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

{"title":"Paving the way for green endoscopy in Saudi Arabia: A call for sustainable gastroenterology practice.","authors":"Syed Anjum Gardezi, Abdulrahman Saleh, Mohammed Al Omar, Turki Alameel, Turki Abullah Alamri","doi":"10.4103/sjg.sjg_367_25","DOIUrl":"10.4103/sjg.sjg_367_25","url":null,"abstract":"<p><p>Green endoscopy, the integration of environmentally sustainable practices into gastrointestinal endoscopy services, is gaining global momentum amid rising concerns about healthcare’s carbon footprint. Endoscopy contributes significantly to greenhouse gas emissions, medical waste, and energy consumption due to its reliance on single-use plastics, energy-intensive reprocessing, and high procedural volumes. International initiatives, including those by the British Society of Gastroenterology and European Society of Gastrointestinal Endoscopy (ESGE), have highlighted strategies such as life cycle assessments, structured waste segregation, reusable devices, and carbon tracking, to reduce the environmental burden of endoscopy. While several high-income countries have adopted these approaches, Saudi Arabia has only begun to explore green endoscopy, despite its alignment with the sustainability objectives of Vision 2030 and the Saudi Green Initiative. Current barriers include lack of national guidelines, limited awareness among healthcare providers, inadequate recycling infrastructure, and infection control concerns. However, opportunities exist through centralized healthcare governance, investment in modern infrastructure, and integration of sustainability into training programs. This first of its kind review based on an extensive appraisal of existing literature examines the current status, challenges, and future opportunities for green endoscopy in Saudi Arabia, highlighting the urgent need for robust local data, supportive policy frameworks, and coordinated cross-sector collaboration. Embedding sustainability into endoscopy practice will not only reduce ecological impact but also position Saudi Arabia as a regional leader in sustainable healthcare.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"85-92"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491190","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":"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":"10.4103/sjg.sjg_199_25","url":null,"abstract":"<p><p>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":"104-120"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986995","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":"A preventable surge: Confronting the rising burden of colorectal cancer in Saudi Arabia through enhanced screening.","authors":"Ahmed A Almohammadi","doi":"10.4103/sjg.sjg_28_26","DOIUrl":"10.4103/sjg.sjg_28_26","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"172-173"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115336","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":"Effectiveness of AI-enhanced colonoscopy: A case-control study using real world evidence in a young screening age population.","authors":"Maryam A Alahmad, Youstina A Ghoris, Colleen S Thomas, Mutaz I Atieh, Heba A Abulkas, Ishtiaq Ahmed, Enas F Ahmed, Ameirah B Al Ali, Darshan Nagaraju, Mohammed A Karajeh, Michael B Wallace","doi":"10.4103/sjg.sjg_233_25","DOIUrl":"10.4103/sjg.sjg_233_25","url":null,"abstract":"<p><strong>Background: </strong>Computer aided detection (CADe) colonoscopy has been shown in randomized controlled trials to improve detection of adenomatous colorectal polyps. However, in real-world settings the benefits are less clear. Our objective was to assess CADe colonoscopy compared to routine colonoscopy in a clinical practice setting in the Arab region with a low screening age (40 years old).</p><p><strong>Methods: </strong>After the implementation of the CADe system (GI Genius, Medtronic) in our hospital in September 2021 until July 2023, all CADe cases were registered and matched to routine colonoscopy cases with (1:4) ratio. Assignment of patients to the CADe system versus the routine colonoscopy was pragmatic design based on scheduling and availability factors. Primary endpoints were adenoma per colonoscopy (APC), and adenoma detection rate (ADR).</p><p><strong>Results: </strong>A total of 840 patients were included, out of that 72 patients were excluded due to Boston Bowel Prep <6. The final analysis included 768 patients (161 with CADe, 607 without). The CADe system was found to significantly increase the mean APC (0.602 vs. 0.293; rate ratio 1.80 [1.40–2.32]; P < 0.001) and ADR, 30.4% with CADe versus 16.8% without CADe (adjusted RR 1.68 [1.27–2.22], P < 0.001). There was no significant difference in withdrawal time with CADe.</p><p><strong>Conclusion: </strong>In our study, CADe significantly increased the detection of adenomatous polyps in a young screening age population in a clinical practice setting. These findings support recent randomized controlled trials and contrast the findings of recent studies showing lack of benefit in real world practice.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"131-138"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121801","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":"Eradication rates of Helicobacter pylori regimens and predictors of treatment failure: A multicenter real-world study in Saudi Arabia.","authors":"Fahd Almalki, Abdullah D Alotaibi, Majed Almaghrabi, Reem S AlSulaiman, Hassan A Alsolami, Jaber M Alelyani, Salem Mi Bafarag, Ayman Alsebaey, Maryam L Aldossari, Sarah H Buhulaigah, Turki A Alamri, Ibrahim A Alhafid, Ibrahim M Alzahrani, Abdullah A Al-Abdulwahab, Reem Y Alhassani, Rawan S Azooni, Donia J Alghamdi, Sarah Ali M Alqhtani, Sulaiman M Alamro, Ahmed A Albadrani, Shaya Y AlQahtani, Reem A Alsaiari, Laila A Alharbi, Manal E Alotaibi, Asim Alhazmi, Abdullah A Alereinan","doi":"10.4103/sjg.sjg_382_25","DOIUrl":"10.4103/sjg.sjg_382_25","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of Helicobacter pylori resistance to clarithromycin and other antibiotics has led to a decline in eradication rates globally. Limited multicenter data from Saudi Arabia exist regarding the comparative effectiveness of various eradication regimens and predictors of treatment failure. This study aimed to evaluate eradication outcomes across different therapeutic lines and identify predictors of eradication failure in a real-world Saudi population.