JGH Open最新文献

{"title":"Comparison of Endoscopic Therapies for Small Rectal Neuroendocrine Tumors: Endoscopic Muscularis Superficialis Dissection Versus Endoscopic Submucosal Dissection.","authors":"Xiawen Shu, Xue Chen, Yirong Ding, Yun Yi, Lurao Li, Kun Li, Jiaoze Shi, Zhishan Chen, Xing Huang, Ying Chang","doi":"10.1002/jgh3.70348","DOIUrl":"https://doi.org/10.1002/jgh3.70348","url":null,"abstract":"<p><strong>Background and aim: </strong>Rectal neuroendocrine tumors (rNETs) often exhibit submucosal tumor-like growth. While endoscopic submucosal dissection (ESD) is widely used, it carries a risk of positive vertical margins, often necessitating repeated surveillance and imposing both financial and psychological burdens on patients. To address this limitation, we developed endoscopic muscularis superficialis dissection (EMSD), a technique involving controlled dissection into the superficial muscularis propria layer to improve complete resection rates. This study aimed to compare the therapeutic outcomes of EMSD and ESD for small rNETs.</p><p><strong>Methods: </strong>This retrospective study enrolled 82 patients (88 rNETs) undergoing ESD or EMSD between May 2019 and June 2025. Primary outcomes included complete resection rates, complication rates, and postoperative hospital stay.</p><p><strong>Results: </strong>The study analyzed 35 lesions treated with EMSD and 53 with ESD. Both groups had similar tumor characteristics. Compared to ESD, EMSD achieved significantly higher rates of both complete vertical margin resection (100% vs. 69.8%, <i>p</i> < 0.001) and R0 resection (100% vs. 67.9%, <i>p</i> < 0.001). However, there were no significant differences in procedure time (47.0 ± 17.0 min vs. 40.0 ± 9.5 min; <i>p</i> = 0.070) and postoperative hospital stay (4.0 ± 1.5 days vs. 4.0 ± 1.0 days; <i>p</i> = 0.676). Postoperative bleeding occurred in 1 EMSD patient (2.9%), which was managed endoscopically. No other bleeding or perforation cases occurred.</p><p><strong>Conclusions: </strong>Compared with ESD, EMSD achieved superior performance in the resection of rNENs ≤ 10 mm in diameter regardless of submucosal invasion depth.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 2","pages":"e70348"},"PeriodicalIF":1.5,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143806","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":"Effect of Disease Extent on Leucine-Rich α2-Glycoprotein as a Marker for Endoscopic Mucosal Healing in Patients With Ulcerative Colitis","authors":"Shogo Kitahata,&nbsp;Mai Saito,&nbsp;Yuka Kimura,&nbsp;Ayaka Nakamura,&nbsp;Toru Usui,&nbsp;Kanako Kato,&nbsp;Kei Onishi,&nbsp;Kozue Kanemitsu-Okada,&nbsp;Tomoe Kawamura,&nbsp;Hideko Ohama,&nbsp;Taira Kuroda,&nbsp;Junko Matsuoka,&nbsp;Fujimasa Tada,&nbsp;Hideki Miyata,&nbsp;Atsushi Hiraoka,&nbsp;Eiji Tsubouchi,&nbsp;Tomoyuki Ninomiya,&nbsp;Yoichi Hiasa","doi":"10.1002/jgh3.70341","DOIUrl":"10.1002/jgh3.70341","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To determine whether the performance of leucine-rich α2-glycoprotein (LRG) as a biomarker for disease activity in patients with ulcerative colitis (UC) may depend on the extent of the disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We evaluated the correlation between various biomarkers, including the serum biomarker LRG, and endoscopic activity in 171 patients with UC. Patients were categorized into two groups based on disease extent: patients with pancolitis and those with left-sided colitis and proctitis. LRG demonstrated similar diagnostic accuracy compared to fecal markers in patients with UC exhibiting pancolitis (area under the curve [AUC] for predicting endoscopic mucosal healing: LRG, 0.92; fecal immunochemical testing [FIT], 0.95; and fecal calprotectin [Fcal], 0.96) (FIT vs. LRG, <i>p</i> = 0.886; Fcal vs. LRG, <i>p</i> = 0.412). Conversely, for patients with left-sided colitis and proctitis, fecal markers outperformed LRG in predicting endoscopic mucosal healing (AUC: LRG, 0.66; FIT, 0.94; and Fcal, 0.92) (FIT vs. LRG, <i>p</i> &lt; 0.001; Fcal vs. LRG, <i>p</i> = 0.004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results support selecting biomarkers according to disease extent for the management of inflammatory bowel disease. In patients with UC and pancolitis, LRG is a viable alternative when fecal samples are not feasible. Conversely, for patients with left-sided colitis and proctitis, fecal markers with high diagnostic accuracy are recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70341","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146136106","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":"Association of Proton Pump Inhibitor and Potassium-Competitive Acid Blocker Use With Discontinuation and Intolerance of Oral 5-Aminosalicylic Acid in Patients With Ulcerative Colitis","authors":"Shinsuke Otagiri,&nbsp;Takahiro Ito,&nbsp;Keiji Yagisawa,&nbsp;Ayumu Sugitani,&nbsp;Atsuo Maemoto","doi":"10.1002/jgh3.70350","DOIUrl":"10.1002/jgh3.70350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Proton pump inhibitors (PPIs) and potassium-competitive acid blockers (PCABs) are widely used for acid-related disorders. Recent studies have raised concerns that acid suppression may alter gut microbiota and drug pharmacokinetics, potentially influencing therapeutic outcomes in patients with inflammatory bowel disease. However, the impact of PPI/PCAB use on oral 5-aminosalicylic acid (5-ASA) therapy and intolerance in ulcerative colitis (UC) remains unclear. We aimed to examine whether concomitant PPI/PCAB use was associated with 5-ASA discontinuation and intolerance in patients with UC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed consecutive patients who received oral 5-ASA for the first time between 2015 and 2022 at a single tertiary center. Patients receiving concomitant steroids or cytapheresis at baseline were excluded. The primary outcome was the association between PPI/PCAB use and 5-ASA intolerance, and the secondary outcome was the association with treatment discontinuation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 181 patients were included in this study. The cumulative continuation rates of oral 5-ASA at 1, 3, and 5 years were 60.4%, 45.4%, and 39.3%, respectively. Overall, 29 patients (16.0%) developed 5-ASA intolerance. In multivariate analyses, concomitant PPI/PCAB use was independently associated with 5-ASA intolerance (OR 9.65, 95% CI 1.92–48.5, <i>p</i> &lt; 0.01) and treatment discontinuation (HR 2.46, 95% CI 1.06–5.65, <i>p</i> = 0.034), whereas age ≥ 40 years was associated with lower odds of intolerance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Concomitant PPI/PCAB use was associated with higher rates of 5-ASA discontinuation and intolerance in patients with UC. These findings suggest novel associations and warrant validation in larger, prospective cohorts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12860887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107844","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":"Effect of Butyrate-Producing Enterobacteria and Proton Pump Inhibitors on Advanced Hepatocellular Carcinoma Treatment With Durvalumab and Tremelimumab","authors":"Kazuhiro Nouso,&nbsp;Akiko Wakuta,&nbsp;Shohei Shiota,&nbsp;Rio Fujita,&nbsp;Kazuya Kariyama,&nbsp;Atsushi Hiraoka,&nbsp;Masanori Atsukawa,&nbsp;Joji Tani,&nbsp;Toshifumi Tada,&nbsp;Shinichiro Nakamura,&nbsp;Kazuto Tajiri,&nbsp;Masaki Kaibori,&nbsp;Masashi Hirooka,&nbsp;Ei Itobayashi,&nbsp;Satoru Kakizaki,&nbsp;Atsushi Naganuma,&nbsp;Toru Ishikawa,&nbsp;Michitaka Imai,&nbsp;Tomoko Aoki,&nbsp;Hironori Tanaka,&nbsp;Takeshi Hatanaka,&nbsp;Kunihiko Tsuji,&nbsp;Kazuhito Kawata,&nbsp;Koichi Takaguchi,&nbsp;Akemi Tsutsui,&nbsp;Chikara Ogawa,&nbsp;Hironori Ochi,&nbsp;Yutaka Yata,&nbsp;Hidekatsu Kuroda,&nbsp;Tomomitsu Matono,&nbsp;Satoshi Yasuda,&nbsp;Hidenori Toyoda,&nbsp;Hiroko Iijima,&nbsp;Masatoshi Kudo,&nbsp;Takashi Kumada","doi":"10.1002/jgh3.70346","DOIUrl":"10.1002/jgh3.70346","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The gut microbiome modulates immune responses, and butyrate-producing bacteria have been linked to improved immune checkpoint inhibitor (ICI) efficacy. Conversely, proton pump inhibitors (PPIs) may negatively impact ICI outcomes by altering gut microbiota. This study aims to elucidate their effects in hepatocellular carcinoma (HCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective multicenter cohort study included 208 HCC patients treated with durvalumab plus tremelimumab at 25 hospitals in Japan. Patients were classified into a butyric acid group (<i>n</i> = 27), who ingested drugs containing butyrate-producing enterobacteria, and a non-butyric acid group (<i>n</i> = 181), as well as a PPI group (<i>n</i> = 107) and a non-PPI group (<i>n</i> = 101). Overall survival (OS) was analyzed using inverse probability of treatment weighting, and