The American Journal of Gastroenterology最新文献

{"title":"Patient Preferences in Hepatocellular Carcinoma Surveillance: A Multi-site Conjoint Analysis.","authors":"Karissa D Kao,Jonathan P Troost,Ju Dong Yang,Reena Salgia,Sean A Woolen,Neil Mehta,Maarouf A Hoteit,Prasun K Jalal,Karim Seif El Dahan,Darine Daher,Lisa Quirk,Nishi Patel,Anish Nayak,Jasmine Gamez,Manaf Alsudaney,Perla Hernandez,Megha Bhongade,Amit G Singal,Neehar D Parikh","doi":"10.14309/ajg.0000000000004023","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004023","url":null,"abstract":"BACKGROUNDSeveral emerging modalities are available for hepatocellular carcinoma (HCC) surveillance; however, patient preferences for surveillance tests - particularly across key subgroups such as race/ethnicity, income, and education level - are poorly characterized.METHODSWe conducted a choice-based conjoint survey among patients with cirrhosis and chronic hepatitis B undergoing HCC surveillance (from 2022-2024) at seven centers in the US. Participants were presented with 15 scenarios, where they chose between surveillance modalities based on test attributes.RESULTSWe included 649 patients, with a median age of 60 years, 51% male, 60% White, 10% Black, and 20% Hispanic. The cohort reflected substantial socioeconomic variation including 12% with Medicaid and 38% with Medicare. The highest priority attribute was surveillance benefits (42.9%; 95% CI: 40.6-45.1%), followed by financial harms (19.4%; 95% CI: 18.1-20.7%). Patients placed less priority on test logistics (12.3%; 95% CI: 11.5-13.2%), test location (9.2%; 95% CI: 8.5-10.0%), test duration (8.3%; 95% CI: 7.8-8.7%), and physical harms (7.9%; 95% CI: 7.2-8.6%). In subgroup analyses, Black participants placed significantly lower importance on surveillance benefits and higher importance on financial harms (p<0.001) and test duration (p=0.001) compared to White participants. Hispanic participants also prioritized financial harms more than non-Hispanic participants (p<0.001), a pattern consistent with cost-related concerns seen across other lower socioeconomic status (SES) subgroups. Lower SES individuals with below a high school education (p=0.01), Medicaid insurance (p=0.001), and income below $25,000 (p<0.001) assigned greater importance to financial harms and less to surveillance benefits.CONCLUSIONSPatients with undergoing HCC surveillance prioritize surveillance test sensitivity; however, results vary by race, ethnicity, and SES. Improving access by reducing financial and logistical barriers through shared-decision-making may enhance surveillance, particularly when modalities present with similar effectiveness.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"4576 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147666988","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":"Endoscopic reconstruction of common bile duct transection after right hepatectomy using an innovative cholangioscopy-assisted ERCP-EUS rendezvous technique.","authors":"Ivo Mendes,Francisco Vara-Luiz,Carolina Palma,Francisco Piçarra,Júlio Veloso,Pedro Pinto-Marques,Gonçalo Nunes","doi":"10.14309/ajg.0000000000004021","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004021","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641761","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":"Making Cents of the Cost of Helicobacter pylori Management.","authors":"Kenneth W Hung","doi":"10.14309/ajg.0000000000003990","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003990","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648906","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":"Association of Body Mass Index with Disorders of Gut-Brain Interaction: A Large Global Population-Based Analysis.","authors":"Daniel Martin Simadibrata,Mohsin Faysal Butt,Benjamin Douglas Liu,Zaid Al-Fakhouri,Laith Alomari,Kueh Yee Cheng,Olafur S Palsson,Ami D Sperber,Shrikant I Bangdiwala,Anthony Lembo,Yeong Yeh Lee","doi":"10.14309/ajg.0000000000004020","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004020","url":null,"abstract":"OBJECTIVESIndividuals with underweight or obesity may have altered gut-brain signaling. This study investigated the association between body mass index (BMI) and the prevalence and burden of disorders of gut-brain interaction (DGBI).METHODSThis cross-sectional analysis utilized the internet-based data from the Rome Foundation Global Epidemiology Study, conducted in 2017-2018 across 26 countries. Adults aged ≥18 years with BMI data were included. DGBI were diagnosed according to the Rome IV criteria. Associations between BMI and DGBI were analyzed across BMI categories and for each 5 kg/m2 increment above 25 kg/m2 using mixed logistic regression models adjusted for age, sex, diabetes, psychological distress, and healthcare utilization. Additional analyses evaluated anatomical DGBI groups, overlapping disorders, and psychometric scales.RESULTSAmong 48,366 participants, the prevalence of DGBI followed a U-shaped pattern across BMI categories. After adjustment, underweight groups had similar odds of any DGBI compared with those with normal BMI, whereas the odds progressively increased for overweight and obesity groups (class I: 1.20; 95%CI 1.13-1.29; class II: 1.23; 95%CI 1.11-1.36; class III: 1.52; 95%CI 1.32-1.74). Every 5 kg/m2 BMI increase above 25 kg/m2 raised DGBI odds by 8% (95%CI 4%-11%). Associations were strongest for esophageal and gastroduodenal disorders. Higher BMI was associated with poorer physical and mental health and greater anxiety and depression, irrespective of the presence of DGBI.CONCLUSIONSHigher, but not lower, BMI is independently associated with increased prevalence and symptom burden of DGBI. Obesity confers the highest odds for overlapping disorders and psychological disturbances, underscoring the importance of integrated metabolic and behavioral management strategies.