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Debourdeau A, Gonzalez JM, Mathias F, Prost C, Barthet M, Vitton V. Gastric volumetry for the assessment of fundic compliance and visceral hypersensitivity in patients with gastroparesis: a retrospective comparative study. Scand J Gastroenterol 2024; 59:254-259. [PMID: 37975245 DOI: 10.1080/00365521.2023.2279928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND/AIMS The evaluation of visceral hypersensitivity and gastric accommodation in patients with gastroparesis (GP) is difficult. CT-scan gastric volumetry allows to test the distension of different regions of the stomach. We aimed to study gastric volumes and patient's sensitivity to gastric distension between in patients with GP compared to patients with GERD. METHOD Retrospective study including patients who had CT-scan volumetry for GP or GERD. Two CT-scan series were made after gastric distension: left lateral decubitus 30° (LLD30) for antrum and right lateral decubitus (RLD) for body. Pain and discomfort were assessed using visual analogue scale (VAS). Gastric volumes were measured for LLD30 and RLD. RESULTS 13 patients (7 GP and 6 GERD) were included. Mean age was 35.6+/-7.3 years. Median gastric volume in the RLD was lower in GP vs GERD (927+/-208 ml vs. 1115+/-163 ml; p = 0.046) while it was similar for LLD30 (1053+/-228 ml vs. 1054+/-193 ml; p = 0.603). GP patients had significantly more pain and discomfort during the procedure: pain VAS for GP was 6[0-9] versus 0[0-2] for GERD, p = 0.004, discomfort VAS for GP was 7[4-10] versus 4[0-5] for GERD, p = 0.007. 66.7% of GERD patients felt no pain vs. 14.3% in GP, p = 0.053. CONCLUSION This pilot study suggests that GP could be associated with a reduced gastric volume compared to GERD in RLD after gaseous distension. In contrast, patient self-assessment of pain related to gastric distension was greater int GP patients. A lack of fundus accommodation and visceral hypersensitivity could explain some mechanisms in the genesis of GP symptoms.
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Affiliation(s)
- Antoine Debourdeau
- Gastroenterology Unit, CHU de Montpellier, Montpellier University MUSE, Montpellier, France
- Gastroenterology Unit, CHU de Nîmes, Montpellier University MUSE, Montpellier, France
| | - Jean-Michel Gonzalez
- Gastroenterology Unit, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Fanny Mathias
- Pharmacy Unit, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | | | - Marc Barthet
- Gastroenterology Unit, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Véronique Vitton
- Gastroenterology Unit, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
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Iwamuro M, Takenaka R, Toyokawa T, Kita M, Tsuzuki T, Yoshioka M, Gotoda T, Okanoue S, Matsubara M, Sakaguchi C, Otsuka M. Endoscopic and clinical features of gastric emphysema. Sci Rep 2024; 14:2202. [PMID: 38273039 PMCID: PMC10810885 DOI: 10.1038/s41598-024-52633-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/22/2024] [Indexed: 01/27/2024] Open
Abstract
Gastric emphysema is characterized by the presence of intramural gas in the stomach without bacterial infection. Due to its rarity, most reports on gastric emphysema have been limited to single-case studies, and this condition's clinical and endoscopic features have not been thoroughly investigated. In this study, we analyzed 45 patients with gastric emphysema from 10 institutions and examined their characteristics, endoscopic features, and outcomes. The mean age at diagnosis of gastric emphysema in our study population (35 males and 10 females) was 68.6 years (range, 14-95 years). The top five underlying conditions associated with gastric emphysema were the placement of a nasogastric tube (26.7%), diabetes mellitus (20.0%), post-percutaneous endoscopic gastrostomy (17.8%), malignant neoplasms (17.8%), and renal failure (15.6%). Among the 45 patients, 42 were managed conservatively with fasting and administration of proton pump inhibitors. Unfortunately, seven patients died within 30 days of diagnosis, and 35 patients experienced favorable recoveries. The resolution of gastric emphysema was confirmed in 30 patients through computed tomography (CT) scans, with a mean duration of 17.1 ± 34.9 days (mean ± standard deviation [SD], range: 1-180 days) from the time of diagnosis to the disappearance of the gastric intramural gas. There were no instances of recurrence. Endoscopic evaluation was possible in 18 patients and revealed that gastric emphysema presented with features such as redness, erosion, coarse mucosa, and ulcers, with fewer mucosal injuries on the anterior wall (72.2%), a clear demarcation between areas of mucosal injury and intact mucosa (61.1%), and predominantly longitudinal mucosal injuries on the stomach folds (50.0%). This study is the first English-language report to analyze endoscopic findings in patients with gastric emphysema.
