Journal of Gastroenterology & Hepatology Reports
Journal of Gastroenterology & Hepatology Reports is an open access peer-reviewed journal from the publishers of Scientific Research and Community (SRC) which publishes articles in the form of written, video and power-point presentations from the arena of Gastroenterology & Hepatology Reports. The journal focuses to build up accessing the complete content of articles freely from online for reader’s perusal. Article acceptance will be in the form of research, review, case reports, analysis, magazines, editorials, opinion, communications, mini-review, short communications, picturized, book review, video type and power point presentations (PPTS). You can submit manuscripts online at: https://srcpublishers.com/gastroenterology-hepatology-repo/user/register or Email: gastroreports@onlinescientificresearch.info 1.023 Impact Factor 84.5% Citations 90% Acceptance
Genetic and Molecular Characteristics of Rare Malignant Tumors of The Colorectal Tract: A Comprehensive Genomic Profiling Study
While the vast majority of colorectal tract malignancies are adenocarcinomas, a subset of rare histological subtypes including neuroendocrine carcinomas (NECs), gastrointestinal stromal tumors (GISTs), and primary colorectal lymphomas account for approximately 1–5% of cases. Due to their low incidence, the genomic landscape of these rare tumors remains poorly characterized. This study aimed to delineate the distinct genetic and molecular profiles of rare malignant colorectal tumors using next-generation sequencing (NGS) to identify potential therapeutic targets and elucidate their pathogenesis.
Copyright (c) 2026 Journal of Gastroenterology & Hepatology Reports
Prevalence of Irritable Bowel Syndrome and Associated Factors Among Medical Students: A Cross-Sectional Study
Background: Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder with significant impact on quality of life. Medical students are considered a high-risk population due to increased psychological stress and lifestyle-related factors. Objective: This study aimed to determine the prevalence of IBS and associated factors among medical students. Methods: A cross-sectional study was conducted among 104 medical students. Data were collected through a structured questionnaire assessing demographic characteristics, gastrointestinal symptoms, and lifestyle-related factors. IBS diagnosis was based on self-reported symptoms. Results: IBS was identified in 31 students, corresponding to a prevalence of 29.8%. Gastrointestinal symptoms were reported by 93.5% of participants. Female students showed a higher tendency toward IBS. Most symptoms were mild, though some students experienced moderate to severe symptoms. Conclusion: IBS is highly prevalent among medical students. Stress, gender, and lifestyle factors appear to play significant roles. Early screening and preventive strategies are recommended.
Irritable Bowel Syndrome, Medical Students, Prevalence, Stress, Gastrointestinal Symptoms
The Difference in Metabolic and Chronological Age is Associated with Steatosis and Liver Fibrosis
Background: The two most common types of fatty liver disease (steatosis) are nonalcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD). NAFLD affects about 30% of people in Western countries and 10% of people in Asia. In the United States, rates are about 35%, with about 7% having severe NASH. NAFLD affects about 10% of children in the United States. Fat accumulation in the liver is accompanied by a disorder of a series of metabolic processes, i.e. metabolic dysfunction with multiple parallel metabolic shocks throughout the body. Material and Methods: A monocentric, controlled, randomized study was conducted involving 20 practically healthy individuals and 31 patients with hepatomegaly without additional specific symptoms of liver pathology. Liver steatosis degree measurement by the Controlled attenuation parameter (CAP) transient elastography. Metabological age (Met-age) was determined based on tetrapolar multifrequency bioimpedancemetry with vector analysis (BIM-V). Results and Discussion: MET-age younger to CHR-age has significantly more Body Cells Mass (BCM) proportion (50,5 (95%CI =50,0-51,1) vs. 43,9(95%CI =42,8-45,0) and less content of Fat Mass (in kg) fixed -14,7 (95%CI =13,7-15,6) vs. 27,9(95%CI =25,3-30,5. The parallel comparition analysis the MET-age, steatosis (STe) and liver fibrosis (F) show following. In practically healthy people Met-age oldest 2 years or more than CHR-age (Age Diff) was found in the subgroup with severe steatosis (S=3) in 88,9% (8 of 9)(95%CI=51,8 – 99,7) and in 1 of 11 individuals with mild.
