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Learning curve of achieving competency in emergency endoscopy in upper gastrointestinal bleeding: how much experience is necessary? BMJ Open Gastroenterol. Pub Date : 2024-03-01 Gabriel Allo, Sonja Lang, Anna Martin, Martin Bürger, Xinlian Zhang, Seung-Hun Chon, Dirk Nierhoff, Ulrich Töx, Tobias Goeser, Philipp Kasper
Objectives The management of upper gastrointestinal bleeding (UGIB) has seen rapid advancements with revolutionising innovations. However, insufficient data exist on the necessary number of emergency endoscopies needed to achieve competency in haemostatic interventions. Design We retrospectively analysed all oesophagogastroduodenoscopies with signs of recent haemorrhage performed between 2015 and 2022
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Prepublication abstract-only reports compared with full-text manuscripts for randomised controlled trials in inflammatory bowel disease: a systematic review BMJ Open Gastroenterol. Pub Date : 2024-03-01 Vassiliki Sinopoulou, Morris Gordon, Gordon William Moran, Abdullah Mohammed Abousaleh ma Egiz, Sanjana Phlananthachai, Aditi Rane, Ahmed Hussein Ali Al-Tameemi
Introduction Randomised controlled trials (RCTs) of key therapies in inflammatory bowel disease (IBD) are often presented and available as abstracts for significant periods of time prior to full publication, often being employed to make strategic and clinical prescribing decisions. We compared the concordance of prepublication abstract-only reports and their respective full-text manuscripts. Methods
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CD, or not CD, that is the question: a digital interobserver agreement study in coeliac disease BMJ Open Gastroenterol. Pub Date : 2024-02-01 James Denholm, Benjamin A Schreiber, Florian Jaeckle, Mike N Wicks, Emyr W Benbow, Tim S Bracey, James Y H Chan, Lorant Farkas, Eve Fryer, Kishore Gopalakrishnan, Caroline A Hughes, Kathryn J Kirkwood, Gerald Langman, Betania Mahler-Araujo, Raymond F T McMahon, Khun La Win Myint, Sonali Natu, Andrew Robinson, Ashraf Sanduka, Katharine A Sheppard, Yee Wah Tsang, Mark J Arends, Elizabeth J Soilleux
Objective Coeliac disease (CD) diagnosis generally depends on histological examination of duodenal biopsies. We present the first study analysing the concordance in examination of duodenal biopsies using digitised whole-slide images (WSIs). We further investigate whether the inclusion of immunoglobulin A tissue transglutaminase (IgA tTG) and haemoglobin (Hb) data improves the interobserver agreement
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Efficacy of TIPS plus extrahepatic collateral embolisation in real-world data: a validation study BMJ Open Gastroenterol. Pub Date : 2024-02-01 Lianhui Zhao, Jun Tie, Guangchuan Wang, Zhengjie Li, Jiao Xu, Yuzheng Zhuge, Feng Zhang, Hao Wu, Bo Wei, Hui Xue, Peijie Li, Wei Wu, Chao Chen, Qiong Wu, Yifu Xia, Xiubin Sun, Chunqing Zhang
Objectives The efficacy of transjugular intrahepatic portosystemic shunt (TIPS) plus extrahepatic collateral embolisation (TIPS+E) in reducing rebleeding and hepatic encephalopathy (HE) post-TIPS was recently reported in a meta-analysis, but further validation is essential. This study aims to confirm the effectiveness of TIPS+E using real-world data. Methods The multicentre retrospective cohort included
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Role of exhaled hydrogen sulfide in the diagnosis of colorectal cancer BMJ Open Gastroenterol. Pub Date : 2024-02-01 Peizhun Du, Yujen Tseng, Pengcheng Liu, Huilu Zhang, Guangjian Huang, Cheng’en Hu, Jian Chen
Background Colorectal cancer (CRC) is often accompanied by increased excretion of hydrogen sulfide (H2S). This study aimed to explore the value of exhaled H2S in the diagnosis of CRC. Methods A total of 80 people with normal colonoscopy results and 57 patients with CRC were enrolled into the present observational cohort study. Exhaled oral and nasal H2S were detected by Nanocoulomb breath analyser
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Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment? BMJ Open Gastroenterol. Pub Date : 2024-02-01 Christian Philipp Selinger, Konstantina Rosiou, Marco V Lenti
Inflammatory bowel disease (IBD) treatment was revolutionised with the arrival of biological therapy two decades ago. There are now multiple biologics and increasingly novel small molecules licensed for the treatment of IBD. Treatment guidelines highlight the need for effective control of inflammation and early escalation to advanced therapies to avoid long-term complications. Consequently, a large
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Determining the optimal treatment target in patients with ulcerative colitis: rationale, design, protocol and interim analysis for the randomised controlled VERDICT trial BMJ Open Gastroenterol. Pub Date : 2024-02-01 Vipul Jairath, Guangyong Zou, Zhongya Wang, Shashi Adsul, Jean-Frederic Colombel, Geert R D’Haens, Marcelo Freire, Gordon W Moran, Laurent Peyrin-Biroulet, William J Sandborn, Shaji Sebastian, Simon Travis, Séverine Vermeire, Gabriela Radulescu, Julie Sigler, Jurij Hanžel, Christopher Ma, Rocio Sedano, Stefanie C McFarlane, Naveen Arya, Melanie Beaton, Peter Bossuyt, Silvio Danese, Daniel Green, William
Introduction Symptoms, endoscopy and histology have been proposed as therapeutic targets in ulcerative colitis (UC). Observational studies suggest that the achievement of histologic remission may be associated with a lower risk of complications, compared with the achievement of endoscopic remission alone. The actiVE ulcerative colitis, a RanDomIsed Controlled Trial (VERDICT) aims to determine the optimal