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Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Ryuta Takenaka
- Department of Internal Medicine, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama, 708‑0841, Japan
| | - Tatsuya Toyokawa
- Department of Gastroenterology, National Hospital Organization Fukuyama Medical Center, 4-14-17 Okinogami-cho, Fukuyama, Hiroshima, 720-8520, Japan
| | - Masahide Kita
- Department of Internal Medicine, Okayama City Hospital, 3-20-1 Kitanagase Omote-cho, Kita-ku, Okayama, Okayama, 700‑8557, Japan
| | - Takao Tsuzuki
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, 1-12-1 Shimoteno, Himeji, Hyogo, 670-8540, Japan
| | - Masao Yoshioka
- Department of Internal Medicine, Okayama Saiseikai General Hospital, 2-25 Kokutai-cho, Kita-ku, Okayama, 700-8511, Japan
| | - Tatsuhiro Gotoda
- Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Shotaro Okanoue
- Department of Gastroenterology, Mitoyo General Hospital, 708 Himehama, Toyohama-cho, Kan-onji, Kagawa, 769-1695, Japan
| | - Minoru Matsubara
- Department of Gastroenterology, Sumitomo Besshi Hospital, 3-1, Ojicho, Niihama, Ehime, 792‑8543, Japan
| | - Chihiro Sakaguchi
- Department of Endoscopy, National Hospital Organization Shikoku Cancer Center, Kou 160, Minamiumemotomachi, Matsuyama, 791-0280, Japan
| | - Motoyuki Otsuka
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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3
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Wu TT, Zhang MY, Tan ND, Chen SF, Zhuang QJ, Luo Y, Xiao YL. Patients at risk for further examination with conventional gastroscopy after undergoing magnetically controlled capsule endoscopy. J Dig Dis 2023; 24:522-529. [PMID: 37681236 DOI: 10.1111/1751-2980.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE In this study we aimed to compare the need for further examination with conventional gastroscopy within 1 year after magnetically assisted capsule endoscopy (MCCE) examination between patients with gastrointestinal (GI) symptoms and asymptomatic individuals. METHODS After propensity score matching analysis, 372 patients with GI symptoms and 372 asymptomatic individuals who had undergone MCCE at the First Affiliated Hospital of Sun Yat-sen University from January 1, 2019 to December 30, 2020 were retrospectively enrolled. Demographic and clinical characteristics of the participants and their MCCE and gastroscopic findings (performed within 1 year after MCCE) were analyzed. RESULTS Fifty-one (6.85%) patients underwent further examination with conventional gastroscopy within 1 year after MCCE. Those with GI symptoms were more likely to undergo conventional gastroscopy than those without (9.95% vs 3.76%, P < 0.001). Polyps were the most common finding of MCCE. The rate of conventional gastroscopy in patients with focal lesions was significantly higher than that in those without focal lesions (P < 0.05). However, such rate did not differ in the different age groups (P = 0.106). CONCLUSIONS MCCE is an optimal alternative for gastric examination, especially for large-scale screening of asymptomatic individuals. Patients with GI symptoms or focal lesions detected by MCCE are more likely to seek further examination with conventional gastroscopy for biopsy or endoscopic treatment than those without.
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Affiliation(s)
- Ting Ting Wu
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Meng Yu Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Nian Di Tan
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Song Feng Chen
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Qian Jun Zhuang
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Yu Luo
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Ying Lian Xiao
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
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Deissová T, Zapletalová M, Kunovský L, Kroupa R, Grolich T, Kala Z, Bořilová Linhartová P, Lochman J. 16S rRNA gene primer choice impacts off-target amplification in human gastrointestinal tract biopsies and microbiome profiling. Sci Rep 2023; 13:12577. [PMID: 37537336 PMCID: PMC10400661 DOI: 10.1038/s41598-023-39575-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/27/2023] [Indexed: 08/05/2023] Open
Abstract
16S rRNA amplicon sequencing or, more recently, metatranscriptomic analysis are currently the only preferred methods for microbial profiling of samples containing a predominant ratio of human to bacterial DNA. However, due to the off-target amplification of human DNA, current protocols are inadequate for bioptic samples. Here we present an efficient, reliable, and affordable method for the bacteriome analysis of clinical samples human DNA content predominates. We determined the microbiota profile in a total of 40 human biopsies of the esophagus, stomach, and duodenum using 16S rRNA amplicon sequencing with the widely used 515F-806R (V4) primers targeting the V4 region, 68F-338R primers and a modified set of 68F-338R (V1-V2M) primers targeting the V1-V2 region. With the V4 primers, on average 70% of amplicon sequence variants (ASV) mapped to the human genome. On the other hand, this off-target amplification was absent when using the V1-V2M primers. Moreover, the V1-V2M primers provided significantly higher taxonomic richness and reproducibility of analysis compared to the V4 primers. We conclude that the V1-V2M 16S rRNA sequencing method is reliable, cost-effective, and applicable for low-bacterial abundant human samples in medical research.