risk factors were assessed with Cox proportional hazards modeling. Tumor response was evaluated by RECIST v1.1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant OS differences were observed between the butyric acid and non-butyric acid groups (<i>p</i> = 0.921), or between PPI and non-PPI groups (<i>p</i> = 0.917). The objective response rate was 3.7% in the butyric acid group versus 15.5% in the non-butyric acid group (<i>p</i> = 0.543) and 15.8% in the PPI group versus 12.1% in the non-PPI group (<i>p</i> = 0.222). Disease control rates were comparable. Multivariate analysis identified ECOG performance status (<i>p</i> = 0.019) and ALBI score (<i>p</i> &lt; 0.001) as independent prognostic factors, while butyrate-producing bacteria and PPI use were not associated with survival outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Neither butyrate-producing bacteria nor PPI use significantly influenced the efficacy of durvalumab plus tremelimumab in HCC. The liver's immunotolerant microenvironment may limit the impact of microbiome modulation on ICI efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094717","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":"Eosinophilic Gastrointestinal Disease After Pediatric Organ and Bone Marrow Transplantation","authors":"Erin Sinai,&nbsp;Bridget E. Wilson,&nbsp;Melissa Pecak,&nbsp;Shauna Schroeder,&nbsp;Edward L. Swing,&nbsp;Cindy Bauer","doi":"10.1002/jgh3.70344","DOIUrl":"https://doi.org/10.1002/jgh3.70344","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies have shown an increased prevalence of eosinophilic gastrointestinal disease (EGID) in pediatric liver and heart transplant recipients. However, EGID after other solid organ and bone marrow transplantations has not been extensively evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The purpose of this study is to determine relationships between subsets of EGID with different solid organ and bone marrow transplants in pediatric patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a single-center retrospective chart review of pediatric patients with transplant and EGID between 2007 and 2023. For comparison between transplant groups, ANOVA was used for statistical analysis of continuous variables, and Fisher's exact test was used for categorical variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 30 patients with EGID (eosinophilic esophagitis [EoE] = 21; eosinophilic gastritis [EoG] = 4; EoE + EoG = 3; EoE + eosinophilic colitis [EoC] = 1; eosinophilic duodenitis [EoD] = 1) and history of transplant (liver = 15; heart = 9; bone marrow = 3; multivisceral liver + small bowel + pancreas = 2; kidney = 1). When comparing the transplant groups, there was a significant difference in EoE + EoG incidence (<i>p</i> = 0.011), specifically, EoE + EoG was present in 2 (100%) multivisceral and in 1/15 (7%) liver transplant patients. A statistically significant difference in the presence of gastroesophageal reflux (GER) and oral allergy syndrome between groups was noted (<i>p</i> = 0.036, <i>p</i> = 0.033). There was no significant difference in the symptoms leading to EGID work-up: incidence; morphologic features; achievement of histologic remission; medications; or family history of atopy between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This retrospective biopsy-confirmed cohort demonstrates that EGID subtype varies by transplant type, with higher rates of EoE + EoG in multivisceral recipients. Findings are exploratory and hypothesis-generating; larger multicenter studies including more non-liver and non-heart transplant patients are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgh3.70344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058058","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 Gender and Race on Gastrointestinal Diseases in Patients With Parkinson's Disease: A Nationwide Analysis","authors":"Mohamed H. Eldesouki,&nbsp;Ahmed Yasser Shaban,&nbsp;Mohamed Mahmoud Marey,&nbsp;Eslam Mohammed Rabea,&nbsp;Abdulrhman Helal,&nbsp;Mohamed Seisa,&nbsp;Omar Abdelhalim,&nbsp;Hazem Abosheaishaa,&nbsp;Mohamed Khalaf","doi":"10.1002/jgh3.70302","DOIUrl":"10.1002/jgh3.70302","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastrointestinal (GI) diseases are common non-motor features of Parkinson's disease (PD), significantly impacting quality of life. The impact of racial and gender disparities in this population remains underexplored. This study