Turkish Journal of Gastroenterology最新文献

Cite this article as: Inci I, Celik ZS, Kani HT. Assessing the disease activity in Crohn's disease, nothing is enough alone. Turk J Gastroenterol. 2026;37(2):279-280.

Cite this article as: Ozturk O, Cagir Y, Durak MB, Ergul M, Atay A, Yuksel I. Endoscopic management of a rare intraluminal duodenal "windsock" diverticulum causing recurrent pancreatitis. Turk J Gastroenterol. 2026;37(2):270-272.

Cite this article as: Kemik F. The role of pancreatic enzyme insufficiency in the etiology of functional dyspepsia resistant to standard treatment. Turk J Gastroenterol. 2026;37(1):144-145.

Cite this article as: Feng J, Zhai Y, Liu Z, Linghu E. Novel endoscopic suture anchor device for large defect closure following endoscopic submucosal dissection. Turk J Gastroenterol. 2026;37(1):136-138.

Background/aims: Selecting the initial antiviral regimen for chronic hepatitis B (CHB) requires balancing patients' comorbidities and long-term safety. This study examines the differences in patient and disease-related factors that guide clinicians to prescribe either entecavir (ETV) or tenofovir disoproxil fumarate (TDF) as the initial treatment.

Materials and methods: The study included treatment-naïve CHB patients aged 18 or older who had been diagnosed for at least 1 year since 2010 and initiated on antiviral therapy. The data included variables such as age, gender, body mass index (BMI), comorbidities, liver disease activity, biopsy results, cirrhosis, hepatic steatosis, hepatitis B e antigen status, hepatitis B virus DNA levels, triglycerides, cholesterol, renal function, and baseline bone mineral density (BMD), which were assessed by dual-energy x-ray absorptiometry (DEXA).

Results: Among 2259 patients (61.6% male), 1270 patients (56.22%) received TDF, while 989 patients (43.78%) received ETV as first line therapy. The TDF was more commonly prescribed to patients with a lower BMI (median 25.7 vs. 26.2, P = .001) and lower baseline creatinine (0.75 vs. 0.80 for ETV, P < .001). Clinicians preferred ETV among patients with an estimated glomerular filtration rate (eGFR) < 60 (n = 36), (P < .001). The BMD was evaluated in 365 patients (16.3%). The DEXA scans were performed for 116 patients (11.8%) in the ETV group and 249 patients (19.8%) in the TDF group (P < .001).

Conclusions: This national multicenter study emphasizes that patient-related factors, including gender, age, baseline renal function, and liver disease severity, significantly influence the choice of first-line antiviral therapy for CHB, often outweighing disease-specific factors.   Cite this article as: Yamazhan T, Zerdali E, Önlen Y, et al. A national multicenter study on initial antiviral treatment preferences on chronic hepatitis B: Entecavir versus tenofovir disoproxil fumarate. Turk J Gastroenterol. 2026;37(2):179-185.

Background/aims: Celiac disease, a chronic autoimmune disorder, has been reported to be associated with pancreatic involvement, including exocrine pancreatic insufficiency, pancreatitis, and cystic fibrosis. The aim of this cross-sectional study was to determine the frequency of pancreatic steatosis (PS) in patients with celiac disease and compare it with that in healthy controls.

Materials and methods: Sixty patients with celiac disease and 60 healthy participants were included in this study. Biochemical and hematological parameters were collected from all participants. Hepatic steatosis (HS) and PS were diagnosed by ultrasonography and were compared between the groups.

Results: Age, gender, and body mass index were similar between the groups (P > .05). Pancreatic steatosis (81.7%) and HS (66.7%) were more prevalent in the celiac group compared to healthy controls (P < .001). A positive and significant correlation was found between PS and HS in the celiac group (rho = 0.464, P < .05). Hepatic steatosis and PS did not differ between tissue transglutaminase Immunoglobulin A (IgA)-positive and -negative patients with celiac disease (P > .05). No differences in HS or PS were found between celiac patients who adhered to a gluten-free diet and those who did not (P > .05).

