European Gastroenterology Week Research Articles

Review of United European Gastroenterology (UEG) Week 2023

Review of United European Gastroenterology (UEG) Week 2023

31st United European Gastroenterology Week 2023.

31st United European Gastroenterology Week 2023.

Review of Russian Abstracts Accepted for United European Gastroenterology Week (2022)

Aim: to present an analysis of the Russian abstracts published in the materials of the 30th. United European Gastroenterology Week (UEGW).Key points. In the materials of 30 UEGW, 17 abstracts of Russian authors from Moscow, St. Petersburg, Novosibirsk, Kazan and other cities were published. The abstracts were devoted to topical issues of pathogenesis, diagnosis and treatment of intestinal liver and pancreatic diseases.Conclusion. Analysis of the published abstracts testifies to the high scientific level and large practical significance of the conducted research.

Recent Advances in the Management of Gastrointestinal Disease

Interdisciplinary sessions at the recent United European Gastroenterology (UEG) Week, held in Vienna, Austria, from 8th to 11th October 2022, covered new approaches to the diagnosis and treatment of gastrointestinal and hepatic disorders, with a focus on advances in the non-invasive management of these diseases. Abstract-based and poster sessions presented original research from Europe and other parts of the world. This review summarises selected data presented in the fields of inflammatory bowel disease (IBD), disorders of gut–brain interaction (DGBI), gastro-oesophageal reflux disease (GORD), and disorders of the pancreas. Previously termed functional gastrointestinal disorders, the Rome Foundation is gradually moving toward the use of DGBI in place of functional gastrointestinal disorders to avoid stigma. Cristina Rubín de Célix, Gastroenterology Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Universidad Autónoma de Madrid (UAM), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain, described a systematic review and meta-analysis of real-world evidence for ustekinumab in the treatment of Crohn’s disease. Regarding irritable bowel syndrome (IBS), Salvatore Crucillà, Gastroenterology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Italy, showed that following a Mediterranean diet resulted in symptom improvement and faecal microbiota changes in patients with constipation-predominant IBS. Fiona Kinnear, Novozymes A/S, Cork, Ireland, reported patients’ experiences of probiotics for IBS. Tatyana Kugler, Department of Internal Medicine, Donetsk National Medical University, Ukraine, discussed quality of life (QoL) in patients with functional dyspepsia (FD), and Ayesha Shah, Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, and Faculty of Medicine and Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia, considered the impact of a diagnosis of more than one DGBI. James White, Medscape Global Education, London, UK, considered the impact of continuing medical education (CME) on confidence in the management of GORD. Additionally, Peter Macinga, Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czechia, provided evidence that chronic pancreatitis is associated with an alteration in the gut microbiota, and Joakim Svahn, Viatris AB, Stockholm, Sweden, described the use of a patient support programme (PSP) in patients prescribed pancreatic enzyme replacement therapy (PERT) for pancreatic exocrine insufficiency (PEI).

Challenges and Opportunities for Treating Clostridium difficile in 2022

IN A symposium session presented at United European Gastroenterology (UEG) Week 2022, experts delved into the challenges presented by Clostridium difficile infection (CDI) and the opportunity that faecal microbiota transplants (FMT) can provide. Benjamin Mullish, Gastroenterology and Hepatology Division of Digestive Diseases, Imperial College London, UK, and Georgiana-Emmanuela Gîlcă-Blanariu, Grigore T. Popa University of Medicine and Pharmacy, Iași, Romania, shared novel research and real-world experience. The symposium examined all aspects of CDI from the importance of understanding pathways of pathophysiology to the logistical challenges that pioneering an FMT clinic can prese

ESGENA at UEG Week 2022

Ulrike Beilenhoff looks back on what the 30th United European Gastroenterology (UEG) Week had to offer nurses and other allied health professionals in endoscopy

Closing the gender gap: building a successful career and leadership in research as a female gastroenterologist

