Prevalence Of Gastrointestinal Diseases Research Articles

Anti-ulcerogenic activity of Citrus medica var. sarcodactylis fruit extract nano-emulsion in gastric ulcer rat model through modulating HMBG1/TLR4/NF-κB and Nrf2/HSP70/PGE2 signaling pathways

One of the most prevalent gastrointestinal multi-etiological diseases is gastric ulcer, with several consequences and serious side influences. Nowadays, nanotechnology is one of the advanced tools to enhance drug delivery and bioavailability. Hence, the prime goal of this study was to create safe gastro-protective therapy using methanol fruit extract of Citrus medica var. sarcodactylis (CMF) and its prepared nano formula (Nano-CMF). CMF or its nano form was given to rats at dose 600 mg/kg/day for a week along with a single oral administration of ethanol (5 ml/kg) at the 7th day. The particle size distribution of formulated CMF reflected the successful preparation of nano form, with average size 65 nm. Pretreatment with CMF or its nano formula to ethanol challenged rats significantly controlled the inflammatory response through down-regulated gastric HMBG1/TLR4/NF-κB signaling pathway and its downstream mediators at p<0.001. Moreover, CMF or nano-CMF lessened oxidative stress incidence via modulating Nrf2 signaling pathway, sustaining prostaglandin content, and reducing gastric juice acidity with a significant p value less than 0.001, as compared to the EtOH-intoxicated rats. In addition, nano form effectively preserved the gastric mucosal integrity and alleviated apoptosis in gastric cells as validated by ulcer index (p<0.001), and the histological and immunohistochemical findings, when matched to the EtOH-treated group. The metabolomics analysis revealed the characterization of 36 compounds. GC/MS of CH2Cl2 fraction led to the identification of 34 compounds, the major category was fatty acid esters amounting 43.92%. The TLC technique for methanol extract led to isolation of 8 compounds: (4,5-O-Dicaffeoylquinic acid, ferulic acid, hesperidin, limettin, 5-demethylsinensetin, brassicasterol, campesterol and β-sitosterol). Brassicasterol is newly reported from species while 5-demethylsinensetin was newly reported from the Citrus genus. Furthermore, the docking experiments revealed strong binding affinity interactions of these compounds with TLR-4, Nrf2-Keap1 complex, and pNF-κBp65. In conclusion, mechanism of action of CMF or its nano formula exerting anti-ulcer effect was postulated based on the synergistic action of its reported compounds which possesses anti-inflammatory, antioxidant, and anti-apoptotic activities. To be noted, nano CMF showed a superior potent anti-ulcer activity than CMF and conventional therapy, omeprazole.

Pancancer analysis of NDUFA4L2 with focused role in tumor progression and metastasis of colon adenocarcinoma.

Colon adenocarcinoma (COAD) is a prevalent gastrointestinal malignant disease with a high mortality rate, and identification of novel prognostic biomarkers and therapeutic targets is urgently needed. Although NDUFA4L2 has high expressions in various tumors and affects tumor progression, its role in COAD remains unclear. The role of NDUFA4L2 in COAD was analyzed utilizing datasets available from public databases including The Cancer Genome Atlas, The Genotype-Tissue Expression (GTEx), Gene Expression Omnibus, Alabama Cancer Database (UALCAN), and The Human Protein Atlas databases. The prognostic value of NDUFA4L2 was determined using Kaplan-Meier analysis and Cox regression analysis. To investigate the possible mechanism underlying the role of NDUFA4L2 in COAD, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) were employed. The correlation between NDUFA4L2 expression and immune cell infiltration levels was examined through single-sample gene set enrichment analysis (ssGSEA). The NDUFA4L2 expression levels in COAD patients and cell lines were validated through immunohistochemistry, immunofluorescence, qRT-PCR, and Western blot. Wound healing assay was also performed to evaluate the effect of NDUFA4L2 on COAD metastasis. Furthermore, the NDUFA4L2 mediated competing endogenous RNA (ceRNA) regulatory network was predicted and constructed through a variety of databases. The comprehensive pan-cancer analysis showed that NDUFA4L2 possesses diagnostic and prognostic value in many cancers, especially in COAD. GO-KEGG and GSEA analyses indicated that NDUFA4L2 was associated with multiple biological functions including epithelial-mesenchymal transition and adaptation to hypoxia. The ssGSEA analysis showed that NDUFA4L2 expression was associated with immune infiltration. In vitro experiments confirmed upregulation of NDUFA4L2 in COAD tissues and cell lines, and NDUFA4L2 overexpression significantly promoted migration of COAD cells. In addition, the C9orf139 /miR-194-3p axis was speculated as the possible upstream regulators of NDUFA4L2 in COAD. This study demonstrated that NDUFA4L2 upregulation was correlated with tumor progression, relapsed prognosis and aggressive migration of COAD, suggesting that NDUFA4L2 can act as an effective prognostic biomarker and a promising therapeutic target for COAD treatment.

