The Korean journal of helicobacter and upper gastrointestinal research最新文献

{"title":"Chronic Eosinophilic Gastritis Presenting as Gastric Outlet Obstruction in a Young Man: A Case Report.","authors":"Na Young Kim, Jin Lee, Ji Eun Na, Yong Eun Park, Jongha Park, Tae Oh Kim","doi":"10.7704/kjhugr.2025.0006","DOIUrl":"10.7704/kjhugr.2025.0006","url":null,"abstract":"<p><p>Eosinophilic gastritis, a relatively rare condition characterized by eosinophilic infiltration of the gastrointestinal wall, has a chronic course involving relapses and remissions. Herein, we describe the case of a 25-year-old man with chronic eosinophilic gastritis complicated by gastric outlet obstruction. The patient had a history of persistent gastrointestinal symptoms since adolescence and had developed severe dyspepsia and vomiting two months before presentation. Eosinophilic gastritis was confirmed using endoscopy and biopsy. The symptoms improved after steroid treatment, although the mucosal lesions did not completely resolve. This case shows that eosinophilic gastritis can have a chronic course with persistent mucosal lesions, despite symptomatic improvement. Early diagnosis and appropriate treatment of eosinophilic gastritis are important for preventing chronic gastric mucosal changes.</p>","PeriodicalId":520887,"journal":{"name":"The Korean journal of helicobacter and upper gastrointestinal research","volume":"25 2","pages":"172-177"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478616","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":"Current Practices in Histological Diagnosis and Management of Asymptomatic Gastric Subepithelial Lesions: A Multicenter Survey in Korea.","authors":"Sang Hoon Kim, Jae Yong Park, Ayoung Lee, Bong Eun Lee, Byung-Hoon Min, Chan Hyuk Park, Da Hyun Jung, Hyeong Ho Jo, Hyunsoo Chung, In Hyuk Yoo, Seon Young Park, Seung-Woo Lee, Yonghoon Choi, Jeong Hoon Lee, Seung Han Kim, Jae Myung Park, Joon Sung Kim, Sung Eun Kim, Hwoon-Yong Jung","doi":"10.7704/kjhugr.2025.0009","DOIUrl":"10.7704/kjhugr.2025.0009","url":null,"abstract":"<p><strong>Objectives: </strong>Gastric subepithelial lesions (SELs) are elevated lesions covered by normal mucosa often detected during esophagogastroduodenoscopy. Because of its submucosal location, accurate diagnosis through biopsy is challenging. We conducted a nationwide survey to identify differences in clinical practices across healthcare institutions with varying medical resources in Korea.</p><p><strong>Methods: </strong>We surveyed gastroenterologists in Korea between September 2023 and February 2024 using email, text messages, and Quick Response codes. The survey collected comprehensive data on respondent demographics, clinical practices for histological diagnosis, treatment decisions based on lesion size, and perceptions regarding endoscopic resection, including lesion size and the key factors influencing the decision to consider endoscopic resection.</p><p><strong>Results: </strong>The 341 respondents surveyed included 104 (30.4%), 66 (19.3%), and 171 (50.3%) primary, secondary, and tertiary healthcare institutions, respectively. Most endoscopists did not perform biopsies of SELs <1 cm (70.4%, 240/341). However, for SELs 2-3 cm in size, most patients in primary and secondary healthcare institutions were transferred (85.9%), and EUS-guided biopsies (40.4%) were performed in tertiary hospitals. Endoscopic resection of gastric SELs was mainly performed in tertiary institutions (32.8% vs. 4.1%, p<0.001), and 75.7% (258/341) of the respondents considered endoscopic resection applicable for lesions <3 cm.</p><p><strong>Conclusions: </strong>Clinical practices for the histological diagnosis and treatment of asymptomatic gastric SELs vary according to the lesion size and healthcare institution type. Specific guidelines for the management of gastric SELs considering their size, features, and institutions are required.</p>","PeriodicalId":520887,"journal":{"name":"The Korean journal of helicobacter and upper gastrointestinal research","volume":"25 2","pages":"159-166"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478617","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":"Changes in Helicobacter pylori Status in Patients Who Underwent Partial Gastrectomy for Gastric Cancer Therapy.","authors":"Yonghoon Choi","doi":"10.7704/kjhugr.2025.0018","DOIUrl":"10.7704/kjhugr.2025.0018","url":null,"abstract":"<p><p>The role of Helicobacter pylori eradication in patients with gastric cancer (GC) undergoing gastrectomy remains unknown because current evidence is limited. This retrospective study investigated H. pylori infection status, eradication therapy, and success rates based on surgical methods. A total of 2827 patients underwent gastrectomy for GC; 1510 (53.4%) tested positive for H. pylori, 1121 (39.7%) tested negative, and 196 (6.9%) were not tested. Among H. pylori-positive patients, 765 underwent eradication therapy, with treatment failure in 36 patients. Among the untreated patients, H. pylori was observed to have spontaneously disappeared by follow-up in 206 of 745 patients. The proportion of patients with spontaneous negative conversion was higher in the proximal and pylorus-preserving gastrectomy groups than in the distal gastrectomy group. However, no difference was observed in the failure rate of eradication therapy based on the surgical method used.