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9. Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Author

Ghoshal, Uday C., Sachdeva, Sanjeev, Pratap, Nitesh, Karyampudi, Arun, Mustafa, Uzma, Abraham, Philip, Bhatt, Chetan B., Chakravartty, Karmabir, Chaudhuri, Sujit, Goyal, Omesh, Makharia, Govind K., Panigrahi, Manas Kumar, Parida, Prasanta Kumar, Patwari, Sudhanshu, Sainani, Rajesh, Sadasivan, Shine, Srinivas, M., Upadhyay, Rajesh, and Venkataraman, Jayanthi

Published
2023
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17. Meta‐Analysis: Global Prevalence of Coeliac Disease in Type 1 Diabetes.

Author

Karimzadhagh, Sahand, Abbaspour, Elahe, Shahriarinamin, Maryam, Shamsi, Pourya, Poursadrolah, Selvana, Khorasani, Mehrdad, Daghighi, Mahzad, Malek, Arash, Talesh, Jouan Taheri, Makharia, Govind K., and Rostami‐Nejad, Mohammad

Subjects
TYPE 1 diabetes, CELIAC disease, HUMAN Development Index, MEDICAL screening, DISEASE prevalence
Abstract

Background: Coeliac disease (CD) is common in patients with type 1 diabetes (T1D), but prevalence varies globally due to differing screening protocols. There have been substantial changes in screening guidelines over the past two decades. Aim: To evaluate CD prevalence in patients with T1D, focusing on screening studies using antitissue transglutaminase (anti‐tTG) antibody. Methods: We searched PubMed, Web of Science, Embase and Scopus for studies published up to 11 December 2023 using keywords related to CD and diabetes. We used random‐effects models for overall prevalence and all subgroups, with heterogeneity assessed using Cochran's Q test and the I2 statistic performed in STATA 18. Results: We included 106 articles involving 65,102 T1D patients across 40 countries. The pooled CD seroprevalence and confirmed CD prevalence were 9% (95% confidence interval, CI, 8%–10%) and 6% (95% CI 5%–7%), respectively. The prevalence was higher in females and children. Denmark, Saudi Arabia and Libya exhibited the highest prevalence (11%), followed by India and Egypt (10%). Belgium, France, Germany, South Africa and the United States had the lowest prevalence (2%). High‐income countries showed significantly a lower CD prevalence than middle‐income countries (p = 0.03). Meta‐regression based on the Human Development Index (HDI) indicated that countries with higher HDI have lower seroprevalence and confirmed CD prevalence. Conclusion: Approximately 1 in 16 patients globally and 1 in 12 patients in Asia and the Middle East with T1D has CD. We suggest that all patients with T1D should be screened for CD. [ABSTRACT FROM AUTHOR]

Published
2025
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19. Intravenous Albumin Infusion Does not Augment the Response Rate to a Combination of Exclusive Enteral Nutrition and Intravenous Steroids in Acute Severe Ulcerative Colitis: A Randomised Controlled Trial.

Author

Mundhra, Sandeep K, Madan, Divya, Golla, Rithvik, Sahu, Pabitra, Vuyyuru, Sudheer K, Kante, Bhaskar, Kumar, Peeyush, Thomas, David Mathew, Prasad, Shubham, Vaishnav, Manas, Verma, Mahak, Virmani, Shubi, Bajaj, Aditya, Markandey, Manasvani, Ranjan, Mukesh Kumar, Arora, Umang, Singh, Mukesh Kumar, Makharia, Govind K, Ahuja, Vineet, and Kedia, Saurabh

Abstract

Introduction Overall, 30–40% patients with acute severe ulcerative colitis [ASUC] fail intravenous [IV] steroids, requiring medical rescue therapy/colectomy. Low baseline albumin predicts steroid non-response, and exclusive enteral nutrition [EEN] has been shown to improve steroid response and albumin levels. Albumin infusion, due to its anti-inflammatory and antioxidant properties, might further improve steroid response in ASUC, which was evaluated in the present study. Methods In this open-label, randomised, controlled trial, patients with ASUC were randomised in 1:1 ratio to either albumin + standard of care [SOC] + EEN [Albumin arm] or SOC + EEN [SOC arm], over January 2021–February 2023. Both arms received 5 days of EEN with 400 mg IV hydrocortisone/day. Patients in the Albumin arm were administered 5 days of 20% weight/volume [w/v] intravenous albumin [100 ml]. Primary outcome was first, steroid failure [need for rescue medical therapy or colectomy] and second, proportion of patients with adverse events. Results In all, 61 patients [albumin: 30, SOC: 31][mean age 31.6 ± 0.4 years, male 57.4%], were included. Baseline characteristics were comparable. There was no difference in steroid failure between Albumin and SOC arms (10/30 [33.33%] vs 13/31[41.94%], p  = 0.49). No adverse events were reported with albumin infusions. Colectomy rate [10% vs 9.68%, p  = 1], response to salvage medical therapy [88.89% vs 76.92%, p  = 0.62] and median [interquartile range] duration of hospitalisation [10.5 [7-16] vs 10 [7-20], p  = 0.43] were also comparable. The long-term composite outcome of colectomy and re-admission rates was numerically higher in the Albumin than the SOC arm [37.04% vs 17.86%, p  > 0.05], although this did not reach statistical significance. Conclusion There was no benefit of intravenous albumin infusion as an adjunct to IV steroids and EEN in patients with ASUC. [ABSTRACT FROM AUTHOR]