Relationship between Helicobacter pylori infection and digestive tract diseases and analysis of risk factors: a cross-sectional study based on 3867 Chinese patients.

Helicobacter pylori (H. pylori) infect nearly half of the global population, contributing to upper digestive tract diseases. This 2019 cross-sectional study included 3,867 patients undergoing esophagogastroduodenoscopy (EGD) and 2,875 undergoing both colonoscopy and EGD. Subjects were categorized into H. pylori positive and negative groups by rapid urease test (RUT). In addition to exploring the relationship between H. pylori infection and upper gastrointestinal diseases, this study further revealed that H. pylori infection was closely related to lower digestive tract diseases, including colorectal polyp (63.28%) and colorectal cancer (75.76%), as well as upper and lower gastrointestinal comorbidities, including chronic atrophic gastritis with colorectal polyp (79.85%), peptic ulcer with colorectal polyp (79.72%), gastric polyp with colorectal polyp (66.24%), and chronic atrophic gastritis with colorectal cancer (92.86%). Besides, a univariate logistic regression analysis was conducted to compare the differences between the two groups (including gender, nationality, marital status, smoking history, drinking history, living area, age, BMI, glycosylated hemoglobin, fasting blood glucose, total cholesterol, and triglyceride levels), the results identified marital status and age as independent risk factors for H. pylori infection (OR, 1.435; 95% CI, 1.042 to 1.977; OR, 1.007; 95% CI, 1.001 to 1.013). Further clarification of the correlation between the prevalence of gastrointestinal diseases and H. pylori infection will be important for H. pylori infection management strategies and the treatment and prevention of gastrointestinal diseases.

Artificial Intelligence for the Automatic Diagnosis of Gastritis: A Systematic Review.

Background and Objective: Gastritis represents one of the most prevalent gastrointestinal diseases and has a multifactorial etiology, many forms of manifestation, and various symptoms. Diagnosis of gastritis is made based on clinical, endoscopic, and histological criteria, and although it is a thorough process, many cases are misdiagnosed or overlooked. This systematic review aims to provide an extensive overview of current artificial intelligence (AI) applications in gastritis diagnosis and evaluate the precision of these systems. This evaluation could highlight the role of AI as a helpful and useful tool in facilitating timely and accurate diagnoses, which in turn could improve patient outcomes. Methods: We have conducted an extensive and comprehensive literature search of PubMed, Scopus, and Web of Science, including studies published until July 2024. Results: Despite variations in study design, participant numbers and characteristics, and outcome measures, our observations suggest that implementing an AI automatic diagnostic tool into clinical practice is currently feasible, with the current systems achieving high levels of accuracy, sensitivity, and specificity. Our findings indicate that AI outperformed human experts in most studies, with multiple studies exhibiting an accuracy of over 90% for AI compared to human experts. These results highlight the significant potential of AI to enhance diagnostic accuracy and efficiency in gastroenterology. Conclusions: AI-based technologies can now automatically diagnose using images provided by gastroscopy, digital pathology, and radiology imaging. Deep learning models exhibited high levels of accuracy, sensitivity, and specificity while assessing the diagnosis, staging, and risk of neoplasia for different types of gastritis, results that are superior to those of human experts in most studies.

SLC12A8 upregulation promotes colorectal cancer progression and chemoresistance.

Colorectal cancer (CRC), a prevalent gastrointestinal malignant disease, causes substantial morbidity and mortality. Identification of novel prognostic biomarkers and therapeutic targets is critically needed to improve patient outcomes. Although solute carrier family 12 member 8 (SLC12A8) has high expression in various tumors and affects tumor progression, its role in CRC remains unclear. The aim of this study was to investigate the functions of SLC12A8 in CRC. SLC12A8 expression and its association with clinical significance in CRC patients were explored via multiple public databases, including The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx), The Human Protein Atlas (HPA), The University of ALabama at Birmingham CANcer data analysis Portal (UALCAN), and Kaplan-Meier plotter. The effects of SLC12A8 on the CRC cell apoptosis, epithelial-mesenchymal transition (EMT), reactive oxygen species (ROS) production, and sensitivity to oxaliplatin were verified by in vitro experiments. SLC12A8 expression was upregulated in CRC tissues compared with normal colorectal tissues. Furthermore, high expression of SLC12A8 was associated with poorer prognosis in CRC patients. Pathway enrichment analyses revealed SLC12A8 involvement in oxidative stress and transforming growth factor-beta (TGF-β) signaling. Experiments in CRC cells showed that SLC12A8 upregulation promoted apoptosis resistance, EMT, and inhibited ROS production. Moreover, SLC12A8 knockdown enhanced the sensitivity of CRC cells to oxaliplatin chemotherapy. Our integrative analyses identify SLC12A8 as a candidate biomarker for CRC progression. Targeting SLC12A8 may improve patient responses to oxaliplatin-based treatment regimens.

