American Journal of Gastroenterology

Introduction Vonoprazan, a new oral potassium-competitive acid blocker (PCAB), has shown promise in terms of superior acid suppression when compared to Proton pump inhibitors (PPIs). We evaluated the efficacy of PCABs versus PPIs in preventing rebleeding in high-risk peptic ulcer patients after endoscopic hemostasis. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines, we conducted a comprehensive search for relevant studies across Medline...

ObjectivesGastric cancer (GC) is a leading cause of cancer mortality in the United States (U.S.), yet no routine screening strategy exists. Opportunistic upper endoscopy (EGD) performed during screening colonoscopy (EGD-SC) may provide a practical early detection approach. We evaluated the feasibility, acceptability, patient perspectives, and diagnostic yield of EGD-SC. MethodsThis single-center, open-label, single-arm prospective trial enrolled adults aged 45-80 years scheduled for colonoscopy...

ObjectiveTo identify independent risk factors for early ([≤]7-day) re-bleeding after peptic ulcer bleeding (PUB) and to compare the predictive performance of Forrest classification, Complete Rockall Score (CRS), and Glasgow-Blatchford Score (GBS). MethodsWe retrospectively analyzed adults with endoscopy-confirmed peptic ulcer bleeding from 2015-2020. Early re-bleeding was defined as [≤]7 days after index hemostasis. We applied univariable and multivariable logistic regression and assessed...

BackgroundPerianal Crohns disease (PCD) represents one of the most severe and refractory forms of pediatric inflammatory bowel disease (IBD). Constipation and colonic redundancy, particularly type 1 dolichocolon (T1-DC), may increase distal rectosigmoid pressure, and exacerbate perianal pathology. We hypothesized that T1-DC is more common in children with PCD than in those with uncomplicated ileocolonic Crohns disease (CD) or non-IBD controls. MethodsWe retrospectively analyzed 20 consecutive p...

BackgroundSeveral colorectal cancer (CRC) screening modalities are guideline-recommended in the United States, yet they vary considerably in screening interval and real-world adherence. As a result, single-round test performance may not reflect cumulative effectiveness over time. This study compared the 10-year longitudinal outcomes of two CRC screening strategies-- triennial next-generation multitarget stool DNA testing (ng mt-sDNA) and decennial screening colonoscopy. MethodsThis study used t...

IntroductionObesity and related cardiometabolic comorbidities, including hypertension, dyslipidemia, diabetes, metabolic dysfunction-associated steatotic liver disease (MASLD), and atherosclerotic cardiovascular disease (ASCVD), are increasingly prevalent among individuals with inflammatory bowel disease (IBD). These conditions influence disease activity, therapeutic response, surgical outcomes, and overall quality of life, yet evidence remains fragmented. The Modulate Obesity and relateD metabo...

BackgroundEndoscopic resection is the standard treatment for rectal neuroendocrine tumors (r-NETs) [≤]10 mm, yet the optimal technique remains controversial. Modified endoscopic mucosal resection (m-EMR) has emerged as a potential alternative compared to endoscopic submucosal dissection (ESD), but existing evidence is largely retrospective and the results of recent randomized controlled trials (RCTs) are inconclusive. AimsTo compare the efficacy and safety of m-EMR versus ESD for r-NETs [&le...

Background and AimsAvoidance of symptom-related situations is common in chronic gastrointestinal (GI) conditions, contributing to greater symptom severity, psychological distress, and reduced quality of life. However, no validated measure exists to comprehensively assess GI-specific avoidance. We developed and validated the GI-specific Avoidance Scale (GIAS), a self-report instrument measuring behavioral and cognitive avoidance specific to GI symptoms. MethodsFollowing literature review and mul...

BackgroundAnti-tumor necrosis factor (anti-TNF), particularly infliximab, have transformed inflammatory bowel disease (IBD) management, but their high cost imposes a significant economic burden. Infliximab biosimilars were introduced to reduce the unmet needs. Despite the approval of infliximab biosimilars, real-world evidence of cardiovascular safety and effectiveness of infliximab biosimilars is lacking among patients with IBD. In this trial emulation, we compared the effectiveness and cardiov...

BackgroundMetabolic dysfunction-associated steatohepatitis (MASH) is a prevalent and progressive liver disease with limited pharmacologic treatment options. Pemvidutide, a GLP-1-glucagon dual receptor agonist, has shown promise in targeting both hepatic steatosis and fibrosis. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of pemvidutide in adults with MASH. MethodsWe systematically searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL through Decembe...

