Eur J Gastroenterol Hepatol [JOURNAL]
Sun
200 papers
Disease burden, diagnosis pathways and treatment patterns in patients with eosinophilic esophagitis: a real-world study.
Ma C, von Arm U, Zerbib F … +8 more , Pela T, Radwan A, Jacob-Nara JA, Parikh RC, Borsos K, Bello F, Thomas RB, Tilton ST
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40991676 · Full text
BACKGROUND: Despite a rising prevalence of eosinophilic esophagitis (EoE), real-world data on current management challenges remain limited. OBJECTIVE: To evaluate demographic and clinical characteristics, treatment patte...
BACKGROUND: Despite a rising prevalence of eosinophilic esophagitis (EoE), real-world data on current management challenges remain limited. OBJECTIVE: To evaluate demographic and clinical characteristics, treatment patterns, and health outcomes in patients with EoE. METHODS: Physicians from Canada, France, Germany, Spain, and the UK retrospectively reviewed records of patients (aged ≥12 years) who were newly diagnosed with EoE between January 2009 and December 2019. EoE diagnosis was confirmed by esophageal biopsy demonstrating a peak eosinophil count ≥15 eosinophils/high-power field (eos/hpf) within 90 days before or after the documented diagnosis (index). Included patients had ≥1 follow-up endoscopy with biopsy and known eosinophil count within 24 months. Data on demographics, clinical characteristics, treatment, and health outcomes were collected 12-month preindex to the last record entry/death. RESULTS: Overall, 415 patients [mean age (SD): 31.8 (14.6) years] were included. The mean (SD) diagnostic delay from symptom onset was 3.4 (4.8) years [median (range): 1.7 (0.7-4.0)]. The average eosinophil count was 41.4 eos/hpf; 80.2% of patients had endoscopic abnormalities of the esophagus at diagnosis. Post-EoE diagnosis, 77.1% of patients received proton-pump inhibitors, 68.2% swallowed topical corticosteroids, 48.4% made dietary modifications, and 18.8% had esophageal dilation. At diagnosis, 74.5% of patients had dysphagia and 46.0% had heartburn. After diagnosis, 63.5%, 62.2%, and 57.6% did not achieve histologic remission (<15 eos/hpf) at the first, second, and third endoscopy, respectively. CONCLUSION: Patients with EoE experience a substantial disease burden, with a significant delay in diagnosis. Achieving optimal disease control remains an unmet need with conventional nonbiologic therapies.
Dissecting causal relationships between inflammatory factors, plasma metabolites, and nonalcoholic fatty liver disease: a mediating Mendelian randomization study.
Zhong D, Deng S, Dong Y … +6 more , Qian Y, Zhu S, Hu M, Liu M, Tan K, Tang H
Eur J Gastroenterol Hepatol · 2026 Apr · PMID 40986606 · Full text
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), which affects approximately 25% of the global adult population, is a metabolic-associated hepatic disorder characterized by the interplay between inflammation and met...
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), which affects approximately 25% of the global adult population, is a metabolic-associated hepatic disorder characterized by the interplay between inflammation and metabolism. Although evidence linking inflammatory factors and plasma metabolites to NAFLD progression, their causal relationships and mediating mechanisms remain unclear. METHODS: This study employed a bidirectional Mendelian randomization (MR) approach combined with mediation analysis to investigate the causal relationships between inflammatory factors, plasma metabolites, and NAFLD. Summary data for 91 inflammatory factors and 1400 plasma metabolites were extracted from the genome-wide association studies databases and analyzed using MR. Mediation analysis was performed to examine whether the nine selected metabolites mediated the relationship between the eight inflammatory factors and NAFLD. All the analyses included tests for heterogeneity and pleiotropy. RESULTS: This study identified 11 inflammatory factors and 110 plasma metabolites that were significantly associated with NAFLD. Mediation analysis revealed that specific metabolites, including pregnenetriol disulfate, alanine: asparagine ratio, and X-21471, mediate the relationship between inflammatory factors and NAFLD. Notably, X-21471 was identified as a shared mediator of both tumor necrosis factor receptor superfamily member 9 (TNFRSF9) and CCL20. CONCLUSION: This integrative MR mediation analysis delineates an inflammation-metabolism-NAFLD axis, in which specific metabolites (X-21471, pregnenetriol disulfate) transmit pro-inflammatory signals (TNFRSF9/CCL20) involved in NAFLD pathogenesis. These findings suggest that combined targeting of TNFRSF9 and X-21471 may represent a precise preventive strategy for high-risk populations with metabolic comorbidities.
Histological disease progression in patients with metabolic dysfunction-associated steatotic liver disease using paired liver biopsy.
Turan Gokce D, Ekelik M, Gumussoy M … +13 more , Kiremitci S, Bodakci E, Yilmaz V, Guvenir T, Duman S, Ellik Z, Ozercan M, Er E, Karakaya F, Sümer H, Elhan AH, Savas B, Idilman R
Eur J Gastroenterol Hepatol · 2026 Jan · PMID 40986605 · Publisher ↗
BACKGROUND AND AIMS: The aims of the present study were to assess the histological evolution of patients with metabolic dysfunction-associated steatotic liver disease (MASLD) using paired liver biopsies, identify the fac...
