Gastroenterología y Hepatología (English Edition)最新文献

英文中文

Non-polypoid growth colorectal cancer 非息肉样生长结直肠癌

Gastroenterología y Hepatología (English Edition)

Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.gastre.2026.502605

Joaquín Fisac Vázquez , Aurora Burgos , Laura Guerra Pastrián , Vivian Díaz Castro

引用次数: 0

Severe acute hepatitis E with unilateral amyotrophic neuralgia: A diagnostic challenge 严重急性戊型肝炎伴单侧肌萎缩性神经痛：诊断挑战

Gastroenterología y Hepatología (English Edition)

Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.gastre.2026.502585

Ana Pascual-Dapena , Anna Pocurull , Xavier Forns

引用次数: 0

Tuberculosis and inflammatory bowel disease 肺结核和炎症性肠病

Gastroenterología y Hepatología (English Edition)

Pub Date : 2026-03-01 Epub Date: 2026-02-18 DOI: 10.1016/j.gastre.2026.502587

Lucía Madero , Iria Bastón , Eduard Brunet-Mas , Margalida Calafat , Grupo Joven de GETECCU

Inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn’s disease, carries an increased risk of tuberculosis (TB), particularly in patients treated with immunosuppressive therapies such as anti-TNF agents. The risk is further elevated when combined with immunomodulators. Other drugs, including anti-integrins, IL-12/23 inhibitors, and JAK inhibitors (JAK-i), present a variable risk of TB reactivation. Given this risk, screening for latent tuberculosis infection (LTBI) is essential in IBD patients before initiating immunosuppressive therapy. Guidelines recommend performing this screening ideally at the time of IBD diagnosis or, alternatively, before advanced therapy. Diagnostic tests include the tuberculin skin test (TST) and interferon-gamma release assays (IGRA). In immunocompromised patients, false negatives may occur; therefore, dual testing is advised. Chest X-rays are reserved for cases with positive tests or clinical suspicion. In the presence of LTBI, chemoprophylaxis with isoniazid or rifampicin is recommended prior to initiating immunosuppression. If active TB is diagnosed, immunosuppressive therapy must be discontinued and standard antituberculous treatment initiated. The reintroduction of immunosuppressive therapy should be assessed on a case-by-case basis, prioritizing agents with lower reactivation risk. Finally, BCG vaccination is not recommended in IBD patients undergoing immunosuppressive treatment due to its nature as a live vaccine.

炎症性肠病（IBD），包括溃疡性结肠炎和克罗恩病，会增加患结核病（TB）的风险，特别是在接受免疫抑制疗法（如抗肿瘤坏死因子药物）治疗的患者中。当与免疫调节剂联合使用时，风险进一步升高。其他药物，包括抗整合素、IL-12/23抑制剂和JAK抑制剂（JAK- 1），呈现出结核病再激活的可变风险。考虑到这种风险，在IBD患者开始免疫抑制治疗之前，筛查潜伏性结核感染（LTBI）是必不可少的。指南建议最好在IBD诊断时或在高级治疗前进行这种筛查。诊断试验包括结核菌素皮肤试验（TST）和干扰素释放试验（IGRA）。免疫功能低下的患者可能出现假阴性；因此，建议进行双重测试。胸部x光检查只用于检查结果呈阳性或有临床怀疑的病例。在存在LTBI时，建议在开始免疫抑制之前使用异烟肼或利福平进行化学预防。如果诊断为活动性结核病，必须停止免疫抑制治疗，并开始标准的抗结核治疗。重新引入免疫抑制治疗应根据具体情况进行评估，优先考虑再激活风险较低的药物。最后，由于卡介苗是一种活疫苗，因此不建议接受免疫抑制治疗的IBD患者接种卡介苗。

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引用次数: 0

Implementation of a digital tool to assist physicians during breath tests for SIBO: Impact on diagnostic accuracy, report quality and physician workload 实施数字工具协助医生进行SIBO呼吸测试：对诊断准确性、报告质量和医生工作量的影响

Gastroenterología y Hepatología (English Edition)

Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.gastre.2026.502589

Lisandro Pereyra , Leandro Steinberg , Sofia Navar , Federico Bentolila , Silvia Pedreira , Francisco Schlottmann

Objective

We aimed to evaluate the implementation of a digital tool that assists physicians during breath tests (BTs) for small intestinal bacterial overgrowth (SIBO), measuring its impact on diagnostic accuracy, report quality, and physician workload. Tool usability was also assessed.

