BMC Gastroenterology最新文献

{"title":"Characteristics and outcomes of small-bowel vascular lesions and nonvascular lesions in patients with suspected small-bowel bleeding detected by deep enteroscopy: a single-center experience in Taiwan.","authors":"Ming Chun Hsieh, Peng-Jen Chen, Yu-Lueng Shih, Wei-Kuo Chang, Tsai-Yuan Hsieh, Tien-Yu Huang","doi":"10.1186/s12876-026-05128-2","DOIUrl":"10.1186/s12876-026-05128-2","url":null,"abstract":"<p><strong>Background: </strong>Small-bowel vascular lesions are a major cause of suspected small-bowel bleeding (SSBB), which poses considerable challenges in clinical practice. Hence, this study aimed to identify the clinical characteristics, management, and comparison between small bowel vascular and nonvascular lesions in patients with SSBB who underwent deep enteroscopy.</p><p><strong>Methods: </strong>Between September 2009 and December 2023, 385 patients underwent single-balloon enteroscopy (SBE; a total of 592 procedures) at Tri-Service General Hospital. Among them, 203 patients with SSBB who underwent SBE (308 procedures) were enrolled. The clinical characteristics and endoscopy findings of small bowel vascular and nonvascular lesions were collected, and multiple variables were analyzed to determine the factors associated with lesion type and to evaluate clinical outcomes.</p><p><strong>Results: </strong>Among patients with SSBB who underwent SBE, the lesion detection rate was 79% (161 patients). In patients with positive findings, vascular and nonvascular lesions were found in 39.1% and 60.9% of the patients, respectively. The most common etiologies of vascular and nonvascular lesions were angioectasia (88.89%) and ulcers (30.6%). Among the 63 patients with vascular lesions, angioectasia was the most common subtype, identified in 56 patients (88.89%), followed by Dieulafoy's lesion and lymphangioectasia (each 3.17%), and arteriovenous malformation, hemangioma, and varices (each 1.59%). Nonvascular lesions were more heterogeneous, with ulcers being the most common (30.61%), followed by diverticula (27.55%), active bleeding without identified source (15.31%), malignancy (10.20%), and inflammatory bowel disease (6.12%), among others. Among patients with end-stage renal disease (ESRD), those undergoing dialysis, or those using anticoagulant medications, vascular lesions were significantly more common than nonvascular lesions. APC was the most frequently used enteroscopic treatment in the vascular lesion group, whereas surgical intervention was more frequently performed in the nonvascular lesion group.</p><p><strong>Conclusion: </strong>In our study, angioectasia was the most common vascular lesion etiology in patients with SSBB. ESRD is independently associated with vascular lesion type among patients with SSBB and positive enteroscopic findings, and patients undergoing dialysis may represent a population with a higher likelihood of harboring vascular lesions. In conclusion, most vascular lesions in patients with SSBB can be successfully diagnosed and managed using deep enteroscopy. However, surgical or other interventional treatments may still be required in selected patients, particularly those with tumors, refractory bleeding, or lesions not amenable to enteroscopic therapy.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of bilirubin reduction rate after percutaneous transhepatic cholangiographic drainage with major complications in hilar cholangiocarcinoma.","authors":"Tong Yuan, Ran Tao, Zhenhui Xie, Qiuyi Nie, Deyu Li, Chuang Peng, Zhiyong Huang, Xiaoping Chen, Qi Cheng, Erlei Zhang","doi":"10.1186/s12876-026-05114-8","DOIUrl":"10.1186/s12876-026-05114-8","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated whether the dynamic change in total bilirubin (TBIL) after percutaneous transhepatic cholangiographic drainage (PTCD) was associated with major postoperative complications and 90-day mortality in patients with hilar cholangiocarcinoma (HCCA).</p><p><strong>Methods: </strong>We retrospectively analyzed 173 patients with HCCA who underwent PTCD before curative-intent resection at three Chinese centers. The bilirubin reduction rate (BRR) was defined as the difference between the TBIL level measured one day before PTCD and that measured one day before surgery, divided by the interval between measurements. Logistic regression was used for major complications, and Firth's penalized logistic regression was used for 90-day postoperative mortality. Receiver operating characteristic analysis assessed the discriminatory performance of BRR for major complications.