BACKGROUND AND AIMS: The aims of the present study were to assess the histological evolution of patients with metabolic dysfunction-associated steatotic liver disease (MASLD) using paired liver biopsies, identify the factors associated with fibrosis and clinical disease progression, and determine the relationship between histological progression and clinical outcomes. METHODS: This was a single-center study. A total of 114 patients with MASLD who had at least two liver biopsies were included in the analysis. RESULTS: From baseline to follow-up biopsy, 44% of patients showed histological progression. Fibrosis progressed in 28 patients, regressed in 21, and showed no change in 65. The proportion of metabolic dysfunction-associated steatohepatitis (MASH) increased from 83% to 90%, with 95% of MASH patients remaining MASH and 70% of MASL patients fulfilling MASH criteria at follow-up biopsy. Among MASL patients with progression, 87% had lobular inflammation at baseline. During the median follow-up of 10 years, half of the patients with MASLD showed clinical progression, with 73% having MASH at baseline. No new metabolic abnormality developed in patients with MASL who maintained MASL status at follow-up. Multivariable logistic regression analysis showed that baseline hypertension (Odds Ratio [OR]: 2.611, p = 0.024) and high serum ALT levels (OR: 2.815, p = 0.049) were predictors of clinical progression in patients with MASLD. CONCLUSIONS: Patients with MASLD, MASL, and MASH, exhibit disease progression. Hypertension and baseline abnormal liver injury test results are predictors of clinical disease progression in patients with MASLD.
Development of a retinal vascular nomogram for predicting hepatitis B virus-related cirrhosis: insights into extrahepatic microcirculatory dysfunctions.
Huang X, Wang H, Hu J … +2 more , Cai M, Zhong Y
Eur J Gastroenterol Hepatol · 2026 Apr · PMID 40986573 · Publisher ↗
BACKGROUND: The progression of hepatitis B virus-related cirrhosis (HBC) is characterized by notable intrahepatic and extrahepatic microvascular alterations and dysfunctions. The retinal vasculature offers a noninvasive...
BACKGROUND: The progression of hepatitis B virus-related cirrhosis (HBC) is characterized by notable intrahepatic and extrahepatic microvascular alterations and dysfunctions. The retinal vasculature offers a noninvasive window to assess systemic microcirculation. This cross-sectional study aimed to evaluate retinal microcirculatory alterations in HBC and develop a retinal vascular nomogram for diagnosing HBC. METHODS: We included 328 participants from two medical centers between March 2019 and October 2022. Multivariate logistic regression identified independent retinal predictors of HBC, and a nomogram was constructed. Associations between retinal parameters and clinical indicators of HBC were examined using univariate analyses. RESULTS: Retinal vascular caliber, retinal vascular branching angle, and retinal vascular fractal dimension were independent predictors of HBC. The nomogram achieved an area under the receiver operating characteristic curve of 0.778, with a sensitivity of 77.5% and specificity of 65.5%. The model demonstrated good calibration (Hosmer-Lemeshow test, P = 0.376) and significant net benefit on decision curve analysis. Internal validation confirmed its reliability. Retinal vascular alterations correlated with indicators of portal hypertension and liver insufficiency. CONCLUSION: We developed a nomogram based on retinal vascular parameters to predict HBC, providing clinicians an intuitive, noninvasive diagnostic tool. The retinal microvascular alterations in HBC may reflect extrahepatic microcirculatory dysfunctions related to portal hypertension and liver insufficiency.
Hepatocellular carcinoma arising from ectopic liver tissue: a systematic review of the literature.
Akbulut S, Sahin TT
Eur J Gastroenterol Hepatol · 2026 Mar · PMID 40986569 · Publisher ↗
Ectopic liver tissue (ELT) is a rare congenital anomaly characterized by hepatic parenchyma located outside the native liver. In this systematic review, 55 cases of hepatocellular carcinoma (HCC) arising from ELT were id...
Ectopic liver tissue (ELT) is a rare congenital anomaly characterized by hepatic parenchyma located outside the native liver. In this systematic review, 55 cases of hepatocellular carcinoma (HCC) arising from ELT were identified through a literature search performed in PubMed, MEDLINE, Scopus, and Web of Science, in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251084866). The median age was 61 years (IQR: 52-68), and 65.5% were male. Hepatitis B and C were present in 26.5% cases. The most common tumor locations were the subphrenic ( n = 11), peritoneal ( n = 7), retroperitoneal ( n = 6), and pancreatic ( n = 6) regions. Solitary tumors were reported in 78.2% of cases, with a median tumor size of 71 mm (IQR: 36.5-100). AFP was elevated in 74.4% of patients, and AFP-L3 (100%) and PIVKA-II (72.7%) were elevated in most tested cases. Immunohistochemistry frequently showed positivity for HepPar-1 (88.6%), glypican-3 (81.3%), and arginase-1 (87.5%). Surgical resection was the primary treatment modality, and in addition, transarterial chemoembolization, tyrosine kinase inhibitors, and immune checkpoint inhibitors have been used as therapeutic options. The median follow-up was 17 months (IQR: 12-36), during which 85.4% of patients were alive. Distant metastasis occurred in 18.6% of cases, and local recurrence in 6.7%. In conclusion, ectopic HCC is a rare tumor entity with variable clinical presentations. Despite limited classical risk factors, surgical resection remains associated with a favorable prognosis. Histopathological confirmation is essential for diagnosis, and multimodal treatment strategies should be considered for advanced disease.
