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Role of magnetic resonance in bowel pathologies:Beyond inflammatory bowel disease 认领 引用
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作者 Carlos Ignacio Gonzalez Baerga Manuel Menendez Santos +3 位作者 Ruben Gabriel Ortiz Cordero Oswaldo Andre Guevara Tirado Mayur Virarkar Dheeraj Reddy Gopireddy 《World Journal of Radiology》 2026年第7期21-32,共12页
Magnetic resonance imaging(MRI)has an established role for identifying and monitoring inflammatory bowel disease.This review summarizes key MRI findings and select technique considerations for bowel pathologies beyond... Magnetic resonance imaging(MRI)has an established role for identifying and monitoring inflammatory bowel disease.This review summarizes key MRI findings and select technique considerations for bowel pathologies beyond inflammatory bowel disorders,emphasizing how imaging features within this modality can support diagnosis and assist with management.We highlight MRI features of inflammatory and infectious conditions,mechanical obstruction,neoplasms,and mesenteric ischemia.We also discuss how particular imaging techniques may improve diagnostic confidence,including diffusion-weighted imaging when contrast cannot be administered and rapid motion-robust sequences to reduce motion artifacts from peristalsis and breathing. 展开更多
关键词 Magnetic resonance imaging Mesenteric ischemia Bowel obstruction Small bowel Inflammatory bowel disease Enteritis
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Surgical interventions in inflammatory bowel disease:Indications,techniques,outcomes,and future directions 认领 引用
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作者 Himanshu Agrawal Nikhil Gupta 《World Journal of Gastrointestinal Pharmacology and Therapeutics》 2026年第2期162-174,共13页
BACKGROUND Inflammatory bowel disease(IBD),encompassing ulcerative colitis(UC)and Crohn’s disease(CD),is a chronic relapsing condition in which surgical intervention remains a cornerstone of management despite advanc... BACKGROUND Inflammatory bowel disease(IBD),encompassing ulcerative colitis(UC)and Crohn’s disease(CD),is a chronic relapsing condition in which surgical intervention remains a cornerstone of management despite advances in medical therapy.Surgery plays a definitive role in UC and a complication-directed,bowelpreserving role in CD.AIM To provide a comprehensive narrative overview of contemporary surgical management in IBD,focusing on indications,operative strategies,perioperative optimization,postoperative outcomes,and future directions.METHODS A narrative review was conducted following the principles of the PRISMA 2009 guidelines.A comprehensive literature search of PubMed/MEDLINE,EMBASE,Scopus,and the Cochrane Library was performed for studies published between January 2000 and December 2024.Relevant original studies,systematic reviews,and meta-analyses addressing surgical interventions in adult IBD patients were included.Evidence was synthesized descriptively.RESULTS Surgical indications in UC include medically refractory disease,dysplasia or malignancy,and life-threatening complications,with restorative proctocolectomy and ileal pouch-anal anastomosis(IPAA)representing the standard elective procedure.In CD,surgery is primarily indicated for fibrostenotic and penetrating complications,with emphasis on bowel-sparing approaches such as limited resection and strictureplasty.Minimally invasive and robotic techniques have demonstrated favorable short-term outcomes without compromising long-term results.Perioperative optimization-including nutritional support,steroid minimization,and appropriate integration of biologic therapy-plays a critical role in reducing complications.Postoperative recurrence in CD and pouch-related disorders following IPAA remain major challenges,requiring structured surveillance and multidisciplinary care.CONCLUSION Surgery continues to play a vital and evolving role in the management of IBD.Advances in surgical techniques,perioperative care,and integration with medical therapy have improved outcomes and quality of life.Optimal results depend on individualized decision-making within a multidisciplinary framework,with ongoing research needed to refine strategies for recurrence prevention and long-term functional preservation. 展开更多
关键词 Inflammatory bowel disease Ulcerative colitis Crohn’s disease Ileal pouch-anal anastomosis Bowel-sparing surgery
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Efficacy and safety of a novel sodium picosulfate oral tablet in a randomized controlled trial for bowel preparation 认领 引用 被引量：1
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作者 Su Bum Park Sang Bum Kang +12 位作者 Geom Seog Seo Chang Soo Eun Chang Hwan Choi Dong-Hoon Yang Jae Jun Park Chang Mo Moon Sung Hoon Jung Hyung Park Mi Hee Park Ho Kyun Yoo Jiwon Kim Jung A Heo Dong Il Park 《World Journal of Gastroenterology》 SCIE CAS 2026年第6期57-66,共10页
BACKGROUND Oral sulfate tablets(OSTs)are commonly used in South Korea,but the requirement to ingest 28 tablets and concerns regarding renal and gastrointestinal safety may reduce patient compliance.DWJ1609 is a novel ... BACKGROUND Oral sulfate tablets(OSTs)are commonly used in South Korea,but the requirement to ingest 28 tablets and concerns regarding renal and gastrointestinal safety may reduce patient compliance.DWJ1609 is a novel OST formulation that contains sodium picosulfate and 25%less sulfate,requiring only 20 tablets.This modification is expected to improve tolerability while maintaining cleansing efficacy.AIM To evaluate the bowel cleansing efficacy and safety of DWJ1609 compared with conventional OSTs and to assess adverse events.METHODS This prospective,randomized,single-blinded(investigator),multicenter,phase III clinical trial was conducted at seven university hospitals in South Korea.The primary endpoint was the non-inferiority of DWJ1609 based on the proportion of participants achieving a“successful”grade A or B on the Harefield Cleansing Scale,as assessed by independent central readers.Safety was monitored through adverse events and laboratory evaluations.RESULTS Overall,215 participants were randomized,and 200 were included in the per-protocol analysis(DWJ1609:99;OST:101).Successful bowel cleansing was achieved in 96.97% of the DWJ1609 group,which was non-inferior to the OST group(100.00%),with a difference of 3.03%.DWJ1609 showed significantly higher tolerability,with lower incidence of nausea,headache,and dizziness,although vomiting occurred slightly more frequently.CONCLUSION DWJ1609 demonstrated non-inferior bowel cleansing efficacy,improved tolerability,and a favorable safety profile compared with conventional.DWJ1609 has the potential to improve compliance and overall quality of colonoscopy. 展开更多
