BMJ Open Gastroenterology最新文献

{"title":"Naturally nutrient rich (NNR) score and the risk of colorectal cancer: a case-control study.","authors":"Naeemeh Hassanpour Ardekanizadeh, Mahdi Mousavi Mele, Saeideh Mohammadi, Soheila Shekari, Mobina Zeinalabedini, Mohammad Masoumvand, Seyedeh Hayedeh Mousavi Shalmani, Seyed Ali Askarpour, Maryam Gholamalizadeh, Farhad Vahid, Saeid Doaei","doi":"10.1136/bmjgast-2023-001242","DOIUrl":"10.1136/bmjgast-2023-001242","url":null,"abstract":"<p><strong>Background: </strong>The association between colorectal cancer (CRC) and nutrients has been studied frequently. However, the association of nutrient density of diets with the risk of CRC has been less studied. This study aimed to investigate the association between CRC and naturally nutrient rich (NNR) score in Iranian adults.</p><p><strong>Method: </strong>This case-control study included 160 patients with colorectal cancer and 320 controls aged 35-70 years in Tehran, Iran. Dietary intake was assessed using a 168-item food frequency questionnaire. The NNR score was obtained by calculating the average daily value of 14 nutrients including protein, vitamins A, C, D, E, B₁, B₂, B₁₂, calcium, zinc, iron, folate, potassium and unsaturated fatty acids.</p><p><strong>Results: </strong>Regarding dietary intake of the components of NNR score, the case group had a lower intake of polyunsaturated fat (15.41±4.44 vs 16.54±4.20 g/day, p=0.01), vitamin E (10.15±4.16 vs 13.1±5.33; p=0.001), vitamin B₁ (2±0.86 vs 2.19±0.84 mg/day, p=0.03) and folate (516.45±96.59 vs 571.05±80.31; p=0.001) and a higher intake of oleic acid (8.21±5.46 vs 5.59±3.17 g/day, p=0.01) compared with the control group. Colorectal cancer risk was inversely associated with the NNR score after adjusting for the confounders (OR 0.92; 95% CI 0.88 to 0.97; p=0.03).</p><p><strong>Conclusion: </strong>Low NNR scores may be linked to CRC. If confirmed by future longitudinal research, this result may help prevent CRC by recommending nutrient-rich diets.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"10 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482029","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":"People with IBD evidence more microarousals during sleep architecture assessments","authors":"Jessica K Salwen-Deremer, Matthew J Reid, Sarah J Westvold, Corey A Siegel, Michael T Smith","doi":"10.1136/bmjgast-2023-001249","DOIUrl":"https://doi.org/10.1136/bmjgast-2023-001249","url":null,"abstract":"Objective Poor sleep is common in inflammatory bowel disease (IBD) and may be associated with overall worse disease outcomes. While the sleep/IBD literature is growing, the data are often self-reported. Further, much of the research using objective measures of sleep architecture, or the overall pattern of sleep depth, rely on single-night assessments, which can be of questionable validity. Design Participants with IBD and healthy controls were recruited from Dartmouth-Hitchcock Medical Center as part of a two-phase clinical trial. Sleep architecture was assessed using three nights of in-home electroencephalographic monitoring and scored according to the American Academy of Sleep Medicine guidelines. Results Our sample included 15 participants with IBD and 8 healthy controls. Participants with IBD were more psychiatrically complex, with more self-reported insomnia, anxiety and depression. Participants with IBD evidenced greater microarousals than healthy controls. In participants with IBD, microarousals were associated with lower insomnia and greater depression scores. Within IBD, participants with clinically significant insomnia evidenced trend towards lower sleep efficiency, while self-reported disease activity did not significantly impact findings. Conclusions The methodology of past research may have impacted findings, including the reliance on single-night assessments and limited generalisability. Future research that uses robust, multinight assessments of sleep architecture in large, diverse samples is clearly warranted, as is research exploring the impact of cognitive and behavioural factors on sleep architecture and arousal. Trial registration number [NCT04132024][1]. The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study. The data will be shared on reasonable request to the corresponding author. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04132024&atom=%2Fbmjgast%2F10%2F1%2Fe001249.atom","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"19 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139056595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of artificial intelligence in imaging and endoscopy for the diagnosis, monitoring and prognostication of inflammatory bowel disease: a scoping review protocol","authors":"Mallory Chavannes, Lynn Kysh, Mariangela Allocca, Noa Krugliak Cleveland, Michael Todd Dolinger, Tom S Robbins, David T Rubin, Shintaro Sagami, Bram Verstockt, Kerri Novak","doi":"10.1136/bmjgast-2023-001182","DOIUrl":"https://doi.org/10.1136/bmjgast-2023-001182","url":null,"abstract":"Introduction Inflammatory bowel diseases (IBD) are immune-mediated conditions that are increasing in incidence and prevalence worldwide. Their assessment and monitoring are becoming increasingly important, though complex. The best disease control is achieved through tight monitoring of objective inflammatory parameters (such as serum and stool inflammatory markers), cross-sectional imaging and endoscopic assessment. Considering the complexity of the information obtained throughout a patient’s journey, artificial intelligence (AI) provides an ideal adjunct to existing tools to help diagnose, monitor and predict the course of disease of patients with IBD. Therefore, we propose a scoping review assessing AI’s role in diagnosis, monitoring and prognostication tools in patients with IBD. We aim to detect gaps in the literature and address them in future research endeavours. Methods and analysis We will search electronic databases, including Medline, Embase, Cochrane CENTRAL, CINAHL Complete, Web of Science and IEEE Xplore. Two reviewers will independently screen the abstracts and titles first and then perform the full-text review. A third reviewer will resolve any conflict. We will include both observational studies and clinical trials. Study characteristics will be extracted using a data extraction form. The extracted data will be summarised in a tabular format, following the imaging modality theme and the study outcome assessed. The results will have an accompanying narrative review. Ethics and dissemination Considering the nature of the project, ethical review by an institutional review board is not required. The data will be presented at academic conferences, and the final product will be published in a peer-reviewed journal. No data are available.","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"196 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138572163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of the FIB-4 index among patients with chronic HCV infection and early liver disease","authors":"Lisette A P Krassenburg, Raoel Maan, Amy Puenpatom, Nicole S Erler, Christoph Welsch, Stijn van Hees, Orlando Cerrhoci, Johannes Vermehren, Robert J de Knegt, Bettina E Hansen, Stefan Zeuzem, Thomas Vanwolleghem, Harry L A Janssen, Robert A de Man, Jordan J Feld, Adriaan J van der Meer","doi":"10.1136/bmjgast-2023-001209","DOIUrl":"https://doi.org/10.1136/bmjgast-2023-001209","url":null,"abstract":"Background and aims Historical paired liver biopsy studies are likely to underestimate current progression of disease in patients with chronic hepatitis C virus (HCV) infection. We aimed to assess liver disease progression according to the non-invasive Fibrosis-4 (FIB-4) index in patients with chronic HCV and early disease. Methods and results Patients diagnosed with chronic HCV and FIB-4 <3.25 from four international liver clinics were included in a retrospective cohort study. Follow-up ended at start of antiviral therapy resulting in sustained virological response, at time of liver transplantation or death. Primary outcome of advanced liver disease was defined as FIB-4 >3.25 during follow-up. Survival analyses were used to assess time to FIB-4 >3.25. In total, 4286 patients were followed for a median of 5.0 (IQR 1.7–9.4) years, during which 41 071 FIB-4 measurements were collected. At baseline, median age was 47 (IQR 39–55) years, 2529 (59.0%) were male, and 2787 (65.0%) patients had a FIB-4 <1.45. Advanced liver disease developed in 821 patients. Overall, 10-year cumulative incidence of advanced disease was 32.1% (95% CI 29.9% to 34.3%). Patients who developed advanced disease showed an exponential FIB-4 increase. Among patients with a presumed date of HCV infection, cumulative incidence of advanced disease increased 7.7-fold from 20 to 40 years as opposed to the first 20 years after HCV infection. Conclusions The rate of