</p>","PeriodicalId":520887,"journal":{"name":"The Korean journal of helicobacter and upper gastrointestinal research","volume":"25 2","pages":"191-194"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478615","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":"Infective Esophagitis.","authors":"Na Young Kim, Jin Lee","doi":"10.7704/kjhugr.2025.0007","DOIUrl":"10.7704/kjhugr.2025.0007","url":null,"abstract":"<p><p>Infectious esophagitis is caused by a viral, fungal, or bacterial infection of the esophagus. The most common viral pathogens are cytomegalovirus (CMV) and herpes simplex virus (HSV); Candida is the most common fungal pathogen. Bacterial esophagitis is rare, typically occurring only in immunocompromised individuals, and is often caused by the reactivation of a latent infection. The symptoms of infectious esophagitis range from an asymptomatic presentation to dysphagia, chest pain, and fever. Diagnoses are based on endoscopic findings and biopsy results for pathogen identification. In immunocompromised patients, treatment involves the use of antimicrobial agents. CMV esophagitis is characterized by esophageal ulcers visible during endoscopy and is diagnosed when intranuclear or cytoplasmic inclusions are observed in biopsy samples. Patients with HSV esophagitis present with volcano-like ulcers visible during endoscopy and are treated with acyclovir. Candida esophagitis is identified by the presence of white plaques and is treated using fluconazole. Although rare, bacterial esophagitis can be caused by Mycobacterium tuberculosis or oral/respiratory tract bacteria. This form of infectious esophagitis presents as nonspecific esophagitis during endoscopy; patients are treated using antibiotics. This review discusses the causative pathogens, endoscopic features, diagnosis, and treatment of infectious esophagitis.</p>","PeriodicalId":520887,"journal":{"name":"The Korean journal of helicobacter and upper gastrointestinal research","volume":"25 2","pages":"108-116"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478623","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":"Real World Clinical Practice for Low-Grade Gastric Adenoma in South Korea.","authors":"Da Hyun Jung","doi":"10.7704/kjhugr.2025.0026","DOIUrl":"10.7704/kjhugr.2025.0026","url":null,"abstract":"","PeriodicalId":520887,"journal":{"name":"The Korean journal of helicobacter and upper gastrointestinal research","volume":"25 2","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478624","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":"Reflux Esophagitis.","authors":"Kyoungwon Jung","doi":"10.7704/kjhugr.2025.0001","DOIUrl":"10.7704/kjhugr.2025.0001","url":null,"abstract":"<p><p>Reflux esophagitis is a significant clinical manifestation of gastroesophageal reflux disease (GERD), and its prevalence is increasing because of lifestyle changes and increasing obesity. The diagnosis of GERD primarily emphasizes symptom-based approaches that focus on heartburn and acid regurgitation. GERD can be confirmed through proton pump inhibitor (PPI) therapy, endoscopy, and 24-hour impedance-pH monitoring. Of these methods, endoscopy plays a critical role in diagnosing reflux esophagitis. Recently, both PPIs and potassium-competitive acid blockers (P-CABs) have been recommended as first-line treatments, with P-CABs showing greater efficacy in severe cases or in patients unresponsive to PPIs. This review discusses the prevalence and risk factors of reflux esophagitis, presents the latest insights into its pathophysiology and diagnosis, and provides a comparative analysis of recent domestic and international guidelines.</p>","PeriodicalId":520887,"journal":{"name":"The Korean journal of helicobacter and upper gastrointestinal research","volume":"25 2","pages":"98-107"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478625","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":"Two Cases of Pneumothorax Induced by Fish Bones Impacted in the Esophagus.","authors":"Donghyoun Lee, Heung Up Kim, Hyun Joo Song, Hyun Wook Kang","doi":"10.7704/kjhugr.2024.0076","DOIUrl":"10.7704/kjhugr.2024.0076","url":null,"abstract":"<p><p>Although most digestive tract foreign bodies pass naturally, approximately 10% require endoscopic removal and another 1% require surgical intervention. The upper esophagus is the most common site of foreign body impaction. In the East, fish bones are the most commonly encountered foreign bodies in the esophagus, whereas in the West, meat is the most common. Prompt removal of these impacted foreign bodies is important because they may lead to serious complications, such as esophageal perforation or obstruction. The esophagus is located in the deepest part of the chest and is in close proximity to vital organs, such as the aorta, heart, lungs, and vena cava. Thus, a sharp foreign body that penetrates the esophagus may puncture nearby organs, potentially leading to a variety of intrathoracic organ complications, including an aortoesophageal fistula, pericarditis, and pneumothorax. Although pneumothorax rarely results from fish bones impacted in the esophagus, we report two cases of characteristic pneumothorax caused by fish bone foreign bodies in the esophagus and provide a review of the associated literature.</p>","PeriodicalId":520887,"journal":{"name":"The Korean journal of helicobacter and upper gastrointestinal research","volume":"25 2","pages":"184-190"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478628","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":"Detection of Clarithromycin Resistance in Helicobacter pylori Using the AllplexTM H. pylori & ClariR Assay and the Ezplex® HP-CLA Real-Time PCR Kit.","authors":"Tae-Woo Kim, Won Seok Lee, Dong Jin Yoon, Ilsoo Kim, Joon Sung Kim","doi":"10.7704/kjhugr.2024.0070","DOIUrl":"10.7704/kjhugr.2024.0070","url":null,"abstract":"<p><strong>Objectives: </strong>The success of Helicobacter pylori eradication using clarithromycin-based triple therapy relies on the bacteria being sensitive to clarithromycin. This study evaluated the diagnostic performance of two frequently used polymerase chain reaction (PCR) methods (AllplexTM H. pylori & ClariR Assay [Seegene] and Ezplex® HP-CLA Real-time PCR [SML Genetree]) to detect H. pylori infection and identify point mutations associated with clarithromycin resistance.</p><p><strong>Methods: </strong>Patients who underwent esophagogastroduodenoscopy between August 2023 and April 2024 at Incheon St. Mary's Hospital were enrolled in this study. The diagnostic performance of the Allplex method was evaluated against the rapid urease test (RUT), culture, and Ezplex HP-CLA methods. Point mutation detection using the Allplex and Ezplex methods was compared with the results of gene sequencing. The rates of H. pylori eradication following Ezplex-based tailored therapy were also analyzed.</p><p><strong>Results: </strong>Eighty-seven gastric biopsy specimens were analyzed. For diagnosing H. pylori infections, Allplex demonstrated kappa values of 0.670 compared with RUT, 0.468 compared with culture, and 0.880 compared with Ezplex. Among the 87 bacterial isolates subjected to gene sequencing to detect clarithromycin resistance-associated point mutations, the Allplex and Ezplex methods demonstrated 74 and 76 concordant results, respectively. The H. pylori eradication rate using Ezplex-based tailored therapy was 90.7%.</p><p><strong>Conclusions: </strong>This study demonstrated that both the Allplex and Ezplex methods are helpful for diagnosing H. pylori infections and detecting clarithromycin resistance. Furthermore, the Ezplex method was clinically effective for guiding tailored therapy to yield successful H. pylori eradication.</p>","PeriodicalId":520887,"journal":{"name":"The Korean journal of helicobacter and upper gastrointestinal research","volume":"25 1","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478592","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":"Gastric Ulcers Caused by Non-Helicobacter pylori Infections.","authors":"Bong Eun Lee","doi":"10.7704/kjhugr.2024.0078","DOIUrl":"10.7704/kjhugr.2024.0078","url":null,"abstract":"<p><p>Gastric ulcers are characterized by mucosal damage extending into the submucosa or deeper, with the most common causes being Helicobacter pylori infection and nonsteroidal anti-inflammatory drug use. However, various infectious pathogens, such as pyogenic bacteria, Treponema pallidum, Mycobacterium tuberculosis, viruses, fungi, and parasites, can also cause gastric ulcers. Non-H. pylori infectious gastric ulcers are uncommon and often present with nonspecific symptoms, making their diagnosis challenging. A differential diagnosis requires a comprehensive understanding of the underlying diseases and familiarity with their characteristic endoscopic features. For instance, acute phlegmonous gastritis requires a prompt diagnosis based on typical clinical symptoms and abdominal computed tomography findings, followed by empiric antibiotic therapy. Infections such as gastric syphilis, gastric tuberculosis, cytomegalovirus (CMV) gastritis, and gastric candidiasis necessitate pathogen identification through tissue diagnoses. When this is challenging, the clinical history, endoscopic findings, and serological tests should be integrated to ensure an accurate diagnosis and management. Unlike gastric syphilis and tuberculosis, CMV gastritis and gastric candidiasis often occur secondary to preexisting gastric ulcers; therefore, conventional anti-ulcer therapy is sufficient for immunocompetent patients with mild symptoms. However, antiviral or antifungal agents should be administered to immunocompromised patients and to those with systemic symptoms related to the infection. Similarly, understanding the characteristic history and symptoms of gastric anisakidosis is crucial for an accurate diagnosis, and prompt endoscopic examination is essential to identify and remove the larvae. Clinicians should consider the possibility of infectious gastric ulcers in patients with atypical ulcerative lesions or ulcers that are unresponsive to conventional therapies. Accurate diagnoses and timely treatments are essential for improving patient outcomes.</p>","PeriodicalId":520887,"journal":{"name":"The Korean journal of helicobacter and upper gastrointestinal research","volume":"25 1","pages":"23-33"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478599","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":"Treatment of a Large Gastric Phytobezoar With Coca-Cola, Cellulase, and Endoscopic Fragmentation in a Community Hospital.","authors":"Jaewon Song, Dong Yeol Shin","doi":"10.7704/kjhugr.2024.0066","DOIUrl":"10.7704/kjhugr.2024.0066","url":null,"abstract":"<p><p>Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar's hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.</p>","PeriodicalId":520887,"journal":{"name":"The Korean journal of helicobacter and upper gastrointestinal research","volume":"25 1","pages":"73-77"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478609","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}