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REVIEW
Takaomi Kessoku, Noboru Misawa, Hidenori Ohkubo, Atsushi Nakajima
BACKGROUND: The prevalence of constipation in Japan is estimated to be 2-5%. Constipation is a disease found in older adults. In particular, Japan is an aging society, with 65% of men and 80.5% of women aged 65 years or older accounting for the majority of its population. Chronic constipation may be associated with survival, cardiovascular events, decreased quality of life, and death. This study summarizes the recent findings regarding constipation treatment practice in Japan. SUMMARY: Until recently, the diagnosis of constipation was mainly based on medical interviews; however, with the recent development of handheld ultrasound devices, both physicians and nurses can easily and objectively diagnose fecal retention...
September 11, 2023: Digestion
#2
REVIEW
Masatomo Ishioh, Tsukasa Nozu, Toshikatsu Okumura
BACKGROUND: Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by chronic abdominal symptoms, but its pathogenesis is not fully understood. SUMMARY: We have recently shown in rats that neuropeptides such as orexin, ghrelin, and oxytocin act in the brain to improve the intestinal barrier dysfunction, which is a major pathophysiology of IBS. We have additionally shown that the neuropeptides injected intracisternally induced a visceral antinociceptive action against colonic distension...
September 6, 2023: Digestion
#3
JOURNAL ARTICLE
Yudai Takehara, Ken Yamashita, Shin Morimoto, Fumiaki Tanino, Noriko Yamamoto, Yuki Kamigaichi, Hidenori Tanaka, Hidehiko Takigawa, Ryo Yuge, Yuji Urabe, Shiro Oka
INTRODUCTION: The virtual scale endoscope (VSE) is a newly introduced endoscope that helps endoscopists in measuring colorectal polyp size (CPS) during colonoscopy by displaying a virtual scale. This study aimed to determine the usefulness of the VSE for CPS measurement and the educational benefit of using VSE images to improve CPS estimation accuracy. METHODS: This study included 42 colorectal polyps in 26 patients treated at Hiroshima University Hospital. In study 1, CPS measured using a VSE before endoscopic mucosal resection was compared with CPS measured on resected specimens, and the agreement between the two measurement methods was evaluated via Bland-Altman analysis...
September 5, 2023: Digestion
#4
JOURNAL ARTICLE
Atsushi Sawada, Kingo Hirasawa, Chiko Sato, Sho Sato, Tsutomu Sato, Kazuya Sugimori, Chikara Kunisaki, Shin Maeda
INTRODUCTION: Endoscopic full-thickness resection (EFTR) without laparoscopic assistance (pure EFTR) is an emerging, less invasive treatment for gastrointestinal stromal tumors (GISTs). However, the technique has seldom been performed outside China because of concerns regarding pneumoperitoneum, maintenance of endoscopic view, and endoscopic suturing. This study aimed to evaluate the efficacy and safety of endoscopic resection with one-port placement (EROPP) for gastric GISTs. METHODS: This retrospective study included 17 patients with gastric GISTs originating from the muscularis propria who underwent EROPP between 2019 and 2022...
August 30, 2023: Digestion
#5
REVIEW
Yoshimasa Hoshikawa, Katsuhiko Iwakiri
BACKGROUND: Esophageal motility disorders (EMDs) are caused by the impaired relaxation of the upper/lower esophageal sphincter and/or defective esophageal peristaltic contractions, resulting in dysphagia and noncardiac chest pain. High-resolution manometry (HRM) is essential for the diagnosis of primary EMD; however, the recognition of EMD and HRM by general practitioners in Japan is limited. This review summarizes the diagnosis of and treatment strategies for EMD. SUMMARY: HRM is a specific test for the diagnosis of EMD, whereas endoscopy and barium swallow as screening tests provide characteristic findings (i...
August 25, 2023: Digestion
#6
JOURNAL ARTICLE
Satoshi Sugino, Ken Inoue, Kan Zen, Masaki Yashige, Reo Kobayashi, Kazuaki Takamatsu, Nobuyasu Ito, Naoto Iwai, Ryohei Hirose, Toshifumi Doi, Osamu Dohi, Naohisa Yoshida, Kazuhiko Uchiyama, Tomohisa Takagi, Takeshi Ishikawa, Hideyuki Konishi, Satoaki Matoba, Yoshito Itoh
INTRODUCTION: Aortic stenosis (AS) is sometimes associated with gastrointestinal bleeding, and this phenomenon is known as Heyde's syndrome. Such bleeding is most often considered to originate from gastrointestinal angiodysplasias, but the frequency and endoscopic features of such bleeding remain unclear. This study aimed to determine the frequency and endoscopic features of gastrointestinal angiodysplasia in patients with severe AS. PATIENTS AND METHODS: In this multicenter, retrospective study, we evaluated consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with severe AS from May 2016 to December 2019...
