Pub Date : 2024-11-06DOI: 10.14309/ajg.0000000000003192
Steven J Ackerman, Amir F Kagalwalla, Zhaoxing Pan, Joshua Wechsler, Kaitlin Keeley, Nirmala Gonsalves, Ikuo Hirano, Angelika Zalewski, Paul Menard-Katcher, Calies Menard-Katcher, Sandeep K Gupta, Nikhil Chauhan, Milica Grozdanovic, Dan Atkins, Nathalie Nguyen, Glenn T Furuta
Background: Endoscopy, standard-of-care for monitoring Eosinophilic Esophagitis (EoE), assesses mucosal inflammation. The Esophageal String Test (EST®), a minimally invasive swallowed capsule and immunoassays, quantifies EoE inflammation. We determined whether the EST/EoEScore can monitor disease in patients undergoing treatment.
Methods: Thirty-three samples from 14 EoE patients (7 children, 7 adults) who underwent repeat endoscopies and ESTs were studied. Biopsies were analyzed for peak eosinophil counts; ESTs analyzed for EoEScores.
Results: Eosinophil counts and EoEScores significantly correlated during treatment, distinguishing patients with active EoE from treatment-associated remissions for 93.9% of ESTs performed.
Conclusion: The EST can be used to longitudinally monitor responses to treatment in EoE.
{"title":"The Minimally Invasive 1-Hr Esophageal String Test (EST) Monitors Therapeutic Changes in Mucosal Inflammation in Eosinophilic Esophagitis.","authors":"Steven J Ackerman, Amir F Kagalwalla, Zhaoxing Pan, Joshua Wechsler, Kaitlin Keeley, Nirmala Gonsalves, Ikuo Hirano, Angelika Zalewski, Paul Menard-Katcher, Calies Menard-Katcher, Sandeep K Gupta, Nikhil Chauhan, Milica Grozdanovic, Dan Atkins, Nathalie Nguyen, Glenn T Furuta","doi":"10.14309/ajg.0000000000003192","DOIUrl":"10.14309/ajg.0000000000003192","url":null,"abstract":"<p><strong>Background: </strong>Endoscopy, standard-of-care for monitoring Eosinophilic Esophagitis (EoE), assesses mucosal inflammation. The Esophageal String Test (EST®), a minimally invasive swallowed capsule and immunoassays, quantifies EoE inflammation. We determined whether the EST/EoEScore can monitor disease in patients undergoing treatment.</p><p><strong>Methods: </strong>Thirty-three samples from 14 EoE patients (7 children, 7 adults) who underwent repeat endoscopies and ESTs were studied. Biopsies were analyzed for peak eosinophil counts; ESTs analyzed for EoEScores.</p><p><strong>Results: </strong>Eosinophil counts and EoEScores significantly correlated during treatment, distinguishing patients with active EoE from treatment-associated remissions for 93.9% of ESTs performed.</p><p><strong>Conclusion: </strong>The EST can be used to longitudinally monitor responses to treatment in EoE.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-05DOI: 10.14309/ajg.0000000000003130
Emma Vanderschueren, Wim Laleman
{"title":"Reply to Prakash and Sethi.","authors":"Emma Vanderschueren, Wim Laleman","doi":"10.14309/ajg.0000000000003130","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003130","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-05DOI: 10.14309/ajg.0000000000003173
Neena S Abraham, Meridith Phillips
{"title":"Developing the ACG Leadership Pipeline: Impact of the ACG Institute Leadership Programs 2018-2023.","authors":"Neena S Abraham, Meridith Phillips","doi":"10.14309/ajg.0000000000003173","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003173","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-05DOI: 10.14309/ajg.0000000000003180
Daniel Marino, Jasmine Saini, Scott Tenner
{"title":"Guidelines in Practice: Management of Acute Pancreatitis.","authors":"Daniel Marino, Jasmine Saini, Scott Tenner","doi":"10.14309/ajg.0000000000003180","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003180","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-04DOI: 10.14309/ajg.0000000000003134
Avi Toiv, Zachary Saleh, Andrew M Watson, Cyrus R Piraka
{"title":"Duodenal Obstruction Caused by an Isolated Spontaneous Celiac Artery Dissection.","authors":"Avi Toiv, Zachary Saleh, Andrew M Watson, Cyrus R Piraka","doi":"10.14309/ajg.0000000000003134","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003134","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The prospective study aimed to investigate the long-term associated risks of cirrhosis and hepatocellular carcinoma (HCC) across various subtypes of steatotic liver disease (SLD).