examines the association of race and gender with GI diseases in hospitalized patients with PD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study using the National Inpatient Sample was conducted, including 124,345 hospitalized patients with PD. Multivariable logistic regression was used to assess associations between GI diseases and race/ethnicity (White, Black, Hispanic) and sex, adjusting for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall prevalence of GI diseases in PD was 48.49%. Compared with White males, Black males had higher odds of dysphagia (aOR 1.27, 95% CI 1.04–1.56), and both Black (aOR 2.19, 95% CI 1.48–3.36) and Hispanic patients (aOR 1.7, 95% CI 1.05–2.77) had significantly higher odds of gastrostomy tube placement. White females had significantly higher odds of gastroesophageal reflux (GERD) (aOR 1.35, 95% CI 1.25–1.46), constipation (aOR 1.34, 95% CI 1.23–1.59), gastroparesis (GP) (aOR 3.44, 95% CI 2.23–5.31), and IBS (aOR 3.1, 95% CI 2.2–4.2), but lower odds of dysphagia (aOR 0.82, 95% CI 0.74–0.91), compared with White males. Hispanic females (aOR 2.64, 95% CI 1.52–4.56, <i>p</i> &lt; 0.01) and Asian males (aOR 2.82, 95% CI 1.47– 5.41, <i>p</i> &lt; 0.01) demonstrated significantly higher odds of <i>H. pylori</i> compared with white males.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Significant racial and gender disparities were observed in GI diseases among hospitalized patients with PD. White females showed higher odds of GERD, constipation, GP, and IBS, while Black and Hispanic patients were more likely to require gastrostomy tube placement. <i>Helicobacter pylori</i> infection was higher in Hispanic females and Asian males when comapred to White males. These differences highlight the need for tailored, equitable care strategies and further research to better understand and address disparities in PD-related GI outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12827495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054466","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":"Brief Report: Can Fecal Microbiota Transplantation Treat Depression?","authors":"Sara Benterkia,&nbsp;Jenny Blythe","doi":"10.1002/jgh3.70336","DOIUrl":"10.1002/jgh3.70336","url":null,"abstract":"&lt;p&gt;Major depressive disorder (MDD) is a debilitating condition affecting around 280 million people worldwide [&lt;span&gt;1&lt;/span&gt;]. Despite advances in pharmacological and psychotherapeutic treatments, around 30% of patients develop treatment-resistant depression, characterized by marked functional impairment, diminished quality of life, and increased suicidality. The global prevalence of depression continues to rise, with a further 25% increase reported since the Covid-19 pandemic [&lt;span&gt;2&lt;/span&gt;]. This growing burden underscores the need for novel therapeutic approaches, including investigation of the gut–brain axis (GBA)—the bidirectional communication between the central nervous system and gastrointestinal microbiota. This report reviews pre-clinical and clinical evidence evaluating fecal microbiota transplantation (FMT) as a potential treatment for depression.&lt;/p&gt;&lt;p&gt;Disruption of the gut microbiota, termed dysbiosis, has been implicated in the development of psychiatric conditions including depression [&lt;span&gt;1&lt;/span&gt;]. Dysbiosis contributes to depression through reduced production of short-chain fatty acids (SCFAs), which normally promote anti-inflammatory cytokines and support neurological functions such as serotonin synthesis [&lt;span&gt;1&lt;/span&gt;]. Inflammatory microbes drive gut inflammation and increase intestinal permeability via cytokine release (e.g., TNF-α, IFN-γ, IL-6) [&lt;span&gt;1&lt;/span&gt;]. SCFA supplementation in mice has demonstrated antidepressant effects, supporting a link between dysbiosis-driven inflammation and depression [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;FMT, already approved for refractory &lt;i&gt;Clostridium difficile&lt;/i&gt; infection, has been proposed as a novel method to restore microbial balance and improve mental health outcomes [&lt;span&gt;3&lt;/span&gt;]. It aims to restore a healthy microbial ecosystem by transferring stool from a screened, healthy donor into the gastrointestinal tract of a recipient. The donor selection process includes rigorous screening, followed by administration via colonoscopy, enema, or encapsulated oral formulations. In