The pillars of academic promotion include clinical service, research, teaching, and public engagement. Although women are more likely than men to pursue a career in academia after a gastroenterology fellowship (40% of women vs 25% of men choose this path), gender disparity in research and academic leadership remains. For example, only one woman was appointed assistant professor in all gastroenterology and hepatology divisions of university hospital centres in France in 2017–18, whereas ten men were appointed full professors and seven were appointed associate professors in that same period. 1 Aubart FC Roeser A Costedoat-Chalumeau N Papo T Piette J-C Women in internal medicine academic positions in France. Eur J Intern Med. 2019; 64: e18-e29 Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar Only 20% of faculty and 25% of full professors in divisions of gastroenterology in the USA are women; this gender disparity has not diminished over the past 35 years and is similar across basic science and clinical departments. 2 Richter KP Clark L Wick JA et al. Women physicians and promotion in academic medicine. N Engl J Med. 2020; 383: 2148-2157 Crossref PubMed Scopus (103) Google Scholar Even though the representation of female physicians as first authors (42%) and senior (23%) authors of original research published in US gastroenterology journals has increased over the past two decades, the proportion of female senior authors increased at a slower rate than female first authors and was lower than expected based on the proportion of women in academia. 3 Long MT Leszczynski A Thompson KD Wasan SK Calderwood AH Female authorship in major academic gastroenterology journals: a look over 20 years. Gastrointest Endosc. 2015; 81: 1440-1447 Summary Full Text Full Text PDF PubMed Scopus (78) Google Scholar , 4 Bhatia S Eluri S Kim E Angle H Dellon E Shaheen N Trends in female authorship of high impact publications in gastroenterology journals, 1997–2017. Am J Gastroenterol. 2018; 113: S652-S653 Google Scholar Similarly, representation of female first authors in high-impact European journals has increased since 1994, but it has plateaued in recent years. 5 Filardo G da Graca B Sass DM Pollock BD Smith EB Martinez MA-M Trends and comparison of female first authorship in high impact medical journals: observational study (1994–2014). BMJ. 2016; 352: i847 Crossref PubMed Scopus (271) Google Scholar In addition, the proportion of invited women speakers at major national gastroenterological meetings remains low: for example, at the British Society of Gastroenterology meeting in 2014, only 26% of speakers were female; at United European Gastroenterology week 2019, only 28% of speakers were female; and at Digestive Disease Week 2019, only 33% of speakers were female. 6 Brooks AJ Taylor EJ Arthurs EA et al. Gender differences in leadership, workforce and scholarly presentation within a national society: a gastroenterology perspective. Frontline Gastroenterol. 2019; 10: 2-6 Crossref PubMed Scopus (2) Google Scholar , 7 Khan Z Rukhshan R Bhatt A et al. persistent speaker gender gap at the premier digestive disease event. Dig Dis Sci. 2022; 67: 390-396 Crossref PubMed Scopus (1) Google Scholar , 8 Nakov R Alboraie M Tiniakos D UEG Equality and Diversity Task ForceHow to identify, encourage, and support suitable candidates for leading roles in scientific societies: the UEG experience. United European Gastroenterol J. 2021; 9: 874-876 Crossref PubMed Scopus (2) Google Scholar How can female gastroenterologists effectively build a successful career in research and overcome these barriers to achieving leadership and academic advancement?

United European Gastroenterology Week (UEGW) 2021 - 29th Annual Conference. Virtual - October 3-5, 2021

United European Gastroenterology Week (UEGW) 2021 - 29th Annual Conference. Virtual - October 3-5, 2021

Selecting End Points for Disease-Modification Trials in Inflammatory Bowel Disease: the SPIRIT Consensus From the IOIBD

