Digestive diseases (Basel, Switzerland)最新文献

{"title":"Treatment Outcomes with Empirical Clarithromycin-Based Triple Therapy for <i>Helicobacter pylori</i> in Zambia, Sub-Saharan Africa.","authors":"Ibrahim Patel, Lailai Kinkungwe, Shabir Lakhi, Violet Kayamba","doi":"10.1159/000552612","DOIUrl":"10.1159/000552612","url":null,"abstract":"<p><strong>Introduction: </strong>Helicobacter pylori (H. pylori) infection is highly prevalent in Zambia, with an estimated population prevalence of 79%. However, data on eradication treatment outcomes in routine clinical practice are lacking.</p><p><strong>Methods: </strong>We conducted a single-arm cohort study in Lusaka, Zambia, to evaluate the effectiveness of empirical H. pylori eradication therapy using stool antigen testing (SAT). Symptomatic patients with confirmed H. pylori infection were treated empirically with clarithromycin-, tinidazole-, and omeprazole-based regimens. Eradication was assessed using SAT at least 4 weeks after completion of therapy. Demographic and clinical factors associated with treatment outcomes were analysed using multivariate logistic regression in Stata version 15.</p><p><strong>Results: </strong>Of 331 patients tested, 216 (65%) were positive for H. pylori infection. Post-treatment SAT results were available for 139 (64%) patients, of whom 93 (67%) were female. The median age was 43 years (interquartile range: 36-54). Overall, eradication was achieved in 85 patients, yielding a treatment success rate of 61%. Multivariate analysis demonstrated that a history of prior eradication attempts (odds ratio [OR]: 0.20, 95% confidence interval [CI]: 0.04-0.60) was independently associated with treatment failure. In contrast, the occurrence of dysgeusia during therapy (OR: 3.20, 95% CI: 1.20-8.70) and prior proton pump inhibitor use (OR: 5.30, 95% CI: 1.40-19.80) were associated with higher odds of eradication.</p><p><strong>Conclusion: </strong>The effectiveness of empirical clarithromycin-based therapy for H. pylori infection in Zambia is suboptimal and falls below internationally recommended targets. These findings underscore the need to reassess empirical treatment strategies, particularly among patients with previous eradication attempts, and highlight the importance of locally informed antibiotic selection.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298643","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 Submucosal Dissection-Associated Bacteremia: Proper Antibiotic Management.","authors":"Wenhui Xia, Yuxuan Chen, Jianyu Lv, Qianqian Wang, Menglu Ding, Shuo Zhang","doi":"10.1159/000552613","DOIUrl":"10.1159/000552613","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic submucosal dissection (ESD) is of great value in the medical field as an effective means for the treatment of early gastrointestinal cancer and precancerous lesions. However, due to its technical difficulty and long procedure time, ESD is prone to complications such as perforation, bleeding, and infection. In particular, perforation facilitates the entry of pathogenic microorganisms into the blood circulation through iatrogenic wounds, increasing the risk of bacteremia, which may lead to serious adverse events such as peritonitis and septic shock.</p><p><strong>Summary: </strong>This narrative review, based on a systematic search of PubMed, Embase, and the Cochrane Library through January 2026, analyzes the risk of bacteremia in ESD across different parts of the digestive tract and the necessity of antibiotic therapy, aiming to provide a reference for more in-depth exploration and clinical application.</p><p><strong>Key messages: </strong>Current evidence indicates that the overall incidence of bacteremia after ESD is low (typically <5%), mostly transient, and rarely progresses to clinical infection.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-12"},"PeriodicalIF":2.1,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267410","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":"The Investigation and Treatment of <i>Helicobacter pylori</i> for the Prevention of Gastric Cancer: A Narrative Review and Assessment of Management Approaches.","authors":"Conor Costigan, Deirdre McNamara","doi":"10.1159/000552758","DOIUrl":"10.1159/000552758","url":null,"abstract":"<p><strong>Background: </strong>The rate of gastric cancer has reduced globally in all ages in recent years, but some data have started to emerge of a slowing in the decrease or even an increase in those aged >50 years, particularly in wealthier countries. Helicobacter pylori infection is associated with 89% of gastric cancer diagnoses worldwide, and its eradication is associated with a risk reduction. This review aims to assess the various approaches to diagnosing this carcinogenic pathogen.