Conclusion: Celiac disease may be associated with an increased risk of HS and PS.   Cite this article as: Tarhan A, Gökden Y, Aydemir S, Önol S, Özek FZ. Evaluation of pancreatic steatosis in patients with celiac disease. Turk J Gastroenterol. 2026;37(2):233-241.

Background/aims: Patients with hepatitis B-related decompensated cirrhosis may achieve recompensation. The alanine aminotransferase (ALT) to quantitative hepatitis B surface antigen (qHBsAg) ratio is a novel predictor for hepatitis B surface antigen (HBsAg) seroclearance. This study evaluates its utility in predicting recompensation based on Baveno VII criteria.

Materials and methods: Decompensated hepatitis B-related cirrhosis patients were recruited and received antiviral treatment for at least 12 months. Classification of these participants into the decompensated and recompensated groups was established according to the Baveno VII criteria. Logistic regression and subgroup analysis assessed the correlation between the ratio of ALT to qHBsAg at baseline and cirrhotic recompensation.

Results: A total of 136 patients were involved in this study; 80 (58.8%) patients achieved recompensation. Univariate analysis associated recompensation with sex, age, ALT, aspartate aminotransferase, hepatitis B virus DNA (HBV DNA), qHBsAg, and ALT/logqHBsAg. Multivariate analysis confirmed that higher ALT/logqHBsAg independently predicted greater recompensation likelihood (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 1.00~1.02; P = .027). Categorically, ALT/logqHBsAg > 23.48 significantly increased recompensation probability (OR = 3.21, 95% CI = 1.31~7.90, P = .011). Subgroup analyses across 7 pre-specified subgroups (sex, age, hepatitis B e antigen, HBV DNA, Child-Pugh grade, Model for End-Stage Liver Disease score, qHBsAg) demonstrated consistent relationships. Enhanced predictive power was observed in Child-Pugh class C versus classes A/B and in males versus females.

Conclusion: Elevated baseline ALT/logqHBsAg predicts a higher likelihood of hepatic recompensation in hepatitis B-related cirrhosis under Baveno VII criteria.

Cite this article as: Aykut H, Ordu B, Dertsiz B, Saruhan MA, Adalı G. Splenic artery aneurysm following endoscopic ultrasound guided fine-needle aspiration: A rare complication presenting with delayed massive gastrointestinal bleeding. Turk J Gastroenterol. 2026;37(2):276-278.

Background/aims: Persistent dyspeptic symptoms are common during the proton pump inhibitor (PPI) washout period before Helicobacter pylori (H. pylori) testing. However, the role of rebamipide in symptom management during this interval remains unclear.

Materials and methods: This double-blind, randomized controlled trial enrolled 65 patients with H. pylori-associated dyspepsia or gastritis, randomized (1:1) to receive rebamipide (100 mg 3 times daily) or placebo for 4 weeks, following a 14-day eradication regimen. The primary outcome was the proportion of responders achieving a ≥25% reduction in pain symptom scores on the Severity of Dyspepsia Assessment scale at week 6. Secondary outcomes included changes in pain symptoms, non-pain symptoms, and dyspepsia-related health scores, as well as eradication rates and safety.

Results: All patients completed the trial. Although the proportion of responders was higher in the rebamipide group (18 patients, 56.3% vs. 13 patients, 39.4%), this difference was not statistically significant (P = .17). Scores for pain, non-pain, and dyspepsia-related health improved similarly in both groups. Eradication rates were comparable (87.5% vs. 90.0%), and no serious adverse events were reported.

Conclusion: The responder rate was higher in the rebamipide group, but the difference did not reach statistical significance. The poten tial benefit of rebamipide as a rescue therapy during the PPI washout period before H. pylori testing warrants further investigation in larger trials.   Cite this article as: Suksai N, Chueansuwan R, Yongsiri S, Witoon R, Juttuporn A. Rebamipide for managing dyspeptic symptoms during proton-pump inhibitor washout before Helicobacter pylori testing: A randomized, double-blind, placebo-controlled trial. Turk J Gastroenterol. 2026;37(2):251-259.

Cite this article as: Akca S. Reconsidering the role of exocrine pancreatic insufficiency in functional dyspepsia. Turk J Gastroenterol. 2026;37(1):142-143.