Copyright (c) 2025 Journal of Gastroenterology & Hepatology Reports
Series of Clinical Studies on the Eradication of Helicobacter Pylori with the Potassium - Competitive Acid Blocker- Amoxicillin Dual - Therapy Regimen
In recent years, the Potassium - competitive acid blocker (P-CABs) - amoxicillin dual - therapy regimen has been recommended for the eradication of Helicobacter pylori (H.pylori). However, there are still uncertainties about the optimal drug dosage and treatment duration. Our research group carried out a series of multi - center clinical studies in Fujian Province, China, aiming to explore the efficacy and safety of this dual - therapy regimen for H.pylori eradication. The study covered different treatment durations (7 - day, 10 - day, and 14 - day), various types of P-CABs (vonoprazan, tegoprazan, and keprazan), and different dosages of P-CABs. The results demonstrated that the 10 - day and 14 - day dual - therapy regimens outperformed the 7 - day one, and the 10 - day regimen was non - inferior to the 14 - day one. Moreover, all dual - therapy regimens with different P-CABs achieved an eradication rate of over 90%, and the low - dose P-CABs-amoxicillin dual - therapy regimen was as effective as the high - dose one. These findings hold significant implications. In China, they can directly guide clinicians in Fujian and other regions to select more appropriate treatment options for H.pylori eradication, potentially improving the overall treatment efficiency and reducing unnecessary medical costs. On a global scale, considering the high prevalence of H.pylori infection worldwide, our research provides valuable references for international medical communities. It offers a new perspective on optimizing the P-CABs - amoxicillin dual - therapy regimen, which may contribute to the development of more standardized and effective treatment strategies for H.pylori eradication globally.
The review proposes a model of the etiology of celiac disease. It describes how an enteroviral attack by a lytic virus leads to hyper-extracellular Transglutaminase 2, (Tg2), evident at all stages of the disease by the presence of anti-tTG. The demand for Tg2 is supplied by both the cell and the lytic virus. The demand leads to excess Tg2 passing through the cell wall, excess ingress of Ca2+, the destruction of the mitochondria by Ca2+, and pyroptosis of the cell. The increase in extracellular Tg2 during the cell’s life and following pyroptosis has two effects. First, it binds a C1r inhibitor to the vascular wall, preventing C1r-LP from converting prehaptoglobin (zonulin) into haptoglobin, causing the weakening of the tight junctions among the epithelial cells and allowing the entry of extraneous luminal materials and particularly the access of Tg2 arterial and luminal, as it is now open directly to the lumen and the mesenchyme structure. It is this Tg2 that damages the villus structure as the Tg2 binds fibronectin into the mesenchyme, causing scarring, shrinkage, and turning the villi into the rigid scarred structures characteristic of CD. The model suggests why CD is a chronic lifelong disease reactivated upon the resumption of gluten consumption. A discussion of refractory CD follows. The paper explains how extracellular transglutaminase causes prehaptoglobin (zonulin) and damages the extracellular membrane. Thus, prehaptoglobin (zonulin) is a symptom, not a cause. Notably, the paper demonstrates that the basic tenet of autoimmune diseases that the cells destroy themselves is incorrect, at least for CD. Applying this etiology to other conditions may be relevant because of the almost universal glutaminolysis in cells and the substantial amount of Gluten in modern diets.
Successful Surgical Treatment of Anterior Fusion Implants Injury of the Cervical Esophagus: Two Case Reports
We report of two patient’s cases, who underwent anterior cervical fusion for polytrauma due to car accident. The patients suffered very rare complications of the surgery: cage dislocation into the cervical esophagus in first case and injury of esophageal wall with fistulae formation in the second one. By surgical treatment the extraction of the cage, removal the ventral plate and repair of the esophageal wall defect were performed. To prevent failure of the sutures placed on the wound of the esophagus, the method of covering the suture line with a pedicled flap cut from the medial portion of the sternocleidomastoid muscle was used. Feeding gastrostomy was also created. The control X-Ray examination was performed at 6th p/o day, which reveals no extravasation and free passage of contrast to the stomach. We consider, that the method of covering the suture line by pedicled flap from sternocleidomastoid muscle in cases of difficult suturing of defects of the cervical esophagus, is a good surgical option. Surgeons should be aware of the risk of implant injury of esophageal wall and cage dislocation of cervical fusion procedure.
Endoscopy after Bariatric Surgery Case Series
Morbid Obesity contributes to the constellation of medical comorbidities that comprise Metabolic Syndrome. As >2/3 of America is Overweight (BMI 25-29.9) or Obese (BMI 30+). There are many treatment modalities for Morbid Obesity, but none is more effective long term than Bariatric Surgery, not even the newest GLP-1 agonists can compete with the Laparoscopic Sleeve Gastrectomy (LSG) or the Roux-en-Y Gastric Bypass (RYGB). About 300,000 Metabolic and Bariatric Surgery (MBS) procedures were performed yearly (1/1000 population of the US per year). As surgical treatment for Morbid Obesity becomes more common, we as Gastroenterologists must continue to learn about the topic and how to treat potential complications. Sleeve Gastrectomy continues to be the most performed procedure, RYGB continues to be 20-25% of the MBS volume yearly. RYGB complications that may require Endoscopic interventions may include: Leak (which is usually at the Gastro-Jejunostomy/GJ) and may require stenting, Stricture (which may require dilation with either an endoscopic balloon or with a bougie, Formation of Marginal Ulcers, Bleeding (which can require any number of methods to control endoscopically, owing to the stomach’s rich blood supply), Perforation, Pouch or GJ enlargement. The Gastrogastric Fistula (GGF) is a rare (1%) but complex problem that requires clinical insight and suspicion. GGF typically presents with: weight regain, pain, worsening GERD symptoms. It may occur because of a complication from surgery (leak, infection, bleed) where a fistula forms between the gastric pouch and the remnant stomach due to a staple line breakdown. Alternatively, it may result from iatrogenic methods.