the context of depression, FMT is hypothesized to reverse dysbiosis, reduce inflammation, and enhance neurotransmitter function [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Figure 1 summarizes these GBA pathways [&lt;span&gt;1, 4-6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;A search of the PubMed database was undertaken to identify studies examining the relationship between FMT and depression. Search terms used were (“faecal microbiota transplantation” OR “fecal/faecal microbiota transplantation” OR “FMT”) AND (“depression” OR “treatment-resistant depression” OR “TRD” OR “mental health” OR “gut–brain axis” OR “gut dysbiosis” OR “microbiome”), including all types of studies published in the English language since 2016 (the year reflecting the novel use of considering FMT for depressive conditions). The search was keyword-based but cross-checked with MeSH headings (e.g., depressive disorder, fecal microbe transplantation) for consistency. The search found one pre-clinical ","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047179","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":"Esophageal Perforation in Zollinger–Ellison Syndrome: A Scoping Review of Management and Outcomes","authors":"Agostino Fernicola,&nbsp;Domenico Parmeggiani,&nbsp;Felice Crocetto,&nbsp;Armando Calogero,&nbsp;Alessio Cece,&nbsp;Domenico Romano,&nbsp;Giacomo Benassai,&nbsp;Gennaro Quarto,&nbsp;Michele Santangelo","doi":"10.1002/jgh3.70323","DOIUrl":"10.1002/jgh3.70323","url":null,"abstract":"<p>Esophageal perforation in Zollinger–Ellison syndrome (ZES) is an exceedingly rare and life-threatening manifestation of gastrinoma-related acid hypersecretion. While peptic ulceration and severe reflux are recognized complications of ZES, perforation represents the ultimate consequence of uncontrolled hyperacidity. Evidence remains confined to isolated case reports with no prior systematic synthesis. A scoping review was conducted in accordance with PRISMA-ScR and the Joanna Briggs Institute framework. A comprehensive search of PubMed, Embase, Scopus, and Web of Science was performed from database inception to September 2025. Eligible studies included any report describing esophageal perforation in confirmed or suspected ZES. Iatrogenic perforations were excluded. Data were extracted on patient demographics, clinical presentation, diagnostic modalities, management strategies, and outcomes. <b>S</b>even eligible cases published between 2001 and 2025 were identified. Patients were aged 44–63 years (4 males, 3 females). The distal esophagus was affected in approximately 70% of cases, usually after chronic peptic injury; three patients (≈43%) presented with spontaneous Boerhaave-type rupture. Computed tomography was diagnostic in all cases, and endoscopy was used in six. Surgical repair with mediastinal drainage or T-tube repair was the mainstay of management, while conservative therapy failed. Endoscopic stenting achieved successful leak control in one patient, whereas overall survival across all cases was approximately 86%, with one death due to delayed diagnosis and sepsis. Esophageal perforation in ZES represents a predictable but preventable endpoint of chronic acid injury. Rapid imaging, decisive surgical or endoscopic repair, and definitive acid suppression are essential to survival. Awareness of this rare complication among surgeons and gastroenterologists may facilitate early recognition and improve outcomes.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12827053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054395","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":"Pregnancy Outcomes and Disease Activity in Women With Inflammatory Bowel Disease in Qatar: A Retrospective Cohort Study","authors":"Anwar I. Joudah,&nbsp;Abdulwahab Hamid,&nbsp;Ayman Al-Dahshan,&nbsp;Mohamed Sidahmed Elmahdi,&nbsp;Alia Al-Battah,&nbsp;Adel Alnaimi,&nbsp;Khalid Al-Ejii,&nbsp;Fatema Asheer,&nbsp;Huda Saleh,&nbsp;Rafie A. Yakoob,&nbsp;Muneera Almohannadi","doi":"10.1002/jgh3.70311","DOIUrl":"10.1002/jgh3.70311","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Inflammatory bowel disease (IBD) commonly affects women of childbearing age and may complicate pregnancy. This study evaluated disease activity, treatment patterns, and pregnancy outcomes among women with IBD in Qatar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Retrospective cohort study at a multidisciplinary Obstetric-IBD clinic