Digestive System Diseases Commons^™

Biotic Therapies For Irritable Bowel Syndrome: Current Interventions, Gina Wodarczyk, Maria Winte, Diana Mastellone, Termen Singh, Joshua Desipio, Sangita Phadtare

Division of Gastroenterology and Hepatology Faculty Papers

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by recurrent abdominal pain and changes in bowel habits without measurable disease processes. Recent research emphasizes the gut-brain-microbiome (GBM) axis and explores how microbiota influence gastrointestinal and central nervous system functions. Here, we first discuss a brief overview of various treatment approaches for IBS, focusing on interventions such as probiotics, prebiotics, or synbiotics that target the GBM axis in adults with IBS. Relevant trials discussed the use of probiotics, prebiotics, or synbiotics.

Endoscopic Retrograde Cholangiopancreatography And Primary Sclerosing Cholangitis: A Retrospective Study Of A High-Volume Program, Kristel Leung, Michael Youssef, Yasi Xiao, Catherine Streutker, Aliya Gulamhusein, Bettina Hansen, Natalia Calo, Gary May, Jeffrey Mosko, Gideon Hirschfield

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is valuable in management of primary sclerosing cholangitis (PSC). Herein, we characterize individuals with PSC who underwent ERCP on-demand at a high-volume quaternary centre, with evaluation of pathology results and short-term postprocedural outcomes.

METHODS: This retrospective cohort study evaluated patients with PSC who underwent ERCP at St Michael's Hospital between April 2011 and July 2021. Chart review was conducted to collect clinical, procedural, and pathology data, and reported post-ERCP complications within 90 days. Logistic regression analyses were conducted to evaluate factors associated with post-ERCP complications and placement of a biliary stent.

RESULTS: One hundred and …

Epidemiology Of Metabolic Syndrome In Patients With Inflammatory Bowel Disease: A Population-Level Cohort Study From The United States, Aakash Desai, Himsikhar Khataniar, Jana G. Hashash, Priya Sehgal, Francis A. Farraye, Gursimran S. Kochhar

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Epidemiological data on metabolic syndrome (MetS) in patients with inflammatory bowel disease (IBD) are limited.

METHODS: A retrospective cohort study was conducted using the United States (US) Collaborative Network (TriNetX) to obtain data for patients with IBD between 2010 and 2023. The primary aim of the study was to estimate the prevalence of MetS in ulcerative colitis (UC) and Crohn's disease (CD). Prevalence was further characterized by age, sex, race, disease location, IBD medications, history of surgery, and IBD phenotype.

RESULTS: Among 100,890 patients with IBD, metabolic syndrome (MetS) affected 34.4% overall (UC 32.4%, CD 34.3%). Prevalence rose sharply …

Glucagon-Like Peptide 1 Receptor Agonists And The Clinical Outcomes Of Inflammatory Bowel Disease: A Systematic Review And Meta-Analysis, Ahmed B. Bayoumy, Lindsay M. Clarke, Parakkal Deepak, Aakash Desai, Priya Sehgal, Uri Gorelik, Haggai Bar-Yoseph, Marie Villumsen, Chris J. J. Mulder, Dirk J. Stenvers, Maarten E. Tushuizen, Nanne K. H. De Boer

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Prior studies showed worse outcomes in obese inflammatory bowel disease (IBD) patients, especially those related to hospitalizations, surgery, and steroid-free remission. Glucagon-like peptide-1 receptor agonists (GLP1-RAs) have demonstrated significant metabolic benefits for patients with type 2 diabetes mellitus (T2DM) and obesity. Hence, GLP1-RAs may improve clinical outcomes in patients with IBD, especially those with obesity. The objective was to systematically evaluate the impact of GLP1-RAs on clinical outcomes in patients with IBD.

METHODS: A comprehensive literature search was performed using the databases PubMed, Embase, Web of Science, and Cochrane Library from inception to March 15, 2025. Studies reporting outcomes …

Neighborhood Social Cohesion Associated With Chronic Liver Disease Prevalence And All-Cause Mortality, Tiange P. Zhang, Jennifer L. Dodge, Divya Ayyala-Somayajula, Norah A. Terrault

Division of Gastroenterology and Hepatology Faculty Papers

Background and Aims: Neighborhood social cohesion (NSC)—the degree of trust and solidarity within a community—may influence health through multiple pathways including shaping healthy norms, perception of safety, and stress. Whether NSC influences chronic liver disease (CLD) prevalence and associated mortality in the United States is unknown. Methods: Using 172,047 adults from the 2013–2018 National Health Interview Survey with linkage to National Death Index mortality data, NSC was measured using questions on help availability, accountability, trustworthiness, and connectedness among neighbors, with composite scores (4–16) categorized as minimal (4–7), low (8–10), moderate (11–13), and high (14–16). Logistic and Cox regression tested the …

The Predilection Of Specific Diseases To Affect Different Sections Of The Esophagus, Monjur Ahmed

Division of Gastroenterology and Hepatology Faculty Papers

Certain esophageal diseases have a predilection for affecting different parts of the esophagus. This predilection is noted in our clinical practice as we investigate various esophageal diseases using multiple imaging and motility studies, as well as endoscopic procedures with biopsies. Clinical presentations vary with the stage and location of the disease. Clinicians can suspect certain diseases when a particular part of the esophagus is involved and then can perform appropriate investigations. Esophageal diseases with section involvement, with their symptomatology, diagnostic tests, and management, have been discussed in this narrative review. This review aims to revisit those diseases with a current …