关键词 DWJ1609 Sodium picosulfate Oral sulfate tablets Bowel preparation Colon cleansing
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Advancing bowel preparation:DWJ1609 represents a patientcentered evolution in colonoscopy preparation 认领 引用
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作者 Iyad A Issa Taly Issa 《World Journal of Gastroenterology》 SCIE CAS 2026年第30期25-31,共7页
Bowel preparation quality remains a central determinant of colonoscopy success,yet patient intolerance to existing regimens continues to limit adherence to colorectal cancer screening.In a recent phase III randomized ... Bowel preparation quality remains a central determinant of colonoscopy success,yet patient intolerance to existing regimens continues to limit adherence to colorectal cancer screening.In a recent phase III randomized controlled trial,DWJ1609,a novel oral sulfate tablet(OST)formulation,was designed to improve the patient experience without compromising cleansing efficacy.By reducing sulfate content by approximately 75%and incorporating sodium picosulfate to maintain laxative effectiveness,DWJ1609 achieved a 96.97%successful cleansing rate,meeting noninferiority criteria compared with conventional OSTs.More importantly,the formulation demonstrated a markedly improved tolerability profile,with nearly half the rate of adverse drug reactions and substantial reductions in nausea and headache—symptoms that frequently deter patients from undergoing colonoscopy.These findings highlight a meaningful shift toward patient-centered bowel preparation,addressing a longstanding barrier to screening participation.While the study population was younger and healthier than typical screening cohorts,and further validation in high-risk groups is needed,the results suggest that DWJ1609 may offer a more acceptable and safer alternative for many patients.As colorectal cancer screening expands to younger populations,innovations that enhance preparation tolerability will play an increasingly important role in improving screening uptake and outcomes. 展开更多
关键词 Bowel preparation Colonoscopy Oral sulfate tablets DWJ1609 Colorectal cancer screening Sodium picosulfate Bowel cleansing efficacy
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Mechanism of anti-human antigen D(HuD/ELAVL4)autoantibodyinduced enteric neuronal apoptosis in irritable bowel syndrome and its potential for targeted intervention 认领 引用
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作者 Yu Zhang Chen Zhu +7 位作者 Su-Hong Xia Ming-Yu Zhang Yi-Ran Liu Jia-Lun Guan Yu-Jie Huang Kai Zhao Jia-Zhi Liao Wen-Juan Fan 《World Journal of Gastroenterology》 SCIE CAS 2026年第22期68-87,共20页
BACKGROUND Irritable bowel syndrome(IBS)is a common disorder of gut-brain interaction and is characterized by chronic abdominal pain and altered bowel habits.Current evidence indicates that immune activation and autoa... BACKGROUND Irritable bowel syndrome(IBS)is a common disorder of gut-brain interaction and is characterized by chronic abdominal pain and altered bowel habits.Current evidence indicates that immune activation and autoantibody production contribute to IBS pathogenesis.However,the mechanisms by which autoantibodies affect the enteric nervous system and contribute to IBS-related symptoms are poorly understood.AIM To investigate the role of anti-human antigen D[HuD,also known as ELAV-like protein 4(ELAVL4)]autoantibodies in enteric neuronal apoptosis in an IBS animal model.METHODS A passive-transfer rat model of IBS was generated by intraperitoneal administration of HuD autoantibodies.Gastrointestinal motility,visceral sensitivity,fecal output,and water content were assessed.Enteric neuronal apoptosis in intestinal tissues and primary enteric neurons was analyzed by immunofluorescence.Mechanisms were examined using quantitative reverse transcription polymerase chain reaction,western blotting,and confocal microscopy.Interventions included recombinant HuD,immunoglobulin,5-hydroxytryptamine receptor modulators,and protein kinase C(PKC)agonists.RESULTS Administration of HuD autoantibodies induced IBS-like phenotypes in rats.We observed increased fecal output,elevated fecal water content,accelerated intestinal transit,and enhanced visceral hypersensitivity.HuD autoantibody exposure significantly increased enteric neuronal apoptosis in vivo and in vitro and suppressed the expression of special AT-rich sequence-binding protein 1(SATB1).Mechanistically,HuD autoantibodies disrupted HuD-mediated RNA regulation,leading to SATB1 downregulation and inhibition of the phosphatidylinositol 3-kinase(PI3K)-protein kinase B(AKT)signaling pathway.PKC activation restored HuD and SATB1 expression,reactivated PI3K-AKT signaling,and significantly reduced neuronal apoptosis.Treatment with immunoglobulin and 5-hydroxytryptamine receptor agonists showed limited or inconsistent protective effects.CONCLUSION HuD autoantibodies induced enteric neuronal apoptosis through disruption of the HuD-SATB1-PI3K-AKT signaling axis and contributed to IBS-like gastrointestinal dysfunction.Activation of PKC may be a potential therapeutic strategy for IBS. 展开更多
关键词 Irritable bowel syndrome Anti-HuD autoantibody Enteric neuron Apoptosis Intervention
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Nanotechnology-based natural remedies:Advancing inflammatory bowel disease treatment through targeted drug delivery 认领 引用
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作者 Luqing Zhao Dan Dou +5 位作者 Di Zhang Shuqing Wang Xihan Zhu Ning Ding Shengsheng Zhang Chao Li 《Chinese Chemical Letters》 SCIE CAS CSCD 2026年第5期92-100,共9页
