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

{"title":"Large duct primary sclerosing cholangitis with or without inflammatory bowel disease in Saudi patients.","authors":"Hamdan S AlGhamdi, Nawaf M AlYahya, Ibrahim M Bahabri, Majed A Al Ashaikh, Abdulrahman K Habib, Abdulaziz A AlAhmary, Nuha Al Ajlan, Abdulrahman I AlAbdulgader, Abduljaleel M Alalwan, Faisal M Sanai","doi":"10.4103/sjg.sjg_32_25","DOIUrl":"https://doi.org/10.4103/sjg.sjg_32_25","url":null,"abstract":"<p><strong>Background: </strong>Primary sclerosing cholangitis (PSC) is often associated with inflammatory bowel disease (IBD). We aimed to compare the clinical presentations and outcomes of PSC in patients with and without IBD in Saudi population.</p><p><strong>Methods: </strong>The medical records of patients with PSC, diagnosed between 2009 and 2020, in a single referral center in Saudi Arabia were reviewed. Primary outcomes included liver-related clinical decompensations, while secondary outcomes encompassed hepatobiliary malignancies, liver-related mortality, and liver transplantation.</p><p><strong>Results: </strong>Among 87 patients, 52 (59.8%) had PSC-IBD and 35 (40.2%) had PSC without IBD. PSC-IBD patients were significantly younger at diagnosis (35.4 ± 13.3 vs. 43.6 ± 12.8 years, P = 0.005). Non-IBD patients exhibited higher rates of diabetes (P = 0.045), hyperlipidemia (P = 0.022), and autoimmune hepatitis (P = 0.008). While clinical presentations were similar, non-IBD patients demonstrated more frequent cytopenia from splenomegaly (31.4% vs. 5.8%, P = 0.001) and hepatic decompensation (37.1% vs. 7.7%, P = 0.001). Bilirubin (P = 0.002) and aspartate aminotransferase (P = 0.042) levels were increased in non-IBD patients, while PSC-IBD patients had higher white blood cell (P = 0.021) and platelet counts (P < 0.001). Liver biopsies were more frequently performed in non-IBD patients (45.7% vs. 19.2%, P = 0.008). Overall mortality was 12.8%, with no difference in median survival time between groups (P = 0.782). Multivariate analysis identified age (hazard ratio [HR]: 1.048, P = 0.044) and MELD-Na (HR: 1.155, P = 0.016) as independent predictors of mortality.</p><p><strong>Conclusion: </strong>In this Saudi cohort, non-IBD PSC patients were diagnosed later and presented with more comorbidities and hepatic decompensation. However, IBD status did not impact overall survival. Older age and higher MELD-Na scores at presentation were significant risk factors for mortality in PSC patients.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234826","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":"Eating behaviors in childhood eosinophilic esophagitis: A retrospective case-controlled study.","authors":"Mohammed Hasosah, Feras Baowaidan, Ashraf AlSahafi, Ali Zaidan, Ghassan Sukkar, Sameha Khayyat, Khlood O Alotibey","doi":"10.4103/sjg.sjg_186_25","DOIUrl":"https://doi.org/10.4103/sjg.sjg_186_25","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory disease in the esophagus. It is associated with feeding difficulties. We aimed to assess eating behaviors in patients with EoE and compare them with controls.</p><p><strong>Methods: </strong>This case-controled study enrolled children aged 0-16 years where their eating/behavior scores were measured. Child Behavior Frequency Scores (CBFS) >61, Parents Feeling/strategies Frequency Score (PFSFS) >20 and the Total Behavioral Pediatric Feeding Assessment Scores (BPFAS) >84 were considered as abnormal results.</p><p><strong>Results: </strong>The study involved 80 children with 40 in the EoE group and 40 in the control group. The mean age of EoE diagnosis was 6.4 ± 4.0 years, while the mean age of the control group was 8.4 ± 4.0 years. Fifty four of the 80 patients (67.5%) were male. There was a significant difference between the EoE patients and the controls regarding child feeding difficulties. The mean scores were as follows: problems chewing food, 2.4 ± 1.6 in EoE vs. 1.3 ± 0.7 in controls, P < 0.001; drinking more than eating, 2.6 ± 1.7 in EoE vs. 1.6 ± 1.2 in controls, P = 0.002; taking longer than 20 min to finish a meal, 3.3 ± 2.0 in EoE vs. 2.2 ± 1.5 in controls, P = 0.008; and parents get frustrated or anxious when feeding the child, 2.8 ± 1.7 in EoE vs. 1.3 ± 0.8 in controls, P < 0.001. Our results confirmed that the mean frequency score for parent feelings and strategies was significantly higher in the EoE group compared to controls (24.2 ± 7.4 vs. 18.9 ± 7.6); 95% confidence interval (CI), 2.0-8.7, P = 0.002. Additionally, the mean frequency score for Child behavior was 60.3 ± 16.9 in EoE vs. 43.5 ± 12.7 in controls; 95% CI, 10.2-23.4, P < 0.001. Furthermore, the total BPFA frequency mean score was 84.5 ± 22.7 in EoE vs. 62.3 ± 19.3 in controls; 95% CI, 12.8-31.5, P < 0.001.</p><p><strong>Conclusions: </strong>This is the first pediatric study demonstrating CBFS, PFSFS and total BPFAS used as measures for scoring the symptoms of EoE. Our results suggest that the identification of altered eating behavior was strongly associated with EoE in comparison to controls.