ASIDE Gastroenterology
type: channel
description: ASIDE Gastroenterology Journal is a peer-reviewed, open-access journal published and owned by PubPorta Publishing LLC, 16192 Coastal Highway, Lewes, Delaware 19958, USA. Academic oversight and scholarly guidance are provided by the American Society for Inclusion, Diversity, and Equity in Healthcare (ASIDE). The journal is dedicated to advancing gastroenterology and hepatology through the publication of high-quality scholarly work across digestive and liver diseases. It promotes diversity, equity, inclusion, and accessibility in healthcare by highlighting health disparities, inclusive clinical approaches, the role of social determinants of health, and strategies to improve outcomes for underserved and marginalized populations. It serves as an international platform for clinicians, researchers, educators, and public health professionals to share knowledge that strengthens patient care, supports education, and advances more equitable healthcare practice and policy.
publisher: PubPorta Publishing LLC
language: en
publication name: ASIDE Gastroenterology
issn: 3066-4004
copyright: Copyright and Licensing All articles published in ASIDE Gastroenterology are open access and are made freely available online immediately upon publication, without embargo. Creative Commons License This journal applies the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0). Under this license, anyone may copy, redistribute, remix, transform, and build upon the material for any purpose (including commercial use), provided that appropriate credit is given to the original author(s), a link to the license is provided, and any changes are indicated. Machine-readable license metadata is embedded in each article and its DOI record. Copyright Holder Copyright in all articles remains with the author(s). By submitting a manuscript, authors grant the publisher (American Society for Inclusion, Diversity, and Equity in Healthcare – ASIDE) a non-exclusive license to publish, distribute, and archive the work under CC BY 4.0. Third-party Material Any material (e.g., images, figures, or tables) that is not covered by CC BY 4.0 will be clearly indicated within the article. Users must obtain permission directly from the relevant copyright holder for reuse of such third-party material. Author Rights and Self-Archiving Authors may deposit all versions of their work (preprint, author’s accepted manuscript, and the version of record) in institutional or subject repositories of their choice immediately upon publication, without embargo, provided that the DOI and license information (CC BY 4.0) are included.
items: Alternative Gastrointestinal Conditions Identified in Patients Meeting Rome IV Criteria for Irritable Bowel Syndrome or Functional Diarrhea Referred to Secondary Care: A Prospective Study
items: The Liver-Heart Axis: A Narrative Review of Clinical Implications of the MASLD Redefinition for Internists
items: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Multisystemic Narrative Review of Cardiovascular and Oncological Implications
items: Fish-Bone Migration to the Liver Causing Hepatic Abscess: A Scoping Review of Published Cases (2015–2025)
items: ERCP Timing in Gallstone Disease: A Meta-Analysis of One-Stage versus Two-Stage Strategies
items: Endoscopic Sphincterotomy Increases the Risk of Pyogenic Liver Abscess: A Retrospective Study Using Real-World Data
items: Efficacy and Safety of Tofacitinib in Pediatric Ulcerative Colitis Patients: A Systematic Review
items: The Impact of Vonoprazan on Tacrolimus Blood Levels in Transplant Recipients: A Systematic Review and Meta-Analysis
items: Mycophenolate Mofetil Use for Inflammatory Bowel Disease
items: Dexmedetomidine as an Adjunctive Sedative in Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis
items: Potential Use of Icosapent Ethyl in the Management of Acute Pancreatitis
items: Emphysematous Gastritis in a Patient with Concomitant COVID-19 Infection and Celiac Trunk Stenosis: A Case Report
items: Usage of Trapezoid RX Wire Guided Retrieval Basket with the Alliance™ II Inflation Handle for Treatment of Bouveret Syndrome: A Rare Clinical Entity
items: Safety and Efficacy of Na Alginate and Mesna in Endoscopic Submucosal Dissection: A Systematic Review and Meta-analysis
items: Comparative Outcomes of Esophageal Stent Placement in Esophageal Cancer Patients: A Prospective Study of 183 Cases
items: Evaluating Biliary Complications in Jaundiced Patients with Alcohol-Related Hepatitis: A Retrospective Study
items: https://www.asidejournals.com/index.php/Gastroenterology/article/view/77
items: An Unusual Case of Disseminated Hydatid Disease: A Laparoscopic Wonder
items: A Systematic Review and Meta-Analysis of Liver Transplant Outcomes in Lean Versus Non-Lean Metabolic Dysfunction-Associated Steatotic Liver Disease Patients
items: Gastrointestinal Non-Hodgkin Lymphoma: A Multifaceted Malady
items: Annular Pancreas in Adults Presenting as Chronic Pancreatitis and Duodenal Obstruction: Literature Review and a Case Report
items: Mycophenolate Mofetil for the Treatment of Resistant Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
items: Pancreatic Rest Complicated by Actinomyces Gastric Abscess in a Young Male: A Case Report
items: Insights into the Epidemiology and Determinants of Helicobacter Pylori Negative Gastritis: A Retrospective Study

Alternative Gastrointestinal Conditions Identified in Patients Meeting Rome IV Criteria for Irritable Bowel Syndrome or Functional Diarrhea Referred to Secondary Care: A Prospective Study
type: item
description: Introduction: Organic gastrointestinal (GI) disorders can be missed in individuals with irritable bowel syndrome (IBS). This study investigated the frequency of organic disorders in patients with diarrhea-predominant IBS or functional diarrhea and the impact of treatment for any identified alternative diagnoses. Methods: Between April 2019 and March 2020, the results of comprehensive investigations, including blood and fecal tests, a 75selenium homophobic acid taurine scan, a breath test, and endoscopies performed on consecutive eligible patients, were recorded. Symptom burden was reassessed after treatment for any GI conditions identified. Results: 66 (15 males) consecutive patients were included. Two patients (3%) were diagnosed with colonic malignancy; 21 (38%) had bile acid diarrhea; one (1%) had pancreatic exocrine insufficiency; and 31 (54%) had small intestinal bacterial overgrowth. 21 patients (32%) had at least two GI diagnoses. Significant improvement in symptoms occurred following treatment (p<0.0001). Conclusions: Multiple co-existing conditions were detected in many of these patients, with one-third of the cohort having more than one abnormal test. When these alternative diagnoses were treated, patients reported significant symptomatic improvement. Larger studies are required to validate our findings, and these patients' investigative and management pathways should be amended accordingly.
subject: Original Article
  topic: section
subject: Irritable Bowel Syndrome (IBS)
  topic: keywords
subject: Organic Gastrointestinal Disorders
  topic: keywords
subject: Bile Acid Diarrhea
  topic: keywords
subject: Diarrhea-predominant IBS
  topic: keywords
subject: Small Intestinal Bacterial Overgrowth
  topic: keywords
subject: irritable bowel syndrome
  topic: subjects
subject: functional diarrhoea
  topic: subjects
subject: concurrent treatable organic gastrointestinal conditions
  topic: subjects
subject: Biological Sciences
  topic: subjects
subject: Health Sciences
  topic: subjects
subject: Gastroenterology
  topic: subjects
subject: Internal Medicine
  topic: subjects
subject: Clinical Medicine
  topic: subjects
subject: Digestive Diseases
  topic: subjects
subject: Hepatology
  topic: subjects
subject: Infectious Diseases
  topic: subjects
subject: Pathology
  topic: subjects
subject: Nutrition and Dietetics
  topic: subjects
subject: Medicine
  topic: disciplines
subject: Gastroenterology
  topic: disciplines
subject: Pathology
  topic: disciplines
subject: Hepatology
  topic: disciplines
subject: Surgery
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Clinical Research
  topic: disciplines
creator: Dennis Poon
creator: Giles Major
creator: Jervoise Andreyev
rights: Copyright (c) 2025 Dennis Poon, Giles Major, Jervoise Andreyev https://creativecommons.org/licenses/by/4.0
date: 2025-06-20
publication date: 2025-06-20
starting page: 5
ending page: 12
doi: 10.71079/ASIDE.GI.06112565

The Liver-Heart Axis: A Narrative Review of Clinical Implications of the MASLD Redefinition for Internists
type: item
description: Introduction: Metabolically-dysfunction-associated steatotic liver disease (MASLD) represents a paradigm shift emphasizing the metabolic underpinnings of hepatic steatosis and its systemic consequences. MASLD carries a substantial cardiovascular burden. This review examines the clinical implications of the MASLD redefinition for internists, with particular focus on the liver-heart axis. Methods: We conducted a narrative review synthesizing evidence through December 2024. Literature searches were performed in PubMed, EMBASE, and Cochrane Library using terms including "MASLD," "nonalcoholic fatty liver disease," "metabolic dysfunction-associated steatohepatitis, "cardiovascular disease," and "cardiometabolic risk." Priority was given to systematic reviews, meta-analyses, and large prospective cohort studies. Results: MASLD is associated with increased risks of coronary artery disease, myocardial infarction, heart failure with preserved ejection fraction, atrial fibrillation, and cardiovascular mortality. These associations are mediated through insulin resistance, chronic inflammation, oxidative stress, atherogenic dyslipidemia, hepatokine dysregulation, gut-derived metabolites, and genetic determinants — though substantial residual confounding by shared cardiometabolic risk factors remains. Hepatic fibrosis stage emerges as a critical amplifier of cardiovascular risk. Integrated management requires systematic case-finding, fibrosis risk stratification using validated noninvasive tools, comprehensive cardiovascular assessment, intensive lifestyle intervention, and pharmacotherapy including incretin-based therapies, sodium-glucose cotransporter-2 inhibitors, and statins. Conclusions: Internists must adopt integrated approaches addressing both hepatic and cardiovascular manifestations of MASLD. The liver-heart axis requires recognition as an interconnected system, with cardiovascular risk management prioritized alongside hepatic care. While the MASLD nomenclature is inte…
subject: Review Article
  topic: section
subject: Metabolically-dysfunction-associated steatotic liver disease
  topic: keywords
subject: Cardiovascular disease
  topic: keywords
subject: Liver-heart axis
  topic: keywords
subject: Hepatic fibrosis
  topic: keywords
subject: Cardiometabolic risk
  topic: keywords
subject: MASLD
  topic: subjects
subject: Hepatic steatosis
  topic: subjects
subject: Cardiovascular diseases
  topic: subjects
subject: Liver fibrosis
  topic: subjects
subject: Coronary artery disease
  topic: subjects
subject: Heart failure
  topic: subjects
subject: Atrial fibrillation
  topic: subjects
subject: Myocardial infarction
  topic: subjects
subject: Insulin resistance
  topic: subjects
subject: Metabolic syndrome
  topic: subjects
subject: Internal Medicine
  topic: disciplines
subject: Hepatology
  topic: disciplines
subject: Gastroenterology
  topic: disciplines
subject: Cardiology and Cardiovascular Medicine
  topic: disciplines
subject: Endocrinology, Diabetes and Metabolism
  topic: disciplines
subject: General Medicine
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Nutrition and Dietetics
  topic: disciplines
subject: Radiology, Nuclear Medicine and Imaging
  topic: disciplines
creator: Hassan A. Abdou
creator: Saied A. Omar
rights: Copyright (c) 2026 Hassan A. Abdou, Saied A. Omar https://creativecommons.org/licenses/by/4.0
date: 2026-03-18
publication date: 2026-03-18
starting page: 26
ending page: 42
doi: 10.71079/ASIDE.GI.031826446