</p><p><strong>Methods: </strong>A retrospective multicenter cohort study was conducted across several tertiary hospitals in Saudi Arabia, from January 2020 to December 2024. Adult patients with confirmed H. pylori infection who received first-line or subsequent eradication therapy were included. Data were collected from electronic medical records, including demographic characteristics, comorbidities, diagnostic methods, treatment regimens, and therapy outcomes. Eradication success was confirmed by urea breath, stool antigen testing, or histopathology, at least four weeks post-therapy. Multivariate logistic regression was used to identify independent predictors of eradication failure.</p><p><strong>Results: </strong>A total of 690 patients were included (61.0% female; mean age 41 ± 13 years). Concomitant quadruple therapy was the most frequently prescribed regimen (49.0%), followed by standard triple therapy (25.9%). Eradication rates were significantly higher for concomitant (90.2%), levofloxacin-based regimens (87.8%) compared with standard triple therapy (73.7%; P < 0.001). There was no treatment failure among the 28 patients who received bismuth-based therapy, resulting in a 100% eradication rate. Univariate analysis suggested cardiovascular disease as a potential predictor of treatment failure (P = 0.03), but no independent predictors were identified after multivariate adjustment. No demographic or medication-related variables significantly influenced eradication outcomes.</p><p><strong>Conclusion: </strong>In this large, real-world Saudi cohort, concomitant and levofloxacin-based regimens achieved excellent H. pylori eradication rates, while bismuth-based therapy is effective; the reported eradication rate of 100% is most likely inflated, given the small number of patients who received this regimen. In contrast, standard triple therapy showed suboptimal efficacy, likely due to clarithromycin resistance. The findings support replacing triple therapy with quadruple bismuth-containing or non-bismuth-based therapies, or levofloxacin-containing regimens, as first-line therapy, and highlight the need for local antimicrobial resistance surveillance to guide treatment strategies.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"163-171"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021282","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":"Precision medicine in Crohn's disease: Navigating the path from biomarker discovery to clinical implementation.","authors":"Lijuan Sun, Xiaomei Sun, Cuixia Qiao, Yongpan Lu, Qian Li, Qianqian Wang, Hairui Gao","doi":"10.4103/sjg.sjg_384_25","DOIUrl":"https://doi.org/10.4103/sjg.sjg_384_25","url":null,"abstract":"<p><strong>Abstract: </strong>Crohn's disease (CD) is a highly heterogeneous inflammatory bowel disorder. Despite an expanding therapeutic arsenal, treatment selection remains largely empirical, often leading to delayed effective control and suboptimal outcomes. Precision medicine, which tailors therapy to individual patient characteristics, offers a promising alternative. Advances in biomarker discovery are enabling more personalized approaches. Research has moved beyond conventional markers to high-dimensional data from genomics, proteomics, and microbiome studies. Over 200 genetic susceptibility loci have been identified, and dysbiosis is recognized as a key modulator of disease and treatment response. Integrating these multi-omics data is crucial for building predictive models, a task increasingly aided by artificial intelligence and machine learning. However, translating these discoveries into clinical practice faces significant hurdles. These include insufficient validation across diverse populations, methodological heterogeneity, and a lack of real-world evidence. Biomarker performance may vary significantly across genetically diverse patient cohorts, raising concerns that precision medicine tools validated only in homogeneous populations could inadvertently propagate health disparities. It is also important to consider regional contexts, such as the Middle East and Saudi Arabia, where rising IBD incidence due to urbanization and unique genetic architectures may affect biomarker performance and therapy response. This review synthesizes recent progress, outlines the major barriers to implementation, and discusses future directions, such as leveraging digital health technologies and international collaborations, to accelerate the adoption of precision medicine and improve outcomes for CD patients.</p>","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914587","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":"10.4103/sjg.sjg_256_25","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"33-41"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140000","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":"Patterns and predictors of biologic therapy switching in inflammatory bowel disease at a tertiary care center: A retrospective observational study.","authors":"Ahmed G Alghamdi, Hadeel S Aldofaian, Mohammed S Alahmari, Bashaar K Alibrahim, Mishal A Alshowair, Hussam A Alhamidi, Abdullah H Bawazir, Amal M Aseri, Alaa A Aldeibani, Mohanned M AlRaddadi, Reem O Almutairi, Sultan S Alshahrani, Abdullah D Alenezi, Rakan H Alshala, Abeer M Alhuraibi, Renad M Alharbi","doi":"10.4103/sjg.sjg_169_25","DOIUrl":"10.4103/sjg.sjg_169_25","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"49-59"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145498013","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":"Addressing the gaps in biologic therapy utilization trends in IBD from Saudi Arabia.","authors":"Zaki Alhashimalsayed","doi":"10.4103/sjg.sjg_432_25","DOIUrl":"10.4103/sjg.sjg_432_25","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"79-80"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145867174","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":"The per-oral endoscopic myotomy (POEM) era in Saudi Arabia: Bridging tertiary-center experience with clinical care pathways.","authors":"Ahmad Najdat Bazarbashi","doi":"10.4103/sjg.sjg_428_25","DOIUrl":"10.4103/sjg.sjg_428_25","url":null,"abstract":"","PeriodicalId":520774,"journal":{"name":"Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association","volume":" ","pages":"1-3"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145728346","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}