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Mpox gastrointestinal manifestations: a systematic review BMJ Open Gastroenterol. Pub Date : 2024-01-01 Rahul Ramakrishnan, Atira Shenoy, Ranganathan Madhavan, Damon Meyer
Introduction Mpox is a viral infection caused by the monkeypox virus, a member of the Poxviridae family and Orthopoxvirus genus. Other well-known viruses of the Orthopoxvirus genus include the variola virus (smallpox), cowpox virus and vaccinia virus. Although there is a plethora of research regarding the dermatological and influenza-like symptoms of mpox, particularly following the 2022 mpox outbreak
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Investigating the role of iron status in the development of coeliac disease: a Mendelian randomisation study BMJ Open Gastroenterol. Pub Date : 2024-01-01 Isabel A Hujoel, Margaux Louise Anna Hujoel
Objective The environmental trigger behind the increasing prevalence of coeliac disease is not known. One suggested cause is iron deficiency, which is common in coeliac disease. We aimed to evaluate this possible association with Mendelian randomisation (MR), which under certain assumptions can suggest a causal relationship. Design We conducted a two-sample MR study examining the relationship between
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Impact of AI-aided colonoscopy in clinical practice: a prospective randomised controlled trial BMJ Open Gastroenterol. Pub Date : 2024-01-01 Johanna Schöler, Marko Alavanja, Thomas de Lange, Shunsuke Yamamoto, Per Hedenström, Jonas Varkey
Objective Colorectal cancer (CRC) has a significant role in cancer-related mortality. Colonoscopy, combined with adenoma removal, has proven effective in reducing CRC incidence. However, suboptimal colonoscopy quality often leads to missed polyps. The impact of artificial intelligence (AI) on adenoma and polyp detection rate (ADR, PDR) is yet to be established. Design We conducted a randomised controlled
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Mental Imagery to Reduce Alcohol-related harm in patients with alcohol use disorder and alcohol-related liver damaGE: the MIRAGE randomised pilot trial results BMJ Open Gastroenterol. Pub Date : 2024-01-01 Ashwin Dhanda, Jackie Andrade, Hannah Allende, Victoria Allgar, Matthew Bailey, Lynne Callaghan, Laura Cocking, Elizabeth Goodwin, Annie Hawton, Christopher Hayward, Ben Hudson, Wendy Ingram, Alison Jeffery, Angela King, Victoria Lavers, Joe Lomax, C Anne McCune, Crispin Musicha, Richard Parker, Christopher Rollinson, Jonny Wilks, E Siobhan Creanor
Objective The healthcare burden of alcohol-related liver disease (ARLD) is increasing. ARLD and alcohol use disorder (AUD) is best managed by reduction or cessation of alcohol use, but effective treatments are lacking. We tested whether people with ARLD and AUD admitted to hospital could be recruited to and retained in a trial of Functional Imagery Training (FIT), a psychological therapy that uses
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Controversies in the management of anti-TNF therapy in patients with Crohn’s disease: a Delphi consensus BMJ Open Gastroenterol. Pub Date : 2024-01-01 Yago González-Lama, Elena Ricart, Daniel Carpio, Guillermo Bastida, Daniel Ceballos, Daniel Ginard, Ignacio Marin-Jimenez, Luis Menchen, Fernando Muñoz
Background Despite research, there are still controversial areas in the management of Crohn’s disease (CD). Objective To establish practical recommendations on using anti-tumour necrosis factor (TNF) drugs in patients with moderate-to-severe CD. Methods Clinical controversies in the management of CD using anti-TNF therapies were identified. A comprehensive literature review was performed, and a national
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Association of metabolic dysfunction-associated fatty liver disease with gastrointestinal infections: insights from National Inpatient Sample Database BMJ Open Gastroenterol. Pub Date : 2024-01-01 Jay Patel, Aalam Sohal, Kanwal Bains, Hunza Chaudhry, Isha Kohli, Tejasvini Khanna, Dino Dukovic, Marina Roytman
Objectives The study aimed to compare the risk of gastrointestinal infections among patients with and without metabolic dysfunction-associated fatty liver disease (MAFLD). Methods This was a population-based, retrospective, observational study using data from the National Inpatient Sample (NIS), the largest all-payer US inpatient care database. Setting Hospitalisation of adults aged ≥18 years old admitted
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Validity assessment of the POLARS score tool in the prediction of post rectal cancer surgery LARS score in a population-based Swedish cohort BMJ Open Gastroenterol. Pub Date : 2024-01-01 Boglarka Rethy, Caroline Nordenvall, Emil Pieniowski, Gabriella Jansson-Palmer, Asif Johar, Pernilla Lagergren, Mirna Abraham-Nordling
Objective Low anterior resection syndrome (LARS) is one of the most common functional impairments after rectal cancer surgery with a high impact on quality of life. The Pre-Operative LARS score (POLARS) nomogram and its online tool has been developed to predict the degree of postoperative LARS. The aim of this study was to analyse how accurately the POLARS score could predict LARS scores when compared
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Naturally nutrient rich (NNR) score and the risk of colorectal cancer: a case-control study BMJ Open Gastroenterol. Pub Date : 2023-12-01 Naeemeh Hassanpour Ardekanizadeh, Mahdi Mousavi Mele, Saeideh Mohammadi, Soheila Shekari, Mobina Zeinalabedini, Mohammad Masoumvand, Seyedeh Hayedeh Mousavi Shalmani, Seyed Ali Askarpour, Maryam Gholamalizadeh, Farhad Vahid, Saeid Doaei
