American Journal of Gastroenterology

OBJECTIVES: Sleep quality may impact symptom experience in Irritable Bowel Syndrome (IBS). Our aim was to investigate the relationship between sleep quality and gastrointestinal (GI) symptoms using actigraphy and the Experience Sampling Method (ESM). METHODS: IBS patients were recruited from a tertiary Neurogastroenterology clinic and the community. GI symptoms and mood were recorded on a smartphone application, ten times per day, over seven consecutive days. Subjective sleep quality was recorded every morning to reflect the night before...

INTRODUCTION: The prognostic value of the modified Rutgeerts score (mRS) in patients with Crohn's disease (CD) needs to be further elucidated. This study assessed the prognostic value of the mRS for long-term outcomes after primary ileocecal resection (ICR) in patients with CD. METHODS: CD patients after primary ICR with an available mRS at first postoperative ileocolonoscopy (index mRS) were retrospectively included. Primary outcome was surgical recurrence. Secondary outcomes were clinical recurrence and progression to severe endoscopic recurrence (≥i3)...

BACKGROUND: Successful biliary drainage and antibiotics are the mainstays of therapy in management of patients with acute cholangitis. However, the duration of antibiotic therapy after successful biliary drainage has not been prospectively evaluated. We conducted a single centre, randomized, non-inferiority trial to compare short and conventional duration of antibiotic therapy in patients with moderate or severe cholangitis. METHODS: Consecutive patients were screened for the inclusion criteria and randomized into either conventional duration(CD group; 8 days) or short duration (SD group; 4 days) of antibiotic therapy...

BACKGROUND: Diet is a modifiable NAFLD risk factor, but few studies have been conducted among Hispanic patients, despite the fact that NAFLD prevalence and severity are highest among this ethnic subgroup. We aimed to identify prevalent dietary patterns among Hispanic patients using cluster analysis and to investigate associations with NAFLD severity. METHODS: This cross-sectional analysis included 421 Harris County NAFLD Cohort participants who self-reported Hispanic ethnicity and completed baseline food frequency questionnaires (FFQ)...

INTRODUCTION: Anorectal function testing is traditionally relegated to subspecialty centers. Yet it is an office-based procedure that appears capable of triaging care for the many patients with Rome IV functional constipation that fail empiric over-the-counter therapy in general gastroenterology, as an alternative to empirical prescription drugs. We aimed to evaluate cost-effectiveness of routine anorectal function testing in this specific population. METHODS: We performed a cost-effectiveness analysis from the patient perspective and a cost-minimization analysis from the insurer perspective to compare three strategies: (1) empiric prescription drugs followed by pelvic floor physical therapy (PFPT) for drug failure; (2) empiric PFPT followed by prescription drugs for PFPT failure; or, (3) care directed by up-front anorectal function testing...

BACKGROUND: Osteoporosis in candidates for liver transplantation (LT) is often under-diagnosed despite the important consequences in terms of morbidity. PATIENTS METHODS: We included 376 cirrhotic patients evaluated for LT with available CT scan. Prevalent vertebral fractures (VF) were identified on CT reconstructions, and bone density was assessed by measuring CT attenuation of the L1 vertebra (L1-CT). RESULTS: We identified 139 VF in 55 patients (14...

OBJECTIVES: The aim of this study was to compare the effectiveness of glucagon versus placebo in resolving esophageal foreign body impaction (EFBI), as well as the length of the procedure and adverse events. METHODS: This was a multicenter, randomized, double-blind trial involving consecutive patients diagnosed with alimentary EFBI. Participants were randomized to receive either 1 mg of intravenous glucagon or placebo. All patients underwent upper endoscopy, and adverse events were assessed through a protocolized telephonic interview seven days later...

BACKGROUND AND AIMS: When initial resection of Rectal Neuroendocrine tumours (r-NET) is not R0, persistence of local residue could lead to disease recurrence. This study aimed to evaluate the interest of systematic resection of non-R0 r-NET scars. METHODS: Retrospective analysis of all the consecutive endoscopic revisions and resections of the scar after non-R0 resections of r-NETs. RESULTS: 100 patients were included. Salvage endoscopic procedure using ESD or EFTR showed a R0 rate of near 100%...

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INTRODUCTION: This study focused on defining the global prevalence of clinically relevant levels of psychological distress and somatic symptoms and the prevalence of coexistence between these symptoms and Disorders of Gut-Brain Interaction (DGBI). We also analyzed how clinically relevant psychological distress and somatic symptoms and coexistent DGBI are associated with health-related outcomes. METHODS: We included a representative sample of 54,127 adult participants (49,1% women; mean age of 44...

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OBJECTIVES: Data suggest atherosclerotic-related inflammation may play a role in the pathogenesis of inflammatory bowel disease (IBD), but large-scale studies are missing. METHODS: In this nationwide case-control study, we used the Swedish Patient Register and the ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden) cohort to identify adult cases of incident IBD between 2002-2021, with each case matched to up to 10 general population controls...

Anal cancer is a rare but deadly disease that disproportionately affects patients with Inflammatory Bowel Disease (IBD). Rates of adenocarcinoma and HPV related squamous cell carcinoma have been consistently demonstrated to be higher in patients with ulcerative colitis (UC) and Crohn's disease (CD). Despite this increased risk, uniform screening, diagnosis, and treatment algorithms are lacking. This review describes the most recent literature surrounding anal cancer in the IBD population as well as the unique challenges inherent in diagnosing and treating this population...

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BACKGROUND AND AIMS: The American Gastroenterological Association (AGA) has compiled risk factors that may be predictive of disease complications in Crohn's disease (CD) and ulcerative colitis (UC). The aim of this study was to evaluate the performance of the AGA risk factors for risk stratification in UC and CD. METHODS: We included participants of two cohorts: OSCCAR and the Mayo Clinic cohort. Baseline clinical risk factors were extracted according to the AGA pathway...

BACKGROUND: The incidence of post ERCP infections is reported to be up to 18% in patients with biliary obstruction. Antibiotic prophylaxis may reduce the risk of infectious complications after ERCP; however, the clinical value of prophylactic antibiotics in ERCP remains controversial. METHODS: We conducted a double-blind, placebo-controlled, randomized trial to investigate whether the use of prophylactic antibiotics would reduce infectious complications after ERCP in patients with biliary obstruction...