Search

Background and Aim: The histological diagnosis of autoimmune hepatitis (AIH) is challenging. A new consensus recommendation was provided by the International AIH Pathology Group to address the problems in the histological diagnosis. The purpose of this study is to compare the 2008 ‘simplified’ criteria for AIH with the ‘consensus recommendation’ of 2022 in terms of diagnostic sensitivity. Materials and Methods: A retrospective analysis was conducted on pathological specimens of patients diagnosed with Autoimmune Hepatitis (AIH) between 2010 and 2022. Out of 188 patients enlisted, 88 were selected based on exclusion criteria. The specimens were examined by two experienced hepatopathologists and a resident pathologist. All specimens were analyzed using both the “simplified” criteria and the new consensus recommendations. Results: Out of a total of 78 patients, the 2022 consensus recommendations raised the diagnostic category of 16 patients (20.5%) to a higher level. Six patients who were previously diagnosed as “atypical” were now considered “possible AIH”, while 10 patients with a “compatible” diagnosis were elevated to “likely AIH” category. No patients were found to fall into a lower diagnostic category according to the new recommendations. A significant difference in diagnostic sensitivity was observed between the 2008 criteria and the 2022 consensus report (p<0.001). Conclusion: The 2022 consensus recommendation may be more sensitive in the diagnosis of AIH in comparison to the 2008 ‘simplified’ histological criteria. More studies are needed both for the validation of the sensitivity of the new consensus recommendation and for the determination of the specificity. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate patients diagnosed with inflammatory bowel disease (IBD), the effects of drug groups used in the treatment of inflammatory bowel disease on depression and anxiety. This study was a single-center prospective study involving 94 patients with inflammatory bowel disease, 51 of whom had ulcerative colitis (UC) and 43 had Crohn's disease (CD). Harvey-Bradshaw activity scores for CD and Mayo Clinic activation scores for UC were calculated. Depression and anxiety data were collected with the Beck Depression Inventory and Beck Anxiety Inventory. The mean age for UC and CD were 40.25 ± 14 and 38.9 ± 13.8 years, respectively. There was a positive correlation between disease activation and depression and anxiety levels in both IBD subgroups (p<0.05). All patients included in the study were compared in terms of depression and anxiety levels before and after treatment, and a statistically significant improvement was found with the remission of both ulcerative colitis and Crohn's disease (p<0.001). There was a significant difference in depression and anxiety levels before and after treatment according to treatment options (p<0.001). There is a positive relationship between the disease activation score and the level of depression and anxiety in IBD. Immunosuppressive and immunomodulatory drugs used in the treatment of IBD may also improve the parameters of depression and anxiety in this disease. [ABSTRACT FROM AUTHOR]

Objective: Irritable bowel syndrome is a common functional gastrointestinal disorder that affects the quality of life and the ability to work. It is known that irritable bowel syndrome occurs as a result of a multifactorial change in microbiota and immunology. We aimed to evaluate the effects of Bacillus subtilis on inflammatory parameters and quality of life in irritable bowel syndrome. Methods: Irritable bowel syndrome volunteers diagnosed according to Rome IV criteria were recruited in the single-center prospective study and were given 5 billion B. subtilis once a day for 3 weeks. The primary outcome, the irritable bowel syndrome symptom severity score, fecal microbiota analysis, and serum inflammatory parameters were evaluated at the beginning of the study and at the end of the 3-week study period. Results: The mean age of 22 patients included in the study was 39.90 ± 11.93 years. The mean irritable bowel syndrome symptom severity score was 144.31 ± 104.86 before the treatment and 62.50 ± 43.69 after the treatment and the difference between them was statistically significant (P < .001). After treatment, an increase in total oxidant status, total antioxidant status, oxidative stress index, interleukin-10, interferon-gamma levels, and a decrease in interleukin-6 and tumor necrosis factor-α levels were observed, but the difference was not statistically significant (P > .05). While there was no difference in Shannon diversity after the application of alpha diversity analysis, a decrease was observed in the Chao (P < .006) analysis. Conclusion: The use of probiotics containing B. subtilis spores in patients with diarrheal-type irritable bowel syndrome reduces the severity of the disease, but no significant effect was observed in terms of inflammatory parameters. [ABSTRACT FROM AUTHOR]

Objective: In celiac disease (CD), gluten intake triggers the release of T-cell-derived pro-inflammatory cytokines leading to an increase in the level of serum amyloid A (SAA). To confirm inflammation caused by CD in patients, SAA level is expected to be a better biomarker candidate than C-reactive protein (CRP). This study investigated the relationship between clinical and biochemical variables used in the follow-up of CD patients and SAA levels. Methods: This study is a cross-sectional observational study which was conducted in patients who presented with a diagnosis of CD in a university hospital between June 1, 2019 and December 1, 2019. Patients were categorized into two groups based on the presence of tissue transglutaminase (tTG) immunoglobulin. Statistical analysis of data was performed by considering the age, gender, duration of the disease, frequency of compliance with a gluten-free diet, body mass index, and some laboratory parameters [vitamin D (VD), tTG IgA-IgG, CRP] taken simultaneously with the SAA levels. Results: A total of 90 patients, 28 (31.1%) antibody positive and 62 (68.9%) antibody negative, were included in the study. We found out that there was a statistically significant difference between between SAA level, VD levels, and the duration of CD in the patients (p=0.03 and p=0.009, respectively). Conclusion: VD levels <20 ng/mL, in advanced age, and duration of CD >5 years should be evaluated in the high-risk groups in terms of high SAA levels. If there is a persistent increase in SAA level during follow-up visits of patients with CD, they should be evaluated in terms of complications caused by the chronic inflammation. [ABSTRACT FROM AUTHOR]

Objective: Intrahepatic Cholestasis of Pregnancy (ICP) is a pregnancy complication characterized by pruritus, elevation in liver enzymes and concentration of serum bile acids (SBA). In the current study, we aimed to investigate the relationship after treatment of ursodeoxycholic acid (UDCA) in patients with ICP between pruritus and the level of alanine aminotransferase (ALT) and SBA. Methods: A total of 30 pregnant diagnosed with ICP in the Gastroenterology outpatient clinic of Kanuni Sultan Süleyman Training and Research Hospital were enrolled in the study in 2018. Data including patient age, pregnancy week, delivery week, pruritus score, level of SBA and ALT levels were recorded. Results: The mean age of pregnant was 29.9±6.5 and the mean week of pregnancy was 31.8±3,74. There was no significant difference in terms of ALT level between before and after period of UDCA treatment (106.13 ± 91.27 vs. 45.8 ± 35.76 U / L, p = 0.87, respectively). A significant difference was observed in terms of ALT level between postpartum period and post-UDCA treatment (22.2 ± 5.79 vs. 45.8 ± 35.76 U / L, p = 0.002, respectively). There was a significant difference in terms of visual analog scores between before and after period of UDCA treatment (6.6 ± 1.44 vs. 2.03 ± 1.49, p = 0.02, respectively). Conclusion: The treatment of UDCA in ICP positively effects on level of pruritus, but does not contribute to regression of ALT level. [ABSTRACT FROM AUTHOR]

Acute pancreatitis (AP) is a clinical condition that arises acutely in the pancreas through various inflammatory pathways due to multiple causes. Turkish Society of Gastroenterology Pancreas Working Group developed comprehensive guidance statements regarding the management of AP that include its epidemiology, etiology, clinical presentation, diagnostic criteria, disease severity, treatment, prognosis, local and systemic complications. The statements were developed through literature review, deliberation, and consensus opinion. These statements were ultimately used to develop a conceptual framework for the multidisciplinary management of AP.