Background The association between colorectal cancer (CRC) and nutrients has been studied frequently. However, the association of nutrient density of diets with the risk of CRC has been less studied. This study aimed to investigate the association between CRC and naturally nutrient rich (NNR) score in Iranian adults. Method This case-control study included 160 patients with colorectal cancer and 320
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Does Hispanic ethnicity play a role in outcomes for diverticular surgery in the USA? BMJ Open Gastroenterol. Pub Date : 2023-12-01 Jesse K Kelley, Kathrine Kelly, Charles Reed, Nathan Winkler, Jessica Parker, James Ogilvie
Objective The aim of this study is to investigate whether origins of ethnicity affect the outcomes of surgery for diverticulitis in the USA. Design The American College of Surgeons National Surgical Quality Improvement Programme database from 2008 to 2017 was used to identify patients undergoing colectomy for diverticulitis. Patient demographics, comorbidities, procedural details and outcomes were
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People with IBD evidence more microarousals during sleep architecture assessments BMJ Open Gastroenterol. Pub Date : 2023-12-01 Jessica K Salwen-Deremer, Matthew J Reid, Sarah J Westvold, Corey A Siegel, Michael T Smith
Objective Poor sleep is common in inflammatory bowel disease (IBD) and may be associated with overall worse disease outcomes. While the sleep/IBD literature is growing, the data are often self-reported. Further, much of the research using objective measures of sleep architecture, or the overall pattern of sleep depth, rely on single-night assessments, which can be of questionable validity. Design Participants
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Role of artificial intelligence in imaging and endoscopy for the diagnosis, monitoring and prognostication of inflammatory bowel disease: a scoping review protocol BMJ Open Gastroenterol. Pub Date : 2023-12-01 Mallory Chavannes, Lynn Kysh, Mariangela Allocca, Noa Krugliak Cleveland, Michael Todd Dolinger, Tom S Robbins, David T Rubin, Shintaro Sagami, Bram Verstockt, Kerri Novak
Introduction Inflammatory bowel diseases (IBD) are immune-mediated conditions that are increasing in incidence and prevalence worldwide. Their assessment and monitoring are becoming increasingly important, though complex. The best disease control is achieved through tight monitoring of objective inflammatory parameters (such as serum and stool inflammatory markers), cross-sectional imaging and endoscopic
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Complications of colonoscopy: common and rare—recognition, assessment and management BMJ Open Gastroenterol. Pub Date : 2023-12-01 William Waddingham, Umair Kamran, Bhaskar Kumar, Nigel J Trudgill, Zacharias P Tsiamoulos, Matthew Banks
An understanding of the potential complications of diagnostic lower gastrointestinal endoscopy is a necessary part of being an independent endoscopist. Creating a culture of safety and prevention of adverse events (AEs) should be part of routine endoscopy practice. Appropriate patient selection for procedures, informed consent, peri-procedure risk assessments and an inclusive team approach, all contribute
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Progression of the FIB-4 index among patients with chronic HCV infection and early liver disease BMJ Open Gastroenterol. Pub Date : 2023-12-01 Lisette A P Krassenburg, Raoel Maan, Amy Puenpatom, Nicole S Erler, Christoph Welsch, Stijn van Hees, Orlando Cerrhoci, Johannes Vermehren, Robert J de Knegt, Bettina E Hansen, Stefan Zeuzem, Thomas Vanwolleghem, Harry L A Janssen, Robert A de Man, Jordan J Feld, Adriaan J van der Meer
Background and aims Historical paired liver biopsy studies are likely to underestimate current progression of disease in patients with chronic hepatitis C virus (HCV) infection. We aimed to assess liver disease progression according to the non-invasive Fibrosis-4 (FIB-4) index in patients with chronic HCV and early disease. Methods and results Patients diagnosed with chronic HCV and FIB-4 <3.25 from
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Evaluating clinical outcomes and prognosis in patients with cirrhosis and portal hypertension: a retrospective observational cohort study BMJ Open Gastroenterol. Pub Date : 2023-11-01 Nerissa Hoi Ching Lee, Steven J Kiddle, Shardul Chandankhede, Shubh Agrawal, Daniel M Bean, Phillip R Hunt, Victoria E R Parker, Peter J Greasley, Philip Ambery
Objective Cirrhosis describes the end-stage of chronic liver disease. Irreversible changes in the liver cause portal hypertension, which can progress to serious complications and death. Only a few studies with small sample sizes have investigated the prognosis of cirrhosis with portal hypertension. We used electronic healthcare records to examine liver-related outcomes in patients with diagnosed/suspected
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Interval colorectal cancers after negative faecal immunochemical test in the New Zealand Bowel Screening Pilot BMJ Open Gastroenterol. Pub Date : 2023-11-01 Kai Sheng Saw, Kerry Sexton, Paul Frankish, Mike Hulme-Moir, Ian Bissett, Susan Parry
Objective Evaluate the diagnostic performance of faecal immunochemical test (FIT), identify risk factors for FIT-interval colorectal cancers (FIT-IC) and describe long-term outcomes of participants with colorectal cancers (CRC) in the New Zealand Bowel Screening Pilot (BSP). Design From 2012 to 2017, the BSP offered eligible individuals, aged 50–74 years, biennial screening using a quantitative FIT
