adults: Real-World Outcomes Across Different Dosing Regimens from the EoE CONNECT Registry.","authors":"Emilio J Laserna-Mendieta,Victoria Úbeda-Vargas,Edurne Amorena,Edoardo V Savarino,Sergio Casabona-Francés,Marina Coletta,Javier Molina-Infante,Isabel Pérez-Martínez,Carlo María Rossi,Emanuele Dilaghi,Danila Guagnozzi,Leonardo Blas-Jhon,Elena Betoré,Sonia Fernández-Fernández,Juan Enrique Naves,Valentín Roales,Stefania Piccirelli,Alicia Granja-Navacerrada,Raúl Honrubia-López,Laura Martín-Asenjo,Gaia Pellegatta,Anne Lund Krarup,Diana Zaffalon,Silvia Patricia Ortega-Moya,Julia Nicolay-Maneru,Daria Maniero,Elena Resina,Roberto Penagini,Matteo Ghisa,Óscar Nantes-Castillejo,Ángel Arias,Cecilio Santander,Alfredo J Lucendo","doi":"10.14309/ajg.0000000000004088","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004088","url":null,"abstract":"BACKGROUNDReal-world data on dupilumab for eosinophilic esophagitis (EoE), particularly regarding flexible dosing and fibrostenotic phenotypes, are scarce.OBJECTIVETo evaluate the effectiveness and safety of dupilumab in clinical practice using the EoE CONNECT registry.METHODSThis cross-sectional analysis included all patients prospectively recruited in the largest European multicenter EoE registry. Baseline characteristics, dosing regimens (300 mg weekly vs. semi-weekly), clinico-histological response (CHR), dose adjustments, and treatment tolerability were assessed.RESULTSWe analyzed 161 patients (145 adults; 16 adolescents). At baseline, 69.1% of patients displayed endoscopic fibrotic features (rings/strictures). After a median of 6.5 months, peak eosinophil count decreased from 57±45 to 8±19 eos/hpf, EREFS score declined from 3.0±1.6 to 1.3±1.3, and DSS improved from 5.8±3.7 to 2.5±2.8 (all p<0.001). CHR was achieved by 86.0% of patients on 300 mg weekly and 81.2% on semi-weekly dosing (p=0.57). Multivariate analysis identified severe atopy as the reason for starting dupilumab as the strongest predictor for semi-weekly regimen choice (OR: 26.9; p<0.001), with conjunctivitis, asthma, and having two or more food allergies being significant. Both regimens were equally effective in reducing peak eos/hpf, symptomatology and EREFS. Dose tapering from weekly to semi-weekly/monthly was successful in all evaluable cases (8/8), while dose escalation from semi-weekly to weekly rescued 80% (4/5) of non-responders. Discontinuation occurred only in 8 patients (5%), primarily due to adverse events.CONCLUSIONDupilumab is effective and safe in real-world EoE management, with no significant differences between weekly and semi-weekly induction. Efficacy was generally regained after escalation or maintained after dose tapering.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148305002","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":"Quantifying Esophageal Hydrogen Ion Exposure using a novel pH-impedance metric improves prediction of PPI response compared with conventional acid exposure time in GERD.","authors":"Mentore Ribolsi,Lorenzo Marchetti,Chiara Catamo,Laura Galdi,Marco Distefano,Michele Cicala","doi":"10.14309/ajg.0000000000004092","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004092","url":null,"abstract":"BACKGROUNDAcid exposure time (AET) is the reference metric quantifying esophageal acid burden, yet patients with pathological AET may fail to respond to PPI therapy. Given the logarithmic nature of pH, AET does not account for the exponential increase in hydrogen ion (H+) concentration at lower pH values.AIMTo quantify acid burden using total integrated acidity exposure (TIAE), a dose-based metric integrating H+ load over time, and to assess whether TIAE improves prediction of PPI response compared with conventional AET.METHODSImpedance-pH data were retrospectively evaluated. TIAE was calculated by integrating H+ concentration (10-pH) at 1-second resolution across all acid reflux episodes. Diagnostic performance for PPI response was assessed using ROC analysis, multivariable logistic regression and decision curve analysis (DCA).RESULTSAmong 174 patients (97 PPI responders, 77 non-responders), responders exhibited higher TIAE than non-responders and controls (p<0.0001). TIAE showed superior discrimination for PPI response compared with AET (AUC 0.78 vs 0.64). In multivariable models, TIAE independently predicted response both as a dichotomized and continuous variable, whereas continuous AET was not independently associated. TIAE correlated more strongly with MNBI than AET (ρ=-0.49 vs -0.26). DCA demonstrated greater net clinical benefit for models incorporating TIAE across clinically relevant threshold probabilities. In patients with inconclusive AET (4-6%), TIAE accurately segregated responders from non-responders. Very low pH (pH<2) greatly affected TIAE value and showed the strongest association with treatment response.CONCLUSIONSQuantifying H+ load provides a physiologically grounded assessment of esophageal acid burden and improves prediction of PPI response.