Inflammatory bowel disease(IBD),which includes Crohn's disease and ulcerative colitis,represents a significant health challenge due to its intricate interplay of genetic,environmental,and immunological factors.Whi... Inflammatory bowel disease(IBD),which includes Crohn's disease and ulcerative colitis,represents a significant health challenge due to its intricate interplay of genetic,environmental,and immunological factors.While current treatments are effective at managing symptoms,they are not without drawbacks,such as potential side effects,the financial strain on patients,and the risk of complications.Nanotechnology presents an innovative solution to these challenges,offering the potential to improve the bioavailability,stability,and precise delivery of natural compounds with potent anti-inflammatory properties.This review examines the array of nanoparticle(NP)delivery systems that are revolutionizing IBD treatment,including lipid-based NPs,polymeric NPs,metallic NPs,plant-derived exosomes,and mesoporous silica NPs.Furthermore,the review explores the various responsive mechanisms of NPs,including p H-responsive,reactive oxygen species(ROS)-responsive,enzyme-responsive,charge-mediated,ligand-receptor targeted,and multi-responsive systems.The therapeutic potential of nanomedicines derived from natural products is highlighted,with a focus on their roles in immunomodulation,reducing inflammation,repairing the intestinal barrier,and modulating the gut microbiota.Nanotechnology boosts IBD treatment with novel natural NPs.NPs delivery systems offer notable benefits,such as improving drug solubility,increasing the efficiency of absorption,alongside providing a controlled and sustained release of therapeutic agents directly at the inflammation site.Despite the promising capabilities of nanotechnology in IBD treatment,obstacles remain.These include the necessity for comprehensive toxicological assessments,formulating strategies to guarantee the safety and effectiveness of these innovative treatments.Therefore,this review provides a systematic analysis that provides guidance for the research and development of NPs based natural products. 展开更多
关键词 Inflammatory bowel disease Natural product nanomaterials Colon targeting Drug delivery system Therapeutic mechanisms
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Electroacupuncture repairs intestinal mucosal barrier in rats with diarrhea-predominant irritable bowel syndrome by regulating adherens junctions through mast cells and microRNAs 认领 引用
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作者 Yu-jun Hou Hua-bin Zheng +6 位作者 Kai Wang Hui-ling Jiang Ying Chen Lu Wang Qian-hua Zheng Ying Li Si-yuan Zhou 《Journal of Integrative Medicine》 SCIE CAS CSCD 2026年第1期125-136,共12页
Objective:To assess whether electroacupuncture(EA)can facilitate the restoration of the intestinal mucosal barrier in rats with diarrhea-predominant irritable bowel syndrome(IBS-D)by regulating adherens junctions thro... Objective:To assess whether electroacupuncture(EA)can facilitate the restoration of the intestinal mucosal barrier in rats with diarrhea-predominant irritable bowel syndrome(IBS-D)by regulating adherens junctions through mast cells(MCs)and micro RNAs.Methods:Forty Sprague–Dawley rats were divided into control group and IBS-D group.Rats were given Senna solution via gavage and subjected to a 14-day chronic unpredictable mild stress procedure.Subsequently,rats in the IBS-D group were assigned to a model group,an EA group,and an EA+MC agonist group.Visceral pain threshold and diarrhea index(DI)were measured.Transmission electron microscopy was used to observe the ultrastructure of MCs.Enzyme-linked immunosorbent assay(ELISA)was used to measure tryptase and diamine oxidase(DAO)levels.Western blotting and quantitative polymerase chain reaction(q PCR)techniques were used to evaluate the quantities of E-cadherin and acatenin.Immunohistochemistry and ELISA were used to assess the levels of F-actin and vinculin.micro RNAs from the colon were sequenced,and q PCR was used to validate the sequencing results.In vitro,Caco-2 cells were used to establish the intestinal epithelium model.After transfection with mi R-494-3p mimics,q PCR was performed to measure the expression of micro RNAs,E-cadherin and acatenin;the transmittance of fluorescein isothiocyanate-dextran was detected to measure permeability of the cell layer.Results:In the model group,DI,and tryptase and DAO concentration increased;body weight,visceral pain threshold and the expression of E-cadherin,a-catenin,F-actin and vinculin were significantly decreased compared to the control group.This pattern was reversed in the EA group.No significant difference was found between the EA+MC agonist group and the model group.Sequencing revealed that the expression of mi R-541-5p and mi R-494-3p was significantly higher in the model group and lower in the EA group.Enrichment analyses revealed that the majority of enrichments were associated with adherens junctions.Spearman's correlation tests indicated that the expression of mi R-541-5p and mi R-494-3p had a positive correlation with serum DAO and colonic tryptase levels,while showing a negative correlation with E-cadherin level.After micro RNA mimic transfection,the expression of mi R-494-3p and the barrier permeability were significantly increased,and the expression of E-cadherin was significantly decreased.Conclusion:In rats with IBS-D,EA may help repair the intestinal barrier function by modulating adherens junctions and cytoskeletal components through the inhibition of MCs;mi R-494-3p may play pivotal roles in this process. 展开更多
关键词 Irritable bowel syndrome Electroacupuncture Mast cells Adherens junction Cytoskeletal components microRNA
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Development and validation of an interpretable machine learning model to predict high-risk patients with acute small bowel obstruction 认领 引用
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作者 Yingsong Zhao Hongda Wang +9 位作者 Eryang Zhao Guangyu Zhao Junrong Zhang Sanyang Chen Yang Li Yong Zhao Wenfeng Zhuo Guozheng Lyu Ping Hu Gang Zhao 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2026年第4期344-352,共9页
