Pub Date : 2025-04-01DOI: 10.1016/j.rgmxen.2024.09.009
G. Renau, J. Domènech, A. Sánchez
{"title":"Umbilical cutaneous metastasis as initial presentation of Sigmoid adenocarcinoma","authors":"G. Renau, J. Domènech, A. Sánchez","doi":"10.1016/j.rgmxen.2024.09.009","DOIUrl":"10.1016/j.rgmxen.2024.09.009","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 314-315"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268119","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmxen.2025.02.001
M.A. Valdovinos-Díaz , A. Hani , C. Defilippi-Guerra , L. Fernando-Pineda , J.M. Remes-Troche , A. Riquelme , L.J. Abrahão-Junior , L. Aguilar-Paiz , C. Almonte-Nuñez , H. Burgos , C. Días , O. Gómez-Escudero , I. Hanna-Jairala , C. Olano , J.A. Olmos , A. Ortiz , G. Otoya , J.L. Tamayo-de la Cuesta , J. Suazo-Barahona , E. Vesco-Monteagudo , J.S. Arenas-Martínez
Introduction and aim
Due to its elevated prevalence, complex pathophysiology, and broad spectrum of clinical manifestations, gastroesophageal reflux disease (GERD) requires precision diagnosis and treatment. The aim of this Latin American expert review was to provide good clinical practice recommendations for the rational use of diagnostic tests and the personalized treatment of GERD.
Methods
Good clinical practice recommendations were developed by a group of Latin American experts in GERD. A thorough review of the literature was conducted, and recommendations on the diagnosis and treatment of GERD were issued after three group discussions.
Results
Twenty-one experts on GERD formulated 30 clinical recommendations for appropriately indicating diagnostic tests for disease phenotypes and their medical treatment, refractory GERD management, endoscopic and surgical treatment indications, the control of GERD in obesity, pregnancy, and older adults, as well as the role of Helicobacter pylori infection and GLP-1 agonists.
Conclusions
Determining GERD phenotypes in patients through the appropriate use of diagnostic tests enables personalized treatment to be prescribed. The recommendations established in this document may contribute to improving the quality of care of patients with GERD.
{"title":"Good clinical practice recommendations for the management of gastroesophageal reflux disease. A Latin American expert review","authors":"M.A. Valdovinos-Díaz , A. Hani , C. Defilippi-Guerra , L. Fernando-Pineda , J.M. Remes-Troche , A. Riquelme , L.J. Abrahão-Junior , L. Aguilar-Paiz , C. Almonte-Nuñez , H. Burgos , C. Días , O. Gómez-Escudero , I. Hanna-Jairala , C. Olano , J.A. Olmos , A. Ortiz , G. Otoya , J.L. Tamayo-de la Cuesta , J. Suazo-Barahona , E. Vesco-Monteagudo , J.S. Arenas-Martínez","doi":"10.1016/j.rgmxen.2025.02.001","DOIUrl":"10.1016/j.rgmxen.2025.02.001","url":null,"abstract":"<div><h3>Introduction and aim</h3><div>Due to its elevated prevalence, complex pathophysiology, and broad spectrum of clinical manifestations, gastroesophageal reflux disease (GERD) requires precision diagnosis and treatment. The aim of this Latin American expert review was to provide good clinical practice recommendations for the rational use of diagnostic tests and the personalized treatment of GERD.</div></div><div><h3>Methods</h3><div>Good clinical practice recommendations were developed by a group of Latin American experts in GERD. A thorough review of the literature was conducted, and recommendations on the diagnosis and treatment of GERD were issued after three group discussions.</div></div><div><h3>Results</h3><div>Twenty-one experts on GERD formulated 30 clinical recommendations for appropriately indicating diagnostic tests for disease phenotypes and their medical treatment, refractory GERD management, endoscopic and surgical treatment indications, the control of GERD in obesity, pregnancy, and older adults, as well as the role of <em>Helicobacter pylori</em> infection and GLP-1 agonists.</div></div><div><h3>Conclusions</h3><div>Determining GERD phenotypes in patients through the appropriate use of diagnostic tests enables personalized treatment to be prescribed. The recommendations established in this document may contribute to improving the quality of care of patients with GERD.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 288-308"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276968","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmxen.2025.05.002
G. Mendoza-Domínguez , Z.M. Garrido-Santos , C. Lau , R. Balbuena , A.D. Santana-Vargas , M. Schmulson-Wasserman
Introduction and aims
Bile acid malabsorption (BAM) is responsible for 30% of cases of diarrhea-predominant irritable bowel syndrome (IBS-D) or functional diarrhea and 63.5% of cases of diarrhea following cholecystectomy. 75SeHCAT is the gold standard diagnostic method but is unavailable in Mexico. Alternatively, primary bile acid (PBA) and total bile acid (TBA) determination in 48 h stools and 7αC4 measurement have been proposed as screening tests.
