Gastro hep advances最新文献

{"title":"Tumor Budding as a Risk Factor for Lymph Node Metastasis and Local Recurrence in pT1 Colorectal Cancer: A Systematic Review and Meta-Analysis","authors":"Heng Zhang ,&nbsp;Femke Simmer ,&nbsp;Alessandro Lugli ,&nbsp;Iris D. Nagtegaal","doi":"10.1016/j.gastha.2025.100713","DOIUrl":"10.1016/j.gastha.2025.100713","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Implementation of population screening programs resulted in an increase in early colorectal cancer (CRC, pT1). For these small CRC, endoscopic local resection is the preferred treatment. However, the presence of lymph node metastasis (LNM) and risk of local recurrence might require additional surgery. Tumor budding (TB) is a well-known biomarker for adverse outcomes in pT1 CRC. This study aims to further explore the relationship between TB and in pT1 CRC and to clarify the relationship between TB and local recurrence, to provide more strategies for the selection of surgical treatment.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using the MEDLINE and EMBASE databases to investigate the relationship between TB and LNM and local recurrence in pT1 CRC. Meta-analysis based on a random-effects model was performed to evaluate the relationship between TB and these 2 factors.</div></div><div><h3>Results</h3><div>A total of 57 observational studies were included in the meta-analysis, with a total of 24,956 patients. High-grade TB was significantly associated with both LNM (risk ratio (RR) = 4.04, 95% confidence interval (CI), 3.52–4.64, I² = 56.11%, <em>P</em> &lt; .001) and local recurrence (RR = 2.35, 95% CI, 1.21–4.54, I² = 26.18%, <em>P</em> = .01). Sensitivity analysis confirmed the robustness of our pooled results. Subgroup analysis also explored possible sources of heterogeneity. For LNM, geographical location (Asia: RR = 4.22, 95% CI, 3.64–4.89; Others: RR = 2.72, 95% CI, 2.08–3.57, <em>P</em> = .01) and year of publication (&lt;2015: RR = 4.96, 95% CI, 4.01–6.15; ≥2015: RR = 3.58, 95% CI, 2.99–4.29, <em>P</em> = .02) showed significant differences in the subgroup analysis. We cannot rule out publication bias for LNM risk.</div></div><div><h3>Conclusion</h3><div>Our findings confirm that TB is a strong predictor of local recurrence, but in particular of LNM in pT1 CRC and offers effective guidance for selecting further surgical treatment strategies.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 9","pages":"Article 100713"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711586","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":"Multiomic Sequencing Reveals Distinctive Gene Expression and Epigenetic Alterations Associated With Primary Sclerosing Cholangitis Development in Treatment-Naïve Pediatric Ulcerative Colitis","authors":"Alejandra Rodriguez-Sosa ,&nbsp;Ololade Lawal ,&nbsp;Ciaran McDonnell ,&nbsp;Luke Grant ,&nbsp;John O’Brien ,&nbsp;Muhammad Ali ,&nbsp;Ian Stephens ,&nbsp;Grainne Kirwan ,&nbsp;Flavia Genua ,&nbsp;Alexander Kel ,&nbsp;Anna Dominik ,&nbsp;Roisin Stack ,&nbsp;Gregory Yochum ,&nbsp;Michael McDermot ,&nbsp;Glen Doherty ,&nbsp;Seamus Hussey ,&nbsp;Sudipto Das","doi":"10.1016/j.gastha.2024.11.002","DOIUrl":"10.1016/j.gastha.2024.11.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Primary sclerosing cholangitis (PSC) is a progressive cholestatic disease with up to 80% of patients also suffering from ulcerative colitis (PSC-UC). The difficulty in the diagnosis along with the increased risk for developing cancer represents a clinical challenge. Furthermore, the precise molecular factors regulating the phenotype of this disease subtype remain unknown.</div></div><div><h3>Methods</h3><div>We applied methyl-capture sequencing and mRNA sequencing to colonic mucosal biopsies from 3 groups of treatment-naïve children at diagnosis from the Determinants and Outcomes in CHildren and AdolescentS study: UC (n = 10), PSC-UC (n = 10), and healthy controls (n = 10).