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Multisystemic Narrative Review of Cardiovascular and Oncological Implications
type: item
description: Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) has surpassed viral hepatitis as the primary driver of chronic liver disease globally. While traditionally viewed through the lens of hepatic progression, its clinical trajectory is increasingly defined by extrahepatic complications. Objective: This narrative review evaluates MASLD as a manifestation of systemic metabolic failure, specifically analyzing its role in accelerating cardiovascular dysfunction and extrahepatic carcinogenesis—the two principal causes of mortality in this population. Methods: A comprehensive literature synthesis was conducted from 2020 to December 2025, using databases including PubMed, Scopus, and the Egyptian Knowledge Bank (EKB) to identify high-impact studies and international guidelines. Results: The pathophysiology involves a metabolic cascade whereby hepatic lipid accumulation and insulin resistance trigger systemic inflammatory signaling. Disrupted lipid handling and genetic determinants promote pro-atherogenic and pro-oncogenic environments. The review advocates a transition to risk-stratified approaches using noninvasive biomarkers, such as the FIB-4 index. Conclusion: Addressing the bidirectional relationship between hepatic steatosis and systemic comorbidities requires a multidisciplinary therapeutic strategy. This framework provides a basis for early intervention to reduce the burden of cardiovascular events and malignancy among patients with MASLD.
subject: Review Article
  topic: section
subject: MASLD
  topic: keywords
subject: Cardiovascular disease
  topic: keywords
subject: Hepatocellular carcinoma
  topic: keywords
subject: FIB-4 index
  topic: keywords
subject: Metabolic syndrome
  topic: keywords
subject: Steatotic liver
  topic: keywords
subject: Systemic inflammation
  topic: keywords
subject: Resmetirom
  topic: keywords
subject: Nomenclature transition
  topic: subjects
subject: Liver fibrosis
  topic: subjects
subject: NAFLD
  topic: subjects
subject: MASLD
  topic: subjects
subject: Cardiometabolic risk factors
  topic: subjects
subject: Non-invasive biomarkers
  topic: subjects
subject: metabolic syndrome
  topic: subjects
subject: MASH
  topic: subjects
subject: Steatotic liver disease
  topic: subjects
subject: Cardiovascular disease
  topic: subjects
subject: Atherosclerotic cardiovascular risk
  topic: subjects
subject: Hepatocellular carcinoma
  topic: subjects
subject: Colorectal cancer
  topic: subjects
subject: Extrahepatic malignancies
  topic: subjects
subject: FIB-4 index
  topic: subjects
subject: Hepatology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Gastroenterology
  topic: disciplines
subject: Obesity and Metabolic Disorders
  topic: disciplines
subject: Endocrinology
  topic: disciplines
subject: Cardiology
  topic: disciplines
subject: Oncology
  topic: disciplines
subject: Preventive medicine
  topic: disciplines
subject: Clinical epidemiolog
  topic: disciplines
subject: Diagnostic imaging
  topic: disciplines
subject: Risk stratification
  topic: disciplines
creator: Menatalla M. A. Mohamed
creator: Maha M. M. I. Taha
creator: Mohnd M. M. R. Ibrahim
rights: Copyright (c) 2026 Menatalla M. A. Mohamed, Maha M. M. I. Taha, Mohnd M. M. R. Ibrahim https://creativecommons.org/licenses/by/4.0
date: 2026-02-26
publication date: 2026-02-26
starting page: 15
ending page: 25
doi: 10.71079/ASIDE.GI.022626448

Fish-Bone Migration to the Liver Causing Hepatic Abscess: A Scoping Review of Published Cases (2015–2025)
type: item
description: Background: Foreign body ingestion is common; however, migration of an ingested fish bone into the liver with subsequent abscess formation is rare, frequently presents with nonspecific abdominal symptoms, and poses a diagnostic challenge in routine clinical practice, often leading to delayed diagnosis. Methods: A scoping review of PubMed, Google Scholar, SciELO, and ScienceDirect identified human case reports and case series (2015–2025) describing confirmed intrahepatic fish-bone migration or penetration causing hepatic abscess. Reports without radiologic or intraoperative confirmation and those involving non–fish-bone foreign bodies were excluded. Extracted data included demographics, migration routes, imaging findings, management, and outcomes. Results: Twenty-seven publications reporting 29 patients met the inclusion criteria, including 25 individual case reports and 2 case series. Presumed transgastric migration was reported in 22 patients (75.9%), and the left hepatic lobe was involved in 20 cases (69.0%). Computed tomography identified a linear radiodense foreign body in 24 patients (82.8%). Surgical or minimally invasive foreign-body removal was performed in 21 patients (72.4%), with generally favorable outcomes, although follow-up reporting was variable. Conclusion: Intrahepatic fish-bone migration is a rare but clinically important cause of hepatic abscess and should be considered in patients with unexplained, particularly left-lobe, hepatic abscesses when CT demonstrates a linear foreign body or when response to standard therapy is atypical; timely source control is usually effective.
subject: Review Article
  topic: section
subject: Fish bone
  topic: keywords
subject: Intrahepatic migration
  topic: keywords
subject: Pyogenic liver abscess
  topic: keywords
subject: Computed tomography
  topic: keywords
subject: Fish bone
  topic: subjects
subject: Intrahepatic migration
  topic: subjects
subject: Hepatic abscess
  topic: subjects
subject: Pyogenic liver abscess
  topic: subjects
subject: Foreign body ingestion
  topic: subjects
subject: Gastrointestinal perforation
  topic: subjects
subject: Liver infection
  topic: subjects
subject: Abscess drainage
  topic: subjects
subject: Laparoscopic surgery
  topic: subjects
subject: CT imaging
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Hepatology
  topic: disciplines
subject: Surgery
  topic: disciplines
subject: Radiology
  topic: disciplines
subject: Infectious diseases
  topic: disciplines
subject: Clinical pathology
  topic: disciplines
subject: Internal medicine
  topic: disciplines
subject: Diagnostic imaging
  topic: disciplines
subject: Minimally invasive surgery
  topic: disciplines
subject: Emergency medicine
  topic: disciplines
creator: Zaid Alezzi
creator: Tarek Aboubakr
creator: Ashraf Yahia Hegab
creator: ‪Abdulkarim Hasan‬‏
rights: Copyright (c) 2026 Zaid Alezzi, Tarek Aboubakr, Ashraf Yahia Hegab, ‪Abdulkarim Hasan‬‏ https://creativecommons.org/licenses/by/4.0
date: 2026-02-21
publication date: 2026-02-21
starting page: 8
ending page: 14
doi: 10.71079/ASIDE.GI.022126507

ERCP Timing in Gallstone Disease: A Meta-Analysis of One-Stage versus Two-Stage Strategies
type: item
description: Background: Cholecystocholedocholithiasis involves gallbladder and bile duct stones. Standard two-stage care involves ERCP followed by cholecystectomy, whereas single-stage intraoperative ERCP may streamline treatment. We performed a meta-analysis comparing stone clearance, complications, and hospital stay between single-stage and two-stage strategies. Method: We systematically searched PubMed, Scopus, Web of Science, and the Cochrane Library up to April 2025 for clinical studies comparing one-stage laparo-endoscopic rendezvous with two-stage ERCP + LC. RCTs and observational studies reporting stone clearance, complications, conversion, bile leaks, hospital stay, repeat ERCP, or cannulation failure were included. Data extraction and ROB2/NOS assessments were done independently. Result: Twenty-four studies met the inclusion criteria. The one-stage approach demonstrated significantly higher CBD clearance (96.5% vs. 91.8%; RR = 1.03) and a notably lower overall complication rate (11.55% vs. 19.56%; RR = 0.51). Postoperative pancreatitis (RR = 0.50), cholangitis (RR = 0.33), and bleeding (RR = 0.47) were also significantly reduced. Although conversion to open surgery and bile leak rates were lower in the one-stage group, these differences were not statistically significant. Importantly, single-stage management resulted in shorter hospital stays (mean difference = −3.23 days), fewer postoperative repeat ERCPs (RR = 0.21), and markedly reduced cannulation failure (RR = 0.26). Conclusion: The one-stage approach for managing bile duct stones offers higher clearance rates, fewer complications, and shorter hospital stays compared to the two-stage approach. These results support adopting one-stage treatment as a more effective and efficient clinical strategy.
subject: Original Article
  topic: section
subject: One-stage treatment
  topic: keywords
subject: Two-stage treatment
  topic: keywords
subject: Common bile duct clearance
  topic: keywords
subject: ERCP
  topic: keywords
subject: Postoperative complications
  topic: keywords
subject: Laparoscopic cholecystectomy
  topic: keywords
subject: Cholecystocholedocholithiasis
  topic: subjects
subject: Common bile duct stones
  topic: subjects
subject: Endoscopic retrograde cholangiopancreatography (ERCP)
  topic: subjects
subject: One-stage management
  topic: subjects
subject: Two-stage management
  topic: subjects
subject: Laparoscopic cholecystectomy
  topic: subjects
subject: Laparoendoscopic rendezvous (LERV)
  topic: subjects
subject: Common bile duct clearance
  topic: subjects
subject: Post-ERCP complications
  topic: subjects
subject: Hospital length of stay
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Hepatobiliary surgery
  topic: disciplines
subject: Minimally invasive surgery
  topic: disciplines
subject: Endoscopy
  topic: disciplines
subject: Digestive system diseases
  topic: disciplines
subject: Surgical outcomes research
  topic: disciplines
subject: Evidence-based medicine
  topic: disciplines
subject: Meta-analysis
  topic: disciplines
subject: Clinical surgery
  topic: disciplines
subject: Translational clinical research
  topic: disciplines
creator: Mohamed Gamal
creator: Mohamed Wagdy
creator: Mahmoud Abd El-Nasser
creator: Abdalla Ahmed Mohamed
creator: Abdelrhman Waleed
creator: Abdulrahman Ziada
creator: Abdelrahman Abdalla Mohamed
rights: Copyright (c) 2025 Mohamed Gamal, Mohamed Wagdy, Mahmoud Abd El-Nasser, Abdalla Ahmed Mohamed, Abdelrhman Waleed Kotb, Abdulrahman Ziada, Abdelrahman Abdalla Mohamed https://creativecommons.org/licenses/by/4.0
date: 2025-12-31
publication date: 2025-12-31
starting page: 1
ending page: 7
doi: 10.71079/ASIDE.GI.123125198

