Annals of Gastroenterology最新文献

{"title":"Admissions for acute biliary pancreatitis without necrosis and infection complicated by severe sepsis and septic shock: a national study.","authors":"Renuka Verma, Kamleshun Ramphul, Hemamalini Sakthivel","doi":"10.20524/aog.2025.0968","DOIUrl":"https://doi.org/10.20524/aog.2025.0968","url":null,"abstract":"<p><strong>Background: </strong>Severe sepsis with septic shock (SSWSS) is a potential and severe complication that can arise among patients hospitalized for acute biliary pancreatitis.</p><p><strong>Methods: </strong>We queried the 2018-2021 National Inpatient Sample for adults with a primary diagnosis code of acute biliary pancreatitis without necrosis or infection. Baseline characteristics of the patients were studied and multivariate regression models were used to appraise the roles of different factors for events of SSWSS.</p><p><strong>Results: </strong>We evaluated 136,140 adults who had acute biliary pancreatitis without necrosis or infection on admission; their median age was 57.0 years, and the majority were female (60.6%). Of these, 435 patients developed SSWSS. Higher odds were seen in cases with coexisting chronic kidney disease (P<0.001), liver cirrhosis (P<0.001), and human immunodeficiency virus infection (P<0.001). Races other than White/Black/Hispanics had higher odds (P<0.001) than Whites. Females were less likely to report SSWSS (P<0.001) than males. Moreover, patients from the 26^th-50^th median household quartiles had lower odds of SSWSS than those in the 0-25^th quartiles. Medium (P<0.001) and large (P<0.001) hospitals reported more cases than small hospitals. Admissions in the southern areas of the United States also exhibited higher odds (P=0.026), than Northeast regions. Lower odds were noted in smokers (P<0.001) and cases with dyslipidemia (P=0.048). SSWSS led to higher mortality rates (65.5% vs. 0.4%).</p><p><strong>Conclusions: </strong>In our nationwide analysis, we found that episodes of SSWSS among patients with acute biliary pancreatitis were influenced by several factors. SSWSS patients also had higher mortality.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 3","pages":"337-344"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075382","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":"Antidepressants in irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials.","authors":"Maria José Temido, Margarida Cristiano, Carolina Gouveia, Bárbara Mesquita, Pedro Figueiredo, Francisco Portela","doi":"10.20524/aog.2025.0962","DOIUrl":"https://doi.org/10.20524/aog.2025.0962","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) treatment relies on a low level of evidence. In this systematic review with meta-analysis of randomized, double-blind, placebo-controlled trials we assessed the efficacy of antidepressants in IBS.</p><p><strong>Methods: </strong>This study followed the PRISMA guidelines and was registered in the PROSPERO database (CRD42024502427). PubMed, EMBASE and the Cochrane Library were searched from inception to January 2024. Only randomized, double-blind, placebo-controlled trials were included. Quality of evidence was assessed using the Cochrane tool (RoB 2). A random-effects model was used. Heterogeneity was evaluated by the <i>I</i> ² statistic and publication bias by funnel plots and the Egger test.</p><p><strong>Results: </strong>The search strategy identified 1340 studies, of which 20 were included in the systematic review and 16 in the meta-analysis, totaling 1428 patients. The meta-analysis unveiled the efficacy of antidepressants in patients with IBS in overall symptom improvement (odds ratio [OR] 3.02; 95% confidence interval [CI] 2.16-4.2). Subgroup analysis revealed similar results regarding the efficacy of tricyclic antidepressants (OR 3.39, 95%CI 2.24-5.12); of selective serotonin reuptake inhibitors (OR 2.39, 95%CI 1.14-5.01); in patients refractory to first-line measures (OR 2.96, 95%CI 1.67-5.25); in patients without known comorbid psychological conditions (OR 2.92, 95%CI 1.6-5.31); and in the improvement in abdominal pain (OR 3.27, 95%CI 1.63-6.53), and bloating (OR 2.4, 95%CI 1.11-5.22). Publication bias was detected, and potential sources were identified. Sub-analysis without these sources of bias revealed similar results.</p><p><strong>Conclusions: </strong>Antidepressants demonstrate efficacy in IBS. These medications can be beneficial to patients resistant to initial treatments and those lacking psychopathological symptoms.