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Affiliation(s)
- Tereza Deissová
- Department of Biochemistry, Faculty of Science, Masaryk University, Kamenice 735/5, 62500, Brno, Czech Republic
| | - Martina Zapletalová
- Department of Biochemistry, Faculty of Science, Masaryk University, Kamenice 735/5, 62500, Brno, Czech Republic
| | - Lumír Kunovský
- Department of Gastroenterology and Internal Medicine, University Hospital Brno, and Faculty of Medicine, Masaryk, University, Jihlavská 20, 62500, Brno, Czech Republic
- Department of Surgery, University Hospital Brno, and Faculty of Medicine, Masaryk University, Jihlavská 20, 62500, Brno, Czech Republic
| | - Radek Kroupa
- Department of Gastroenterology and Internal Medicine, University Hospital Brno, and Faculty of Medicine, Masaryk, University, Jihlavská 20, 62500, Brno, Czech Republic
| | - Tomáš Grolich
- Department of Gastroenterology and Internal Medicine, University Hospital Brno, and Faculty of Medicine, Masaryk, University, Jihlavská 20, 62500, Brno, Czech Republic
| | - Zdeněk Kala
- Department of Surgery, University Hospital Brno, and Faculty of Medicine, Masaryk University, Jihlavská 20, 62500, Brno, Czech Republic
| | - Petra Bořilová Linhartová
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 62500, Brno, Czech Republic
- Faculty of Science, RECETOX, Masaryk University, Kotlářská 2, Brno, Czech Republic
| | - Jan Lochman
- Department of Biochemistry, Faculty of Science, Masaryk University, Kamenice 735/5, 62500, Brno, Czech Republic.
- Department of Pathophysiology, Faculty of Medicine, Masaryk University, Jihlavská 20, 62500, Brno, Czech Republic.
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5
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Naz J, Sharif MI, Sharif MI, Kadry S, Rauf HT, Ragab AE. A Comparative Analysis of Optimization Algorithms for Gastrointestinal Abnormalities Recognition and Classification Based on Ensemble XcepNet23 and ResNet18 Features. Biomedicines 2023; 11:1723. [PMID: 37371819 DOI: 10.3390/biomedicines11061723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/23/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Esophagitis, cancerous growths, bleeding, and ulcers are typical symptoms of gastrointestinal disorders, which account for a significant portion of human mortality. For both patients and doctors, traditional diagnostic methods can be exhausting. The major aim of this research is to propose a hybrid method that can accurately diagnose the gastrointestinal tract abnormalities and promote early treatment that will be helpful in reducing the death cases. The major phases of the proposed method are: Dataset Augmentation, Preprocessing, Features Engineering (Features Extraction, Fusion, Optimization), and Classification. Image enhancement is performed using hybrid contrast stretching algorithms. Deep Learning features are extracted through transfer learning from the ResNet18 model and the proposed XcepNet23 model. The obtained deep features are ensembled with the texture features. The ensemble feature vector is optimized using the Binary Dragonfly algorithm (BDA), Moth-Flame Optimization (MFO) algorithm, and Particle Swarm Optimization (PSO) algorithm. In this research, two datasets (Hybrid dataset and Kvasir-V1 dataset) consisting of five and eight classes, respectively, are utilized. Compared to the most recent methods, the accuracy achieved by the proposed method on both datasets was superior. The Q_SVM's accuracies on the Hybrid dataset, which was 100%, and the Kvasir-V1 dataset, which was 99.24%, were both promising.