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148299032","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":"PREVALENCE AND RISK FACTORS ASSOCIATED WITH MASLD AND ADVANCED FIBROSIS AMONG OVERWEIGHT INDIVIDUALS: IMPLICATIONS FOR SCREENING GUIDELINES.","authors":"Maria Mironova,Kaleb Tesfai,Egbert Madamba,Lisa Richards,Ricki Bettencourt,Michael Docherty,Rohit Loomba","doi":"10.14309/ajg.0000000000004091","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004091","url":null,"abstract":"BACKGROUND AND AIMSCurrent AASLD guidelines recommend evaluation for fibrosis in diabetes or medically complicated obesity, and screening for metabolic dysfunction-associated steatotic liver disease (MASLD) in people with cardiometabolic risk factors (CMRFs), but they do not define which metabolic and other risk factors warrant screening in overweight individuals. We aimed to identify risk factors that should prompt liver disease assessment in overweight individuals.METHODSThis is a cross-sectional analysis of community-dwelling adults (aged 40-75) residing in Southern California and enrolled in a prospective study. MASLD was defined as liver fat content ≥5% measured by MRI-PDFF in the absence of other liver diseases and with no or mild alcohol use; advanced fibrosis was defined as ≥3.63 kPa measured by MRE.RESULTSAmong 220 overweight individuals (mean age 56.8 ± 9.6 years, 50.9% male), 52% had MASLD, of whom 7% had advanced fibrosis. Hypertriglyceridemia was the strongest independent MASLD predictor (OR 3.11, 95% CI 1.42-6.81, p=0.005), followed by hypertension (OR 2.51, 95% CI 1.21-5.23, p=0.014). For advanced fibrosis, Hispanic ethnicity, diabetes and low HDL were significant predictors. Notably, 61% of overweight individuals with MASLD did not have diabetes. Targeting overweight individuals with any CMRF for evaluation would identify 93.9% of MASLD cases, compared to only 40.5% when using diabetes alone as the screening trigger.CONCLUSIONCurrent guidelines should be expanded to include overweight individuals with any cardiometabolic risk factor, not just diabetes, as candidates for FIB-4 assessment. Fibrosis surveillance among overweight individuals should prioritize those with diabetes, as recommended by current guidelines, as well as people of Hispanic ethnicity.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148299034","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":"If it breaks us, we must fix it! An ergonomic summit as a path to better ergonomics in endoscopy.","authors":"Neena Mohan,Vivek Kaul,Neil Stollman,Harish Gagneja,Patrick Young","doi":"10.14309/ajg.0000000000004085","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004085","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148299331","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":"Behçet-like Gastrointestinal Lesions and IgA Vasculitis Associated with Trisomy 8-Negative Myelodysplastic Syndrome.","authors":"Ryoji Koshiba,Kazuki Kakimoto,Hiroki Nishikawa","doi":"10.14309/ajg.0000000000004093","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004093","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148299031","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":"Yield of Fecal Immunochemical Test Screening for Colorectal Cancer in Adults Aged 45-49 vs 50-54 years.","authors":"Le Wang,Chen Zhu,Yu Qiu,Weimiao Wu,Tingting Pan,Weiwei Gong,Shi Wang,Wei Wu,Dong Hang,Ni Li,Partha Basu,Lingbin Du","doi":"10.14309/ajg.0000000000004087","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004087","url":null,"abstract":"BACKGROUNDThe rising incidence of early-onset colorectal cancer (CRC) has prompted debate over lowering screening initiation age. However, real-world evidence on fecal immunochemical test (FIT)-based screening effectiveness in 45-49 years remains limited. Our study aimed to evaluate screening yield of FIT-based CRC screening between 45-49 and 50-54 years.METHODSConducted within a provincial CRC screening program in China, this study employed two-sample FIT screening followed by colonoscopy for positive results. Screening outcomes, including FIT positivity, colonoscopy completion, positive predictive values (PPVs) and detection rates of adenoma and advanced colorectal neoplasia, were compared between participants aged 45-49 and 50-54 years. Robust Poisson regression was used to estimate adjusted risk ratios (aRRs), using 50-54-year-old group as reference.RESULTSAmong 733,137 participants, 89,446 were aged 45-49 years and 