Involvement of circ_0029407 in Caerulein-Evoked Cytotoxicity in Human Pancreatic Cells via the miR-579-3p/TLR4/NF-κB Pathway.

Acute pancreatitis (AP) is the most prevalent gastrointestinal inflammatory disease. Circular RNAs (circRNAs) are implicated in the development of AP. Here, we identified the precise action of circ_0029407 in AP development. Human pancreatic epithelial cells (HPECs) were stimulated with caerulein. Cell viability, proliferation, and apoptosis were gauged by Cell Counting Kit-8 (CCK-8), 5-ethynyl-2'-deoxyuridine (EdU), and flow cytometry assays, respectively. Circ_0029407, microRNA (miR)-579-3p, and toll-like receptor 4 (TLR4) were quantified by a qRT-PCR or western blot assay. Dual-luciferase reporter and RNA pull-down assays were performed to evaluate the direct relationship between miR-579-3p and circ_0029407 or TLR4. Our results indicated that circ_0029407 was markedly overexpressed in AP serum samples and caerulein-stimulated HPECs. Reduction of circ_0029407 attenuated caerulein-imposed HPEC damage by promoting cell proliferation and repressing cell apoptosis and inflammation. Mechanistically, circ_0029407 contained a miR-579-3p binding site, and miR-579-3p downregulation reversed the effect of circ_0029407 reduction on caerulein-imposed HPEC damage. TLR4 was identified as a direct and functional target of miR-579-3p, and TLR4 overexpression reversed the impact of miR-579-3p upregulation on attenuating caerulein-imposed HPEC damage. Moreover, circ_0029407 regulated the TLR4/nuclear factor NF-kappaB (NF-κB) signaling by acting as a competing endogenous RNA (ceRNA) for miR-579-3p. Our study suggests that circ_0029407 regulates caerulein-imposed cell injury in human pancreatic cells at least in part via the TLR4/NF-κB signaling pathway by functioning as a ceRNA for miR-579-3p.

Effects of diet on the bacterial and eukaryotic microbiota across the gastrointestinal tract of healthy rabbits (Oryctolagus cuniculus).

This study aimed to characterize the bacterial and eukaryotic microbiota of the gastrointestinal (GI) tract in domestic rabbits and to evaluate the effect of different diet characteristics, such as pelleting, extrusion, and hay supplementation. 30 New Zealand White rabbits (15 male and 15 female; 6 to 7 months old) were fed 1 of 6 diets (5 rabbits per diet) for 30 days after an initial acclimation period. At the end of the trial, samples were collected from the stomach, small intestine, cecum, large intestine, and hard feces. The samples were analyzed using 16S rRNA and internal transcribed spacer 1 region-targeted amplicon sequencing. The bacterial microbiota was distinct between the foregut and hindgut. The most abundant bacterial genera included an unclassified genus in the Bacteroidales order and Alistipes. Candida was the most abundant genus in the eukaryotic dataset. In the bacterial dataset, diet No Hay/Pellet E was shown to have lower diversity (Shannon diversity, P < .05) compared to all diet groups except for No Hay/Pellet M. Few significant differences in alpha-diversity indexes between diet groups were detected in the eukaryotic dataset. Our findings demonstrated that feeding hay had a significant effect on the beta diversity of the bacterial microbiota. Given the prevalence of gastrointestinal disease in the domestic rabbit population, furthering our understanding of what constitutes a healthy rabbit microbiota and the effects of different diets on the microbial community can help veterinarians implement better intervention strategies and allow pet owners to provide the best level of care.

High expression of NXPH4 correlates with poor prognosis, metabolic reprogramming, and immune infiltration in colon adenocarcinoma.