Gastroenterology Viewed Through a Glass Darkly – An IDI Focused Perspective
The linear expansion of medical information has already precipitated fragmentation of physician-based clinical care into multiple subspecialties predicated on site of disease dysfunction. Through the widespread expansion and dissemination of information in the areas of diagnostic and case-management, Artificial Intelligence (AI) stands to erode exclusivity of patient care and redirect committed populations to alternate healthcare providers. Governing a broad area of patient care, gastroenterologists have the responsibility to identify the canaries in the coal mine within their area of expertise. When canaries have been disregarded, the fiscal fallout has been significant: e.g. Individuals lacking production of gastric acid who developed peptic ulcer disease are just such canneries. When it was documented that PUD was of infectious disease causation and curable using antibiotics, the income of gastroenterologists dramatically decreased. Largely due to disease entities grouped under the term, Inflammatory Bowel Disease (IBD), gastroenterologists are currently the second-best compensated subspecialists within internal medicine. Not having addressed the discipline’s scientific deficiencies that were unmasked by the PUB debacle, gastroenterologists have set the stage for another fall from fiscal grace. This IDI Perspective is an analysis of gastroenterology’s vulnerable scientific underbelly, why history stands to repeat itself, and what can be done to minimize the consequences.
Meditation, Yoga and Spiritual Fitness Heal Dementia and Brain Disorders
Older adults underestimate their level of life stress and early adversity, and kind of the impact that has. For some people, early adversity can affect their entire lives, but for other people, it seems like it catches up to them once they’re aging. our frontal lobes helping moderate our emotional responses. But the frontal lobes are also one of the main areas of the brain that begins to decline with age in terms of function. By sitting in any posture, standing, lying or walking for few minutes meditation include general wellbeing improvement, like decreasing depression and anxiety and improving sleep hygiene. By meditation like this one, you’re turning on the frontal lobes as you repeat the sounds and touch your fingers. Another area that becomes activated is the thalamus, which is a very core structure of the brain that helps regulate neuronal information flow. Most beneficial aspect of meditation training is increased self-control of emotions and attention. Psychologists are fond of touting the popular phrase “willpower is like a muscle,” meaning that the more a person practices delaying gratification, the easier it becomes to deny oneself in the short term for a better payoff later. As per the genetic makeup and climatic conditions different person will observe different sensation on body parts. The Gamma, Beta, Alpha, Theta and Delta ray regulate the brain activities as per sleep and function Fig. And so when you have these areas turned on, what that is basically doing is helping you better concentrate and regulate different parts of the brain. If you right now focus for the next few seconds or minutes on your breathing-breathe in and breathe out very slowly results in you’re going to reduce your heart rate, blood pressure and calm your brain down. So it is important to make sure that you can fully engage the practice whether it is meditation, prayer, yoga, or some other spiritual practice.
A Case Report of Non-Puerperal Galactorrhea Induced by Long Term Use of Domperidone and Literature Review
Objective: To investigate the clinical features, pathogenesis, and key points of diagnosis and treatment of non-puerperal galactorrhea induced by long-term use of domperidone, aiming to enhance clinicians’ awareness of this adverse drug reaction and promote rational drug use. Method: The clinical data of a 54-year-old female patient with non-puerperal galactorrhea caused by long-term oral domperidone were reported. The case was discussed and analyzed in conjunction with a review of relevant literature. Results: The patient was a 54-year-old woman who presented with “intermittent galactorrhea for two weeks” and significant anxiety. For gastric discomfort, she had been taking domperidone (brand name: Motilium) 10 mg three times daily for two consecutive months. Upon admission, her serum prolactin level was found to be significantly elevated. Based on her medication history, a diagnosis of drug-induced hyperprolactinemia was considered. Domperidone was discontinued without any other specific treatment. Two weeks after cessation, the galactorrhea symptoms resolved, and a re-examination of serum prolactin returned to a normal level. Conclusion: As a peripheral dopamine D2 receptor antagonist, long-term use of domperidone can lead to hyperprolactinemia and galactorrhea by blocking dopamine receptors in the tuberoinfundibular pathway. Clinicians should pay close attention to its endocrine side effects, strictly adhere to the treatment duration recommended in the drug’s label, and strengthen physician-patient communication and adverse reaction monitoring during therapy to avoid unnecessary patient anxiety and waste of medical resources.