</p><p><strong>Results: </strong>Major complications occurred in 64 patients (37.0%), and 8 patients (4.6%) died within 90 days after surgery. On multivariable analysis, BRR (OR = 0.86, 95% CI 0.79-0.95, p = 0.002) and intraoperative transfusion (OR = 2.04, 95% CI 1.06-3.92, p = 0.033) were independently associated with major complications. Lower platelet count (OR = 0.99, 95% CI 0.97-1.00, p = 0.013) and lower albumin (OR = 0.80, 95% CI 0.65-0.99, p = 0.042) remained independently associated with 90-day postoperative mortality. BRR showed modest discriminatory ability for major complications (AUC = 0.644, 95% CI 0.563-0.726). Using the optimal cutoff value (4.863 μmol/L·day^-1), the high-BRR group had lower rates of major complications and 90-day mortality than the low-BRR group.</p><p><strong>Conclusions: </strong>BRR after PTCD was independently associated with major complications after HCCA resection, but its modest discriminatory performance supports its use only as an adjunctive marker.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the content and quality of gastrointestinal endoscopy videos on TikTok, Bilibili, and Kwai: a cross - sectional study.","authors":"Jingsong Wang, Jing Wan, Bingxi Liu, Yixing Luo, Xu Shu, Linlin Liu, Zhenhua Zhu","doi":"10.1186/s12876-026-05108-6","DOIUrl":"10.1186/s12876-026-05108-6","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal endoscopy is essential for diagnosing digestive diseases, yet public misconceptions persist. Short-video platforms (TikTok, Bilibili, Kwai) are now major health-information sources, but the quality of endoscopy-related content is inconsistent.</p><p><strong>Methods: </strong>We analyzed 300 endoscopy videos from the three platforms, categorizing uploaders as medical or non-medical professionals and scoring content with Global Quality Score (GQS), Journal of the American Medical Association (JAMA) benchmark criteria and Modified DISCERN scores across six dimensions (definition, eligibility, preparation, procedure, techniques, management).</p><p><strong>Results: </strong>Of the 300 videos analyzed, 63.3% were uploaded by medical professionals, with the highest proportion on TikTok (91.0%). Non-medical professionals contributed 36.7% of the videos, primarily on Bilibili and Kwai. TikTok and Kwai videos had higher user engagement (likes, comments, collections) but were shorter in duration compared to Bilibili videos. Quality assessments revealed significant differences among platforms, with TikTok videos scoring higher in reliability and accuracy (JAMA and Modified DISCERN scores) than Bilibili and Kwai videos. However, content completeness was generally low across all platforms, with most videos lacking comprehensive information on key aspects of gastrointestinal endoscopy.</p><p><strong>Conclusions: </strong>The quality and comprehensiveness of gastrointestinal endoscopy-related videos on TikTok, Bilibili, and Kwai are unsatisfactory, with significant variations in content quality and user engagement. Efforts should be intensified to improve video content quality, encourage more contributions from medical professionals, optimize algorithms to prioritize high-quality content, and implement stricter content reviews to enhance public health education and the dissemination of accurate medical information.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of gut-brain neuromodulators in functional esophageal disorders: a systematic review.","authors":"Zimeng Wang, Zhi Zheng, Xicheng Wei, Xueqi Li, Chenglin Xin, Dan Tian, Haiqiao Zhang, Xiaoye Liu, Lingyue Dong, Anning Li, Yu Fu, Zhongtao Zhang, Jie Yin, Gang Wang, Jun Zhang","doi":"10.1186/s12876-026-05089-6","DOIUrl":"10.1186/s12876-026-05089-6","url":null,"abstract":"<p><strong>Background: </strong>Patients with functional esophageal disorders exhibit symptoms such as chest pain, heartburn, dysphagia, globus sensation, or reflux hypersensitivity in the absence of structural abnormalities. This is characterized by dysregulated gut-brain interactions and visceral hypersensitivity.