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153155","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":"Achalasia management with per-oral endoscopic myotomy: A study of clinical success and complications at a tertiary center in Saudi Arabia.","authors":"Abdulrahman Alfadda, Abdullah Alqaraawi, Aymen Almuhaidb, Khalid Al Kahtani, Faisal M Alyahya, Mohmmed Alzomia, Adnan Almahrouq, Musthafa C Peedikayil","doi":"10.4103/sjg.sjg_256_25","DOIUrl":"https://doi.org/10.4103/sjg.sjg_256_25","url":null,"abstract":"<p><strong>Background: </strong>Per-oral endoscopic myotomy (POEM) has emerged as a minimally invasive treatment for achalasia, with growing global adoption. However, regional data from Saudi Arabia are scarce. This study aimed to evaluate the efficacy, safety, and long-term outcomes of POEM in a tertiary referral center in Riyadh.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all consecutive patients with achalasia who underwent POEM at King Faisal Specialist Hospital and Research Centre between April 2017 and October 2023. Diagnosis was confirmed by high-resolution manometry and classified using the Chicago Classification v3.0 or v4.0. Clinical success was defined as an Eckardt score ≤3 at follow-up. Secondary outcomes included adverse events, gastroesophageal reflux disease (GERD), and need for further intervention.</p><p><strong>Results: </strong>A total of 105 patients (mean age 41.2 ± 13.9 years; 50.5% male) underwent POEM. The majority had type II achalasia (77.1%), followed by type III (12.4%) and type I (10.5%). Prior interventions were recorded in 25.7% of patients. Clinical success was achieved in 77.1%, with a significant reduction in mean Eckardt score (6.8 ± 2.3 to 1.8 ± 1.7; P < 0.001). The median follow-up was 1118 days. Patient satisfaction (≥80% symptom relief) was 69.5%. Complications occurred in 26.7%, predominantly gas-related events, with no procedure-related mortality. Major adverse events were rare (perforation 1.9%, reoperation 1.9%). Post-POEM GERD was confirmed in 24.4% of those tested with the Ph study, and 58.8% required proton pump inhibitor therapy at follow-up. Comparative analysis across time periods showed no significant difference in complication rates, although hospital stay was longer in the later cohort. Multivariable analysis did not identify independent predictors of clinical success.</p><p><strong>Conclusion: </strong>POEM is a safe and effective treatment for achalasia in Saudi Arabia, achieving substantial symptom relief with acceptable complication rates, consistent with international experience. The notable incidence of post-procedure GERD underscores the need for long-term reflux monitoring and management.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140000","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":"Use of wireless capsule endoscopy for the diagnosis and grading of esophageal varices in patients with portal hypertension: A systematic review and meta-analysis.","authors":"Omer Usman, Deipthan Prabakar, Maryam A Malik, Muhammad A Basit, Abdul R Awan, Muhammad W Khan, Muhammad U Shahbaz, Ibrar Atiq, Abirami Rajendiran, Paul Estrada, Rehaab Mujahid, Abdullah Ahmad","doi":"10.4103/sjg.sjg_140_25","DOIUrl":"https://doi.org/10.4103/sjg.sjg_140_25","url":null,"abstract":"<p><strong>Background: </strong>Esophageal varices are a life-threatening complication of portal hypertension, necessitating timely screening for optimal patient outcomes. While esophagogastroduodenoscopy (EGD) remains the gold standard for diagnosis, its invasiveness poses challenges for patient compliance. Wireless capsule endoscopy has emerged as a potential noninvasive alternative. This meta-analysis evaluates the diagnostic accuracy of wireless capsule endoscopy in screening and diagnosing esophageal varices compared to EGD.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, Embase, Web of Science, and Cochrane Library database from 1995 to 2024. Studies assessing the sensitivity, specificity, and overall diagnostic efficacy of wireless capsule endoscopy for esophageal varices were included. The QUADAS-2 tool was employed to assess the risk of bias. Sensitivity and specificity were analyzed using a 95% confidence interval (CI), and heterogeneity among studies was evaluated using the I² statistic.</p><p><strong>Results: </strong>A total of 20 studies met the inclusion criteria, comprising 3350 unique records screened. Pooled analysis demonstrated that wireless capsule endoscopy had a sensitivity of 81.2% (95% CI: 78.5-83.7) and a specificity of 86.2% (95% CI: 82.7-89.1) for detecting esophageal varices. Minimal heterogeneity was observed (I² = 0%), reinforcing the robustness of the findings. Wireless capsule endoscopy was particularly effective in identifying high-risk varices, with some studies reporting sensitivity and specificity exceeding 95%. Additionally, patient tolerance and satisfaction with wireless capsule endoscopy were higher compared to EGD.</p><p><strong>Conclusion: </strong>Wireless capsule endoscopy demonstrates substantial diagnostic accuracy for esophageal varices, offering a noninvasive, well-tolerated alternative to EGD. Its role in clinical practice warrants further investigation.