advanced liver disease is high among chronic HCV-infected patients with early disease at time of diagnosis, among whom liver disease progression accelerated over time. These results emphasise the need to overcome any limitations with respect to diagnosing and treating all patients with chronic HCV across the globe. Data are available upon reasonable request.","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"3 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138554832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of colonoscopy: common and rare—recognition, assessment and management","authors":"William Waddingham, Umair Kamran, Bhaskar Kumar, Nigel J Trudgill, Zacharias P Tsiamoulos, Matthew Banks","doi":"10.1136/bmjgast-2023-001193","DOIUrl":"https://doi.org/10.1136/bmjgast-2023-001193","url":null,"abstract":"An understanding of the potential complications of diagnostic lower gastrointestinal endoscopy is a necessary part of being an independent endoscopist. Creating a culture of safety and prevention of adverse events (AEs) should be part of routine endoscopy practice. Appropriate patient selection for procedures, informed consent, peri-procedure risk assessments and an inclusive team approach, all contribute to preventing AEs. Early recognition, prompt management and transparent communication with patients are essential for the holistic and optimal management of AEs. In this review, we discuss the complications of diagnostic lower gastro-intestinal endoscopy, including their recognition, treatment and prevention.","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"12 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138554560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating clinical outcomes and prognosis in patients with cirrhosis and portal hypertension: a retrospective observational cohort study.","authors":"Nerissa Hoi Ching Lee, Steven J Kiddle, Shardul Chandankhede, Shubh Agrawal, Daniel M Bean, Phillip R Hunt, Victoria E R Parker, Peter J Greasley, Philip Ambery","doi":"10.1136/bmjgast-2023-001234","DOIUrl":"10.1136/bmjgast-2023-001234","url":null,"abstract":"<p><strong>Objective: </strong>Cirrhosis describes the end-stage of chronic liver disease. Irreversible changes in the liver cause portal hypertension, which can progress to serious complications and death. Only a few studies with small sample sizes have investigated the prognosis of cirrhosis with portal hypertension. We used electronic healthcare records to examine liver-related outcomes in patients with diagnosed/suspected portal hypertension.</p><p><strong>Design: </strong>This retrospective observational cohort study used secondary health data between 1 January 2017 and 3 December 2020 from the TriNetX Network, a federated electronic healthcare records platform. Three patient groups with cirrhosis and diagnosed/suspected portal hypertension were identified ('most severe', 'moderate severity' and 'least severe'). Outcomes studied individually and as a composite were variceal haemorrhage, hepatic encephalopathy, complications of ascites and recorded mortality up to 24 months.</p><p><strong>Results: </strong>There were 13 444, 23 299, and 23 836 patients in the most severe, moderate severity and least severe groups, respectively. Mean age was similar across groups; most participants were white. The most common individual outcomes at 24 months were variceal haemorrhage in the most severe group, recorded mortality and hepatic encephalopathy in the moderate severity group, and recorded mortality in the least severe group. Recorded mortality rate was similar across groups. For the composite outcome, cumulative incidence was 59% in the most severe group at 6 months. Alcohol-associated liver disease and metabolic-associated steatohepatitis were significantly associated with the composite outcome across groups.</p><p><strong>Conclusion: </strong>Our analysis of a large dataset from electronic healthcare records illustrates the poor prognosis of patients with diagnosed/suspected portal hypertension.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"10 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457896","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":"Interval colorectal cancers after negative faecal immunochemical test in the New Zealand Bowel Screening Pilot.","authors":"Kai Sheng Saw, Kerry Sexton, Paul Frankish, Mike Hulme-Moir, Ian Bissett, Susan Parry","doi":"10.1136/bmjgast-2023-001233","DOIUrl":"10.1136/bmjgast-2023-001233","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the diagnostic performance of faecal immunochemical test (FIT), identify risk factors for FIT-interval colorectal cancers (FIT-IC) and describe long-term outcomes of participants with colorectal cancers (CRC) in the New Zealand Bowel Screening Pilot (BSP).