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Cardiac and intramuscular adaptations following short-term exercise prehabilitation in unfit patients scheduled to undergo hepatic or pancreatic surgery: study protocol of a multinuclear MRI study BMJ Open Gastroenterol. Pub Date : 2023-11-01 Allard G Wijma, Heleen Driessens, Jeroen A L Jeneson, Maryska L G Janssen-Heijnen, Tineke P Willems, Joost M Klaase, Bart C Bongers
Introduction Short-term exercise prehabilitation programmes have demonstrated promising results in improving aerobic capacity of unfit patients prior to major abdominal surgery. However, little is known about the cardiac and skeletal muscle adaptations explaining the improvement in aerobic capacity following short-term exercise prehabilitation. Methods and analysis In this single-centre study with
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Practical multidisciplinary framework for the assessment and management of patients with unexplained chronic aerodigestive symptoms BMJ Open Gastroenterol. Pub Date : 2023-11-01 Nathan Quigley, Sandeep G Mistry, Dipesh H Vasant, Sarju Vasani
Objective Patients experiencing unexplained chronic throat symptoms (UCTS) are frequently referred to gastroenterology and otolaryngology outpatient departments for investigation. Often despite extensive investigations, an identifiable structural abnormality to account for the symptoms is not found. The objective of this article is to provide a concise appraisal of the evidence-base for current approaches
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Elobixibat improves rectal sensation in patients with chronic constipation aged ≥60 years: a randomised placebo-controlled study BMJ Open Gastroenterol. Pub Date : 2023-11-01 Noriaki Manabe, Minami Umeyama, Sonoko Ishizaki, Takumi Ota, Shinji Kuratani, Ryo Katsumata, Minoru Fujita, Ken Haruma, Michael Camilleri
Objective High rectal sensory thresholds (RSTs) are associated with chronic constipation (CC), especially in older patients. Bile acids (BAs) affect the RSTs of healthy individuals. Here, we aimed to investigate the effects of the BA transporter inhibitor elobixibat in patients with CC aged ≥60 years. Design We prospectively compared the RSTs of 17 patients with CC aged ≥60 years with those of 9 healthy
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Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the West of Scotland: a cohort study BMJ Open Gastroenterol. Pub Date : 2023-11-01 Alistair Stewart McLaren, Johannes A Spoor, Douglas Cartwright, Gregory Naylor, Stephen Barclay, Matthew Priest, Srikanth Puttagunta, Kirsty Armstrong, Stuart Ballantyne, Adrian Stanley, Thomas R Jeffry Evans
Objective The COVID-19 pandemic had an undoubted impact on the provision of elective and emergency cancer care, including the diagnosis and management of patients with hepatocellular carcinoma (HCC). Our aim was to determine the effects of the COVID-19 pandemic on patients with HCC in the West of Scotland. Design This was a retrospective audit of a prospectively collated database of patients presented
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COVID-19 severity is associated with the risk of gastrointestinal bleeding BMJ Open Gastroenterol. Pub Date : 2023-11-01 Shuji Hibiya, Takashi Fujii, Toshimitsu Fujii, Shinji Suzuki, Mayumi Kondo, Shinya Ooka, Yohei Furumoto, Seishin Azuma, Kei Tanaka, Hitoshi Kurata, Shohei Tanaka, Masayuki Kurosaki, Kazuyoshi Nagayama, Fumihiko Kusano, Yasuhiro Iizuka, Takahiro Kawamura, Hidekazu Ikemiyagi, Shinya Sakita, Tsunehito Yauchi, Hideki Watanabe, Ami Kawamoto, Yusuke Matsuyama, Kazuo Ohtsuka, Ryuichi Okamoto
Objective The association between the severity of COVID-19 and gastrointestinal (GI) bleeding is unknown. This study aimed to determine whether the severity of COVID-19 is a risk factor for GI bleeding. Design A multicentre, retrospective cohort study was conducted on hospitalised patients with COVID-19 between January 2020 and December 2021. The severity of COVID-19 was classified according to the
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Quality standards for the management of alcohol-related liver disease: consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology ARLD special interest group BMJ Open Gastroenterol. Pub Date : 2023-10-01 Richard Parker, Michael Allison, Seonaid Anderson, Richard Aspinall, Sara Bardell, Vikram Bains, Ryan Buchanan, Lynsey Corless, Ian Davidson, Pauline Dundas, Jeff Fernandez, Ewan Forrest, Erica Forster, Dennis Freshwater, Ruth Gailer, Robert Goldin, Vanessa Hebditch, Steve Hood, Arron Jones, Victoria Lavers, Deborah Lindsay, James Maurice, Joanne McDonagh, Sarah Morgan, Tania Nurun, Christopher Oldroyd
Objective Alcohol-related liver disease (ALD) is the most common cause of liver-related ill health and liver-related deaths in the UK, and deaths from ALD have doubled in the last decade. The management of ALD requires treatment of both liver disease and alcohol use; this necessitates effective and constructive multidisciplinary working. To support this, we have developed quality standard recommendations
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Time to treat the climate and nature crisis as one indivisible global health emergency BMJ Open Gastroenterol. Pub Date : 2023-10-01 Chris Zielinski
Over 200 health journals call on the United Nations (UN), political leaders and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency. The world is currently responding to the climate crisis and