Colon adenocarcinoma (COAD) is a prevalent gastrointestinal malignant disease with high mortality rate, and identification of novel prognostic biomarkers and therapeutic targets is urgently needed. Although neurexophilin 4 (NXPH4) has been investigated in several tumors, its role in COAD remains unclear. The aim of this study was to explore the prognostic value and potential functions of NXPH4 in COAD. The expression of NXPH4 in COAD were analyzed using The Cancer Genome Atlas (TCGA) and datasets from the Gene Expression Omnibus (GEO) database. The prognostic value of NXPH4 was determined using Kaplan-Meier analysis and Cox regression analysis. To investigate the possible mechanism underlying the role of NXPH4 in COAD, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) were employed. The correlation between NXPH4 expression and immune cell infiltration levels was examined thorough single-sample gene set enrichment analysis (ssGSEA). Furthermore, the competing endogenous RNA (ceRNA) regulatory network that may be involved in NXPH4 in COAD was predicted and constructed through a variety of databases. NXPH4 expression was significantly higher in COAD tissue compared with normal colon tissues. Meanwhile, high expression of NXPH4 was associated with poor prognosis in COAD patients. GO-KEGG and GSEA analyses indicated that NXPH4 was associated with glycolysis and hypoxia pathway, and may promote COAD progression and metastasis by modulating metabolic reprogramming. ssGSEA analysis demonstrated that NXPH4 expression also associated with immune infiltration. Furthermore, we identified various microRNAs (miRNAs) and long noncoding RNAs (lncRNAs) as upstream regulators of NXPH4 in COAD. The present study revealed that high expression of NXPH4 is associated with tumor progression, metabolic reprogramming, and immune infiltration. These findings suggest that NXPH4 could serve as a reliable prognostic biomarker and a promising therapeutic target in COAD.

Neutrophil- and Platelet-Lymphocyte Ratio as Biomarkers of Severity in Complicated Diverticular Disease.

Diverticulitis is a prevalent gastrointestinal disease that may require surgical intervention. The aim of the study was to investigate the involvement of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as biomarkers of severity in complicated diverticular disease (CDD) in Mexican patients and their correlation with the need for surgical intervention, the length of hospital stay, and mortality. An observational, longitudinal, and retrospective study performed from 2017 to 2021 was considered in patients over 18 years of age, with a diagnosis of CDD by using computed tomography and with a hemogram taken in the first 24 hours upon admission to the emergency department to describe the sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) of NLR and PLR in the CDD. Results: A total of 102 Mexican patients suffering from CDD, 54% women and 46% men with a mean of 59 years, were analyzed. According to Hinchey's classification, 79 (77.5%) patients showed type I, 12 (12.8%)type II, 5 (4.9%) type III, and 6 (5.9%)type IV. The mean hospital stay was 8.8 days, with a mortality rate of 3.9%.The cut-off value was established at 5.1 for NLR according to the results of the receiver operating characteristic (ROC) curve with an area under the curve (AUC) of 0.633, a sensitivity of 90%, a specificity of 43%, PPV of 21.8%, and NPV of 96% for the prediction of CDD. A cut-off value for PLR at 72 was established according to the results of the ROC curve with an AUC of 0.482, a sensitivity of 78%, a specificity of 40%, PPV of 96%, and NPV of 9% for the prediction of CDD. The NLR and PLR are easily calculable and accessible biomarkers that can be part of the decision-making for the diagnosis and treatment of CDD in Mexican people as has been observed in other populations. However, more prospective, multicenter comparative studies are needed to assess the efficacy and safety of these biomarkers in relation to those already described.

A prospective comparative study of the intraoperative difficulties during laparoscopic cholecystectomy in patients taking homeopathic medications for cholelithiasis versus cholelithiasis patients with no history of homeopathic medication

Background: Gallstone disease is one of the most prevalent gastrointestinal diseases with a substantial burden to health-care systems. Patients present with right upper quadrant pain, dyspepsia, nausea or vomiting. Owing to the side effects of allopathic drugs, many patients resort to homeopathic treatment for relief of pain. There are several homeopathic drugs that decrease the pain of cholecystitis as well as high cholesterol in these patients but cannot cure them off the disease. Finally, they come to general surgeon for cholecystectomy. We have noticed that performing laparoscopic cholecystectomy (LC) in these patients is difficult and time consuming. Aims and Objectives: To determine whether or not homeopathic medicine intake for treatment of cholelithiasis act as an independent factor that leads to intraoperative difficulties during LC. Materials and Methods: Study design: A prospective randomized comparative study. Study period: July 2022–December 2023 (18 months). Study groups: Group H = Patients with history of (H/O) intake of homeopathic medicines for treatment of cholelithiasis = 60 patients, Group N = Patients with no H/O homeopathic medicine intake = 60 patients. Results: Twenty-six (43.33%) patients in Group H and 11 (18.33%) patients in Group N had a difficult LC. 7 (11.67%) patients in Group H and 1 (1.67%) patient in Group N had dense adhesions around the gallbladder (GB). 13 (21.67%) patients of Group H and 3 (5%) patients of Group N had a Frozen Calot’s Triangle (fibrosis and difficult Calot’s triangle dissection). This was statistically significant. Conclusion: Our study proved that intake of homeopathic medications for the treatment of cholelithiasis leads to dense adhesions around GB as well as fibrotic adhesions leading to difficult Calot’s triangle dissection leading to a difficult LC.

