Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association最新文献

{"title":"Pediatricians' knowledge and practice styles regarding cow milk protein allergy among Arab countries.","authors":"Mohammed Hasosah, Hamed Aljiffry, Hasan Isa, Hayder Swaij, Azad Haleem, Ibrahim Rozi, Mohammed Kambal, Eman Buhamrah, Maria Karam, Tariq Al Farsi, Basil Nasrallah, Hatim Abdelrhman, Peggy Nehme, Sherif El Sherif","doi":"10.4103/sjg.sjg_230_26","DOIUrl":"https://doi.org/10.4103/sjg.sjg_230_26","url":null,"abstract":"<p><strong>Background: </strong>Cow's milk protein allergy (CMPA) affects 2-6% of children, with peak prevalence in the first year of life. Despite published guidelines, significant gaps remain in awareness and practice among healthcare providers. The aim of this study was to evaluate pediatricians' knowledge and practice styles (KPS) among pediatric care providers (PCPs) working in different Arab countries regarding their diagnosis and treatment approach to CMPA.</p><p><strong>Methods: </strong>We conducted a cross-sectional multinational survey in eight Arab countries including Saudi Arabia, Iraq, Lebanon, Oman, Bahrain, United Arab Emirates (UAE), Qatar, and Kuwait. The following PCPs: pediatric specialists (PSs), pediatric residents (PRs), pediatric consultants (PCs), pediatric gastroenterologists (PGs), pediatric immunologists (PIs), general physicians (GPs), and family doctors (FDs) were included in this study. The survey was anonymous, and participants provided input on the diagnosis and management of CMPA.</p><p><strong>Results: </strong>Of the 3000 questionnaires distributed to PCPs, 2145 (response rate 72%) were completed and analyzed. The majority of the respondents were male (n = 1255; 58.5%). The majority of participants were PSs (48%). Regarding the methods to diagnose CMPA, pediatricians and non-pediatricians used clinical diagnosis (61.4%), oral elimination challenge test (27.6%), specific IgE for cow's milk (8.6%) and skin prick test (1.2%) for diagnosis of CMPA ( P < 0.001). Furthermore, pediatricians used \"clinical diagnosis\" method to confirm CMPA significantly more than other non- pediatricians (87% vs 13%, respectively; P < 0.001). In terms of management of CMPA in breastfed infants, 67.8% reported that continuing breastfeeding with maternal elimination of cow's milk and dairy products was the best treatment approach, with significant differences between pediatricians and non-pediatricians ( P < 0.001). In terms of management of mild-moderate CMPA in formula-fed infants, hydrolyzed formula (eHF) was the most commonly prescribed (53%), while rice-based milk was the formula least often prescribed. eHF was prescribed as a first-line treatment of CMPA significantly more frequently by pediatricians than by non-pediatricians (88.9% vs 11.1%, respectively; P < 0.001). PCPs were more likely to comply (71.1%) with European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) clinical guidelines for CMPA. PCPs were fully agreed (68.1%) to establish unified CMPA guidelines in Arab countries.</p><p><strong>Conclusions: </strong>Substantial variability in pediatricians' KPS regarding CMPA across the participating Arab countries was identified. The identification of these gaps highlights the need for policymakers to develop educational materials for PCPs to increase their knowledge of CMPA. Evidence-based guidelines and standardized practice are needed in the Middle East.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229853","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":"Response to: Interpreting the prognostic value of the lactate-to-albumin ratio in severe acute pancreatitis.","authors":"Hanwen Tong, Wenzhen Zhou, Lingli Wu, Qingcheng Zhu","doi":"10.4103/sjg.sjg_392_26","DOIUrl":"https://doi.org/10.4103/sjg.sjg_392_26","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187609","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":"Interpreting the prognostic value of the lactate-to-albumin ratio in severe acute pancreatitis: Statistical considerations.","authors":"Remzi Ekici","doi":"10.4103/sjg.sjg_381_26","DOIUrl":"https://doi.org/10.4103/sjg.sjg_381_26","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123876","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":"Dietary management in inflammatory bowel disease: A narrative review of the current evidence.","authors":"Mahmoud H Mosli","doi":"10.4103/sjg.sjg_225_26","DOIUrl":"https://doi.org/10.4103/sjg.sjg_225_26","url":null,"abstract":"<p><strong>Abstract: </strong>Diet is increasingly recognized as both