BackgroundPatients with chronic immune-mediated disorders (IMIDs), including inflammatory bowel disease (IBD), are at increased risk of cardiovascular disease. While advanced therapies show cardioprotective effects in other IMIDs, their impact on major adverse cardiovascular events (MACE) in IBD remains unclear. We conducted a meta-analysis of randomized controlled trials (RCTs) and observational studies evaluating MACE risk with advanced therapies in IBD. MethodsSystematic search of PubMed, Em...

Chronic constipation is highly prevalent, and cases refractory to treatment are particularly challenging to manage. High-resolution colonic manometry (HRM) is used to further evaluate these patients to identify cases of intrinsic motor dysfunction (underlying myopathy or neuropathy). However, HRM is invasive and resource-intensive, limiting uptake and clinical utility. This study presents Body Surface Colonic Mapping (BSCM), a non-invasive cutaneous electrical recording technique, as a clinical ...

IntroductionPrevious studies have shown that Aquamin(R), a multi-mineral extract from red marine algae, enhances barrier integrity proteins in the human colon. These findings prompted further investigation into Aquamin(R)s effects on gastrointestinal barrier function and permeability. MethodsSubjects with mild or in remission ulcerative colitis (UC) and healthy controls were enrolled in an open-label trial and received Aquamin(R) capsules (800 mg calcium/day) for 90 days. Intestinal permeabilit...

BackgroundAchieving deep remission, such as e.g. histo-endoscopic remission, is a key objective in inflammatory bowel disease (IBD). However, this metric depends on invasive procedures that are impractical in routine care, whereas current non-invasive blood biomarkers demonstrate only limited correlation with disease activity. ObjectiveWe used serum metabolomics to identify blood-based signatures that comprehensively assess disease activity. DesignSerum was collected from HC (n=195), UC (n=183...

BackgroundComprehensive data on the prevalence of Helicobacter pylori infection and its associated risk factors among patients with gastrointestinal symptoms remain limited. Generating this evidence would help inform clinical management and improve antibiotic stewardship. H. pylori infection affects a substantial proportion of the global population, with prevalence varying widely across regions. In Uganda, previous studies have documented the presence of H. pylori infection. However, data specif...

PurposeHirschsprung-associated enterocolitis remains a major postoperative complication of Hirschsprungs disease (HD), and impaired epithelial barrier integrity has been proposed as a contributing factor. In this study, we investigated whether 12-hydroxyheptadecatrienoic acid (12-HHT), an endogenous leukotriene B4 receptor 2 (BLT-2) agonist, enhances the epithelial barrier and exerts anti-inflammatory effects in patient-derived colonic organoids. MethodsNormoganglionic specimens from rectal/rec...

BackgroundCrohns disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract characterized by high post-operative recurrence (POR) rates, reaching up to 90% within one year. Current clinical and endoscopic predictors show limited accuracy. ObjectiveThis study aimed to identify molecular mechanisms associated with POR at the time of surgery through integrated transcriptomic and bacteriomic analyses of ileal tissue. DesignIleal samples were obtained during surgery from 20 patie...

Background and aimsGastrointestinal symptoms remain common in adults with cystic fibrosis (CF) despite cystic fibrosis transmembrane conductance regulator modulator use, suggesting persistent and heterogeneous gut dysfunction. This prospective observational study tests the hypothesis that distinct gut symptom phenotypes in CF can be observed and linked to underlying mechanisms. MethodsAdults from three UK CF centres completed the Gastrointestinal Symptom Rating Scale, Patient Assessment of Cons...

ObjectivesTo characterize ultra-processed food (UPF) circulating metabolic signatures associated with Crohns disease (CD) and to localize key metabolic mediators linking UPF intake to CD risk. DesignProspective cohort study. SettingTwo large multi-center cohorts (UK Biobank [UKB] and Whitehall II [WHII] study) across the UK and an Eastern multi-center cohort ONE-IBD Study from China. ParticipantsUK Biobank discovery cohort (n=10,229) for signature derivation, internal validation cohort (n=91,...

BackgroundAntithrombotic drugs are widely used for cardiovascular disease prevention, but their association with non-gallstone acute pancreatitis (NGAP) remains unclear. ObjectiveTo prospectively investigate the association between regular antithrombotic drug use and the risk of incident NGAP. DesignProspective cohort study. ParticipantsA total of 431,754 participants from the UK Biobank who were free of cancer, gallstone disease, and pancreatitis at baseline. Main MeasuresThe exposure was d...