BACKGROUND:Small bowel obstruction(SBO) is a common emergency surgical disease for which identifying patients need emergency surgical resection due to nonviable small bowel tissue poses a significant challenge. This s... BACKGROUND:Small bowel obstruction(SBO) is a common emergency surgical disease for which identifying patients need emergency surgical resection due to nonviable small bowel tissue poses a significant challenge. This study aimed to develop and validate a predictive model to guide surgical decision-making using readily available clinical data.METHODS:A retrospective cohort study was conducted using data from Wuhan Union Hospital between 2017 and 2023 to establish the prediction model, with an external validation cohort from two other medical centers. Six machine learning algorithms(Logistic Regression[LR], Random Forest[RF], K Nearest-Neighbours[KNN], Multilayer Perceptron[MLP], Adaptive Boosting[AdaBoost]and eXtreme Gradient Boosting[XGBoost]) were employed, and the final model was based on LR classifier. Performance was evaluated with various metrics including AUC-ROC, accuracy,and decision curve analysis. SHapley Additive exPlanations(SHAP) method was used for model interpretation.RESULTS:High-risk and low-risk SBO groups differed significantly in clinical, laboratory,imaging, treatment, and outcome variables. Ten predictors were retained:white blood cell count,history of abdominal operation, platelet, albumin, neutrophil, spiral sign, acute bellyache, ascites,lymphocyte count, and rebound tenderness. After comparing the six algorithms, LR was selected because it showed the most consistent generalization and calibration. The final LR model achieved an AUC of 0.889(95%CI 0.855–0.923) in the training data, a mean cross-validation AUC of 0.876(95%CI 0.773–0.978), and an AUC of 0.873(95%CI 0.818–0.929) in the independent test set. In the external validation cohort from the two other medical centers, the model achieved an AUC of 0.762(95%CI 0.693–0.831).CONCLUSION:An interpretable machine learning model was developed and validated for prediction of high-risk SBO patients upon admission. The model may offer decision support for clinicians, aiding in risk stratification and guiding treatment strategies. 展开更多
关键词 Small bowel obstruction Machine learning Prediction model
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Role of physical therapy in irritable bowel syndrome:Current strategies and prospective options 认领 引用
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作者 Jing Chai Zhen-Yi Wang +7 位作者 Zhi-Jun Weng Zi-Jun Zhang Lu-Yi Wu Fang Zhang Lu-Lu Cao Zi-Yi Chen Huan-Gan Wu Hui-Rong Liu 《World Journal of Gastroenterology》 SCIE CAS 2026年第29期27-43,共17页
Irritable bowel syndrome(IBS)is a chronic functional gastrointestinal disorder characterized by dysregulation of the gut-brain interaction.It has a high global prevalence,significantly impairs quality of life,and impo... Irritable bowel syndrome(IBS)is a chronic functional gastrointestinal disorder characterized by dysregulation of the gut-brain interaction.It has a high global prevalence,significantly impairs quality of life,and imposes a substantial socioeconomic burden.The pathophysiology of IBS is complex and not yet fully elucidated,with its heterogeneity reflecting the interplay of multiple factors,including abnormal gastrointestinal motility,visceral hypersensitivity,gut microbiota dysbiosis,low-grade inflammation,and central nervous system dysfunction.This mechanistic complexity not only accounts for the highly individualized symptom profile of IBS but also highlights the limitations of monotherapy in addressing the long-term management needs of patients.Given the limited efficacy,frequent adverse effects,and insufficient adaptability of pharmacological treatments to the heterogeneity of IBS,non-pharmacological interventions have increasingly attracted attention.Among these,physical therapies-using electrical,magnetic,thermal,photic,or mechanical stimulation-can modulate neural activity at central,peripheral,and autonomic levels and have shown promising potential in alleviating IBS symptoms.The underlying mechanisms of physical therapies for IBS are proposed to involve neural modulation,visceral sensory regulation,immunoinflammatory control,and optimization of gut-brain axis function,representing a multi-system,synergistic mode of action.This narrative review synthesizes and contextualizes recent advances in emerging physical therapies for IBS,with a focus on clinical efficacy,safety,and feasibility,while discussing their potential mechanisms within a unified theoretical framework.The current limitations of the evidence,including small sample sizes,inconsistent intervention parameters,and insufficient mechanistic validation,are also addressed.Finally,future research directions are proposed,encom-passing mechanism-driven clinical studies,standardization of intervention parameters,and high-quality rando-mized controlled trials.Overall,physical therapy offers a non-pharmacological,multi-mechanistic intervention capable of modulating multiple physiological systems. 展开更多
关键词 Irritable bowel syndrome Physical therapy Non-pharmacological treatment Exercise therapy Acupuncture
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Identification of strong correlations of clearance with clinical outcomes for inflammatory bowel disease 认领 引用
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作者 Diane R Mould Maximillian Kutschera +8 位作者 Christian Primas Sieglinde Reinisch Gottfried Novacek CorneliaLichtenberger Thierry Dervieux Yunju Bae Sun Hee Lee Joon Ho Lee Walter Reinisch 《World Journal of Gastroenterology》 SCIE CAS 2026年第5期78-92,共15页
BACKGROUND Low drug concentrations have been linked to antidrug antibody(ADA)formation.High clearance is a major reason for low drug levels leading to treatment failure in patients with inflammatory bowel disease(IBD)... BACKGROUND Low drug concentrations have been linked to antidrug antibody(ADA)formation.High clearance is a major reason for low drug levels leading to treatment failure in patients with inflammatory bowel disease(IBD)receiving infliximab(IFX).AIM To explore the predictive value of initial IFX clearance on outcomes and assess the impact of Bayesian model(iDose)-guided IFX dosing on clearance and outcomes during induction and early maintenance treatment.METHODS Data from a Phase 3 study of 220 CT-P13/originator IFX-treated patients with Crohn’s disease were used to develop probability models for outcomes including mucosal healing(MHEAL),biomarker response[C-reactive protein(CRP)],ADA development,a composite endpoint and time to first ADA formation,based on initial clearance.Subsequently,patients with characteristics suggesting rapid initial clearance were enrolled in a≤120-day(October 2018 to December 2019)compassionate use program of iDose-guided IFX treatment as a proof of concept to determine if the probabilities from initial clearance could be improved with individualized therapy.Serial serum IFX concentrations,clearance,outcome probabilities,and treatment outcomes were analyzed.RESULTS