Endoscopic Sphincterotomy Increases the Risk of Pyogenic Liver Abscess: A Retrospective Study Using Real-World Data
type: item
description: Introduction: Pyogenic liver abscess (PLA) after Endoscopic Retrograde Cholangiopancreatography (ERCP) is a rare infectious adverse event. The association between post-ERCP PLA and endoscopic sphincterotomy has not been extensively studied. Methods: We conducted a retrospective study using the TriNetX platform by including patients without history of PLA who received ERCP between October 2015 and December 2020. Two groups were made: the endoscopic sphincterotomy (ES) group (patients who received ES during ERCP) and the control group (patients who did not receive ES). The primary outcome was the risk of developing PLA within 1 year of the index ERCP. The secondary outcomes included sepsis, broad-spectrum antibiotics use, need for PLA drainage, and post-ERCP mortality within one year of the index ERCP. Results: There were 169 patients (1.43%) in the ES group who developed PLA compared to 123 patients (1.04%) in the control group, Relative Risk (RR): 1.37, P-value = 0.007. A total of 241 patients (2.05%) in the ES group developed sepsis compared to 176 patients (1.49%) in the control group, RR: 1.37, P-value = 0.001. A total of 2,954 patients (25.1%) in the ES group received treatment with broad-spectrum antibiotics compared to 2,132 patients (18.1%) in the control group, RR: 1.5, P-value < 0.0001. There was no statistically significant difference in the need for PLA drainage (RR: 1.19, P-value = 0.34) or mortality (RR: 0.969, P-value = 0.49). Conclusion: ES during ERCP was associated with an increased risk for PLA, sepsis, and broad-spectrum antibiotics use. No mortality difference was found.
subject: Original Article
  topic: section
subject: Endoscopic Sphincterotomy
  topic: keywords
subject: ERCP
  topic: keywords
subject: Pyogenic Liver Abscess
  topic: keywords
subject: Endoscopic Sphincterotomy
  topic: subjects
subject: ERCP
  topic: subjects
subject: Pyogenic Liver Abscess
  topic: subjects
subject: Post-ERCP complications
  topic: subjects
subject: Biliary tract infection
  topic: subjects
subject: Sepsis with enteric organisms
  topic: subjects
subject: Broad-spectrum antibiotic use
  topic: subjects
subject: Biliary intervention complications
  topic: subjects
subject: Liver abscess risk
  topic: subjects
subject: Hepatobiliary infection
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Hepatology
  topic: disciplines
subject: Infectious Disease
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Digestive diseases
  topic: disciplines
subject: Clinical epidemiology
  topic: disciplines
subject: Retrospective cohort study
  topic: disciplines
subject: Real-world evidence
  topic: disciplines
subject: Electronic health records
  topic: disciplines
subject: Propensity score matching
  topic: disciplines
subject: Outcomes research
  topic: disciplines
creator: Abdellatif Ismail
creator: Bisher Sawaf
creator: Pinghsin Hsieh
creator: Khalid Aloum
creator: Shahem Abbarh
creator: Mhd Kutaiba Albuni
creator: Mohammed Al-Aquily
creator: Mostafa Suhail Najim
creator: Amir Humza Sohail
creator: Saurabh Chandan
rights: Copyright (c) 2025 Abdellatif Ismail, Bisher Sawaf, Pinghsin Hsieh, Khalid Aloum, Shahem Abbarh, Mhd Kutaiba Albuni, Mohammed Al-Aquily, Mostafa Suhail Najim, Amir Humza Sohail, Saurabh Chandan https://creativecommons.org/licenses/by/4.0
date: 2025-12-31
publication date: 2025-12-31
starting page: 27
ending page: 32
doi: 10.71079/ASIDE.GI.123125111

Efficacy and Safety of Tofacitinib in Pediatric Ulcerative Colitis Patients: A Systematic Review
type: item
description: Introduction: Ulcerative colitis (UC), an inflammatory Bowel Disease (IBD), is a chronic illness of unknown mechanism affecting the colonic mucosa, mainly causing diarrhea and bleeding. It can potentially disrupt the quality of life. Tofacitinib, a Janus Kinase inhibitor, showed a promising effect in inducing remission in IBD patients. In this study, we aim to assess the efficacy and safety of Tofacitinib in treating children with ulcerative colitis. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), we searched four electronic databases (PubMed, Scopus, Cochrane Library, Embase, and Web of Science) to identify eligible studies reported up to July 2024. We reported outcomes as frequencies and proportions in our study. Results: We identified five studies encompassing 83 children diagnosed with IBD, of which 57 children had ulcerative colitis. The proportion of patients achieving a clinical response across one included study was 66.67%. The proportion of patients achieving clinical remission was 38.46%. Also, the proportion of patients achieving steroid-free remission across the three studies was 48.57%. The rate for serious adverse events was 25.53% across the three included studies. Conclusion: Tofacitinib could be useful in achieving clinical remission in children with UC and reducing colectomy rates. Also, a low infection rate and the incidence of serious adverse events were observed. Future randomized controlled trials with larger samples and longer follow-up periods are needed to support these findings.
subject: Original Article
  topic: section
subject: Inflammatory bowel disease
  topic: keywords
subject: Ulcerative colitis
  topic: keywords
subject: Crohn's disease
  topic: keywords
subject: Tofacitinib
  topic: keywords
subject: Janus kinase
  topic: keywords
subject: Pediatric Gastroenterology
  topic: subjects
subject: Inflammatory Bowel Disease
  topic: subjects
subject: Drug Therapy
  topic: subjects
subject: Pharmacology
  topic: subjects
subject: Systematic Review
  topic: subjects
subject: Biologic and Targeted Therapies
  topic: subjects
subject: Evidence-Based Medicine
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Medicine
  topic: disciplines
subject: Pediatrics
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Clinical Medicine
  topic: disciplines
subject: Clinical Research
  topic: disciplines
subject: Public Health
  topic: disciplines
creator: Abdelaziz A. Awad
creator: Mohamed A. Aldemerdash
creator: Ahmed Aldemerdash
creator: Esraa Awad
creator: Salma Allam
creator: Ahmed L. Youseif
creator: Alshimaa M. Abu alabbas
creator: Nermin Elhossiny
creator: Hazem Abosheaishaa
rights: Copyright (c) 2025 Abdelaziz A. Awad, Mohamed A. Aldemerdash, Ahmed Aldemerdash, Esraa Awad, Salma Allam, Ahmed L. Youseif, Alshimaa M. Abu alabbas, Nermin Elhossiny, Hazem Abosheaishaa https://creativecommons.org/licenses/by/4.0
date: 2025-04-21
publication date: 2025-04-21
starting page: 3
ending page: 8
doi: 10.71079/ASIDE.GI.04212519

The Impact of Vonoprazan on Tacrolimus Blood Levels in Transplant Recipients: A Systematic Review and Meta-Analysis
type: item
description: Background: Tacrolimus is essential for immunosuppression in transplant recipients but presents risks of toxicity and rejection due to its narrow therapeutic window. Vonoprazan, increasingly replacing proton pump inhibitors (PPIs) in these patients, may alter tacrolimus blood levels, but its impact remains unclear. Objective: To assess how switching from PPIs to vonoprazan affects tacrolimus through concentration and concentration-to-dose ratio, and to summarize related liver and kidney safety markers in transplant recipients. Methods: A systematic review was conducted of four Japanese studies (140 kidney or liver transplant recipients) evaluating tacrolimus-based immunosuppression before and after conversion to vonoprazan. The synthesis used exploratory meta-analyses and narrative interpretation, with clinically meaningful changes prespecified, while emphasizing study limitations. Results: Across studies, a trend toward higher tacrolimus levels was seen after switching to vonoprazan. However, the magnitude and consistency of these changes varied substantially between studies, and most results did not surpass thresholds for clinical concern. Liver and kidney safety signals were generally small and inconsistent. High risk of bias, considerable heterogeneity, and absence of pooled clinical endpoints prevent drawing firm conclusions from quantitative data. Pooled estimates are reported as exploratory only. Conclusions: There is low-certainty evidence that vonoprazan may increase tacrolimus exposure in transplant recipients, but the clinical significance is unclear due to small, regionally focused studies with major methodological limitations. Therapeutic drug monitoring during and after conversion is prudent, and well-controlled trials in diverse populations are needed before definitive recommendations can be made.
subject: Original Article
  topic: section
subject: Transplantation
  topic: keywords
subject: Drug-Drug Interaction
  topic: keywords
subject: Immunosuppression
  topic: keywords
subject: Calcineurin Inhibitors
  topic: keywords
subject: Acid Suppressants
  topic: keywords
subject: Tacrolimus
  topic: subjects
subject: Vonoprazan
  topic: subjects
subject: Drug–Drug Interaction
  topic: subjects
subject: Proton Pump Inhibitors
  topic: subjects
subject: Potassium-Competitive Acid Blockers
  topic: subjects
subject: CYP3A4/5 Metabolism
  topic: subjects
subject: Tacrolimus Trough Levels
  topic: subjects
subject: Concentration-to-Dose Ratio (C0/D)
  topic: subjects
subject: Organ Transplant Recipients
  topic: subjects
subject: Immunosuppressive Therapy
  topic: subjects
subject: Clinical Pharmacology
  topic: disciplines
subject: Transplant Medicine
  topic: disciplines
subject: Gastroenterology
  topic: disciplines
subject: Nephrology
  topic: disciplines
subject: Hepatology
  topic: disciplines
subject: Pharmaceutical Sciences
  topic: disciplines
subject: Clinical Therapeutics
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
subject: Systematic Review
  topic: disciplines
subject: Meta-Analysis
  topic: disciplines
creator: Islam Rajab
creator: Mohamed R. Ezz
creator: Mohamed S. Elgendy
creator: Omar K. Elsawy
creator: Mohamed Wagdy
creator: Mohamed A. Elshewikh
creator: Abdallah Hussein
creator: Patrick Tempera
creator: Walid Baddoura
rights: Copyright (c) 2025 Islam Rajab, Mohamed R. Ezz, Mohamed S. Elgendy, Omar K. Elsawy, Mohamed Wagdy, Mohamed A. Elshewikh, Abdallah Hussein, Patrick Tempera, Walid Baddoura https://creativecommons.org/licenses/by/4.0
date: 2025-12-17
publication date: 2025-12-17
starting page: 19
ending page: 26
doi: 10.71079/ASIDE.GI.121725125