August 24, 2023: Digestion
#7
REVIEW
Tadayuki Oshima
BACKGROUND: Functional dyspepsia (FD) is a common disorder characterized by chronic or recurrent upper abdominal pain or discomfort without any structural abnormalities in the gastrointestinal tract. FD is categorized into two subgroups based on symptoms: postprandial distress syndrome (PDS) and epigastric pain syndrome. SUMMARY: The pathophysiology of FD involves several mechanisms. Delayed gastric emptying is observed in approximately 30% of FD patients but does not correlate with symptom patterns or severity...
August 18, 2023: Digestion
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JOURNAL ARTICLE
Sayaka Nagao, Yu Takahashi, Tamami Denda, Yukihisa Tanaka, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Yoshiki Sakaguchi, Seiichi Yakabi, Yosuke Tsuji, Keiko Niimi, Naomi Kakushima, Nobutake Yamamichi, Yasunori Ota, Kazuhiko Koike, Mitsuhiro Fujishiro
INTRODUCTION: Submucosal invasion is a core hallmark of early gastric cancer (EGC) with poor prognosis. However, the molecular mechanism of the progression from intramucosal gastric cancer (IMGC) to early submucosal-invasive gastric cancer (SMGC) is not fully understood. The objective of this study was to identify genes and pathways involved in the submucosal invasion in EGC using comprehensive gene expression analysis. METHODS: Gene expression profiling was performed for eight cases of IMGC and eight cases of early SMGC with submucosal invasion ≥500 μm...
August 18, 2023: Digestion
#9
REVIEW
Kazuhiro Ota, Toshihisa Takeuchi, Kazuhide Higuchi, Shun Sasaki, Yosuke Mori, Hironori Tanaka, Akitoshi Hakoda, Noriaki Sugawara, Taro Iwatsubo, Hiroki Nishikawa
BACKGROUND: The 3rd edition of the evidence-based clinical practice guidelines for gastroesophageal reflux disease (GERD) 2021 from the Japanese Society of Gastroenterology states that the treatment strategy for potassium-competitive acid blocker (PCAB)-refractory GERD remains unclear. Furthermore, even if GERD improves with the administration of an acid secretion inhibitor, it is feared that GERD may flare up after discontinuation of the drug, resulting in some cases in which patients are forced to take vonoprazan semipermanently (the so-called PCAB-dependent cases)...
August 17, 2023: Digestion
#10
JOURNAL ARTICLE
Minoru Fujita, Tomonori Aoki, Noriaki Manabe, Yoichiro Ito, Katsumasa Kobayashi, Atsushi Yamauchi, Atsuo Yamada, Jun Omori, Takashi Ikeya, Taiki Aoyama, Naoyuki Tominaga, Yoshinori Sato, Takaaki Kishino, Naoki Ishii, Tsunaki Sawada, Masaki Murata, Akinari Takao, Kazuhiro Mizukami, Ken Kinjo, Shunji Fujimori, Takahiro Uotani, Hiroki Sato, Sho Suzuki, Toshiaki Narasaka, Junnosuke Hayasaka, Tomohiro Funabiki, Yuzuru Kinjo, Akira Mizuki, Shu Kiyotoki, Tatsuya Mikami, Ryosuke Gushima, Hiroyuki Fujii, Yuta Fuyuno, Naohiko Gunji, Yosuke Toya, Kazuyuki Narimatsu, Koji Nagaike, Tetsu Kinjo, Yorinobu Sumida, Sadahiro Funakoshi, Kiyonori Kobayashi, Tamotsu Matsuhashi, Yuga Komaki, Kuniko Miki, Kazuhiro Watanabe, Maki Ayaki, Takahisa Murao, Mitsuhiko Suehiro, Akiko Shiotani, Jiro Hata, Ken Haruma, Mitsuru Kaise, Naoyoshi Nagata
INTRODUCTION: Length of stay (LOS) in hospital affects cost, patient quality of life, and hospital management; however, existing gastrointestinal bleeding models applicable at hospital admission have not focused on LOS. We aimed to construct a predictive model for LOS in acute lower gastrointestinal bleeding (ALGIB). METHODS: We retrospectively analyzed the records of 8,547 patients emergently hospitalized for ALGIB at 49 hospitals (the CODE BLUE-J Study). A predictive model for prolonged hospital stay was developed using the baseline characteristics of 7,107 patients and externally validated in 1,440 patients...