Mild liver function decline in patients treated with atezolizumab and bevacizumab for hepatocellular carcinoma: a real-world study.
Delhoume V, Girot P, Khaldi M … +3 more , Boilève J, Salimon M, Touchefeu Y
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40986563 · Publisher ↗
BACKGROUND: Atezolizumab plus bevacizumab is recommended as first-line systemic therapy for patients with advanced hepatocellular carcinoma (HCC). This study aimed to investigate the prognostic significance of early mild...
BACKGROUND: Atezolizumab plus bevacizumab is recommended as first-line systemic therapy for patients with advanced hepatocellular carcinoma (HCC). This study aimed to investigate the prognostic significance of early mild liver function deterioration in a real-world cohort. METHODS: This retrospective study included patients with HCC treated with atezolizumab plus bevacizumab as first-line between September 2020 and January 2024. We evaluated the evolution of liver function during the first 6 months of treatment, survival, and adverse events, and the impact of mild deterioration [change in albumin-bilirubin (ALBI) grade, without clinical ascites, encephalopathy, jaundice, or gastrointestinal bleeding] on overall survival (OS). RESULTS: Among 155 patients, 44 had a Child-Pugh score ⩾ B7, and 111 had ALBI grade ⩾ 2 at baseline. Median OS was 24.1 months. There was a significant deterioration in the ALBI score at cycle 2 ( P = 0.001), 3 ( P = 0.001), and 4 ( P = 0.015), with no deterioration in the subsequent treatment. In multivariate analyses, baseline ALBI grade 3 (vs. 1), Eastern Cooperative Oncology Group 1 (vs. 0), macrovascular invasion, but not mild deterioration of liver function, were identified as independent prognostic predictors for OS. CONCLUSION: Early mild liver function deterioration does not impact OS during first-line treatment with atezolizumab and bevacizumab.
Prevalence and risk factors of metabolic dysfunction-associated steatotic liver disease in patients with inflammatory bowel disease.
Tamimi TA, Abu-Farsakh N, AlRyalat SA … +9 more , Obeidat K, Ali SD, Hameed H, Aldabbagh S, Quzli A, AlSamhori JF, Abu-Sneineh AT, Khitan ZJ, Rayyan YM
Eur J Gastroenterol Hepatol · 2026 Jan · PMID 40929686 · Publisher ↗
AIM: The purpose of our study was to evaluate the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and its associated risk factors in patients with inflammatory bowel disease (IBD). METHODS:...
AIM: The purpose of our study was to evaluate the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and its associated risk factors in patients with inflammatory bowel disease (IBD). METHODS: This was a retrospective chart review of patients who underwent treatment for IBD at Jordan University Hospital between January 2013 and 2022. Case finding methods and clinical chart reviews were used to evaluate the clinical profile of patients with IBD. Demographic, anthropometric, and biochemical data; endoscopic severity scores; and imaging were obtained. RESULTS: A total of 367 patients with IBD were included: 194 with Crohn's disease and 173 with ulcerative colitis. MASLD was diagnosed through imaging in 152 (41.4%) and compared with 215 (58.6%) patients without MASLD. Univariate analysis revealed several factors associated with MASLD in patients with IBD: age, number of relapses, longer IBD duration (all P < 0.001), severity of Crohn's disease based on the simple endoscopic score for Crohn's disease ( P = 0.05), Crohn's disease penetrating behavior based on the Montreal classification ( P < 0.001), increased triglyceride level ( P = 0.002), and the presence of diabetes mellitus and hypertension ( P < 0.001). In the binary logistic regression analysis, increased number of relapses [ P < 0.001, oddsratio (OR) = 1.526], penetrating disease behavior ( P < 0.001, OR = 3.304), and presence of hypertension ( P = 0.027, OR = 6.728) were independent risk factors associated with an increased risk of MASLD, while shorter disease duration was associated with a decreased risk of MASLD ( P = 0.008, OR = 0.849). CONCLUSION: A substantial proportion of patients with IBD experienced concurrent MASLD. Increased IBD duration and number of relapses, penetrating Crohn's disease behavior, and presence of hypertension were independent risk factors associated with MASLD.
Comparative effectiveness and safety of second-line therapies and dosing regimens for advanced hepatocellular carcinoma: a network meta-analysis.
Lei X, He K, Guo Y … +2 more , Liu M, Liu C
Eur J Gastroenterol Hepatol · 2026 Mar · PMID 40929683 · Full text
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-associated death globally. Second-line therapies are crucial for improving survival and quality of life among individuals suffering from advanced HCC...