In the CT-P13 study,population pharmacokinetic was consistent with previously published models.Initial clearance was a significant predictor of several outcomes including MHEAL,CRP normalization,a composite endpoint((1)CDAI at week 54 was at least 150 points less than baseline;(2)MHEAL at week 54;(3)CRP was in normal range at week 54;and(4)FCP was less than 250 at week 54)and ADA formation.In the proof-of-concept study,10 patients received iDose-guided IFX treatment.Initial clearance ranged from 0.017 L/day to 1.11 L/day,prompting up to three IFX infusions within the first 2 weeks.Two patients were discontinued due to ADA.Generally,clearance slowed over time and inflammatory biomarker levels improved.There were no adverse effects.CONCLUSION Initial IFX clearance correlates with efficacy metrics and ADA formation.These probability curves may be useful to identify patients at risk of treatment failure or ADA who may benefit from individualized therapy.iDose-guided treatment successfully achieved targeted serum IFX concentrations,reducing risk of ADA formation.Proactive therapeutic drug monitoring and targeted dosing based on early IFX clearance may improve treatment outcomes for patients with IBD. 展开更多
关键词 Antidrug antibodies Bayesian model-guided dosing Clearance Inflammatory bowel disease Infliximab Pharmacokinetics Therapeutic drug monitoring
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Predicting gastrointestinal bleeding and audio biomarkers based on machine learning analysis of bowel sounds 认领 引用
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作者 Lei Zhang Meng-Yue Wang +6 位作者 Shi-Yu Wei Cheng Su Sen-Yi Hu Xiao-Yang Ren Ya-Ping Liu Chang Liu Yong Wan 《World Journal of Gastroenterology》 SCIE CAS 2026年第14期81-95,共15页
BACKGROUND Early diagnosis of upper gastrointestinal bleeding(UGIB)relies on invasive endoscopy and laboratory tests,which carry procedural risks and diagnostic delays.The pathophysiological relationship between bowel... BACKGROUND Early diagnosis of upper gastrointestinal bleeding(UGIB)relies on invasive endoscopy and laboratory tests,which carry procedural risks and diagnostic delays.The pathophysiological relationship between bowel sounds(BSs)as a noninvasive monitoring metric and UGIB remains to be elucidated.AIM To investigate the feasibility of BS acoustic signatures as UGIB screening biomarkers,analyze their pathological correlations with hematological indices,and construct a machine learning-assisted diagnostic model.METHODS A prospective study enrolled 40 UGIB patients(endoscopy-confirmed within 24 hours)and 40 age-/sex-matched healthy controls.BS signals were recorded at the right lower umbilical quadrant using a G-200 device(60 seconds/subject,4 kHz sampling).After denoising via variational mode decomposition,78-dimensional features were extracted across four domains:Time-domain,frequency-domain,time-frequency domain,and nonlinear dynamics.Weighted feature importance was calculated using an integrated strategy and gradient-optimized feature subsets were used to train four classifiers:Support vector machine,random forest,logistic regression,and K-nearest neighbor.SHapley Additive exPlanations analysis was conducted on the features of the optimal model.Model performance was evaluated by fivefold cross-validation.Spearman’s correlation analysis was performed to assess key BS features against red blood cell count,hemoglobin,hematocrit,C-reactive protein(CRP),and high-sensitivity CRP.RESULTS The support vector machine classifier with 25-feature subsets achieved optimal performance(area under the curve>0.89),significantly outperforming other models.Acoustic feature importance analysis identified band_Energy and Mel-frequency cepstral coefficient variance as core biomarkers(cumulative contribution>60%).Key pathological correlations included:(1)Significant negative correlations between spectral centroid and red blood cell count/hemoglobin/hematocrit(P<0.01);(2)Positive correlation between wavelet entropy and these hematological parameters(P<0.05),suggesting multiscale microcirculatory flow fluctuations;and(3)Positive wavelet energy correlations with CRP/high-sensitivity-CRP(P<0.05).CONCLUSION Multidimensional BS features enable noninvasive UGIB screening.Their strong correlation with anemia/inflammation indicators reveals an acoustic-hemato-physiological coupling mechanism,providing a novel paradigm for early UGIB monitoring. 展开更多
关键词 Bowel sound analysis Upper gastrointestinal bleeding Support vector machine Machine learning Non-invasive diagnosis
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Latent tuberculosis screening for inflammatory bowel disease in tuberculosis endemic region remains porous and suboptimal:A multicentre study 认领 引用
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作者 Daya Krishna Jha Shilpa Prasad +25 位作者 Arun Valsan Shubhra Mishra Priya Nair Anoop K Koshy Sonal Singh Ajay Shankar Prasad Rajat Shukla Rizwan Ahamed Philip Augustine Kartik Natarajan Kiran Peddi Akshay Kulkarni Sumit Bhatia Aditya V Pachisia Pradeep K Singh Anuraag Jena Swatantra Gupta Shubham Jain Kodavoor Padmaprakash Rinkalben Kakadiya Amit Kumar Siddharth Shukla Usha Dutta Vivek Hande Sandeep Thareja Vishal Sharma 《World Journal of Gastroenterology》 SCIE CAS 2026年第4期42-53,共12页
BACKGROUND Screening for latent tuberculosis(LTB)before initiating advanced therapy for inflammatory bowel disease(IBD)helps reduce the risk of tuberculosis(TB)development.However,there is limited data on screening pr... BACKGROUND Screening for latent tuberculosis(LTB)before initiating advanced therapy for inflammatory bowel disease(IBD)helps reduce the risk of tuberculosis(TB)development.However,there is limited data on screening practices from TBendemic regions.AIM To study the practices of screening for LTB and study the incidence of TB in patients with IBD on biological and small molecule inhibitors.METHODS This retrospective multicentre study analyzed LTB screening practices in IBD patients starting advanced therapies between 2018 and 2022.We included patients who were initiated on biologics(infliximab,adalimumab,vedolizumab)or small molecule inhibitors(tofacitinib).We assessed compliance with LTB screening methods,including the tuberculin skin test,interferon-gamma release assay(IGRA),chest X-ray,and computed tomography chest,both at initiation and annually.We also evaluated the incidence of active TB and its