Digestive and Liver Diseases Research Papers (original) (raw)

2025, Journal of the American Society of Cytopathology

2025, Case reports in dermatology

Leukocytoclastic vasculitis (LCV) is a small-vessel vasculitis with a reported incidence rate of 30 cases per million persons per year. It usually presents as a palpable purpuric skin rash on legs, though any part of the body can be affected. LCV rash may have an associated burning sensation or pain and in some cases may involve internal organs. In some cases, LCV rash may present as nodules, recurrent ulcerations or asymptomatic lesions. The diagnosis of LCV is usually made on skin biopsy. Etiological triggers may not be identified in as many as half of the cases. Treatment is usually conservative and includes identification and removal or treatment of the etiological trigger except in cases with internal organ involvement where systemic steroids and immunosuppressant may be necessary. In this article we present a case of indomethacin-associated LCV that improved with discontinuation of the offending agent.

2025, Nature Biotechnology

2025, Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology

Patients with celiac disease who present with symptoms of gastrointestinal hypomotility have abnormal antroduodenal manometry. There are no data on antroduodenal manometry in malabsorption syndrome (MAS) due to causes other than celiac disease. Fasting, post-prandial and post-octreotide antroduodenal motility parameters were compared in 18 untreated patients with MAS presenting with chronic diarrhea (tropical sprue 10, small bowel bacterial overgrowth 3, celiac disease 2, common variable immunodeficiency 1, AIDS with isosporidiasis and bacterial overgrowth 1, giardiasis 1) and 8 healthy subjects. Number of patients with MAS and controls having spontaneous migratory motor complexes (MMC) during fasting was comparable (11/18 vs 7/8; p=ns). Fasting contraction amplitude was weaker in MAS than in controls in the gastric antrum (median 42 [range 17-90] vs 80 [31-120] mmHg; p=0.001), proximal duodenum (50 [18-125] vs 72 [48-107]; p=0.013) and distal duodenum (45 [20-81] vs 76 [51-98]; p=0...

2025, American Journal of Clinical Pathology

Introduction/Objective Morbidity and mortality among adult patients presenting with acute abdominal pain are high, and these patients often require hospitalization with prompt surgical consultation Important differentials include small bowel obstruction from previous surgeries and hernias, acute mesenteric ischemia, and ruptured abdominal aortic aneurysm. Intussusception in adults is rare accounting for about 1% - 5% of small bowel obstructions and thus requiring a high index of suspicion for early detection. In most cases, the lead point is a benign mass, commonly a lipoma, but histopathologic examination of the resected segment is required to rule out malignancy. Methods/Case Report We present a case of a 50-year old male with a medical history of psoriasis and hypertension who was admitted on account of a 1-day history of sudden onset persistent abdominal pain with associated nausea non-bilious emesis. Physical examination reveals no fever and soft non-distended abdomen with diff...

2025, Uva Clinical Research Lab 2025 © Uva Clinical Anaesthesia and Intensive Care ISSN 2827-7198

Motilin is a 22-amino acid peptide hormone primarily secreted by enteroendocrine M cells located in the mucosal lining of the duodenum and proximal jejunum. It plays a pivotal role in regulating gastrointestinal (GI) motility during the fasting state by orchestrating the migrating motor complex (MMC), a cyclic, phasic pattern of peristaltic activity that ensures the clearance of luminal contents between meals. Motilin enhances smooth muscle contractility in the stomach and small intestine, promotes gastric acid and pepsin secretion, influences gallbladder emptying, and increases lower esophageal sphincter tone. It also interfaces with central neuroendocrine circuits to stimulate hunger. The hormone’s secretion is influenced by luminal pH and nutritional content, being suppressed by carbohydrates and stimulated by duodenal acidification and, in certain contexts, dietary fats.
Dysregulation of motilin signaling has been implicated in a range of motility disorders, including diabetic gastroparesis, functional dyspepsia, and duodenal-biliary reflux. Clinically, motilin receptors have become therapeutic targets for prokinetic agents, particularly motilides such as erythromycin, though long-term efficacy is limited by receptor desensitization. Interest in selective motilin receptor agonists remains high, offering promise in treating GI hypomotility syndromes. Furthermore, motilin levels fluctuate under physiological conditions, such as pregnancy, where reduced levels correlate with hypomotility-related symptoms. This review explores motilin’s physiological functions, mechanisms of action, cellular targets, developmental context, and clinical implications, underscoring its centrality in digestive physiology and its emerging role in gastrointestinal pharmacology.

2025, International Journal of Molecular Sciences

Gastric cancer (GC) remains one of the most common causes of mortality worldwide. Intestinal metaplasia (IM) is one of the preneoplastic gastric lesions and is considered an essential predisposing factor in GC development. Here we present a review of recent most relevant papers to summarize major findings on the molecular alterations in gastric IM. The latest progress in novel diagnostic methods allows scientists to identify various types of molecular alterations in IM, such as polymorphisms in various genes, changes in the expression of micro-RNAs and long noncoding RNAs, and altered microbiome profiles. The results have shown that some of these alterations have strong associations with IM and a potential to be used for screening, treatment, and prognostic purposes; however, one of the most important limiting factors is the inhomogeneity of the studies. Therefore, further large-scale studies and clinical trials with standardized methods designed by multicenter consortiums are needed. As of today, various molecular alterations in IM could become a part of personalized medicine in the near future, which would help us deliver a personalized approach for each patient and identify those at risk of progression to GC.