</p><p><strong>Design: </strong>From 2012 to 2017, the BSP offered eligible individuals, aged 50-74 years, biennial screening using a quantitative FIT with positivity threshold of 15 µg haemoglobin (Hb)/g faeces. Retrospective review of prospectively maintained data extracted from the BSP Register and New Zealand Cancer Registry identified any CRC reported in participants who returned a definitive FIT result. Further details were obtained from hospital records. FIT-ICs were primary CRC diagnosed within 24 months of a negative FIT. Factors associated with FIT-ICs were identified using logistic regression.</p><p><strong>Results: </strong>Of 387 215 individuals invited, 57.4% participated with 6.1% returning positive FIT results. Final analysis included 520 CRC, of which 111 (21.3%) met FIT-IC definition. Overall FIT sensitivity for CRC was 78.7% (95% CI=74.9% to 82.1%), specificity was 94.1% (95% CI=94.0% to 94.2%). In 78 (70.3%) participants with FIT-IC, faecal Hb was reported as undetectable. There were no significant associations between FIT-IC and age, sex, ethnicity and deprivation. FIT-ICs were significantly associated with proximal tumour location, late stage at diagnosis, high-grade tumour differentiation and subsequent round screens. Median follow-up time was 74 (2-124) months. FIT-IC had significantly poorer overall survival.</p><p><strong>Conclusion: </strong>FIT sensitivity in BSP compared favourably to published data. FIT-ICs were more likely to be proximal tumours with poor long-term outcomes. Further lowering of FIT threshold would have minimal impact on FIT-IC.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"10 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440256","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":"Practical multidisciplinary framework for the assessment and management of patients with unexplained chronic aerodigestive symptoms.","authors":"Nathan Quigley, Sandeep G Mistry, Dipesh H Vasant, Sarju Vasani","doi":"10.1136/bmjgast-2022-000883","DOIUrl":"10.1136/bmjgast-2022-000883","url":null,"abstract":"<p><strong>Objective: </strong>Patients experiencing unexplained chronic throat symptoms (UCTS) are frequently referred to gastroenterology and otolaryngology outpatient departments for investigation. Often despite extensive investigations, an identifiable structural abnormality to account for the symptoms is not found. The objective of this article is to provide a concise appraisal of the evidence-base for current approaches to the assessment and management of UCTS, their clinical outcomes, and related healthcare utilisation.</p><p><strong>Design: </strong>This multidisciplinary review critically examines the current understanding of aetiological theories and pathophysiological drivers in UCTS and summarises the evidence base underpinning various diagnostic and management approaches.</p><p><strong>Results: </strong>The evidence gathered from the review suggests that single-specialty approaches to UCTS inadequately capture the substantial heterogeneity and pervasive overlaps among clinical features and biopsychosocial factors and suggests a more unified approach is needed.</p><p><strong>Conclusion: </strong>Drawing on contemporary insights from the gastrointestinal literature for disorders of gut-brain interaction, this article proposes a refreshed interdisciplinary approach characterised by a positive diagnosis framework and patient-centred therapeutic model. The overarching aim of this approach is to improve patient outcomes and foster collaborative research efforts.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"10 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138298414","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":"Cardiac and intramuscular adaptations following short-term exercise prehabilitation in unfit patients scheduled to undergo hepatic or pancreatic surgery: study protocol of a multinuclear MRI study.","authors":"Allard G Wijma, Heleen Driessens, Jeroen A L Jeneson, Maryska L G Janssen-Heijnen, Tineke P Willems, Joost M Klaase, Bart C Bongers","doi":"10.1136/bmjgast-2023-001243","DOIUrl":"10.1136/bmjgast-2023-001243","url":null,"abstract":"<p><strong>Introduction: </strong>Short-term exercise prehabilitation programmes have demonstrated promising results in improving aerobic capacity of unfit patients prior to major abdominal surgery. However, little is known about the cardiac and skeletal muscle adaptations explaining the improvement in aerobic capacity following short-term exercise prehabilitation.