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-associated death globally. Second-line therapies are crucial for improving survival and quality of life among individuals suffering from advanced HCC who have not responded to first-line therapies. This study sought to evaluate the safety and efficacy of different second-line therapies for advanced HCC by network meta-analysis. A network meta-analysis was carried out on 26 randomized controlled trials comprising 10 368 people suffering from advanced HCC. The treatments evaluated included cabozantinib, pembrolizumab, brivanib, apatinib, and other targeted therapies. The principal results assessed included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). The evaluation also encompassed adverse events (AEs) as well as those classified as grade 3-4 AEs. Cabozantinib 60 mg once daily (QD) demonstrated the most significant improvement in OS [mean difference (MD) = 3.36, 95% confidence interval (CI) = 2.01, 4.70] and PFS (MD = 3.26, 95% CI = 2.59, 3.94), ranking highest among the therapies evaluated. Brivanib 800 mg once daily (OD) was most effective in terms of ORR [odds ratio (OR) = 7.13, 95% CI = 1.42, 35.88], while apatinib 750 mg QD ranked highest for DCR (OR = 3.92, 95% CI = 1.76, 8.71). Codrituzumab 1600 mg administered every 2 weeks demonstrated the most advantageous health profile, markedly decreasing AEs and instances of grade 3-4 AEs. Pembrolizumab 200 mg administered every 3 weeks indicated good effectiveness. Alongside a tolerable safety profile, indicating its potential as a reasonable second-line treatment option. Cabozantinib 60 mg QD and pembrolizumab 200 mg Q3W arise as the most suitable second-line therapies alternatives for advanced HCC, offering substantial improvements in survival and disease control with manageable adverse effects. These findings support the integration of both targeted and immune therapies in handling of advanced HCC.
Exploring the molecular mechanism of Crohn's disease and rheumatoid arthritis: a bioinformatics and functional analysis approach.
Qin Y, He C, Zhong N … +3 more , Guo L, Yang Z, Yu J
Eur J Gastroenterol Hepatol · 2026 Mar · PMID 40929681 · Publisher ↗
BACKGROUND: Crohn's disease (CD) and rheumatoid arthritis (RA) are autoimmune diseases. CD is known to be closely associated with RA. However, the mechanisms underlying these relationships remain unclear. This study aime...
BACKGROUND: Crohn's disease (CD) and rheumatoid arthritis (RA) are autoimmune diseases. CD is known to be closely associated with RA. However, the mechanisms underlying these relationships remain unclear. This study aimed to explore the common genetic features and potential molecular mechanisms of CD and RA. METHODS: Microarray data of CD and RA in the Gene Expression Omnibus database were downloaded. Weighted gene coexpression network analysis (WGCNA) was used to identify the coexpression modules related to CD and RA. The shared genes existing in CD and RA were subjected to gene ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis using R software. The results were validated by differentially expressed genes (DEGs) analysis to enrich for common differential genes and unique genes in CD and RA. Based on CD-RA common hub genes, we explored the feasibility of developing new gene-antibody coupled targeted drugs for the treatment of CD-RA. RESULTS: Enrichment analysis of gene modules identified through WGCNA revealed disease pathway models suggesting potential mechanisms of RA secondary to CD. Furthermore, we identified key shared pathogenic genes between CD and RA, such as S100P and IL2RB that may be important targets for the treatment of both diseases. CONCLUSION: The study is the first to reveal the key pathways underlying the shared pathogenesis of CD and RA, identify novel candidate genes that could serve as biomarkers or potential therapeutic targets. Finally, we propose new ideas for the development of gene-antibody coupled targeted drugs.
Feasibility and Preliminary Efficacy of combined home-based fecal calprotectin self-testing and therapeutic drug monitoring-guided intervention in Patients with moderate-to-severe inflammatory bowel disease.
Lu G, Sun J, Du H
Eur J Gastroenterol Hepatol · 2026 Mar · PMID 40929656 · Publisher ↗
BACKGROUND: Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, significantly impact patients' lives. Effective management often involves invasive and costly monitoring. OBJECTIVE: To eva...
BACKGROUND: Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, significantly impact patients' lives. Effective management often involves invasive and costly monitoring. OBJECTIVE: To evaluate the feasibility of integrating home-based fecal calprotectin testing with therapeutic drug monitoring (TDM) in managing moderate-to-severe IBD. METHODS: A prospective, single-arm pilot study involved patients performing weekly home-based fecal calprotectin tests and attending regular clinic visits for TDM. Data on adherence, clinical disease activity, fecal calprotectin levels, therapeutic adjustments, and healthcare utilization were collected and analyzed. RESULTS: High adherence to home-based fecal calprotectin testing (88%) and strong concordance with laboratory-based fecal calprotectin measures were observed. Clinical disease activity scores significantly decreased from a baseline of 7.2-2.7 by week 24. The proportion of patients achieving clinical remission increased from 0% at baseline to 50% at week 24. TDM facilitated 28 therapeutic adjustments, including 20 dose escalations, five de-escalations, and three therapy switches. CONCLUSION: Integrating home-based fecal calprotectin testing with TDM is feasible for personalized management of IBD. The observed clinical trends warrant confirmation in controlled trials.