643,691 aged 50-54 years. Participants aged 45-49 years had higher FIT positivity (10.61%) and colonoscopy completion (46.75%) than those aged 50-54 years. However, detection rates for advanced neoplasia (0.30% vs. 0.39%; aRR, 0.78; 95% CI, 0.68-0.88) and any adenoma (0.78% vs. 0.95%; aRR, 0.83; 95% CI, 0.77-0.90) were significantly lower in the younger group, with similar results observed for PPVs. Within the 45-49 year group, comparable detection rates to 50-54 year age group were observed among individuals with established risk factors, most notably among smokers (RR, 1.50; 95% CI, 1.22-1.84), frequent alcohol drinkers (RR, 1.33; 95% CI, 1.01-1.75), and males (RR, 1.20; 95% CI, 1.03-1.40).CONCLUSIONSOverall, adults aged 45-49 years showed higher screening participation but lower screening yield than those aged 50-54 years. These findings highlight the importance of prioritizing individuals with elevated risk profiles for CRC screening in younger populations.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148305009","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":"Cost-effectiveness of Microbiota Restoration Therapies for Recurrent Clostridioides difficile Infection.","authors":"Parul Berry,Vishwesh Bharadiya,Darrell S Pardi,Sahil Khanna","doi":"10.14309/ajg.0000000000004083","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004083","url":null,"abstract":"BACKGROUNDRecurrent Clostridioides difficile infection (rCDI) is associated with substantial morbidity, healthcare utilization, and costs. FDA-approved microbiota-based therapies, fecal microbiota spores, live-brpk (VOS) and fecal microbiota, live-jslm (RBL), reduce recurrence risk, but cost-effective placement within the rCDI treatment pathway remains uncertain.METHODSWe performed a U.S. payer-perspective cost-effectiveness analysis using decision-tree modeling according to CHEERS 2022 guidelines. Adult with rCDI entered the model after the first or second recurrence and were followed for <1 year. Effectiveness inputs were derived from ECOSPOR III/IV (VOS), PUNCH CD3/CD3-OLS (RBL) trials, and published literature for standard-of-care (SoC) comparators. Outcomes included costs (2025 USD), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). Probabilistic and deterministic sensitivity analyses were performed using a willingness-to-pay threshold of $150,000/QALY. ICERs were interpreted across $50,000, $100,000, $120,000, and $150,000/QALY.RESULTSAfter the first recurrence, RBL was cost-effective versus SoC alone ($25,415/QALY). Early initiation remained favorable compared with delayed use for VOS ($27,239/QALY) and RBL ($26,704/QALY). After the second recurrence, VOS remained cost-effective versus SoC (ICER $53,983/QALY), whereas RBL exceeded the willingness-to-pay threshold (ICER $171,496/QALY). Exploratory cross-trial VOS-versus-RBL comparisons yielded ICERs of $124,636/QALY after first recurrence and $137,350/QALY after second recurrence, indicating threshold-sensitive product-to-product comparisons.CONCLUSIONSEarlier initiation of microbiota-based therapies after the first CDI recurrence provides greater health benefits at acceptable cost-effectiveness thresholds compared with delayed use, supporting earlier integration into rCDI treatment strategies. VOS-versus-RBL comparisons should be interpreted as exploratory indirect comparisons pending comparative real-world or head-to-head data.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148286745","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":"CT Esophagram Demonstrating Bezoar in a Colonic Interposition Conduit.","authors":"Brody M Fogleman,Shannon Xue,Robert Fugatt,Amol Sharma","doi":"10.14309/ajg.0000000000004039","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004039","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147754927","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":"Machine Learning Models Using Hospital Admission Characteristics Do Not Optimally Predict Nosocomial Infection Development in a Global Cirrhosis Cohort.","authors":"Scott Silvey,Ashok K Choudhury,Patrick S Kamath,Qing Xie,Florence Wong,Peter C Hayes,Wai-Kay Seto,Umang Arora,Garima Singhal,Dinesh Jothimani,Sumeet Asrani,Adrian Gadano,Dinc Dincer,Alberto Queiroz Farias,Daneille Adebayo,José Antonio Velarde-Ruiz Velasco,Adam Doyle,Anand V Kulkarni,Nabil Debzi,Jawaid Shaw,Sezgin Barutcu,Hailemicheal Desalgn,Dominik Bettinger,Ponan Claude Regis Lah,Andres Duarte-Rojo,Dilara Turan,Lei Wang,Rene Male Velazquez,Xin Zheng,Sevda Aghayaeva,Zeki Karasu,Coskun Demirtas,Chenghai Liu,Jacqueline Cordova-Gallardo,Bin Xu,Aabha Nagral,Haibing Gao,Harendran Elangovan,James Fung,Neil Rajorya,Xinrui Wang,Helena Katchmann,Dibyalochan Praharaj,Sanjiv Mahadeva,Yongfang