Eur J Gastroenterol Hepatol [JOURNAL]
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200 papers
Differential effects of sleep duration on cardiovascular risk in metabolic-associated fatty liver disease vs. without metabolic-associated fatty liver disease: evidence from National Health and Nutrition Examination Survey and Mendelian randomization.
Wang S, Liu X, He J … +2 more , Cui Y, Jia A
Eur J Gastroenterol Hepatol · 2025 Dec · PMID 40900530 · Publisher ↗
BACKGROUND: Cardiovascular disease (CVD) risk increases in patients with metabolic-associated fatty liver disease (MAFLD). While sleep duration is linked to CVD risk, it is unclear whether it differs between individuals...
BACKGROUND: Cardiovascular disease (CVD) risk increases in patients with metabolic-associated fatty liver disease (MAFLD). While sleep duration is linked to CVD risk, it is unclear whether it differs between individuals with and without MAFLD. METHODS: Data from the National Health and Nutrition Examination Survey (2007-2020; n = 10 386) were analyzed using multivariable logistic regression to examine the relationship between sleep duration and CVD. Subgroup analyses and a restricted cubic spline model assessed interactions and potential nonlinear associations, while Mendelian randomization (MR) was used to infer causality. RESULTS: Long sleep duration (≥9 h) was associated with an increased CVD risk in MAFLD patients [ P = 0.005, odds ratio (OR) = 1.92, 95% confidence intervals (CI): 1.22-3.02], while short sleep duration (≤6 h) was linked to a higher CVD risk in non-MAFLD individuals ( P = 0.030, OR = 1.63, 95% CI: 1.05-2.52). Subgroup analysis revealed that marital status modified this association in MAFLD patients. A U -shaped relationship was observed, with the lowest CVD risk occurring at 6.7 h of sleep for MAFLD patients and 7.9 h for non-MAFLD individuals. MR suggested a causal link ( P = 0.03, OR = 1.42, 95% CI: 1.02-1.97), with the results remaining robust after adjusting for potential confounders. CONCLUSION: Long sleep duration increases CVD risk in MAFLD patients, with a U -shaped relationship indicating the lowest risk at 6.7 h of sleep in MAFLD and 7.9 h in non-MAFLD individuals. MR analysis suggests a causal link between sleep duration and CVD.
Transcutaneous electrical nerve stimulation therapy for intractable childhood constipation: a clinical observational and comparative study.
Aktas I, Bayrak NA, Sezer Yamanel RG
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40900525 · Publisher ↗
PURPOSE: To determine the efficacy of transcutaneous electrical nerve stimulation (TENS) on children with intractable constipation and compare treatment success between TENS application twice weekly and three times weekl...
PURPOSE: To determine the efficacy of transcutaneous electrical nerve stimulation (TENS) on children with intractable constipation and compare treatment success between TENS application twice weekly and three times weekly. METHODS: We recruited otherwise healthy consecutive children aged 6-17 years old suffering from intractable constipation over a 6-month period. Anatomic causes and organic pathologies were ruled out. All children received TENS treatment for 20 min, during 4 weeks, three times a week in group 1 and twice a week in group 2 for 4 weeks. Patients were evaluated for defecation frequency, stool consistency, symptom relief, and fecal incontinence before, at the first week, at the end, and 4 weeks after treatment was discontinued. RESULTS: Twenty patients were enrolled in group 1 and 15 in group 2. Age, gender, and duration of constipation were indifferent among groups. After treatment, there was a significant increase in the number of weekly defecations ( P < 0.001), improvement in fecal incontinence ( P < 0.05), and painful defecation ( P < 0.001) in both groups; however, each group's improvements did not persist 4 weeks after the treatment's discontinuation ( P > 0.05). Meanwhile, twice weekly TENS was as effective as three-times weekly TENS ( P > 0.05). CONCLUSION: TENS treatment appears to improve weekly defecation, fecal incontinence, and pain in children with intractable constipation; however, effects are not sustained after discontinuation. The twice-weekly and three-times weekly protocols yielded comparable results; however, the study lacked sufficient power to conclusively demonstrate noninferiority.
Serum metabolites and gut microbiota mediate the causal link between anxiety and nonalcoholic fatty liver disease: a Mendelian randomization analysis.
Wang S, Liu X, He J … +2 more , Cui Y, Jia A
Eur J Gastroenterol Hepatol · 2025 Dec · PMID 40900524 · Publisher ↗
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is defined by liver fat accumulation exceeding 5% in individuals who do not consume significant amounts of alcohol. This condition can advance to more severe outcomes,...