Mycophenolate Mofetil Use for Inflammatory Bowel Disease
type: item
description: Mycophenolate Mofetil (MMF) is a prodrug that gets converted to mycophenolic acid (MPA). MPA inhibits the Akt/mTOR and STAT5 pathways and has a reversible cytostatic effect on T and B lymphocytes [1]. MMF is FDA-approved for immunosuppressive therapy after solid organ transplantation. MMF has been used for multiple inflammatory/autoimmune conditions including psoriasis, dermatomyositis, autoimmune hepatitis, lupus erythematosus, myasthenia gravis, and Takayasu arteritis [2]. In this Editorial, we discuss the recently published systematic review and meta-analysis by Balassiano et al [3]. This systematic review and meta-analysis studied the use of MMF for the treatment of IBD patients. This review included both retrospective studies, case series, and clinical trials that evaluated the use of MMF in patients with IBD. Included patients were intolerant or unresponsive to Azathioprine. MMF was used in the included studies for induction and maintenance of remission, or as a steroid sparing agent/immunomodulator. This study demonstrated MMF’s efficacy in both induction and maintenance of remission in IBD patients. MMF was associated with added benefits for patients on steroids as well as those on anti-TNF therapy [3]. MMF has several boxed warnings in the United States, limiting its use outside FDA-approved indications. MMF should be prescribed only by healthcare providers experienced in immunosuppressive therapy and organ transplant management, with access to comprehensive laboratory and medical resources [4]. There is also a significant risk of infections associated with immunosuppression including but not limited to opportunistic infections, which may result in significant morbidity and mortality. MMF use is associated with an increased risk of malignancy including but not limited to lymphoma and skin cancers. There is also a boxed warning suggesting avoiding MMF use in pregnancy if alternative therapies are available as its use is associated with congenital malformatio…
subject: Editorial
  topic: section
subject: Mycoohenolate Mofetil
  topic: keywords
subject: Inflammatory bowel disease
  topic: keywords
subject: Crohn's disease
  topic: keywords
subject: Ulcerative colitis
  topic: keywords
subject: Immunosuppressive Therapy
  topic: keywords
subject: Anti-inflammatory Agents
  topic: keywords
subject: Immunomodulators
  topic: keywords
subject: Gastrointestinal Inflammation
  topic: keywords
subject: Mycophenolic Acid
  topic: keywords
subject: IBD
  topic: subjects
subject: Inflammatory Bowel Diseases
  topic: subjects
subject: Mycophenolate Mofetil
  topic: subjects
subject: Crohn’s Disease
  topic: subjects
subject: Immunosuppressive Agents
  topic: subjects
subject: Ulcerative Colitis
  topic: subjects
subject: Immunomodulation
  topic: subjects
subject: Gastrointestinal Diseases
  topic: subjects
subject: Drug Therapy
  topic: subjects
subject: Anti-TNF Therapy
  topic: subjects
subject: Steroid-Sparing Agents
  topic: subjects
subject: Biosimilars
  topic: subjects
subject: Medicine
  topic: disciplines
subject: Clinical Medicine
  topic: disciplines
subject: Gastroenterology
  topic: disciplines
subject: Immunology
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
creator: Ahmed Abomhya
creator: Ahmed Elmoursi
rights: Copyright (c) 2025 Ahmed Abomhya, Ahmed Elmoursi https://creativecommons.org/licenses/by/4.0
date: 2025-04-14
publication date: 2025-04-14
starting page: 1
ending page: 2
doi: 10.71079/ASIDE.GI.04142552

Dexmedetomidine as an Adjunctive Sedative in Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis
type: item
description: Introduction: Endoscopic submucosal dissection (ESD) is a technique for removing dysplastic lesions in the gastrointestinal tract, but it carries risks like pain and perforation. Dexmedetomidine, an α2-receptor agonist, offers potential benefits as an adjunct sedative during ESD by providing anxiolysis and analgesia. This systematic review and meta-analysis assess its efficacy and safety. Methodology: We searched databases including Embase, Medline/PubMed, Scopus, and Web of Science up to April 21, 2024, following PRISMA guidelines. Eligible studies used dexmedetomidine with other sedatives for ESD. We analyzed outcomes such as en-bloc and complete resection rates, sedation duration, and adverse events, using RevMan for meta-analysis with a random-effects model. Results: The initial search retrieved 216 studies, and eight studies were included in the final analysis after screening. Dexmedetomidine showed no significant difference in en-bloc or complete resection rates compared to controls. Sedation and procedure times were similar between the two groups as well. Dexmedetomidine significantly reduced restlessness (OR 0.15, 95% CI:0.07 to 0.29) and increased bradycardia (OR 7.15, 95% CI 3.17 to 16.11) compared to controls. Upon subgroup analysis, Dexmedetomidine plus Propofol and Dexmedetomidine plus Midazolam revealed the same findings regarding restlessness and bradycardia compared to controls, which confirmed the adjunctive effects of Dexmedetomidine. Conclusion: Dexmedetomidine appears safe and effective as an adjunctive sedative in ESD, reducing restlessness without significant adverse events. The risk of bradycardia is increased, which may reflect reduced physiological stress. Future studies should explore optimal dosing and compare Dexmedetomidine with other sedatives in diverse populations.
subject: Original Article
  topic: section
subject: Dexmedetomidine
  topic: keywords
subject: Endoscopic submucosal dissection
  topic: keywords
subject: ESD
  topic: keywords
subject: Precedex
  topic: keywords
subject: Systematic Review
  topic: keywords
subject: Meta-Analysis
  topic: keywords
subject: Gastroenterology
  topic: subjects
subject: Sedatives in medical procedures
  topic: subjects
subject: Dexmedetomidine use in endoscopic procedures
  topic: subjects
subject: Medicine
  topic: disciplines
subject: Clinical Medicine
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Health Sciences
  topic: disciplines
creator: Hazem Abosheaishaa
creator: Abdallfatah Abdallfatah
creator: Abdelmalek Abdelghany
creator: Arshia Sethi
creator: Abdellatif Ismail
creator: Doha Mohamed
creator: Moataz Aboeldahb
creator: Omar Abdelhalim
creator: Islam Mohamed
creator: Ahmed Y. Azzam
creator: Muhammed Amir Essibayi
creator: David J. Altschul
creator: Mahmoud Nassar
creator: Mohammad Bilal
rights: Copyright (c) 2025 Hazem Abosheaishaa , Abdallfatah Abdallfatah, Abdelmalek Abdelghany, Arshia Sethi, Abdellatif Ismail, Doha Mohamed, Moataz Aboeldahb, Omar Abdelhalim, Islam Mohamed, Ahmed Y. Azzam, Muhammed Amir Essibayi, David J. Altschul, Mahmoud Nassar, Mohammad Bilal https://creativecommons.org/licenses/by/4.0
date: 2025-03-11
publication date: 2025-03-11
starting page: 7
ending page: 14
doi: 10.71079/ASIDE.GI.0109257

Potential Use of Icosapent Ethyl in the Management of Acute Pancreatitis
type: item
description: Dear Editor, We are writing to highlight the potential use of Icosapent Ethyl (Vascepa) as a management option for acute pancreatitis. To the best of my knowledge, a limited number of studies have investigated this use, but it is not yet Food and Drug Administration (FDA) approved for this indication. Previous studies have suggested that omega-3 fatty acids, such as Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA), may have anti-inflammatory properties and could potentially be beneficial in reducing the inflammation and triglyceride levels associated with acute pancreatitis [1]. These mechanisms consist of systemic inflammation reduction by the inhibition of inflammatory mediators since omega-3 fatty acids inhibit the synthesis of pro-inflammatory cytokines such as IL-1β and IL-6 [2]. Moreover, they alter intracellular signaling pathways linked to transcription factors such as nuclear factor-κB, which impacts the expression of genes linked to inflammation [3]. Surprisingly, it helped with inflammation resolution by enhancing the removal of inflammatory cells and promoting the production of certain pro-resolving mediators in mice with pancreatitis [4]. EPA may serve as a valuable dietary supplement for individuals with risk factors for heart disease. It has potential benefits for conditions such as cardiovascular disease, diabetes, obesity, cancer, and stroke. EPA has been shown to lower inflammation, cholesterol, blood pressure, and blood clotting, and improve coronary artery function. Additionally, it can reduce inflammation and enhance body composition, supporting weight loss efforts [5]. A case study reported the use of Icosapent Ethyl as a treatment for severe acute pancreatitis in a 31-year-old male patient with abrupt acute alcoholic pancreatitis, requiring ICU admission, intubation, and mechanical ventilation, renal replacement therapy, and pressors; the patient showed remarkable improvement after initiation of icosapent Ethyl treatment via gastrost…
subject: Letter to the Editor
  topic: section
subject: Icosapent Ethyl
  topic: keywords
subject: Acute Pancreatitis
  topic: keywords
subject: Eicosapentaenoic Acid
  topic: keywords
subject: Anti-inflammatory Therapy
  topic: keywords
subject: Hypertriglyceridemia
  topic: keywords
subject: Vascepa
  topic: keywords
subject: Pancreatic Inflammation Management
  topic: keywords
subject: Acute Pancreatitis
  topic: subjects
subject: Omega-3 Fatty Acids
  topic: subjects
subject: Eicosapentaenoic Acid (EPA)
  topic: subjects
subject: Inflammation Management
  topic: subjects
subject: Medicine
  topic: disciplines
subject: Gastroenterology
  topic: disciplines
subject: Pharmacology
  topic: disciplines
creator: Hazem Abosheaishaa
creator: Mahmoud Nassar
rights: Copyright (c) 2025 Hazem Abosheaishaa, Mahmoud Nassar https://creativecommons.org/licenses/by/4.0
date: 2025-01-07
publication date: 2025-01-07
starting page: 5
ending page: 6
doi: 10.71079/ASIDE.GI.0107256