Evaluating the completeness of postoperative endoscopic recurrence assessment in Crohn's disease patients with Kono-S anastomoses.
Parkash N, Keung C, Bell SJ … +1 more , Moore GT
Eur J Gastroenterol Hepatol · 2026 Mar · PMID 40929655 · Publisher ↗
BACKGROUND AND AIMS: Despite therapeutic advances, resection rates in Crohn's disease remain high. Kono-S is a novel anastomosis for ileocolonic resections; however, its altered configuration may challenge standard endos...
BACKGROUND AND AIMS: Despite therapeutic advances, resection rates in Crohn's disease remain high. Kono-S is a novel anastomosis for ileocolonic resections; however, its altered configuration may challenge standard endoscopic assessment, particularly in the absence of validated scoring tools. This study evaluated the endoscopic assessment of Kono-S anastomosis anatomy and recurrence stratification using Rutgeert's score. METHODS: This retrospective study included colonoscopies performed on Crohn's disease patients with Kono-S anastomosis between March 2021 and 2025. Data included procedure dates, endoscopist subspecialty [inflammatory bowel disease (IBD) vs. non-IBD], and colonoscopy findings. Colonoscopies were rescored via Rutgeert's score and evaluated for completeness of assessment, defined as correct identification and photodocumentation of the anastomosis substructures. Factors associated with completeness were determined using Mann-Whitney U or Fisher's exact tests. Inter-rater reliability between endoscopists was calculated using Fleiss' kappa. RESULTS: Forty-nine colonoscopies performed a median of 31 weeks postsurgery were included. Endoscopic recurrence (≥i2b) was 16.2% (median follow-up 153 weeks). Most procedures (89.5%) were performed by IBD subspecialists. Thorough assessments were achieved in 73.5% of colonoscopies, with IBD endoscopists significantly more likely to provide complete assessments (79.5%) compared with non-IBD endoscopists (20%, P = 0.014). Agreement with the rescored Rutgeerts occurred in 41 (93.2%) cases. Concordance with the central reading was high for IBD endoscopists (Fleiss' kappa: 0.897, P < 0.001) but tended towards moderate for non-IBD endoscopists (Fleiss' kappa: 0.467, P = 0.351). CONCLUSION: With increasing adoption of the Kono-S technique, this study suggests that IBD-specific endoscopy training is essential for accurate assessment of postoperative recurrence in patients with Crohn's disease.
Bevacizumab for refractory gastrointestinal angiodysplasia: a case report and literature review.
Furumaya A, Goltstein LCMJ, Tushuizen ME … +1 more , Klemt-Kropp M
Eur J Gastroenterol Hepatol · 2025 Dec · PMID 40929654 · Full text
Currently, symptomatic gastrointestinal (GI) angiodysplasia is treated with argon plasma coagulation (APC) via endoscopic procedures, supplemented with octreotide or thalidomide treatment. However, suboptimal response an...
Currently, symptomatic gastrointestinal (GI) angiodysplasia is treated with argon plasma coagulation (APC) via endoscopic procedures, supplemented with octreotide or thalidomide treatment. However, suboptimal response and side effects are often seen. Bevacizumab, an angiogenesis inhibitor, may provide an alternative systemic therapy for patients with refractory GI angiodysplasia. A 75-year-old male patient with cirrhosis and portal hypertension due to metabolic dysfunction-associated steatotic liver disease presented with recurrent anemia and overt GI bleeding. Initial endoscopic findings showed a combination of portal hypertensive gastropathy and GI angiodysplasia. Anemia persisted despite repeated APC and octreotide. After transjugular intrahepatic portosystemic shunt, portal hypertensive gastropathy resolved; however, GI angiodysplasia remained and caused refractory symptomatic anemia and overt bleeding. Finally, we resorted to off-label bevacizumab in the absence of other viable treatment options. The patient initially responded to treatment but has needed top-up dosing, the effect of which remains to be evaluated. In conclusion, we describe our initial experience with off-label bevacizumab in the treatment of refractory GI angiodysplasia. Based on our experience and literature, bevacizumab may be a viable option for patients with refractory GI angiodysplasia, which should be further evaluated in future studies before it can be implemented in clinical practice.
Comparative effectiveness and safety of probiotics with psychotropic potential in mental health benefits in irritable bowel syndrome: a systematic review and network meta-analysis.
Rokkas T, Ekmektzoglou K, Tsanou E … +4 more , Bricca L, Menni AE, Golfakis P, Kotzampassi K
Eur J Gastroenterol Hepatol · 2026 Jan · PMID 40929652 · Publisher ↗
BACKGROUND: The use of probiotics as a treatment for irritable bowel syndrome (IBS) is gaining attention, with recent studies indicating that certain probiotics or combinations may have mental health benefits for patient...