Jiang,Katina Zheng,Kessarin Thanapirom,C E Eapen,Radha K Dhiman,Mingqin Lu,Marco Arrese,Minghua Su,Sarai Gonzalez Hueso,Chuanwu Zhu,Hanna Aberra,Henok Fisseha,Hiang Keat Tan,Caiyan Zhao,Ningping Zhang,Sunil Taneja,Aloysious D Aravinthan,Amey Sonavane,Anoop Saraya,Cameron Gofton,Gerry MacQuillan,Gustavo Pereira,K Rajender Reddy,Shiv K Sarin,Zhujun Cao,Mark Topazian,Ramazan Idilman,Aldo Torre,Jacob George,Mario Alvares da Silva,Brian J Bush,Jasmohan S Bajaj, ","doi":"10.14309/ajg.0000000000004031","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004031","url":null,"abstract":"BACKGROUNDNosocomial infections (NI) in cirrhosis are associated with high mortality but could be preventable. Logistic regression (LR) models have failed to identify high-risk patients. We aimed to develop machine learning (ML) models to predict NI.METHODSThe CLEARED consortium consists of prospectively enrolled cirrhosis inpatients from >120 centers. Using day-of-admission clinical data, three ML approaches[Random Forest (RF), Extreme Gradient Boosting (XGBoost), and Neural Networks (NN)] were used to predict NI. Data were split 80:20 for training and testing stratified by the outcome. Models were compared using Area-under-Receiver-operating-characteristic curve (AUC).RESULTS8,263 patients (55.90±13.34 years; 64.1% men) from 127 centers in 37 countries were included. NI developed in 869 (10.5%) a median of 6 (4-11) days post-admission. Major NIs were respiratory (29.6%) and urinary tract infection (15.7%), and spontaneous bacterial peritonitis (13.5%). NIs occurred more frequently in patients from low/low-middle income countries and those with severe liver disease, alcohol etiology, and admission infections. NIs were associated with inpatient mortality (31.9% vs. 8.1%, p<0.001) and liver transplantation (4.8% vs. 1.9%, p<0.001). While the RF model (AUC 0.69) showed good calibration (Brier score 0.09), outperforming XGBoost, NN, and LR models (AUC 0.66 for all; LR comparison p = 0.043), no model achieved AUC ≥0.80 for clinical utility. At 10% predicted probability threshold, RF model demonstrated only 75.4% sensitivity, 52.9% specificity, and 15.9% PPV.CONCLUSIONSNIs cannot be accurately predicted from day-of-admission data using ML models, even in a large, prospective, global cirrhosis cohort. Every hospitalized patient with cirrhosis should receive protocolized infection-control measures.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751358","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":"Associations between Physical Activity and Irritable Bowel Syndrome in the All of Us Research Program.","authors":"Jack Loesch,Sarah Kim,Madison Simons,Eyad Hamza,John Brown,Sara Valencia,Samita Garg,Trisha Pasricha,Prashant Singh,Sarah Ballou,Anthony Lembo","doi":"10.14309/ajg.0000000000004037","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004037","url":null,"abstract":"INTRODUCTIONIrritable bowel syndrome (IBS) is a disorder of gut-brain interaction that affects over 6% of Americans. Increased physical activity improves IBS symptoms and may be associated with lower odds of IBS; however, prior studies are small or limited by self-reported measurements. This study aimed to investigate associations between Fitbit-recorded physical activity data and the prevalence of IBS.METHODSA retrospective, cross-sectional analysis was conducted using the All of Us Research Program. Adults over 18, who shared Fitbit and electronic healthcare record data, were included. Participants were placed into quartiles based upon their mean daily activity metrics: steps, active minutes, sedentary minutes, and maximum heart rate. Covariates included demographics, lifestyle factors (alcohol and smoking), BMI, education, income, and comorbidities. Multivariable logistic regression was used to analyze associations between activity metrics and IBS.RESULTSOf 43,967 participants, 1551 (3.5%) had an IBS diagnosis. The IBS group was 83% female, 79% White, with a median age of 53 years. Compared to the lowest quartile, participants in the highest quartile of average daily steps (OR: 0.82; p=0.028), very active minutes (OR: 0.72; p<0.001), and maximum heart rate (OR: 0.65; p<0.001) had significantly lower odds of IBS. Conversely, those in the highest quartile of sedentary minutes had higher odds of IBS (OR: 1.24; p=0.007).DISCUSSIONThis large, real-world study, using objective physical activity data, demonstrates that higher levels of physical activity is associated with lower odds of IBS. Prospective studies are warranted to determine whether physical activity has a causal protective effect against IBS.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751357","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}