2025, International Journal of Molecular Sciences

2025, BMJ case reports

Ascaris lumbricoides is one of the most prevalent parasitic infections, especially in developing countries. Its presence can lead to a multitude of presentations, one of the rarer ones being obstructive jaundice due to migration of the worm in to the biliary tree. We describe a case of a man who presented as an emergency to the general surgeons complaining of abdominal pain, fever, jaundice and vomiting. Ultrasound was used and the diagnosis of biliary ascariasis was made. The patient underwent surgery consisting of a cholecystectomy, common bile duct exploration and T-tube choledochostomy. Our report highlights the varied aetiology of obstructive jaundice and the importance of including biliary ascariasis in the differential diagnosis of the jaundiced patient, especially from endemic areas.

2025, The Turkish journal of gastroenterology

Background/aims: This observational, retrospective cohort study assessed outcomes of the current management strategies for nonvariceal upper gastrointestinal bleeding in several European countries (Belgium, Greece, Italy, Norway, Portugal, Spain, and Turkey) (NCT00797641; ENERGIB). Materials and Methods: Turkey contributed 23 sites to this study. Adult patients (≥18 years old) consecutively admitted to hospital and who underwent endoscopy for overt non-variceal upper gastrointestinal bleeding (hematemesis, melena or hematochezia, with other clinical/laboratory evidence of acute upper GI blood loss) were included in the study. Data were collected from patient medical records regarding bleeding continuation, re-bleeding, pharmacological treatment, surgery, and mortality during a 30-day follow-up period. Results: A total of 423 patients (67.4% men; mean age: 57.8±18.9 years) were enrolled in the Turkish study centers, of whom 96.2% were admitted to hospital with acute non-variceal upper gastrointestinal bleeding. At admission, the most common symptom was melena (76.1%); 28.6% of patients were taking aspirin, 19.9% were on non-steroidal anti-inflammatory drugs, and 7.3% were on proton pump inhibitors. The most common diagnoses were duodenal (45.2%) and gastric (27.7%) ulcers and gastritis/gastric erosions (26.2%). Patients were most often managed in general medical wards (45.4%). A gastrointestinal team was in charge of treatment in 64.8% of cases. Therapeutic procedures were performed in 32.4% of patients during endoscopy. After the endoscopy, most patients (94.6%) received proton pump inhibitors. Mean (SD) hospital stay was 5.36±4.91 days. The cumulative proportions of continued bleeding/re-bleeding, complications and mortality within 30 days of the non-variceal upper gastrointestinal bleeding episode were 9.0%, 5.7% and 2.8%, respectively. In the Turkish sub-group of patients, the significant risk factors for bleeding continuation or re-bleeding were age >65 years, presentation with hematemesis or shock/syncope, and the diagnosis of duodenal ulcer. The risk of clinical complications after non-variceal upper gastrointestinal bleeding was higher in female patients older than 65 years, in patients with comorbidities, and in patients presenting with shock/syncope, and also according to time to endoscopy. The use of aspirin, non-steroidal anti-inflammatory drugs or warfarin at baseline was negatively associated with the development of bleeding or clinical complications. The risk of death within 30 days after non-variceal upper gastrointestinal bleeding was significantly higher in patients older than 65 years and in those receiving transfusions other than intravenous fluid or red blood cells within 12 hours of presentation. Conclusions: According to the survey results, non-variceal upper gastrointestinal bleeding in Turkey varies from that in other European countries in a number of aspects. These differences could be associated with a younger population and Helicobacter pylori incidence. Despite the diminishing need for surgical intervention and mortality rates for non-variceal upper gastrointestinal bleeding, as is the case in other European countries, non-variceal upper gastrointestinal bleeding remains a serious problem.

2025, Expert Review of Gastroenterology & Hepatology

Background: Great efforts by the scientific community are rapidly expanding the evidence on the clinical interplay between Covid-19 and inflammatory bowel disease (IBD). Aims: We performed a systematic review of the literature on published Covid-19 cases occurring in patients with IBD. Methods: PubMed Central/Medline and Embase were systemically searched for records up to May 31, 2020. Results: 13 cohort studies and 5 single case reports were included in the qualitative synthesis. A cumulative number of approximately 800 patients with IBD and Covid-19 were identified. The case fatality rate ranged from 0% to 20.0%. Overall, immunomodulators and biologics were not associated with higher risk of Covid-19 or with negative outcomes, while the use of systemic corticosteroids was related to worse prognosis in some studies. Conclusions: This systematic review highlighted two main points that may help clinicians dealing with IBD in reassuring their patients: (1) patients with IBD do not seem to be at higher risk of being infected by SARS-COV-2 than the general population; (2) in case of Covid-19, treatment with immunomodulators or biologics is not associated with worse prognosis, while systemic steroids are suspected to be potentially detrimental, even if more data are needed to confirm this point.

2025

Pedunculated polyps of the esophagus containing elements of the mesenchymal tissue are benign tumors that occur in the cervical and upper thoracic esophagus, particularly in the region of the cricopharyngeus muscle. Large pedunculated tumors, can cause dysphagia, dyspnea, or sudden choking. Herein, we describe the case of a 70-year-old man initially diagnosed with a 21 cm giant pedunculated mixed mesenchymal tumor of the esophagus. Our case study demonstrates endoscopic evaluation and the successful surgical resection of the esophageal lesion.