Log Odds of Positive Lymph Nodes Predict Surgical Prognosisin Intrahepatic Cholangiocarcinoma based on Seer Cohort and Nomogram Model
Background: Intrahepatic cholangiocarcinoma (ICC) has a high postoperative recurrence rate, but quantitative assessment of lymph node metastasis (LNM) by AJCC staging remains inadequate. The log odds of positive lymph nodes (LODDS) have prognostic value in digestive system tumors, but its application in ICC has yet to be studied. Method: Based on the SEER database (2010-2017), 593 ICC patients after hepatectomy or choledochotomy surgery, Cox regression was applied to analyze the association between LODDS and the risk of all-cause mortality (ACM) and cancer-specific mortality (CSM), and risk thresholds were determined by restricted cubic spline (RCS), and a nomogram predictive model was constructed based on variables screened by Boruta’s algorithm. Patients were stratified by optimal nomogram cutoff, and survival was compared via Kaplan-Meier curves. Results: LODDS was positively linear correlated with ACM (HR=2.062, 95% CI: 1.683, 2.527, P<0.001) and CSM (HR=2.068, 95% CI: 1.632, 2.622, P<0.001), with the optimal cutoff value of -0.63. The risk of death was increased 1.7 times in the high LODDS group (>-0.477) compared with the baseline group. The nomogram integrating variables such as LODDS, T-staging, and tumor size had a C-index of 0.711, which had a good predictive performance. Survival differences were statistically significant for both LODDS-based stratification and nomogram-based risk groups. Conclusion: LODDS is an independent prognostic factor for post-operative ICC survival, enabling optimized risk stratification and personalized followup strategies.
Log Odds of Positive Lymph Nodes (LODDS)
Effect of Combined Ethanol Leaf Extracts of Vernonia Amygdalina(Bitter Leave) and Gongronema Latifolium (Utazi) on Lead Induced Hepatoxicity in Wistar Rats
This study evaluated the effect of leaf extract of Vernonia Amygdalina and Gongronema Latifolium on the liver of lead-induced toxicity wistar rats. A total of thirty (30) albino wistar rats were used for this study. Five (5) albino wistar rats were used for acute toxicity of the leave extracts of Vernonia Amygdalina andGongronema latifolium; while the remaining 25 albino wistar rats were divided into 5 groups: Group 1 which served as normal control received only water. Group 2 (NC) negative control received only lead. Group 3 (PC) positive control received lead + Vit. C. (standard drug for lead) via oral administration. Group 4: animals received lead + ethanol fraction of Vernonia Amygdalina and Gongronema Latifolium through oral administration (200 mg/Kg)/. Group 5: animals received lead + ethanol fraction of Vernonia amygdalina and Gongronema Lafifolium via oral administration (400 Mg/Kg). The combined effect of Vernonia amygdalina and Gongronema Latifolium thus has protective and curative properties against lead-induced liver damage.
Pegylated Granulocyte Colony Stimulating Factor Combined with Anti-Pd-1/Pd-L1 Inhibitors in the Treatment of Recurrent or Metastatic Biliary Tract Cancer
Background: Biliary tract cancer (BTC) is a malignancy with an extremely poor prognosis. For patients with recurrent or metastatic BTC who have failed first-line chemotherapy, treatment options are limited. Although anti-PD-1/PD-L1 inhibitors have shown efficacy in various tumors, their single-agent activity in BTC is limited, particularly in previously treated patients. Preclinical evidence suggests that granulocyte-colony stimulating factor (G-CSF) may enhance the efficacy of anti-PD-1/PD-L1 inhibitors by remodeling the tumor immune microenvironment. This study aimed to evaluate whether the addition of long-acting G-CSF (pegylated recombinant human G-CSF, pegfilgrastim) could restore or enhance the efficacy of anti-PD-1/PD-L1 inhibitors in patients with resistant BTC. Methods This was a single-arm, prospective, Phase II clinical trial. The inclusion criteria were histologically confirmed recurrent or metastatic BTC that had progressed after at least one line of systemic chemotherapy. All patients received an anti-PD-1 inhibitor (sintilimab 200mg IV q3w) or an anti-PD-L1 inhibitor (atezolizumab 1200mg IV q3w). On day 2 of each cycle, pegfilgrastim (6mg subcutaneously) was administered. The primary endpoint was the Objective Response Rate (ORR) as assessed by the investigator according to RECIST v1.1. Secondary endpoints included Disease Control Rate (DCR), Progression-Free Survival (PFS), Overall Survival (OS), duration of response (DoR), and safety. Results A total of 42 patients were enrolled. The median follow-up time was 12.8 months (95% CI: 10.5-15.1 months). The confirmed ORR was 21.4% (95% CI: 10.3%-36.8%), with 1 patient achieving a complete response (CR) and 8 patients achieving a partial response (PR). The DCR was 66.7% (95% CI: 50.5%- 80.4%). The median PFS was 4.2 months (95% CI: 3.1-5.3 months), and the median OS was 11.5 months (95% CI: 9.2-13.8 months). The most common treatment-related adverse events (TRAEs) of any grade were leukopenia (45.2%), neutropenia (40.5%), and fatigue (31.0%). Grade 3 or higher TRAEs occurred in 19.0% of patients, with the most common being neutropenia (9.5%) and anemia (4.8%). No treatment-related deaths were reported. Exploratory biomarker analysis suggested that patients with a baseline neutrophil-to-lymphocyte ratio (NLR) < 3 had a higher ORR and longer PFS. Conclusion For patients with recurrent or metastatic BTC who have progressed on prior chemotherapy, the combination of long-acting G-CSF and anti-PD-1/PD-L1 inhibitors demonstrated promising anti-tumor activity and a manageable safety profile. This regimen appears to be a viable therapeutic option, capable of restoring sensitivity to immunotherapy in this difficult-to-treat population. Further validation from randomized controlled trials is warranted.