predictors.RESULTS Of 378 patients(mean age:36.9±14.9 years,males:56.9%),158(41.8%)and 216(57.1%)had ulcerative colitis and Crohn’s disease,respectively.Advanced therapy used were anti-tumor necrosis factor in 309(81.74%),tofacitinib in 41(10.84%)and vedolizumab in 28(7.40%).Standard screening and diligent screening strategy was employed in 59%and 33%of patients,respectively.Compliance with tuberculin skin test and IGRA was noted in 261(69.04%)and 298(78.83%)patients,respectively.Chest X-Ray and computed tomography chest were performed in 300(79.36%)and 242(64.02%),respectively.Annual screening in those on advanced therapy for>1 year was performed in 27.2%(50/184).Active TB developed in 17(4.49%);15(88.23%)were on anti-tumor necrosis factor.LTB was detected in 40(10.72%),with most diagnosed on the basis of IGRA(21/40,52.50%).Among 17 patients who developed active TB,LTB screen was negative in 12(70.58%).CONCLUSION Standard screening practices for LTB,prior to starting advanced therapy,remain suboptimal(<60%)in India despite high TB endemicity. 展开更多
关键词 Tuberculosis Inflammatory bowel disease Advanced therapy Ulcerative colitis Crohn’s disease
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Antibiotic consumption of inpatients with inflammatory bowel disease during 2015-2024 and future prediction:Evidence from a general hospital 认领 引用
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作者 Wen Zeng Wei-Kun Zhang +4 位作者 Duo Xu Kun He Yu-Ping Huang Yu-Xi Liu Hui-Fang Yang 《World Journal of Gastroenterology》 SCIE CAS 2026年第4期68-78,共11页
BACKGROUND Inflammatory bowel disease(IBD)is a chronic,gastrointestinal condition including ulcerative colitis and Crohn’s disease.Patients diagnosed with IBD are more susceptible to infections and frequently require... BACKGROUND Inflammatory bowel disease(IBD)is a chronic,gastrointestinal condition including ulcerative colitis and Crohn’s disease.Patients diagnosed with IBD are more susceptible to infections and frequently require antibiotics.AIM To analyze the antibiotic consumption of IBD inpatients and project future relevant trends.METHODS We retrospectively collected the demographic and antibiotic usage data from the IBD patients hospitalized between 2015 and 2024.The antibiotics were classified,and the consumption intensity was calculated.The appropriate statistical methods were applied to compare the differences between groups.The Monte Carlo simulation was used to forecast the antibiotic consumption from 2025 to 2027.RESULTS A total of 1985 hospitalizations and 372 antibiotic prescriptions were included in this work.The antibiotic-exposed patients were older,had longer hospital stays,and higher costs.Males and ulcerative colitis patients showed a higher antibiotic usage.The highest consumption was observed in 2019,2022,and 2024.The common indications were intestinal infections and perioperative prophylaxis.Cephalosporins andβ-lactam antimicrobials were most commonly used,while carbapenems and glycopeptide antibacterials increased during 2022-2024.Although the antibiotic usage rates decreased in 2020-2024 when compared to 2015-2019,the consumption intensity significantly increased.The Monte Carlo simulation projected a 170.0%(95%uncertainty interval:-42.1%to 689.7%)consumption increase by 2027.CONCLUSION These findings highlight the need to strengthen antibiotic stewardship and infection control strategies in IBD inpatient management to prevent further escalation of antimicrobial resistance. 展开更多
关键词 Inflammatory bowel disease Inpatients Ulcerative colitis Crohn’s disease Antibiotic consumption Monte Carlo simulation
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Relationship between statin use and inflammatory bowel disease:Exploring possible implications 认领 引用
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作者 Antonietta G Gravina Raffaele Pellegrino +6 位作者 Michele Izzo Ilaria De Costanzo Giuseppe Imperio Assunta Tambaro Alessia Lamart Fabio Landa Alessandro Federico 《World Journal of Gastroenterology》 SCIE CAS 2026年第18期1-17,共17页
Inflammatory bowel diseases(IBD)have a chronic,relapsing,remitting course and impose a substantial clinical impact and economic burden.Despite the expansion of therapeutic options,a significant proportion of patients ... Inflammatory bowel diseases(IBD)have a chronic,relapsing,remitting course and impose a substantial clinical impact and economic burden.Despite the expansion of therapeutic options,a significant proportion of patients continue to fail to achieve relevant outcomes,representing a difficult-to-overcome therapeutic ceiling and highlighting the need to explore complementary pharmacological strategies.In this context,statins,widely used in cardiovascular prevention,have attracted increasing attention for their anti-inflammatory and immunomodulatory effects,independent of their lipid-lowering action.This review summarizes the available data on the relationship between statin use and IBD,including preclinical data,observational studies and clinical trials.Experimental studies demonstrate that statins modulate key pathways of intestinal inflammation,reducing pro-inflammatory cytokine production,improving epithelial barrier function and influencing both innate and adaptive immune responses.Large-scale epidemiological studies further suggest an association between statin use and a reduced risk of IBD onset,as well as a less aggressive clinical course in patients with established disease,with a lower need for corticosteroids,hospitalizations and surgery.Preliminary evidence also indicates a potential role in reducing the risk of colorectal carcinoma associated with chronic inflammation.Although the current data do not yet justify the adoption of statins as a specific treatment for IBD,these findings demonstrate a clear potential for these pharmacological agents to enter the therapeutic armamentarium of IBD. 展开更多
关键词 Statins Inflammatory bowel disease Crohn’s disease Ulcerative colitis Immunomodulation Anti-inflammatory effects Cardiovascular comorbidity Disease activity Colorectal cancer Complementary therapy
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Letter to the Editor:Gut microbiota–bile acid crosstalk-Prevotellaceae NK3B31 and 7-ketolithocholic acid drive metabolic benefits of distal bowel resection with preservation of terminal ileum 认领 引用
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作者 Xu Cui Long-Yao Xu +3 位作者 Bing-Qian Yin Liu Chen Zheng Liang Chao-Ming Zhou 《World Journal of Hepatology》 2026年第5期313-317,共5页