2025, Digestive Diseases and Sciences

To examine the applicability across subgroups of the Manning criteria commonly used to diagnose the irritable bowel syndrome, a 22-item symptom questionnaire was administered to male and female African-American and Caucasian adults (N = 1344). Principal components factor analysis with wtrimax rotation was used to identify symptom clusters. Consistent with the findings of a previous factor analytic study, three of the six Manning symptoms (loose stools and more frequent bowel movements with onset of pain, pain relieved by defecation) formed a cluster corresponding to the irritable bowel syndrome in all subgroups. It is concluded that: (1) The three core Manning symptoms have equal applicability to both gcnders and to African-Americans as well as to Caucasians. They are useful symptom criteria for the diagnosis of IBS when used in conjunction with medical evaluation. (2) Three of the six Manning symptoms rarely correlate with the others; if confirmed in patient samples, this would indicate that these three symptoms are not useful for making a diagnosis of the irritable bowel syndrome.

2025, Digestive Diseases and Sciences

Excessive spontaneous swallowing has been associated with a variety of common gastrointestinal symptoms including abdominal pain, heartburn, and bloating and may contribute to disorders such as hiatus hernia, duodenal ulcer, and irritable bowel syndrome. The present study investigated the hypothesis that changes in emotional state alter spontaneous swallowing rate. Subjects were 38 generally healthy undergraduates assigned to either a pleasant low arousal, neutral, or aversive high arousal condition. Each experimental session was divided into 30-min baseline and arousal manipulation periods. Spontaneous swallowing rate increased significantly with emotional arousal: for low, neutral, and high arousal groups, means were 7.9 _+ 1.9 (SE), 15.8 _ 2.4, and 23.7 +_ 3.6 swallows/30 min, respectively. Other physiological and self-report measures, used to check the effectiveness of the arousal manipulation, varied appropriately with experimental procedures. These results indicate that changes in emotional state alter spontaneous swallowing rate in generally healthy individuals. Further research with patients is needed to establish whether stress-induced increases in swallowing rate produce or exacerbate clinically significant gastrointestinal symptomatology.

2025, Digestive Diseases and Sciences

High rates of psychiatric disorder have been documented in patients with functional bowel syndromes sampled from physicians" oltices. Lifetime psychiatric disorders and/or current psychiatric symptoms arc thought to be much more highly associated with current gastrointestinal bowel symptoms in clinical settings than in the community. The relationship of lifetime functional gastrointestinal symptoms to lifetime psychiatric disorders has not been examined systematically in randomly selected samples of general community populations. The current study reports findings from existing data on a large, randomly selected population sample that may hclp to clariD these associations. Epidemiologic Catchment Area (ECA) project data were analyzed to examine relationships of functional gastrointestinal symptoms and psychiatric diagnoses in the community. Individuals with two or more medically unexplained gastrointestinal symptoms had high rates of psychiatric disorders. This was also true for the subgroup in which abdominal pain was one of the two symptoms. The overwhelming majority of subjects reporting medically unexplained gastrointestinal symptoms said they had consulted physicians for those symptoms. General population ECA data indicate that women in the community report more functional gastrointestinal complaints than men, that individuals with lifetime gastrointestinal complaints have high rates of lifetime psychiatric disorders (not necessarily currently symptomatic), and most have contacted a physician regarding their gastrointestinal symptorns. These data complement studies showing that patients with current gastrointestinal symptoms often do not consult a physician, or when they do, such behavior is associated with active psychiatric symptoms. The present data are consistent with the hypothesis that patients with recurrent symptoms are those who routinely seek medical help and who have high rates of psychiatric disorders, whereas those with symptoms that resolve or are improved by a medical intervention do not maintain treatmentseeking behavior.

2025, Digestive Diseases and Sciences

Alcohol consumption, age at infection, and male gender have been identified as risk factors for faster fibrosis progression in patients with chronic hepatitis C (CHC). Yet the influence of liver steatosis, light to moderate alcohol consumption, or iron overload on this progression remains controversial. To analyze the effect of individual risk factors and their interaction on fibrosis progression in a group of patients with CHC and a definite date of infection, we studied 133 consecutive untreated patients. Covariates included were age, body mass index (BMI), gender, age at infection, alcohol intake, serum lipids, glycemia, serum ALT, AST, GGT, iron, and ferritin, grade and stage (METAVIR and Scheuer), and hepatic stainable iron (Perl's stain). The rate of fibrosis progression was inferred from the METAVIR score. By logistic regression analysis, hepatic steatosis (odds ratio [OR], 3.035; 95% confidence interval [CI], 1.16-7.93), serum ferritin levels higher than 290 ng/ml (OR, 5.5;, and light to moderate ethanol intake (1-50 g/day) (OR, 5.22; 1.5-17.67) were independently associated with faster fibrosis progression. There was no effect of interaction between these variables on the rate of fibrosis progression. Liver steatosis, serum ferritin levels, and light to moderate alcohol intake are associated with faster fibrosis progression in chronic hepatitis C. Combination of these factors did not further accelerate this progression. The impact of modification of these factors on progression should be tested in longitudinal studies.