</p><p><strong>Summary: </strong>A test-and-treat approach (noninvasive H. pylori testing for symptomatic patients) towards young people has been advocated among European populations to date, and has been validated for improving symptoms of dyspepsia, and shown cost savings compared to symptomatic dyspepsia treatment alone. Randomised data on the reduction of gastric cancer since the introduction of this approach are lacking, but some retrospective studies show a clear cancer benefit to eradication. Several pilot studies in high-incidence countries have demonstrated cost-effective and real-world reductions in gastric cancer rates with population-based H. pylori screenings (screen-and-treat approach). Many of these countries have adopted national gastric cancer prevention strategies that incorporate H. pylori screening. Abundant modelling data in these countries show economic benefits to nearly all types of screening programmes; however, data in European populations, who have documented lower risks of both infection and progression to gastric cancer, are lacking. Modelled data suggest it may be feasible, but currently no guidelines recommend this approach. Currently, prospective European studies are underway to assess the practicality and cost-effectiveness of various methods of screening. We discuss the use of both endoscopy (test-scope-and-treat) and biomarkers as possible adjuncts to potential population-based screening to ensure maximum gastric cancer reduction from any such proposed approach.</p><p><strong>Key messages: </strong>Prospective data from H. pylori high-incidence countries in Asia have shown a clear reduction in gastric cancer diagnoses after the introduction of population screening. Cost-effectiveness of population-wide screening is well documented in these countries and forms part of many national gastric cancer screening programmes. Modelled data from H. pylori low-incidence countries show population-based screening may be cost-effective, but real-world feasibility data are lacking.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207608","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":"Analysis of <i>Helicobacter pylori</i> Resistance and Its Trends in Chongqing: A 10-Year Retrospective Study.","authors":"Su Na-Yun, Liu Yu-Xiang, Shi Qing, Huang Xin-Yi, Ma He, Li Hao-Feng, Fu Tao, Zheng Yan, Lu Shengren, Shen Xiao-Chun, Lan Chun-Hui","doi":"10.1159/000552421","DOIUrl":"10.1159/000552421","url":null,"abstract":"<p><strong>Introduction: </strong>The high rates of Helicobacter pylori resistance to antibiotics and increasing eradication failure have received much attention worldwide.</p><p><strong>Methods: </strong>Gastric mucosa specimens were collected from 7,921 patients with H. pylori infection confirmed by urea breath test from January 2015 to December 2024. H. pylori isolation and culture were performed, followed by antimicrobial susceptibility testing.</p><p><strong>Results: </strong>The overall and multidrug resistance (MDR) rates of the 5,205 H. pylori isolates to antibiotics were 95.93% and 18.83%, respectively. The listed antibiotic resistance rates in descending order were metronidazole (94.33%), levofloxacin (36.14%), clarithromycin (32.10%), amoxicillin (0.48%), and furazolidone or tetracycline (0%). The analysis demonstrated no significant difference between resistance rates for periods 2015-2019 (95.90%) and 2020-2024 (96.11%) (p > 0.05). Resistance rates differed significantly between the two periods: levofloxacin (35.33% vs. 41.62%), clarithromycin (27.86% vs. 60.93%), and amoxicillin (0.33% vs. 1.50%) (p < 0.05). The MDR rates increased significantly from 16.75% in 2015-2019 to 32.93% in 2020-2024 (p < 0.001). Treatment-experienced patients demonstrated elevated resistance levels and MDR rates (99.31% and 39.45%) in comparison to treatment-naïve individuals (94.99% and 15.02%; p ≤ 0.001). Besides, treatment-experienced patients exhibited significantly higher resistance rates to metronidazole (97.92%), clarithromycin (67.47%), levofloxacin (46.02%), and amoxicillin (1.04%) compared to treatment-naïve patients (92.54%, 32.07%, 35.04%, 0%; p < 0.001).</p><p><strong>Conclusion: </strong>The study revealed elevated overall resistance rates and MDR rates of H. pylori to metronidazole, clarithromycin, and levofloxacin, with significantly higher rates observed in treatment-experienced patients. Notably, a rising pattern in resistance rates to levofloxacin, clarithromycin, amoxicillin, and MDR rates was observed in recent years.