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is defined by liver fat accumulation exceeding 5% in individuals who do not consume significant amounts of alcohol. This condition can advance to more severe outcomes, including fibrosis, cirrhosis, and liver cancer. Although numerous factors contribute to the progression of NAFLD, the influence of psychological elements, especially anxiety, remains inadequately explored. METHODS: This study applied Mendelian randomization (MR) using genome-wide association data from 4761 NAFLD cases and 373 227 controls to investigate the causal relationship between psychological factors and NAFLD. We conducted both multivariable and mediation MR analyses to determine how anxiety influences NAFLD through pathways involving gut microbiota and metabolites. Furthermore, we examined datasets related to anxiety and NAFLD from the Gene Expression Omnibus, identified differentially expressed genes, and conducted enrichment analyses on the genes shared between these two conditions. RESULTS: The MR analysis established a direct causal relationship between genetically predicted anxiety and the development of NAFLD (β=0.229, 95% confidence interval = 1.11-1.41, P = 0.0002). This association was confirmed by multivariable MR, independent of BMI and type 2 diabetes. Mediation MR revealed that specific metabolites and fatty acid-related gut microbiota mediate the relationship between anxiety and NAFLD. Additionally, enrichment analysis confirmed the involvement of fatty acids in genes common to both anxiety and NAFLD. CONCLUSION: This study suggests that genetically predicted anxiety contributes to the development of NAFLD by influencing specific gut microbiota and metabolites, underscoring the vital role of mental health in mitigating NAFLD risk.
The efficacy and safety of endoscopic submucosal resection in periappendiceal lesions: a systematic review and meta-analysis.
Abosheaishaa H, Ismail A, Awadalla M … +10 more , Mohammed S, Abdalla M, Elawad A, Ezeani C, Phung J, Abdallah M, Nero N, Bhatt A, Sanaka M, Bilal M
Eur J Gastroenterol Hepatol · 2025 Dec · PMID 40900440 · Publisher ↗
INTRODUCTION: Endoscopic submucosal dissection (ESD) is a promising technique for early-stage gastrointestinal neoplasms; however, its use for periappendiceal lesions poses challenges because of anatomical complexities a...
INTRODUCTION: Endoscopic submucosal dissection (ESD) is a promising technique for early-stage gastrointestinal neoplasms; however, its use for periappendiceal lesions poses challenges because of anatomical complexities and the potential risk of appendicitis or perforation. As a result, these lesions are often managed surgically. This systematic review and meta-analysis evaluate the safety and efficacy of ESD for periappendiceal lesions. METHODOLOGY: A systematic search across multiple databases was conducted, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies focused on adult populations undergoing ESD for periappendiceal lesions. The primary outcome was a technical success, and secondary outcomes included R0 resection, en-bloc resection, adverse events, and need for surgery. Data were reported using percentages with associated confidence intervals (CIs) and heterogeneity ( I ²). RESULTS: Six studies comprising 298 patients were included. Technical success was achieved in 98% (95% CI: 97-100%, I2 : 4.63%), with R0 resection and en-bloc resection rates of 84% (95% CI: 77-91%, I2 : 61.86%) and 92% (95% CI: 86-97%, I2 : 66.11%), respectively. The overall rates of polyp recurrence, appendicitis, and bleeding were 0.1% (95% CI: 0-2%, I2 : 0%), 3% (95% CI: 0-4%, I2 : 0%), and 1% (95% CI: 0-3%, I2 : 0%), respectively. Conversely, perforation exhibited a relatively high incidence of 11% (95% CI: 3-19%, I2 : 84.55%); however, the need for surgical intervention was 6% (95% CI: 1-10%, I2 : 74.12%). CONCLUSION: ESD provides a safe and effective alternative to surgical resection for managing periappendiceal lesions.
Home-based transcutaneous electrical acupuncture-point stimulation for depressive symptoms in inflammatory bowel disease: a randomized feasibility study.
Huang C, Czuber-Dochan W, Norton C
Eur J Gastroenterol Hepatol · 2025 Dec · PMID 40900432 · Full text
BACKGROUND: Depressive symptoms are common in individuals with inflammatory bowel disease (IBD) and are associated with poor disease outcomes. Transcutaneous electrical acupuncture point stimulation (TEAS) is a noninvasi...