Gastrointestinal Fistulas-What Gastroenterologists Need To Know In 2025, Monjur Ahmed

Division of Gastroenterology and Hepatology Faculty Papers

Gastrointestinal fistulas are increasingly being encountered in our clinical practice because of the increased burden of Crohn's disease, bariatric surgeries, interventional endoscopic procedures, nonsurgical trauma, and war and disaster zones worldwide. Presentation depends on the location and specific type of the fistula. Symptomatic ones can have a tremendous impact on social life and can cause dehydration, electrolyte imbalance, malnutrition, increased morbidity, and mortality. Different imaging studies and endoscopic procedures are done to establish the diagnosis. Treatment modalities to close the fistula depend on the underlying disease and the type of fistula. They include conservative treatment, medical therapy, endoscopic interventions, and …

The Need For Targeted Prevention And Screening In Gastrointestinal Cancer Disparities, Jason C. Lin, John C. Lin, Joy Zhao

Division of Gastroenterology and Hepatology Faculty Papers

No abstract provided.

Glucagon-Like Peptide-1 Receptor Agonists Improve Metabolic Dysfunction-Associated Steatotic Liver Disease Outcomes, Brandon Havranek, Rebecca Loh, Beatriz Torre, Rachel Redfield, Dina Halegoua-De Marzio

Division of Gastroenterology and Hepatology Faculty Papers

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease and is associated with significant cardiovascular morbidity and mortality. This study aims to investigate the association of glucagon-like peptide-1 (GLP-1) agonists with major cardiovascular events, clinically significant portal hypertension events, and all-cause mortality in patients with MASLD. A large, population-based retrospective cohort study was conducted using the TriNetX platform, which provided real-time access to electronic health records of 634,265 adult patients with MASLD/MASH. Propensity score matching (PSM) was employed to create two cohorts: A GLP-1 agonists group and a control group without GLP-1 agonists usage. Hazard …

Efficacy Of Dietary Interventions For Irritable Bowel Syndrome: A Systematic Review And Network Meta-Analysis, Hossein Haghbin, Fariha Hasan, Manesh Kumar Gangwani, Nurruddinkhodja Zakirkhodjaev, Wade Lee-Smith, Azizullah Beran, Faisal Kamal, Benjamin Hart, Muhammad Aziz

Division of Gastroenterology and Hepatology Faculty Papers

Introduction: Irritable bowel syndrome (IBS) is a common condition that alters the quality of life of patients. A variety of dietary interventions have been introduced to address this debilitating condition. The low-FODMAP diet (LFD), gluten-free diet (GFD), and Mediterranean diet are examples showing efficacy. The aim of this network meta-analysis was to compare these interventions to find the best approach. Methods: We performed a systematic review of the available literature through 14 March 2024 in the following databases: Embase, PubMed, MEDLINE OVID, Web of Science, CINAHL Plus, and Cochrane Central. We only included randomized controlled trials (RCTs). We used a …

Feasibility And Safety Of Peroral Endoscopic Myotomy With Fundoplication In Patients With Achalasia: A Systematic Review And Meta-Analysis, Faisal Kamal, Muhammad Ali Khan, Wade Lee-Smith, Sachit Sharma, Ashu Acharya, Umer Farooq, Zahid Ejaz, Muhammad Aziz, Manesh Kumar Gangwani, Umar Hayat, Anand Kumar, Alexander Schlachterman, David E. Loren, Thomas E. Kowalski

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Achalasia can cause disabling symptoms that may substantially impair the quality of life. Peroral endoscopic myotomy (POEM) has shown promising results in the management of achalasia. In this meta-analysis we have evaluated the feasibility and safety of single-session POEM with fundoplication (POEM+F) in patients with achalasia.

METHODS: We reviewed several databases from inception to July 08, 2022, to identify studies evaluating the feasibility and/or safety of single-session POEM+F for patients with achalasia. Our outcomes of interest included the technical success of POEM+F, adverse events, esophagitis and wrap integrity on follow-up upper endoscopy, total procedure time, and fundoplication time. Pooled …

Infection-Related Readmissions Are Rising Among Patients With Hepatorenal Syndrome: A Nationwide Analysis, Umer Farooq, Zahid I. Tarar, Ammad J. Chaudhary, Abdallah E. Alayli, Faisal Kamal, Chengdu Niu, Kamran Qureshi

Division of Gastroenterology and Hepatology Faculty Papers

Hepatorenal syndrome (HRS) is a unique form of renal dysfunction that results from circulatory hemodynamic dysfunction in advanced liver disease. We aimed to determine longitu- dinal trends in both all-cause and cause-specific readmissions for HRS in the United States. Using the National Readmission Database (2010–2018), we identified adult HRS patients during index admission via ICD codes. Fisher’s exact test and Cox regression analysis were used to compare pro- portions and compute adjusted p-values, respectively. Regression models were adjusted for gender, age, the Charlson comorbidity index, median household income, and hospital factors. A total of 169,522 HRS patients were included in …