</p><p><strong>Methods: </strong>A systematic search of the MEDLINE, EMBASE, Web of Science and the Cochrane central register of controlled trials databases was performed to December 31, 2025. Relevant randomized controlled trials (RCT) reporting the effects of gut-brain neuromodulator (GBN) therapy on functional chest pain (FCP), functional heartburn (FH), reflux hypersensitivity (RH), functional dysphagia (FD), and globus were analyzed.</p><p><strong>Key results: </strong>Among 2538 screened records, 29 RCTs were included. Neuromodulators provided symptom relief in 18-67% of patients with FCP, with 52-71% achieving ≥ 50% symptom reduction. Moreover, 46-80% of patients experienced a globus reduction of more than 50%. In contrast, the number of included studies for RH and FH was small, and the evidence was inconsistent. In healthy individuals, human experimental models indicated that central or local sensory-modulatory pathways can mitigate acid-induced hyperalgesia, thereby offering a promising therapeutic strategy for RH. Convincing evidence to support the use of GBN in the treatment of FD is lacking. However, its effects on normal human esophageal motility also provides strategies for drug selection, although these outcome indicators vary substantially.</p><p><strong>Conclusions and inferences: </strong>GBNs can alleviate FCP, improve globus, and to some extent regulate esophageal sensation. However, their effectiveness for FD, FH, and RH remains controversial. Accordingly, future well-designed and phenotype-specific RCTs are required to establish the role of GBNs in clinical management.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Masked polycythemia vera presenting as non-cirrhotic portal hypertension with isolated gastric varices: a case report.","authors":"Hammam Jallad, Ayman Khaled, Heba Qabaja, Yahya Ayyash Qabaja, Mohammad Qabaja, Amjad Awartani, Ibrahim Barham, Mohammad Yaseen","doi":"10.1186/s12876-026-05111-x","DOIUrl":"10.1186/s12876-026-05111-x","url":null,"abstract":"<p><strong>Background: </strong>Myeloproliferative neoplasms (MPN) are an uncommon but important cause of non-cirrhotic portal hypertension (NCPH) and may present with variceal bleeding rather than overt hematologic abnormalities. Diagnosis may be further delayed when polycythemia vera (PV) is masked by iron deficiency or prior venesection, resulting in non-elevated hemoglobin despite an underlying JAK2-positive neoplasm. We report a rare case of isolated gastric variceal bleeding as the presenting manifestation of presinusoidal NCPH in a patient with early myelofibrosis evolving from iron-deficient PV.</p><p><strong>Case presentation: </strong>A 57-year-old man presented with intermittent rectal bleeding and melena. His history was notable for prior erythrocytosis managed with recurrent therapeutic venipunctures and superficial thrombophlebitis. Upper endoscopy revealed isolated gastric varices without esophageal varices. Abdominal computed tomography showed massive splenomegaly with dilated portal and splenic veins, a radiologically normal liver, and no portal or splenic vein thrombosis. Laboratory evaluation showed hemoglobin of 13.2 g/dL and normal liver chemistries. The patient underwent transjugular liver biopsy with concurrent hepatic venous pressure gradient (HVPG) measurement, which demonstrated a normal gradient of 5 mmHg, while histopathology revealed focal hepatic extramedullary erythropoiesis without cirrhosis. JAK2 V617F testing was positive. Peripheral blood smear and bone marrow biopsy showed leukoerythroblastosis, absent iron stores, panmyelosis, atypical megakaryocytic clustering, and grade 1-2 reticulin fibrosis, consistent with early myelofibrosis evolving from iron-deficient polycythemia vera.</p><p><strong>Conclusions: </strong>This case highlights that masked MPN should be considered in patients with non-cirrhotic portal hypertension, massive splenomegaly, or variceal bleeding even when hemoglobin is normal at presentation. Early JAK2 testing and bone marrow evaluation are essential for diagnosis.