</div></div><div><h3>Results</h3><div>Differential gene expression between UC and PSC-UC showed significantly higher gene expression changes in PSC-UC patients when compared to UC. Specifically, expression of these genes was regulated by master transcriptional regulators (NLRP3, DLL1) and transcription factors (RELA, Myogenin, and FOXO1), which are shown to regulate expression of inflammatory response and immune-associated genes in PSC-UC patients exclusively. Differential methylation analysis between PSC-UC and UC demonstrated &gt;2000 differentially methylated regions with a large proportion of them enriched in gene promoter and enhancer regions. We further show no difference in epigenetic age between PSC-UC and UC. Finally, we identify KLHL17 as hypomethylated and upregulated in PSC-UC patients.</div></div><div><h3>Conclusion</h3><div>Our study, for the first time, identifies distinct gene expression and DNA methylation alterations that differentiate UC from PSC-UC at diagnosis in treatment-naïve pediatric patients. We show the gene expression differences observed between PSC-UC and UC are modulated by intricate molecular mechanisms involving master transcriptional regulator-mediated signaling through transcription factors. These findings suggest the potential utility of these molecular markers as predictive biomarkers for PSC development in UC at an early stage of development. Further validation in larger patient cohorts is warranted.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100586"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167818","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 Comparison of Intravenous Infliximab Versus Subcutaneous Infliximab on Remission Rates, Safety, Costs, Patient Preferences in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis","authors":"Alejandro Nieto Dominguez ,&nbsp;Abhishek Bhurwal ,&nbsp;Hemant Mutneja ,&nbsp;Sarah E. Eichinger ,&nbsp;Bhanu Pinnam ,&nbsp;Daniel Guifarro Rivera ,&nbsp;Chun-Wei Pan","doi":"10.1016/j.gastha.2024.11.004","DOIUrl":"10.1016/j.gastha.2024.11.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Infliximab, widely used as a mainstay treatment of inflammatory bowel disease (IBD), is traditionally administered intravenously. The subcutaneous (SC) formulation appears to offer a more convenient route of administration. This is a systematic review and meta-analysis comparing the outcomes of intravenous (IV) and SC routes of administration of Infliximab.</div></div><div><h3>Methods</h3><div>All observational studies and randomized controlled trials comparing efficacy, effectiveness, safety, costs, and patient preferences between IV vs SC infliximab in adult human patients with IBD between January 1, 1997, and September 9, 2023, were analyzed. The primary outcome was comparison of the remission rates between SC and IV infliximab in IBD patients. Secondary outcomes were analyzing the different safety profiles and adverse events of IV infliximab vs SC infliximab qualitatively and quantitatively, comparing costs between both groups and evaluating patient preferences among the different studies found on our systematic review.</div></div><div><h3>Results</h3><div>Twenty studies were included in the qualitative synthesis and 9 were included in the quantitative synthesis, with a total of 960 patients. There was no significant difference in clinical remission rates between the IV and SC infliximab groups at 8 weeks, 6 months, and 1 year. Switching to SC infliximab was overall safe. Patient satisfaction was higher in patients using SC infliximab, with additional cost-saving benefits.</div></div><div><h3>Conclusion</h3><div>The systematic review and meta-analysis reveal that SC infliximab could be a safe, cost-effective, well tolerated alternative for achieving disease remission in patients with IBD.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100588"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167832","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":"Endoscopic Submucosal Dissection of Gastric High-Grade Foveolar Dysplasia With Normal Background Mucosa","authors":"Gonzalo Latorre ,&nbsp;Alberto Espino ,&nbsp;Christine E. Orr ,&nbsp;Robert Bechara","doi":"10.1016/j.gastha.2024.10.005","DOIUrl":"10.1016/j.gastha.2024.10.005","url":null,"abstract":"<div><div>Most gastric neoplastic lesions appear in patients with gastric premalignant conditions. Here, we present the case of a 75-year-old woman with no prior history of <em>Helicobacter pylori</em> infection, with a big gastric adenoma resected by endoscopic submucosal dissection. Histopathological examination revealed high-grade foveolar dysplasia. Interestingly, surrounding mucosa was normal, without signs of <em>H. pylori</em> infection or gastric preneoplastic conditions. The presented case emphasizes that high-risk gastric lesions may be present within a normal stomach without endoscopic signs of <em>H. pylori</em> infection or premalignant conditions. This underscores the importance of careful examination in regular practice of esophagogastroduodenoscopy, even in low-risk patients.