Published
2024
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20. Spectrum of height in patients with celiac disease

Author

Aggarwal, Nishant, Dwarakanathan, Vignesh, Singh, Alka, Agarwal, Ashish, Khuttan, Akhilesh, Ahmed, Anam, Rajput, Mahendra Singh, Chauhan, Ashish, Banyal, Vikas, Verma, Anil K., Gupta, Vipin, Lodha, Rakesh, Ahuja, Vineet, and Makharia, Govind K.

Published
2021
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24. Virtual Education is the Need of the Hour for the Global Gastroenterology Community: A Survey of Leaders of Professional Gastroenterology Organizations.

Author

Makharia, Govind K., Agrawal, Samagra, Hansen-Barkun, Christopher, Sadgehi, Anahita, Moreira, Leticia, Yeong Yeh Lee, Leung, Wai K., Kaplan, Gilaad, Leddin, Desmond, Metz, Geoffrey, and Barkun, Alan N.

Subjects
*CAREER development, *COVID-19, *ADMINISTRATIVE fees, *VIRTUAL communications, *CIVIC leaders
Abstract

Background & Aims: Since the onset of the Coronavirus disease 2019 (COVID-19) pandemic, there has been a significant opportunity to leverage virtual platforms for communication and dissemination of knowledge. An online survey was conducted to examine the viewpoints of World Gastroenterology Organization (WGO) leaders concerning the necessity, primary priority areas, and implementation strategies for a virtual global gastroenterology educational program. Methods: We conducted a survey of leaders of WGO member societies to assess their opinions on creating opportunities for global education using virtual platforms, identifying practical implementation steps and priority educational areas. Results: Responses were obtained from 57/117 (48.7%) contacted leaders with 56/57 (98.2%) identifying such a need. Five mutually exclusive priority educational topics were proposed in the survey: clinical gastroenterology, endoscopy, nutritional support, research methodology, and professional development. Overall, most participants prioritized clinical gastroenterology (45/57; 78.9%) and endoscopy/hand skills (27/57; 47.3%) as educational topics to be addressed by the virtual global gastroenterology educational program. A majority of WGO member society leaders surveyed favored monthly teaching activities (33/57; 57.8%), ideally carried out between 1500-2100 local time (31/57; 54.3%), ideally with no administrative fees (47/57; 82.4%). Conclusions: This truly global survey of WGO member societies achieved a good response rate and provides important insights into the need for and scope of future virtual education programs under the aegis of the WGO. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Ten missteps in the management of inflammatory bowel disease in Asia: An expert report by the Asian Pacific Association of Gastroenterology Working Group on Inflammatory Bowel Disease.

Author

Ahuja, Vineet, Hilmi, Ida, Ye, Byong Duk, Ling, Khoon Lin, Ng, Siew C., Leong, Rupert W., Kumar, Peeyush, Khoo, Xin Hui, Makharia, Govind K., Sollano, Jose, Pisespongsa, Pises, Mustaffa, Nazri, Banerjee, Rupa, Leow, Alex Hwong‐Ruey, Raja Ali, Raja Affendi, Chuah, Sai Wei, Palaniappan, Shanthi, Ooi, Choon Jin, and Leung, Wai K.

Subjects
CROHN'S disease, INFLAMMATORY bowel diseases, LATENT infection, ULCERATIVE colitis, PHYSICIANS
Abstract

Inflammatory bowel disease (IBD) is rapidly emerging in the Asia Pacific region. However, there are many challenges in the diagnosis and management of this condition. The Asian Pacific Association of Gastroenterology (APAGE) Working Group on IBD conducted a round table meeting to identify 10 common mistakes in the management of IBD in Asia. To summarize, many physicians still over rely on a definitive histological diagnosis before starting treatment and do not fully establish disease extent such as perianal and proximal gastrointestinal involvement in Crohn's disease (CD) or extent of involvement in ulcerative colitis (UC). It is also essential to actively look for evidence of extra‐intestinal manifestations, which may influence choice of therapy. In terms of conventional therapy, underuse of topical 5 aminosalicylates (5‐ASAs) in UC and inappropriate dosing of corticosteroids are also important considerations. Acute severe UC remains a life‐threatening condition and delay in starting rescue therapy after inadequate response to intravenous steroids is still common. Anti‐tumor necrosis factors should be considered first line in all cases of complex perianal fistulizing CD. Most patients with IBD are on potent immunosuppressive therapy and should be screened for latent infections and offered vaccinations according to guidelines. Under‐recognition and management of significant complications such as anemia, osteoporosis, malnutrition, and thromboembolism should also be addressed. Colonoscopy is still not properly performed for dysplasia/cancer surveillance and for evaluating post‐op recurrence of CD. Another common misstep is inappropriate withdrawal of medications during pregnancy leading to increased complications for the mother and the newborn. [ABSTRACT FROM AUTHOR]

Published
2024
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32. Reproductive functions and pregnancy outcome in female patients with celiac disease.