August 3, 2023: Digestion
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JOURNAL ARTICLE
Hidenori Tanaka, Shiro Oka, Akiko Shiotani, Mitsushige Sugimoto, Hidekazu Suzuki, Yuji Naito, Osamu Handa, Tadakazu Hisamatsu, Shin Fukudo, Mitsuhiro Fujishiro, Satoshi Motoya, Naohisa Yahagi, Satoru Yamaguchi, Francis K L Chan, Sun-Young Lee, Baiwen Li, Tiing Leong Ang, Murdani Abdullah, Maria Carla Tablante, Varayu Prachayakul, Shinji Tanaka
INTRODUCTION: Diagnostic and therapeutic methods for colorectal cancer (CRC) have advanced; however, they may be inaccessible worldwide, and their widespread use is challenging. This questionnaire survey investigates the current status of diagnosis and treatment of early-stage CRC in Asian countries. METHODS: Responses to the questionnaire were obtained from 213 doctors at different institutions in 8 countries and regions. The questionnaire consisted of 39 questions on the following four topics: noninvasive diagnosis other than endoscopy (6 questions), diagnosis by magnification and image-enhanced endoscopy (IEE) including artificial intelligence (AI) (10 questions), endoscopic submucosal dissection (ESD), proper use among other therapeutic methods (11 questions), and pathologic diagnosis and surveillance (12 questions)...
July 27, 2023: Digestion
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JOURNAL ARTICLE
Kozo Tsuruta, Hidetoshi Takedatsu, Shinichiro Yoshioka, Masahiro Yoshikai, Kensuke Tomiyasu, Masaru Morita, Kotaro Kuwaki, Keiichi Mitsuyama, Takumi Kawaguchi
INTRODUCTION: Small bowel tumors (SBTs) are difficult to diagnose because of limited opportunities and technical difficulties in evaluating the small bowel. Asymptomatic conditions or nonspecific symptoms make SBT diagnosis more challenging. In Asia, SBTs are reported to be more frequently malignant lymphoma (ML), adenocarcinoma, and gastrointestinal stromal tumor (GIST). In this study, we examined 66 patients diagnosed with SBTs and determined their clinical characteristics. METHODS: This retrospective study was conducted from January 2013 to July 2020 at Kurume University Hospital...
July 12, 2023: Digestion
#13
JOURNAL ARTICLE
Yoshimasa Hoshikawa, Eri Momma, Noriyuki Kawami, Katsuhiko Iwakiri
INTRODUCTION: Esophageal hypersensitivity is associated with gastroesophageal reflux disease (GERD). Since sleep disturbance causes esophageal hypersensitivity, hypnotics may ameliorate GERD. However, zolpidem prolongs esophageal acid clearance. Lemborexant is a new hypnotic with higher efficacy and fewer adverse events than zolpidem. Therefore, the present study investigated the effects of lemborexant on GERD. METHODS: Patients with heartburn and/or regurgitation and insomnia who did not take acid suppressants or hypnotics in the last month were recruited...
July 10, 2023: Digestion
#14
REVIEW
Naoya Tada, Hideki Kobara, Noriko Nishiyama, Shintaro Fujihara, Tsutomu Masaki, Noriya Uedo
BACKGROUND: With the development of endoscopic technology and devices, endoscopic full-thickness resection (EFTR) has been challengingly introduced for gastric subepithelial tumors (SETs). The resection and closure strategies are under investigation. This systematic review was performed to assess the current status and limitations of EFTR for gastric SETs. SUMMARY: MEDLINE was searched using the keywords "endoscopic full-thickness resection" or "gastric endoscopic full-thickness closure" AND "gastric" or "stomach" from January 2001 to July 2022...
July 7, 2023: Digestion
#15
JOURNAL ARTICLE
Junya Arai, Ryota Niikura, Atsuo Yamada, Tomonori Aoki, Nobumi Suzuki, Yosuke Tsuji, Yoku Hayakawa, Takashi Kawai, Mitsuhiro Fujishiro
INTRODUCTION: Colonic diverticular bleeding is the major cause of lower gastrointestinal bleeding. Hypertension is a major risk factor for diverticular rebleeding. Direct evidence of an association between actual 24-h blood pressure (BP) and rebleeding is lacking. Therefore, we analyzed the association between 24-h BP and diverticular rebleeding. METHODS: We performed a prospective observational cohort trial involving hospitalized patients with colonic diverticular bleeding...
