Journal of Gastroenterology and Hepatology

BACKGROUND AND AIMS: Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is considered a biliary manifestation of IgG4-related diseases. However, there has been a controversy on the clinical outcomes according to the location of the involved bile duct. We therefore compared the clinical outcomes and long-term prognosis of IgG4-SC with proximal bile duct involvement (proximal IgG4-SC) and IgG4-SC with distal bile duct involvement (distal IgG4-SC). METHODS: We reviewed the data of patients with IgG4-SC that were prospectively collected at 10 tertiary centers between March 2002 and October 2020...

BACKGROUND AND AIM: The clinical severity and course of acute lower gastrointestinal bleeding (ALGIB) are believed to differ between inpatient-onset and outpatient-onset cases, but no reports have investigated these issues in detail. We aimed to evaluate the clinical differences between inpatient- and outpatient-onset ALGIB. METHODS: Medical records of patients who had undergone emergency colonoscopy for ALGIB were retrospectively reviewed. The severity was evaluated using the NOBLADS score...

No abstract text is available yet for this article.

BACKGROUND: The optimal infliximab dose intensification strategy to address secondary loss of response (LOR) remains unclear. This study aimed to compare clinical and pharmacokinetic outcomes following (1)upfront infliximab re-induction with (2)ongoing 6-weekly dose interval shortening (DIS), after the same number of doses. METHODS: A prospective parallel cohort study of inflammatory bowel disease patients who required infliximab dose intensification for secondary LOR using (1)re-induction (i...

No abstract text is available yet for this article.

BACKGROUNDS: Antiviral therapy (AVT) is the mainstay of hepatitis B virus (HBV) management. We investigated whether AVT improves the outcomes of HBV-related decompensated cirrhosis and undetectable HBV DNA. METHODS: Between 2000 and 2017, treatment-naïve patients with HBV-related decompensated cirrhosis and undetectable HBV DNA were recruited from two tertiary hospitals. The endpoints included death and hepatocellular carcinoma (HCC). RESULTS: A total of 429 patients were analyzed (50 and 379 patients in the AVT and Non-AVT groups, respectively)...

We read with interest the randomized controlled trial by Ahuja et al, which pointed out that nutrition therapy prevents the recurrence of overt hepatic encephalopathy (OHE) in patients with cirrhosis and also leads to improvement in anthropometry, ammonia levels, inflammatory markers, and myostatin levels showcasing the pathophysiological basis behind the nutrition therapy i.e. by lowering ammonia, improving sarcopenia and decreasing inflammation. Moreover, this study also showed the benefit of nutrition therapy in the prevention of complications of cirrhosis as well as mortality benefit...

INTRODUCTION: Clostridioides difficile infection (CDI) is the leading cause of hospital acquired-infectious diarrhea in the United States. In this study, we assess the prevalence and impact of CDI in COVID-19 hospitalizations in the United States. METHODS: We used the 2020 National Inpatient Sample database to identify adult patients with COVID-19. The patients were stratified into two groups based on the presence of CDI. The impact of CDI on outcomes such as in-hospital mortality, ICU admission, shock, acute kidney injury (AKI), and sepsis rates...

Liver diseases contribute notably to the global concern of mortality and disease. Emerging evidence has demonstrated that intestinal microbiota can regulate intestinal barrier function and produce bioactive metabolites. Failure of any aspect of this barrier can result in the translocation of microbes into the blood and sustained inflammatory response that promotes liver injury, fibrosis, and cirrhosis. Here, we review the mechanisms by that intestinal microbiota regulate the intestinal barrier. The multiple underlying mechanisms of intestinal microbiota in liver disease are elaborated in detail, emphasizing them as the bridge linking the liver with gut microbiota...

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BACKGROUND AND AIM: Severe acute pancreatitis (SAP) in patients progresses rapidly, and can cause multiple organ failures associated with high mortality. We aimed to train a machine learning (ML) model and establish a nomogram that could identify SAP, early in the course of acute pancreatitis (AP). METHODS: In this retrospective study, 631 patients with AP were enrolled in the training cohort. For predicting SAP early, five supervised ML models were employed, such as random forest (RF), K-nearest neighbors (KNN), and naive Bayes (NB), which were evaluated by accuracy (ACC) and the areas under the receiver operating characteristic curve (AUC)...

BACKGROUND AND AIMS: Lack of visual recognition of colorectal polyps may lead to interval cancers. The mechanisms contributing to perceptual variation, particularly for subtle and advanced colorectal neoplasia, has scarcely been investigated. We aimed to evaluate visual recognition errors and provide novel mechanistic insights. METHODS: Eleven participants (7 trainees, 4 medical students) evaluated images from the UCL polyp perception dataset, containing 25 polyps, using eye tracking equipment...

BACKGROUND AND AIM: Whether vitamin D (VD3) supplementation is associated with improved liver fibrosis is controversial. METHODS: Liver fibrosis models were treated with VD3, active VD (1,25-OH2 Vitamin D3), or collaboration with GSK126 (Ezh2 inhibitor) respectively. Hepatic stellate cells (HSCs) were co-cultured with hepatocytes and then, stimulated with TGF-β. Autophagy of hepatocytes was determined after the intervention of 1,25-OH2 Vitamin D3 and GSK126...

BACKGROUND: Emergence of drug resistance, especially to second-line drugs, hampers tuberculosis elimination efforts. The present study evaluated MTBDRplus and MTBDRsl assays for detecting first-line and second-line drug resistance, respectively in gastrointestinal tuberculosis (GITB). METHODS: 30 ileo-caecal biopsy specimens, processed in the Department of Microbiology between 2012-2022, that showed growth of M. tuberculosis on culture were included in the study...

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BACKGROUND AND AIM: Double-balloon endoscopic retrograde cholangiography (DBERC) is a valuable procedure for patients with altered gastrointestinal anatomy. Nonetheless, it is time-consuming and burdensome for both patients and endoscopists, partly because route selection in the reconstructed bowel with complicating loop is challenging. Carbon dioxide insufflation enterography is reportedly useful for route selection in the blind loop. This prospective randomized clinical trial investigated the usefulness of carbon dioxide insufflation enterography for route selection by comparing it with conventional observation...

BACKGROUND: Patients with ulcerative proctitis (UP) have favourable long-term outcomes but are typically excluded from ulcerative colitis clinical trials. Refractory proctitis presents a management conundrum for gastroenterologists and there remains a lack of clarity as to the best therapeutic strategy. AIMS: To undertake a systematic review of studies assessing the clinical efficacy and safety of therapies for refractory proctitis METHODS: PubMed, Embase, Cochrane Library and Medline databases were searched without restriction through to 27th October 2022...

No abstract text is available yet for this article.

INTRODUCTION: a perianal fistula is an abnormal tract that connects anal canal to skin. Current medical and surgical interventions have a high failure rate particularly in complex and refractory cases. MSC-derived exosomes have demonstrated immunomodulatory effects without the conventional complications; hence in this study we evaluated the safety of their application for complex perianal fistula. METHODS: Placenta-derived MSCs were cultured and exosomes were isolated using ultracentrifugation...

BACKGROUND AND AIM: Appendectomy is associated with various diseases, but whether it increases the risk of colorectal cancer (CRC) remains uncertain. We conducted a systematic review and meta-analysis aimed at investigating the suggested correlation between appendectomy and CRC. METHODS: Systematic retrieval was performed using the PubMed, Embase, Cochrane library, Web of Science, ClinicalTrials.gov databases up to May 04, 2022 for studies reported the influence of appendectomy on CRC, colon cancer (CC) or rectal cancer (RC)...