Emphysematous Gastritis in a Patient with Concomitant COVID-19 Infection and Celiac Trunk Stenosis: A Case Report
type: item
description: This case report reviews a 75-year-old male with several comorbidities who presented with acute encephalopathy and sepsis in the setting of COVID-19 pneumonia, who was noted to have significant gaseous distention of the stomach, emphysematous gastritis (EG), and severe stenosis of the celiac trunk on initial CT imaging. He was treated with empiric IV antibiotics, including ceftriaxone and metronidazole, which were changed to intravenous piperacillin-tazobactam after 24 hours. After being evaluated by surgery and gastroenterology, it was determined that risks outweighed the benefits of EGD and surgical intervention as the patient had a labile hemodynamic status. After extensive goals of care discussions with the patient’s family, he was transitioned to comfort measures only on day 4 of admission and ultimately passed the same day due to cardiopulmonary arrest. EG is often diagnosed late in its course and is associated with extremely high mortality, even with surgical intervention. Evidence from recent case series suggests increasing success with conservative management in selected patients; there are no formal guidelines.
subject: Case Report
  topic: section
subject: Emphysematous gastritis
  topic: keywords
subject: covid-19
  topic: keywords
subject: Celiac trunk stenosis
  topic: keywords
subject: Gastric distention
  topic: keywords
subject: Sepsis
  topic: keywords
subject: Emphysematous gastritis
  topic: subjects
subject: Gastric wall gas
  topic: subjects
subject: Portal venous gas
  topic: subjects
subject: Celiac trunk stenosis
  topic: subjects
subject: COVID-19 infection
  topic: subjects
subject: Gastrointestinal ischemia
  topic: subjects
subject: Gas-forming bacterial infection
  topic: subjects
subject: Acute abdomen
  topic: subjects
subject: Sepsis and shock
  topic: subjects
subject: Conservative management in EG
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Internal medicine
  topic: disciplines
subject: Infectious diseases
  topic: disciplines
subject: Radiology / CT imaging
  topic: disciplines
subject: Critical care medicine
  topic: disciplines
subject: Emergency medicine
  topic: disciplines
subject: Surgical gastroenterology
  topic: disciplines
subject: Clinical case reports
  topic: disciplines
subject: Geriatric medicine
  topic: disciplines
subject: Vascular medicine
  topic: disciplines
creator: Hira Khan
creator: Anjali Rajagopal
creator: Karim Al Annan
creator: Murali Dharan
rights: Copyright (c) 2025 Hira Khan, Anjali Rajagopal, Murali Dharan https://creativecommons.org/licenses/by/4.0
date: 2025-12-03
publication date: 2025-12-03
starting page: 14
ending page: 18
doi: 10.71079/ASIDE.GI.120325228

Usage of Trapezoid RX Wire Guided Retrieval Basket with the Alliance™ II Inflation Handle for Treatment of Bouveret Syndrome: A Rare Clinical Entity
type: item
description: Bouveret Syndrome is an infrequent manifestation of gallstone disease, causing gastric outlet obstruction. This syndrome has diagnostic and therapeutic challenges due to its rarity and non-specific clinical presentation. Here, we present a case report involving a 78-year-old female patient who experienced gastric outlet blockage due to the presence of a sizable gallstone. A novel technique was applied wherein a trapezoid RX wire-guided retrieval basket (Boston Scientific) was utilized with Esophagogastroduodenoscopy to remove the stone without the need for surgical intervention. Post-procedure monitoring demonstrated a smooth recovery with immediate relief of symptoms. Imaging confirmed the absence of residual gallstones or obstruction.
subject: Case Report
  topic: section
subject: Gallstones
  topic: keywords
subject: Gastric outlet obstruction
  topic: keywords
subject: Bouveret syndrome
  topic: keywords
subject: Trapezoid
  topic: keywords
subject: Case report
  topic: keywords
subject: Gastroenterology
  topic: keywords
subject: Gastroenterology
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Clinical Medicine
  topic: disciplines
creator: Mahmod Ghoname
creator: Hazem Abosheaishaa
creator: Arshia Sethi
creator: Sharif Abbas
creator: Sherif Hegab
creator: Moataz Yousry Soliman
rights: Copyright (c) 2025 Mahmod Ghoname, Hazem Abosheaishaa, Arshia Sethi, Sharif Abbas, Sherif Hegab, Moataz Yousry Soliman https://creativecommons.org/licenses/by/4.0
date: 2025-01-02
publication date: 2025-01-02
starting page: 1
ending page: 4
doi: 10.71079/ASIDE.GI.0102255

Safety and Efficacy of Na Alginate and Mesna in Endoscopic Submucosal Dissection: A Systematic Review and Meta-analysis
type: item
description: Background: Sodium hyaluronate, commonly used in ESD, has drawbacks such as high cost and potential tumorigenesis. Sodium alginate (Na alginate) and Mesna offer promising alternative solutions with their viscoelastic and mucolytic properties. In this review we aimed to evaluate the safety and efficacy of Na alginate and Mesna solutions in ESD. Methods: A systematic search was conducted across multiple databases. Inclusion criteria were randomized controlled trials and observational studies assessing Na alginate and Mesna in ESD. Primary outcome included en-bloc resection rates. Secondary outcomes included adverse events such as perforation and delayed bleeding, and procedural time. Results: Eight studies involving 255 patients were included in this analysis. Overall en-bloc resection rate for sodium alginate was 97% [95% CI (93%-99%); I2:0%]. En-bloc resection subgroup analysis revealed 97% [95% CI (93%-99%); I2:0%] for 0.6% sodium alginate and 95% [95% CI (70%-99%); I2: 0%] for 0.4% sodium alginate. Moreover, En-bloc resection rate for Mesna was 98% [95%CI: 92%-100%); I2: 0%]. Delayed bleeding rates for sodium alginate were 5% [95% CI (1%-20%); I2: 65.2%]; however, after subgroup analysis delayed bleeding was 2% [95% CI (1%-6%); I2: 0%] for 0.6% sodium alginate and 22% [95% CI (8%-49%); I2:0%] for 0.4% sodium alginate. Perforation rate for 0.6% sodium alginate was 1% [95% CI (0%-5%); I2: 0%]. Conclusion: Na alginate (0.6%) and Mesna are effective and safe alternatives to sodium hyaluronate for submucosal injection in ESD. These solutions offer potential cost-effective and safer options for clinical practice, with Na alginate (0.6%) showing particularly low adverse event rates.
subject: Original Article
  topic: section
subject: Mesna
  topic: keywords
subject: Endoscopic Submucosal Dissection
  topic: keywords
subject: Sodium Alginate
  topic: keywords
subject: Na alginate
  topic: keywords
subject: Gastroenterology
  topic: subjects
subject: Surgical Techniques
  topic: subjects
subject: Pharmacology
  topic: subjects
subject: Gastrointestinal Oncology
  topic: subjects
subject: Evidence-Based Medicine
  topic: subjects
subject: Medicine
  topic: disciplines
subject: Surgery
  topic: disciplines
subject: Gastroenterology
  topic: disciplines
subject: Clinical Medicine
  topic: disciplines
subject: Clinical Research
  topic: disciplines
creator: Hazem Abosheaishaa
creator: Abdallfatah Abdallfatah
creator: Imad Samman Tahhan
creator: Abdelmalek Abdelghany
creator: Iyiad Alabdul Razzak
creator: Mohamed Amer
creator: Ahmed Y. Azzam
creator: Muhammed Amir Essibayi
creator: Mahmoud Nassar
creator: Omar Abdelhalim
creator: Sherif Andrawes:
rights: Copyright (c) 2025 Hazem Abosheaishaa, Abdallfatah Abdallfatah , Imad Samman Tahhan, Abdelmalek Abdelghany , Iyiad Alabdul Razzak, Mohamed A. M. Amer , Ahmed Y. Azzam, Muhammed Amir Essibayi, Mahmoud Nassar, Omar Abdelhalim , Sherif Andrawes https://creativecommons.org/licenses/by/4.0
date: 2025-04-22
publication date: 2025-04-22
starting page: 9
ending page: 15
doi: 10.71079/ASIDE.GI.04222537

Comparative Outcomes of Esophageal Stent Placement in Esophageal Cancer Patients: A Prospective Study of 183 Cases
type: item
description: Introduction: Esophageal stent placement is a vital, minimally invasive procedure for alleviating dysphagia and enabling smoother food passage. It offers immediate relief, reduces hospital stays, and enhances quality of life for high-risk patients. Effective for both malignant and benign conditions, stenting is cost-efficient and requires skilled professionals for optimal outcomes. This study examines outcomes of various stent types in esophageal cancer patients, evaluating efficacy, safety, and quality-of-life impacts. Methods: Between January and December 2022, 183 patients with esophageal cancer were enrolled from three tertiary healthcare facilities. Patients were divided into three groups based on the esophageal stent used: self-expanding metallic stents (SEMS, n = 84), self-expanding plastic stents (SEPS, n = 61), and fully covered self-expanding metallic stents (FCSEMS, n = 38). All stent placements were performed under endoscopic guidance, with follow-up assessments at 1 week, 1 month, 3 months, and 6 months to evaluate stent patency, dysphagia relief, and complications. Results: Technical success rates were high: SEMS 96.4%, SEPS 95.1%, and FCSEMS 97.4%. Immediate dysphagia relief occurred in 87.4% of patients. FCSEMS had a significantly longer median patency duration (8.0 months) compared to SEMS (6.3 months) and SEPS (5.6 months). Additionally, SEPS exhibited a higher migration rate (13.1%), while overall complications were noted in 18.0% of patients. Conclusions: Esophageal stent placement effectively palliates dysphagia in cancer patients. FCSEMS shows advantages with prolonged patency, yet careful stent selection is essential to optimize patient outcomes. These findings underscore the importance of individualized treatment planning and regular monitoring to achieve optimal outcomes.
subject: Original Article
  topic: section
subject: Esophageal cancer
  topic: keywords
subject: Esophageal stent
  topic: keywords
subject: SEMS
  topic: keywords
subject: Dysphagia palliation
  topic: keywords
subject: Stent migration
  topic: keywords
subject: Esophageal cancer
  topic: subjects
subject: Dysphagia
  topic: subjects
subject: Esophageal stent placement
  topic: subjects
subject: Self-expanding metallic stents (SEMS)
  topic: subjects
subject: Self-expanding plastic stents (SEPS)
  topic: subjects
subject: Fully covered self-expanding metallic stents (FCSEMS)
  topic: subjects
subject: Stent migration
  topic: subjects
subject: Stent patency
  topic: subjects
subject: Quality of life in cancer patients
  topic: subjects
subject: Palliative intervention
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Oncology
  topic: disciplines
subject: Palliative oncology
  topic: disciplines
subject: Endoscopy
  topic: disciplines
subject: Interventional gastroenterology
  topic: disciplines
subject: Surgical oncology
  topic: disciplines
subject: Medical devices in gastroenterology
  topic: disciplines
subject: Clinical epidemiology
  topic: disciplines
subject: Cancer therapeutics
  topic: disciplines
subject: Digestive disease research
  topic: disciplines
creator: Ahmed E. Salem
creator: Hazem Abosheaishaa
creator: Sarah Meribout
creator: Morad Zaaya
creator: Carla Barberan Parraga
creator: Kantash Kumar
creator: Aye Cherry
creator: Mohammed Abusuliman
creator: Mohamed Eldesouki
creator: Omar Abdelhalim
creator: Yuriy Tsirlin
creator: Aaron Z. Tokayer
rights: Copyright (c) 2025 Ahmed E. Salem, Hazem Abosheaishaa, Sarah Meribout, Morad Zaaya, Carla Barberan Parraga, Kantash Kumar, Aye Cherry, Mohammed Abusuliman, Mohamed Eldesouki, Omar Abdelhalim, Yuriy Tsirlin, Aaron Z. Tokayer https://creativecommons.org/licenses/by/4.0
date: 2025-09-24
publication date: 2025-09-24
starting page: 7
ending page: 13
doi: 10.71079/ASIDE.GI.09242544