This letter commends on the study published in World Journal of Gastroenterology by Xu et al,which elucidated the mechanism by which distal bowel resection with terminal ileum preservation(DBRPI)improves hepatic gluco... This letter commends on the study published in World Journal of Gastroenterology by Xu et al,which elucidated the mechanism by which distal bowel resection with terminal ileum preservation(DBRPI)improves hepatic gluconeogenesis via the Prevotellaceae NK3B31_group/7-ketolithocholic acid(7-KLCA)/farnesoid X receptor(FXR)axis.Using multiomics and functional assays,Xu et al identified this microbial–bile acid(BA)axis as central to the metabolic benefits of DBRPI,linking microbial enrichment(e.g.,Prevotellaceae NK3B31_group)to increased 7-KLCA levels and FXR activation,thereby suppressing gluconeogenic gene expression.We highlight the novelty of this work in its focus on taxon-specific microbial and BA dynamics,which advances the understanding of postoperative glucose regulation.Additionally,we note its translational potential—targeting this axis via probiotics or 7-KLCA analogs—and raise several open questions,including causal validation of the microbial taxon,serum 7-KLCA dynamics,and glucagon-likepeptide-1/FXR interplay.Overall,this study bridges gut microbiota and BA crosstalk,offering actionable insights for the treatment of metabolic disease. 展开更多
关键词 Distal bowel resection with terminal ileum preservation Gut microbiota Bile acid metabolism Prevotellaceae NK3B31_group 7-ketolithocholic acid Glucose homeostasis
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Letter to the Editor:Probiotics counteract polyethylene glycol bowel preparation dysbiosis and infection risk 认领 引用
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作者 Yang Fu 《World Journal of Gastroenterology》 SCIE CAS 2026年第28期157-160,F0003,共4页
Polyethylene glycol(PEG)bowel preparation,though widely used,can significantly disrupt gut microbiota composition.Kou et al recently published study in the World Journal of Gastroenterology,which demonstrated that PEG... Polyethylene glycol(PEG)bowel preparation,though widely used,can significantly disrupt gut microbiota composition.Kou et al recently published study in the World Journal of Gastroenterology,which demonstrated that PEG-treated mice challenged with Citrobacter rodentium exhibit higher pathogen loads,elevated virulence gene expression,and worsened colitis,mediated by microbiota dysbiosis.Importantly,Lactobacillus acidophilus supplementation restored microbial balance and mitigated infection severity,suggesting PEG-induced loss of colonization resistance exposes a 14-day infection window.This paradigm aligns with a rare human case of septic shock after PEG bowel preparation,highlighting potential opportunistic infection risk.Probiotic Lactobacillus strengthen the epithelial barrier and modulate immunity,and clinical trials support their efficacy and safety in gastrointestinal contexts.We discuss the translational significance of these findings and advocate microbiota-protective strategies(probiotic supplementation,optimal timing of endoscopy,and dietary adjustments)during bowel preparation. 展开更多
关键词 Polyethylene glycol Bowel preparation Dysbiosis Citrobacter rodentium Probiotics Colonoscopy Infection risk
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Genetic factors that predict response and failure of biologic therapy in inflammatory bowel disease 认领 引用
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作者 Milena Peruhova Daniela Stoyanova +3 位作者 Dimitrina Georgieva Miteva Meglena Kitanova Milko Bozhidarov Mirchev Tsvetelina Velikova 《World Journal of Experimental Medicine》 2025年第1期11-23,共13页
Inflammatory bowel disease(IBD)represents a significant disease burden marked by chronic inflammation and complications that adversely affect patients’quality of life.Effective diagnostic strategies involve clinical ... Inflammatory bowel disease(IBD)represents a significant disease burden marked by chronic inflammation and complications that adversely affect patients’quality of life.Effective diagnostic strategies involve clinical assessments,endoscopic evaluations,imaging studies,and biomarker testing,where early diagnosis is essential for effective management and prevention of long-term complications,highlighting the need for continual advancements in diagnostic methods.The intricate interplay between genetic factors and the outcomes of biological therapy is of critical importance.Unraveling the genetic determinants that influence responses and failures to biological therapy holds significant promise for optimizing treatment strategies for patients with IBD on biologics.Through an indepth examination of current literature,this review article synthesizes critical genetic markers associated with therapeutic efficacy and resistance in IBD.Understanding these genetic actors paves the way for personalized approaches,informing clinicians on predicting,tailoring,and enhancing the effectiveness of biological therapies for improved outcomes in patients with IBD. 展开更多
关键词 Inflammatory bowel disease Genetic predictors Inflammatory bowel disease treatment Biologic therapy Biologic therapy response Genetic markers in inflammatory bowel disease Inflammatory bowel disease treatment failure Pharmacogenomics Biologic therapy efficacy Genetic variability
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Microbial and functional shifts between flare and remission in a single-center cohort of children with inflammatory bowel disease 认领 引用
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作者 James Guoxian Huang Carina Jing-Xuan Tay +2 位作者 Marion Margaret Aw Yung-Seng Lee Delicia Shu-Qin Ooi 《World Journal of Clinical Pediatrics》 2026年第3期302-316,共15页