Methods: We enrolled 332,175 adults who participated in a health screening program between 1997 and 2013. Participants were categorized into various subtypes, including metabolic dysfunction-associated SLD (MASLD), MASLD with excessive alcohol consumption (MetALD), and alcohol-related liver disease (ALD), based on ultrasonography findings, alcohol consumption patterns, and cardiometabolic risk factors. We used computerized data linkage with nationwide registries from 1997 to 2019 to ascertain the incidence of cirrhosis and HCC.
Results: After a median follow-up of 16 years, 4,458 cases of cirrhosis and 1,392 cases of HCC occurred in the entire cohort, resulting in an incidence rate of 86.1 and 26.8 per 100,000 person-years, respectively. The ALD group exhibited the highest incidence rate for cirrhosis and HCC, followed by MetALD, MASLD, and non-SLD groups. The multivariate adjusted hazard ratios for HCC were 1.92 (95% confidence interval [CI] 1.51-2.44), 2.91 (95% CI 2.11-4.03), and 2.59 (95% CI 1.93-3.48) for MASLD, MetALD, and ALD, respectively, when compared with non-SLD without cardiometabolic risk factors. The pattern of the associated risk of cirrhosis was similar to that of HCC (all P value <0.001). The associated risk of cirrhosis for ALD increased to 4.74 (95% CI 4.08-5.52) when using non-SLD without cardiometabolic risk factors as a reference.
Discussion: This study highlights elevated risks of cirrhosis and HCC across various subtypes of SLD compared with non-SLD, emphasizing the importance of behavioral modifications for early prevention.
{"title":"Long-term Risks of Cirrhosis and Hepatocellular Carcinoma Across Steatotic Liver Disease Subtypes.","authors":"Yi-Ting Chen, Tzu-I Chen, Tsai-Hsuan Yang, Szu-Ching Yin, Sheng-Nan Lu, Xia-Rong Liu, Yun-Zheng Gao, Chih-Jo Lin, Chia-Wei Huang, Jee-Fu Huang, Ming-Lun Yeh, Chung-Feng Huang, Chia-Yen Dai, Wan-Long Chuang, Hwai-I Yang, Ming-Lung Yu, Mei-Hsuan Lee","doi":"10.14309/ajg.0000000000002778","DOIUrl":"10.14309/ajg.0000000000002778","url":null,"abstract":"<p><strong>Introduction: </strong>The prospective study aimed to investigate the long-term associated risks of cirrhosis and hepatocellular carcinoma (HCC) across various subtypes of steatotic liver disease (SLD).</p><p><strong>Methods: </strong>We enrolled 332,175 adults who participated in a health screening program between 1997 and 2013. Participants were categorized into various subtypes, including metabolic dysfunction-associated SLD (MASLD), MASLD with excessive alcohol consumption (MetALD), and alcohol-related liver disease (ALD), based on ultrasonography findings, alcohol consumption patterns, and cardiometabolic risk factors. We used computerized data linkage with nationwide registries from 1997 to 2019 to ascertain the incidence of cirrhosis and HCC.</p><p><strong>Results: </strong>After a median follow-up of 16 years, 4,458 cases of cirrhosis and 1,392 cases of HCC occurred in the entire cohort, resulting in an incidence rate of 86.1 and 26.8 per 100,000 person-years, respectively. The ALD group exhibited the highest incidence rate for cirrhosis and HCC, followed by MetALD, MASLD, and non-SLD groups. The multivariate adjusted hazard ratios for HCC were 1.92 (95% confidence interval [CI] 1.51-2.44), 2.91 (95% CI 2.11-4.03), and 2.59 (95% CI 1.93-3.48) for MASLD, MetALD, and ALD, respectively, when compared with non-SLD without cardiometabolic risk factors. The pattern of the associated risk of cirrhosis was similar to that of HCC (all P value <0.001). The associated risk of cirrhosis for ALD increased to 4.74 (95% CI 4.08-5.52) when using non-SLD without cardiometabolic risk factors as a reference.</p><p><strong>Discussion: </strong>This study highlights elevated risks of cirrhosis and HCC across various subtypes of SLD compared with non-SLD, emphasizing the importance of behavioral modifications for early prevention.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140292421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-07-16DOI: 10.14309/ajg.0000000000002923
Lu Hao, Jisu Xue
{"title":"Improving Insights Into Ultra-processed Food Consumption and Gastrointestinal Cancer Risk.","authors":"Lu Hao, Jisu Xue","doi":"10.14309/ajg.0000000000002923","DOIUrl":"10.14309/ajg.0000000000002923","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Management of intractable childhood constipation is still challenging. The efficacy of retrograde colonic enema (RCE) with fecal microbiota transplantation (FMT) in intractable childhood constipation has not been established, although both have demonstrated potential in gastrointestinal diseases. The aim of this study was to determine the safety and efficacy of RCE-based FMT in the treatment of intractable constipation in children.