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Polygenic risk score predicts risk of primary sclerosing cholangitis in inflammatory bowel disease BMJ Open Gastroenterol. Pub Date : 2023-10-01 Ming-Hsi Wang, Jessica J Friton, Laura E Raffals, Jonathan A Leighton, Shabana F Pasha, Michael F Picco, Kelly Monroe, Billy D Nix, Rodney D Newberry, William A Faubion
Background Forty distinct primary sclerosing cholangitis (PSC) genomic loci have been identified through multiancestry meta-analyses. The polygenic risk score (PRS) could serve as a promising tool to discover unique disease behaviour, like PSC, underlying inflammatory bowel disease (IBD). Aim To test whether PRS indicates PSC risk in patients with IBD. Materials and methods Mayo Clinic and Washington
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Implementation of BSG/ACPGBI/PHE polypectomy surveillance guidelines safely reduces the burden of surveillance in a screening cohort: a virtual model study BMJ Open Gastroenterol. Pub Date : 2023-09-01 Roisin Stack, Jayne Doherty, Neil O'Moráin, Blathnaid Nolan, Juliette Sheridan, Garret Cullen, Hugh Mulcahy, Maire Buckley, Gareth Horgan, Mohamed Hamed, Edel McDermott, Glen Doherty
Objective To evaluate the impact of British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England (BSG/ACPGBI/PHE) 2019 polypectomy surveillance guidelines within a national faecal immunochemical test-based bowel cancer screening (BS) cohort on surveillance activity and detection of pathology by retrospective virtual application. Design A retrospective
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Evaluation of vitamin B6 supplementation in Wilson’s disease patients treated with D-penicillamine BMJ Open Gastroenterol. Pub Date : 2023-08-01 Justin Mbala, Abdelouahed Belmalih, Olivier Guillaud, Alain Lachaux, Eduardo Couchonnal Bedoya
Introduction Wilson’s disease (WD) is a copper metabolism disorder characterised by a progressive accumulation of this metal mainly in the liver and the brain. Treatment is based on the removal of copper operated by the chelators, among which, D-penicillamine (DP) is prescribed as a first-line treatment in most situations. There is some evidence in linking the use of DP with a risk of vitamin B6; therefore
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Evaluation of the efficacy and safety of an innovative flavonoid lotion in patients with haemorrhoid: a randomised clinical trial BMJ Open Gastroenterol. Pub Date : 2023-08-01 Sara Razdar, Yunes Panahi, Ramtin Mohammadi, Leila Khedmat, Hossein Khedmat
Objective Haemorrhoids are one of the most common gastrointestinal and anal diseases. In olive oil and honey propolis, flavonoids have beneficial effects on improving vascular function and decreasing vascular resistance. In this study, we aimed to produce a combination of these two substances in the form of lotions and assess their healing and side effects in comparison with routine treatment, anti-haemorrhoid
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Vascular pathology in patients with alveolar echinococcosis: framework for assessment and clinical management – a retrospective case series BMJ Open Gastroenterol. Pub Date : 2023-08-01 Paula Gieser, Uta Merle, Thomas Junghanss, Tim F Weber, Marija Stojković
Objective Alveolar echinococcosis (AE) is a parasitic liver disease with infiltrative growth similar to solid organ malignancies. Major vascular damage is frequent and often remains untreated until catastrophic events precipitate. Detailed clinical and radiological assessment is required to guide individualised treatment decisions. Standardised radiological reporting templates of malignancies with
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Cost-effectiveness analysis of antibiotic prophylaxis versus no antibiotic prophylaxis for acute cholecystectomy BMJ Open Gastroenterol. Pub Date : 2023-08-01 Maya Satheeskaran, Aminah Hussan, Ailin Anto, Laure de Preux
Objective For acute cholecystitis, the treatment of choice is laparoscopic cholecystectomy. In mild-to-moderate cases, the use of antibiotic prophylaxis for the prevention of postoperative infectious complications (POICs) lacks evidence regarding its cost-effectiveness when compared with no prophylaxis. In the context of rising antimicrobial resistance, there is a clear rationale for a cost-effectiveness
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Technical and clinical outcomes following EUS-guided thrombin injection and coil implantation for parastomal varices BMJ Open Gastroenterol. Pub Date : 2023-08-01 Andrew Todd, Chander Shekhar, Joanne O’Rourke, Colm Forde, Arvind Pallan, Sharan Suresh Wadhwani, Dhiraj Tripathi, Brinder Singh Mahon
Background and aims Bleeding from parastomal varices causes significant morbidity and mortality. Treatment options are limited, particularly in high-risk patients with significant underlying liver disease and other comorbidities. The use of EUS-guided embolisation coils combined with thrombin injection in gastric varices has been shown to be safe and effective. Our institution has applied the same
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Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists BMJ Open Gastroenterol. Pub Date : 2023-07-01 Daisuke Murakami, Masayuki Yamato, Yuji Amano, Takayoshi Nishino, Makoto Arai
Objective The documented variation in gastric cancer (GC) detection among endoscopists has often been dismissed as a coincidental artefact of the low incidence of gastric neoplasms; it is not considered associated with differences in physicians’ performance of the esophagogastroduodenoscopy procedure. This study is to confirm whether significant variations among endoscopists in early GC detection suggest