BACKGROUND: The use of probiotics as a treatment for irritable bowel syndrome (IBS) is gaining attention, with recent studies indicating that certain probiotics or combinations may have mental health benefits for patients with IBS. AIMS: To systematically review and meta-analyze, using network meta-analysis (NWM), the comparative effectiveness and safety of probiotics with psychotropic potential on quality of life, depression, and anxiety in patients with IBS. METHODS: Relevant randomized controlled trials (RCTs) were analyzed, using a Bayesian NWM, to compare the performance of probiotics with mental health benefits in IBS treatment. Treatment effectiveness was assessed using surfaces under cumulative ranking (SUCRA) values. RESULTS: The analysis included 3154 participants assigned to nine different treatments: Bifidobacterium longum, Saccharomyces, Clostridium butyricum, Bifidobacterium lactis, Lactobacillus acidophilus, Lactobacillus casei strain Shirota, Lactobacillus plantarum, probiotic combinations, and placebo. B. longum and probiotic combinations were found to be significantly more effective than placebo. In terms of improving quality of life (QoL), B. longum was the most effective (SUCRA = 89.7%), while L. plantarum was the least effective (SUCRA = 14.9%). For alleviating depression and anxiety, the combination of probiotics (SUCRA = 95.6%) and L. acidophilus (SUCRA = 74.2%) showed the best results, respectively. CONCLUSION: Some probiotics or combinations may offer benefits for patients with IBS in improving QoL, depression, and anxiety; however, as this is a developing field, additional research is necessary to fully understand the effectiveness, underlying mechanisms, and specific strains that may be advantageous. More high-quality RCTs are needed to substantiate these therapeutic possibilities.
Understanding the epidemiology of gastric cancer: a review and case-only analysis from Italy.
Collatuzzo G, Fiorini G, Renieri T … +5 more , Pavoni M, Boccia S, D'Errico A, Vaira D, Boffetta P
Eur J Gastroenterol Hepatol · 2025 Nov · PMID 40929649 · Publisher ↗
BACKGROUND: Gastric cancer epidemiology evolved rapidly in the last century, shifting from being one of the main causes of cancer-related death to the sixth in high-income countries. METHODS: We conducted a narrative rev...
BACKGROUND: Gastric cancer epidemiology evolved rapidly in the last century, shifting from being one of the main causes of cancer-related death to the sixth in high-income countries. METHODS: We conducted a narrative review on gastric cancer epidemiology. Our review focused on trends of gastric cancer and its relationship with Helicobacter pylori infection; cardia and noncardia gastric cancer risk factors; early onset gastric cancer; second primary cancers in patients with gastric cancer; and implementation of gastric cancer prevention strategies. In addition, we provided results of a case-only analysis of recently diagnosed gastric cancer from a middle-risk population. RESULTS: Literature consistently describes the ongoing declining trend of gastric cancer rates and the overall increase in in absolute number of incident cases because of a change in population. The evolving distribution of risk factor prevalence impacts the epidemiology of gastric cancer, with an increase in early onset and in cardia gastric cancer. A negative correlation was observed between H. pylori prevalence and the proportion of cardia gastric cancer. The analysis of 117 gastric cancer cases observed between 2016 and 2020 in Bologna, Italy, showed that smoking and epigastric pain were significantly associated with increased risk of early-onset gastric cancer after accounting for confounders. CONCLUSION: Multifaceted strategies are needed to address challenges in gastric cancer control, early diagnosis, and clinical management in a changing epidemiological landscape. Prevention remains the cornerstone to reduce the gastric cancer burden.
Dietary vitamin E intake in metabolic dysfunction-associated steatotic liver disease and all-cause/cause-specific mortality.
Kim D, Danpanichkul P, Wijarnpreecha K … +1 more , Ahmed A
Eur J Gastroenterol Hepatol · 2026 Jan · PMID 40929647 · Publisher ↗
AIMS: We investigated the independent association between dietary vitamin E intake among individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) and all-cause and cause-specific mortality in a r...
AIMS: We investigated the independent association between dietary vitamin E intake among individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) and all-cause and cause-specific mortality in a representative sample of the USA. METHODS: We used the 2007-2014 US National Health and Nutrition Examination Survey with mortality follow-up through 2019 (median: 8.6 years). Cox regression models were used to assess the association between dietary vitamin E intake in MASLD and all-cause and cause-specific mortality. RESULTS: Among the 10 193 individuals with MASLD (mean age: 46.8 years and male: 48.0%), greater dietary vitamin E intake was correlated with a gradual reduction in the risk of all-cause mortality, which remained significant after adjustment for clinical and metabolic risk factors (hazard ratio: 0.68, 95% confidence interval: 0.50-0.94 for the fourth quartile compared with the first quartile; P for trend = 0.018). This association remained more pronounced in older populations, males, and non-Hispanic Whites than in their counterparts. Increased dietary vitamin E intake demonstrated trends associated with reduced cancer-related mortality. CONCLUSION: Higher dietary vitamin E intake in MASLD was associated with a lower risk of all-cause mortality.
Association between diabetes duration and risk of pancreatic cancer: a meta-analysis of observational studies.
Hua X, Fu R, Yin Z … +1 more , Gong H
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40929644 · Publisher ↗
BACKGROUND: Prior studies have implicated diabetes as a risk factor for pancreatic cancer, yet the impact of diabetes progression on pancreatic cancer incidence remains unclear. We aim to assess pancreatic cancer risk ac...