Methods: A randomized, double-blind, controlled trial with 110 children was conducted. The patients were randomly assigned to the FMT with RCE group or the placebo with RCE group. All participants received a daily RCE, followed by a 4-week FMT treatment (twice a week) and a 12-week follow-up period. Spontaneous bowel movements ≥ 3 per week were the main outcomes, and the risk ratio with 95% confidence interval (CI) was calculated. Changes in intestinal bacterial profile were analyzed by BOX-PCR-based DNA fingerprinting and sequencing. The adverse effects were assessed based on symptoms.
Results: At the end of the follow-up period, 22 patients (40.0%) in the FMT with RCE group and 10 patients (18.2%) in the placebo with RCE group had ≥ 3 spontaneous bowel movements per week (net difference = 21.8%, 95% CI: 13.2%-30.4%; risk ratio: 1.364, 95% CI: 1.063-1.749; P < 0.05). Both RCE and FMT enriched the intestinal bacterial diversity of patients with constipation. The adverse events were all mild self-limiting gastrointestinal symptoms.
Discussion: FMT enhances the efficacy of RCE, and the use of RCE-based FMT is a safe and effective method in the treatment of intractable constipation in children.
{"title":"Effects of Retrograde Colonic Enema-Based Fecal Microbiota Transplantation in the Treatment of Childhood Constipation: A Randomized, Double-Blind, Controlled Trial.","authors":"Xu Gu, Zhonghua Yang, Youwei Kou, Fan Yang, Yang Wang, Ying Chen, Enhui Wang, Xuzheng Jiang, Yuzuo Bai, Zhibo Zhang, Shucheng Zhang","doi":"10.14309/ajg.0000000000002958","DOIUrl":"10.14309/ajg.0000000000002958","url":null,"abstract":"<p><strong>Introduction: </strong>Management of intractable childhood constipation is still challenging. The efficacy of retrograde colonic enema (RCE) with fecal microbiota transplantation (FMT) in intractable childhood constipation has not been established, although both have demonstrated potential in gastrointestinal diseases. The aim of this study was to determine the safety and efficacy of RCE-based FMT in the treatment of intractable constipation in children.</p><p><strong>Methods: </strong>A randomized, double-blind, controlled trial with 110 children was conducted. The patients were randomly assigned to the FMT with RCE group or the placebo with RCE group. All participants received a daily RCE, followed by a 4-week FMT treatment (twice a week) and a 12-week follow-up period. Spontaneous bowel movements ≥ 3 per week were the main outcomes, and the risk ratio with 95% confidence interval (CI) was calculated. Changes in intestinal bacterial profile were analyzed by BOX-PCR-based DNA fingerprinting and sequencing. The adverse effects were assessed based on symptoms.</p><p><strong>Results: </strong>At the end of the follow-up period, 22 patients (40.0%) in the FMT with RCE group and 10 patients (18.2%) in the placebo with RCE group had ≥ 3 spontaneous bowel movements per week (net difference = 21.8%, 95% CI: 13.2%-30.4%; risk ratio: 1.364, 95% CI: 1.063-1.749; P < 0.05). Both RCE and FMT enriched the intestinal bacterial diversity of patients with constipation. The adverse events were all mild self-limiting gastrointestinal symptoms.</p><p><strong>Discussion: </strong>FMT enhances the efficacy of RCE, and the use of RCE-based FMT is a safe and effective method in the treatment of intractable constipation in children.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}