2025, Journal of Clinical and Translational Hepatology

Hepatocellular carcinoma (HCC) is a common malignant tumor with high incidence and cancer mortality worldwide. Post-translational modifications (PTMs) of proteins have a great impact on protein function. Almost all proteins can undergo PTMs, including phosphorylation, acetylation, methylation, glycosylation, ubiquitination, and so on. Many studies have shown that PTMs are related to the occurrence and development of cancers. The findings provide novel therapeutic targets for cancers, such as glypican-3 and mucin-1. Other clinical implications are also found in the studies of PTMs. Diagnostic or prognostic value, and response to therapy have been identified. In HCC, it has been shown that glycosylated alpha-fetoprotein (AFP) has a higher detection rate for early liver cancer than conventional AFP. In this review, we mainly focused on the diagnostic and prognostic value of PTM, in order to provide new insights into the clinical implication of PTM in HCC.

2025, Digestive Diseases and Sciences

2025, Journal of Digestive Diseases

To establish the clinical course of ulcerative colitis (UC) in the Malaysian population, comparing the three major ethnic groups: Malay, Chinese and Indian. Patients who were diagnosed with UC from seven major medical referral centers in Malaysia were recruited. Their baseline characteristics, and the extent of the disease, its clinical course and complications were recorded. A total of 118 patients was included. The extent of disease was as follows: proctitis alone in 22 (18.6%), sigmoid colon in 23 (19.5%), descending colon in 16 (13.6%), transverse colon in 11 (9.3%), ascending colon and pancolitis 46 (39%). Most patients had chronic intermittent disease. Extraintestinal complications were seen in 27 (22.9%) patients and fulminant colitis was seen in four (3.4%). None developed colorectal cancer. The overall cumulative colectomy rates at 1, 5 and 10 years were 3.4% (CI: 0.9-8.5), 5.9% (CI: 1.9-13.2) and 15.6% (CI: 6.5-29.4), respectively. There was a higher prevalence of extra-intestinal manifestations and a trend towards more extensive disease among Indian patients. However, no significant differences were seen in the age of onset, the severity of disease (fulminant colitis, refractory disease) and the colectomy rate. CONCLUSION: As in developed countries, most of our patients have a remitting and relapsing pattern of disease but the clinical course appears to be milder, with lower rates of colectomies. There are differences in clinical presentation among the three major ethnic groups, with Indians having a higher prevalence of extra-intestinal manifestations and a trend towards more extensive disease.

2025, Digestive Diseases and Sciences

Previous studies have suggested a relationship between the presence of digital arches and the occurrence of early-onset chronic intestinal pseudoobstruction (CIP). We recently had under our care a patient who died of complications from neuropathic familial CIP (FCIP) and who had family members with symptoms and radiographic findings consistent with FCIP. Our aim was to determine if there is a relationship between FCIP and digital arches using members of this patient's family tree. Questionnaires, telephone follow-up, and clinical and radiographic evidence were all utilized to determine whether a diagnosis of CIP could be made for the family members of this deceased FCIP patient. Fingerprints were sought for all study subjects. Eight of the 26 study subjects who were fingerprinted had clinically diagnosed FCIP and four of these eight had radiographic confirmation. All eight were positive for one or more arches (sensitivity = 100%). Only one of the 18 subjects without a diagnosis of FCIP who were fingerprinted had arches (specificity = 94%). The likelihood of linkage between the presence of digital arches and FCIP in our study family was significant by genetic linkage analysis criteria. These results show a significant correlation between FCIP and digital arches (P < 0.0001). Whether this relationship is a causal one, ie, the gene responsible for digital arches is also responsible for FCIP, or is the result of linkage between the genes for FCIP and digital arches remains unclear.

2025, Digestive Diseases and Sciences

Interferon-alpha (IFN) and ursodeoxycholic acid(UDCA) combined have a controversial role in thetreatment of chronic type C hepatitis. We studied thelong-term efficacy of both drugs alone or incombination. In a three-year period, 108 patients wererandomized into three treatment arms: (1) IFN alone 3 MUthree times a week (N = 49), (2) IFN 3 MU three times aweek + UDCA 250 mg

2025, Digestive Diseases and Sciences

Aim/Materials and Methods Between January 2000 and June 2007, 3,548 endoscopic retrograde cholangiopancreatography (ERCP) were performed for extrahepatic cholestasis, cholangitis, and choledocholithiasis. The results of ERCPs were evaluated retrospectively and examined carefully to investigate the management and endoscopic therapy of biliary parasites. Results Of the 3,548 patients who underwent ERCP, 24 (0.66%) were found to have biliary parasitosis. The mean age of the biliary parasitosis patients (16 women) was 48.6 (15-77) years. Of these 24 cases, 16 patients had hydatid cystic disease (eight with partial obstruction of the biliary tract, and eight with ruptured cysts), four patients had Fasciola hepatica, and four patients had Ascaris lumbricoides infestation. Endoscopic sphincterotomy was performed, after which the choledochus was examined carefully by balloon catheter and basket procedure. Conclusion The ERCP procedure is very useful in the therapy of biliary parasitic infestations.