ECCO Fellowship Generation of an IBD single-cell multiome ATLAS for deeper understanding of IBD sub-phenotypes

Abstract Background and Aims Inflammatory Bowel Disease (IBD) is one of the most prevalent gastrointestinal diseases worldwide (1, 2, 3). Disabling symptoms affect the quality of life of IBD patients, and incurred disability and healthcare costs result in a high socio-economic burden (1, 4, 5). Despite new biologicals and small-molecule drugs, patients deal with high rates of non-response, requiring therapy switching without evidence-based guidance on optimal therapy choices for each specific disease condition. Methods In an effort to better understand the disease pathomechanisms underlying IBD, an essential role has been played by single-cell RNA sequencing (scRNAseq). Two scRNAseq studies, one in Crohn’s disease (CD) (Martin e.a., Cell 2019), and one in ulcerative colitis (UC) (Smillie e.a., Cell 2019), characterized the molecular and functional heterogeneity of phenotypically similar IBD cases, and gave us the first clues on the mechanism underlying non-response to anti-TNFa. However, the statistical power of these studies is limited due to their small cohort sizes (6, 7, 8). To acquire further insights into IBD, and to definitively establish the mechanism underlying anti-TNFa non-response without having to generate costly new single-cell experiments, we propose harmonizing smaller IBD scRNAseq studies and performing large-scale meta-analyses. Specifically, our goal is to start with meta-analyzing four IBD scRNAseq datasets (two CD, each ~100 ind, and two UC, each ~30 ind) and to perform a powerful meta-analysis. To easily add more datasets we will create a pipeline for integrating scRNAseq data. Anticipated Impact The large meta-analysis will allow us to get more insight into the mechanisms underlying disease subphenotypes, and to get insight into the effect of commonly used IBD therapies (anti-TNFa, thiopurines) on the gut mucosal composition and inflammatory pathways. The datasets and related results will be made publicly available through a single-cell IBD ATLAS web interface, fulfilling the need for an easily queryable large IBD scRNAseq dataset.

The rhizomes of Atractylodes macrocephala relieve loperamide-induced constipation in rats by regulation of tryptophan metabolism

Ethnopharmacological relevanceConstipation is one of the most prevalent gastrointestinal tract diseases that seriously affects health-related quality of human life and requires effective treatments without side effect. The rhizome of Atractylodes macrocephala Koidz. (Compositae), called Atractylodes Macrocephala Rhizome (AMR), a commonly used traditional Chinese medicine, has been used to relieve the clinical symptoms of patients with constipation. Aim of the studyTo reveal the dose-dependent laxative effect and potential mechanism of AMR on loperamide-induced slow transit constipation (STC) rats. Materials and methodsLoperamide-induced constipation rat model was established and the dose-dependent laxative effect of AMR was investigated. Untargeted metabolomics based on an UPLC-Q/TOF-MS technique combined with western blot analysis was used to explain the potential mechanism of AMR relieve loperamide-induced constipation in rats. ResultsThe results showed that medium dose of AMR (AMR-M, 4.32 g raw herb/kg) and high dose of AMR (AMR-H, 8.64 g raw herb/kg) treatments significantly increased the fecal water content, Bristol score, gastrointestinal transit rate, and recovered the damaged colon tissues of constipated rats, but low dose of AMR (AMR-L, 2.16 g raw herb/kg) did not show laxative effect. Both AMR-M and AMR-H treatments also remarkably reduced the serum levels of vasoactive intestinal peptide (VIP), somatostatin (SS) and dopamine (DA), and increased the levels of motilin (MTL), gastrin (GAS) and 5-hydroxytryptamine (5-HT). Urine metabolomics revealed that constipation development was mainly ascribed to the perturbed tryptophan metabolism, and AMR-M and AMR-H markedly corrected the abnormal levels of five urine tryptophan metabolites, namely 4,6-dihydroxyquinoline, indole, 4,8-dihydroxyquinoline, 5-hydroxytryptamine, and kynurenic acid. Additionally, western blot analysis confirmed that the abnormal expression of rate-limiting enzyme involving in tryptophan metabolism, including tryptophan hydroxylase (TPH), monoamine oxidase (MAO) and indoleamine-2,3-dioxygenase (IDO) in the colon of constipated rats, were mediated by AMR-M and AMR-H. Conclusions: The findings provide insight into the mechanisms of STC and AMR could be developed as new therapeutic agent for prevention or healing of constipation.