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146128","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-Onset Colorectal Cancer in Australia: Environmental, Microbial, and Policy Implications.","authors":"Rathin Gosavi, Stephen Bell, Geraldine Ooi, Paul John McMurrick, Satish Warrier, Vignesh Narasimhan","doi":"10.1159/000552644","DOIUrl":"10.1159/000552644","url":null,"abstract":"<p><p><p>Background: Early-onset colorectal cancer (EOCRC; age <50 years) is rising in Australia despite improving outcomes in older adults. EOCRC shows a strong birth cohort effect, disproportionate growth in left-sided and rectal tumours, and more frequent stage III-IV presentation. Most cases occur without a family history, suggesting that environmental and biological pressures are accelerating carcinogenesis in otherwise average-risk hosts. Summary: Traditional risk factors such as obesity, metabolic syndrome, sedentary behaviour, alcohol, and smoking likely contribute through insulin resistance, chronic inflammation, and insulin-like growth factor 1-mediated signalling, but they do not fully explain the recent acceleration or distal predominance of EOCRC. Hereditary syndromes account for only a minority of cases, and tumour driver mutation patterns broadly resemble those of later-onset colorectal cancer, supporting earlier triggering rather than novel genetics. Emerging evidence implicates gut dysbiosis and exposures that disrupt mucosal defences or cause direct DNA damage. Colibactin-producing Escherichia coli may induce distinctive mutational signatures enriched in early and distal tumours. Microplastics and plasticisers may impair barrier function and promote low-grade inflammation, while per- and polyfluoroalkyl substances and related endocrine-disrupting chemicals are linked to metabolic and immune perturbation and altered bile acid biology. Antibiotic exposure, particularly early in life, may reduce microbial diversity and favour pathobionts. Inflammatory phenotypes, including inflammatory bowel disease, provide an additional model of inflammation-driven carcinogenesis relevant to EOCRC. Key Messages: EOCRC in Australia is a growing clinical and public health challenge that cannot be explained by inherited predisposition alone. A unifying exposome model may help integrate dietary, microbial, inflammatory, and environmental drivers of risk. Clinicians should promote earlier participation in the National Bowel Cancer Screening Program, including the 45-49 opt-in pathway, expedite investigation of rectal bleeding, altered bowel habit, and iron deficiency anaemia in younger adults, and embed lifestyle counselling into routine and survivorship care. Research priorities include prospective cohorts with early-life exposure data, integrated exposomics, microbiome profiling, and mutational signature analysis to clarify modifiable drivers and guide prevention. </p>.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis Obesity Correlates with Severity and Mortality in Acute Pancreatitis: An Updated Meta-Analysis.","authors":"Max Ole Hubert, Mahmood Ahmad, Alexander Crispin, Georg Beyer, Julia Mayerle, Simon Sirtl","doi":"10.1159/000552102","DOIUrl":"10.1159/000552102","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of acute pancreatitis (AP) is steadily increasing worldwide. Overweight and obesity are recognized epidemiological risk factors for more severe disease courses and higher mortality, while the direct pathomechanism is only speculated on. The aim was to reassess the association between obesity and severity and mortality of AP as approximately half of the patients have not been included in the latest meta-analysis, and furthermore, to explore associations between underlying characteristics of obesity aiming to understand the pathophysiological mode of action.</p><p><strong>Methods: </strong>A systematic search was performed for studies published up to April 2025. Eligible studies included adult AP patients with BMI-based definitions of overweight and obesity and reported outcomes on severity or mortality. Odds ratios (ORs) and mean differences (MDs) were pooled using a random-effects model.</p><p><strong>Results: </strong>Twenty-eight studies comprising 18,062 patients met inclusion criteria, roughly 50% of patients not being included in previous analyses. The mean BMI was significantly higher in severe versus mild AP (MD = 1.77 kg/m2; 95% CI: 1.11-2.42). Overweight (BMI ≥25 kg/m2) and obesity (BMI ≥30 kg/m2) were associated with increased risk of severe disease (OR = 3.24; 95% CI: 2.07-4.42; OR = 2.18; 95% CI: 1.55-2.81). Mortality risk was likewise elevated for BMI ≥25 kg/m2 (OR = 2.80; 95% CI: 1.18-4.42) and BMI ≥30 kg/m2 (OR = 5.30; 95% CI: 1.30-9.30). Heterogeneity of studies was too high to establish pathophysiological modes of action with respect to the inflammatory reaction.</p><p><strong>Conclusions: </strong>This analysis represents the largest, most extensive synthesis to date establishing the impact of obesity on outcome in AP, but failed to meta-analytically identify independent drivers of severity as a starting point for further mechanistic studies.