BACKGROUND: Prior studies have implicated diabetes as a risk factor for pancreatic cancer, yet the impact of diabetes progression on pancreatic cancer incidence remains unclear. We aim to assess pancreatic cancer risk across different stages of diabetes. METHODS: Employing a predefined search strategy, we conducted a literature review of electronic databases up to 29 February 2024. Extracting odds ratios (OR) and 95% confidence intervals (CIs) relevant to diabetes, we aimed to evaluate pancreatic cancer risk among diabetic patients and conduct subgroup analyses. RESULTS: Our systematic review comprised 29 observational cohort studies with 25 million participants. We observed a 2.13-fold higher likelihood of pancreatic cancer among diabetic individuals compared with nondiabetic counterparts. Specifically, males with diabetes exhibited a greater pancreatic cancer risk than females; however, regional disparities in pancreatic cancer risk among diabetic patients were NS. Regarding diabetes duration, pooled ORs (95% CI) for pancreatic cancer risk were 2.41 (2.07-2.81) for 1-4 years, 1.67 (1.50-1.85) for 4-10 years, and 2.01 (1.81-2.22) for over 10 years. CONCLUSION: The results of this study confirm a significant association between diabetes and pancreatic cancer. Although there was no statistically significant difference in risk between different diabetes duration groups, diabetic patients overall face a higher risk of pancreatic cancer. Therefore, diabetic patients should undergo regular pancreatic cancer screening and take appropriate management measures to detect potential pancreatic cancer at an early stage.
Triglyceride glucose index as a causal risk factor for metabolic dysfunction-associated fatty liver disease: evidence from the National Health and Nutrition Examination Survey 2017-2020 and Mendelian randomization.
Su Z, Xue J, Sun J … +2 more , Ding Y, Ji C
Eur J Gastroenterol Hepatol · 2025 Nov · PMID 40900616 · Publisher ↗
BACKGROUND/AIMS: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a global health burden increasing liver-related mortality. Existing cross-sectional studies lack causal evidence between the triglyceride g...
BACKGROUND/AIMS: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a global health burden increasing liver-related mortality. Existing cross-sectional studies lack causal evidence between the triglyceride glucose (TyG) index and MAFLD. Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 and Mendelian randomization, this study aimed to investigate the causal association between the TyG index and MAFLD. METHODS: On the basis of the 2017-2020 NHANES data, baseline characteristics of MAFLD cases and the control group were comparatively analyzed. Multivariate logistic regression evaluated the association between the TyG index and MAFLD, with restricted cubic splines (RCS) employed for nonlinear relationship assessment. A two-sample Mendelian randomization analysis examined potential causal relationships, while comprehensive sensitivity analyses validated the robustness of the principal findings. RESULTS: Cross-sectional analysis revealed a significant positive linear association between the TyG index and MAFLD risk. After multivariable adjustment, the odds ratio (OR) was 2.30 [95% confidence interval (CI) = 1.71-3.10, P < 0.001]. RCS analysis further confirmed a monotonic linear relationship between the TyG index and MAFLD risk. The test for nonlinearity was nonsignificant ( P = 0.07), confirming a linear dose-response. Mendelian randomization analysis indicated that a genetically predicted 1-unit increase in TyG index was associated with 64% higher MAFLD risk (OR = 1.64, 95% CI = 1.07-2.50, P = 0.02). CONCLUSION: This study using cross-sectional data and Mendelian randomization confirms the TyG index as an independent causal risk factor for MAFLD, highlighting the need for early monitoring and intervention to inform precision prevention strategies.
Tegoprazan vs. proton pump inhibitors for erosive esophagitis: a superior alternative or just another option? A systematic review and meta-analysis of randomized controlled trials.
Nayyer MA, Rasool H, Murtaza H … +4 more , Safdar MR, Khan SM, Khalid S, Umer M
Eur J Gastroenterol Hepatol · 2025 Dec · PMID 40900566 · Publisher ↗
Tegoprazan, a novel potassium-competitive acid blocker, has emerged as a potential alternative to proton pump inhibitors (PPIs) for the treatment of erosive esophagitis (EE), especially in light of long-term safety conce...
Tegoprazan, a novel potassium-competitive acid blocker, has emerged as a potential alternative to proton pump inhibitors (PPIs) for the treatment of erosive esophagitis (EE), especially in light of long-term safety concerns associated with PPIs. This study aimed to assess the efficacy and safety of tegoprazan compared to PPIs in patients with EE. A systematic review and meta-analysis were conducted following preferred reporting items for systematic reviews and meta-analyses guidelines, including three randomized controlled trials with a total of 658 patients diagnosed with EE. The primary outcomes were cumulative endoscopic healing rates across 4-8 weeks and at 4 and 8 weeks, while secondary outcomes included any adverse events, drug-related treatment-emergent adverse events (TEAEs), and serious adverse events (SAEs). Tegoprazan demonstrated noninferior healing rates at 4 weeks [relative risk (RR) = 1.05, 95% confidence interval (CI): 0.96-1.16; P = 0.28; I ² = 51%] and 8 weeks (RR = 1.01, 95% CI: 0.96-1.06; P = 0.73; I ² = 0%) compared to PPIs. There was no statistically significant difference in the overall incidence of adverse events or SAEs (RR = 1.19, 95% CI: 0.92-1.53; P = 0.19; I ² = 24%). However, a significantly higher rate of drug-related TEAEs was observed in the tegoprazan group (RR = 1.23, 95% CI: 1.03-1.48; P = 0.02; I ² = 0%). In conclusion, tegoprazan is an effective treatment option for EE, with comparable efficacy to PPIs, though further studies are warranted to evaluate its long-term safety before routine clinical use.