July 5, 2023: Digestion
#16
JOURNAL ARTICLE
Jörg D Ulrich, Paul Rechberger, Jeannine Bachmann, Alexander Herner, Guido V Figura, Tobias Lahmer, Veit Phillip, Ulrich Mayr, Bernhard Haller, Moritz Jesinghaus, Roland M Schmid, Mohamed Abdelhafez, Christoph Schlag
INTRODUCTION: Cold snare polypectomy (CSP) is a safe and effective procedure for small colorectal polyps ≤9 mm. There are only limited data regarding CSP of larger neoplastic lesions. This study evaluated the efficacy and safety of CSP for polyps between 10 and 15 mm in size. METHODS: In this prospective single-arm observational pilot study, patients with a least one polyp 10-15 mm were included. These polyps were preferably removed by CSP using a dedicated hybrid snare...
June 16, 2023: Digestion
#17
JOURNAL ARTICLE
Kazunori Tsuda, Shinwa Tanaka, Tetsuya Yoshizaki, Yoshinobu Yamamoto, Takayuki Ose, Tsukasa Ishida, Yasuaki Kitamura, Daisuke Obata, Mineo Iwatate, Atsushi Ikeda, Ryusuke Ariyoshi, Fumiaki Kawara, Hiroshi Takihara, Hirofumi Abe, Toshitatsu Takao, Yoshinori Morita, Yasushi Sano, Eiji Umegaki, Hogara Nishisaki, Takashi Toyonaga, Yuzo Kodama
INTRODUCTION: Favorable long-term outcomes of endoscopic submucosal dissection (ESD) for early remnant gastric cancer (ERGC) have been reported in single-center studies from advanced institutions. However, no studies have examined the long-term outcomes using a multicenter database. This study aimed to investigate the long-term outcomes of the aforementioned approach using a large multicenter database. METHODS: This retrospective multicenter cohort study included 242 cases with 256 lesions that underwent ESD for ERGC between April 2009 and March 2019 across 12 centers...
June 1, 2023: Digestion
#18
JOURNAL ARTICLE
Zhaowei Zou, Jianyang Yu, Renli Huang, Jinlong Yu
INTRODUCTION: Gap junctions can transmit signals between cells, including miRNAs, leading to the amplification of adjacent cell damage. No previous study has addressed gap junctions and miRNAs in sepsis because the internal mechanism of sepsis-induced intestinal injury is complex. Therefore, we studied the relationship between connexin43 (Cx43) and miR-181b and provided a research direction for further study of sepsis. METHODS: A mouse caecal ligation and puncture method was used to construct a mouse sepsis model...
May 25, 2023: Digestion
#19
JOURNAL ARTICLE
Yuka Kawasaki, Kazuki Kakimoto, Yasuyoshi Tanaka, Hikaru Shimizu, Koji Nishida, Keijiro Numa, Naohiko Kinoshita, Yoshihiro Tatsumi, Kei Nakazawa, Ryoji Koshiba, Yuki Hirata, Kazuhiro Ota, Naokuni Sakiyama, Tetsuji Terazawa, Toshihisa Takeuchi, Takako Miyazaki, Masahiro Goto, Haruka Yokota, Yutaka Makizaki, Yoshiki Tanaka, Shunji Nakajima, Hiroshi Ohno, Kazuhide Higuchi, Shiro Nakamura, Hiroki Nishikawa
BACKGROUND AND AIM: Fluoropyrimidines (FPs) are key drugs in many chemotherapy regimens; however, recipients are often prone to diarrhea due to gastrointestinal toxicity. Disruption of the intestinal epithelial barrier function by FPs leads to dysbiosis, which may exacerbate intestinal epithelial cell damage as a secondary effect and trigger diarrhea. However, despite studies on chemotherapy-induced changes in the intestinal microbiome of humans, the relationship between dysbiosis and diarrhea is unclear...
May 11, 2023: Digestion
#20
JOURNAL ARTICLE
Shingo Ishihara, Shiko Kuribayashi, Keigo Sato, Tomohiro Kudo, Setsuo Yamazaki, Teruki Inoue, Yoichi Hazama, Kensuke Furuya, Tetsuo Nakayama, Yoko Hachisu, Kyoko Marubashi, Toshio Uraoka
INTRODUCTION: Non-esophageal eosinophilic gastrointestinal disorders (non-EoE EGIDs) are rare, but their prevalence has recently increased. Although it has been reported that one-half of patients with non-EoE EGIDs have intractable clinical courses, their clinical features are not fully understood. METHODS: This is a multicenter retrospective study in which 10 institutions in Japan participated. Clinical databases from January 1998 to December 2020 were reviewed to identify patients with non-EoE EGIDs...
April 21, 2023: Digestion
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