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided hepaticogastrostomy versus EUS-guided hepaticogastrostomy with antegrade stent placement in patients with unresectable malignant distal biliary obstruction: a meta-analysis of individual patient data.","authors":"Mahmoud Shaaban Abdelgalil, Ahmad Abdelrazek, Mahmoud Samir Mohamed, Amro Hassan, Manar Alaa Mabrouk, Mohamed Nasser, Eyad Khalil Alhmeid, Abdullah Nizar, Abid Wazir, Noha Ali, Adam Hraybi, Ryad Iqbal, Sadia Paracha, Shray Amin","doi":"10.1186/s12876-026-05102-y","DOIUrl":"10.1186/s12876-026-05102-y","url":null,"abstract":"<p><strong>Background: </strong>In patients with malignant biliary obstruction (MBO) where endoscopic retrograde cholangiopancreatography (ERCP) fails, endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an important rescue option. This study compared the safety and efficacy of EUS-HGS alone versus EUS-HGS with antegrade stenting (EUS-HGAS).</p><p><strong>Methods: </strong>PubMed, Scopus, and Web of Science were searched for studies comparing EUS-HGS and EUS-HGAS in MBO. Primary outcomes included reintervention rates, and time to recurrent biliary obstruction (TRBO). Secondary outcomes were technical success, clinical success, procedure duration, and adverse events. Individual patient data for TRBO were reconstructed from Kaplan Meier curves and analyzed using restricted mean survival time.</p><p><strong>Results: </strong>Five observational studies including 451 patients were analyzed (250 EUS-HGS, 201 EUS-HGAS). Reintervention rates were significantly higher in the EUS-HGS group compared with the EUS-HGAS group (RR = 3.00; 95% CI: 1.69-5.34; P = 0.0002). No significant differences were observed between the two groups in terms of technical success, clinical success, procedure duration, overall adverse events, cholangitis, or bleeding. TRBO was significantly longer with EUS-HGAS (mean 651 vs. 227 days; HR = 0.15; 95% CI: 0.03,0.83; P = 0.03), indicating improved stent patency. EUS-HGS was associated with a lower risk of pancreatitis (RR 0.14; 95% CI 0.03-0.60; P=0.008) but a higher risk of bile leakage (RR 5.58; 95% CI 1.03-30.09; P=0.05).</p><p><strong>Conclusion: </strong>This meta-analysis suggests that EUS-HGAS may provide longer time to recurrent biliary obstruction and lower reintervention rates compared with EUS-HGS, while maintaining similar technical and clinical success and procedure time. Overall adverse events were comparable, although bile leakage was more frequent with EUS-HGS and acute pancreatitis with EUS-HGAS. These findings may indicate a potential advantage of EUS-HGAS in terms of stent durability, warranting further studies for confirmation.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13356786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explainable early prediction of short-term severe deterioration in gallstone-related biliary disease using MIMIC-IV, eICU, and local real-world data.","authors":"Qianli Chen, Xiaoxiong Wu","doi":"10.1186/s12876-026-05080-1","DOIUrl":"10.1186/s12876-026-05080-1","url":null,"abstract":"<p><strong>Background: </strong>Patients with gallstone-related biliary disease may deteriorate rapidly before definitive source control. This study aimed to develop an interpretable 0-24-hour prediction model for short-term severe deterioration in gallstone-related biliary disease and validate it across eICU-CRD and a local real-world cohort.</p><p><strong>Methods: </strong>MIMIC-IV was used for model development, eICU-CRD for primary external validation, and local clinical data for secondary validation. Eligible patients had gallstone disease, cholecystitis, cholangitis, or biliary obstruction. The outcome was a composite of in-hospital or ICU death, vasopressor use, mechanical ventilation, continuous renal replacement therapy, or prolonged ICU stay. Feature selection, imputation, scaling, model selection, and threshold determination were restricted to MIMIC-IV development data. Performance was assessed using AUROC, AUPRC, Brier score, calibration, decision curves, threshold consequences, subgroup analyses, bootstrap risk uncertainty, and SHAP explanations.