2025, Digestive Diseases and Sciences

Achalasia of the cardia is an esophageal motor disorder of unknown etiology characterized by an often hypertensive lower esophageal sphincter (LES), which does not relax after deglutition, and an aperistaltic esophageal body in which 100% of deglutitions provoke no response or the response consists of synchronic waves which, on occasions, are repetitive and reach a pressure equal or similar to normal (vigorous achalasia) (1). The term pseudoachalasia is used in cases where this motor pattern is secondary to known etiological circumstances; this has been described in Chagas' disease (2), gastric neoplasms due to myenteric plexi infiltration (3), distant neoplasms due to paraneoplastic neuropathy (4), pseudocysts of the pancreas with mediastinal involvement, probably due to compression (5), following surgical vagotomy (6), and in amyloidosis . The aim of this paper is to present two cases of benign stenosis of the cardia secondary to fibrosis following antireflux surgery, in which the patients developed a motor alteration in the esophageal body similar to that of achalasia of the cardia.

2025, Digestive Diseases and Sciences

2025, The Journal of the Association of Physicians of India

T he term "dyspepsia" is derived from the Greek language and it literally means "bad digestion." 1 Dyspepsia is a common complaint among individuals seeking medical care as well as in general population. 2 Dyspepsia is diagnosed in presence of symptoms thought to originate from the gastro-duodenal region (early satiation, postprandial fullness, epigastric pain or burning). Before undertaking esophagogastroduodenoscopy, patients are categorized as un-investigated dyspepsia (UD). If there is no organic cause to explain dyspeptic symptoms on upper gastrointestinal endoscopy, the patient is diagnosed having functional dyspepsia (FD). 2 Dyspepsia is a condition of great clinical significance as large proportion of patients visiting gastroenterology clinics all over have dyspepsia. Prevalence of dyspepsia is about 20-30% worldwide. 5 although most prevalence studies in community report prevalence of UD, it is still reasonable to accept that majority of dyspeptic patients have FD as organic causes are quite uncommon. 6 a study from India reported prevalence of dyspepsia to be 30.4%. In another multi-centric study from India, primarily targeted to study epidemiology and clinical profile of irritable bowel syndrome (IBS, another functional bowel disorder that may overlap with FD), found frequency of dyspeptic symptoms to be as high as 49% in community. In a study from chandigarh, India, of 2048 individuals, 155 (7.5%) had dyspepsia (defined as intermittent or persistent pain, nausea or discomfort referable to the upper alimentary tract that has been present for 1 month or more and was unrelated to exertion). 9 Therefore, from the limited data available, it may be concluded that 7.6 to 49% of Indian population report dyspeptic symptoms. however, in none of these studies, currently accepted criteria such as rome criteria, were used to diagnose FD. 10 hence, wide variation in reported prevalence of dyspepsia might be related to variation in criteria used for the diagnosis or to true difference in prevalence in different parts of the country.

2025, Digestive Diseases and Sciences

The aim of this study was to investigate the effects of melatonin on serum amylase, tumor necrosis factor-alpha (TNF-a) and histological changes in rats with taurocholate-induced acute pancreatitis. Thirty male Wistar rats were randomly divided into three groups; group 1, group 2 and group 3 were enrolled as melatonin, control and sham groups, respectively (n = 10 per group). Acute pancreatitis was induced by 1 ml/kg body weight using 5% taurocholate injection into the biliopancreatic duct in groups 1 and 2 after clamping the hepatic duct. Those in group 1 received 50 mg/ kg body weight melatonin by intraperitoneal (i.p.) injection. Group 2 received physiological saline i.p. at the same dose. Group 3 solely underwent laparotomy with cannulation of the biliopancreatic duct. Twenty-four hours after the intervention, the rats were killed, and serum samples were collected to measure amylase and TNF-a levels. Simultaneously, pancreatic tissues were removed, stained with hematoxylin-eosin and examined under a light microscope. Serum amylase and TNF-a levels were significantly lower in the melatonin group compared to the controls (P \ 0.001). The total histological score, including edema, inflammation, perivascular infiltrate, acinar necrosis, fat necrosis and hemorrhage, was also significantly lower in the melatonin group as compared to the control (P \ 0.0001). In conclusion, melatonin is potentially capable of reducing pancreatic damage by decreasing serum TNF-a levels in taurocholateinduced acute pancreatitis in rats. This result supports the idea that melatonin might be beneficial in ameliorating the severity of acute pancreatitis.

2025, Scientific reports

Expression of the Helicobacter pylori blood group antigen binding adhesin A (BabA) is more common in strains isolated from patients with peptic ulcer disease or gastric cancer, rather than asymptomatic colonization. Here we used mouse models to examine host determinants that affect H. pylori BabA expression. BabA expression was lost by phase variation as frequently in WT mice as in RAG2-/- mice that do not have functional B or T cells, and in MyD88-/-, TLR2-/- and TLR4-/- mice that are defective in toll like receptor signaling. The presence of other bacteria had no effect on BabA expression as shown by infection of germ free mice. Moreover, loss of BabA expression was not dependent on Le(b) expression or the capacity of BabA to bind Le(b). Surprisingly, gender was the host determinant most associated with loss of BabA expression, which was maintained to a greater extent in male mice and was associated with greater bacterial load. These results suggest the possibility that loss of Ba...