an environmental determinant and a therapeutic target in inflammatory bowel disease (IBD), yet dietary guidance for clinicians has historically been inconsistent and, in many cases, excessively restrictive. This narrative review synthesizes current evidence-based dietary recommendations for the management of IBD across disease phases, anchored on the European Crohn's and Colitis Organization (ECCO) 2025 Dietary Management Consensus and supplemented by landmark randomized controlled trials, systematic reviews, meta-analyses, and consensus guidelines published through September 2025. The ECCO 2025 Dietary Management Consensus (published September 2025) and select regional Saudi guidelines published after the initial literature search were incorporated as pre-specified anchor references given their direct relevance to this review's framework. No single IBD diet is universally applicable. During active Crohn's disease (CD), exclusive enteral nutrition (EEN) has the strongest evidence for inducing remission, while the Crohn's Disease Exclusion Diet with Partial Enteral Nutrition (CDED + PEN) offers an evidence-based, food-based alternative, particularly for biologic-naive patients. Specific dietary modifications are warranted in patients with fibrostenotic strictures. During remission, dietary fiber is associated with a lower relapse risk, the Mediterranean dietary pattern supports remission maintenance in ulcerative colitis (UC), and partial enteral nutrition may sustain remission in CD. Dietary fiber and dairy products do not require routine restriction; ultra-processed foods and excessive red meat intake should be reduced. Micronutrient deficiencies - affecting more than 50% of IBD patients - require systematic monitoring and targeted supplementation rather than empirical universal supplementation. Multiple prevalent dietary misconceptions lack scientific support and cause measurable nutritional harm if left uncorrected. Evidence-based dietary management of IBD requires individualized, phase-specific recommendations, access to IBD-experienced dietitians, and systematic micronutrient monitoring. Gastroenterologists are well-positioned to translate this evidence into meaningful clinical practice for their patients. As a narrative review, this work is subject to inherent methodological limitations, including potential selection bias in the literature and the absence of formal quality assessment of individual studies.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077183","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":"Improving operational efficiency in endoscopy units: A multi-domain narrative review.","authors":"Suliman Alshankiti, Ammar Alotaibi, Muhammad F Mubarak, Rasheed Alkhiari, Majid A Almadi","doi":"10.4103/sjg.sjg_199_26","DOIUrl":"https://doi.org/10.4103/sjg.sjg_199_26","url":null,"abstract":"<p><strong>Abstract: </strong>Endoscopy units are faced with increasing procedural demand; while staffing, space, and budgets are not. Lasting gains in efficiency rarely come from a single intervention; rather, they come from working on several fronts at once, from unit design and scheduling through to staffing, sedation choice, technology, and quality governance. We set out to bring the evidence on this for the working endoscopist, or unit manager can use. We conducted a narrative review of the literature published between 2000 and 2025, searching PubMed, Embase, and the Cochrane database with terms including \"endoscopy efficiency,\" \"endoscopy scheduling,\" \"endoscopy quality improvement,\" \"Lean endoscopy,\" \"plan-do-study-act (PDSA) endoscopy,\" and \"endoscopy key performance indicators (KPIs).\" We supplemented this with consensus statements and quality measures from the American Society for Gastrointestinal Endoscopy (ASGE), the European Society of Gastrointestinal Endoscopy (ESGE), and the British Society of Gastroenterology (BSG). Eight inter-related domains were identified: meaningful KPI measurement, physical design that supports patient flow, evidence-based scheduling, lean and PDSA-driven workflow change, staffing models matched to case mix, procedure-level sedation choices, targeted technology, and quality benchmarking. In individual published series, reported gains are substantial: PDSA-based interventions increased procedural volume by up to 18% and reduced mean first-case delay by 15.5 min. Lean redesign can reduce room turnover from 28 to 18 minutes and daily cases per room from 9 to 12. Scheduling optimization can improve room utilization from below 70% to above 85% in published quality improvement series. Endoscopy efficiency needs careful metric selection, a layout that improves patients, experience, intelligent rostering, ongoing process work, flexible staffing, sensible sedation, the right technology in the right places, and honest benchmarking. The frameworks set out in this review are intended to give units of any size a starting point.