American Journal of Gastroenterology最新文献

{"title":"Ileal Pouch Adenocarcinoma in a Young Patient With Newly Diagnosed Crohn's-Like Disease of the Pouch.","authors":"Katie Dunleavy, Katrina Pedersen, Robert Cima, Victor Chedid","doi":"10.14309/ajg.0000000000003426","DOIUrl":"10.14309/ajg.0000000000003426","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy tTG-IgA seropositivity and maternal and infant health in the Child Health and Development Studies.","authors":"Piera M Cirillo, Rajitha D Venkatesh, Jennifer J Iscol, Kajal Sangal, Nickilou Y Krigbaum, Lauren M Zimmermann, Susan M Flaherty, Kartik K Venkatesh, Barbara A Cohn, Alessio Fasano","doi":"10.14309/ajg.0000000000003424","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003424","url":null,"abstract":"<p><strong>Background: </strong>We examined associations between pregnancy anti-tissue transglutaminase immunoglobulin A (tTG-IgA) seropositivity, a screening test for celiac disease, and celiac-related conditions in pregnancy and offspring health outcomes. We hypothesized that seropositivity would identify pregnant women and infants at risk of poor health.</p><p><strong>Methods: </strong>The Child Health and Development Studies enrolled pregnant woman from 1959-1967 and prospectively followed their pregnancies and offspring. tTG-IgA was measured from stored pregnancy serum using QUANTA Lite R h-tTG IgA ELISA. Pregnant women were randomly selected into a \"high-risk\" (n=937), or background-risk (n=831) group based on high-risk markers of celiac comorbidity. We used logistic regression to compare associations between tTG-IgA seropositivity and high-risk markers in pregnancy, placental to birth weight ratio (PWR), and infant weight gain through one year.</p><p><strong>Results: </strong>Overall prevalence of tTG-IgA seropositivity was 3%. Seropositivity was associated with having two or more maternal high-risk markers (OR=2.6, 95% confidence interval (CI) 1.2, 5.3, including diabetes, nutritional deficiency, gastrointestinal complications, Down syndrome child, cesarean delivery, and thyroiditis); lower PWR (OR=2.9, 95% CI 1.3, 6.0); and lower weight gain in late infancy (OR=2.3, 95% CI 1.0, 5.4). Offspring associations did not differ by maternal risk group, suggesting that seropositivity rather than comorbidity was the underlying risk factor.</p><p><strong>Conclusions: </strong>tTG-IgA seropositivity was associated with the presence of two or more markers of celiac comorbidity. Offspring exposed to maternal seropositivity had poorer fetal growth and lower infant weight gain. Findings support the potential beneficial role of tTG-IgA screening during pregnancy, both for the pregnant woman and exposed offspring.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of ileus and bowel obstruction during pregnancy in women who have had surgery for IBD: A population-based study.","authors":"Sonia Friedman, Jan Nielsen, Mette Louise Andersen, Bente Mertz Nørgård","doi":"10.14309/ajg.0000000000003425","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003425","url":null,"abstract":"<p><strong>Objectives: </strong>Women with inflammatory bowel disease (IBD) who have IBD surgery before pregnancy have an increased risk of adverse maternal and fetal outcomes. Very few studies have examined the risks of gastrointestinal complications during pregnancy in this group of women.</p><p><strong>Methods: </strong>Using the Danish national registries, we identified live born children of mothers with ulcerative colitis (UC) or Crohn's disease (CD) who had IBD surgery before pregnancy. We compared the outcomes of ileus/bowel obstruction during pregnancy in women with UC or CD who had surgery compared to women with UC or CD who did not have surgery prior to pregnancy.</p><p><strong>Results: </strong>IBD surgery prior to pregnancy was more common in women with CD than in women with UC (31.5% versus 6.3%). For live births, 7.1% of mothers with UC surgery and 1.8% of mothers with CD surgery had a diagnosis of ileus/bowel obstruction during pregnancy. Patients who had UC surgery had an adjusted odds ratio (aOR) of 71.98 (95% CI 33.13-156.39) of an ileus/bowel obstruction compared to those with UC who had not had surgery. For UC: permanent ileostomies: aOR 128.69 (95% CI 57.57-287.63); ileoanal pouch anastomosis (IPAA) with diverting ostomy: aOR 40.14 (95% CI 11.19-143.96). Patients who had CD surgery had an aOR of 10.00 (95% CI 4.64-21.55). For CD: intestinal surgery (no stoma): aOR 7.96 (95% CI 3.48-18.22); intestinal surgery (with stoma): aOR 43.89 (95% CI 17.40-110.69).