Gut
65 FOLLOWERS
Gut is a leading international journal in gastroenterology and hepatology and has an established reputation for publishing first-class clinical research of the alimentary tract, the liver, biliary tree, and pancreas. Gut delivers up-to-date, authoritative, clinically oriented coverage in all areas of gastroenterology and hepatology.
Gut
2w ago
Objective
Hyperferritinaemia is associated with liver fibrosis severity in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), but the longitudinal implications have not been thoroughly investigated. We assessed the role of serum ferritin in predicting long-term outcomes or death.
Design
We evaluated the relationship between baseline serum ferritin and longitudinal events in a multicentre cohort of 1342 patients. Four survival models considering ferritin with confounders or non-invasive scoring systems were applied with repeated five-fold cross-validation schema. Pr ..read more
Gut
2w ago
Recently, Lopes et al quantified the effect of modifiable lifestyle factors in inflammatory bowel disease (IBD) prevention using population attributable risk, and reported that 42.9% of Crohn’s disease (CD) cases and 44.4% of ulcerative colitis (UC) cases could have been prevented by lifestyle interventions. This interesting result was based on 6 prospective cohorts including 3 US cohorts with 208 070 participants and 3 large European cohorts that were used for validation.1 Undoubtedly, this well-performed study illustrates the possible merits of lifestyle modification as a prevention strategy ..read more
Gut
2w ago
Oesophageal adenocarcinoma (OAC) is a devastating disease with an average 5-year survival of around 15%.1 Moreover, rates of OAC have increased substantially in recent decades, adding greatly to the clinical and economic burden of this disease.2
OAC arises out of a metaplastic precursor in which the normal squamous lining of the oesophagus is replaced with columnar, mucin-secreting cells. This is termed Barrett’s oesophagus (BO) and is thought to form as a protective mechanism in response to gastro-oesophageal reflux disease (GORD).
The cells that make up this oesophageal metaplasia can take s ..read more
Gut
2w ago
We thank Ludvigsson for his interest in our work and for providing additional insights. As noted, our joint works implicate the role of antibiotics in the development of inflammatory bowel disease (IBD), however, there are limitations as well as unique strengths to our study design which should be noted.1 2
Although confounding may exist, our prospective cohort study design limits this possibility. For example, if an individual is not prescribed an antibiotic course for the first 10 years of follow-up, they will initially contribute at-risk time to the ‘no antibiotic exposure’ group. If, howev ..read more
Gut
2w ago
Eosinophilic oesophagitis (EoE) is an immune-mediated disease of uncertain aetiology. The diagnosis of EoE relies on the epithelial infiltration of eosinophils (peak eosinophil count of ≥15 per high-power field (HPF)) and on the presence of symptoms. Consequently, a combined clinical–histological endpoint has been devised to assess response to treatments in clinical trials. Recent guidelines drafted by the British Society of Gastroenterology have confirmed the pivotal role of swallowed topical steroid and, for the first time, explicitly considered the use of biological therapy in case of a coe ..read more
Gut
2w ago
Background
Intestinal fibrosis resulting in stricture formation and obstruction in Crohn’s disease (CD) and increased wall stiffness leading to symptoms in ulcerative colitis (UC) is among the largest unmet needs in inflammatory bowel disease (IBD). Fibrosis is caused by a multifactorial and complex process involving immune and non-immune cells, their soluble mediators and exposure to luminal contents, such as microbiota and environmental factors. To date, no antifibrotic therapy is available. Some progress has been made in creating consensus definitions and measurements to quantify stricture ..read more
Gut
2w ago
Objective
Whether gastric metaplasia (GM) of the oesophagus should be considered as Barrett’s oesophagus (BO) is controversial. Given concern intestinal metaplasia (IM) may be missed due to sampling, the UK guidelines include GM as a type of BO. Here, we investigated whether the risk of misdiagnosis and the malignant potential of GM warrant its place in the UK surveillance.
Design
We performed a thorough pathology and endoscopy review to follow clinical outcomes in a novel UK cohort of 244 patients, covering 1854 person years of follow-up. We complemented this with a comparative genomic analys ..read more
Gut
2w ago
Case presentation
An 18-year-old woman presented with a 4-day history of worsening abdominal pain. Physical examination revealed tenderness in the left mid abdomen, without rebound tenderness. Laboratory workups revealed neutrophilia (10 890/µL), elevated C reactive protein (38.59 mg/L) and increased faecal calprotectin (>50 µg/g). Haemoglobin, liver function, renal function and urinalysis results were within normal range. Immunological investigations, including immunoglobulin levels, antineutrophil cytoplasmic antibodies and antinuclear antibodies, were all normal. An abdominal CT scan dem ..read more
Gut
2w ago
Chronic liver diseases are prevalent, particularly among patients with type 2 diabetes, who have a higher incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) and are subject to other liver diseases.1 With no pharmacotherapy for these liver conditions, recent attention was given to glucagon-like peptide-1 receptor agonists (GLP1a) for their effectiveness in treating type 2 diabetes and obesity and in reducing liver enzyme levels and liver fat levels.2 A 72-week, phase II, placebo-controlled randomised trial in patients with non-alcoholic steatohepatitis (NASH) and live ..read more
Gut
2w ago
Message
Endoscopic neoplasia detection in inflammatory bowel disease (IBD) remains challenging. We developed and validated a novel artificial intelligence (AI) model for lesion detection and characterisation in 478 images from 30 patients with IBD, 10 of whom had a total of 25 neoplastic lesions (including 8 sessile serrated polyps); sensitivity and specificity for lesion detection were 93.5% and 80.6%, respectively. The IBD model was then further validated during a real-time endoscopic assessment of a further 30 consecutive patients with 25 neoplastic lesions found in 11/30 of them and achiev ..read more