Evaluating Biliary Complications in Jaundiced Patients with Alcohol-Related Hepatitis: A Retrospective Study
type: item
description: Introduction: This study aims to differentiate whether jaundice in patients with alcoholic hepatitis (AH) is due to alcohol-related liver disease or underlying biliary pathology, including choledocholithiasis, primary sclerosing cholangitis, primary biliary cholangitis, benign strictures, cholangiocarcinoma, or pancreatic cancer. Accurate differentiation is crucial for appropriate treatment decisions. Methods: A non-interventional retrospective study examined patients admitted to our institute for presumed alcohol-related hepatitis management from 2016 to 2023. The primary outcome was the occurrence of biliary processes, whether benign or malignant, in patients managed for alcohol-related hepatitis within 90 days. Secondary outcomes assessed bilirubin level trends over seven days to evaluate steroid effects on alcohol-related hepatitis and predict underlying biliary processes. Variables were analyzed using bivariate and multivariate logistic regression with biliary process as the dependent variable. Results: Our study revealed that patients with alcohol-related hepatitis and jaundice who had dilated common bile duct (CBD) or pancreatic duct (PD) on cross-sectional imaging were more likely to have biliary processes regardless of cholecystectomy history p-value 0.007 (CI 0.03-0.242) OR 7.5 and p-value 0.001 (CI 0.58-1.34), OR 1.2 respectively. However, there was no correlation between biliary process incidence and various demographic or clinical factors. Conclusion: Cross-sectional imaging should be routinely used to evaluate biliary tree conditions in alcohol-related hepatitis patients with jaundice who have dilated CBD, particularly those with previous cholecystectomy or gallstones on imaging studies. This systematic approach enables early identification of underlying biliary issues and facilitates prompt, appropriate management decisions.
subject: Original Article
  topic: section
subject: Alcoholic hepatitis
  topic: keywords
subject: Jaundice
  topic: keywords
subject: Biliary complications
  topic: keywords
subject: Common bile duct dilation
  topic: keywords
subject: Cross-sectional imaging
  topic: keywords
subject: Hepatobiliary
  topic: subjects
subject: alcohol
  topic: subjects
subject: jaundice
  topic: subjects
subject: Alcoholic Hepatitis
  topic: subjects
subject: Biliary Diseases
  topic: subjects
subject: Alcohol-Related Liver Disease
  topic: subjects
subject: Hepatology
  topic: subjects
subject: Gastroenterology
  topic: subjects
subject: Hepatic/Biliary Imaging
  topic: subjects
subject: Pancreatic Diseases
  topic: subjects
subject: Cholecystectomy
  topic: subjects
subject: Choledocholithiasis
  topic: subjects
subject: Biliary Obstruction
  topic: subjects
subject: Pancreatic Cancer
  topic: subjects
subject: Retrospective Studies
  topic: subjects
subject: Clinical Research
  topic: subjects
subject: Diagnostic Imaging
  topic: subjects
subject: Risk Factors
  topic: subjects
subject: Epidemiology
  topic: subjects
subject: Internal Medicine
  topic: subjects
subject: Clinical Medicine
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Gastroenterology & Hepatology
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Oncology
  topic: disciplines
subject: Pathology
  topic: disciplines
subject: Surgery
  topic: disciplines
subject: Radiology
  topic: disciplines
creator: Junaid Khan
creator: Qamar Iqbal
creator: Gajendra Acharya
creator: Mubasshar Shahid
creator: Safana Ismail
creator: Umme Ferdaush
creator: Christina Gomez
creator: Osama Kaddourah
rights: Copyright (c) 2025 Junaid Khan, Qamar Iqbal , Gajendra Acharya , Mubasshar Shahid , Safana Ismail , Umme Ferdaush , Christina Gomez , Osama Kaddourah https://creativecommons.org/licenses/by/4.0
date: 2025-06-24
publication date: 2025-06-24
starting page: 21
ending page: 25
doi: 10.71079/ASIDE.GI.06242551

https://www.asidejournals.com/index.php/Gastroenterology/article/view/77
type: item
title: Efficacy and Safety of Tislelizumab in Combination with Chemotherapy versus Placebo Plus Chemotherapy in Patients with Advanced Gastric Cancer or Gastroesophageal Junction Cancer: A Systematic Review of Randomized Controlled Trials
description: Introduction: Advanced gastric cancer or gastroesophageal junction cancer (GC/GEJC) is an aggressive malignancy often having a poor prognosis. Despite current systemic therapies, GC/GEJC remains the third most common cause of cancer-related deaths worldwide. Tislelizumab, an anti-PD1 antibody, has shown promising results in treating various cancers. Therefore, this systematic review investigated the efficacy and safety of tislelizumab plus chemotherapy for patients with GC/GEJC. Methods: Five databases were systematically searched until July 10, 2024. Articles identified in the screening process included two RCTs based on predefined inclusion criteria. We performed data extraction sheets and quality assessments using the Cochrane ROB2 tool. Results: Out of the two randomized controlled trials (RCTs), 1646 patients were included in our systematic review. In Rational-306, efficacy outcomes improved, overall survival (OS) significantly improved from 10.6 months (95\% CI 9.3–12.1) to 17.2 months (95\% CI 15.8–20.1), and progression-free survival (PFS) from 5.6 months (4.9–6.0) to 7.3 months (6.9–8.3). Rational-305 also notably significantly improved. Outcomes: Improved OS from 12.9 months (12.1-14.1) to 15 months (13.6-16.5), and PFS from 6.2 months (5.6 to 6.9) to 6.9 months (5.7 to 7.2). The proportion of patients with any grade 3 or worse treatment-related adverse events was similar between treatment groups. Conclusion: Compared with chemotherapy and placebo, Tislelizumab plus chemotherapy demonstrates superior efficacy with a similar safety profile in the two groups, encouraging the use of the tislelizumab group in patients with GC/GEJC.
subject: Original Article
  topic: section
subject: Immuno-oncology
  topic: keywords
subject: Gastric cancer
  topic: keywords
subject: Gastroesophageal junction cancer
  topic: keywords
subject: Tislelizumab
  topic: keywords
subject: Targeted therapy
  topic: keywords
subject: Immunotherapy
  topic: keywords
subject: Immuno-oncology
  topic: subjects
subject: Immunotherapy
  topic: subjects
subject: Cancer
  topic: subjects
subject: Oncology
  topic: subjects
subject: Gastric cancer
  topic: subjects
subject: Gastroesophageal junction cancer
  topic: subjects
subject: Tislelizumab
  topic: subjects
subject: Targeted therapy
  topic: subjects
subject: Clinical trials
  topic: subjects
subject: Systematic review
  topic: subjects
subject: Chemotherapy
  topic: subjects
subject: PD-1 inhibitor
  topic: subjects
subject: Gastrointestinal cancers
  topic: subjects
subject: Meta-analysis
  topic: subjects
subject: Advanced cancer
  topic: subjects
subject: Precision medicine
  topic: subjects
subject: Tumor immunology
  topic: subjects
subject: Survival analysis
  topic: subjects
subject: Drug safety
  topic: subjects
subject: Evidence-based medicine
  topic: subjects
subject: Biomarkers
  topic: subjects
subject: Clinical Medicine
  topic: disciplines
subject: Immunology
  topic: disciplines
subject: Medicine
  topic: disciplines
subject: Oncology
  topic: disciplines
subject: Gastroenterology
  topic: disciplines
subject: Surgery
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Molecular Medicine
  topic: disciplines
subject: Translational Medicine
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Pathology
  topic: disciplines
subject: Bioinformatics
  topic: disciplines
subject: Biostatistics
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
creator: Ahmed Reda Bahr
creator: Ahmed Magdy Hassan
creator: Mohamed Wagdy
creator: Mahmoud Abdelkader
creator: Ahmed Samy Elgammal
rights: Copyright (c) 2025 Ahmed Reda Bahr, Ahmed Magdy Hassan, Mohamed Wagdy, Mahmoud Abdelkader, Ahmed Samy Elgammal https://creativecommons.org/licenses/by/4.0
date: 2025-06-05
publication date: 2025-06-05
starting page: 16
ending page: 20
doi: 10.71079/ASIDE.GI.06052577

An Unusual Case of Disseminated Hydatid Disease: A Laparoscopic Wonder
type: item
description: Human echinococcosis, caused by Echinococcus tapeworms, is a zoonotic disease in which ingested eggs of the tapeworm form cysts in the organs known as Hydatid cysts. These cysts are commonly found in the Liver and lungs, but in rare cases, they can also be found in the spleen, ovaries, round ligament, and peritoneal cavity. Treatment typically involves surgery. This is a case of a 32-year-old female who presented with chief complaints of pain in the abdomen for 2 months, which was associated with nausea, vomiting, reduced appetite, and increased size of mass per abdomen. Further investigations revealed the presence of multiple disseminated hydatid cysts in the upper abdomen and the peritoneal cavity. This was a rare & unusual entity that was meticulously managed by minimally invasive laparoscopic surgery. Echinococcosis can occur anywhere in the body, with concurrent localizations in the liver, spleen, round ligament, ovaries, and peritoneal cavity, which are rare and pose a diagnostic as well as a surgical management challenge. The inconvenience of multiple localization and the risk of contamination usually lead to open surgery in these cases. The presented case is unique due to the laparoscopic approach to the multiple localizations of hydatid disease, advocating for a minimally invasive first-line approach even in these particular localizations.
subject: Case Report
  topic: section
subject: Echinococcus
  topic: keywords
subject: Human echinococcosis
  topic: keywords
subject: Disseminated hydatid disease
  topic: keywords
subject: Laparoscopic surgery
  topic: keywords
subject: Case report
  topic: keywords
subject: Gastroenterology
  topic: subjects
subject: Laparoscopic
  topic: subjects
subject: Gastric abscess
  topic: subjects
subject: Endoscopic ultrasound (EUS)
  topic: subjects
subject: Heterotopic pancreas
  topic: subjects
subject: Pancreatic rest
  topic: subjects
subject: Actinomyces infection
  topic: subjects
subject: Diagnostic imaging
  topic: subjects
subject: Infectious complications
  topic: subjects
subject: Rare pancreatic lesions
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Medicine
  topic: disciplines
creator: Gajendra Bhati
creator: Raghav Bansal
creator: Vanessa Pamela Salolin Vargas
creator: Ripanbir Singh Kahlon
rights: Copyright (c) 2025 Gajendra Bhati, Raghav Bansal, Vanessa Pamela Salolin Vargas , Ripanbir Singh Kahlon https://creativecommons.org/licenses/by/4.0
date: 2025-06-22
publication date: 2025-06-22
starting page: 13
ending page: 18
doi: 10.71079/ASIDE.GI.05242570