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Identifying the need for a UK colorectal cancer screening programme for patients with cystic fibrosis (CF): 10-year retrospective review of colonoscopy and colorectal cancer outcomes at a single CF centre BMJ Open Gastroenterol. Pub Date : 2023-07-01 Karuna Sapru, Peter Barry, Andrew Jones, John Walmsley, Javaid Iqbal, Dipesh H Vasant
Objective Patients with cystic fibrosis (pwCF) have a high incidence of early colorectal cancer (CRC). In the absence of a UK CRC screening programme for pwCF, we evaluated the utility and outcomes of colonoscopy and CRC at a large UK CF centre. Design In a retrospective study of colonoscopy and CRC outcomes between 2010 and 2020 in pwCF aged≥30 years at a large CF centre, data were collected on colonoscopy
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Prevalence and trends of transfusion transmissible infections among blood donors in Basra, Iraq BMJ Open Gastroenterol. Pub Date : 2023-07-01 Khairallah A S Mohammed, Maha M Hameed, Abdullah H Mousa, Amar T Saleh
Background Despite saving millions of lives through blood transfusion, transfusion-transmissible infections (TTIs) still threaten the lives of patients requiring blood transfusion. Hence, screening blood donors and studying the prevalence of TTIs among blood donors may display the burden of these diseases among our population. The aim of this study was to assess the seroprevalence rates of transfusion
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Toll-like receptor 5 tunes hepatic and pancreatic stellate cells activation BMJ Open Gastroenterol. Pub Date : 2023-07-01 Pietro Di Fazio, Sophia Mielke, Isabell T Böhm, Malte Buchholz, Sami Matrood, Detlef Schuppan, Thaddeus Wissniowski
Objective Stellate cells are responsible for liver and pancreas fibrosis and strictly correlate with tumourigenesis. Although their activation is reversible, an exacerbated signalling triggers chronic fibrosis. Toll-like receptors (TLRs) modulate stellate cells transition. TLR5 transduces the signal deriving by the binding to bacterial flagellin from invading mobile bacteria. Design Human hepatic and
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Effectiveness of using a patient education mobile application to improve the quality of bowel preparation: a randomised controlled trial BMJ Open Gastroenterol. Pub Date : 2023-06-01 Hang Viet Dao, Quan Viet Dao, Hoa Ngoc Lam, Long Bao Hoang, Van Thi Nguyen, Thuy Thi Nguyen, Dat Quoc Vu, Christopher S Pokorny, Hoa Lan Nguyen, Jeroan Allison, Robert Joel Goldberg, An Thi Minh Dao, Toan Thanh Thi Do, Long Van Dao
Aims To determine the effectiveness of a mobile application (app) in improving the quality of bowel preparation for colonoscopy. Method An endoscopist-blinded randomised controlled trial enrolled patients who were undergoing a colonoscopy on the same day of bowel preparation. The intervention used a Vietnamese mobile app that provides instructions on bowel preparation while patients in the comparison
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Randomised controlled trials of non-pharmacological interventions to improve patient-reported outcomes of colonoscopy: a scoping review BMJ Open Gastroenterol. Pub Date : 2023-06-01 Colin Sue-Chue-Lam, Matthew Castelo, Amina Benmessaoud, Teruko Kishibe, Diego Llovet, Christine Brezden-Masley, Amy YX Yu, Jill Tinmouth, Nancy N Baxter
Background and aims Non-pharmacological interventions to improve patient-reported outcomes of colonoscopy may be effective at mitigating negative experiences and perceptions of the procedure, but research to characterise the extent and features of studies of these interventions is limited. Methods We conducted a scoping review searching multiple databases for peer-reviewed publications of randomised
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EUS-guided through the needle microbiopsy: a useful adjunct in the investigation of pancreatic cystic lesions BMJ Open Gastroenterol. Pub Date : 2023-06-01 Wafaa Ahmed, Mikaeil Mirzaali, Caroline Young, Latifu Sanni, Simon Everett, Bharat Paranandi, Matthew T Huggett, Wei On
Objective Endoscopic ultrasound-guided through-the-needle microbiopsy (EUS-TTNB) forceps is a recent development that facilitates sampling of the walls of pancreatic cystic lesions (PCL) for histological analysis. We aimed to assess the impact of EUS-TTNB and its influence on patient management in a tertiary pancreas centre. Design A prospective database of consecutive patients who underwent EUS-TTNB
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Association between 6-thioguanine nucleotide levels and preventing production of antibodies to infliximab in patients with inflammatory bowel disease BMJ Open Gastroenterol. Pub Date : 2023-06-01 Jennifer Phillips, Sam Leary, Jonathan Tyrrell-Price
Objective Combination therapy with infliximab and a thiopurine has been shown to be more effective than monotherapy in patients with inflammatory bowel disease (IBD). The therapeutic efficacy of thiopurines is correlated with 6-thioguanine (6-TGN) levels between 235 and 450 pmol/8×108 erythrocytes. The primary aim of the study was to investigate the association between 6-TGN levels and inhibition prevention
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Risk of malignant lymphomas in patients with inflammatory bowel disease: a population-based cohort study BMJ Open Gastroenterol. Pub Date : 2023-05-01 Jingru Yu, Erle Refsum, Paulina Wieszczy, Lise M Helsingen, Vera Perrin, Amanda Högdén, Magnus Løberg, Johannes Blom, Michael Bretthauer, Hans-Olov Adami, Weimin Ye, Mette Kalager