</p><p><strong>Results: </strong>The study included 2818 MIMIC-IV stays, 1492 eICU-CRD stays, and 115 local patients, with event rates of 58.4%, 65.7%, and 52.2%, respectively. The locked elastic net model retained 12 routine early predictors. AUROC was 0.70 in MIMIC-IV internal validation, 0.64 in eICU-CRD external validation, and 0.63 in local validation. Calibration, net benefit, threshold consequences, and SHAP analyses supported use as a bedside risk-support tool rather than a replacement for clinical judgment.</p><p><strong>Conclusions: </strong>A routine early model captured multi-system deterioration signals in gallstone-related biliary disease and showed transportable, moderate discrimination across external cohorts.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-stage versus two-stage ERCP and laparoscopic cholecystectomy for gallbladder stones with choledocholithiasis: a retrospective cohort study with long-term prognostic comparative analysis.","authors":"Yanmei Li, Shengli Ge, Changbin Peng, Yanwei Che","doi":"10.1186/s12876-026-05061-4","DOIUrl":"10.1186/s12876-026-05061-4","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal treatment strategy for gallbladder stones with concurrent choledocholithiasis remains controversial. This study aims to compare the long-term prognosis of single-stage versus two-stage approaches combining endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC).</p><p><strong>Methodology: </strong>A retrospective cohort study was conducted from January 2020 to December 2022, including 120 patients with gallbladder stones and choledocholithiasis. Patients were divided into two groups: single-stage group (n = 57) underwent the single-stage procedure (simultaneous ERCP and LC), whereas two-stage group (n = 63) received the two-stage approach (ERCP followed by LC after 2-8 weeks). Perioperative parameters, early complications, stone recurrence, cholangitis recurrence, and quality of life were assessed using Gastrointestinal Quality of Life Index (GIQLI). Survival analysis was performed using Kaplan-Meier curves and log-rank tests.</p><p><strong>Results: </strong>Single-stage group demonstrated shorter total operative time (156.2 ± 28.5 vs. 189.7 ± 32.2 min, P < 0.001), reduced hospital stay (3.0 vs. 5.0 d, P < 0.001), and lower total medical costs (32,457 ± 4,235 vs. 38,789 ± 5,568 CNY, P < 0.001) compared to two-stage group. Both groups achieved comparable high success rates (96.5% vs. 96.8%) with similar blood loss and early complication rates (14.0% vs. 19.1%, P > 0.05). No mortality occurred in either group. During follow-up of 36 months, stone recurrence (12.3% vs. 14.3%) and cholangitis recurrence rates (8.8% vs. 11.1%) were similar between groups, with no significant differences in recurrence-free survival curves (P > 0.05). Quality of life assessment showed superior early recovery in single-stage group at one month postoperatively (GIQLI score: 85.1 ± 15.2 vs. 78.3 ± 9.8, P < 0.05), but both groups achieved equivalent long-term quality of life outcomes at 36 months follow-up (116.7 ± 12.5 vs. 115.2 ± 11.8, P > 0.05).</p><p><strong>Conclusion: </strong>Both single-stage and two-stage approaches provide safe and effective treatment for gallbladder stones with choledocholithiasis. The single-stage strategy offers advantages in operative efficiency, hospital stay, cost-effectiveness, and early quality of life recovery, while maintaining comparable long-term recurrence rates and safety profiles.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albumin-to-creatinine ratio as non-invasive marker for prediction of non- bleeding esophageal varices. a cross-sectional observational study.","authors":"Nasser Mousa, Alaa Elmetwalli, Mostafa Abdelsalam, Mohamed Wahba, Niveen El-Wakeel, Marwa Mansour, Mohamed Selim, Muhammad Diasty, Eman Abdelkader, Adel El-Assmy, Mohammed Abdelaziz, Ali El-Assmy, Ahmed Alhawarey","doi":"10.1186/s12876-026-05029-4","DOIUrl":"10.1186/s12876-026-05029-4","url":null,"abstract":"<p><strong>Background and aims: </strong>Esophageal varices (EV) are a frequent complication of liver cirrhosis and a leading cause of gastrointestinal bleeding and mortality. While upper gastrointestinal endoscopy is the preferred method for detecting EV, it may not be feasible in all settings. Non-invasive biomarkers could assist in identifying high-risk patients who should undergo prompt endoscopic evaluation. This study assessed the accuracy of the albumin-to-creatinine ratio (ACR) as a non-invasive predictor of EV in individuals with liver cirrhosis.