Management of Gastrointestinal Failure in the Adult Critical Care Environment
Most healthcare professionals concur on the necessity of providing nutrition to patients and acknowledge the heightened morbidity and mortality associated with malnutrition [1]. However, the delayed consequences of acute underfeeding complicate this responsibility, often relegating it to nursing staff, similar to the tasks of early mobilization and pressure injury prevention. Patients in the ICU typically present with acute organ failure(s) and the management thereof. While cardiac, pulmonary, and renal failures are routinely evaluated and monitored, gastrointestinal failure remains inadequately addressed and acknowledged. This critical organ system has, until now, been omitted from the evaluation criteria of multiple organ failure scores, such as the SOFA score, which only includes the liver to represent the entire gastrointestinal tract [2].
Polyprenol-Based Nanoformulations: Dual-Platform Innovation for Parenteral and Diagnostic Applications
Polyprenols, long-chain isoprenoid alcohols of plant origin, possess notable hepatoprotective, antioxidant, antiviral, and immunomodulatory properties and function as metabolic precursors to dolichols, keyessential in for glycoprotein synthesis. Despite growing pharmaceutical interest, their hydrophobic nature hampers bioavailability in aqueous systems. We address this challenge via patented liposomal and nanoemulsion technologies, enhancing solubility, stability, and controlled parenteral release. To bridge research and regulatory application, we propose three novel indices-IMMPREN, TRANSPREN, and STERILPREN—designed to quantify immunomodulatory potential, translational readiness, and sterilization resilience, respectively. IMMPREN evaluates immune traceability through macrophage polarization and Receiver Operating Characteristic (ROC)-based justification; TRANSPREN structures regulatory narratives for GRAS (Generally Recognized As Safe) and Novel Food dossiers; STERILPREN quantifies colloidal and structural integrity post- moist-heat sterilization, aligning with SAL Sterility Assurance level (SAL) standards. Each index enables formulation traceability, clarity in health claims, and stratification by cytokine/cell marker response, supporting injectable and diagnostic deployment. Collectively, our platform offers a modular, regulatory-explainable framework for polyprenol-based therapeutics—positioning these nanofor emulations as dual-use innovations in clinical translation and safety compliance.
Novel Ultrasensitive Eco-Friendly Spectrophotometric Determination of Carvedilol in Pharmaceutical Preparations and Environmental Wastewater Samples: Application to Content Uniformity Testing
A simple, novel, accurate, precise, rapid, economical and sensitive Ultra violet spectrophotometric method has been developed for the determination of Carvedilol in pharmaceutical preparations and environmental wastewater samples, which shows maximum absorbance at 242 nm in methanol. Beer’s law was obeyed in the range of 0.5 -10 μg/ ml, with molar absorptivity of 5.4467×104 L.mol-1.cm-1, relative standard deviation of the method was less than 1.6%, and accuracy (average recovery %) was 100 ± 1.3. No interference was observed from common excipients and additives often accompany with Carvedilol in pharmaceutical preparations. The method was successfully applied to the determination of Carvedilol in some pharmaceutical formulations (tablets) and industrial wastewater samples. The proposed method was validated by sensitivity and precision which proves suitability for the routine analysis of Carvedilol in true samples.
Clinical Case: Colonic Metastasis of Operated Hepatocellular Carcinoma
Background: Hepatocellular carcinoma (HCC) is the most common liver tumor and ranks as the second leading cause of cancer-related mortality worldwide due to its poor prognosis. Its prognosis is influenced by metastatic spread, mainly intrahepatic but also extrahepatic, which carries a more unfavorable prognosis. The most frequent hepatic metastases occur in the lungs, lymph nodes, bones, and adrenal glands. Atypical sites such as colonic involvement are exceptionally rare and scarcely documented in the literature. Case Presentation: A 60-year-old female was referred for an atypical hepatic lesion in segment VII, which developed in an otherwise healthy liver. She underwent laparoscopic right hepatectomy in 2016. In 2022, she presented with tumor recurrence, elevated AFP levels, and the appearance of a tumor nodule in the right hypochondrium, suggestive of peritoneal metastatic localization from her previously operated HCC. She underwent right colectomy, and histopathological analyses confirmed the metastatic nature of the lesion, not peritoneal but colonic. Conclusion: Elevated AFP levels in the context of HCC, even after surgery, should raise suspicion of metastatic recurrence, particularly extrahepatic. Even though rare, colonic metastasis could appear, sometimes in the form of very late recurrence. This underscores the importance of lifelong biological monitoring, including abdominal-pelvic CT scans.