BACKGROUND: Depressive symptoms are common in individuals with inflammatory bowel disease (IBD) and are associated with poor disease outcomes. Transcutaneous electrical acupuncture point stimulation (TEAS) is a noninvasive intervention with potential benefits for inflammation but remains untested in IBD. We developed a smartphone application for home-based TEAS self-administration and evaluated its feasibility, acceptability, and preliminary effects. METHODS: In a randomized feasibility study, IBD patients with Patient Health Questionnaire-9 (PHQ-9) scores ≥ 8 were recruited through Crohn's and Colitis UK. Participants were remotely trained to use the TEAS device, locate acupoints, and self-administer the treatment via the app. Group A completed 30-min daily sessions for 21 days from week 1, while Group B started in week 6. Outcomes [recruitment, retention, acceptability, depression, fatigue, pain, and quality of life (QoL)] were assessed at baseline, week 4, and week 9. RESULTS: Of the 109 individuals of interest, 57 were assessed, 37 were eligible, and 36 were randomized. In Group A, 83% (15/18) completed ≥ 18 sessions, compared to 50% (9/18) in Group B. The questionnaire completion rates were 92% ( n = 33) at baseline, 83% ( n = 30) at 4 weeks, and 67% ( n = 24) at 9 weeks. Most participants (81%) recommended TEAS. Preliminary analysis showed reduced depressive symptoms and improved QoL postintervention and at the follow-up. Postintervention, the mean PHQ-9 score decreased from 13.9 to 7.7 in Group A and from 14.2 to 6.5 in Group B. CONCLUSIONS: Home-based TEAS is feasible, acceptable, and has a clinical potential. A full-scale randomized controlled trial is needed to confirm its efficacy in the treatment of IBD-related depression.
The role of chest X-ray in latent tuberculosis infection screening for inflammatory bowel disease patients in low-incidence countries: in response to Gatt et al. (Eur J Gastroenterol Hepatol 2025;37:728-732).
Braasch T, Siegmund B
Eur J Gastroenterol Hepatol · 2025 Oct · PMID 40893034 · Publisher ↗
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Changes in antiviral treatment rate for hepatitis B virus before hepatocellular carcinoma diagnosis: a nationwide Korean study.
Chon YE, Lee J, Yoon EL … +4 more , Kim SS, Ahn SB, Jeong SW, Jun DW
Eur J Gastroenterol Hepatol · 2025 Oct · PMID 40893033 · Full text
BACKGROUND AND AIMS: Antiviral treatment (AVT) reduces hepatitis B virus (HBV) reactivation and hepatocsellular carcinoma (HCC) development; however, the impact of AVT timing - before versus after HCC diagnosis - on prog...
BACKGROUND AND AIMS: Antiviral treatment (AVT) reduces hepatitis B virus (HBV) reactivation and hepatocsellular carcinoma (HCC) development; however, the impact of AVT timing - before versus after HCC diagnosis - on prognosis remains unclear. This study aimed to evaluate the current status, changes, and clinical outcomes of AVT before HCC diagnosis in Korea. METHODS: Data were extracted from the Korean National Health Insurance Service for patients newly diagnosed with HBV-related HCC from 2008 to 2018. Patients were categorized into an early cohort (2008-2013) and a late cohort (2014-2018). AVT trends were analyzed using Joinpoint regression, and clinical outcomes were compared between groups. RESULTS: Among 82 609 patients (early cohort: n = 45 804; late cohort: n = 36 805), the proportion receiving AVT before HCC diagnosis increased from 22.4% in 2008 to 46.8% in 2018. AVT after diagnosis also rose from 16.3 to 21.3%. Overall survival rates in the late cohort were significantly improved compared with the early cohort (P < 0.001). More than half of the patients with HCC who received transplantation or local ablation treatment had received AVT before HCC diagnosis. AVT before HCC diagnosis was associated with reduced mortality rate (adjusted hazard ratio = 0.592; 95% confidence interval: 0.580-0.604; P < 0.001). Elderly patients (≥80 years) consistently had a lower AVT rate before HCC diagnosis compared with other age groups (P < 0.05). CONCLUSION: The AVT rate before HCC diagnosis significantly increased over the past 10 years in Korea. Further efforts are needed to improve the AVT rate in elderly patients with HBV-related HCC.
Accuracy of the American Society for Gastrointestinal Endoscopy, European Society of Gastrointestinal Endoscopy, and Society of American Gastrointestinal and Endoscopic Surgeons criteria in predicting common bile duct microlithiasis.
Cui Y, Li J, Huang Q … +5 more , Hong J, Li S, Chen L, Bao J, Mei Q
Eur J Gastroenterol Hepatol · 2025 Dec · PMID 40829054 · Publisher ↗
BACKGROUND: Patients with suspected common bile duct stones are classified as high risk (HR), intermediate risk (IR), or low risk (LR) based on the American Society for Gastrointestinal Endoscopy (ASGE), European Society...
BACKGROUND: Patients with suspected common bile duct stones are classified as high risk (HR), intermediate risk (IR), or low risk (LR) based on the American Society for Gastrointestinal Endoscopy (ASGE), European Society of Gastrointestinal Endoscopy (ESGE), and Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). This study validated common bile duct microlithiasis (CBDM) clinical risk stratification utility. METHODS: We retrospectively reviewed cases of suspected CBDM between November 2017 and May 2024. After liver function tests, ultrasound or computed tomography, all patients were stratified according to ASGE, ESGE, and SAGES into HR, IR, and LR. RESULTS: Among 269 HR patients, diagnostic accuracy was 61.71% [95% confidence interval (CI): 55.77-67.32] for ASGE, 60.59% (95% CI: 54.65-66.25) for ESGE, and 56.51% (95% CI: 50.53-62.30) for SAGES. In the IR group, CBDM confirmation by endoscopic ultrasound (EUS) or magnetic resonance cholangiopancreatography (MRCP) revealed: under ASGE ( n = 108), E US detected CBDM in 52 (no stones: 13) vs. MRCP identified CBDM in 19 (negative: 46), yielding 36.5% sensitivity; for ESGE ( n = 93), EUS identified CBDM in 46 (no stones:9) vs. MRCP identified CBDM in 32 (negative: 25) at 69.6% sensitivity; per SAGES ( n = 69), in the 43 receiving both modalities, EUS detected CBDM in 37 (no stones: 6) vs. MRCP detected CBDM in 14 (negative: 29) with 37.8% sensitivity. CONCLUSION: We validated ASGE, ESGE, and SAGES for CBDM prediction but found suboptimal. EUS demonstrates superior sensitivity over MRCP for IR evaluation.
Shifting alanine aminotransferase distribution among US adults, the National Health and Nutrition Examination Survey 1988-2020.
Kouambo Beckodro C, Masud N, Mallhi AK … +4 more , Edwards Q, Nwaobi S, Wei Y, Zhang J
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40810295 · Publisher ↗
BACKGROUND: The dynamics of alanine aminotransferase (ALT) remain poorly described in the general population owing to the unavailability of widely accepted cutoffs to define abnormal levels and insensitivity of dichotomi...
BACKGROUND: The dynamics of alanine aminotransferase (ALT) remain poorly described in the general population owing to the unavailability of widely accepted cutoffs to define abnormal levels and insensitivity of dichotomized ALT values. METHODS: With data from the National Health and Nutrition Examination Survey 1988-1994 ( n = 11 854), 1999-2004 (12 280), 2005-2010 (14 204), 2011-2016 (14 145), and 2017-2020 (7047), we examined the age- and sex-standardized distribution of log-transformed serum ALT and tested the elevated ALT prevalence trend among American adults aged 19 years and older. RESULTS: The ALT geometric mean increased from 15.89 U/L (95% confidence interval = 15.43-16.37) in 1988-1994 to 21.97 U/L (21.75-22.20) in 1999-2004. The means remained around 22 U/L between 2004 and 2016 and then decreased to 19.19 U/L (18.85-19.54) in 2017-2020 ( P for quadratic trends <0.001). However, the 95 th percentile of the bell-distribution remained around 49 U/L by the end of the study after jumping from 38.39 U/L (35.73-41.06) in 1988-1994 to 48.86 U/L (47.34-50.39) in 1999-2004. Correspondingly, the elevated ALT prevalence doubled from 1988-1994 to 1999-2004 and remained unchanged through 2020, independent of the cutoffs used. CONCLUSIONS: The ALT mean level decreased in recent years, but the right end of the bell-shaped distribution was stagnant, and the elevated ALT prevalence levels remained persistently high. The reductions in ALT levels likely corresponded to population-wide reductions in fructose consumption. The prevalent elevated ALT requires effective clinical interventions.
Correlating endoscopic findings with pathology to optimize biopsy strategies in gastritis: insights from a large cohort study.
Abu Baker F, Hazzan R, Gal O … +4 more , Natour R, Nicola D, Farah A, Mari A
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40810293 · Publisher ↗
BACKGROUND: Despite advancements in endoscopic technology, the concordance between endoscopic findings and histopathological diagnoses in gastritis remains inconsistent. This study aimed to evaluate the correlation betwe...
BACKGROUND: Despite advancements in endoscopic technology, the concordance between endoscopic findings and histopathological diagnoses in gastritis remains inconsistent. This study aimed to evaluate the correlation between endoscopic and histopathological findings, identify predictors of pathological outcomes, and assess the role of biopsies in routine clinical practice. METHODS: A retrospective analysis of 4927 gastroscopies with biopsy over 6 years was performed. Demographics, endoscopic features, and histopathological findings were analyzed. Logistic regression identified predictors of Helicobacter pylori infection and precancerous conditions, with predictive accuracy assessed using receiver operating characteristic (ROC) analysis. Endoscopic patterns were categorized according to structured classification systems, with severity and anatomical distribution systematically documented. RESULTS: Normal biopsies were found in 28.6%, H. pylori in 33.6%, and histologically confirmed precancerous conditions - including atrophy, intestinal metaplasia, and low-grade dysplasia - in 13.5% of cases. Nodular gastropathy [odds ratio (OR) = 1.54, P = 0.0006] and erosive raised gastropathy (OR = 1.31, P = 0.037) predicted H. pylori infection, while atrophic-appearing gastropathy (OR = 8.42, P < 0.001) and erosive raised gastropathy (OR = 2.47, P < 0.001) strongly predicted precancerous lesions. Erythematous gastropathy was inversely associated with H. pylori and precancerous conditions. Predictive accuracy was moderate for H. pylori [area under the ROC curve (AUC) = 0.60] and good for precancerous conditions (AUC = 0.74). CONCLUSION: While certain endoscopic features and patient demographics may assist in identifying individuals at higher risk of significant pathology, their predictive value remains modest. These findings may contribute to future efforts aimed at risk stratification; however, histological assessment remains essential, and prospective validation is warranted before altering current biopsy practices.
Role swapping between nurses and physicians in simulated endoscopy training enhances collaboration and teamwork: a prospective observational pilot study.
Borrelli de Andreis F, Vadalà di Prampero SF, Simonelli I … +8 more , Motta F, Fusha S, Esposito F, Mancini A, Di Gemma A, Costamagna G, Bulajic M, Digestive Endoscopy Unit Group of Isola Tiberina – Gemelli Isola Hospital
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40810288 · Full text
BACKGROUND AND AIMS: Gastrointestinal endoscopy is a collaborative process requiring technical and nontechnical skills from both physicians and nurses. Role swapping during simulated procedures has the potential to enhan...
BACKGROUND AND AIMS: Gastrointestinal endoscopy is a collaborative process requiring technical and nontechnical skills from both physicians and nurses. Role swapping during simulated procedures has the potential to enhance skill development and team dynamics. The study aimed to evaluate the impact of role swapping on technical and nontechnical skills, as well as on team collaboration and satisfaction, among endoscopists and nurses during simulated endoscopic procedures. METHODS: A pilot study was conducted with 22 participants (10 endoscopists and 12 nurses). Participants completed pre- and postsimulation assessments using validated self-rating scales: Non-Technical Skills for Surgeons (NOTSS), Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS), and customised technical skills questionnaires. Role swapping training sessions included onsite classes, randomised role-swapping simulations, and a 2-week postsimulation assessment. Wilcoxon nonparametric tests assessed differences between pre- and postsimulation scores. RESULTS: Role swapping significantly improved NOTSS and SPLINTS scores across key domains: communication, decision-making, situational awareness, and teamwork ( P < 0.05). Endoscopists reported significant confidence gains in instrument preparation, medication dilution, and patient discharge ( P < 0.05). Nurses demonstrated improvement in motor skills, mucosal inspection, and loop reduction handling during colonoscopy ( P < 0.05). Both groups expressed high satisfaction with role swapping training. CONCLUSION: Role swapping in simulated settings significantly enhances technical and nontechnical skills, fostering teamwork and mutual respect between physicians and nurses. This innovative approach could improve clinical practice and patient safety in real-world settings.
Global liver cancer burden attributed to high body mass index: trends, projections, and its relationship with socioeconomic development status (1990-2021).
Ma X, Pan T, Gao N … +4 more , Yu S, Ma X, Pan D, Liang P
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40810278 · Full text
BACKGROUND: As the third leading cause of cancer-related mortality globally, liver cancer exhibits a rising metabolic risk profile, with high BMI emerging as a critical etiological driver. OBJECTIVE: To systematically qu...
BACKGROUND: As the third leading cause of cancer-related mortality globally, liver cancer exhibits a rising metabolic risk profile, with high BMI emerging as a critical etiological driver. OBJECTIVE: To systematically quantify the global burden of liver cancer disease attributable to high BMI from 1990 to 2021 and project its epidemiological trajectory through 2036. METHODS: Using the Global Burden of Disease data for 2021, we analyzed mortality rates, disability-adjusted life years (DALYs), and age-standardized rates categorized by sex, age, time cohort, and sociodemographic index (SDI) strata. We employed spatiotemporal clustering to identify regional patterns of burden, and utilized autoregressive integrated moving average models to predict future trends. RESULTS: In 2021, high BMI accounted for 46 200 (95% uncertainty interval: 42 800-49 700) liver cancer deaths and 1.24 million (95% uncertainty interval: 1.15-1.33) DALYs globally, representing 3.5 and 3.2% increases from 1990, respectively. The burden of deaths and DALYs demonstrated significant sex differences (male to female ratio of 1.6 : 1 and 1.9 : 1, respectively), age-dependent progression (peak mortality at 90-94 years for men: 6.54 per 100 000; peak mortality at 95+ for women: 6.53 per 100 000), and SDI-associated increases ( R2 = 0.039, P < 0.0001). Projections indicate that the age-standardized death rate will rise to 17.63 per 100 000 (95% uncertainty interval: 16.83-18.44) by 2036, representing a 120% increase from 2021 levels. CONCLUSION: High BMI-associated liver cancer burden has intensified globally since 1990, disproportionately affecting males, aging populations, and high-SDI regions. Accelerated epidemiological transitions and persistent obesity trends suggest continued burden escalation without targeted metabolic intervention strategies.
Nourishing remission: the role of Crohn's disease exclusion diet and partial enteral nutrition in pregnancy: a comprehensive review.
Micallef S, Mintoff F, Ellul P … +1 more , Sciberras M
Eur J Gastroenterol Hepatol · 2025 Oct · PMID 40801225 · Publisher ↗
The management of Crohn's disease during pregnancy presents significant challenges. Active Crohn's disease can be treated with corticosteroids or biologics. While these treatments are generally considered safe during pre...
The management of Crohn's disease during pregnancy presents significant challenges. Active Crohn's disease can be treated with corticosteroids or biologics. While these treatments are generally considered safe during pregnancy, they are not without potential side effects, leading to patient hesitancy in initiating therapy despite guidance from inflammatory bowel disease specialists. We present the case of a 34-year-old woman who was diagnosed with Crohn's disease 3 weeks before getting pregnant and who opted not to use medication during her pregnancy. For the initial 26-28 weeks, she received conservative treatment. Following a deterioration in her symptoms and an increase in calprotectin levels, she commenced the Crohn's disease exclusion diet (CDED) combined with partial enteral nutrition (PEN). This led to significant symptomatic improvement and a decrease in faecal calprotectin levels. At 40 weeks of gestation, she gave birth to a healthy baby. This case underscores the potential efficacy of CDED and PEN as dietary management strategies for Crohn's disease even during pregnancy, although further research is warranted to compare these approaches with conventional treatments. In addition, it emphasises the critical role of preconception counselling regarding medication safety and effective disease management during pregnancy.
Eosinophilic esophagitis is the leading cause of dysphagia in an outpatient setting.
Furnari M, Calabrese F, Pasta A … +7 more , Marabotto E, Barbera L, Bodini G, Savarino EV, Savarino V, Zentilin P, Giannini EG
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40801220 · Publisher ↗
BACKGROUND AND AIM: Dysphagia is an alarming symptom often associated with upper gastrointestinal organic diseases. Its incidence has increased in the last decades, although updated clinical data related to patients pres...
BACKGROUND AND AIM: Dysphagia is an alarming symptom often associated with upper gastrointestinal organic diseases. Its incidence has increased in the last decades, although updated clinical data related to patients presenting with dysphagia are lacking. Thus, in this study, we aimed to provide an update of the main characteristics of patients presenting with dysphagia to an outpatient clinic. METHODS: We retrospectively evaluated consecutive patients first referred to our outpatient clinic (June 2021-December 2022) for dysphagia as the main symptom. All patients underwent upper digestive endoscopy as the first diagnostic examination, with or without biopsies. According to clinician assessment, patients also underwent high-resolution manometry (HRM). RESULTS: During the study period, a total of 78 patients met the inclusion criteria. Endoscopy showed abnormal features in 25 patients (32.1%), and the most common findings were those associated with eosinophilic esophagitis ( n = 8, 10.3%). Biopsies of the esophagus and/or cardia were obtained in 61 patients (78.2%), and 28 patients had abnormal histologic findings. Overall, the most common histological diagnosis was eosinophilic esophagitis, identified in 12 patients (15.3%), with 4/12 (33.3%) without endoscopic alterations suggestive of this diagnosis. HRM was performed in 34/78 patients (43.6%), and in these patients, achalasia was the most common diagnosis (7/34, 20.6%). CONCLUSION: Among patients complaining of dysphagia referred to an outpatient gastroenterology clinic, eosinophilic esophagitis is the most common underlying cause of the symptom. Given its high frequency, biopsies should always be performed in patients with dysphagia, regardless of endoscopic findings.
Malignant bile duct obstruction and the microbiota: encouraging advances and unanswered questions.
Koker G
Eur J Gastroenterol Hepatol · 2025 Sep · PMID 40801210 · Publisher ↗
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Colorectal cancer mortality among Asian Americans: a disaggregated analysis from 2018 to 2023.
Tariq MA, Asrar A, Amin H
Eur J Gastroenterol Hepatol · 2025 Sep · PMID 40801209 · Publisher ↗
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Real-life data on hepatocellular carcinoma in the French prospective CHIEF cohort in the era of immunotherapy.
Nguyen-Khac E, Merle P, Ben Khadhra H … +30 more , Giuliana A, Decaens T, Uguen T, Blanc JF, Ganne-Carrie N, Bouattour M, Cattan S, Silvain C, Riachi G, Peron JM, Anty R, Bronowicki JP, Baron A, Pageaux GP, Loustaud-Ratti V, Oberti F, Allaire M, Manfredi S, Ben Merabet Y, Ollivier-Hourmand I, Lequoy M, Nousbaum JB, Gelu-Simeon M, Grados L, Nahon P, Costentin C, Barbare JC, Ducournau G, Ganry O, CHIEF Cohort Group
Eur J Gastroenterol Hepatol · 2025 Sep · PMID 40801208 · Publisher ↗
BACKGROUND: The burden of hepatocellular carcinoma (HCC) increases worldwide. We report the current landscape of HCC, in France. METHODS: Carcinome HépatocellulaIrE en France (CHIEF) is a national, prospective, observati...
BACKGROUND: The burden of hepatocellular carcinoma (HCC) increases worldwide. We report the current landscape of HCC, in France. METHODS: Carcinome HépatocellulaIrE en France (CHIEF) is a national, prospective, observational cohort initiated in 2019 with the aim of including 5000 patients with HCC, with a 5-year follow-up for each. CHIEF Epidemio 2000, is the first global analysis. RESULTS: In September 2021, 2043 patients were included in 32 centers. We analyzed 1640 patients, 86% men, 68-year-old, BMI 26.8. 70.8% of patients had cirrhosis (MELD score 9, Child-Pugh A in 77.8%, and portal hypertension in 39%. Liver disease was related to alcohol 58.5%, metabolic syndrome 39%, and virus 23.3%. HCC was confirmed by histology in 46.3%. The Milan criteria fulfilled 32.9%, median AFP 39 ng/ml, 5.9% portal thrombosis, and 10.7% metastases. BCLC classes 0, A, B, C, and D were 6.1, 29.8, 28.8, 32.1, and 3.2%, respectively. HCC was detected during a surveillance program in 35.2% associated with better survival (P < 0.001). Median follow-up was 17.76 months (29.1% deaths). The 6, 12, and 18 months overall survival rates were 84.9% (95% CI: 82.8-87), 76.7% (95% CI: 74.2-79.2), 69.3% (95% CI: 66.4-72.3). One-year survival for BCLC 0, A, B, C, and D was at 95.6, 89.7, 81.7, 54.9, and 40%, respectively (P < 0.0001). First-line treatment was curative, locoregional, or systemic in 40.5, 36.2, and 19.2%, with 1-year survival at 92.9, 82.2, and 57.8%, respectively (P < 0.0001). Atezolizumab-bevacizumab yielded a median overall survival of 17.05 months versus nine for TKI (P < 0.0001). CONCLUSION: In real-life data, metabolic syndrome becomes the second cause of HCC in France. The 1-year survival rates are high for all treatments applied, and Immunotherapy yields similar results than in trials.
Metabolomic comparative study in patients with liver cirrhosis and hepatocellular carcinoma related to hepatitis B virus infection.
Wang Y, Wang H, Wei S … +5 more , Gao Z, Gao H, Wang X, Liang H, Yang D
Eur J Gastroenterol Hepatol · 2025 Sep · PMID 40801207 · Publisher ↗
INTRODUCTION: Chronic hepatitis B virus (HBV) infection can increase the risk of developing liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Timely detection of precancerous lesions for patients with chronic HBV...
INTRODUCTION: Chronic hepatitis B virus (HBV) infection can increase the risk of developing liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Timely detection of precancerous lesions for patients with chronic HBV infection is critical in preventing worse consequences. The purpose of this study is to reveal the key serum metabolic biomarkers that can be applied to the early recognition of HCC in patients with HBV-associated cirrhosis. METHODS: Blood samples from patients with LC, HCC, and healthy subjects were collected, and endogenous metabolites in serum were detected by ultra high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF/MS). Differential metabolites (DM) were screened, and metabolic pathways and Kyoto Encyclopedia of Genes and Genomes signals involved in DM were analyzed. RESULTS: Metabolomics results revealed that patients with LC and HCC had significantly different metabolic characteristics. Patients with LC and HCC shared 22 biomarkers, LC had six different biomarkers, and HCC had 10 different biomarkers. The expressions of these metabolites all showed significant differences between groups. Pathway enrichment analysis revealed that the differential biomarkers of LC were primarily involved in the regulation of phospholipid biosynthesis, while the differential biomarkers of HCC were mainly involved in the regulation of endogenous androgen signaling, mitochondrial fatty acid metabolism, and purine metabolism signaling. The common biomarkers are enriched in bile acid metabolism, amino acid metabolism, and arachidonic acid metabolism. CONCLUSION: We clarified the blood metabolism characteristics of LC and HCC. These findings provided potential endogenous metabolic indicators for early recognition of HBV-chronically infected cirrhotic patients who may progress to HCC.
Investigation of the efficacy and safety of endoscopic wide band resection in the treatment of colorectal polyps.
Kutluana U
Eur J Gastroenterol Hepatol · 2025 Nov · PMID 40801204 · Publisher ↗
BACKGROUND AND STUDYS PURPOSE: Endoscopic band ligation is commonly used in gastroenterology but limited in colorectal polyps (CRPs) treatment due to narrow cap diameters. Endoscopic mucosal resection and endoscopic subm...
BACKGROUND AND STUDYS PURPOSE: Endoscopic band ligation is commonly used in gastroenterology but limited in colorectal polyps (CRPs) treatment due to narrow cap diameters. Endoscopic mucosal resection and endoscopic submucosal dissection (ESD) are effective but carry higher bleeding risks in patients with concomitant comorbidities. Considering the narrowest part of the colon, the rectosigmoid junction measures approximately 2.5 cm, we developed a custom endoscopic wide band resection (EWBR) cap with a 24 mm external diameter for CRPs <25 mm, particularly in high-risk patients. This study evaluates the efficacy and safety of EWBR. PATIENTS AND METHODS: We prospectively collected and analyzed the outcomes of 32 patients with CRPs treated using EWBR and 34 matched patients treated with ESD between November 2020 and December 2024. MAIN RESULTS: The groups were similar in age, gender, and lesion size (all P > 0.05). Comorbidities were significantly more common in the EWBR group (78.6 vs. 8.8%; P < 0.001). EWBR was associated with shorter procedure time (14.2 vs. 35 min; P < 0.001), lower rates of prolonged bleeding that extended the procedure (3.1 vs. 52.9%; P < 0.001), smaller hemoglobin decreases (0.55 vs. 1.17 g/dl; P = 0.002), and shorter hospital stays (1.03 vs. 2.11 days; P = 0.001). Only one patient (3.1%) in the EWBR group developed asymptomatic minor strictures. No recurrences were observed in either group. CONCLUSION: EWBR is a safe and effective alternative for CRPs <25 mm, especially in high-risk patients. It reduces procedure time, bleeding, and hospital stay, making it a promising therapeutic option.
Global, regional, and national burden of liver cancer due to hepatitis B, 1990-2021 and projections to 2051: a systematic analysis of the Global Burden of Disease Study 2021.
Yang P, Huang W, Xu Y … +7 more , Li Q, Shu X, Zuo J, Ren W, Huang Y, Teng Y, Shu P
Eur J Gastroenterol Hepatol · 2026 Feb · PMID 40742284 · Full text
PURPOSE: Using the Global Burden of Disease 2021 data, this study reports the global, regional, and national disease burden of liver cancer due to hepatitis B (LCDHB) from 1990 to 2021, stratified by age, sex, and sociod...
PURPOSE: Using the Global Burden of Disease 2021 data, this study reports the global, regional, and national disease burden of liver cancer due to hepatitis B (LCDHB) from 1990 to 2021, stratified by age, sex, and sociodemographic index (SDI), and projects future burden to 2051. METHODS: We examined incidence, deaths, and disability-adjusted life years (DALYs) of LCDHB. Age-standardized incidence rates (ASIR), age-standardized death rates (ASDR), and age-standardized DALYs rates were analyzed (1990-2021). Spearman correlation assessed age-standardized rates-SDI relationships. The Bayesian age-period-cohort (BAPC) model projected the burden to 2051. RESULTS: Compared to 1990, the number of LCDHB incidences, deaths, and DALYs increased by 46.9, 41.2, and 33.9% in 2021; however, from 1990 to 2021, the ASIR, ASDR, and age-standardized DALYs rate all exhibited a declining trend. In 2021, the highest ASIR occurred in East Asia, High-income Asia Pacific, and Western sub-Saharan Africa. At the national and regional levels, Mongolia, the Republic of Paraguay, and the Commonwealth of the Bahamas showed peak ASIR. ASIR was higher in males and increased with age, peaking at 85-89 age group for both males and females in 2021. A reverse U-shaped correlation existed between age-standardized DALYs and SDI during 1990-2021. BAPC projections indicate declining global ASIR, ASDR, and age-standardized DALYs rates (2021-2051). CONCLUSION: Despite rising incidence, deaths, and DALYs, LCDHB treatment challenges persist, especially for males and elderly populations. Our findings on epidemiological trends and demographic variations provide crucial insights for policymakers addressing this global health burden.
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