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 3","pages":"284-293"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075444","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":"<i>Helicobacter pylori</i> infection negatively affects response of gastric cancer to immunotherapy.","authors":"Malek Shatila, Gabriel Sperling, Antonio Pizuorno Machado, Muhammad Vohra, Elliot Baerman, Enrico N De Toni, Helga-Paula Török, Dan Zhao, Yan Zhou, Mehnaz A Shafi, Anusha Shirwaikar Thomas, Mazen Alasadi, Yinghong Wang","doi":"10.20524/aog.2025.0966","DOIUrl":"https://doi.org/10.20524/aog.2025.0966","url":null,"abstract":"<p><strong>Background: </strong><i>Helicobacter pylori</i> (<i>H. pylori</i>) is a known risk factor for gastric cancer, possibly via the PD-1/L1 pathway, and this infection may reduce the efficacy of immune checkpoint inhibitors (ICIs). This study explored the effects of <i>H. pylori</i> infection status on survival outcomes in patients with gastric cancer.</p><p><strong>Methods: </strong>This single-center, retrospective study included patients with gastric adenocarcinoma between June 1985 and August 2022. Patients with different histological subtypes were excluded. Primary variables of interest included <i>H. pylori</i> infection status and treatment with ICIs. Other clinical information included demographics, cancer histology, the presence of other cancers, and vital status.</p><p><strong>Results: </strong>A total of 2930 patients were included, of whom 206 (7.0%) received ICIs, 196 (6.7%) had prior <i>H. pylori</i> infection, and 1037 (35.4%) had a diffuse subtype. Diffuse cancer subtypes were associated with better survival (P<0.05) at 3 and 5 years compared to intestinal-type adenocarcinomas. Diffuse cancers demonstrated better survival outcomes than intestinal cancers at 10 years, but only among <i>H. pylori-</i>positive patients (P=0.013). <i>H. pylori</i> positivity was associated with worse survival at 3 years (P=0.041) among patients taking ICIs, but not in those not receiving ICIs (P=0.325).</p><p><strong>Conclusions: </strong>These findings suggest <i>H. pylori</i> infection may be an obstacle to successful immunotherapy, and may interact with cancer subtypes to differentially impact survival. Future studies are needed to validate the potential prognostic value of <i>H. pylori</i> positivity in gastric cancer.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 3","pages":"262-269"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075348","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":"Beyond biopsy: evaluating noninvasive techniques to diagnose celiac disease in adults.","authors":"Suzanne Cauchi, Abigail Pace, Martina Sciberras, Pierre Ellul","doi":"10.20524/aog.2025.0959","DOIUrl":"https://doi.org/10.20524/aog.2025.0959","url":null,"abstract":"<p><strong>Background: </strong>Duodenal biopsies are standard for diagnosing celiac disease (CD), but a biopsy-free approach has gained attention in the past decade. Evidence suggests that immunoglobulin A anti-tissue transglutaminase (IgA tTg) antibody levels ≥10 times the upper limit of normal (ULN) may reduce the need for histology. This study aimed to assess whether IgA tTg antibody titers ≥10 × ULN correlate with the histological diagnosis in adults.</p><p><strong>Methods: </strong>The retrospective study was conducted at Mater Dei Hospital, Malta, analyzing adult patients who underwent upper gastrointestinal endoscopy with duodenal biopsies between 2012 and 2024. Data on demographics, symptoms, risk factors, serology and histological results were collected. Patients who had positive serology but initial negative biopsies and underwent repeat biopsies were also reviewed.</p><p><strong>Results: </strong>Of 114 patients (78.1% female, mean age 41.0 years), 97.4% tested positive for IgA tTg antibodies and 93.8% for endomysial antibodies (EMA). CD was histologically confirmed in 70.2%, with females more frequently diagnosed than males (75.3% vs. 52%, P=0.025). CD-related symptoms were reported by 79.8%, while 20.2% were asymptomatic. Levels of tTg ≥10 × ULN were found in 41.2% patients, and this cutoff had a sensitivity of 58.8%, specificity of 100%, positive predictive value of 100% and negative predictive value of 50.7% for CD (P<0.001).</p><p><strong>Conclusion: </strong>This study supports a biopsy-free approach for diagnosing CD when IgA tTg levels are ≥10 x ULN, especially with EMA positivity and typical clinical presentation.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 3","pages":"270-275"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075447","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":"Impact of atrial fibrillation on in-hospital outcomes following endoscopic retrograde cholangiopancreatography: a propensity score-matched analysis of the National Inpatient Sample (2016-2020).","authors":"Abdulrahim Y Mehadi, Bekure B Siraw, Parth Patel, Eli A Zaher, Ebrahim A Mohamed, Shahin Isha, Abel Tenaw Tasamma, Yordanos T Tafesse, Yonas Gebrecherkos, Juveriya Yasmeen, Mouaz Oudih, Mohammed Haroun","doi":"10.20524/aog.2025.0964","DOIUrl":"https://doi.org/10.20524/aog.2025.0964","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is a critical tool in managing hepatobiliary and pancreatic diseases. Atrial fibrillation (AF) has been associated with greater morbidity in patients undergoing ERCP. This study compared in-hospital ERCP outcomes in patients with and without AF.