The Dermatological Manifestations of Inflammatory Bowel Disease: Looks Might be Deceiving!
Inflammatory bowel diseases (IBD) is a poorly understood autoimmune clinical entity that include indeterminate colitis, Crohn’s (CD) and ulcerative colitis (UC). Being a chronic relapsing illness, IBD is a multi-system disorder than can involve the eyes, skin, joints, Liver and kidneys, but mostly characterized by chronic relapsing intestinal inflammation. Although IBD, is a chronic inflammatory disorder of the gut, the manifestations of CD and UC are not limited to the gastrointestinal tract. Extraintestinal manifestations (EIMs) are frequently observed in patients with IBD, with a reported frequency of 6-46% [1]. The skin, musculoskeletal, joints, eyes, and hepato-biliary tract are the organs most affected by EIMs.
The Clinical Brilliance of Immunohistochemistry “IHC” in Gastrointestinal Oncology
Immunohistochemistry, or “IHC,” is a powerful tool in clinical diagnostics within the field of gastrointestinal oncology and anatomical pathology. It is utilized to assist in classification of neoplastic, infectious, and inflammatory diseases. The technique generally involves the specific binding between an antibody and antigen to detect and localize specific antigens within tissue samples, usually examined with light microscopy. Biopsies are collected in a number of ways, including snaring, fine needle aspiration, endoscopic mucosal resection, and more; these samples are then processed by a pathologist. This information can be vital in clinical decision making for patients with potential malignancy.
Life After Breast Cancer: How Lymphedema Affects the Quality of Life in Women
According to data from the World Health Organization, more than 10 million new cases of breast cancer (BC) are diagnosed each year. This type of cancer ranks as the leading malignancy among women, accounting for up to 16% of all cancer cases. For every 100 women diagnosed with breast cancer, there is 1 man. In Europe, over 370,000 new cases are registered annually, with approximately 130,000 women succumbing to this disease. The highest mortality rates from breast cancer are observed in the United Kingdom, Denmark, and France, while countries such as India, Ethiopia, China, and Mongolia report significantly lower rates [1].
A Smart, Sensitive Estimation of Thiamine Chloride Hydrochloride(Vitamin B1) in Pharmaceutical Preparations and Environmental Wastewater Samples: Application to Content Uniformity TestingA Smart, Sensitive Estimation of Thiamine Chloride Hydrochloride(Vitamin B1) in Pharmaceutical Preparations and EnvironmentalWastewater Samples: Application to Content Uniformity Testing
A fast, greener, simple, accurate, precise, rapid, economical and high sensitive ultraviolet spectrophotometric method has been developed for the determination of Thiamine Chloride Hydrochloride (Vitamin B1) in pharmaceutical preparations and environmental wastewater samples, which shows maximum absorbance at 235 nm in distilled water. Beer’s law was obeyed in the range of 2.5-30μg/ ml, with molar absorptivity of 1.028x104 L.mol-1.cm-1, relative standard deviation of the method was less than 1.9%, and accuracy (average recovery %) was 100 ± 0. 8. No interference was observed from common excipients and additives often accompany with Thiamine Chloride Hydrochloride in pharmaceutical preparations. The method was successfully applied to the determination of Thiamine Chloride Hydrochloride in some pharmaceutical formulations (tablets) and industrial wastewater samples. The proposed method was validated by sensitivity and precision which proves suitability for the routine analysis of Thiamine Chloride Hydrochloride in true samples.
Thiamine Chloride Hydrochloride (Vitamin B1)
Gastric Outlet Obstruction Due to Actinomycosis, An Uncommon Presentation of a Rare Disease: A Case Report
Background: Actinomyces is gram positive Bacterium part of normal human flora. Even though actinomyces infect various organ systems, including the gastrointestinal tract (GIT), gastric outlet obstruction is extremely uncommon. Case Presentation: We present a case of a 66-year-old female patient who presented with nausea, vomiting and unintentional weight loss. Clinical imaging and upper GI endoscopy revealed narrowed gastric pylorus diagnosed as gastric outlet obstruction (GOO). The Patient required multiple gastroscopies with balloon dilatation and biopsy specimens. Histopathology was consistent with Actinomyces. Subsequent appropriate antibiotics therapy led to GOO resolution and clinical improvement. Discussion: Actinomyces presenting as GOO is a rarely seen clinical diagnosis that may mimic malignancy. It must be considered in the differential diagnosis of abdominal masses broadly and tumor-like infiltrative lesions of the stomach particularly. Proper antibiotic therapy renders favorable outcomes and eliminates unwarranted invasive intervention. Conclusion: Actinomyces presenting as GOO is a rare differential diagnosis of abdominal masses broadly, and tumor-like infiltrative lesions of the stomach particularly. Proper antibiotic therapy facilitates favorable outcomes and eliminates unwarranted invasive interventions. Our patient is such an example where gastric actinomycosis was managed medically and the patient improved, avoiding unnecessary surgical interventions.