Inflammatory bowel diseases (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), are chronic and disabling disorders. Prospective disease-modification trials to prevent disease progression are eagerly awaited. However, disease progression is not clearly defined. The objective of the Selecting End PoInts foR Disease-ModIfication Trials (SPIRIT) initiative was to achieve international expert consensus on the endpoints to be used in future IBD-disease modification trials. This initiative under the auspices of the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) began with a systematic literature search to evaluate the current evidence on the definition of disease progression in IBD. On October 22, 2019, a consensus meeting took place during the United European Gastroenterology Week (UEGW) Congress in Barcelona, during which predefined proposed statements were discussed in a plenary session and voted on anonymously. Agreement was defined as at least 75% of participants voting for any one statement. The group agreed that the ultimate therapeutic goal in both CD and UC is to prevent disease impact on patient's life (health-related quality of life, disability, fecal incontinence), midterm complications (encompass bowel damage in CD, IBD-related surgery and hospitalizations, disease extension in UC, extraintestinal manifestations, permanent stoma, short bowel syndrome), and long-term complications (gastrointestinal and extraintestinal dysplasia or cancer, mortality). Recommendations on which goals to achieve in disease-modification trials for preventing disease progression in patients with IBD are proposed by the SPIRIT consensus. However, these recommendations will require validation in actual clinical studies before implementation in disease-modification trials.

28th Annual United European Gastroenterology Week (UEGW) 2020. Virtual - October 11-13, 2020

28th Annual United European Gastroenterology Week (UEGW) 2020. Virtual - October 11-13, 2020

Prevalence of small bowel bacterial overgrowth in patients with functional dyspepsia: a meta-analysis

Systematization of data on the frequency of detection of the syndrome of bacterial overgrowth in the small intestine (SIBO) in patients with functional dyspepsia (FD). MEDLINE/PubMed, EMBASE, Cochrane, Google Scholar, the Russian Science Citation Index (RSCI) through July 2020 were searched to identify studies evaluating the prevalence of SIBO in FD. In addition, a search for relevant abstracts was carried out in the electronic databases of the United European Gastroenterology Week (UEG), American College of Gastroenterology (ACG), International Conference on Nutrition and Food (ICNF). For the final analysis, publications were selected that used validated tests for the assessment of SIBO (hydrogen breath test using glucose or lactulose) with detailed descriptive statistics, allowing the resulting data to be included in the meta-analysis. The final analysis included 7 studies with 1248 patients with FD. Overall pooled prevalence of SIBO in patients with FD was 34.73% (95% CI 24.80745.383). There was significant heterogeneity between the results (p0.0001; I2=89.91%). When excluded from the meta-analysis of a study in which the incidence of SIBO was studied in patients with refractory FD, the pooled prevalence was 38.98% (95% CI 28.96449.490). This meta-analysis has demonstrated that SIBO is often associated with FD and is observed in about every third patient with this functional gastrointestinal tract disease.

The Gene Expression Signature Modulated by Dupilumab is Correlated with Histological Severity and Endoscopic Features of Mucosal Inflammation and Remodelling in Eosinophilic Oesophagitis

Dupilumab is a monoclonal antibody that inhibits IL-4 and IL-13 signalling in multiple Type 2 inflammatory disorders, including eosinophilic oesophagitis (EoE). This article reviews the oral presentation given by Dr Collins at the United European Gastroenterology (UEG) Week Virtual 2020 and describes the results of a post hoc analysis of a Phase II proof-of-concept study of dupilumab in adults with active EoE. The aim of the analysis was to ascertain whether there were any correlations between gene expression and disease severity in patients enrolled in the study.

S0526 Mortality and Infectious Adverse Events in Neutropenic Patients Undergoing Gastrointestinal Endoscopic Procedures: A Systematic Review and Meta-Analysis