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Affiliation(s)
- Javeria Naz
- Department of Computer Science, COMSATS University Islamabad, Wah Campus, Wah 47040, Pakistan
| | - Muhammad Imran Sharif
- Department of Computer Science, COMSATS University Islamabad, Wah Campus, Wah 47040, Pakistan
| | - Muhammad Irfan Sharif
- Department of Computer Science, University of Education Lahore, Jauharabad Campus, Lahore 54770, Pakistan
| | - Seifedine Kadry
- Department of Applied Data Science, Noroff University College, 4612 Kristiansand, Norway
- Department of Electrical and Computer Engineering, Lebanese American University, Byblos P.O. Box 13-5053, Lebanon
- Artificial Intelligence Research Center (AIRC), College of Engineering and Information Technology, Ajman University, Ajman 346, United Arab Emirates
- MEU Research Unit, Middle East University, Amman 11831, Jordan
| | - Hafiz Tayyab Rauf
- Centre for Smart Systems, AI and Cybersecurity, Staffordshire University, Stoke-on-Trent ST4 2DE, UK
| | - Adham E Ragab
- Industrial Engineering Department, College of Engineering, King Saud University, P.O. Box 800, Riyadh 11421, Saudi Arabia
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6
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Wen X, Su B, Gao M, Chen J, Zhou D, You H, Li N, Chang S, Cheng X, Qian C, Gao J, Yang P, Qu S, Bu L. Correction to: Obesity-associated up-regulation of lipocalin 2 protects gastric mucosa cells from apoptotic cell death by reducing endoplasmic reticulum stress. Cell Death Dis 2023; 14:181. [PMID: 36878915 PMCID: PMC9988890 DOI: 10.1038/s41419-022-05546-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- Xin Wen
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.,National Metabolic Management Center, Shanghai, 200072, China
| | - Bin Su
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.,National Metabolic Management Center, Shanghai, 200072, China
| | - Mingming Gao
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, 250 West Green Street, Athens, GA, 30602, USA
| | - Jiaqi Chen
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.,Department of Endocrinology and Metabolism, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Donglei Zhou
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Hui You
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.,National Metabolic Management Center, Shanghai, 200072, China
| | - Nannan Li
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.,National Metabolic Management Center, Shanghai, 200072, China
| | - Shuaikang Chang
- Department of Hematology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Xiaoyun Cheng
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.,National Metabolic Management Center, Shanghai, 200072, China
| | - Chunhua Qian
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.,National Metabolic Management Center, Shanghai, 200072, China
| | - Jingyang Gao
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.,National Metabolic Management Center, Shanghai, 200072, China
| | - Peng Yang
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.,National Metabolic Management Center, Shanghai, 200072, China
| | - Shen Qu
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China. .,National Metabolic Management Center, Shanghai, 200072, China.
| | - Le Bu
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China. .,National Metabolic Management Center, Shanghai, 200072, China.
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Koyama Y, Sugimoto M, Kawai T, Mizumachi M, Yamanishi F, Matsumoto S, Suzuki Y, Nemoto D, Shinohara H, Ichimiya T, Muramatsu T, Kagawa Y, Matsumoto T, Madarame A, Morise T, Uchida K, Yamaguchi H, Kono S, Naito S, Fukuzawa M, Itoi T. Visibility of early gastric cancers by texture and color enhancement imaging using a high-definition ultrathin transnasal endoscope. Sci Rep 2023; 13:1994. [PMID: 36737509 DOI: 10.1038/s41598-023-29284-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
We evaluated whether texture and color enhancement imaging (TXI) using a high-definition ultrathin transnasal endoscope (UTE) improves the visibility of early gastric cancer (EGC) compared with white-light imaging (WLI). This study included 31 EGCs observed by TXI mode 2 using a high-definition UTE prior to endoscopic submucosal dissection. The first outcome was to compare the color differences based on Commission Internationale de l'Eclairage L*a*b* color space between EGCs and the surrounding mucosa by WLI and TXI using the UTE (objective appearance of EGC). The second outcome was to assess the visibility of EGCs by WLI and TXI using the UTE in an image evaluation test performed on 10 endoscopists (subjective appearance of EGC). Color differences between EGCs and non-neoplastic mucosa were significantly higher in TXI than in WLI in all EGCs (TXI: 16.0 ± 10.1 vs. WLI: 10.2 ± 5.5 [mean ± standard deviation], P < 0.001). Median visibility scores evaluated by 10 endoscopists using TXI were significantly higher than those evaluated using WLI (TXI: 4 [interquartile range, 4-4] vs. WLI: 4 [interquartile range, 3-4], P < 0.001). TXI using high-definition UTE improved both objective and subjective visibility of EGCs compared with WLI.
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8
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Shah S, Cappell K, Sedgley R, Pelletier C, Jacob R, Bonafede M, Yadlapati R. Diagnosis and treatment patterns among patients with newly diagnosed Helicobacter pylori infection in the United States 2016-2019. Sci Rep 2023; 13:1375. [PMID: 36697470 PMCID: PMC9876904 DOI: 10.1038/s41598-023-28200-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/13/2023] [Indexed: 01/27/2023] Open
Abstract
Approximately 36% of the United States (US) population is infected with Helicobacter pylori (HP), a known major risk factor for peptic ulcer disease and gastric cancer. HP eradication reduces the rate of complications; however, the benefits are undermined by rising rates of HP eradication treatment failure. This real-world observational cohort analysis aims to describe HP diagnostic and treatment patterns among insured patients in the US. Using diagnoses, lab results, and treatment patterns, we identified adults (18+) with new diagnoses of HP in the Veradigm Health Insights EHR Database linked to Komodo claims data (1/1/2016-12/31/2019). Patients were required to have ≥ 12 months of data pre-/post-index. We captured patient characteristics, HP-related diagnostic testing, and the use of US guideline-recommended HP eradication regimens. HP eradication rates following first-line eradication treatment were measured among patients with available lab results. Overall, 31.8% of the 60,593 included patients did not receive guideline-recommended treatment. Among the 68.2% (41,340) with first-line treatment, 80.2% received clarithromycin-based triple therapy, and 6.6% received bismuth quadruple therapy. Of the 4569 patients with a repeated course of eradication therapy, 53.4% received the same regimen as their first-line, the majority (90.7%) of whom received two rounds of clarithromycin-based triple therapy. Among the 2455 patients with results of HP non-serology testing following first-line treatment, the 180-day eradication rate was 80.2% overall, with differences based on treatments and demographics. This study highlights gaps between guideline-recommended HP management and real-world patterns, underscoring the need to improve HP testing, treatment, and follow-up practices.