Copyright (c) 2024 Journal of Gastroenterology & Hepatology Reports
Pulmonary Vascular Complications in Liver Disease: A Comprehensive Review of Porto-Pulmonary Hypertension and HepatopulmonarySyndrome with Illustrative Case Studies
Background: Porto-pulmonary hypertension (PoPH) and hepatopulmonary syndrome (HPS) are significant pulmonary vascular complications in liver disease patients. Understanding their distinct features is crucial for optimal care. Objectives: To provide an updated overview of PoPH and HPS, compare these conditions, and highlight diagnostic and treatment challenges using illustrative case studies. Methods: A comprehensive literature review was conducted using PubMed, Embase, and Cochrane databases. Two case studies illustrate key clinical features and management considerations. Results: Orthotopic liver transplantation (OLT) generally improves outcomes more consistently in HPS than in PoPH. Appropriate bridging therapy can significantly improve PoPH prognosis prior to OLT. Case studies highlight these approaches, including an atypical HPS presentation with acute liver injury, Budd-Chiari syndrome, and portal hypertension without pre-existing cirrhosis. Conclusion: PoPH and HPS present distinct challenges in liver disease. Early recognition, accurate diagnosis, and tailored management strategies are crucial for improving outcomes. Clinicians must maintain a high index of suspicion for these complications, even in atypical presentations, to ensure timely diagnosis and optimal management.
The Clinical Spectrum of Liver Masses: Know Before You Judge
Liver Masses present a common clinical dilemma, particularly with the wide spread use of cross-sectional imaging in the Emergency Departments. The accurate and reliable determination of the nature of the liver mass is critical, not only to reassure individuals with benign lesions but also to ensure that malignant lesions are diagnosed correctly. In general, Liver Mass can be divided into two main categories: benign lesions and malignant lesions. Benign asses are usually Inflammatory masses including an abscess which can be divided into amebic and pyogenic and truly tumor masses which can be divided into malignant or benign tumors.
The Significance of Biliary Anatomical Variation as a Key Indicator in Laparoscopic Bile Duct Injuries
Introduction: The science of Gastrointestinal (GI) endoscopy is the science and art of millimeters that has marvelously evolved over the past 30 years. Cholecystectomy, most of which is done laparoscopically, is one of the most common procedures performed today (approximately 750,000 cases are performed annually in the USA) and is considered relatively safe. However, laparoscopic cholecystectomy is associated with bile duct injuries. Several studies examining bile duct injuries have found significant rates of complication (0.39%---1.5%, that comes roughly to over 3,000 patient per year). Therefore, bile duct injuries are commonly encountered, and a clear understanding of the extensive variation in biliary anatomy is imperative to appropriately and successfully manage this common clinical problem to ultimately provide the highest level of patient care. Aim: To educate gastroenterologists, general surgeons, and Hepato-Pancreato-Biliary (HPB) surgeons regarding the definition of anatomical variation and its various anatomical markers. Materials and Methods: A Survey research about our GI department in addition to an online research of published literature was made on PubMed, Ovid Medline, Science Direct, and Springer. Results: This paper presents the various anatomical variations of the biliary tree which is critical in defining bile duct injuries during surgical hepatopancreato-biliary (HPB) procedures.
Biliary Track Cancer Retrospective Analysis of Last 10 Years
Surgical resection could offer the only chance of a long-term survival for biliary tract cancer. In fact, only a small number of these patients can undergo surgery with curative intent. The majority receive palliative chemotherapy or other systemic treatments. In patients with localized disease the only treatment is a complete resection. We present herein our experience with 33 patients the last 10 years and summarize the surgical strategies and prognostic factors focusing on the role of surgical resection.
Development of Patient Satisfaction Model in Gastrointestinal Endoscopic Procedures in Indonesia
Background: Patient satisfaction is an indicator of quality and success of medical service. Improvement on the valuation model has been applied in some countries. Aim: This study aimed to test and analyse the effects of the patient satisfaction on revisit intention in patients who undergo gastrointestinal endoscopy in Indonesia. Method: A quantitative survey was conducted through a purposive sampling technique to collect data from XYZ. Results: The survey resulted in 147 responses, which were analysed through partial least squares-structural equation modelling (PLS-SEM). The direct influence on patient satisfaction was found to be the strongest from Skill and Hospital Facility. It was found that patient satisfaction positively and significantly predicted revisit intention. This study has implications for policymakers and hospital management in improving skill and hospital facility and information before endoscopy in optimizing revisit intention through patient satisfaction.