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-13"},"PeriodicalIF":2.1,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950640","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 Frail Status with Incident Digestive Diseases: A Large Prospective Cohort Study.","authors":"Zihan Qin, Lubo Shi, Kun Zhang, Mincong Pan, Yifei Liu, Jiafei Peng, Yaohang Zhang, Zinan Zhang, Shutian Zhang, Hongtao Wei","doi":"10.1159/000552186","DOIUrl":"10.1159/000552186","url":null,"abstract":"<p><strong>Introduction: </strong>Frailty, reflecting age-related decline in physiological reserve, has been implicated in adverse health outcomes, but its contribution to digestive disease risk is not well established.</p><p><strong>Methods: </strong>Leveraging two prospective cohorts from the UK Biobank (n ≈ 340,000 and n ≈ 358,000) with participants free of gastrointestinal diseases (GID) or hepatobiliary-pancreatic diseases (HBPD) at baseline, we evaluated incident disease over a median follow-up of 13.7 years using a validated frailty phenotype.</p><p><strong>Results: </strong>Individuals classified as frail showed consistently higher rates of digestive disorders than robust peers. After multivariable adjustment, hazard ratios (HRs) for frailty were 1.65 (95% confidence interval [CI]: 1.57-1.72) for overall GID and 1.78 (95% CI: 1.66-1.92) for HBPD. Risk elevations were observed for gastroesophageal reflux disease (HR: 1.70), peptic ulcer (HR: 1.81), inflammatory bowel disease (IBD) (HR: 1.48), irritable bowel syndrome (HR: 2.43), diverticulosis (HR: 1.38), constipation (HR: 2.25), coeliac disease (HR: 1.58), cirrhosis (HR: 2.22), metabolic dysfunction-associated steatotic liver disease (HR: 1.76), gallbladder disease (HR: 1.69), and pancreatic disease (HR: 1.60), all with p values of <0.01. Subgroup analyses across age, sex, adiposity, and comorbidity strata yielded similar results. Exploratory mediation using the C-reactive protein-to-albumin ratio, an index of inflammation and nutritional status, suggested partial attenuation of the frailty-disease associations (up to 9.5% for IBD and 4.1% for cirrhosis). Excluding early events and adding extensive lifestyle and biochemical covariates did not materially change the findings.</p><p><strong>Conclusion: </strong>Frailty, including pre-frail states, appears to be an independent marker of vulnerability to a broad range of digestive diseases, supporting its potential use in early risk assessment and targeted preventive strategies.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849073","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":"Bone Mineral Density Does Not Predict Overall Survival in Patients with Advanced Hepatocellular Carcinoma: A Subanalysis of the SORAMIC Trial.","authors":"Maximilian Thormann, Andreas Wienke, Ricarda Seidensticker, Kerstin Schütte, Christoph J Zech, Christian Loewe, Otto van Delden, Vincent Vandecaveye, Chris Verslype, Bernhard Gebauer, Christian Sengel, Irene Bargellini, Roberto Iezzi, Thomas Berg, Heinz Klümpen, Julia Benckert, Antonio Gasbarrini, Holger Amthauer, Bruno Sangro, Peter Malfertheiner, Maciej Pech, Jan Borggrefe, Jens Ricke, Max Seidensticker, Alexey Surov","doi":"10.1159/000552228","DOIUrl":"10.1159/000552228","url":null,"abstract":"<p><p><p>Introduction: Low bone mineral density (BMD) is an increasingly recognized marker of skeletal frailty, associated with higher fracture risk and mortality in cancer patients. In advanced hepatocellular carcinoma (HCC), however, the prognostic significance of baseline BMD remains unclear. This exploratory subanalysis of the SORAMIC trial evaluated whether CT-derived BMD predicts overall survival (OS) in patients with unresectable HCC.</p><p><strong>Methods: </strong>In this exploratory post hoc study, 342 patients with unresectable HCC and preserved liver function (Child-Pugh ≤B7) were enrolled in the palliative arm of the SORAMIC trial and randomized to receive either sorafenib monotherapy (n = 170) or selective internal radiation therapy (SIRT) plus sorafenib (n = 172). BMD (in Hounsfield units [HU]) was measured at the third lumbar vertebra on pre-treatment contrast-enhanced CT scans. Patients were stratified into low and high BMD groups using three definitions: the cohort median (139.5 HU for men, 130.0 HU for women), <160 HU for men and <175 HU for women (Meister criteria), and <160 HU (Jang criteria). Cox regression analyses assessed the impact of BMD on OS.</p><p><strong>Results: </strong>Median OS in the overall cohort was 11.1 months. No significant association between BMD and OS was observed in the entire cohort or within the sorafenib and SIRT/sorafenib subgroups. Similar nonsignificant results occurred in alcohol-, viral-, and metabolic dysfunction-associated steatohepatitis/metabolic dysfunction-associated steatotic liver disease-induced HCC subgroups.