INTRODUCTION: The safety of gastrointestinal endoscopy in neutropenic patients is unclear. American Society for Gastrointestinal Endoscopy guidelines state that patients with absolute neutrophil count (ANC) < 500 cells/µL and advanced hematologic malignancies are at increased risk for bacteremia and sepsis after endoscopy. Infectious Diseases Society of America guidelines state that endoscopy should be avoided in neutropenic patients. We performed a systematic review and meta-analysis to assess the safety of endoscopy in patients with neutropenia. METHODS: Bibliographic databases (Medline, EMBASE, Cochrane Library, Web of Science, Scopus, PubMed) were searched through November 2019 for studies in neutropenic patients (ANC < 1000 cells/µL) undergoing endoscopy with outcome data on infections, mortality, or fever. Abstracts from Digestive Disease Week, American College of Gastroenterology Annual Scientific Meeting, and United European Gastroenterology Week from January 2017 to January 2020 were also searched. Two independent reviewers identified studies meeting inclusion criteria, performed data extraction using a standardized form, and assessed risk of bias using the Newcastle-Ottawa scale. Co-primary outcomes were 30-day infection-related mortality and new infection within 30 days of endoscopy. Secondary outcomes included new bacteremia and new fever within 30 days. Random effects meta-analysis was used to calculate pooled proportions and effect estimates. RESULTS: Database search identified 2733 unique citations. Four studies from database search and 1 from conference abstract review met eligibility criteria (N = 928). All studies had high risk of bias. Overall proportion of infection-related mortality was 0.0% (95% CI: 0.0–0.4% I2: 0.0%) and infectious adverse events was 1.9% (95% CI: 0.0–6.4% I2: 77.0%) (Table 1). The proportion of neutropenic patients developing bacteremia was 1.7% (CI: 0.0-6.8% I2: 82.3%) and new fever was 0.0% (95% CI: 0.0–0.0% I2: 0.0%) (Table 2). Subgroup analysis was not performed due to zero events in a majority of studies and limited number of studies. However, data on antibiotic use prior to endoscopy was available in 3 studies; here the proportion of patients on antibiotics that developed new infections ranged from 0.0 to 1.2%. CONCLUSION: This systematic review and meta-analysis showed a low rate of mortality and infection following endoscopy in neutropenic patients. Additional large studies designed to assess the safety of endoscopy in neutropenic patients are needed.Figure 1.: PRISMA flow diagram summarizing study selection.Table 1.: Primary outcomes: 30 day infection-related mortality and infectious adverse events in neutropenic patients undergoing endoscopyTable 2.: Secondary outcomes: Bacteremia and new fever in neutropenic patients undergoing endoscopy

Systematic review of the prevalence and development of osteoporosis or low bone mineral density and its risk factors in patients with inflammatory bowel disease.

BACKGROUNDThe inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, immune-mediated disorders of the digestive tract. IBD is considered to be a risk factor for developing osteoporosis; however current literature on this matter is inconsistent.AIMTo assess prevalence and development of osteoporosis and low bone mineral density (BMD), and its risk factors, in IBD patients.METHODSSystematic review of population-based studies. Studies were identified by electronic (January 2018) and manual searches (May 2018). Databases searched included EMBASE and PubMed and abstracts from 2014-2018 presented at the United European Gastroenterology Week, the European Crohn’s and Colitis Organisation congress, and Digestive Disease Week were screened. Studies were eligible for inclusion if they investigated either the prevalence of osteoporosis or osteopenia and/or risk factors for osteoporosis or low BMD in IBD patients. Studies on children under the age of 18 were excluded. Only population-based studies were included. All risk factors for osteoporosis and low BMD investigated in any included article were considered. Study quality and the possibility of bias were analysed using the Newcastle-Ottawa scale.RESULTSTwelve studies including 3661 IBD patients and 12789 healthy controls were included. Prevalence of osteoporosis varied between 4%-9% in studies including both CD and UC patients; 2%-9% in studies including UC patients, and 7%-15% in studies including CD patients. Among healthy controls, prevalence of osteoporosis was 3% and 10% in two studies. CD diagnosis, lower body mass index (BMI), and lower body weight were risk factors associated with osteoporosis or low BMD. Findings regarding gender showed inconsistent results. CD patients had an increased risk for osteoporosis or low BMD over time, while UC patients did not. Increased age was associated with decreased BMD, and there was a positive association between weight and BMI and BMD over time. Great heterogeneity was found in the included studies in terms of study methodologies, definitions and the assessment of osteoporosis, and only a small number of population-based studies was available.CONCLUSIONThis systematic review found a possible increase of prevalence of osteoporosis in CD cohorts when compared to UC and cohorts including both disease types. Lower weight and lower BMI were predictors of osteoporosis or low BMD in IBD patients. The results varied considerably between studies.