Association Between Migraine and Gastrointestinal Disease in Pediatric Patients: A Propensity Score Weighting Approach.

Migraine is a neurological disorder affecting pediatric patients of all age groups, with a prevalence ranging from approximately 5% to 15%. It significantly impacts the quality of life in children and adolescents, potentially hampering their learning abilities, school performance, and daily activities. This study investigated the association between migraine and several prevalent gastrointestinal (GI) diseases in pediatric patients. We analyzed the Health Insurance Review and Assessment Service Pediatric Patient Sample (HIRA-PPS) dataset from South Korea. Propensity scores based on patient characteristics (age, sex, and insurance type) were employed through the inverse probability of treatment weighting (IPTW) in binary logistic regression. We included gastroesophageal disease (GERD), peptic ulcer disease (PUD), gastritis, dyspepsia, irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD) as GI diseases. A total of 683,347 patients from the HIRA dataset were included in the study. After IPTW adjustment, the prevalence of GI diseases among pediatric patients with migraine remained significantly increased (OR 4.15; 95% CI 4.12-4.18). Migraine patients showed higher prevalence rates for all six individual GI diseases, with GERD (OR 4.11; 95% CI 4.05-4.16) and IBS (OR 3.79; 95% CI 3.74-3.84) showing the highest associations. We also confirmed a progressively increasing association between the presence of diagnosed migraine and GI diseases. This study highlights a strong association between pediatric migraine and GI diseases, even after adjusting for patient characteristics. The elevated prevalence of various GI diseases in migraine patients suggests the need for comprehensive approaches to their prevention and treatment.

Laparoscopic vs. robotic colectomy for left-sided diverticulitis.

Diverticulitis is a prevalent gastrointestinal disease that often warrants surgical intervention. However, the optimal approach between traditional laparoscopy (LC) and robotic-assisted laparoscopy (RAC) for diverticulitis remains unclear. Our research compares these techniques in patients diagnosed with left-sided diverticulitis treated at a single, tertiary referral center from 2019 to 2022. Among the 134 patients, 86 underwent laparoscopic and 48 robotic-assisted surgeries. The surgeries included in this analysis are left colectomy, sigmoid colectomy, low anterior resection, and Hartmann's procedure. Primary outcomes were major morbidity and 30-day mortality. Secondary outcomes were operative time, conversion to open, length of stay, unplanned return to the operating room, 30-day readmission rate, and overall morbidity. While demographics and comorbidities were similar for both groups, the robotic-assisted group displayed a statistically significant longer operative time (198.0 ± 84.4 LC vs. 264.8 ± 78.5min RAC, p < 0.001). When investigated further, there was a significant difference in operative time for uncomplicated diverticulitis cases favoring the LC approach (169.17 ± 58.1 LC vs. 244.82 ± 58.79min RAC, p < 0.001). This significant difference, however, was not present in complicated diverticulitis cases. Other factors, such as overall and major morbidity, rate of conversion to open approach, ostomy creation, estimated blood loss, time to return of bowel function, length of stay, and 30-day readmission rate, did not significantly differ between the groups. There was no 30-day mortality in either group. Favorable patient outcomes, lack of significant difference in operative time compared with traditional laparoscopy, and absence of differences in morbidities or efficacy, raises an interesting question in the world of minimally invasive surgery: is the robotic-assisted approach emerging as the advantageous approach for complicated diverticulitis cases? We encourage additional, multi-center analysis of specifically complicated diverticulitis managed with both surgical approaches to investigate if these findings are replicated outside of our institution.

The clinical effect of benesco™ on reflux symptoms: A double-blind randomized placebo-controlled trial.

Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal diseases in the western world. Lifestyle modifications and proton pump inhibitors (PPIs) form the basis of the management of GERD. A subset of patients seeks for (natural) alternative therapies besides PPIs. benesco™ is an over-the-counter nutrition based on quercetin which has a presumed positive effect on esophageal barrier function. Therefore we aim to assess the effect of benesco™ on reflux symptoms. We performed a double-blind randomized placebo-controlled trial in participants with reflux symptoms. Participants were assigned randomly (1:1) to receive 6 weeks of benesco™ (three times daily one lozenge containing 200 mg of quercetin) or placebo. The primary outcome was treatment success (≥50% reduction in Reflux Disease Questionnaire Score). Secondary outcomes included GERD-related quality of life, reflux-free days and nights, and participant-reported treatment success. One hundred participants were randomized. Treatment success was seen in 18 (39%) of 46 participants in the intervention group versus 21 (47%) of 45 in the placebo group (p = 0.468). In the intervention group 10 (1-21) reflux-free days were reported compared to 10 (2-25) in the placebo group (p = 0.673). In addition, 38 (34-41) versus 39 (35-42) reflux-free nights were reported (p = 0.409). In our trial benesco™ showed no significant benefit over placebo at group level.

Tooth wear in relation to physical salivary characteristics among gastroesophageal reflux disease

Background: Gastroesophageal reflux disease, is a quite prevalent gastrointestinal disease, among which gastric content (excluding the air) returns into the oral cavity. Many 0ral manifestations related t0 this disease include tooth wear, dental caries also changes in salivary flow rate and pH. This study was conducted among gastroesophageal reflux disease patients in order to assess tooth wear in relation to salivary flow rate and pH among these patients and the effect of gastroesophageal reflux disease duration on this relation. Materials and methods: One hundred patients participate in this cross-sectional study for both genders and having an age range of 20-40 years old, patients had been endoscopically identified as having gastroesophageal reflux disease using the classification of Los Angeles (LA), who were attending the Gastroenterology and Hepatology Teaching Hospital in Baghdad. and divided into two groups: group A with grade severity mucosal breakage not longer than 5 mm and Group B with grade severity mucosal breakage more than 5 mm long, Smith and Knight (1984) tooth wear index criteria were used for the assessment of tooth wear. For measurement of salivary flow rate and pH, saliva sample (unstimulated) had been collected. Results: Of the entire sample (90%) were having tooth wear. Tooth wear was higher in grade B severity than in grade A severity among patients with gastroesophageal reflux disease duration of two years or less, while it was higher in grade A than in grade B among patients with a duration of more than two years but all these results were statistically non-significant. Salivary flow rate and pH showed a non-significant reduction with increasing gastroesophageal reflux disease severity for both of groups concerning disease duration. The correlation of total tooth wear with salivary flow rate and pH was a significantly weak negative correlation in grade A, while a nonsignificant weak negative correlation in grade B. Conclusions: The findings of the present study concluded that patients with gastroesophageal reflux disease recorded a high occurrence of tooth wear and there was a negative correlation of tooth wear with salivary flow rate and pH among patients with gastroesophageal reflux disease.

The Characteristic of the Gastric Secretion After Gastric Cryodenervation and Cryopreserved Placenta Extract Administration

Background. Peptic ulcer is a prevalent gastrointestinal tract disease worldwide. One of the treatment methods for the indicated pathology is trunk gastric cryodenervation (TGC), the feature of which is the preservation of the regenerative potential of n. vagus. Cryopreserved placenta extract (CPE) caught our attention among modern means capable of stimulating regeneration processes. Objective. We are aimed to characterize the state of gastric secretion after TGC and the application of СPE. Methods. TGC was performed by cryoinfusion on the front and back trunks of the abdominal part of n. vagus. Gastric secretion was studied using the H.A. Shay method. Results. On the 30th day after TGC, a statistically significant (p &lt; 0.001) decrease in the total acidity of gastric juice by 33.7% and a decrease (p &lt; 0.01) in the level of free acidity were observed compared to intact animals. Administration of СPE after TGC resulted in a statistically significant (p &lt; 0.001) decrease in total acidity by 24.2 % and a statistically significant (p &lt; 0.001) decrease in free acidity by 48.7% compared to the parameters of intact rats. This led to a statistically significant (p &lt; 0.001) decrease in the "free/bound acidity" ratio compared to the indicator of intact animals (1.4 ± 0.03 RU) which was higher than the similar ratio observed after esomeprazole usage or TGC. Conclusions. Administration of СPE contributed to the partial regeneration of n. vagus, as indicated by an increase in the level of total acidity to 104.1 ± 4.7 RU and a statistically significant (p &lt; 0.001) decrease in the "free/bound acidity" ratio compared to the indicator of intact animals.