Quality of care in inflammatory bowel disease from patient's perspective using QUOTE-IBD: a Greek multicenter prospective study.
Mantaka A, Apostolakis I, Domeyer PR … +6 more , Sarafis P, Psistakis A, Anagnostopoulou E, Karmiris K, Theodoropoulou A, Koutroubakis IE
Eur J Gastroenterol Hepatol · 2025 Nov · PMID 40900548 · Publisher ↗
OBJECTIVE: Most of the existing instruments assessing quality of care (QoC) are based on the perception of healthcare providers that may differ from that of healthcare users. We aimed to measure QoC through the patient's...
OBJECTIVE: Most of the existing instruments assessing quality of care (QoC) are based on the perception of healthcare providers that may differ from that of healthcare users. We aimed to measure QoC through the patient's eyes in a Greek cohort of patients with inflammatory bowel disease (GR QUOTE-IBD) and to investigate putative sociodemographic and disease-related QoC predictors. METHODS: GR QUOTE-IBD questionnaire was delivered to patients at their regular follow-up visit, and adequate time was offered to fill it in. The outcome of the analysis was associated with epidemiological and disease-related characteristics. Statistical analysis was performed with SPSS (version 29, SPSS Inc., Chicago, Illinois, USA). RESULTS: GR QUOTE-IBD questionnaire was completed by 150 patients from three IBD clinics, 93 with Crohn's disease (CD), with a median disease duration of 10 years (range 0.6-43 years). Quality Index (QI) for total care was >9 in all three hospitals. Quality deficit QI <9 was found only for accessibility to IBD care in two of three clinics. Autonomy in decision-making was rated as the least important dimension of QoC from the patients' perspective. A positive association was found between CD diagnosis and QI scores for total care ( P = 0.013). Steroid treatment over two times in lifetime was negatively associated with QI scores for total care ( P = 0.019). CONCLUSION: Total QoC from patients' perspective is high in Crete. CD and disease severity seem to affect patients' perceptions of IBD care. Gastroenterologists in Crete should improve accessibility to IBD care and empower patients' involvement in shared decision-making.
Polygenic risk of refractory celiac disease type II and its association with autoimmune diseases: a phenome-wide association study in the UK Biobank.
Tsali L, Tsilidis K, Katsanos K … +5 more , Ntzani E, Manou M, Papandreou C, Markozannes G, Chalitsios CV
Eur J Gastroenterol Hepatol · 2025 Dec · PMID 40900534 · Full text
OBJECTIVE: Refractory celiac disease-type II (RCDII) is the more severe and adverse form of celiac disease; however, its association with other autoimmune diseases remains unclear. We conducted a phenome-wide association...
OBJECTIVE: Refractory celiac disease-type II (RCDII) is the more severe and adverse form of celiac disease; however, its association with other autoimmune diseases remains unclear. We conducted a phenome-wide association study (PheWAS) to examine the association between the polygenic risk score (PRS) for RCDII and autoimmune diseases. METHODS: To construct the PRS-RCDII, we extracted summary statistics for three non-human leukocyte antigen genetic variants, which were independently associated with RCDII ( r2 < 0.001; P < 5 × 10 -5 ) in a genome-wide association study. We then conducted a PRS-PheWAS in the UK Biobank to investigate the associations of PRS-RCDII with 27 autoimmune diseases, adjusting for age, sex, genetic batch, and genetic ancestry. False discovery rate (FDR < 0.05) correction was applied to account for multiple comparisons. RESULTS: Our study population comprised 373 022 UK Biobank participants (mean age: 57.2 years), of whom 202 865 (54.4%) were females. We constructed the PRS-RCDII, using three genetic variants, namely rs2041570 on chromosome 7p14.3 ( FAM188B ), rs7324708 on chromosome 13q22.1 ( KLF12 ), and rs205047 on chromosome 17p12 ( SHISA6 ). In the PRS-PheWAS, two phenotypes were initially associated with RCDII at a nominal P value threshold, ankylosing spondylitis and systemic sclerosis; however, after adjusting for multiple comparisons, only the association with ankylosing spondylitis remained statistically significant (odds ratio per 1 SD increase = 1.13; 95% confidence interval: 1.04-1.22; PFDR = 0.023). Sex-stratified and single-nucleotide polymorphism (SNP)-by-SNP analyses revealed no significant heterogeneity. CONCLUSION: Our study identified an association between the genetic risk score for RCDII and ankylosing spondylitis, but not with other autoimmune diseases. This finding may have clinical importance for people with RCDII, although replication in future studies is needed.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe