Search

Objective: To investigate the management of Helicobacter pylori (H. pylori) infection by gastroenterologists from secondary and tertiary hospitals in Shandong Province, China, where there is a high prevalence of H. pylori infection. Methods: A questionnaire‐based, stratified sampling survey was conducted from June 1 to August 30, 2021. The ratio of secondary to tertiary hospitals was set at 2:1. An electronic questionnaire was sent to the gastroenterologists via the WeChat platform. Results: A total of 89.09% (1053/1182) gastroenterologists were included. Overall, 34.19% and 60.59% of gastroenterologists recommended screening for and treating H. pylori infection in patients without any competing factors. The most preferred testing method in secondary and tertiary hospitals was the 13C‐urea breath test (53.92% and 80.48%), but the reexamination rate of results close to the cut‐off value was low (55.10% and 59.48%). Gastroenterologists preferred bismuth‐containing quadruple therapy (secondary and tertiary hospitals: 96.67% and 98.53%), but the antibiotic combination prescribed for patients with penicillin allergy was suboptimal in secondary hospitals. The overall post‐treatment follow‐up rate was 64.58%, and gastroenterologists in secondary hospitals were more proactive than those in tertiary hospitals (69.41% vs 60.04%, P = 0.001). Less than 80% of gastroenterologists emphasized the importance of post‐treatment reexamination to their patients. Only a minority of gastroenterologists in secondary and tertiary hospitals (30.79% and 34.36%) achieved acceptable eradication rates (exceeding 80%). Conclusions: Deficiencies exist in gastroenterologists from secondary and tertiary hospitals, and the H. pylori eradication rate is relatively low. Training programs for gastroenterologists are warranted to strengthen their comprehension of guidelines. [ABSTRACT FROM AUTHOR]

Objective This study aimed to compare the diagnostic value and image quality of high-definition magnifying white light endoscopy ( M- WLE) and high-definition magnifying endoscopy with i-scan ( M-i-scan) for Helicobacter pylori ( H. pylori) infection. Methods Patients complaining of dyspepsia who underwent esophagogastroduodenoscopy at the Endoscopy Unit of Qilu Hospital ( Jinan, Shandong Province, China) from January to March, 2011 were prospectively recruited. The greater curvature of the stomach was carefully observed using both M- WLE and M-i-scan. The gastric mucosal classification and image quality scores were recorded. The relationship between gastric mucosal classification and final diagnosis of H. pylori infection was determined. Results A total of 84 patients were recruited in this study. The accuracy and specificity of the combination of types 2-3 patterns predicting H. pylori infection were significantly higher for M-i-scan than those for M- WLE (accuracy: 94.0% vs 84.5%, P = 0.046; and specificity: 93.5% vs 80.6%, P = 0.032), while the sensitivity of the two modes was the same. The M-i-scan provided a better image quality for H. pylori infection than M- WLE ( P < 0.001). Conclusion The M-i-scan may be superior to M- WLE for the prediction of H. pylori infection, but its diagnostic sensitivity needs to be improved. [ABSTRACT FROM AUTHOR]

To standardize the diagnosis and management of Barrett's esophagus (BE) in China, the Chinese Society of Gastroenterology convened the Second National Conference on BE in June 2011 in Chongqing, China. After intense discussion among experts in this field and an extensive review of the literature, a revised consensus on the diagnosis and management of BE was generated. [ABSTRACT FROM AUTHOR]

Objectives: Functional constipation is a gastrointestinal disorder prevalent around the world. Lubiprostone is the first locally acting type-2 chloride channel activator to be used for treating constipation. This study aimed to evaluate the efficacy and safety of lubiprostone in Chinese adults with functional constipation., Methods: This was a multicenter, randomized, double-blind, placebo-controlled study. Patients with functional constipation were randomized to receive either lubiprostone (24 mcg twice daily) or placebo for 4 weeks. The primary end-point was the frequency of spontaneous bowel movements (SBMs) during the first week of treatment. The secondary end-points included the median time of the first SBM, SBM frequency at weeks 2, 3 and 4, weekly response rate of SBMs, the stool consistency score and average number of complete spontaneous bowel movements (CSBMs) per week., Results: In total, 259 patients were randomized, with 130 in the lubiprostone group and 129 in the placebo group. SBM frequency was higher in the lubiprostone group (4.88 ± 4.09/wk) than that in the placebo group (3.22 ± 2.01/wk) at week 1 (P < 0.0001). SBM frequency was also higher in the lubiprostone group at weeks 2, 3 and 4. The average number of CSBMs and the stool consistency score in the lubiprostone group were significantly higher than that in the placebo group at each week. No drug-related serious adverse events (AEs) occurred. The most commonly reported AE was nausea., Conclusion: Lubiprostone was superior to placebo in treating Chinese patients with functional constipation, together with good safety profile., (© 2021 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)

Objective: Celiac disease is a chronic inflammatory enteropathy with a symptom spectrum similar to that of irritable bowel syndrome (IBS). It is a common but largely undiagnosed condition in the Western countries. However, it is extremely rare among Chinese individuals, and few studies have investigated its prevalence in China. The aim was to determine the prevalence of celiac disease in patients with IBS who were diagnosed using the Rome III criteria in a single center of northern China., Methods: This was a single-center, prospective, controlled cohort study performed in Qilu Hospital involving 246 patients with IBS and 246 healthy controls. Blood samples were drawn to assess serum tissue transglutaminase immunoglobulin A (tTg-IgA). Patients with a positive or equivocal tTg-IgA (≥15 U/mL) were subjected to probe-based confocal laser endomicroscopy (pCLE) and duodenal biopsy to confirm celiac disease., Results: Altogether 12 (4.9%) patients with IBS and two (0.8%) healthy controls were positive or equivocal for serum tTg-IgA. Of these, five patients with IBS underwent pCLE and a targeted biopsy; all were histopathologically found to have celiac disease, although one was eventually diagnosed with lymphoma. After implementation of a gluten-free diet, seven patients serologically positive for IBS showed clinical improvement, thus our study illustrated a minimum prevalence of 2.85% of celiac disease among patients with IBS in our center., Conclusions: Celiac disease is not rare in Chinese individuals, particularly among those with IBS. Therefore, it should receive higher attention in clinical practice in China., (© 2018 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)