Osteoimmunology: A Link between Gastrointestinal Diseases and Skeletal Health in Chickens.

Bone serves as a multifunctional organ in avian species, giving structural integrity to the body, aiding locomotion and flight, regulating mineral homeostasis, and supplementing calcium for eggshell formation. Furthermore, immune cells originate and reside in the bone marrow, sharing a milieu with bone cells, indicating a potential interaction in functions. In avian species, the prevalence of gastrointestinal diseases can alter the growth and the immune response, which costs a great fortune to the poultry industry. Previous studies have shown that coccidiosis and necrotic enteritis can dramatically reduce bone quality as well. However, possible mechanisms on how bone quality is influenced by these disease conditions have not yet been completely understood, other than the reduced feed intake. On the other hand, several mediators of the immune response, such as chemokines and cytokines, play a vital role in the differentiation and activation of osteoclasts responsible for bone resorption and osteoblasts for bone formation. In the case of Eimeria spp./Clostridium perfringens coinfection, these mediators are upregulated. One possible mechanism for accelerated bone loss after gastrointestinal illnesses might be immune-mediated osteoclastogenesis via cytokines-RANKL-mediated pathways. This review article thus focuses on osteoimmunological pathways and the interaction between host immune responses and bone biology in gastrointestinal diseases like coccidiosis and necrotic enteritis affecting skeletal health.

CORRELATION OF PRE OPERATIVE AND INTRA OPERATIVE FINDINGS IN GALL STONE DISEASE

Background: Gallstone disease (GD) is a chronic recurrent hepatobiliary disease, the basis for which is the impaired metabolism of cholesterol, bilirubin and bile acids which is characterized by the formation of gallstones in the hepatic bile duct, common bile duct or gallbladder. GD is one of the most prevalent gastrointestinal diseases with a substantial burden to health care systems. GD can result in serious outcomes such as acute gallstone pancreatitis and gallbladder cancer. The epidemiology, correlation with USG ndings and anatomical variants encountered during cholecystectomy are discussed in this study. To compare preoperative and intraope Aims and objectives: rative ndings of gall stone disease in patients who underwent cholecystectomy. 104 patients who underwent cholecystect Materials and methods: omy in Kanyakumari Government Medical College from January 2019 to December 2022. Majority of the patients were Results: in age group between 19 to 78 years of age with a mean age of 42.5. Female predominance was reported in our study comprising 65% of total study participants. The study identied a sensitivity of 0.84 and a specicity of 1 for ultrasound in the identication of gallstones.10 % of the study population had different anatomical variants which were encountered during cholecystectomy. &lt;4% of study population was intraoperatively converted from laparoscopic to open cholecystectomy. 78% of stones are pigment stones based on dry weight analysis. Reproductive Age and fe Summary: male sex are profoundly associated with the incidence of gallstone disease. This study suggests that despite an evolution in the resolution of ultrasound imaging, there has not been a corresponding improvement in sensitivity. Knowledge of Variation in cystic duct anatomy is important to avoid inadvertent injury to the biliary tree during Cholecystectomy. The study population have a predominance of pigment stones based on dry weight analysis

Adjuvant nutraceuticals in the management of gastrointestinal diseases

The prevalence of gastrointestinal diseases has increased substantially in the last few years, bringing consequences not only to quality of life, but also to patients’ emotional/psychological wellbeing. Preliminary data from experimental studies suggest that using nutraceuticals as an adjuvant therapy to improve gastrointestinal symptomology may be a relevant and innovative strategy, since first line pharmacological treatments may pose severe adverse effects, drug resistance and lack of patient compliance. This narrative review aimed to explore the potential of four bioactive compounds at improving gastrointestinal symptomatology and disease management. Additionally, the mechanisms of action and dosages underlying the positive effects of these substances in improving quality of life and risk of disease relapse are also explored. According to the evidence found, peppermint oil and probiotics appear to ameliorate irritable bowel syndrome symptomatology, whereas polyphenols such as curcumin suggest a complementary effect in inducing and maintaining clinical remission among ulcerative colitis patients. Evidence regarding ginger’s effect on gastrointestinal symptoms is lacking and demonstrates little to no expression in irritable bowel syndrome nor functional dyspepsia.In conclusion, the consumption of peppermint oil, polyphenols and probiotics may be a viable adjuvant in the management of gastrointestinal diseases, associated symptomology and quality of life. However, further randomized controlled trials are warranted to elucidate on the optimal dose, safety and long-term efficacy of supplementing with these components, and particularly on the potential relevance of ginger supplementation.