Helicobacter pylori eradication for the prevention of gastric neoplasia.

Gastric cancer is the third most common cause of cancer death worldwide. Individuals infected with Helicobacter pylori have a higher likelihood of developing gastric cancer than individuals who are not infected. Eradication of H. pylori in healthy asymptomatic individuals in the general population may reduce the incidence of gastric cancer, but the magnitude of this effect is unclear. To assess the effectiveness of eradication of H. pylori in healthy asymptomatic individuals in the general population in reducing the incidence of gastric cancer. We identified trials by searching the Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 1), MEDLINE (1946 to February 2020), and EMBASE (1974 to February 2020). We handsearched reference lists from trials selected by electronic searching to identify further relevant trials. We handsearched published abstracts from conference proceedings from the United European Gastroenterology Week (published in Gut) and Digestive Disease Week (published in Gastroenterology) between 2001 and 2019. We contacted members of the Cochrane Upper Gastrointestinal and Pancreatic Diseases Review Group and experts in the field and asked them to provide details of outstanding clinical trials and any relevant unpublished materials. We analysed randomised controlled trials comparing at least one week of H. pylori therapy with placebo or no treatment in preventing subsequent development of gastric cancer in otherwise healthy and asymptomatic H. pylori-positive adults. Trials had to follow up participants for at least two years and needed to have at least two participants with gastric cancer as an outcome. We defined gastric cancer as any gastric adenocarcinoma, including intestinal (differentiated) or diffuse (undifferentiated) type, with or without specified histology. We collected data on incidence of gastric cancer, incidence of oesophageal cancer, deaths from gastric cancer, deaths from any cause, and adverse effects arising due to therapy. Six trials met all our eligibility criteria and provided extractable data in the previous version. Following our updated search, one new RCT was identified, meaning that seven trials were included in this updated review. In addition, one previously included trial provided fully published data out to 10 years, and another previously included trial provided fully published data out to 22 years of follow-up. Four trials were at low risk of bias, one trial was at unclear risk, and two trials were at high risk of bias. Six trials were conducted in Asian populations. In preventing development of subsequent gastric cancer, H. pylori eradication therapy was superior to placebo or no treatment (RR 0.54, 95% confidence interval (CI) 0.40 to 0.72, 7 trials, 8323 participants, moderate certainty evidence). Only two trials reported the effect of eradication of H. pylori on the development of subsequent oesophageal cancer. Sixteen (0.8%) of 1947 participants assigned to eradication therapy subsequently developed oesophageal cancer compared with 13 (0.7%) of 1941 participants allocated to placebo (RR 1.22, 95% CI 0.59 to 2.54, moderate certainty evidence). H. pylori eradication reduced mortality from gastric cancer compared with placebo or no treatment (RR 0.61, 95% CI 0.40 to 0.92, 4 trials, 6301 participants, moderate certainty evidence). There was little or no evidence in all-cause mortality (RR 0.97, 95% CI 0.85 to 1.12, 5 trials, 7079 participants, moderate certainty evidence). Adverse events data were poorly reported. We found moderate certainty evidence that searching for and eradicating H. pylori reduces the incidence of gastric cancer and death from gastric cancer in healthy asymptomatic infected Asian individuals, but we cannot necessarily extrapolate this data to other populations.

Contributions from Japan to gastrointestinal endoscopy training and development: Special report.

Contributions from Japan to gastrointestinal endoscopy training and development: Special report.

Nomenclature and semantic descriptions of ulcerative and inflammatory lesions seen in Crohn's disease in small bowel capsule endoscopy: An international Delphi consensus statement.