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140025","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":"Biologic therapy utilization trends in inflammatory bowel disease: A narrative review from Saudi Arabia.","authors":"Syed A Gardezi, Turki AlAmeel, Eman AlSulais","doi":"10.4103/sjg.sjg_183_25","DOIUrl":"10.4103/sjg.sjg_183_25","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"252-259"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693146","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":"Systematic review and meta-analysis: The efficacy and safety of radiofrequency ablation combined with endoscopic resection for early superficial esophageal squamous cell neoplasia.","authors":"Hsin-Hung Chen, Sz-Iuan Shiu, Hsu-En Cheng, Ching-Tang Tseng, Jun-Peng Chen","doi":"10.4103/sjg.sjg_97_25","DOIUrl":"10.4103/sjg.sjg_97_25","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"260-267"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987037","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, risk factors, and demographic insights of sickle cell hepatopathy in Omani adolescents and adults: A retrospective analysis.","authors":"Said A Al-Busafi, Fatma Al-Zaabi, Salam Al-Kindi","doi":"10.4103/sjg.sjg_177_25","DOIUrl":"10.4103/sjg.sjg_177_25","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"301-312"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126985","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":"Metabolic dysfunction-associated steatotic liver disease management in Saudi Arabia: A modified Delphi-based adaptation of international standards.","authors":"Faisal Abaalkhail, Faisal M Sanai, Khalid AlSwat, Adnan Alzanbagi, Ahmed Aljedai, Ali Alshehri, Assim Alfadda, Hamdan Alghamdi, Majid Almadi, Mohammad Aleissa, Mona Ismail, Saud Alsifri, Turki Alzahrani, Saleh Alqahtani, Waleed Al Hamoudi","doi":"10.4103/sjg.sjg_199_25","DOIUrl":"https://doi.org/10.4103/sjg.sjg_199_25","url":null,"abstract":"<p><strong>Abstract: </strong>The reclassification of nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD) marks a significant shift in understanding liver disease, particularly in Saudi Arabia, where metabolic disorders are highly prevalent. This study aimed to develop expert consensus recommendations for early detection, specialist referral, and management of MASLD/metabolic dysfunction-associated steatohepatitis (MASH) in Saudi Arabia. A modified Delphi process was used to establish consensus among an expert panel of 15 multidisciplinary specialists, including hepatologists, endocrinologists, gastroenterologists, and primary care physicians. The panel addressed six key areas: terminology and epidemiology, screening, risk categories, hepatocellular carcinoma surveillance, first-line treatment, and advanced therapeutic options. A literature review spanning January 2011 to May 2024 informed evidence-based recommendations, assessed using the Grading of Recommendations, Assessment, Development, and Evaluation criteria. The consensus established screening criteria for high-risk groups, emphasizing noninvasive tests (NITs) such as Fibrosis-4 (FIB-4), enhanced liver fibrosis (ELF) score, and magnetic resonance elastography (MRE). Risk stratification thresholds were defined: FIB-4 ≥2.67, liver stiffness measurement (LSM) >12 kPa, and MRE >5.0 kPa indicate advanced fibrosis requiring specialist referral. Treatment recommendations emphasized a multidisciplinary approach, incorporating lifestyle modifications, pharmacotherapy (including glucagon-like peptide-1 receptor agonists [GLP-1 RA], sodium-glucose cotransporter-2 [SGLT2] inhibitors, and pioglitazone), and surgical interventions when appropriate. Bariatric surgery was recommended for eligible patients with noncirrhotic MASLD. This consensus provides evidence-based guidance for MASLD/MASH management in Saudi Arabia, highlighting early detection through NITs, risk-stratified care pathways, and multidisciplinary treatment strategies essential for improving patient outcomes in the region.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986995","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":"Multidimensional fatigue mediates the relationship between sexual quality of life and perceived stress in patients with inflammatory bowel disease.","authors":"Chen Chen, Hui Cao, Tianfang Zhu, Wei Han, Shouli Wang","doi":"10.4103/sjg.sjg_7_25","DOIUrl":"10.4103/sjg.sjg_7_25","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"268-273"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987023","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":"Empowering trainee fellows today will ensure that we build tomorrow's leaders in gastroenterology.","authors":"Zaki Alhashimalsayed","doi":"10.4103/sjg.sjg_312_25","DOIUrl":"10.4103/sjg.sjg_312_25","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"313-314"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093337","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}