A Systematic Review and Meta-Analysis of Liver Transplant Outcomes in Lean Versus Non-Lean Metabolic Dysfunction-Associated Steatotic Liver Disease Patients
type: item
description: Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent hepatic disease with metabolic dysfunction-associated steatohepatitis (MASH) as its severe necro-inflammatory subtype. At present, it is the second leading cause of liver transplant. A systematic literature review (SLR) was conducted to assess the effect of lean vs non-lean BMI on clinical outcomes after transplant in MASLD patients. Methods: A systematic search of PubMed, Cochrane Library, and Google Scholar databases was executed. Review Manager 5.4.1 was used for statistical analyses. A random-effect model was used with the results reported as Odds Ratio (OR) and 95% confidence interval (CI). A narrative approach was used where it was not feasible to conduct a meta-analysis. Results: Eleven observational studies were included in the SLR. Pooled results from three studies showed no significant difference in mortality between lean and non-lean patients at 1 year (OR= 0.78, p= 0.76), 2 years (OR= 0.83, p= 0.24), and 5 years (OR= 1.07, p= 0.51) post-transplant. There was also no significant relation of lean and non-lean BMI in graft survival, observed over 30 days (OR= 1.34, p= 0.27), 1 year (OR= 0.75, p= 0.25), 2 years (OR= 1.20, p= 0.45), and 5 years (OR= 1.07, p= 0.60) post-transplant. Qualitative analysis suggested morbid obesity is linked with higher waitlist dropout in MASH patients. Conclusion: The qualitative analysis of eight studies indicates a trend towards poorer outcomes in the non-lean group. There is a need for further investigations to comprehensively examine the factors influencing the relationship between BMI and post-transplant outcomes.
subject: Original Article
  topic: section
subject: Liver Transplant
  topic: keywords
subject: Graft Survival
  topic: keywords
subject: Metabolic dysfunction-associated steatotic liver disease (MASLD)
  topic: keywords
subject: Non-alcoholic fatty liver disease (NAFLD)
  topic: keywords
subject: Lean MASLD
  topic: keywords
subject: Liver Transplantation
  topic: subjects
subject: Nonalcoholic Steatohepatitis
  topic: subjects
subject: Body Mass Index
  topic: subjects
subject: Lean vs Non-Lean Patients
  topic: subjects
subject: Graft Survival
  topic: subjects
subject: Metabolic Dysfunction-Associated Steatotic Liver Disease
  topic: subjects
subject: Lean Patients
  topic: subjects
subject: Non-Lean Patients
  topic: subjects
subject: Post-Transplant Mortality
  topic: subjects
subject: Obesity-related Liver Disease
  topic: subjects
subject: Transplant Outcomes
  topic: subjects
subject: Hepatology
  topic: disciplines
subject: Transplant Surgery
  topic: disciplines
subject: Gastroenterology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Clinical Epidemiology
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
subject: Obesity and Metabolic Disorders
  topic: disciplines
subject: Health Outcomes Research
  topic: disciplines
subject: Biostatistics and Meta-Analysis
  topic: disciplines
creator: Manesh Kumar Gangwani
creator: Omar Irfan
creator: Muhammad Aziz
creator: Fnu Priyanka
creator: Dushyant Singh Dahiya
creator: Umar Hayat
creator: Fouad Jaber
creator: Hassam Ali
creator: Sumant Inamdar
creator: Mauricio Garcia Saenz de Sicilia
rights: Copyright (c) 2025 Manesh Kumar Gangwani, Omar Irfan, Muhammad Aziz, Fnu Priyanka, Dushyant Singh Dahiya , Umar Hayat , Fouad Jaber, Hassam Ali, Sumant Inamdar , Mauricio Garcia Saenz de Sicilia https://creativecommons.org/licenses/by/4.0
date: 2025-06-26
publication date: 2025-06-26
starting page: 19
ending page: 26
doi: 10.71079/ASIDE.GI.06262582

Gastrointestinal Non-Hodgkin Lymphoma: A Multifaceted Malady
type: item
description: Lymphomas account for approximately 5% of human malignancies and are classified as Hodgkin or non-Hodgkin variants. Non-Hodgkin lymphomas (NHL) constitute nearly 90% of all lymphomas, with diffuse large B-cell lymphoma (DLBCL) being the most prevalent histological subtype. Although primarily nodal, extranodal involvement is common in NHL, with the gastrointestinal (GI) tract being the most frequently involved extranodal site. Lymphomas constitute only 1–4% of gastrointestinal malignancies, with appendix being an exceedingly rare site of involvement. Lymphomas are conventionally staged utilizing the Ann-Arbor system and risk categorized per the International Prognostic Index (IPI). The Dawson’s criteria differentiate primary versus secondary gastrointestinal lymphoma. Diagnosis of lymphoma relies heavily on conventional and immune stained histopathology. Surgery offers the best therapeutic option in localized disease, while chemotherapy is preferred in diffuse or non-resectable diseases. We present a unique and an exceedingly uncommon combination of recurrent DLBCL with appendicular involvement, gastrointestinal hemorrhage, hepatic metastases, and obstructive jaundice. This case highlights the diagnostic challenges posed by extranodal lymphoma, particularly in rare sites such as the appendix. It underscores the critical role of multimodal imaging, endoscopic intervention, and immunohistochemical profiling in diagnosing, staging, and managing intraabdominal lymphomas.
subject: Case Report
  topic: section
subject: Obstructive jaundice
  topic: keywords
subject: Appendix
  topic: keywords
subject: Liver metastasis
  topic: keywords
subject: Melena
  topic: keywords
subject: Lymphoma
  topic: keywords
subject: Gastroenterology
  topic: subjects
subject: Gastrointestinal Oncology
  topic: subjects
subject: Oncology
  topic: subjects
subject: Hematology
  topic: subjects
subject: Appendix Lymphoma
  topic: subjects
subject: Gastrointestinal Bleeding
  topic: subjects
subject: Hepatic Metastasis
  topic: subjects
subject: Obstructive Jaundice
  topic: subjects
subject: Endoscopic Diagnosis
  topic: subjects
subject: Immunohistochemistry
  topic: subjects
subject: Case Report
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Oncology
  topic: disciplines
subject: Hematology
  topic: disciplines
subject: Surgical Gastroenterology
  topic: disciplines
subject: Pathology
  topic: disciplines
subject: Radiology and Imaging
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Multidisciplinary Cancer Care
  topic: disciplines
subject: Clinical Case Reports
  topic: disciplines
subject: Rare Malignancies
  topic: disciplines
creator: Mathew Vadukoot Lazar
creator: George Sarin Zacharia
creator: Mudhasir Ahmad
creator: Syed Mohamed Shimar
creator: Ipsita Panda
creator: Mohammad Ali
creator: Hardik Patel
rights: Copyright (c) 2025 Mathew Vadukoot Lazar, George Sarin Zacharia, Mudhasir Ahmad, Syed Mohamed Shimar, Ipsita Panda, Mohammad Ali, Hardik Patel https://creativecommons.org/licenses/by/4.0
date: 2025-09-11
publication date: 2025-09-11
starting page: 1
ending page: 6
doi: 10.71079/ASIDE.GI.091125122

Annular Pancreas in Adults Presenting as Chronic Pancreatitis and Duodenal Obstruction: Literature Review and a Case Report
type: item
description: Background: Annular pancreas is a rare congenital anomaly with an estimated incidence of 3.4 per 1,00,000 live births. It is more commonly diagnosed in infants. Its occurrence in adults is exceptionally rare but clinically significant, as seen in our case, where it presented as a duodenal obstruction. Case presentation: We present a case of an adult male who presented with a 3-week history of projectile bilious vomiting associated with postprandial abdominal pain and early satiety. Imaging studies revealed a segment of the pancreas encircling the second part of the duodenum, along with pancreatolithiasis. Based on the diagnosis of annular pancreas with chronic calcific pancreatitis, the patient underwent pylorus-preserving pancreatoduodenectomy. Materials and Methods: A structured literature review was performed using PubMed and Scopus databases, covering the period from 2018 to 2024. A total of 24 case reports were analyzed. Results: The review confirms that annular pancreas remains a rare condition, often undiagnosed in asymptomatic individuals with abdominal pain (83.3%) and vomiting (41.6%) as the most common symptoms. The most common diagnostic modality is the CT scan (computed tomography), at 64.1%, and surgical procedures, such as gastrojejunostomy, are the most common treatment modality, at 46.5%. Conclusions: It is a rare congenital condition that usually remains undiagnosed in asymptomatic individuals but typically presents with abdominal pain and vomiting when symptomatic. Diagnosis relies primarily on CT imaging. Conservative management is preferred for asymptomatic cases, and surgery is for symptomatic patients. Further research is needed to develop standardized management protocols.
subject: Case Report
  topic: section
subject: Acute Intestinal Obstruction
  topic: keywords
subject: Annular pancreas
  topic: keywords
subject: Chronic Pancreatitis
  topic: keywords
subject: Pancreatoduodenectomy
  topic: keywords
subject: Whipples procedure
  topic: keywords
subject: Pancreatic Diseases
  topic: subjects
subject: pancreatitis
  topic: subjects
subject: Gastroenterology
  topic: subjects
subject: pancreatic surgery
  topic: subjects
subject: Annular Pancreas
  topic: subjects
subject: Chronic Calcific Pancreatitis
  topic: subjects
subject: Duodenal Obstruction
  topic: subjects
subject: Pancreatoduodenectomy
  topic: subjects
subject: Whipple Procedure
  topic: subjects
subject: Congenital Pancreatic Anomaly
  topic: subjects
subject: Gastroenterology & Hepatology
  topic: disciplines
subject: Clinical Case Studies
  topic: disciplines
subject: Clinical research
  topic: disciplines
subject: Radiology
  topic: disciplines
subject: Clinical Surgery
  topic: disciplines
subject: Abdominal Imaging
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Pancreatic Diseases
  topic: disciplines
subject: Surgical Case Reports
  topic: disciplines
subject: Clinical Pathology
  topic: disciplines
creator: Gajendra Bhati
creator: Shruti Pandey
creator: Ripanbir Singh Kahlon
creator: Raghav Bansal
rights: Copyright (c) 2025 Gajendra Bhati, Shruti Pandey, Ripanbir Singh Kahlon , Raghav Bansal https://creativecommons.org/licenses/by/4.0
date: 2025-07-22
publication date: 2025-07-22
starting page: 27
ending page: 32
doi: 10.71079/ASIDE.GI.072225154