Patients and methods

We conducted a retrospective evaluation of all BTs done at our institution from January 2024 to September 2024. All BTs were performed using the same equipment and interpreted by the same four board-certified gastroenterologists. In May 2024, a digital tool (i.e. Smart Breath) was adopted to help performing and reporting all BTs. Accuracy and report quality were compared before and after implementation of such digital tool. Three blinded SIBO experts used current international guidelines to adjudicate diagnoses and assess report completeness based on 12 quality criteria. Usability of the digital tool and workload were evaluated with the System Usability Scale (SUS) and NASA Task Load Index (NASA-TLX).

Results

A total of 637 BTs were analyzed: 324 standard BT (before the implementation of Smart Breath) and 313 assisted by Smart Breath. Accuracy significantly improved after the implementation of Smart Breath (100% vs. 89.2% for SIBO; 100% vs. 90.1% for IMO; p < 0.0001). Report completeness increased from a median of 6–12 quality elements (p < 0.0001). The digital tool achieved a mean SUS score of 92.5 and workload scores decreased significantly across all NASA-TLX dimensions.

Conclusions

The implementation of a digital assistant for SIBO breath testing significantly improved diagnostic accuracy and report quality while reducing physician workload. Evidence-based digital tools may enhance the performance of complex diagnostic procedures in clinical practice.

目的：我们旨在评估一种数字工具的实施情况，该工具可以帮助医生进行小肠细菌过度生长（SIBO）的呼吸测试（bt），测量其对诊断准确性、报告质量和医生工作量的影响。工具可用性也被评估。患者和方法我们对我院2024年1月至2024年9月间所做的所有BTs进行回顾性评估。所有的bt都是使用相同的设备进行的，并由相同的四位委员会认证的胃肠病学家进行解释。2024年5月，采用了一种数字工具（即智能呼吸）来帮助执行和报告所有bt。比较数字化工具实施前后的准确性和报告质量。三名SIBO盲法专家使用当前的国际指南来评判诊断并根据12个质量标准评估报告的完整性。使用系统可用性量表（SUS）和NASA任务负载指数（NASA- tlx）评估数字工具的可用性和工作量。结果共分析637例BT：实施智能呼吸前标准BT 324例，智能呼吸辅助BT 313例。实施智能呼吸后，准确性显著提高（SIBO为100%对89.2%；IMO为100%对90.1%;p < 0.0001）。报告完整性从6-12个质量要素的中位数增加（p < 0.0001）。数字工具的SUS平均得分为92.5，工作负荷得分在所有NASA-TLX维度上显着下降。结论SIBO呼气检测数字助手的应用显著提高了诊断准确性和报告质量，同时减少了医生的工作量。基于证据的数字工具可以提高临床实践中复杂诊断程序的性能。

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引用次数: 0

Efficacy of extended intravenous induction with risankizumab in refractory Crohn’s disease 利桑单抗延长静脉诱导治疗难治性克罗恩病的疗效

Gastroenterología y Hepatología (English Edition)

Pub Date : 2026-03-01 Epub Date: 2026-02-18 DOI: 10.1016/j.gastre.2026.502635

Marcos A. Rodríguez Amado, Aitor Villalba Campano, María Ruiz Sierras, Begoña Ortiz Pérez, Cristina Rubín de Célix , Fernando Bermejo

引用次数: 0

On the need for patient-centered approaches to Helicobacter pylori management in geriatric populations 在老年人群中以患者为中心的幽门螺杆菌管理方法的必要性

Gastroenterología y Hepatología (English Edition)

Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.gastre.2026.502583

Camila S. Badell , Eloy F. Ruiz

引用次数: 0

Esophagitis dissecans due to glyphosate ingestion 因摄入草甘膦引起的食管夹层炎

Gastroenterología y Hepatología (English Edition)

Pub Date : 2026-03-01 Epub Date: 2026-02-19 DOI: 10.1016/j.gastre.2026.502586

Raúl Fernández García , Marta Lecuona Muñoz , Jesús Canales Fernández , Eduardo Redondo Cerezo , María del Carmen Fernández Cano

引用次数: 0

Pancreatic panniculitis as the only manifestation 胰腺膜炎为唯一表现

Gastroenterología y Hepatología (English Edition)

Pub Date : 2026-03-01 Epub Date: 2026-02-18 DOI: 10.1016/j.gastre.2026.502582

Sara Rodríguez Vega , Yaiza Rey Fanjul , Jorge Rodríguez Prida

引用次数: 0

Relevance of endoscopy and Helicobacter pylori infection in the preoperative management of obesity with sleeve gastrectomy 内窥镜检查与幽门螺杆菌感染在袖式胃切除术患者术前处理中的相关性

Gastroenterología y Hepatología (English Edition)

Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.gastre.2026.502607

Mª Jesús Fernández Aceñero , Lucía Olmos Rodríguez , Carlos Galindo Fernández

Objectives

Obesity has reached pandemic dimensions, representing a large health burden. Conservative therapy has recently been improved, but the most definitive therapy is still surgery. Gastric sleeve is one of the most frequent techniques. Preoperative guidelines sometimes recommend preoperative endoscopy. The aim of this study is to review the preoperative use of endoscopy in bariatric surgery and the possible importance of Helicobacter pylori therapy to avoid surgical complications.

Patients and methods

Retrospective case series of patients undergoing sleeve gastrectomy in two large hospitals. We have reviewed demographic data, associated pathologies, endoscopic findings prior to surgery, histopathological findings in the surgical resection specimen and rate of complications after surgery, as the outcome measure.

Results

455 patients fulfilled criteria for the study. 69% were women and the mean age was 46.93 (SD: 10.6). 68.7% of the patients show at least one comorbid disease, mainly dyslipidemia, but only 7.2% showed three or more comorbidities. Endoscopy was performed in 41.5% of the patients and biopsy in 35.8%, with significant differences between both hospitals. H. pylori were detected in 53 of the patients undergoing endoscopy and eradicated before surgery. Helicobacter was present in 7% of the surgical resection specimens, 68.75% of whom had not undergone a preoperative endoscopy. The postsurgical complication rate was 23.5% in our series and H. pylori was present in 20% of these patients.

Conclusions

Our study confirms the relevance of Helicobacter eradication before bariatric surgery, as Helicobacter infection is significantly linked to the surgical outcome in our area.

肥胖已达到流行病的程度，是一个巨大的健康负担。保守疗法最近有所改进，但最确定的治疗方法仍然是手术。胃袖是最常用的技术之一。术前指南有时建议术前内镜检查。本研究的目的是回顾术前内镜在减肥手术中的应用，以及幽门螺杆菌治疗对避免手术并发症的重要性。患者与方法回顾性分析两家大型医院的套管胃切除术患者。我们回顾了人口统计学数据、相关病理、手术前内镜检查、手术切除标本的组织病理学检查和手术后并发症的发生率，作为结果衡量标准。结果455例患者符合研究标准。69%为女性，平均年龄46.93岁（SD: 10.6）。68.7%的患者至少有一种合并症，主要是血脂异常，但只有7.2%的患者有三种或三种以上合并症。41.5%的患者行内窥镜检查，35.8%的患者行活检，两家医院差异有统计学意义。53例患者行内窥镜检查检出幽门螺杆菌，并在手术前根除。7%的手术切除标本中存在幽门螺杆菌，其中68.75%的患者术前未进行内窥镜检查。在我们的研究中，术后并发症发生率为23.5%，其中20%的患者存在幽门螺杆菌。结论我们的研究证实了在减肥手术前根除幽门螺杆菌的相关性，因为幽门螺杆菌感染与我们地区的手术结果显著相关。