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the National Inpatient Sample (2016-2020). Patients who underwent ERCP during hospitalization were included. Patients with AF were matched 1:1 to those without AF, based on demographic and clinical variables. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included procedure-related and non-procedure-related complications, hospitalization cost and length of stay.</p><p><strong>Results: </strong>The final matched sample consisted of 29,942 patients, with 14,971 in each group (AF and non-AF). Patients with AF demonstrated significantly higher in-hospital mortality compared to those without AF (3.6% vs. 1.9%; odds ratio [OR] 1.87, 95% confidence interval [CI] 1.62-2.17). The AF group had a significantly longer median length of stay (8.1 vs. 6.4 days; β 1.7; 95%CI 1.5-1.8) and incurred higher hospitalization costs ($111,000 vs. $87,255; β $23,745; 95%CI $20,783-26,708). In terms of complications, patients with AF had significantly higher rates of acute kidney injury (OR 1.33, 95%CI 1.27-1.40) and sepsis (OR 1.38, 95%CI 1.30-1.48). However, the rates of procedure-specific complications, including biliary perforation, post-ERCP pancreatitis and post-ERCP cholangitis, were similar between the 2 groups.</p><p><strong>Conclusion: </strong>Patients with AF undergoing ERCP have higher in-hospital mortality, longer stays, greater costs, and higher rates of acute kidney injury and sepsis, although procedure-specific complication rates remain unaffected.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 3","pages":"345-352"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075454","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":"Angiotensin-converting enzyme inhibitor-induced bowel angioedema: clinical features, diagnostic challenges, and recovery predictors from survival analysis: a systematic review of current reported cases.","authors":"Thanathip Suenghataiphorn, Narisara Tribuddharat, Pojsakorn Danpanichkul, Narathorn Kulthamrongsri, Piyawat Kantagowit","doi":"10.20524/aog.2025.0967","DOIUrl":"https://doi.org/10.20524/aog.2025.0967","url":null,"abstract":"<p><strong>Background: </strong>Angiotensin-converting enzyme inhibitor-induced bowel angioedema (ACEi-IAE) is a rare and frequently under-recognized condition. Its nonspecific gastrointestinal symptoms could lead to missed diagnoses, unnecessary procedures and inappropriate treatments. Given the scarcity of studies, we conducted a systematic review to summarize the clinical characteristics of ACEi-IAE, the diagnostic approach and factors predicting delayed recovery.</p><p><strong>Methods: </strong>Electronic databases, including MEDLINE, OVID and EMBASE, were used to identified eligible studies from inception to November 2024. Eligible cases were required to have a clear diagnosis of ACEi-IAE. Kaplan-Meier and multivariate Cox regression analyses were used to identify factors associated with delayed recovery time.</p><p><strong>Results: </strong>Our systematic review included 81 eligible studies, comprising 117 ACEi-IAE cases with a mean age of 50 years, of which 83% were female. Patients were mainly African Americans (50%) taking lisinopril (71%). All patients (100%) presented with abdominal pain and other non-specific features. The median recovery time was 48 h after discontinuing ACEi. Patients who had been taking lisinopril for a longer than average period (25.9 months) had a statistically significantly lower hazard ratio for recovery (adjusted hazard ratio [aHR] 0.39, 95% confidence interval [CI] 0.19-0.81; P=0.012), as did patients who had radiographic evidence of jejunal edema (aHR 0.29, 95%CI 0.11-0.74; P=0.010). Diagnostic criteria were proposed and summarized based on the findings.</p><p><strong>Conclusions: </strong>Clinicians should be aware of ACEi-induced bowel angioedema, particularly in ACEi users with non-specific abdominal pain. Implementation of our proposed diagnostic criteria is recommended to prevent unnecessary investigation and inappropriate treatment.