Author

Prasad, Shubham, Singh, Priyanka, Singh, Alka, Mehtab, Wajiha, Rajput, Simple, Dang, Sana, Chauhan, Ashish, Rajput, Mahendra Singh, Kachhawa, Garima, Jagannath, Soumya, Ahuja, Vineet, and Makharia, Govind K.

Subjects
PREGNANCY outcomes, CELIAC disease, WOMEN patients, GLUTEN-free diet, INTEGRAL functions
Abstract

Background and Aim: Abnormalities in the reproductive functions are often ignored while evaluating a patient with celiac disease (CeD). We evaluated the entire reproductive functions in female patients with CeD. Methods: In a case control study between 2020 and 2021 using detailed questionnaire, we evaluated reproductive functions (age at menarche, menstrual pattern, fertility, pregnancy outcome and menopause) in biopsy‐proven female patients with CeD of age >10 years. The questionnaire was administered either in person or telephonically. Age‐matched healthy female controls (twice the number) were also recruited. Results: Of 1086 CeD patients, 470 were females and 288 were included. As compared with controls (n = 586), females with CeD had higher age at menarche (14.6 ± 2.0 vs 13.6 ± 1.5 years; P = 0.001), delayed menarche (30.8% vs 11.4%; P = 0.001), abnormal menstrual pattern (39.7% vs 25.8%; P < 0.001), involuntary delay in conception at > 1 year (33.8% vs 11.8%; P = 0.01), current infertility rate (10.5% vs 5.2%;P = 0.028), and poorer overall pregnancy outcomes (abortion [23.5% vs 12.8%; P = 0.001], pre‐term birth [16.3% vs 3.7%; P = 0.001]). Conclusions: Either one or more aspect of reproductive functions and pregnancy outcome is affected adversely in three‐fourth female patients with CeD. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology

Author

Bhatia, Shobna J., Makharia, Govind K., Abraham, Philip, Bhat, Naresh, Kumar, Ajay, Reddy, D. Nageshwar, Ghoshal, Uday C., Ahuja, Vineet, Rao, G. Venkat, Devadas, Krishnadas, Dutta, Amit K., Jain, Abhinav, Kedia, Saurabh, Dama, Rohit, Kalapala, Rakesh, Alvares, Jose Filipe, Dadhich, Sunil, Dixit, Vinod Kumar, Goenka, Mahesh Kumar, Goswami, B. D., Issar, Sanjeev K., Leelakrishnan, Venkatakrishnan, Mallath, Mohandas K., Mathew, Philip, Mathew, Praveen, Nandwani, Subhashchandra, Pai, Cannanore Ganesh, Peter, Lorance, Prasad, A. V. Siva, Singh, Devinder, Sodhi, Jaswinder Singh, Sud, Randhir, Venkataraman, Jayanthi, Midha, Vandana, Bapaye, Amol, Dutta, Usha, Jain, Ajay K., Kochhar, Rakesh, Puri, Amarender S., Singh, Shivram Prasad, Shimpi, Lalit, Sood, Ajit, and Wadhwa, Rajkumar T.

Published
2019
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44. Coeliac disease

Author

Lindfors, Katri, Ciacci, Carolina, Kurppa, Kalle, Lundin, Knut E. A., Makharia, Govind K., Mearin, M. Luisa, Murray, Joseph A., Verdu, Elena F., and Kaukinen, Katri

Published
2019
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47. Imaging of the small intestine in Crohn’s disease: Joint position statement of the Indian Society of Gastroenterology and Indian Radiological and Imaging Association

Author

Kedia, Saurabh, Sharma, Raju, Makharia, Govind K., Ahuja, Vineet, Desai, Devendra, Kandasamy, Devasenathipathy, Eapen, Anu, Ganesan, Karthik, Ghoshal, Uday C., Kalra, Naveen, Karthikeyan, D., Madhusudhan, Kumble Seetharama, Philip, Mathew, Puri, Amarender Singh, Puri, Sunil, Sinha, Saroj K., Banerjee, Rupa, Bhatia, Shobna, Bhat, Naresh, Dadhich, Sunil, Dhali, G. K., Goswami, B. D., Issar, S. K., Jayanthi, V., Misra, S. P., Nijhawan, Sandeep, Puri, Pankaj, Sarkar, Avik, Singh, S. P., Srivastava, Anshu, Abraham, Philip, Ramakrishna, B. S., and for Indian Society of Gastroenterology Task Force on Inflammatory Bowel Disease

Published
2017
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