2025, Journal of Hepatology

The real pathogenesis of Nonalcoholic Steatohepatitis(NASH) continue unknown.Oxidative stress in one of mechanism that could be envolved.In this study we measured the generation of ROS(reactive oxigen species) in experimental hepatic steatosis induced by diet deficient in choline.Methods: Wistar rats were randomized into two groups according diet: Group l-rats were fed with a diet deficient in choline for four weeks; Group II(control)-rats were fed standart diet for four weeks. Liver steatosis injury was assessed by biochemical analysis with quantitative score.Oxidative stress was evaluate determing superoxide quantification by lucigeninamplified chemiluminescence in hepatic fragment.Results: Table of resultstrnean t Slxp.Offi) . Oxidative stress was increase in Group I (table).A superoxide blocker(superoxide dismutase) decreases the luminescence generation more than 80% in liver tissue of Group I.Histopathological analysis showed in Group I steatosis macro-microvesicular in portal zone without fibrosis or exuberant lobular inflammation. In Group II(control) the histhopathological feature of liver was normaI.Conciusion:Oxidative stress was increased in experimental hepatic steatosis, may be a importante mechanism in the pathogenesis of NASH, and could provide a potential therapeutical target.

2025

Helicobacter pylori has been deeply implicated in diseases of the gastrointestinal tract and duodenal ulcer. Proper diagnosis and determination of risk factors for acquiring this infection is pertinent in containing it. The study was aimed at determining the prevalence of asymptomatic intestinal bleeding and Helicobacter pylori infection among adolescents of Ebonyi State, Nigeria. The research was a cross sectional study, carried out among students of Ebonyi State University. Samples were randomly collected from 420 students. The blood samples were analyzed for the presence of Helicopter pylori antibody by chromatographic immunoassay while the faecal samples were analyzed for the presence of blood using faecal occult blood test kit. Out of the 420 subjects, 349 were positive of either H. pylori antibody, intestinal bleeding or both while 71 were negative, 303 (72.1%) were Helicopter Pylori seropositive and 134 (31.9%) were positive of faecal occult blood test, whereas, 88(21.0%) wer...

2025, Digestive Diseases and Sciences

Aim-We investigated whether treatment with gliadin induces a paracellular permeability defect that enhances bacterial translocation to mesenteric lymph nodes (MLN) via resident dendritic cells (DC) expressing TLR-2 or 4 in HCD4/HLA-DQ8 transgenic mice. Methods-HLA-DQ8 transgenic mice were sensitized and subsequently gavaged with gliadin, in the presence or absence of AT1001 (paracellular permeability inhibitor). Non-sensitized mice were gavaged with indomethacin (permeability inducer) or rice cereal. CD11c and CD103 (DC markers) and TLR-2 and 4 were investigated by immunostaining. Intestinal permeability was

2025, Digestive diseases and …

Serum amylase and lipase concentrations weredetermined in 78 patients with chronic liver diseases [26 chronic active hepatitis (CAH) and 52 livercirrhosis] and in 15 healthy subjects. Pancreaticisoamylase concentrations and macroamylase... more

2025, Digestive and Liver Disease

Backgmund: Cbmnic atrophic gastritis and intestinal metaplasia arc correlated to H. pylori (HP) infection and considered as lesions incnasing the risk of cancer. Aim To investigate the outcome of Hppositive atrophic gastritis and intestinal metaplasia a& eradication. Metbcdsz Two hundred and ninety pta with Hppositive gash& diagnosed by histology and rapid -e test were enrolled in the study and found to be eradicated at 2 months after a PPI-based triple-therapy. Two tnmdred and twenty-two (76%) and 210 (72%) out of 296 emulIed pts were contmlled at 6 and I2 months. Gastritis and Hp-status were assessed according to the updated Sydney system on 2 biopsies specimens each taken from antrum and corpus at entry and at 2.6 and I2 months after Hperadication. Results: In Htwositive gastritis, activity, chronic inflammation and intestinal metaplasia in antnun we& &nific&tly more sew& than in corpus @=O.OQl). In antmm and corpus, activity and cbmnic inflammation debased significardly at 2 months after Hperadication @ <O.oOl) and quite disappeared after 6 months (p<O.~l). Atrophic gastritis and int&mJ metaplasia in antrum were significantly more diffise than in corpus and did not changed at 12 months after Hpaadication (see Table ). Conclusions: In patients with Hppositivc gastritis, H.pylori cmdication does not induce a regression of atrophic gastritis and bttestimI metaplasia while active and chronic inflammation disappear promsively in I2 months of follow-up.

2025, Digestive and Liver Disease

Purpose: To identify, using tissue microarray (TMA), an immunohistochemical panel predictive of response to ionizing radiation (IR) in rectal cancer. Methods: TMA constructs were prepared from archived stage II/III rectal tumors and matching adjacent mucosa (n = 38) from patients treated with pre-operative chemoradiation. Immunohistochemistry (IHC) was performed for MIB, Cyclin E, p21, p27, p53, survivin, Bcl-2, and BAX. Immunoreactivity along with clinical variables was subjected to univariate and forward stepwise logistic regression analyses. Results: Pathological complete response (pCR) was 23.9%. The number of positive lymph nodes obtained in the resected specimen was associated with pCR. Immunoreactivity for MIB (Sn 15%, Sp 65%, OR 0.33), p53 (Sn 3%, Sp 84%, OR 0.16), Bcl-2 (Sn 11%, Sp 74%, OR 0.35), and BAX (Sn 92%, Sp 80%, OR 46) was associated with pathological response (all p's < 0.001). Forward stepwise logistic regression analysis demonstrated that MIB was an independent predictor of a response to chemoradiation (p = 0.001). Conclusions: A combined panel of mediators of apoptosis alone or combined with clinical factors is a feasible approach that can be applied to rectal tumor biopsies to predict a response to chemoradiation. The most sensitive factor was BAX; while MIB independently predicted a response to chemoradiation. Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.