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 3","pages":"276-283"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075389","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":"Impact of neutrophil-to-lymphocyte ratio on survival outcomes among cirrhotic and non-cirrhotic patients with advanced hepatocellular carcinoma under atezolizumab-bevacizumab combination therapy.","authors":"Spyridon Pantzios, Orestis Sidiropoulos, Antonia Syriha, Ioanna Stathopoulou, Sofia Rellou, Emmanouil Nychas, Georgia Barla, Nikolaos Ptohis, Ioannis Elefsiniotis","doi":"10.20524/aog.2025.0963","DOIUrl":"https://doi.org/10.20524/aog.2025.0963","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of atezolizumab-bevacizumab in patients with hepatocellular carcinoma (HCC) has not been studied separately in cirrhotic and non-cirrhotic patients. Our aim was to evaluate the efficacy of atezolizumab-bevacizumab in these patients, in relation to baseline values of the neutrophil-to-lymphocyte ratio (NLR).</p><p><strong>Methods: </strong>We divided 57 atezolizumab-bevacizumab-treated HCC patients according to baseline NLR (>3: NLR-H, ≤3: NLR-L) and studied overall survival (OS) and progression-free survival (PFS) in 4 groups: group A, non-cirrhotic/NLR-L; group B, non-cirrhotic/NLR-H; group C, cirrhotic/NLR-L; and group D, cirrhotic/NLR-H.</p><p><strong>Results: </strong>The 4 groups were comparable except for etiology, ALBI grade, macrovascular invasion, Barcelona Clinic Liver Cancer stage and prior therapy. Median OS and PFS were 30, 10, 12 and 5 months, and 14, 4, 8 and 2 months, for groups A, B, C, D, respectively (P<0.001). By Cox regression, cirrhotic/NLR-H patients showed significantly worse OS and PFS. Cirrhotic/NLR-L patients had better OS (12 vs. 5 months, P=0.002) and PFS (8 vs. 2 months, P=0.028) compared to cirrhotic/NLR-H. NLR was significantly correlated with OS (P=0.015). Non-cirrhotic/NLR-L patients had better OS (30 vs. 10 months, P=0.006) and PFS (15 vs. 4 months, P=0.01) compared to non-cirrhotic/NLR-H patients. Prior therapy was significantly correlated with better OS (30 vs. 8 months, P<0.001) and PFS (24 vs. 4 months, P<0.001) in non-cirrhotic patients.</p><p><strong>Conclusions: </strong>Cirrhotic/NLR-H HCC patients presented the worst survival. NLR is an independent risk factor for worse survival in cirrhotic patients. Prior therapy is the only factor significantly correlated with OS and PFS in non-cirrhotic patients.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 3","pages":"319-327"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075456","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 peroral endoscopic myotomy improves chronic diarrhea in patients with refractory gastroparesis.","authors":"Maxime Jaccard, Mariola Marx, Elodie Romailler, Meddy Dalex, Marie Phillipart, Fabrice Caillol, Styliani Mantziari, Sébastien Godat","doi":"10.20524/aog.2025.0956","DOIUrl":"https://doi.org/10.20524/aog.2025.0956","url":null,"abstract":"<p><strong>Background: </strong>The main symptoms of gastroparesis are early satiety, nausea, vomiting and bloating. In our daily practice, we observed some patients presenting with concomitant chronic alteration of stool frequency. The present study describes retrospectively the impact of gastric peroral endoscopic myotomy (G-POEM) on patients presenting refractory gastroparesis and concomitant chronic diarrhea or constipation.</p><p><strong>Methods: </strong>This retrospective study analyzed the clinical course of patients with refractory gastroparesis and concomitant chronic alteration of stool frequency who were consecutively treated with G-POEM between January 2019 and October 2023 in a tertiary referral center.</p><p><strong>Results: </strong>Of 107 patients with refractory gastroparesis treated by G-POEM, 11 (10.3%) patients (mean age 60.4±16.2 years, 64% female) had altered bowel frequency for >6 months without any other underlying disease (diarrhea n=10; constipation n=1). Scintigraphy confirmed delayed gastric emptying in 10/11 (91%) of cases. G-POEM was technically feasible in all patients without adverse events during or after endoscopic treatment. The median follow-up period was 170 days (interquartile range [IQR] 33-1002). In 9/11 (81%) patients, G-POEM achieved clinical success with a mean gastroparesis cardinal symptom index (GCSI) of 3.1 (interquartile range [IQR] 2.7-3.4) before, and 0.9 (IQR 0.7-1.7) after the endoscopic treatment. Normalization of bowel movements after G-POEM was observed in 9/11 (81%) of patients. Two patients had partial symptom improvement (loose bowels, but normal frequency), 1 of them without improvement of GCSI and persistent delayed emptying on scintigraphy.</p><p><strong>Conclusion: </strong>Gastroparesis may present with concomitant chronic diarrhea that improves after endoscopic treatment by G-POEM.