</p><p><strong>Methods and analysis: </strong>In this single-centre study with a pretest-post-test design, 12 unfit patients with a preoperative oxygen uptake (VO₂) at the ventilatory anaerobic threshold ≤13 mL/kg/min and/or VO₂ at peak exercise ≤18 mL/kg/min, who are scheduled to undergo hepatopancreatobiliary surgery at the University Medical Center Groningen (UMCG), the Netherlands, will be recruited. As part of standard care, unfit patients are advised to participate in a home-based exercise prehabilitation programme, comprising high-intensity interval training and functional exercises three times per week, combined with nutritional support, during a 4-week period. Pre-intervention and post-intervention, patients will complete a cardiopulmonary exercise test. Next to this, study participants will perform additional in-vivo exercise cardiac magnetic resonance (MR) imaging and phosphorus 31-MR spectroscopy of the quadriceps femoris muscle before and after the intervention to assess the effect on respectively cardiac and skeletal muscle function.</p><p><strong>Ethics and dissemination: </strong>This study was approved in May 2023 by the Medical Research Ethics Committee of the UMCG (registration number NL83611.042.23, March 2023) and is registered in the ClinicalTrials.gov register. Results of this study will be submitted for presentation at (inter)national congresses and publication in peer-reviewed journals.</p><p><strong>Trial registration number: </strong>NCT05772819.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"10 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138298413","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":"Elobixibat improves rectal sensation in patients with chronic constipation aged ≥60 years: a randomised placebo-controlled study.","authors":"Noriaki Manabe, Minami Umeyama, Sonoko Ishizaki, Takumi Ota, Shinji Kuratani, Ryo Katsumata, Minoru Fujita, Ken Haruma, Michael Camilleri","doi":"10.1136/bmjgast-2023-001257","DOIUrl":"10.1136/bmjgast-2023-001257","url":null,"abstract":"<p><strong>Objective: </strong>High rectal sensory thresholds (RSTs) are associated with chronic constipation (CC), especially in older patients. Bile acids (BAs) affect the RSTs of healthy individuals. Here, we aimed to investigate the effects of the BA transporter inhibitor elobixibat in patients with CC aged ≥60 years.</p><p><strong>Design: </strong>We prospectively compared the RSTs of 17 patients with CC aged ≥60 years with those of 9 healthy individuals of the same age range. We next performed a prospective, randomised, parallel-group, double-blind, placebo-controlled clinical trial of 17 patients with CC who administered elobixibat or placebo daily for 1 week. Using barostat methodology, their first constant sensation volume (FCSV), defaecatory desire volume (DDV), and maximum tolerable volume (MTV) thresholds; their rectal compliance; and their faecal BA concentrations were measured before and after treatment.</p><p><strong>Results: </strong>There were no significant differences in the RSTs of healthy individuals and patients with CC, but all of these tended to be higher in the latter group. Elobixibat increased the desire to defaecate, significantly reduced the threshold for FCSV (p=0.0018), and tended to reduce the threshold for DDV (p=0.0899) versus placebo. However, there were no differences in the MTV or rectal compliance of the two groups. The total faecal BA concentration increased, and particularly that of secondary BAs in the elobixibat group. Elobixibat was most efficacious in participants with a longer duration of CC and a history of treatment for CC.</p><p><strong>Conclusion: </strong>Elobixibat reduces the RSTs of patients with CC aged ≥60 years, which may be important for its therapeutic effects.</p><p><strong>Trial registration number: </strong>jRCTs061200030.</p>","PeriodicalId":9235,"journal":{"name":"BMJ Open Gastroenterology","volume":"10 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138294687","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}