BACKGROUND Gut microbial dysbiosis is central to the pathogenesis of inflammatory bowel disease(IBD).While gut microbiome differences between patients with and without IBD are well established,microbiome changes assoc... BACKGROUND Gut microbial dysbiosis is central to the pathogenesis of inflammatory bowel disease(IBD).While gut microbiome differences between patients with and without IBD are well established,microbiome changes associated with disease activity and remission remain limited,particularly in paediatric populations.AIM To examine intra-individual taxonomic and functional gut microbiome changes during transition from active flare to remission under maintenance immunosuppression in a pilot single-center Singapore cohort of children with IBD.METHODS Paired stool samples and clinical data were collected from seven patients with paediatric IBD[5 Crohn’s disease(CD),2 ulcerative colitis;≤18 years]during active disease/flare(visit 1;Pediatric CD Activity Index/Pediatric Ulcerative Colitis Activity Index≥10)and subsequent clinical remission(visit 2;Pediatric CD Activity Index/Pediatric Ulcerative Colitis Activity Index<10).Samples underwent shotgun metagenomic sequencing for high-resolution taxonomic profiling and functional annotation of Kyoto Encyclopaedia of Genes and Genomes pathways.RESULTS Gut microbial diversity was reduced during flare compared to remission,with Actinobacteria abundance significantly higher in remission.Two distinct microbial clusters differentiated flare and remission states:The remission cluster was enriched with Bifidobacterium adolescentis,Bifidobacterium dentium,Lactobacillus gasseri,Faecalibacterium prausnitzii,while the flare state showed increased Klebsiella pneumoniae.Remission was further characterized by a downregulation of pathogenic microbes and an upregulation of beneficial microbes including a higher abundance of the butyrate producer Anaerostipes hadrus(P=0.046).Microbial functional genes enriched in remission were predominantly associated with metabolic pathways including vitamin and cofactor biosynthesis,as well as carbohydrate,amino acid,and lipid metabolism.CONCLUSION The transition from flare to remission in Singaporean children with IBD is characterized by functional remodeling of the gut microbiome,which may contribute to recovery processes related to intestinal barrier integrity,cellular maintenance,and tissue repair.Targeted modulation of the gut microbiome may help sustain remission in paediatric IBD. 展开更多
关键词 Inflammatory bowel disease Pediatrics Metagenomic Gut microbiome Microbial shift Functional shift
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Efficacy of linaclotide with polyethylene glycol at high risk of inadequate bowel preparation:A randomized controlled trial 认领 引用
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作者 Wei-Min Li Xiao-Peng Wang +4 位作者 Yu-Xuan Li Yi-Dong Wang Yi-Jie Sun Guo-Dong Li Jia-Qi Wu 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第6期339-346,共8页
BACKGROUND Adequate bowel preparation is fundamental for colonoscopy.The traditional strategy of 3 L polyethylene glycol(PEG)is often unsatisfactory for people at high risk of inadequate bowel preparation(HR-IBP).AIM ... BACKGROUND Adequate bowel preparation is fundamental for colonoscopy.The traditional strategy of 3 L polyethylene glycol(PEG)is often unsatisfactory for people at high risk of inadequate bowel preparation(HR-IBP).AIM To evaluate bowel preparation quality and adverse events associated with 3 L PEG combined with linaclotide in the HR-IBP population.METHODS This single-center,endoscopist-blinded,randomized controlled trial enrolled patients scheduled for colonoscopy.A total of 167 patients were randomly allocated to either the 3 L PEG group or the 3 L PEG plus linaclotide group.The quality of bowel preparation was assessed using the Boston bowel preparation scale(BBPS).The adenoma detection rate(ADR),polyp detection rate(PDR),polyp characteristics,and adverse events were also analyzed.RESULTS BBPS scores were significantly higher in the 3 L PEG plus linaclotide group than in the 3 L PEG alone group(6.800±1.444 vs 5.593±1.579,P<0.001).The adequate bowel preparation rate was also markedly higher in the 3 L PEG plus linaclotide group(86.250%vs 58.025%,P<0.001).ADR,PDR,polyp characteristics,and adverse events were comparable between the groups.CONCLUSION The combination of 3 L PEG and linaclotide is optimal for bowel cleansing in high-risk cohorts. 展开更多
关键词 Linaclotide Bowel preparation High-risk patients Boston bowel preparation scale Adequate preparation rate
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Bowel preparation with still water for small bowel capsule endoscopy:Less is more 认领 引用
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作者 Ana I Ferreira Francisca Côrte-Real +6 位作者 Mariana M Souto Sofia Xavier Jose R Pereira Cátia Arieira Bruno Rosa Maria A Duarte Jose Cotter 《World Journal of Gastrointestinal Endoscopy》 2026年第6期36-44,共9页
BACKGROUND The optimal bowel preparation for small bowel capsule endoscopy(SBCE)has not been standardized.AIM To compare the rate of complete examinations,quality of bowel preparation,diagnostic yield and tolerability... BACKGROUND The optimal bowel preparation for small bowel capsule endoscopy(SBCE)has not been standardized.AIM To compare the rate of complete examinations,quality of bowel preparation,diagnostic yield and tolerability,using three protocols for SBCE.METHODS A prospective,multicentre,randomized study including patients submitted to SBCE was conducted.Patients ingested a booster once the capsule reached the small bowel,randomized into one of three protocols:(1)1 L of polyethylene glycol(PEG);(2)1 L of PEG and ascorbic acid;and(3)1 L of water.The patients’bowel preparation was evaluated with Small Bowel CLEansing Assessment and Report.RESULTS A total of 261 patients were included,96(36.8%)in protocol 1,93(35.6%)in protocol 2 and 72(27.6%)in protocol 3.The rate of complete examinations,adequate bowel preparation and diagnostic yield were comparable among the groups(P=0.655,P=0.193 and P=0.589,respectively).The overall Small Bowel CLEansing Assessment and Report score was similar among the protocols(P=0.236).Although the preparation of the third tertile had a lower score using protocol 3(protocol 1:2.5±0.1 vs 2:2.6±0.1 vs 3:2.3±0.1,P=0.021),it did not compromise the mucosal visualization,maintaining a mean score above 2 and similar diagnostic yield among the protocols(P=0.850).The patients’reported tolerability was higher in protocol 3(protocol 1:2.8±0.1 vs 2:3.0±0.2 vs 3:0.6±0.1,P<0.001).CONCLUSION Using 1 L of water as a booster in SBCE was better tolerated and associated with comparable rates of complete examinations,adequate bowel preparation and diagnostic yield vs PEG with or without ascorbic acid. 展开更多
关键词 Small bowel capsule endoscopy Intestinal preparation Small bowel cleansing Complete examinations Tolerability
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