In the medical literature, the nomenclature and descriptions (ND) of small bowel (SB) ulcerative and inflammatory (U-I) lesions in capsule endoscopy (CE) are scarce and inconsistent. Inter-observer variability in interpreting these findings remains a major limitation in the assessment of the severity of mucosal lesions, which can impact negatively on clinical care, training and research on SB-CE. Focusing on SB-CE in Crohn's disease (CD), our aim is to establish a consensus on the ND of U-I lesions. An international panel of experienced SB-CE readers was formed during the 2016 United European Gastroenterology Week meeting. A core group of five CE and inflammatory bowel disease (IBD) experts established an Internet-based, three-round Delphi consensus but did not participate in the voting process. The core group built illustrated questionnaires, including SB-CE still frames of U-I lesions from patients with documented CD. Twenty-seven other experts were asked to rate and comment on the different proposals for the ND of the most frequent SB U-I lesions. For each round, we used a 6-point rating scale (varying from 'strongly disagree' to 'strongly agree'). The consensus was reached when at least 80 % of the voting members scored the statement within the 'agree' or 'strongly agree' categories. A 100% participation rate was obtained for all the rounds. Consensual ND were reached for the following seven U-I lesions: aphthoid erosion, deep ulceration, superficial ulceration, stenosis, edema, hyperemia and denudation. Considering the most frequent SB U-I lesions seen in CE in CD, a consensual ND was reached by the international group of experts. These descriptions and names are useful not only for daily practice and medical education, but also for medical research.

Burning Questions in Inflammatory Bowel Disease: Learnings from Emerging Drug Options and Clinical Cases

The symposium, entitled “Burning questions in IBD: Learnings from emerging drug options and clinical cases,” took place during the 2019 United European Gastroenterology (UEG) Week annual congress in Barcelona, Spain. Distinguished experts Prof Peyrin-Biroulet, Prof Vermeire, and Prof Panés tackled several of the outstanding questions in inflammatory bowel disease (IBD) management, focussing the discussion on treat-to-target strategies and how these could be applied in IBD management; when to initiate biologic treatments, and the factors involved in making these treatment decisions; the use of ustekinumab in ulcerative colitis (UC) management; efficacy and safety of biologics; and whether monotherapy or combined treatment is the optimal treatment approach in IBD. The experts used informative patient cases and data from current clinical studies to help illustrate the possible solutions to each ‘burning question’, incorporating questions from the audience into each discussion.

Attending the United European Gastroenterology Week 2018 to invite manuscripts and local travel in Austria

Attending the United European Gastroenterology Week 2018 to invite manuscripts and local travel in Austria

Novel Non-biologic Targets for Inflammatory Bowel Disease.

The biologic era revolutionized the medical management of inflammatory bowel disease (IBD) and allowed for a paradigm shift away from a therapeutic strategy that traditionally relied on corticosteroids and immunomodulators. IBD treatment has now further evolved to encompass novel non-biologic agents. An electronic database search, spanning up to September 2018, was conducted using PubMed, Web of Science, Google Scholar, and Scopus. Abstracts were also reviewed from Digestive Diseases Week, European Crohn's and Colitis Organization congress, Canadian Digestive Diseases Week, and United European Gastroenterology Week. The JAK1/3 inhibitor, tofacitinib, was shown to both induce and maintain clinical remission and mucosal healing in ulcerative colitis (UC). Also, the sphingosine-1-phosphate (SIP) S1P1/S1P5 receptor agonist ozanimod showed benefit with clinical remission and mucosal healing in UC. Anti-trafficking non-biologic therapies such as AJM300 and a phosphodiesterase (PDE) PDE4 inhibitor, apremilast, have shown benefit in terms of clinical response, clinical remission, and mucosal healing in UC. Upadacitinib and filgotinib have shown initial favorable outcomes in CD patients, with further ongoing trials. Non-biologic agents comprise a growing number of mechanisms of action with the promise of safe and effective oral therapy for patients with IBD.