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Affiliation(s)
- Shailja Shah
- University of California, San Diego, CA, USA. .,VA San Diego Healthcare System, San Diego, CA, USA.
| | | | | | | | - Rinu Jacob
- Phathom Pharmaceuticals, Florham Park, NJ, USA
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9
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Liu YF, Liu B. [Exploration on the treatment method of pericardium meridian for stomach diseases]. Zhongguo Zhen Jiu 2022; 42:821-824. [PMID: 35793896 DOI: 10.13703/j.0255-2930.20220308-k0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The ancient and modern discussions on the treatment of acupoints of the pericardium meridian of hand jueyin and non-acupoints along the meridian for stomach diseases were summarized, and the treatment principle of pericardium meridian for stomach diseases was explored. The relationship between pericardium meridian and stomach was discussed from the three perspectives of heart-stomach correlation, organ-meridian correlation and qi-position correlation. Based on these discussions, the guiding significance of the thoughts of selection effective treatment parts and the theoretical construction for clinical practice was considered and examined.
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Affiliation(s)
- Yi-Fei Liu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Bing Liu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
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10
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Ayyaz MS, Lali MIU, Hussain M, Rauf HT, Alouffi B, Alyami H, Wasti S. Hybrid Deep Learning Model for Endoscopic Lesion Detection and Classification Using Endoscopy Videos. Diagnostics (Basel) 2021; 12:diagnostics12010043. [PMID: 35054210 PMCID: PMC8775223 DOI: 10.3390/diagnostics12010043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
In medical imaging, the detection and classification of stomach diseases are challenging due to the resemblance of different symptoms, image contrast, and complex background. Computer-aided diagnosis (CAD) plays a vital role in the medical imaging field, allowing accurate results to be obtained in minimal time. This article proposes a new hybrid method to detect and classify stomach diseases using endoscopy videos. The proposed methodology comprises seven significant steps: data acquisition, preprocessing of data, transfer learning of deep models, feature extraction, feature selection, hybridization, and classification. We selected two different CNN models (VGG19 and Alexnet) to extract features. We applied transfer learning techniques before using them as feature extractors. We used a genetic algorithm (GA) in feature selection, due to its adaptive nature. We fused selected features of both models using a serial-based approach. Finally, the best features were provided to multiple machine learning classifiers for detection and classification. The proposed approach was evaluated on a personally collected dataset of five classes, including gastritis, ulcer, esophagitis, bleeding, and healthy. We observed that the proposed technique performed superbly on Cubic SVM with 99.8% accuracy. For the authenticity of the proposed technique, we considered these statistical measures: classification accuracy, recall, precision, False Negative Rate (FNR), Area Under the Curve (AUC), and time. In addition, we provided a fair state-of-the-art comparison of our proposed technique with existing techniques that proves its worthiness.
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Affiliation(s)
- M Shahbaz Ayyaz
- Department of Computer Science, University of Gujrat, Gujrat 50700, Pakistan; (M.S.A.); (M.H.)
| | - Muhammad Ikram Ullah Lali
- Department of Information Sciences, University of Education Lahore, Lahore 41000, Pakistan; (M.I.U.L.); (S.W.)
| | - Mubbashar Hussain
- Department of Computer Science, University of Gujrat, Gujrat 50700, Pakistan; (M.S.A.); (M.H.)
| | - Hafiz Tayyab Rauf
- Centre for Smart Systems, AI and Cybersecurity, Staffordshire University, Stoke-on-Trent ST4 2DE, UK
- Correspondence:
| | - Bader Alouffi
- Department of Computer Science, College of Computers and Information Technology, Taif University, P. O. Box 11099, Taif 21944, Saudi Arabia; (B.A.); (H.A.)
| | - Hashem Alyami
- Department of Computer Science, College of Computers and Information Technology, Taif University, P. O. Box 11099, Taif 21944, Saudi Arabia; (B.A.); (H.A.)
| | - Shahbaz Wasti
- Department of Information Sciences, University of Education Lahore, Lahore 41000, Pakistan; (M.I.U.L.); (S.W.)