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 3","pages":"255-261"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075451","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":"Racial disparity in inflammatory bowel disease-related complications: a nationwide cohort study.","authors":"Bobak Moazzami, Zohyra E Zabala, Raguraj Chandradevan, Humberto Sifuentes","doi":"10.20524/aog.2025.0958","DOIUrl":"https://doi.org/10.20524/aog.2025.0958","url":null,"abstract":"<p><strong>Background: </strong>Racial disparities in inflammatory bowel disease (IBD)-related complications are increasingly recognized, yet nationwide data remain limited. This study examined racial differences in IBD-related complications across diverse patient populations.</p><p><strong>Methods: </strong>We analyzed data from the Nationwide Inpatient Sample 2016-2021, on over 1.7 million weighted hospitalizations for IBD. Adults with Crohn's disease (CD) or ulcerative colitis (UC) were identified using ICD-10 codes. Key outcomes included anal abscess, intestinal obstruction, rectal bleeding and anal fissure/fistula, were compared across racial groups. Multivariate logistic regression was used to estimate the odds of complications, adjusting for age, sex, insurance, comorbidities, and hospital factors.</p><p><strong>Results: </strong>Compared to White patients, Black and Hispanic patients with CD had higher rates of anal abscesses (2.8% and 2.57% vs. 1.25%) and rectal bleeding (2.85% and 2.51% vs. 1.79%). Multivariate logistic regression showed that Black and Asian patients had higher odds of developing anal abscess compared to White patients (adjusted OR [aOR] 1.41, 95% confidence interval [CI] 1.38-1.45] and aOR 1.19, 95%CI 1.13-1.29, respectively). In UC, Black (aOR 1.33, 95%CI 1.29-1.37), Hispanic (aOR 1.23, 95%CI 1.21-1.27), and Asian patients (aOR 1.12, 95%CI 1.04-1.20) had higher odds of rectal bleeding, while the odds of intestinal obstruction were lower in Black (aOR 0.74, 95%CI 0.67-0.82), compared to White patients.</p><p><strong>Conclusions: </strong>Racial disparities exist in complications associated with IBD. Black and Hispanic patients had higher odds of perianal complications, while White patients had more intestinal obstruction. These findings emphasize the need for earlier intervention and improved access to advanced therapies in diverse populations.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 3","pages":"294-305"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075468","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":"Trends in admissions and outcomes of hospitalizations related to <i>Clostridioides difficile</i> infection: a nationwide analysis from 2005-2020.","authors":"Sheza Malik, Ese Uwagbale, Olayemi A Adeniranc, Arshia Sethi, Raseen Tariq","doi":"10.20524/aog.2025.0960","DOIUrl":"https://doi.org/10.20524/aog.2025.0960","url":null,"abstract":"<p><strong>Background: </strong><i>Clostridioides difficile</i> infection (CDI) is one of the major causes of healthcare-associated infectious colitis. This study analyzed trends in CDI-related hospitalizations in the United States (US) from 2005-2020, focusing on changes in patient demographics, disease severity and outcomes.</p><p><strong>Methods: </strong>Our study was a retrospective observational analysis using the National Inpatient Sample (NIS) from 2005-2020, focusing on US adults with primary and secondary CDI diagnoses. We performed statistical analysis using SAS 9.4 and joinpoint regression models to identify trends and changes in CDI prevalence and severity, as well as patient outcomes, over the 15-year period.</p><p><strong>Results: </strong>The study analyzed 939,282 patients, 30.2% of whom had primary and 69.8% secondary CDI diagnoses. Over the study period, there was a decline in CDI prevalence from 94.8 to 78.1 per 10,000 hospitalizations. This trend showed an increase in prevalence among younger adults (18-34 years) but a notable decrease in older adults (≥85 years). Sex-related and racial/ethnic disparities were also evident. The incidence of megacolon surged from 12.9 per 10,000 hospitalizations in 2005 to 69.8 per 10,000 in 2020, a more than fivefold increase. In contrast, in-hospital mortality from CDI significantly decreased, from 1028 deaths per 10,000 CDI diagnoses in 2005 to 687 per 10,000 in 2020, a 33.1% reduction.</p><p><strong>Conclusions: </strong>Our study indicated improved management and prevention of CDI, as evidenced by the overall decrease in prevalence and mortality. However, the increase in severity markers and the variable trends across different demographic groups highlight the need for ongoing vigilance and targeted interventions.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"38 3","pages":"311-318"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075478","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}