Objective To estimate the risk of non-Hodgkin’s lymphoma (NHL) and Hodgkin’s lymphoma (HL) in patients with inflammatory bowel disease (IBD). Design We undertook a two-country population cohort study with all patients diagnosed with IBD in Norway and Sweden from 1987 and 1993 through 2015 and 2016, respectively, and analysed the risk of NHL and HL. In Sweden, we also analysed prescriptions of thiopurines
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Dutch individuals’ views of screening for oesophageal cancer: a focus group study BMJ Open Gastroenterol. Pub Date : 2023-05-01 Jasmijn Sijben, Yonne Peters, Sharell Bas, Peter Siersema, Linda Rainey, Mireille Broeders
Objective Screening for early oesophageal adenocarcinoma (OAC), including its precursor Barrett’s oesophagus (BO), can potentially reduce OAC-related morbidity and mortality. This study explores Dutch at-risk individuals’ views of screening an at-risk population for BO/OAC. Design We invited 372 individuals with risk factors for OAC from primary care practices, 73 individuals with surveillance experience
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Obstacles to the deceased donor transplantation in Pakistan BMJ Open Gastroenterol. Pub Date : 2023-05-01 Kaleem Ullah, Abdul Wahab Dogar, Sidhant Ochani, Azam Shoaib, Hussain Haider Shah, Mohammad Ebad Ur Rehman
Introduction Transplantation in many Asian countries is moulded by socioeconomic, religious, cultural and health indicators. In most Asian countries, the living-related donation is the common most organ donation. Due to the limited deceased organ donation, live donor programmes flourished in many Asian countries. Another apparent reason for this tremendous growth of living-related programmes in Asian
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Socioeconomic inequalities in interval colorectal cancer are explained by differences in faecal haemoglobin concentration and age: a register-based cohort study BMJ Open Gastroenterol. Pub Date : 2023-05-01 Ulrik Deding, Morten Kobaek-Larsen, Henrik Bøggild, Lasse Kaalby, Marianne Kirstine Thygesen, Gunnar Baatrup
Objective To estimate the risk of interval colorectal cancer (CRC) in faecal immunochemical test (FIT) negative screening participants according to socioeconomic status. Design In this register-based study, first round FIT negative (<20 µg hb/g faeces) screening participants (biennial FIT, citizens aged 50–74) were followed to estimate interval CRC risk. Multivariate Cox proportional hazard regression
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Delphi consensus survey: the opinions of patients living with refractory ulcerative proctitis and the health care professionals who care for them BMJ Open Gastroenterol. Pub Date : 2023-05-01 Maro Kyriacou, Shellie Radford, Gordon W Moran
Background Refractory ulcerative proctitis presents a huge clinical challenge not only for the patients living with this chronic, progressive condition but also for the professionals who care for them. Currently, there is limited research and evidence-based guidance, resulting in many patients living with the symptomatic burden of disease and reduced quality of life. The aim of this study was to establish
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Planning management for complex colorectal polyps: a qualitative assessment of factors influencing decision-making among colonoscopists BMJ Open Gastroenterol. Pub Date : 2023-05-01 Jody Parker, Lenira Semedo, Lavanya Shenbagaraj, Jared Torkington, Sunil Dolwani
Objective Endoscopic therapy is the recommended primary treatment for most complex colorectal polyps, but high colonic resection rates are reported. The aim of this qualitative study was to understand and compare between specialities, the clinical and non-clinical factors influencing decision making when planning management. Design Semi-structured interviews were performed among colonoscopists across
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Severe SARS-CoV-2 infection: does the artificial sweetener sucralose play a role? BMJ Open Gastroenterol. Pub Date : 2023-05-01 Susan S Schiffman, H Troy Nagle
We read with interest the article by Hazan and colleagues “Lost microbes of COVID-19: Bifidobacterium, Faecalibacterium depletion and decreased microbiome diversity associated with SARS-CoV-2 infection severity”1 in which they reported a significant decrement in gut bifidobacteria in persons with severe Covid. This caught our attention because the common artificial sweetener sucralose (eg, Splenda)
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Liver enzymes among COVID-19 patients in Al-Ahsa region of Saudi Arabia BMJ Open Gastroenterol. Pub Date : 2023-04-01 Omar AlOmair
Background Hepatic damage is one of the common forms of extra pulmonary organ destructions among patients with COVID-19 infections. Aim To evaluate the prognosis of liver damage among COVID-19 patients based on their liver enzymes profile. Methods A retrospective study was done to evaluate the records of the hospitably admitted patient due to COVID-19 infection. Retrieved data included clinical presentation
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First reports of clinical effects of transjugular intrahepatic portosystemic shunt in four patients with cirrhotic ascites refractory to tolvaptan BMJ Open Gastroenterol. Pub Date : 2023-04-01 Kota Tsuruya, Jun Koizumi, Yuka Sekiguchi, Shun Ono, Tatsuya Sekiguchi, Takuya Hara, Yusuke Mishima, Yoshitaka Arase, Shunji Hirose, Koichi Shiraishi, Tatehiro Kagawa
Objective Ascites in patients with decompensated cirrhosis can lead to abdominal distention and decrease quality of life. Tolvaptan, a vasopressin V2 receptor antagonist, is an effective agent in the treatment of ascites, whereas some patients are refractory to tolvaptan. The efficacy of transjugular intrahepatic portosystemic shunt (TIPS) for these patients is not known. In this study, we performed
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Yes, they can! Comparing foodborne illness estimates, and the need for greater transparency BMJ Open Gastroenterol. Pub Date : 2023-04-01 Elaine Scallan Walter, Martyn D Kirk, Shannon E Majowicz
To the Editor, In their recent paper, Holland et al ,1 compared foodborne illness rates in the UK, Australia, Canada, and the USA, asking whether such comparisons across countries can legitimately inform trade decisions based on food safety risks. The authors highlighted methodological differences as a major barrier to making accurate comparisons. While we agree that comparing estimates between countries
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Quality of life measures in dysplastic Barrett’s oesophagus are comparable to patients with non-dysplastic Barrett’s oesophagus and do not improve after endoscopic therapy BMJ Open Gastroenterol. Pub Date : 2023-04-01 Elizabeth Ratcliffe, James Britton, Calvin Heal, Richard Keld, Mark Murgatroyd, Robert Willert, John McLaughlin, Shaheen Hamdy, Yeng Ang
Objective Barrett’s oesophagus (BO) is a precursor lesion, via dysplastic phases, to oesophageal adenocarcinoma. Although overall risk from BO is low, it has been shown to adversely affect health-related quality of life (HRQOL). The aim was to compare dysplastic BO patients’ HRQOL pre-endoscopic therapy (pre-ET) and post-ET. The pre-ET BO group was also compared with other cohorts: non-dysplastic BO
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Age-related experiences of colorectal cancer diagnosis: a secondary analysis of the English National Cancer Patient Experience Survey BMJ Open Gastroenterol. Pub Date : 2023-03-01 Syeda Somyyah Owais, Gaston Arnolda, Klay Lamprell, Winston Liauw, Geoff P Delaney, Ian Olver, Jonathan Karnon, Jeffrey Braithwaite
Objective The incidence of colorectal cancer (CRC) in people aged <50 years has been increasing dramatically in the past three decades and such patients are known to face difficulties in diagnosis. The objective of this study was to better understand the diagnostic experiences of patients with CRC and explore age-related differences in the proportion with positive experiences. Method A secondary analysis
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Changes in health-related quality of life and associations with improvements in clinical efficacy: a Phase 2 study of mirikizumab in patients with ulcerative colitis BMJ Open Gastroenterol. Pub Date : 2023-03-01 Marla C Dubinsky, Vipul Jairath, Brian G Feagan, April N Naegeli, Jay Tuttle, Nathan Morris, Mingyang Shan, Vipin Arora, Trevor Lissoos, Noah Agada, Toshifumi Hibi, Bruce E Sands
Objective Mirikizumab, a monoclonal antibody targeting the interleukin-23 p19 subunit, was effective in a Phase 2 study ([NCT02589665][1]) of moderately-to-severely active ulcerative colitis (UC). We studied mirikizumab’s impact on health-related quality of life (HRQoL). Design HRQoL was evaluated using the Inflammatory Bowel Disease Questionnaire (IBDQ) and 36-Item Short Form Health Survey (SF-36)
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Derivation and validation of a novel risk score to predict need for haemostatic intervention in acute upper gastrointestinal bleeding (London Haemostat Score) BMJ Open Gastroenterol. Pub Date : 2023-03-01 Isobel Marks, Imran Karim Janmohamed, Sadek Malas, Athina Mavrou, Thomas Banister, Nisha Patel, Lakshmana Ayaru
Background Acute upper gastrointestinal bleeding (AUGIB) is a common medical emergency, which takes up considerable healthcare resources. However, only approximately 20%–30% of bleeds require urgent haemostatic intervention. Current standard of care is for all patients admitted to hospital to undergo endoscopy within 24 hours for risk stratification, but this is difficult to achieve in practice, invasive
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Evaluation of bowel preparation regimens for colonoscopy including a novel low volume regimen (Plenvu): CLEANSE study BMJ Open Gastroenterol. Pub Date : 2023-03-01 Ahmir Ahmad, Sarah Marshall, Paul Bassett, Kowshika Thiruvilangam, Angad Dhillon, Brian P Saunders
Background Poor bowel preparation is the leading cause of failed colonoscopies and increases costs significantly. Several, split preparation, 2 day regimens are available and recently, Plenvu, a low-volume preparation which can be given on 1 day has been introduced. Aims Assess efficacy and tolerability of commonly used purgative regimens including Plenvu. Method In this service evaluation, patients
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Primary placement of low-profile or ‘button’ versus traditional balloon-retention radiologically inserted gastrostomy catheters in adults: a retrospective review BMJ Open Gastroenterol. Pub Date : 2023-03-01 Hassan Al-Balas, Zeyad Metwalli, Iftikhar Burney, David Sada
Objective De novo percutaneous placement of radiologically inserted low-profile or ‘button-type’ gastrostomy catheters (LPG) is infrequently reported in adults. This study compares the safety and clinical outcomes of primary percutaneous placement of LPG catheters and traditional balloon-retention gastrostomy catheters (TG) using image guidance at a single institution. Design This was a retrospective