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 2","pages":"Article 100565"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049017","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 Standardized Classification Scheme for Gastroduodenal Disorder Evaluation Using the Gastric Alimetry System: Prospective Cohort Study","authors":"Chris Varghese ,&nbsp;Gabriel Schamberg ,&nbsp;Emma Uren ,&nbsp;Stefan Calder ,&nbsp;Mikaela Law ,&nbsp;Daphne Foong ,&nbsp;Vincent Ho ,&nbsp;Billy Wu ,&nbsp;I-Hsuan Huang ,&nbsp;Peng Du ,&nbsp;Thomas Abell ,&nbsp;Charlotte Daker ,&nbsp;Christopher N. Andrews ,&nbsp;Armen A. Gharibans ,&nbsp;Gregory O’Grady","doi":"10.1016/j.gastha.2024.09.002","DOIUrl":"10.1016/j.gastha.2024.09.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric Alimetry™ (Alimetry, New Zealand) is a new clinical test for gastroduodenal disorders involving simultaneous body surface gastric electrical mapping and validated symptom profiling. Studies have demonstrated a range of distinct pathophysiological profiles, and a classification scheme is now required. We used Gastric Alimetry spectral and symptom profiles to develop a mechanism-based test classification scheme, then assessed correlations with symptom severity, psychometrics, and quality of life.</div></div><div><h3>Methods</h3><div>We performed a multicenter prospective cohort study of patients meeting the Rome IV criteria for functional dyspepsia and chronic nausea and vomiting syndromes. Patients underwent Gastric Alimetry profiling, and a standardized digital classification framework was devised and applied to separate patients into those with a) abnormal spectral analyses (ie aberrant gastric frequencies, amplitudes, and rhythms); and normal spectral analyses with b) symptoms <em>correlated</em> to gastric amplitude (subgroups: sensorimotor, postgastric, and activity-relieved), and c) symptoms <em>independent</em> of gastric amplitude (subgroups: continuous, meal-relieved, meal-induced).</div></div><div><h3>Results</h3><div>Two hundred ten patients were included (80% female, median age 37), of whom 169 met the criteria for chronic nausea and vomiting syndromes and 206 met the criteria for functional dyspepsia (79% meeting both criteria). Overall, 83% were phenotyped using the novel scheme, with 79/210 (37.6%) classified as having a spectral abnormality. Of the remainder, the most common phenotypes were “continuous pattern” (37, 17.6%), “meal-induced pattern” (28, 13.3%), and “sensorimotor pattern” (15, 7.1%). Symptom patterns independent of gastric amplitude were more strongly correlated with depression and anxiety (Patient Health Questionnaire 2: exp(β) 2.38, <em>P</em> = .024, State-Trait Anxiety Inventory Short-Form score: exp(β) 1.21, <em>P</em> = .021).</div></div><div><h3>Conclusion</h3><div>A mechanistic classification scheme for assessing gastroduodenal disorders is presented. Classified phenotypes showed independent relationships with symptom severity, quality of life, and psychological measures. The scheme is now being applied clinically and in research studies.