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11
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Wen X, Su B, Gao M, Chen J, Zhou D, You H, Li N, Chang S, Cheng X, Qian C, Gao J, Yang P, Qu S, Bu L. Obesity-associated up-regulation of lipocalin 2 protects gastric mucosa cells from apoptotic cell death by reducing endoplasmic reticulum stress. Cell Death Dis 2021; 12:221. [PMID: 33637683 PMCID: PMC7910621 DOI: 10.1038/s41419-021-03512-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 12/12/2022]
Abstract
Gastric mucosal injury is a less well known complication of obesity. Its mechanism remains to be further elucidated. Here, we explored the protective role of lipocalin 2 (LCN2) against endoplasmic reticulum stress and cell apoptosis in gastric mucosa in patients and mice with obesity. Through molecular and genetic analyses in clinical species, LCN2 secreted by parietal cells expression is elevated in obese. Immunofluorescence, TUNEL, and colorimetry results show that a more significant upregulation of pro-inflammatory factors and increased amount of apoptotic cells in gastric tissue sections in obese groups. Loss- and gain-of-function experiments in gastric epithelial cells demonstrate that increased LCN2 protected against obesity associated gastric injury by inhibiting apoptosis and improving inflammatory state. In addition, this protective effect was mediated by repressing ER stress. Our findings identify LCN2 as a gastric hormone could be a compensatory protective factor against gastric injury in obese.
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Affiliation(s)
- Xin Wen
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
- National Metabolic Management Center, Shanghai, 200072, China
| | - Bin Su
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
- National Metabolic Management Center, Shanghai, 200072, China
| | - Mingming Gao
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, 250 West Green Street, Athens, GA, 30602, USA
| | - Jiaqi Chen
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
- Department of Endocrinology and Metabolism, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Donglei Zhou
- Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Hui You
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
- National Metabolic Management Center, Shanghai, 200072, China
| | - Nannan Li
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
- National Metabolic Management Center, Shanghai, 200072, China
| | - Shuaikang Chang
- Department of Hematology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
| | - Xiaoyun Cheng
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
- National Metabolic Management Center, Shanghai, 200072, China
| | - Chunhua Qian
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
- National Metabolic Management Center, Shanghai, 200072, China
| | - Jingyang Gao
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
- National Metabolic Management Center, Shanghai, 200072, China
| | - Peng Yang
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China
- National Metabolic Management Center, Shanghai, 200072, China
| | - Shen Qu
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
- National Metabolic Management Center, Shanghai, 200072, China.
| | - Le Bu
- Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
- National Metabolic Management Center, Shanghai, 200072, China.
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12
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Tamburini N, Andolfi C, Vigolo C, Sanzi M, Resta G, Marino S, Rubino S, Cavallesco G, Occhionorelli S, Vasquez G, Anania G. The Surgical Management of Acute Gastric Volvulus: Clinical Outcomes and Quality of Life Assessment. J Laparoendosc Adv Surg Tech A 2020; 31:247-250. [PMID: 33121383 DOI: 10.1089/lap.2020.0779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: Surgery is the mainstay of treatment for gastric volvulus. Despite its rarity, early experience from recent publications suggests that laparoscopy is a safe and effective approach for the treatment of acute gastric volvulus. Yet, more data focusing on patients' postoperative quality of life (QoL) is needed. The aim of this study is to report our institutional experience with the management of acute gastric volvulus, assessing surgical outcomes and postoperative QoL. Materials and Methods: We performed a retrospective review of a prospectively maintained database, looking for patients with gastric volvulus, requiring emergency laparotomic or laparoscopic surgery, between 2016 and 2018. Follow-up included clinical evaluation, barium swallow X-ray, and two QoL questionnaires-Gastroesophageal Reflux Disease-Health-Related Quality of Life and Gastrointestinal Symptom Rating Scale. Results: Over a 3-year period, 9 patients underwent emergency surgery for acute gastric volvulus, 5 (55%) of which were performed laparoscopically. In this group, the only postoperative complication was found in 1 (20%) patient who presented mild delayed gastric empty. In the laparotomic group, 3 patients (75%) had immediate (30-day) postoperative complications-1 pneumonia, 1 bowel obstruction, and 1 sepsis with multiorgan failure. At a median follow-up of 25 (15-48) months, hiatal hernia recurred in 1 (20%) patient after laparoscopic repair. No recurrence occurred in the open group. With a 100% response rate, QoL questionnaires revealed that 80% of the subjects treated laparoscopically were fully satisfied of the surgical approach, reporting slightly better QoL scores than the open surgery group. Conclusions: Improved postoperative clinical outcomes and QoL after laparoscopic repair of acute gastric volvulus provide encouraging evidence in support of this minimally invasive approach as an alternative to laparotomy.
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Affiliation(s)
- Nicola Tamburini
- Section of General and Thoracic Surgery, Department of Human Morphology, Surgery, and Experimental Medicine, University of Ferrara School of Medicine, Ferrara, Italy
| | - Ciro Andolfi
- Department of Surgery and Center for Simulation, The University of Chicago Pritzker School of Medicine and Biological Sciences Division, Chicago Illinois, USA.,MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, Illinois, USA
| | - Chiara Vigolo
- Section of General and Thoracic Surgery, Department of Human Morphology, Surgery, and Experimental Medicine, University of Ferrara School of Medicine, Ferrara, Italy
| | - Marcello Sanzi
- Section of General and Thoracic Surgery, Department of Human Morphology, Surgery, and Experimental Medicine, University of Ferrara School of Medicine, Ferrara, Italy
| | - Giuseppe Resta
- Section of General and Thoracic Surgery, Department of Human Morphology, Surgery, and Experimental Medicine, University of Ferrara School of Medicine, Ferrara, Italy
| | - Serafino Marino
- Section of General and Thoracic Surgery, Department of Human Morphology, Surgery, and Experimental Medicine, University of Ferrara School of Medicine, Ferrara, Italy
| | - Serena Rubino
- Section of General and Thoracic Surgery, Department of Human Morphology, Surgery, and Experimental Medicine, University of Ferrara School of Medicine, Ferrara, Italy
| | - Giorgio Cavallesco
- Section of General and Thoracic Surgery, Department of Human Morphology, Surgery, and Experimental Medicine, University of Ferrara School of Medicine, Ferrara, Italy
| | - Savino Occhionorelli
- Section of General and Thoracic Surgery, Department of Human Morphology, Surgery, and Experimental Medicine, University of Ferrara School of Medicine, Ferrara, Italy
| | - Giorgio Vasquez
- Section of General and Thoracic Surgery, Department of Human Morphology, Surgery, and Experimental Medicine, University of Ferrara School of Medicine, Ferrara, Italy
| | - Gabriele Anania
- Section of General and Thoracic Surgery, Department of Human Morphology, Surgery, and Experimental Medicine, University of Ferrara School of Medicine, Ferrara, Italy
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13
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Kouitcheu Mabeku LB, Noundjeu Ngamga ML, Leundji H. Helicobacter pylori infection, a risk factor for Type 2 diabetes mellitus: a hospital-based cross-sectional study among dyspeptic patients in Douala-Cameroon. Sci Rep 2020; 10:12141. [PMID: 32699242 PMCID: PMC7376106 DOI: 10.1038/s41598-020-69208-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/03/2020] [Indexed: 02/07/2023] Open
Abstract
Diabetic mellitus patients are usually prone to chronic infections. However, there have been contradictory reports about the association between H. pylori infection and type II diabetes. The present study is aimed at evaluating the prevalence of Helicobacter pylori infection among type 2 dyspeptic diabetic patients in the littoral region of Cameroon. This cross sectional study comprised 93 type 2 diabetic dyspeptic patients and 112 non-diabetic dyspeptic patients attending the Gastroenterology Department at two reference hospitals in Douala-Cameroon. The study was approved by the local Ethical Committee of Medical Sciences. Participants were screened for the presence of both type 2 diabetes and H. pylori infection. Body mass index (BMI) of all the participants was also recorded. Data was analyzed using SSPS statistical package. H. pylori infection was found in 73.11% of diabetic patients versus 58.05% in non-diabetic participants, this difference was found to be significant (OR = 1.472, p = 0.0279). This relationship persists even when adjusted to factors such as age and income level of participants. Infected participants from age group ≥ 55 years and those with high income were those with a higher risk to develop diabetes. Infected patients with high BMI were more prone to develops diabetic mellitus compared with infected patients with normal BMI (p = 0.0034). Also, participant with high BMI were more prone to develops diabetic mellitus whether they were infected or not. Patients having both H. pylori + ve and BMI ≥ 25 kg/m2 were significantly more affected by diabetic mellitus than those in the others combined groups (p < 0.0001), suggested that high BMI and H. pylori infection together or not are factors that favor diabetes mellitus development. Separately or not, H. pylori infection and high BMI were risk factor for diabetes mellitus in our milieu.