Mycophenolate Mofetil for the Treatment of Resistant Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
type: item
description: Background: This systematic review evaluates the efficacy and safety of Mycophenolate Mofetil (MMF) for managing treatment‐resistant Inflammatory Bowel Disease (IBD), emphasizing remission rates and adverse effects. Methods: Observational and controlled trials assessing MMF’s impact on IBD were included, excluding non-English and pediatric studies. Comprehensive searches were conducted in Embase, Medline/PubMed, Scopus, and Web of Science through October 2023. The risk of bias was evaluated using the NIH quality assessment tool, and results were synthesized using a random-effects meta-analysis model. Results: Twelve studies comprising 446 participants (333 with Crohn’s disease and 113 with ulcerative colitis) were analyzed. The meta-analysis revealed remission rates of 62.2% at 8 weeks and 52.8% at 6 months. Adverse effects occurred in 26.1% of patients, with nausea and vomiting being the most common. Treatment discontinuation due to failure and intolerance was observed in 29.7% and 20% of cases, respectively. Discussion: The findings suggest that MMF effectively induces remission in IBD patients unresponsive to conventional therapies, although a notable proportion experienced adverse events or treatment failure. Careful patient selection and monitoring are essential. Conclusion: MMF presents a promising alternative for managing resistant IBD, but its adverse effect profile warrants cautious application. Further research is needed to optimize dosing strategies and assess long-term outcomes in this challenging patient population. These results underscore the potential of MMF as an effective therapeutic option while emphasizing the importance of individualized treatment plans and rigorous clinical monitoring. Future studies should focus on long-term safety and dosing. Additional robust research is required.
subject: Original Article
  topic: section
subject: Mycoohenolate Mofetil
  topic: keywords
subject: Inflammatory bowel disease
  topic: keywords
subject: Crohn's disease
  topic: keywords
subject: Ulcerative colitis
  topic: keywords
subject: systematic review
  topic: keywords
subject: Meta-analysis
  topic: keywords
subject: Mycophenolate Mofetil
  topic: subjects
subject: Inflammatory Bowel Disease
  topic: subjects
subject: Crohn's Disease
  topic: subjects
subject: Ulcerative Colitis
  topic: subjects
subject: Systematic Review
  topic: subjects
subject: Meta-Analysis
  topic: subjects
subject: Clinical Outcomes
  topic: subjects
subject: Drug Therapy
  topic: subjects
subject: Pharmacotherapy
  topic: subjects
subject: Gastroenterology
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Clinical Medicine
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Health Services Research
  topic: disciplines
subject: Evidence-Based Medicine
  topic: disciplines
creator: Natalie Balassiano
creator: Jasmine Tidwell
creator: Omar Abdelhalim
creator: Mohammed Abusuliman
creator: Mahmoud Nassar
creator: Azizullah Beran
creator: Ivan Cancarevic
creator: Hazem Abosheaishaa
rights: Copyright (c) 2025 Natalie Balassiano, Jasmine Tidwell , Omar Abdelhalim, Mohammed Abusuliman, Mahmoud Nassar, Azizullah Beran, Ivan Cancarevic, Hazem Abosheaishaa https://creativecommons.org/licenses/by/4.0
date: 2025-03-13
publication date: 2025-03-13
starting page: 15
ending page: 22
doi: 10.71079/ASIDE.GI.03132515

Pancreatic Rest Complicated by Actinomyces Gastric Abscess in a Young Male: A Case Report
type: item
description: Pancreatic rest, or ectopic pancreatic tissue, is a rare condition. It is characterized by pancreatic tissue outside its usual location, most commonly in the gastric antrum or proximal small intestine. We present a rare case of a 21-year-old male with recurrent epigastric pain, vomiting, and fever. Imaging and endoscopic ultrasound (EUS) identified a subepithelial lesion with features consistent with pancreatic rest. Subsequent fine-needle aspiration (FNA) grew Actinomyces and Streptococcus. Given persistent symptoms and incomplete resolution despite prolonged antibiotics, he underwent partial gastrectomy. This case highlights an unusual infectious complication of pancreatic rest with Actinomyces and underscores the need to consider surgical intervention in cases refractory to medical therapy.
subject: Case Report
  topic: section
subject: Endoscopic ultrasound (EUS)
  topic: keywords
subject: Gastric abscess
  topic: keywords
subject: Heterotopic pancreas
  topic: keywords
subject: Pancreatic rest
  topic: keywords
subject: Case Report
  topic: subjects
subject: Pancreatic Rest
  topic: subjects
subject: Heterotopic Pancreas
  topic: subjects
subject: Gastric Abscess
  topic: subjects
subject: Endoscopic Ultrasound (EUS)
  topic: subjects
subject: Gastrointestinal Infections
  topic: subjects
subject: Actinomyces
  topic: subjects
subject: Subepithelial Lesions
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Surgery
  topic: disciplines
subject: Infectious Diseases
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Surgical Pathology
  topic: disciplines
subject: Endoscopy
  topic: disciplines
subject: Clinical Case Studies
  topic: disciplines
subject: Radiology
  topic: disciplines
creator: Ayah Obeid
creator: Frank Lin
creator: Anuraag Bandi
creator: Loveleen Sidhu
creator: Sinan Kutty
creator: Gurshawn Singh
creator: Lisa Stoll
rights: Copyright (c) 2025 Ayah Obeid, Frank Lin, Anuraag Bandi, Loveleen Sidhu, Sinan Kutty, Gurshawn Singh, Lisa Stoll https://creativecommons.org/licenses/by/4.0
date: 2025-06-01
publication date: 2025-06-01
starting page: 1
ending page: 4
doi: 10.71079/ASIDE.GI.06012584

Insights into the Epidemiology and Determinants of Helicobacter Pylori Negative Gastritis: A Retrospective Study
type: item
description: Introduction: The prevalence of Helicobacter pylori (HP)-negative gastritis is rising in the United States, yet its origins and risk factors remain largely unexplored. This study aims to assess the prevalence of HP-negative gastritis and explore the demographic, clinical, and risk factor profiles that differentiate HP-negative from HP-positive subjects with histological evidence of gastritis. Methods: We conducted a retrospective analysis of 241 patients who underwent Esophagogastroduodenoscopy (EGD) for upper gastrointestinal symptoms at a tertiary care center between July 2020 and July 2021. Symptoms prompting referral included dysphagia, abdominal pain, nausea, and others. Gastric biopsies were collected from the antrum and body, and clinical, demographic, and laboratory data were analyzed to compare HP-negative and HP-positive gastritis cases. Results: Of the patients biopsied, 38.2% (n=92) showed histological evidence of gastritis, with 78% of these being HP-negative and 22% HP-positive. HP-negative cases were predominantly chronic chemical gastritis (61.5%), while all HP-positive cases were active chronic gastritis. Significant ethnic disparities were noted; 61.5% of HP-negative patients were Caucasian, and 72.7% of HP-positive patients were African American. Medical comorbidities, particularly gastroesophageal reflux disease (GERD), were more associated with HP-negative gastritis. The antrum was more frequently affected in HP-negative cases compared to HP-positive cases. Conclusion: HP-negative gastritis is significantly linked with Caucasian ethnicity and existing medical comorbidities but shows no strong associations with the analyzed lifestyle or medication factors. These findings highlight the need for further large-scale prospective studies to better understand the etiology, risk factors, and clinical implications of HP-negative gastritis.
subject: Original Article
  topic: section
subject: H pylori
  topic: keywords
subject: Helicobacter Pylori
  topic: keywords
subject: GASTRITIS
  topic: keywords
subject: Helicobacter pylori-negative gastritis
  topic: keywords
subject: Gastroesophageal reflux disease (GERD)
  topic: keywords
subject: Chronic chemical gastritis
  topic: keywords
subject: Antral biopsies
  topic: keywords
subject: Gastroenterology
  topic: subjects
subject: Epidemiology
  topic: subjects
subject: Chronic gastritis
  topic: subjects
subject: Gastroesophageal reflux disease (GERD)
  topic: subjects
subject: Esophagogastroduodenoscopy (EGD)
  topic: subjects
subject: Antral biopsies
  topic: subjects
subject: Gastroenterology
  topic: disciplines
subject: Epidemiology
  topic: disciplines
subject: Histopathology
  topic: disciplines
subject: Clinical research
  topic: disciplines
subject: Pathology
  topic: disciplines
subject: Internal Medicine
  topic: disciplines
subject: Infectious Diseases
  topic: disciplines
subject: Public Health
  topic: disciplines
subject: Pharmacology
  topic: disciplines
subject: Healthcare Disparities
  topic: disciplines
creator: Ahmed E. Salem
creator: Syed Matthew Kodilinye
creator: Morad Zaaya
creator: Carla Barberan Parraga
creator: Sarah Meribout
creator: Samar Pal S. Sandhu Sandhu
creator: Cherry Aye
creator: Kantash Kumar
creator: Joseph A. Menand
creator: Neha Sharma
creator: MariaLisa Itzoe
creator: Tanuj R. Chokshi
creator: Mohammed Abusuliman
creator: Islam Mohamed
creator: Abdallfatah Abdallfatah
creator: Hazem Abosheaishaa
creator: Yuriy Tsirlin
rights: Copyright (c) 2025 Ahmed E. Salem, Syed Matthew Kodilinye, Morad Zaaya, Carla Barberan Parraga, Sarah Meribout, Samar Pal S. Sandhu, Cherry Aye, Kantash Kumar, Joseph A. Menand, Neha Sharma, MariaLisa Itzoe, Tanuj R. Chokshi, Mohammed Abusuliman, Islam Mohamed, Abdallfatah Abdallfatah, Hazem Abosheaishaa, Yuriy Tsirlin https://creativecommons.org/licenses/by/4.0
date: 2025-03-15
publication date: 2025-03-15
starting page: 23
ending page: 26
doi: 10.71079/ASIDE.GI.0315258