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100547"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973640","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":"Food and Drug Administration Approval Summary: Odevixibat (Bylvay) for the Treatment of Pruritus With Progressive Familial Intrahepatic Cholestasis","authors":"Sojeong Yi ,&nbsp;Insook Kim ,&nbsp;Rebecca Hager ,&nbsp;Marian M. Strazzeri ,&nbsp;Lili Garrard ,&nbsp;Toru Matsubayashi ,&nbsp;Ruby Mehta","doi":"10.1016/j.gastha.2024.100596","DOIUrl":"10.1016/j.gastha.2024.100596","url":null,"abstract":"<div><div>On July 20, 2021, the Food and Drug Administration approved odevixibat (Bylvay) for the treatment of pruritus in patients 3 months of age and older with progressive familial intrahepatic cholestasis (PFIC). PFIC is a rare disease that results in impaired bile secretion and transport, leading to cholestatic liver injury. Odevixibat is a reversible inhibitor of the ileal bile acid transporter. It decreases the reabsorption of bile acids from the terminal ileum (distal small intestines). Approval was based on the improvement in pruritus demonstrated in a 24-week randomized double-blind placebo-controlled trial conducted in 62 pediatric subjects, aged 6 months to 17 years, with a confirmed molecular diagnosis of PFIC type 1 or type 2 with the presence of pruritus at baseline. Given the subjects’ young age, a single-item observer-reported outcome (ObsRO) was used to measure scratching as observed by the caregiver. Subjects had an average scratching score of greater than or equal to 2 (medium scratching) in the 2 weeks before baseline. The mean percentage of ObsRO assessments over the 24-week treatment period that were scored as 0 (no scratching) or 1 (a little scratching) was 35.4% and 30.1% for 40 mcg/kg/day and 120 mcg/kg/day odevixibat treatment, respectively, compared to 13.2% for placebo. There was general alignment between subject and caregiver assessments of worst weekly pruritus severity among subjects for whom both patient-reported outcome (Worst Weekly Itching Score) and ObsRO (Worst Weekly Scratching Score) data were available. The most common adverse reactions included diarrhea, liver test abnormalities, vomiting, abdominal pain, and fat-soluble vitamin deficiency. The benefit-risk assessment for odevixibat for the treatment of pruritus in the labeled population was considered favorable.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100596"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395983","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":"Massive Gastric Dilation Secondary to Recurrent Benign Idiopathic Prepyloric Stenosis Managed With Lumen-Apposing Metal Stent","authors":"Bibek Saha ,&nbsp;Kayla Finnegan ,&nbsp;Bright Thilagar","doi":"10.1016/j.gastha.2024.100597","DOIUrl":"10.1016/j.gastha.2024.100597","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100597"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143105065","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":"Hepatitis Delta Virus Testing, Prevalence, and Liver-Related Outcomes Among US Veterans With Chronic Hepatitis B","authors":"Robert J. Wong ,&nbsp;Zeyuan Yang ,&nbsp;Janice H. Jou ,&nbsp;Binu V. John ,&nbsp;Joseph K. Lim ,&nbsp;Ramsey Cheung","doi":"10.1016/j.gastha.2024.10.015","DOIUrl":"10.1016/j.gastha.2024.10.015","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Hepatitis delta virus (HDV) infection in patients with chronic hepatitis B (CHB) is associated with worse liver-related outcomes. We aim to comprehensively evaluate HDV testing, diagnosis, and liver-related outcomes among a national cohort of US Veterans with CHB.</div></div><div><h3>Methods</h3><div>US Veterans with CHB from 2010 to 2023 were evaluated to determine trends in HDV testing (anti-HDV antibody, HDV RNA) and proportion positive among those tested. HDV positive patients were 1:2 propensity score matched to CHB patients who were HDV negative to evaluate incidence (per 100,000 person-years) of cirrhosis, hepatic decompensation, or hepatocellular carcinoma using competing risks Nelson-Aalen methods for estimating cumulative hazards.</div></div><div><h3>Results</h3><div>Among the 27,548 CHB patients identified, 16.1% completed HDV testing, among whom 3.25% (n = 144) were positive. After excluding patients with cirrhosis or HCC at baseline, 71 patients with HDV (median follow-up 5.3 years, interquartile range 2.5–7.6) were propensity score matched to 140 CHB patients without HDV (median follow-up 4.5 years, interquartile range 2.6–8.1). Compared to CHB patients without HDV, those with concurrent HDV had significantly greater incidence of cirrhosis (4.39 vs 1.30 per 100,000 person-years, <em>P</em> &lt; .01) and hepatic decompensation (2.18 vs 0.41 per 100,000 person-years, <em>P</em> = .01).