2025, Digestive and Liver Disease

2025, Journal of Digestive Diseases

Tumor necrosis factor (TNF) inhibitors can be used to treat inflammatory bowel disease (IBD) but may lead to anti-nuclear antibody (ANA) positivity and lupus-like reactions. Because of its unique structure, certolizumab has lower rates of these complications. We sought to investigate whether patients who have had lupus-like reactions to infliximab or adalimumab would be able to tolerate certolizumab. We performed a retrospective analysis on the 23 patients at the Roberts Inflammatory Bowel Disease Center who received certolizumab for the treatment of Crohn's disease from March 2008 to June 2009. We identified 6 patients who were switched to this drug because of lupus-like reactions from prior anti-TNF therapy and had documented ANA after the reaction and prior to certolizumab initiation. We then rechecked the ANA status after certolizumab initiation. Five out of 6 patients had a resolution of their arthralgias or lupus-like symptoms after being switched to certolizumab (P < 0.001). Of the 4 patients who were ANA positive after receiving infliximab or adalimumab, 2 became ANA negative after induction with certolizumab (P = 0.17). There was no difference in Harvey Bradshaw index scores (10.3 vs. 9.8) pre-certolizumab and post-certolizumab (P = 0.73). Nearly all patients experienced relief from their lupus-like symptoms with certolizumab and 2 out of 4 patients reversed their ANA positivity. While future investigation is warranted, patients who have lupus-like reactions from infliximab or adalimumab may benefit from switching to certolizumab.

2025, Journal of Medicinal Plants Studies 2017; 5(1): 326-330

Nanded district of Maharashtra state has the major forest area in the district is in Kinwat taluka (i.e.) about 57,800 hectares. This taluka is also a part of area popularly known as Gondwan. Approximately more than three out of every ten persons in taluka are tribals (32 per cent). Among tribals, Rajgond (47 per cent), Andh (36 per cent), Pardhan (9 per cent) and Bhil (5 per cent) are the main tribals. The tribal area is spread over 1146 square kilometers (Census, 1991). Most of the tribal women working in the farming activities and they take care of health of all family members. They are most of the time used medicinal plants and parts to cure health problems. From kinwat taluka six villages were selected and twenty villagers from each village were randomly selected for the study. Thus, from each village 20 respondents making the total sample size 120 were selected. For this study statistical tools were used as frequency, percentage, correlational analysis, multiple regressions. To collect data regarding use of indigenous medicinal plants for digestive disorder by them interview schedule was prepared with help of information regarding diseases name, plant name, medicinal plants used in the form of seed, root stem, bark, leaves, flowers, rhizome, bulb. Plants are one of the most important sources of medicine. The application of plants as medicines dates back to prehistoric period.

2025, URF Publishers

Colonoscopy is a crucial procedure for early detection and prevention of colorectal diseases, but it often presents challenges such as patient discomfort and extended procedural times. This study examines the effectiveness of abdominal belts in enhancing
colonoscopy procedures. A prospective randomized controlled trial was conducted with 54 adult patients, divided into an
intervention group using abdominal belts and a control group without. The abdominal belts provided additional support and stabilization during the procedure. Key outcomes, including procedural duration, patient discomfort and quality of colon visualization, were analyzed. Results indicate that the use of abdominal belts significantly reduced procedural time and improved overall patient experience. These findings suggest that incorporating abdominal belts into standard colonoscopy practice could enhance efficiency and patient comfort.

2025, Indian Journal of Gastroenterology

2025, Life

Liver cirrhosis continues to be a major global health issue, contributing to high morbidity and mortality due to its progressive nature and associated complications. This review explores recent advancements in the diagnosis and treatment of liver cirrhosis and its related syndromes. Non-invasive diagnostic tools, such as elastography and serum biomarkers, have significantly improved early detection, reducing the need for liver biopsies. Advanced imaging techniques, including MRI and CT, further enhance diagnostic accuracy. In parallel, molecular and genomic research is providing new insights into the pathogenesis of the disease, paving the way for precision medicine. On the treatment front, pharmacological innovations, such as antifibrotic agents and targeted therapies, show promise in slowing disease progression. Endoscopic interventions like variceal banding are improving the management of complications, while advancements in liver transplantation and artificial liver support systems offer life-saving alternatives. Regenerative medicine, particularly stem cell therapy and tissue engineering, is emerging as a promising strategy for liver repair. Managing cirrhosis-related syndromes, including portal hypertension, ascites, hepatic encephalopathy, and hepatorenal syndrome, now involves evolving therapeutic approaches such as transjugular intrahepatic portosystemic shunt (TIPS) and novel pharmacotherapies. Prognostic scoring systems like the MELD and Child-Pugh are being refined with new biomarkers for better risk stratification. The future of cirrhosis care will likely involve the integration of artificial intelligence and machine learning for early diagnosis and personalized treatments, alongside emerging therapies currently under investigation. Despite these advancements, challenges such as

2025, ASIAN JOURNAL OF PHARMACEUTICAL AND BIOLOGICAL RESEARCH

The terminology of non-
alcoholic fatty liver disease encompasses a
wide range of conditions, from simple
accumulation of fat ("fatty liver" or
steatosis) to non-alcoholic steatohepatitis,
fibrosis and cirrhosis of the liver with its
clinical consequences [21].The incidence
of non-alcoholic fatty liver disease among
adults is 20-30% and higher in
industrialized countries [2].