</p><p><strong>Methods: </strong>This cross-sectional observational study included 260 adult patients with liver cirrhosis who had not undergone endoscopic screening before. All patients underwent upper gastrointestinal endoscopy to screen for esophageal varices (EV). Demographic, clinical, and laboratory data were collected, and the albumin-to-creatinine ratio (ACR) was calculated from serum albumin and creatinine levels. Logistic regression analysis was used to identify independent predictors of EV. The diagnostic performance of ACR was assessed using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Out of the 260 patients, 162 (62.3%) had EV. Patients with EV had significantly lower levels of ACR, serum albumin, platelet count, and hemoglobin, and higher levels of creatinine, bilirubin, INR, and MELD score compared to those without esophageal varices (all p < 0.05). Logistic regression analysis revealed a significant inverse relationship between ACR and the presence of EV. lower ACR independently predicted the presence of EV (adjusted OR 0.53, 95% CI 0.41-0.68; p = 0.001). ROC analysis demonstrated that an ACR cutoff ≤ 3.12 predicted EV with 88% sensitivity, 55% specificity, and an area under the curve of 0.683 (p < 0.001).</p><p><strong>Conclusion: </strong>The ACR ratio is a cost-effective biomarker that can assist in identifying cirrhotic patients at higher risk of EV, aiding in the prioritization of endoscopic screening, especially in settings with limited resources.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of fecal microbiota transplantation on lipid parameters in patients with metabolic syndrome: a meta-analysis.","authors":"Leyi Wang, Zhihao Liu, Fangfang Fan, Long Zhang, Jianping Li","doi":"10.1186/s12876-026-05037-4","DOIUrl":"10.1186/s12876-026-05037-4","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) is a global health challenge, with impaired lipid metabolism as a key feature. While fecal microbiota transplantation (FMT) shows promise as a MetS therapy, existing meta-analyses have reported conflicting results and focused mainly on glycemic parameters, leaving its impact on lipid metabolism largely unexplored. This meta-analysis systematically assessed the influence of allogenic FMT on lipid parameters in patients with MetS, unraveling its potential as an innovative therapeutic modality for this population.</p><p><strong>Methods: </strong>A meta-analysis was performed to explore the impact of allogenic FMT on lipid parameters (triglycerides, total cholesterol [TCHO], high-density lipoprotein cholesterol [HDL-C] and low-density lipoprotein cholesterol [LDL-C]) in patients with MetS. Terms regarding FMT and MetS were searched in PubMed/Medline, EMBASE, Web of Science, the Cochrane Library, and Scopus from the inception of the databases until 31 August 2023.</p><p><strong>Results: </strong>Nine randomized controlled trials (RCTs) were included and subgroup analyses according to follow-up durations were performed. This study was registered in PROSPERO (ID CRD42023389890). A total of 248 patients were included. Patients undergoing allogenic FMT manifested significantly lower TG level compared with control group (receiving placebo or autologous FMT, pooled MD -0.15 [95% CI: -0.29, -0.01]), as well as higher HDL-C level (MD 0.07 [95% CI: 0.02, 0.12]). Subgroup analysis confirmed that these effects were significant at 4 to 6 weeks post-FMT (TG: MD -0.16, 95% CI: -0.32, -0.01; HDL-C: MD 0.08, 95% CI: 0.02, 0.15). No significant difference was observed between allogenic FMT and control group concerning TCHO and LDL-C levels regardless of lengths of follow-up. In subgroup analysis, the results regarding TG and HDL-C remained consistent in the subgroup with 4 to 6 weeks of follow-up.</p><p><strong>Conclusions: </strong>An overall reduction in TG level and elevation in HDL-C level was observed in patients with MetS receiving allogenic FMT. A potential optimal timeframe for FMT efficacy manifestation might be 4 to 6 weeks after first administration.</p><p><strong>Trial registration: </strong>This study is registered in PROSPERO and is available at https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023389890.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}