Objective
Our aim was to evaluate the experience with PBAs and/or TBAs and to determine whether 7αC4 is a good screening biomarker for BAM in clinical practice.
Material and methods
An ambispective study of patients with chronic diarrhea was conducted. BAM was considered present with 7αC4 > 55 ng/mL (cost $420.00 USD), PBAs ≥ 9.8%, TBAs > 2,337 μmol/48 h, or TBAs > 1,000 μmol/48 h + PBAs > 4% (TBAs + PBAs) ($405.00 USD). However, those tests must be shipped to the US for their analysis (total cost $825.00 USD). Data were compared using the chi-square test and Student’s t test, and Spearman’s Rho correlations were calculated.
Results
We analyzed 48 patients with 7αC4 (age: 58.4 ± 16.9, women: 54.2%). BAM was confirmed by 7αC4 in 12.5%, by PBAs in 38.9%; by TBAs in 5.5%, and by TBAs + PBAs in 16.7%. We found elevated 7αC4 in patients with high or normal PBA/TBA levels (correlation with TBAs: 0.542, p = 0.020; PBAs: -0.127, p = 0.605; TBAs + PBAs: -0.200, p = 0.426). Lastly, BAM identified by 7αC4 was more frequent in patients with previous cholecystectomy (22.7%) vs. those without (3.8%).
Conclusions
Our study confirms that 7αC4 correlates well with TBAs and is a good biomarker for BAM screening because it can be elevated, despite normal PBA/TBA levels. Additionally, it represents a 49% cost savings in BAM investigation.
{"title":"Real-world experience with the diagnosis of bile acid malabsorption (BAM) using serum 7-alpha-C4 and 48-hour stool bile acids","authors":"G. Mendoza-Domínguez , Z.M. Garrido-Santos , C. Lau , R. Balbuena , A.D. Santana-Vargas , M. Schmulson-Wasserman","doi":"10.1016/j.rgmxen.2025.05.002","DOIUrl":"10.1016/j.rgmxen.2025.05.002","url":null,"abstract":"<div><h3>Introduction and aims</h3><div>Bile acid malabsorption (BAM) is responsible for 30% of cases of diarrhea-predominant irritable bowel syndrome (IBS-D) or functional diarrhea and 63.5% of cases of diarrhea following cholecystectomy. <sup>75</sup>SeHCAT is the gold standard diagnostic method but is unavailable in Mexico. Alternatively, primary bile acid (PBA) and total bile acid (TBA) determination in 48 h stools and 7αC4 measurement have been proposed as screening tests.</div></div><div><h3>Objective</h3><div>Our aim was to evaluate the experience with PBAs and/or TBAs and to determine whether 7αC4 is a good screening biomarker for BAM in clinical practice.</div></div><div><h3>Material and methods</h3><div>An ambispective study of patients with chronic diarrhea was conducted. BAM was considered present with 7αC4 > 55 ng/mL (cost $420.00 USD), PBAs ≥ 9.8%, TBAs > 2,337 μmol/48 h, or TBAs > 1,000 μmol/48 h + PBAs > 4% (TBAs + PBAs) ($405.00 USD). However, those tests must be shipped to the US for their analysis (total cost $825.00 USD). Data were compared using the chi-square test and Student’s t test, and Spearman’s Rho correlations were calculated.</div></div><div><h3>Results</h3><div>We analyzed 48 patients with 7αC4 (age: 58.4 ± 16.9, women: 54.2%). BAM was confirmed by 7αC4 in 12.5%, by PBAs in 38.9%; by TBAs in 5.5%, and by TBAs + PBAs in 16.7%. We found elevated 7αC4 in patients with high or normal PBA/TBA levels (correlation with TBAs: 0.542, p = 0.020; PBAs: -0.127, p = 0.605; TBAs + PBAs: -0.200, p = 0.426). Lastly, BAM identified by 7αC4 was more frequent in patients with previous cholecystectomy (22.7%) vs. those without (3.8%).</div></div><div><h3>Conclusions</h3><div>Our study confirms that 7αC4 correlates well with TBAs and is a good biomarker for BAM screening because it can be elevated, despite normal PBA/TBA levels. Additionally, it represents a 49% cost savings in BAM investigation.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 169-175"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096193","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmxen.2025.01.005
J.K. Yamamoto-Furusho
{"title":"Response to Teco-Cortes J.A., regarding “First Mexican consensus on Crohn’s disease from the pathologist’s perspective”","authors":"J.K. Yamamoto-Furusho","doi":"10.1016/j.rgmxen.2025.01.005","DOIUrl":"10.1016/j.rgmxen.2025.01.005","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Page 343"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268117","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmxen.2025.02.002
R.A. Jiménez-Castillo , S. Arumugam , J.M. Remes-Troche , T. Venkatesan
Cannabinoid hyperemesis syndrome (CHS) is a chronic disorder characterized by episodes of severe vomiting, alternating with asymptomatic or minimally symptomatic periods. The episodes of emesis tend to be disabling, negatively affecting quality of life. The disorder’s main characteristic is that it is associated with previous chronic heavy cannabis use. CHS is similar to cyclic vomiting syndrome (CVS), with the exception that the sustained cessation of cannabis use is expected to resolve the vomiting episodes.