</p><p><strong>Conclusion: </strong>There is a significant risk of ileus/bowel obstruction during pregnancy in women who had IBD surgery prior to pregnancy.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linaclotide for Bowel Preparation: Is \"Afterload Reduction\" Not Just for Heart Failure Anymore?","authors":"Brian C Jacobson","doi":"10.14309/ajg.0000000000003375","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003375","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low incidence of Varicella in Pediatric Patients with Inflammatory Bowel Disease.","authors":"Freddy Caldera, Mary S Hayney, Francis A Farraye, Monika Fischer, Huiping Xu, Michael D Kappelman","doi":"10.14309/ajg.0000000000003418","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003418","url":null,"abstract":"<p><strong>Background: </strong>Immune-modifying therapies in pediatric inflammatory bowel disease (IBD) increase infection risks, including varicella.</p><p><strong>Methods: </strong>Using Optum's de-identified Clinformatics® Data Mart Database,a nationwide U.S. commercial insurance claims database (2007-2022), we conducted a retrospective study of 5,368 IBD patients aged ≤21 years matched to a non-IBD cohort. The primary outcome was incidence of varicella.</p><p><strong>Results: </strong>Varicella incidence was low in both groups (IBD: 0.570 vs non-IBD: 0.297 per 1,000 person-years, p=0.23). At year 4, cumulative varicella incidence was 0.27% for IBD and 0.18% for non-IBD (p=0.24). No hospitalizations or deaths occurred.</p><p><strong>Conclusion: </strong>Despite immune-modifying therapy, pediatric IBD patients demonstrate low varicella incidence.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiopaque Medication Mimicking Esophageal Foreign Body: A Case of Lanthanum Carbonate Misidentification.","authors":"Kayleigh C Lewis, Millie D Long, Ellen W Green","doi":"10.14309/ajg.0000000000003419","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003419","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom Resolution and Meaningful Improvement in Quality of Life With Risankizumab in Patients With Ulcerative Colitis: Post Hoc Analysis of the Randomized INSPIRE and COMMAND Studies.","authors":"Joana Torres, Julian Panés, Corey A Siegel, Marla C Dubinsky, Parambir S Dulai, Satoshi Tanida, Silvio Danese, Jasmina Kalabic, Jyun-Heng Lai, Nidhi Shukla, Leah Rizzo, Cecile Holweg, Dolly Sharma, Remo Panaccione","doi":"10.14309/ajg.0000000000003420","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003420","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with ulcerative colitis (UC) experience disruptive symptoms that can impair quality of life (QoL). This study examined the effect of risankizumab (RZB) induction and maintenance treatment on symptom resolution and health-related QoL (HRQoL) outcomes.</p><p><strong>Methods: </strong>For the 12-week induction, patients were randomized to intravenous (IV) RZB 1200 mg (RZB1200) or placebo (PBO). For the 52-week maintenance, clinical responders to induction were re-randomized to subcutaneous (SC) RZB 180 mg (RZB180), RZB 360 mg (RZB360), or PBO (RZB withdrawal). This post hoc analysis assessed individual and comprehensive resolution of UC-related symptoms and clinically meaningful within-person changes (MWPCs) for HRQoL outcomes.</p><p><strong>Results: </strong>RZB improved symptomatic outcomes compared with PBO at week 4 (nominal P ≤ .001; abdominal pain, bowel urgency, fecal incontinence [nominal P ≤ .01]) through the 12-week induction (P ≤ .001; abdominal pain [P ≤ .01]; fecal incontinence, sleep interruption [nominal P ≤ .001]). Greater improvements were achieved with RZB compared with PBO (RZB withdrawal) for symptomatic outcomes through the 52-week maintenance. More patients treated with RZB achieved comprehensive symptom resolution (complete resolution of all six UC-related symptoms) compared with PBO at week 12 of induction (RZB1200, 21.8%; PBO, 9.5% [nominal P ≤ .001]) and week 52 of maintenance (RZB180, 23.5%; RZB360, 19.4%; PBO [RZB withdrawal], 14.2%; nominal P ≤ .05 and P = .1358, respectively). RZB compared with PBO improved MWPCs across HRQoL outcomes at week 12 of induction (nominal P ≤ .001; work time missed [nominal P = .0033]). At week 52 of maintenance, RZB180 compared with PBO (RZB withdrawal) improved MWPCs across HRQoL outcomes (nominal P ≤ .001; overall work impairment [nominal P ≤ .01], work time missed [nominal P = .3324], impairment while working [nominal P ≤ .05]) and more patients treated with RZB360 achieved MWPCs for the Ulcerative Colitis Symptom Questionnaire (UCSQ), Inflammatory Bowel Disease Questionnaire (IBDQ), and the 36-Item Short-Form Survey physical component summary (SF-36 PCS; all nominal P ≤ .05).