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077157","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":"Efficacy and safety of endoscopic full-thickness plication for proton pump inhibitor-dependent gastroesophageal reflux disease: A single-center retrospective cohort study.","authors":"Alya Binmahfouz, Lenah S Binmahfouz, Mazin A Alsayed, Adeeb M Elghalayini","doi":"10.4103/sjg.sjg_249_26","DOIUrl":"https://doi.org/10.4103/sjg.sjg_249_26","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) remain the cornerstone of gastroesophageal reflux disease (GERD) management. However, concerns over long-term use have prompted interest in alternatives. Endoscopic full-thickness plication (eFTP) is a minimally invasive approach designed to enhance lower esophageal sphincter (LES) function, while avoiding surgical morbidity. This study assessed the efficacy and safety of eFTP in patients with PPI-dependent GERD.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 85 patients, who underwent eFTP between December 2022 and March 2024. Data on demographics, symptom duration, PPI use, anatomical findings, postprocedural complications, and 12-month outcomes were collected. The primary endpoint was PPI discontinuation. Logistic regression was performed to identify predictors of successful PPI cessation.</p><p><strong>Results: </strong>Most patients were male (67.1%), and 73% were older than 35 years. Reflux symptoms had persisted for more than 3 years in 76.5% of patients, and 40% had used PPIs for over 5 years. eFTP was well tolerated, with 90.6% discharged within 24 hours. Adverse events were infrequent, including one leak (1.2%) and postprocedural pain in 10.6% of patients. Within 12 months, 57.6% achieved PPI discontinuation. Longer prior PPI use showed a trend toward improved outcomes, whereas a symptom duration of 2-3 years was associated with lower odds of PPI cessation ( P = 0.037). Other variables were not significant.</p><p><strong>Conclusion: </strong>eFTP was associated with reduced PPI dependence and an acceptable safety profile, representing a minimally invasive option for selected patients. Prospective controlled studies are needed to confirm long-term efficacy.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077168","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":"Discordance between observer and patient-reported shared decision-making in inflammatory bowel disease: A multicenter cross-sectional study.","authors":"Eman S Al Sulais, Mohammmed A AlBesher, Zahra A Al Saeed, Ayman A Sakr, Dimah A Alaskar, Turki A AlAmeel","doi":"10.4103/sjg.sjg_99_26","DOIUrl":"10.4103/sjg.sjg_99_26","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"394-400"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166809","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":"STRIDE-II treatment target achievement in inflammatory bowel disease: a cross-sectional study from a tertiary IBD centre in the United Arab Emirates.","authors":"Noorah Al Hosani, Maitha Al Hosani, Abdulla A Aljanahi, Mohammed N Quraishi","doi":"10.4103/sjg.sjg_90_26","DOIUrl":"10.4103/sjg.sjg_90_26","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"438-446"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166848","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":"Comment on antrum resection versus antrum preservation in laparoscopic sleeve gastrectomy: Unaddressed issues.","authors":"Fan Qi, Dehai Xiong","doi":"10.4103/sjg.sjg_312_26","DOIUrl":"10.4103/sjg.sjg_312_26","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"447-448"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908435","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":"Stigma management, social support, and quality of life among adults with Crohn's disease and ulcerative colitis in Saudi Arabia: A cross-sectional study.","authors":"Fahad M Alzahrani","doi":"10.4103/sjg.sjg_213_26","DOIUrl":"10.4103/sjg.sjg_213_26","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"415-424"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13630364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805483","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}