The average time between the onset of acute CHS episodes and diagnosis ranges from three to six years, based on previously published cases. This delay in the diagnosis reflects a lack of awareness of the condition on the part of physicians. Delayed diagnosis of CHS results in frequent emergency room visits and increased healthcare costs, and the lack of effective treatment leads to poor patient outcomes. The diagnosis is challenging, and some authors have diagnosed CHS when patients had cyclic vomiting, in the context of chronic cannabis use, regardless of the duration of use or the potency of the product used.
The aim of this narrative review is to provide a detailed and critical analysis of current knowledge about CHS. The present document focuses on a thorough review of the literature on worldwide cannabis use, the role of the endocannabinoid system in the pathophysiology of CHS, diagnostic criteria, and current management of CHS.
{"title":"Cannabinoid hyperemesis syndrome: A review","authors":"R.A. Jiménez-Castillo , S. Arumugam , J.M. Remes-Troche , T. Venkatesan","doi":"10.1016/j.rgmxen.2025.02.002","DOIUrl":"10.1016/j.rgmxen.2025.02.002","url":null,"abstract":"<div><div>Cannabinoid hyperemesis syndrome (CHS) is a chronic disorder characterized by episodes of severe vomiting, alternating with asymptomatic or minimally symptomatic periods. The episodes of emesis tend to be disabling, negatively affecting quality of life. The disorder’s main characteristic is that it is associated with previous chronic heavy cannabis use. CHS is similar to cyclic vomiting syndrome (CVS), with the exception that the sustained cessation of cannabis use is expected to resolve the vomiting episodes.</div><div>The average time between the onset of acute CHS episodes and diagnosis ranges from three to six years, based on previously published cases. This delay in the diagnosis reflects a lack of awareness of the condition on the part of physicians. Delayed diagnosis of CHS results in frequent emergency room visits and increased healthcare costs, and the lack of effective treatment leads to poor patient outcomes. The diagnosis is challenging, and some authors have diagnosed CHS when patients had cyclic vomiting, in the context of chronic cannabis use, regardless of the duration of use or the potency of the product used.</div><div>The aim of this narrative review is to provide a detailed and critical analysis of current knowledge about CHS. The present document focuses on a thorough review of the literature on worldwide cannabis use, the role of the endocannabinoid system in the pathophysiology of CHS, diagnostic criteria, and current management of CHS.</div></div>","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 214-226"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295460","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmxen.2024.12.002
J.A. Torres-Díaz, I. García-Juárez
{"title":"Should mycophenolate mofetil be first-line treatment in autoimmune hepatitis?","authors":"J.A. Torres-Díaz, I. García-Juárez","doi":"10.1016/j.rgmxen.2024.12.002","DOIUrl":"10.1016/j.rgmxen.2024.12.002","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 323-325"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268118","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmxen.2024.08.008
A. Fuentes-Montalvo, A.L. Ordóñez-Vázquez, J.S. Arenas-Martínez, E. Coss-Adame
{"title":"Impact of biofeedback therapy in constipation due to dyssynergic defecation","authors":"A. Fuentes-Montalvo, A.L. Ordóñez-Vázquez, J.S. Arenas-Martínez, E. Coss-Adame","doi":"10.1016/j.rgmxen.2024.08.008","DOIUrl":"10.1016/j.rgmxen.2024.08.008","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 311-313"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227811","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}
Pub Date : 2025-04-01DOI: 10.1016/j.rgmxen.2024.11.007
J. Crespo, P. Iruzubieta
{"title":"Preoperative management of patients receiving treatment with GLP-1 analogues: Withhold or individualize?","authors":"J. Crespo, P. Iruzubieta","doi":"10.1016/j.rgmxen.2024.11.007","DOIUrl":"10.1016/j.rgmxen.2024.11.007","url":null,"abstract":"","PeriodicalId":74705,"journal":{"name":"Revista de gastroenterologia de Mexico (English)","volume":"90 2","pages":"Pages 344-345"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276969","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}
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