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引用次数: 0

Association between triglyceride glucose-body mass index and chronic diarrhea: A cross-sectional study of NHANES 2005–2010 data 甘油三酯-葡萄糖-体重指数与慢性腹泻之间的关系：NHANES 2005-2010数据的横断面研究

Gastroenterología y Hepatología (English Edition)

Pub Date : 2026-03-01 Epub Date: 2026-03-05 DOI: 10.1016/j.gastre.2026.502604

Jingjing Feng , Liang Ding , Tao Yang

Objective

Insulin resistance (IR) and obesity are reported to impair physiological processes in the intestinal system, but associations between triglyceride glucose-body mass index (TyG-BMI), a marker of IR and obesity, and chronic diarrhea (CD) remain unclear. Thus, this study explored such relationship to provide novel insights for CD management.

Patients and methods

This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010. Univariate and multivariable logistic regression analyses were performed on weighted data to examined potential associations between TyG-BMI and CD. Additionally, subgroup analyses and interaction tests were performed.

Results

This research encompassed 5354 participants, including 416 with CD. In univariate logistic regression analyses, participants with high TyG-BMI had a significantly higher risk of CD (per 10 units, OR = 1.041, 95% CI: 1.027–1.055). This connection was consistent (per 10 units, OR = 1.038, 95% CI: 1.019–1.057) after adjusting for all confounding covariates. The smoothed curve fitting analysis and threshold effect analysis revealed a stronger positive association between TyG-BMI and chronic diarrhea at lower TyG-BMI levels (<247.15, per 10 units: OR = 1.098, 95% CI: 1.040–1.161 vs >247.15: OR = 1.024, 95% CI: 1.002–1.048). Furthermore, subgroup analyses and interaction tests suggested that the correlation between TyG-BMI and CD was more pronounced in those aged 20 to 44 years (per 10 units, OR = 1.072, 95% CI: 1.043–1.103) or non-Hispanic whites (per 10 units, OR = 1.068, 95% CI: 1.041–1.097).

Conclusions

This cross-sectional study revealed that TyG-BMI is positively associated with the risk of CD in US adults, especially in those aged 20–44 years or non-Hispanic whites. This association may provide new management strategies for CD.

据报道，胰岛素抵抗（IR）和肥胖会损害肠道系统的生理过程，但甘油三酯-葡萄糖-体重指数（TyG-BMI）（IR和肥胖的标志）与慢性腹泻（CD）之间的关系尚不清楚。因此，本研究探讨了这种关系，为乳糜泻管理提供了新的见解。患者和方法本横断面研究利用了2005-2010年国家健康和营养检查调查（NHANES）的数据。对加权数据进行单变量和多变量logistic回归分析，以检验TyG-BMI和CD之间的潜在关联。此外，进行亚组分析和相互作用检验。结果该研究包括5354名参与者，其中416名患有CD。在单变量logistic回归分析中，TyG-BMI高的参与者患CD的风险显著更高（每10个单位，OR = 1.041, 95% CI: 1.027-1.055）。在调整所有混杂协变量后，这种联系是一致的（每10个单位，OR = 1.038, 95% CI: 1.019-1.057）。平滑曲线拟合分析和阈值效应分析显示，TyG-BMI水平较低时，TyG-BMI与慢性腹泻之间存在较强的正相关（>247.15，每10单位：OR = 1.098, 95% CI: 1.040-1.161 vs >247.15: OR = 1.024, 95% CI: 1.002-1.048）。此外，亚组分析和相互作用试验表明，TyG-BMI和CD之间的相关性在20至44岁（每10个单位，OR = 1.072, 95% CI: 1.043-1.103）或非西班牙裔白人（每10个单位，OR = 1.068, 95% CI: 1.041-1.097）中更为明显。这项横断面研究显示，TyG-BMI与美国成年人患CD的风险呈正相关，特别是在20-44岁或非西班牙裔白人中。这种联系可能为CD提供新的管理策略。

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