Acta gastro-enterologica Belgica最新文献

{"title":"Assessment of Esophageal Emptying in Patients with Dysphagia: Differences Between High-Resolution Impedance Manometry and Timed Barium Esophagram.","authors":"D L Cohen, J Ghantus, R Tome, B Hijazi, F Abu Baker, H Shirin, D Carter, F Shibli, T Khoury, A Mari","doi":"10.51821/88.1.13772","DOIUrl":"10.51821/88.1.13772","url":null,"abstract":"<p><strong>Background/aims: </strong>Assessment of esophageal emptying is important in the evaluation of patients with dysphagia. As several modalities can evaluate this, we aimed to compare two tests frequently used for assessing esophageal emptying-highresolution impedance manometry (HRiM) and timed barium esophagram (TBE).</p><p><strong>Methods: </strong>A retrospective study compared the results of HRiM and TBE in patients with dysphagia between 2018 and 2022. Abnormal esophageal clearance was defined as ≥30% swallows with incomplete bolus clearance on HRiM and as residual barium ≥2 cm at 5 minutes on TBE.</p><p><strong>Results: </strong>77 patients were included in the study (mean age 51.6; 69% female). The most common HRiM diagnoses were normal motility (37.7%), ineffective esophageal motility (28.6%), and achalasia (19.5%). Effective esophageal clearance was noted on HRiM in only 44 subjects (57.1%), while it was seen on TBE in 57 subjects (74.0%)(P=0.027). There was agreement between the studies in 58 subjects (75.3%). Agreement was significantly affected by the HRiM diagnosis with the highest rate (86.7%) among achalasia patients (P=0.032). The only other factor correlated to agreement between the studies was a lack of alcohol use (P=0.048).</p><p><strong>Conclusions: </strong>According to the parameters used in this study, TBE is more likely to reveal esophageal emptying than HRiM in patients with dysphagia. While there is fair agreement between the results of the two studies, results are especially concordant in achalasia patients suggesting that either study may be useful in evaluating esophageal emptying in that population.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"89-95"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab in an adolescent with eosinophilic esophagitis and eosinophilic duodenitis, a valuable treatment option.","authors":"S Vande Velde, A Hoorens, S Van Biervliet","doi":"10.51821/88.1.13767","DOIUrl":"https://doi.org/10.51821/88.1.13767","url":null,"abstract":"<p><p>The authors report the first adolescent (to our knowledge) in Belgium to receive duplimumab for eosinophilic esophagitis (EoE) and eosinophilic duodenitis (EoD). EoE was diagnosed in 2020 in a 13-year-old boy by endoscopy with biopsies following complaints of abdominal pain. Several treatments (omeprazole, topical steroids, and elemental diet) have been tried without adequate and sustained success. In 2023, in addition to the diagnosis of EoE, a diagnosis of mucosal EoD with significant ulceration was established. In January 2023, the EMA approved the use of dupilumab for EoE in children above the age of 12. Weekly subcutaneous dupilumab 300mg was started in November 2023. After three months, a complete endoscopic and histologic normalization of the esophagus and duodenum was achieved. He reported no further clinical signs or adverse events to date.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"207-210"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-transplantation lymphoproliferative disorder (PTLD) with rectal involvement.","authors":"K Mombaerts, J-B Zeevaert, B Feytmans, M Vivario","doi":"10.51821/88.1.13641","DOIUrl":"https://doi.org/10.51821/88.1.13641","url":null,"abstract":"","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"215-216"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Benefits of Akkermansia muciniphila as a Next-Generation Probiotic in the Maintenance of Overall Liver Health.","authors":"K Rachwal, K Mierczak, T Poplawski","doi":"10.51821/88.1.13037","DOIUrl":"https://doi.org/10.51821/88.1.13037","url":null,"abstract":"<p><strong>Background and study aim: </strong>The gut-liver axis and gut microbiota, with a particular focus on Akkermansia muciniphila, a next-generation probiotic, have been identified as significant factors in preventing the development and progression of liver diseases. This review aims to discuss the potential therapeutic role of A. muciniphila in maintaining liver health, focusing on the latest findings from preclinical and clinical studies.</p><p><strong>Methods: </strong>To achieve the review's purpose, the most common keywords were searched in three online databases (PubMed, bioRxiv, and Google Scholar).</p><p><strong>Results: </strong>The search approach identified 49 references. Studies have shown that the gut microbiota, including A. muciniphila, has the potential to be a therapeutic target for many hepatic disorders. Several studies have demonstrated A. muciniphila's beneficial effects on improving metabolic parameters, including insulin resistance, blood cholesterol levels, and overall liver function.</p><p><strong>Conclusions: </strong>Further research is necessary to determine the optimal dosage, duration, and administration route of A. muciniphila for managing hepatic disorders. While there are promising findings, a more thorough understanding of the underlying mechanisms and the development of effective therapeutic strategies are necessary for successful treatment of liver diseases.