Case Series of Common Omental and Mesenteric Pathologies
Radiological imaging plays a crucial role in the diagnosis and management of a wide range of abdominal pathologies, including those affecting the omentum and mesentery. The omentum and mesentery are important structures in the abdominal cavity, serving a variety of functions, such as providing support to the gastrointestinal tract and facilitating the flow of lymph and blood. Pathologies affecting the omentum and mesentery can result in a wide range of clinical presentations, from mild discomfort to life-threatening complications. Omentum and mesentery are involved in various benign and malignant pathologies like omental infarction, omental torsion, encapsulated fat necrosis, fat saponification due to trauma or pancreatitis, mesenteric panniculitis, epiploic appendagitis, omental nodules and caking in infective and malignant conditions like tuberculosis, peritoneal carcinomatosis and metastasis. Sometimes, there exists a diagnostic dilemma between the benign condition like focal encapsulated fat necrosis and malignant condition like liposarcoma, localized peritoneal carcinomatosis. Therefore, Radiological imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), are invaluable tools for the diagnosis of omental and mesenteric pathologies. In this context, radiologists play a vital role in the accurate interpretation of imaging studies, enabling timely and appropriate management of these complex and often challenging conditions.
An Uncommon Cause of Elevated Liver Transaminases: Immune Reconstitution Inflammatory Syndrome from Unmasking of Occult Mycobacterium Avium Complex Infection in an HIV Infected Patient
Abnormal liver chemistry from the development of immune reconstitution inflammatory syndrome (IRIS) may reflect an unmasking of subclinical disease. We present the case of a 37-year-old female with a mixed pattern of liver injury from disseminated mycobacterium avium complex infection after starting antiretroviral therapy (ART). Presenting symptoms were fever, confusion, dysphagia, and abdominal discomfort for one week. Exam revealed a fever of 103.2°F, hypotension, encephalopathy, and abdominal tenderness. Lab work was significant for acute normocytic anemia, leukopenia, absolute CD4 count 28 cells/cmm, HIV viral load 276 viral copies/ml (vc/ml), ALT 267 U/L, AST 484 U/L, alkaline phosphatase 342 U/L, and normal total bilirubin. Imaging revealed hepatomegaly with steatosis and mesenteric and retroperitoneal lymphadenopathy. Percutaneous liver biopsy demonstrated noncaseating granulomas with AFB-positive organisms, with AFB blood cultures growing Mycobacterium avium complex (MAC), consistent with disseminated MAC infection. Clinicians must have a high index of suspicion for IRIS when determining the etiology of elevated liver transaminases in patients with HIV.
Immune Reconstitution Inflammatory Syndrome
Lipedema and Nutrition: High Fat Ketogenic Diet as Treatment of Choice
Background: Lipedema is a disease of the subcutaneous adipose tissue that was first clinically recognized in the mid-1900s. Lipedema can have a significant impact on physical appearance, mental health, and well-being: people with lipedema, lovingly called “Lippies”, not only complain about their physical appearance, but also the presence of a bunch of symptoms that worsen the quality of life, which is why it is important to study treatments that may have positive effects mainly in the affected areas. Reducing inflammation is the main target of the multidisciplinary treatment of lipedema. Many studies have shown a significant reduction in body fat and in the painful component of lipedema following integrated treatment and, above all, the high fat ketogenic diet. Therefore, we compared the efficacy of a High Fat Ketogenic Diet (HFKD) in patients suffering from lipedema to test the hypothesis that this approach is more effective than a Low Carb Antinflammatory non-ketogenic Diet (LCAD) on reducing the anthropometric measures in the affected areas and on improving symptoms. Methods: Forty-eight female patients followed two different dietary regimens, for 8 weeks. Group A (24 subjects) was assigned a HFKD, based on 1100 Kcal daily, 70% fat, 20% protein, 10% carbohydrates. Group B diet was a low carb with starchy carbohydrate, average daily Kcal around 1400, 45% fat, 25% protein, 30% carbohydrates. To evaluate the effectiveness of both dietary regimens, anthropometric measurements were carried out and a questionnaire evaluating the degree of symptoms was administered at time zero (first meeting) and at time 1 (after 8 weeks). Results: Although both regimens had a very positive effect on the analyzed parameters, HFKD proved to be more effective than LCAD in reducing the circumferences in the affected areas and in improving the main symptoms such as pain, heaviness, fatigue and swelling. Conclusions: High fat ketogenic diet led to significant fat loss in the lower limbs, the most affected area by the development of lipedema, and a greater improvement in the key symptoms afflicting Lippies. HFKD can used as a real therapeutic tool capable of improving the typical symptoms of lipedema, pain, heaviness and swelling of the lower limbs, and of promoting the reduction of circumference in the areas most resistant to conventional diets.