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641371","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":"An Enhanced Treatment Algorithm Targeting Mucosal Healing is Effective and Safe in Older Patients with Crohn's Disease: A Post-hoc Analysis of the REACT2 Trial.","authors":"Shane W Goodwin,Sudheer Kumar Vuyyuru,Rocio Sedano,Guangyong Zou,Parambir S Dulai,Siddarth Singh,Neeraj Narula,Christopher Ma,Vipul Jairath","doi":"10.14309/ajg.0000000000004015","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004015","url":null,"abstract":"INTRODUCTIONSafety and effectiveness of treating to target mucosal healing in older patients with Crohn's disease (CD) is unknown.METHODSWe analyzed CD-related complications by 24 months in the REACT-2 trial that randomized practices to an enhanced-care or step-care algorithm to determine whether patient age modifies the effect of treatment. Data were analyzed using marginal Cox regression and modified Poisson regression.RESULTSThere was no difference in treatment between younger and older patients in at 24 months.DISCUSSIONEC was effective and not associated with increased risk compared with SC in older patients with Crohn's disease.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599247","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":"Spontaneous Autoamputation and Expulsion of Giant Colonic Lipoma.","authors":"Toni-Marie Chandler,Amay Mehta,Petros Benias","doi":"10.14309/ajg.0000000000004016","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004016","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599245","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":"Mesenteric Volvulus: A Unique Complication of EUS-Guided Gastrojejunostomy.","authors":"Arsalan Khan,Vibhu Chittajallu,Matthew Krafft,Shailendra Singh,Shyam Thakkar","doi":"10.14309/ajg.0000000000004018","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004018","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599244","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":"Gastric Heterotopia in the Ileum Diagnosed with Combined EUS and Confocal Laser Endomicroscopy.","authors":"Limei Wang,Peng Wang,Xiuli Zuo,Jun Liu","doi":"10.14309/ajg.0000000000004017","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004017","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"178 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599246","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":"Artificial Intelligence in Clinical Gastroenterology: Promise, Pace, and Proof.","authors":"Ryan W Stidham","doi":"10.14309/ajg.0000000000003972","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003972","url":null,"abstract":"","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"47 1","pages":"811-812"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147599243","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":"Early life intake of marine n-3 fatty acids, genetic fatty acid desaturase variants, and risk of celiac disease.","authors":"Elin M Hård Af Segerstad,Mari Thesen,German Tapia,Anne Lise Brantsæter,Christine L Parr,Maria C Magnus,Lars C Stene,Ketil Størdal,Nicolai A Lund-Blix, ","doi":"10.14309/ajg.0000000000004012","DOIUrl":"https://doi.org/10.14309/ajg.0000000000004012","url":null,"abstract":"BACKGROUNDWe aimed to investigate if early life marine n-3 fatty acids and fish intake, and fatty acid desaturase (FADS) genetic variants, were associated with later risk of celiac disease (CeD).METHODSAmong 85,244 children in the prospective Norwegian Mother, Father, and Child Cohort Study, fish and marine fatty acid intakes were estimated from questionnaires to mothers during pregnancy, and at child's age 6 and 18 months. rs1535 tagged common FADS haplotypes. Child's CeD status was obtained from the Norwegian Patient Registry and parental questionnaires.RESULTSA total of 1,363 (1.6%) children were diagnosed with CeD (follow-up median 16.1 years; range 12.5-19.8). Total pregnancy eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake was not associated with child CeD risk (adjusted odds ratio [aOR] 1.02, 95% confidence interval [CI]=0.94-1.10, per g/d increase). Pregnancy EPA and DHA supplementation was associated with a higher child CeD risk (aOR 1.24, 95%CI=1.09-1.41, compared with non-use). EPA and DHA supplementation at age 6 months (aOR 0.98, 95%CI=0.87-1.10) and 18 months (aOR 0.98, 95%CI=0.86-1.12), and fish intake at age 18 months (aOR 1.00, 95%CI=0.95-1.05, per serving/week), were not associated with CeD. CeD risk was higher in children carrying FADS major alleles (OR 1.10, 95%CI=1.00-1.20, per additional allele).CONCLUSIONOverall, there was no evidence that the total intake of marine n-3 fatty acids in early life was associated with a lower risk of CeD. Instead, data suggested an association in the positive direction for the child's genotypes resulting in higher EPA and DHA status, and EPA and DHA supplements during pregnancy, with child CeD risk.","PeriodicalId":520099,"journal":{"name":"The American Journal of Gastroenterology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578051","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}