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"141-150"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and rebleeding rate of Dieulafoy lesions throughout the gastrointestinal tract.","authors":"H Döngelli, E Yalçin, S Dolu, G Bengi","doi":"10.51821/88.1.13762","DOIUrl":"10.51821/88.1.13762","url":null,"abstract":"<p><strong>Background/objectives: </strong>Dieulafoy lesion (DL) is a rare yet potentially life-threatening cause of gastrointestinal bleeding. This study retrospectively analyzed all patients diagnosed with DL over the past two decades, focusing on clinical outcomes such as rebleeding and mortality. We aimed to identify factors associated with these outcomes to improve the understanding and management of this condition.</p><p><strong>Materials/methods: </strong>This study included 39 hospitalized patients who underwent endoscopy for gastrointestinal bleeding and were diagnosed with Dieulafoy lesions. Data were collected retrospectively, and regression analysis was performed to assess factors associated with all-cause mortality and rebleeding rates.</p><p><strong>Results: </strong>The study included 39 patients, with a mean age of 64 years; 13 (33%) were women. The most common presenting complaint was hematemesis (41%). The most common localization of DLs was the stomach, with 25 (64.1%) DLs detected. Rebleeding rates within one week and mortality within 90 days were 33% and 28%, respectively. In univariate analysis, esophageal localization (HR: 3.398, p = 0.042), low hemoglobin levels (HR: 0.758, p = 0.030), and high Glasgow- Blatchford score (HR: 1.179, p = 0.035) were associated with rebleeding. Duodenal localization was independently associated with higher mortality (HR: 27.276, p < 0.001), after adjusting for age, sex, and comorbidity index.</p><p><strong>Conclusion: </strong>Dieulafoy lesions are most commonly found in the stomach but can also occur in atypical sites like the jejunum or hernia pouch. Enteroscopy is crucial for diagnosing and treating DLs, especially those in atypical small intestine locations. Lesion localization plays a key role in predicting both rebleeding and mortality rates.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"109-117"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical analysis of ultrasound-guided warm saline enema in the treatment of pediatric intussusception.","authors":"Jiankang Guo, Yanhong Bai, You Liang, Ya-Na Liu, Bin Zhang, Zhigang Fan","doi":"10.51821/88.1.13622","DOIUrl":"10.51821/88.1.13622","url":null,"abstract":"<p><strong>Objective: </strong>Few studies have explored using ultrasound-guided warm saline enema to treat acute intussusception in children. This article aimed to assess the effect of warm saline enema on acute intussusception in children.</p><p><strong>Methods: </strong>In this study, we retrospectively analyzed 169 children who underwent ultrasound-guided warm saline enema treatment for pediatric intussusception in 3201 Hospital, Shanxi, China between January 1, 2020, and December 31, 2022.</p><p><strong>Results: </strong>Out of the 169 children included in the study, 156 were successfully treated, while 13 did not respond to the treatment. The success rate was 92.31%, and the failure rate was 7.69%. The reduction time and hospital stay in 169 children ranged from 9 to 54 minutes and 1 to 25 days, respectively. On average, the reduction process took about 20.84±4.86 minutes, and the hospital stay was around 3.79±2.49 days. Among the 169 children, 3 experienced nausea and vomiting, while none had postoperative diarrhea or intestinal perforation. The overall incidence of complications like nausea and vomiting was 1.78%.</p><p><strong>Conclusions: </strong>A total of 169 children with intussusception underwent treatment using ultrasound-guided warm saline enema. The reduction time was consistent with the existing literature. Complications were small in these cases, only manifested as nausea and vomiting. These findings also provide valuable evidence for clinical management of these diseases.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"97-102"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical presentation of Olmesartan-induced gastritis and enteropathy.","authors":"H Schreurs, C Breynaert, G De Hertogh, L Wauters","doi":"10.51821/88.1.13942","DOIUrl":"10.51821/88.1.13942","url":null,"abstract":"<p><p>Olmesartan is an angiotensin II receptor blocker (ARB) used for the management of hypertension. We report a case of Olmesartan-associated severe gastritis and enteropathy (OAE) in a 81-year-old female patient who presented with anorexia and weight loss. After discontinuation of the drug, her symptoms improved and follow-up gastroscopy showed endoscopic improvement. Histopathology showed a reduction of eosinophils and intraepithelial lymphocytosis, but a persisting increase in mast cells. Hence, systemic mastocytosis was excluded by further investigations. To our knowledge, this is the first case report of a patient with Olmesartan-associated severe gastritis with histopathological presence of mast cells. We conclude that mast cells, like eosinophils, could be druginduced, although systemic mastocytosis must be ruled out. Future studies should focus on the link between local mast cells and gastro-intestinal diseases.