</p><p><strong>Conclusion: </strong>Baseline CT-derived BMD does not predict OS in advanced HCC patients, indicating it is not a robust prognostic biomarker in this setting. Low BMD does not affect a patient's resilience to SIRT. </p>.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13363108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wagner-Nelson Analysis to Create \"True\" Gastric Emptying Curves in ¹³C Breath Testing: A Pharmacokinetics-Based Review.","authors":"Masaki Sanaka, Takatsugu Yamamoto","doi":"10.1159/000551572","DOIUrl":"10.1159/000551572","url":null,"abstract":"<p><strong>Background: </strong>Breath testing to study gastric emptying (GE) has been criticized that its conventional analysis provides only an overall GE velocity (half-emptying time) that is far off from the scintigraphic scale, and it cannot give a whole pattern of time-GE curve comparable to what the scintigraphy expresses (\"true\" GE).</p><p><strong>Summary: </strong>GE breath tests (GEBT) approximate absorption of the 13C-marker (GE) from pulmonary 13CO₂elimination. The Wagner-Nelson (WN) method has long been used for accurately describing drug absorption based on urinary elimination. Then, GEBT with WN analysis has been reported to provide a time-GE curve comparable to the \"true\" GE of both solid and liquid meals. To handle the WN method properly, attention should be directed to the two assumptions on which the WN method relies; one-compartment model and first-order kinetics. The former is responsible for the slight overestimation of the \"true\" GE of liquids. The latter is associated with the necessity of longer sampling time, more than 6 h, which could reduce the convenience of GEBT, but a recent study has proposed how to address this problem.</p><p><strong>Key messages: </strong>The WN method gives a complete picture of the time-resolved GE curve (and not just lag phase or half-time values) equivalent to what nuclear scintigraphic studies do.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"1-13"},"PeriodicalIF":2.1,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492455","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":"Clinical Characteristics and Outcomes of Adults with Budd-Chiari Syndrome: A Single-Center Experience in Colombia.","authors":"Ximena Morales-Cruz, Carolina Salinas, Geovanny Hernández-Cely, Cristina Torres, Martin Garzón, Rocio Lopez-Panqueva, Juan Manuel Pérez, Felipe Durán-Torres, Adriana Varón, Oscar Beltrán","doi":"10.1159/000547006","DOIUrl":"10.1159/000547006","url":null,"abstract":"<p><strong>Introduction: </strong>Budd-Chiari syndrome is defined as the obstruction of hepatic venous flow. Limited evidence exists in Colombia regarding the characterization of these patients. This study aimed to describe the clinical characteristics, management, and survival of patients diagnosed with Budd-Chiari syndrome in a Colombian hepatology referral center from 2010 to 2022.</p><p><strong>Methods: </strong>This is a descriptive retrospective longitudinal study of a cohort of patients with Budd-Chiari syndrome in adult patients diagnosed with Budd-Chiari syndrome in a Colombian hepatology center from January 2010 to January 2022.</p><p><strong>Results: </strong>31 patients diagnosed with Budd-Chiari syndrome were included. Of the patients, 61.3% (n = 19) were female. The median age was 28 years [interquartile range (IQR) 23-38]. Acquired thrombophilias were the main risk factor (58.1%, n = 18), mainly secondary to antiphospholipid syndrome (55.5%, n = 10). The primary clinical manifestation presented was ascites 87.1% (n = 27). At diagnosis, 74.2% (n = 23) were in a chronic course, and 5 patients had cirrhosis documented by biopsy. The Rotterdam score was class II (intermediate prognosis) in 48.3% (n = 14). Of the patients, 86% (n = 25) had anticoagulation therapy. Five patients (16.1%) underwent transjugular intrahepatic portosystemic shunt. Eleven patients died (35.5%), with a median survival time from diagnosis to death of 337.1 days (IQR 46.5-647.5).</p><p><strong>Conclusion: </strong>Budd-Chiari syndrome is a poorly characterized disease in the Colombian population. This study shows that acquired thrombophilias are the leading risk factor associated with this medical condition in this population, with clinical features and mortality rates similar to those reported in the literature.</p>","PeriodicalId":520605,"journal":{"name":"Digestive diseases (Basel, Switzerland)","volume":" ","pages":"185-191"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986195","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}