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Affiliation(s)
- Laure Brigitte Kouitcheu Mabeku
- Microbiology and Pharmacology Laboratory, Department of Biochemistry, Faculty of Science, University of Dschang, P. O. Box 67, Dschang, Cameroon.
| | - Michelle Larissa Noundjeu Ngamga
- Microbiology and Pharmacology Laboratory, Department of Biochemistry, Faculty of Science, University of Dschang, P. O. Box 67, Dschang, Cameroon
| | - Hubert Leundji
- Gastroenterology Department, Laquintinie Hospital of Douala, P. O. Box 4035, Douala, Cameroon
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14
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Horiuchi Y, Fujisaki J, Yamamoto N, Ishizuka N, Ishiyama A, Yoshio T, Hirasawa T, Yamamoto Y, Nagahama M, Takahashi H, Tsuchida T. Undifferentiated-type predominant mixed-type early gastric cancer is a significant risk factor for requiring additional surgeries after endoscopic submucosal dissection. Sci Rep 2020; 10:6748. [PMID: 32317768 PMCID: PMC7174380 DOI: 10.1038/s41598-020-63781-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/07/2020] [Indexed: 12/19/2022] Open
Abstract
We aimed to clarify the differences in therapeutic outcomes of patients with pure undifferentiated-type and mixed undifferentiated-type cancers who underwent endoscopic submucosal dissection (ESD), and whether pre-treatment diagnosis of mixed undifferentiated-type cancer is associated with requiring additional surgery after ESD. Patients subjected to ESD as initial treatment between May 2005 and March 2017 were enrolled. There were 277 undifferentiated-type cancers (265 patients). Histologically, 258 lesions were pure-type and 19 were mixed-type. We compared therapeutic outcomes and pre-treatment factors (tumour diameter, tumour depth, ulcerative findings, tumour location, and the macroscopic, and histological type of the biopsy specimen) between pure-type and mixed-type lesions, and between cases not requiring additional surgeries and cases requiring additional surgeries. Tumour diameter >20 mm, submucosal invasion, and the presence of ulcerative findings made pre-treatment diagnosis more difficult for mixed-type than for pure-type lesions. In cases requiring additional surgery, pre-treatment diagnosis of mixed-type lesions was significantly more likely than pre-treatment diagnosis of pure-type lesions. For mixed-type lesions, pre-treatment histological diagnosis and careful consideration are necessary to determine indications for ESD to avoid additional surgery after ESD.
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Affiliation(s)
- Yusuke Horiuchi
- Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan.
| | - Junko Fujisaki
- Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
| | - Noriko Yamamoto
- Department of Pathology, Cancer Institute Hospital, Tokyo, Japan
| | - Naoki Ishizuka
- Department of Clinical Trial Planning and Management, Cancer Institute Hospital, Tokyo, Japan
| | - Akiyoshi Ishiyama
- Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
| | - Toshiyuki Yoshio
- Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
| | - Toshiaki Hirasawa
- Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
| | - Yorimasa Yamamoto
- Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Masatsugu Nagahama
- Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Hiroshi Takahashi
- Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Tomohiro Tsuchida
- Department of Gastroenterology, Cancer Institute Hospital, Tokyo, Japan
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15
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Laube R, Liu K, Schifter M, Yang JL, Suen MK, Leong RW. Oral and upper gastrointestinal Crohn's disease. J Gastroenterol Hepatol 2018; 33:355-364. [PMID: 28708248 DOI: 10.1111/jgh.13866] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/31/2017] [Accepted: 07/06/2017] [Indexed: 12/19/2022]
Abstract
Crohn's disease is a heterogeneous, inflammatory condition that can affect any location of the gastrointestinal tract. Proximal gastrointestinal involvement occurs in 0.5-16% of patients, and it is usually diagnosed after recognition of intestinal disease. Symptoms are often mild and nonspecific; however, upper gastrointestinal disease predicts a more severe Crohn's phenotype with a greater frequency of complications such as obstruction and perforation. Gastroscopy and biopsy is the most sensitive diagnostic investigation. There is a paucity of data examining the treatment of this condition. Management principles are similar to those for intestinal disease, commencing with topical therapy where appropriate, progressing to systemic therapy such as glucocorticoids, 5-aminosalicylic acid, immunomodulators, and biologics. Acid suppression therapy has symptomatic but no anti-inflammatory benefit for gastroduodenal and esophageal involvement. Surgical intervention with bypass, strictureplasty, or less frequently, endoscopic balloon dilation may be required for complications or failed medical therapy.
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Affiliation(s)
- Robyn Laube
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Ken Liu
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Mark Schifter
- Department of Oral Medicine, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Dentistry, Sydney University, Sydney, New South Wales, Australia
| | - Jessica L Yang
- Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Michael K Suen
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Rupert W Leong
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
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