2025, Academia Nutrition and Dietetics

Milk sphingomyelin (SM) and gangliosides represent key bioactive sphingolipids in dairy products increasingly recognized for their multifaceted health benefits. Recent work has demonstrated that dietary (milk) SM can reduce systemic inflammation, modulate gut microbiota, and improve lipid metabolism in models of diet-induced obesity. Sphingolipids exert both pro-and anti-tumorigenic effects depending on the specific cancer cell type and molecular context. Ceramides and related metabolites promote apoptosis and suppress tumor progression, whereas sphingosine-1-phosphate (S1P) facilitates cell survival, angiogenesis, and metastasis. The differential role of sphingolipids in various cancer cell models underscores their potential as therapeutic targets and biomarkers in oncology. SM-protein interactions influence the microstructure and stability of dairy emulsions and have beneficial effects in infant formula and other dairy emulsions, including SLs' techno-functional properties. These studies underscore the potential of milk-based sphingolipids as functional food components for reducing the risk of developing and managing chronic metabolic and developmental disorders. Dietary sphingolipids (SLs) undergo absorption in the small intestine, distribution via lipoproteins, metabolism into ceramide and S1P, and excretion primarily through bile and feces. They are generally recognized as safe (GRAS). However, pharmacological SLs analogs may pose risks such as immune suppression and gastrointestinal effects, necessitating further safety evaluations. This review explores the health-promoting effects of dietary bovine milk SLs, including their absorption, chemical structure, and functional interactions, and their potential applications in functional foods. The mechanisms of the enhanced stability of dairy beverages, increased bioavailability of SLs, and pathogen binding ability of SLs have been unraveled.

2025, Academia Nutrition and Dietetics

2025, Digestive Diseases

Background: Despite its decreasing incidence, gastric cancer (GC) remains one of the leading cancers in the world and an important global healthcare problem due to its overall high prevalence and high mortality rate. Summary: GC is a consequence of Helicobacter pylori infection in 90% of cases, while in 10% Epstein Barr Virus may be responsible. Moreover, some recent epidemiological data suggest an increasing incidence in some young patients groups possibly due to autoimmunity, and if this tendency is confirmed, it may change the epidemiology of GC in the future. The pathogenesis of GC is mainly related to H. pylori infection, but recent data indicate the possible role of other bacteria and their metabolites, like N-nitrosocompounds or acetaldehyde, interfering during the last steps of carcinogenesis. The new molecular classifications of GCs show a great heterogeneity of this neoplasia, which may in the future help to define personalized treatment strategies for the patients. Early ...

2025, Digestive Diseases and Sciences

of Possible metabolic Significance of the rectal localized glucagon like peptide 1 ." (1995) Diabetologia 38(suppl.):A171.

2025

Material & Methods: A Retrospective study was conducted between by viewing medical records and endoscopy reports. Total 31 patients were enrolled with gastric variceal bleed that underwent endoscopic injection of N-butyl-2-cyanoacrylate we examined the mortality rate, hemostasis, Hospital stay, need of blood transfusion, and effectiveness of procedure. Results: A Total of 31 patients, out of which 18 (58.1 %) were male; the mean age was 55.23±8.778 years. Of these patients 23 (74.2 %), had concomitant esophageal varices, Child-Pugh class-A, B, C were seen in 4, 20 & 7 patients (12.9, 64.5 % & 22.6) respectively. Average duration of hospital stay was 5 to 8 days in 22 cases (71.0 %). Less than 3 pints of PRBC were transfused in 17 cases (54.8 %). Hemostasis was achieved in 27 patients (87%). Overall mortality rate was 3 out of 31(9.7%). one patient was referred for TIPSS. No complications from cyanoacrylate injection were observed. Conclusion: Standardized injection technique and regimen ensures the success and safety of N-butyl-2-cyanoacrylate injection for the treatment of gastric fundal varices in experienced hands.

2025, Digestive Diseases and Sciences

An increasing frequency of hepatic granulomas, up to 10%, in chronic hepatitis C patients is reported, and their presence is considered to be a predictor of treatment success. However, there is only one prevalence study on granuloma in chronic hepatitis B, and its significance for treatment outcome is unknown. We aimed to determine the prevalence of hepatic granulomas in a larger group of chronic hepatitis B patients and to compare their presence with the response to interferon therapy. Biopsy specimens of chronic hepatitis B patients were reevaluated for the presence of hepatic granulomas. All patients with hepatic granuloma were screened for other granulomatous diseases by tuberculin skin test, chest X-ray and computed tomography, venereal disease research laboratory, Brucella agglutination tests, and exposure to hepatotoxic agents. We screened 663 cases of chronic hepatitis B. Hepatic granulomas were found in 10 cases (1.5%). The granulomas could not be ascribed to any other reason. Of the 10 patients with hepatic granulomas, 4 responded to interferon therapy, 2 dropped out, and 4 were nonresponders. We conclude that hepatic granuloma is a rare finding in chronic hepatitis B and its presence does not seem to predict the response to interferon therapy.