</div></div><div><h3>Conclusion</h3><div>Among a national cohort of US Veterans with CHB, low rates of HDV testing were observed. This is concerning given that patients with concurrent HDV infection had &gt;3 times and &gt;5 times greater risks of cirrhosis and hepatic decompensation, respectively, compared to CHB patients without HDV, highlighting the importance of timely HDV diagnosis and treatment.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100575"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167817","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":"Acute Kidney Injury in Cirrhosis Revisited—Implications in Clinical Practice","authors":"Akash Roy,&nbsp;Rohit Mehtani,&nbsp;Anand V. Kulkarni","doi":"10.1016/j.gastha.2024.10.023","DOIUrl":"10.1016/j.gastha.2024.10.023","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100583"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143167834","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 Influence of Psychiatric Factors on Health-Care Resource Utilization in Patients With Gastroparesis: A National Population-Based Study","authors":"Karan Sachdeva ,&nbsp;Daniyal Raza ,&nbsp;Lovekirat Singh Dhaliwal ,&nbsp;Rohit Goyal ,&nbsp;Pooja Shah ,&nbsp;Lena Kawji ,&nbsp;Ashley Deville ,&nbsp;Brittany Pass ,&nbsp;Natalie Roppolo ,&nbsp;Ahmad Alkurd ,&nbsp;Farhan Mohiuddin ,&nbsp;Hailey Canezaro ,&nbsp;Victoria Andrus ,&nbsp;Elizabeth Armstrong ,&nbsp;Michelle Neice ,&nbsp;Maryam Mubashir ,&nbsp;Shazia Rashid ,&nbsp;Michael Tran ,&nbsp;Omar Khan ,&nbsp;Qiang Cai","doi":"10.1016/j.gastha.2025.100620","DOIUrl":"10.1016/j.gastha.2025.100620","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastroparesis, characterized by delayed gastric emptying, leads to debilitating gastrointestinal symptoms and often experience comorbid psychiatric disorders, possibly linked to brain-gut network dysfunction. This adversely affects quality of life and necessitates medical care. We aimed to characterize the longitudinal impact of comorbid anxiety, depression, or bipolar disorder on health-care resource utilization in adults hospitalized primarily with gastroparesis.</div></div><div><h3>Methods</h3><div>A retrospective observational study using the 2016–2019 National Inpatient Sample Healthcare Cost and Utilization Project identified patients aged ≥18 years hospitalized with an index diagnosis of gastroparesis (International Classification of Diseases-10 code K31.84). The cohort was stratified based on the presence of comorbid psychiatric mood disorders (depression, anxiety, and bipolar spectrum disorders). We compared the frequency of computed tomography (CT) imaging, gastric emptying studies, endoscopic procedures, length of stay, and hospitalization costs. Chi-square and analysis of variance tests were used.</div></div><div><h3>Results</h3><div>Of 47,265 patients hospitalized with gastroparesis, 21,545 (45.6%) had comorbid psychiatric mood disorders. These patients had a higher mean Elixhauser comorbidity index (3.6 ± 1.8 vs 2.9 ± 1.8, <em>P</em> &lt; .001) and a longer median hospital stay (4, interquartile range: 2–6 vs 3, interquartile range: 2–6, <em>P</em> &lt; .001). Adjusted analysis showed higher CT imaging frequency in this group (adjusted Odds ratio: 1.15; 95% confidence interval: 1.04–1.67). Although the frequency of endoscopic procedures, gastric scintigraphy, and total hospitalization costs were higher in the psychiatric comorbidity group, these differences were not statistically significant in univariable analysis.</div></div><div><h3>Conclusion</h3><div>Nearly 50% of gastroparesis patients had concurrent psychiatric disorders and underwent more frequent CT imaging and had longer hospital stays. This underscores the importance of screening all gastroparesis patients for psychiatric disorders upon admission and exploring the effectiveness of incorporating psychosocial interventions into the treatment plan for gastroparesis patients.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100620"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143825601","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}