</p><p><strong>Conclusion: </strong>RZB treatment improved UC-related symptoms and HRQoL outcomes compared with PBO in patients with UC.</p><p><strong>Clinical trials: </strong>NCT03398148; NCT03398135.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction: Hidden Malabsorptive Syndrome: Sucrase-Isomaltase Deficiency Finally Unveiled in Adulthood S4748.","authors":"Haider S Khalil, Kaely Bade","doi":"10.14309/ajg.0000000000003355","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003355","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Determinants of Health Associated with Metabolic Dysfunction-Associated Steatotic Liver Disease Prevalence and Severity: A Systematic Review and Meta-analysis.","authors":"Mohammed Abu-Rumaileh, Sudheer Dhoop, Jordan Pace, Thabet Qapaja, Maria Elena Martinez, Monica Tincopa, Rohit Loomba","doi":"10.14309/ajg.0000000000003421","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003421","url":null,"abstract":"<p><strong>Background aims: </strong>Social determinants of health (SDOH) impact disease risk and severity leading to health disparities. SDOH impacting metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence and severity are poorly characterized and results are conflicting. The aim of this systematic review and meta-analysis was to assess the impact of individual SDOH factors on MASLD burden for adults in the United States (US).</p><p><strong>Methods: </strong>We searched MEDLINE, Embase and Cochrane databases per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies from January 2010- May 2024 were included. Quantitative studies of adults in the US that evaluated SDOH beyond race/ethnicity were included. Outcomes included prevalence of MASLD, metabolic dysfunction-associated steatohepatitis (MASH), MASH-associated advanced fibrosis or cirrhosis and clinical outcomes.</p><p><strong>Results: </strong>We identified 18 studies comprising of 547,634 total subjects from 11 unique cohorts. Nine studies evaluated MASLD prevalence, three MASH prevalence, six MASH-associated advanced fibrosis/cirrhosis prevalence, and nine clinical outcomes. High diet quality was the most consistent SDOH factor associated with both MASLD and MASH-associated advanced fibrosis/cirrhosis prevalence (summarized OR of 0.76 p <0.01, and 0.74 p <0.01, respectively). Lower income was most consistently associated with risk of clinical outcomes (significant in 3/9 studies).</p><p><strong>Conclusions: </strong>Diet quality was the most consistent SDOH associated with disease prevalence and severity in MASLD, with other SDOH showing inconsistent associations. Prospective assessments using consensus, validated tools to assess the impact of specific SDOH on MASLD burden in heterogenous patient populations are needed to inform public health interventions.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of Acute on Chronic Liver Failure in critically ill patients with cirrhosis using administrative data.","authors":"Luis Garrido-Trevino, Soongjin Ahn, Elliot B Tapper, Olivia C Walker, Gerald Ogola, Sumeet K Asrani","doi":"10.14309/ajg.0000000000003422","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003422","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated the positive predictive value (PPV) of ICD-10 codes used to identify organ failures in critically ill patients with cirrhosis.</p><p><strong>Methods: </strong>A cohort of 315 hospitalized cirrhosis patients was analyzed. PPVs were calculated using chart review as the reference standard.</p><p><strong>Results: </strong>304 patients had an ICD-10 code for cirrhosis. The PPV for liver failure was 33.0%, kidney failure 71.4%, respiratory failure 79.9%, circulatory failure 84.0% and brain failure 33.3%. Adding laboratory thresholds increased PPVs.</p><p><strong>Conclusions: </strong>ICD-10 codes accurately identify organ failures in critically ill patients with cirrhosis and may be helpful for identifying cases of ACLF within administrative data.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}