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"203-206"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balloon Dilation-assisted Extraction of Embedded Self-Expandable Metal Stents.","authors":"M Bronswijk, A Reekmans, S van der Merwe","doi":"10.51821/88.1.14150","DOIUrl":"10.51821/88.1.14150","url":null,"abstract":"<p><strong>Background and study aims: </strong>Embedded transpapillary self-expandable metal stents (SEMS) may require extraction over time and standard approaches often fail. In the current study we describe a newly developed approach to refractory embedded SEMS, using balloon dilation-assisted extraction. Our aim was to evaluate the feasibility and outcomes of this novel technique.</p><p><strong>Patients and methods: </strong>This is an exploratory single-center retrospective analysis of all consecutive patients undergoing endoscopic balloon-assisted stent extraction. Baseline, procedural and follow-up data were collected and analyzed.</p><p><strong>Results: </strong>Twelve patients with embedded transpapillary SEMS were identified (60.0% female, mean age 70.1 [SD±18.1] years, uncovered SEMS 33.3%) with median dwell time of 457.5 (IQR 175.8-1042) days. Previous extraction attempts were undertaken in the majority of cases (83.3%), including SEMS-in-SEMS placement (41.7%). Using the balloon-assisted stent extraction technique, successful SEMS extraction was achieved in 10 out of 12 cases (83.3%). Adverse events occurred in 3 patients (Grade II [n=2, 16.7%] - Grade III [n=1, 8.3%]). After a median follow-up time of 171 (58-260) days, 1 biliary recurrence occurred for which endoscopic re-evaluation was performed.</p><p><strong>Conclusions: </strong>Our data suggest that endoscopic balloonassisted stent extraction should be considered for extraction of embedded self-expandable metal stents, as it showed high efficacy without any major procedure-related adverse events, using readily available endoscopic tools.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"103-108"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Belgian consensus on the management of patients with functional dyspepsia.","authors":"S Kindt, J Arts, P Caenepeel, F de Clerck, H De Schepper, H Louis, P Latour, T Mahler, S Nullens, H Piessevaux, K Routhiaux, J Schol, M Surmont, H Vafa, C Van de Bruaene, K Van Malderen, T Vanuytsel, L Wauters, F Wuestenberghs, J Tack","doi":"10.51821/88.1.14136","DOIUrl":"10.51821/88.1.14136","url":null,"abstract":"<p><strong>Background: </strong>Functional dyspepsia (FD) is a disorder of gutbrain interaction characterised by epigastric pain, epigastric burning, early satiation or postprandial fullness. Despite its high prevalence, clinicians struggle with the diagnosis and management of these patients.</p><p><strong>Methods: </strong>A Delphi consensus was conducted by 20 experts from Belgium, and consisted of a literature review, summarising the existing evidence, and a voting process on 119 statements. Grading of recommendations, assessment, development and evaluation criteria were applied to evaluate the quality of evidence. Consensus was defined as > 80 % agreement.</p><p><strong>Results: </strong>Belgian consensus underlines the multifactorial aetiology of FD. In addition to the cardinal symptoms, bloating and weight loss are also observed in FD. Functional dyspepsia co-exists with other DGBIs, including IBS. Subtyping based on the postprandial nature of symptoms is recommended. Patients should receive a positive diagnosis. Additional testing is not routinely required before initiating therapy, except in the presence of alarm features or treatment-refractory symptoms, and can consist of upper GI endoscopy, abdominal imaging and gastric emptying testing. The consensus refuted the role of carbohydrate malabsorption testing, pyloric impedance planimetry, pH/impedance monitoring, food allergy testing and permeability testing in FD. Explanation and reassurance, also addressing lifestyle factors, represent the cornerstone of the management. Proton Pump Inhibitors are considered the firstline pharmacological treatment. With the exception of specific neuromodulators, the panel did not achieve consensus for other therapeutic options. This consensus recommends against restrictive diets, invasive endoscopic or surgical treatment, parenteral nutrition, antibiotics, spasmolytics and opioids in the management of FD.</p><p><strong>Conclusion: </strong>A panel of Belgian experts summarised the existing evidence on the aetiology, presentation, diagnosis and treatment of FD with attention to the availability within the Belgian healthcare system. Areas of future research are identified.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"157-178"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A slobbering appendix.","authors":"C Collin, J-P Loly","doi":"10.51821/88.1.14237","DOIUrl":"https://doi.org/10.51821/88.1.14237","url":null,"abstract":"","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 2","pages":"219-220"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}