in Doha including 97 pregnant women with confirmed IBD (November 2019–October 2023). Demographics, IBD characteristics, medication use, disease activity (CDAI for Crohn's, Mayo score for ulcerative colitis), and pregnancy outcomes were retrieved from electronic records. Associations were analyzed using chi-square, Fisher's exact tests, and logistic regression, with significance set at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 97 women, 56.7% had ulcerative colitis (UC) and 43.3% Crohn's disease (CD). Pregnancy outcomes did not differ significantly between UC and CD (<i>p</i> = 0.216). Most (88.1%) remained in remission during pregnancy, decreasing to 81.7% postpartum. Biologic therapy was used in 33%. Full-term delivery occurred in 82.6%, with 13% preterm births and 4.4% abortions; Cesarean section rate was 46.7%. Women who received therapy during pregnancy had significantly better outcomes than those who were untreated (OR = 3.4, <i>p</i> = 0.028). Treatment during pregnancy remained protective across trimesters, with monotherapy (OR 4.1–4.8, <i>p</i> &lt; 0.05) and combination therapy (OR 4.4–6.3, <i>p</i> &lt; 0.05) showing consistent benefit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Remission and continuation of therapy during pregnancy were strongly associated with favorable outcomes. These results emphasize that maintaining remission and adhering to therapy both contribute independently to improved maternal and neonatal outcomes. The findings support the safety of continuing therapy and highlight the need for multidisciplinary care to optimize health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020142","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":"Differentiation of Gallbladder Adenomyomatosis and Polyps in a Western Cohort: Prevalence, Ultrasound Characteristics, and Diagnostic Challenges","authors":"Marie Neumann,&nbsp;Michael Kallenbach,&nbsp;Ulrike Morgera,&nbsp;Andrea Cariati,&nbsp;Lars Morawietz,&nbsp;Frank Jacobsen,&nbsp;Frank Dubois,&nbsp;Sebastian Herberger,&nbsp;Falko Hanisch,&nbsp;Slim Khouja,&nbsp;Wolfram Wermke,&nbsp;Yvonne Dörffel","doi":"10.1002/jgh3.70343","DOIUrl":"10.1002/jgh3.70343","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gallbladder adenomyomatosis and polyps are common benign lesions that can mimic malignancy on imaging, often leading to unnecessary cholecystectomy. Despite frequent sonographic detection, the prevalence of adenomyomatosis in living cohorts remains poorly defined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To determine the prevalence and characterize the sonographic features of gallbladder adenomyomatosis and polyps in a large unselected cohort, and to assess clinical relevance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 2674 patients (≥ 16 years) who underwent abdominal ultrasound over 20 months. Examinations were performed by highly experienced sonographers using B-mode, color Doppler, superb microvascular imaging and contrast-enhanced ultrasound. Adenomyomatosis and polyps were classified based on morphology, wall involvement, vascularity, and Rokitansky–Aschoff sinuses (RAS). Follow-up imaging was available in 68 of 123 patients with polyps (median 76 months).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adenomyomatosis was diagnosed in 32 patients (1.2%). Characteristic features included hypoechoic or isoechoic thickened wall with anechoic or microlith-filled RAS, often producing comet-tail and twinkling artifacts. Only one patient required cholecystectomy due to symptomatic diffuse disease. Gallbladder polyps were identified in 123 patients (4.6%). Most polyps remained stable or showed minimal growth, with only three patients undergoing surgery, revealing two cholesterol polyps and one precancerous intracholecystic papillary neoplasm (0.04% of the total cohort).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Structured, high-quality ultrasound enables reliable differentiation of adenomyomatosis and benign polyps from lesions suspicious for malignancy. The vast majority of findings are benign, supporting conservative management. These results provide a reference standard for sonographic assessment and emphasize the importance of awareness and systematic evaluation of gallbladder wall abnormalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"10 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020194","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}