Impact of Corona  Virus Disease-19 (COVID-19) pandemic on gastrointestinal disorders
AbstractWorldwide, several hospitals in different  regions and countries have been affected with Corona Virus Disease-19 (COVID-19). All medical specialties including gastroenterology are impacted by COVID-19. Here, we review the bidirectional comorbidity of chronic gastrointestinal (GI) disorders and COVID-19, including the incidence and outco me of COVID-19 in individuals with various GI disorders and the impact of COVID-19 on the course and outcome of the underlying (or comorbid) GI disorders. Currently, there is no evidence that COVID-19 is more (or less) frequent in comorbid GI disorders. It i...
Source: Indian Journal of Gastroenterology - August 4, 2020 Category: Gastroenterology Source Type: research

Gastrointestinal and hepatic manifestations of Corona Virus Disease-19 and their relationship to severe clinical course: A systematic review and meta-analysis
ConclusionsGI and hepatic involvement should be sought in patients with COVID-19 since it portends severe clinical course. The pathogenesis of GI and hepatic involvement needs to be explored in future studies. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - August 4, 2020 Category: Gastroenterology Source Type: research

Corona Virus Disease (COVID-19) Fecal-oral transmission: Is it a potential risk for Indians?
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 24, 2020 Category: Gastroenterology Source Type: research

Editorial commentary on the Indian Journal of Gastroenterology May-June 2020
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 24, 2020 Category: Gastroenterology Source Type: research

Utility of narrow band imaging in predicting histology in celiac disease
ConclusionNBI with magnification has high sensitivity and specificity in predicting villous atrophy in patients with celiac disease. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 23, 2020 Category: Gastroenterology Source Type: research

Diagnosing childhood celiac disease using ESPGHAN 2012 and 2020 guidelines: Tighter adherence is required!
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 20, 2020 Category: Gastroenterology Source Type: research

Novel and economical apparatus to decrease direct droplet exposure during endoscopy in the ongoing COVID-19 pandemic: A hypothesis-generating innovation
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 3, 2020 Category: Gastroenterology Source Type: research

A brief review of liver injury in patients with Corona Virus Disease-19 during  the pandemic
AbstractThe novel coronavirus Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) infection has been mostly leading to respiratory distress syndrome, but liver injury has also been documented. The mechanism of liver injury is limited and poorly understood. However, the hepatic injury could be due to a consequence of systemic inflammatory response, viral infection of hepatocytes, or as a result of intensive care treatment or drug toxicity. Based on the current studies, this review article emphasizes on the demographic and potential mechanisms of Corona Virus Disease (COVID)-19-related liver dysfunction (Source: In...
Source: Indian Journal of Gastroenterology - July 3, 2020 Category: Gastroenterology Source Type: research

Author ’s reply to comment on review article: Treatment of non-alcoholic fatty liver disease—Current perspectives
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 3, 2020 Category: Gastroenterology Source Type: research

Non-alcoholic fatty liver  and cancer
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 2, 2020 Category: Gastroenterology Source Type: research

Decreasing major surgical rates for Crohn ’s disease in an emerging economy over two decades: Is it due to biologic therapy?
ConclusionsThere has been a significant reduction in intestinal surgical rates for Crohn ’s disease over the last two decades but does not appear to be associated with the increased use of biologics. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - July 1, 2020 Category: Gastroenterology Source Type: research

Biomedical research in developing countries: Opportunities, methods, and challenges
AbstractHealth research is essential for improving global health, health equity, and economic development. There are vast differences in the disease burden, research budget allocation, and scientific publications between the developed and the low-middle-income countries, which are the homes of 85% of the world ’s population. There are multiple challenges, as well as opportunities for health research in developing countries. One of the primary reasons for reduced research output from the developing countries is the lack of research capacity. Many developing countries are striving to build their research capacity. They...
Source: Indian Journal of Gastroenterology - June 30, 2020 Category: Gastroenterology Source Type: research

An Indian national survey of therapeutic drug monitoring with anti-tumor necrosis (TNF) medications in inflammatory bowel disease
ConclusionSignificant barriers to TDM use were availability, cost and time lag for results. If these barriers were removed, almost all the  clinicians would use TDM at least reactively and 25% would use proactively. There is an urgent need to address these barriers and optimize anti-TNF therapy for optimal outcomes. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - June 1, 2020 Category: Gastroenterology Source Type: research

Editorial commentary on the Indian Journal of Gastroenterology March –April 2020 issue
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 29, 2020 Category: Gastroenterology Source Type: research

Reversal of anti-drug antibodies against tumor necrosis factor inhibitors with addition of immunomodulators: A systematic review and meta-analysis
ConclusionIn our meta-analysis, addition of immunomodulators to TNF- α inhibitors was shown to restore the clinical response in 74% of the patients by either decreasing or completely eliminating anti-drug antibody levels. Further long-term multicenter studies are needed to validate these findings. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 28, 2020 Category: Gastroenterology Source Type: research

Changes in the severity of gastric mucosal inflammation associated with Helicobacter pylori in humans coinfected with   intestinal helminths
ConclusionsThe  findings of the present study is perhaps the first histological evidence of a possible modulatory effect of IH on the gastric mucosal inflammatory response due to H. pylori infection  in humans. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 20, 2020 Category: Gastroenterology Source Type: research

Chronic vomiting in children: A prospective study reveals rumination syndrome is an important etiology that is underdiagnosed and untreated
ConclusionThe diagnosis of rumination syndrome is delayed and these children are often inappropriately treated. Therapy in the form of diaphragmatic breathing has a good success rate. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 20, 2020 Category: Gastroenterology Source Type: research

The effect of TJ-28 (Eppikajutsuto) on the prevention of hand-foot syndrome using Capecitabine for colorectal cancer: The Yokohama Clinical Oncology Group Study (YCOG1102)
ConclusionCapecitabine-associated HFS was not markedly prevented by TJ-28 compared with pyridoxine. However, TJ-28 might support the continuation of chemotherapy with capecitabine. Further studies are warranted to clarify the benefits of TJ-28. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 13, 2020 Category: Gastroenterology Source Type: research

Functional constipation or redundancy of the colon?
ConclusionsRecognizing an anatomic anomaly in patients suffering from functional constipation is important for specific treatment, especially when the ratio (rectosigmoid length/L2) is higher than 15. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 13, 2020 Category: Gastroenterology Source Type: research

The Indian gut microbiota —Is it unique?
AbstractColonization of the gut by microbes depends on a number of factors including age, diet, genetic makeup, gender, geographic location, and health status of an individual. India is a megadiverse country and includes 4 biodiversity hot spots. These features, along with the transitioning Indian sociodemographic profile, make the gut microbiota of Indian subjects an interesting area to study. In this review, we critically discuss the present status of the gut microbiome in the Indian population and its difference from other populations. We also discuss the aberrations in the available study designs that could introduce h...
Source: Indian Journal of Gastroenterology - May 9, 2020 Category: Gastroenterology Source Type: research

Role of esophageal manometry and 24-h pH testing in  patients with refractory reflux symptoms
AbstractBackgroundA proportion of patients with gastroesophageal reflux disease (GERD) do not respond to proton pump inhibitor (PPI) therapy.Aim of the studyTo determine the  findings on high-resolution esophageal manometry (HREM) and 24-h pH recording in patients with typical GERD symptoms, refractory to PPI treatment.MethodsRetrospective analysis of prospectively maintained database of patients referred for HREM and 24-h pH recording was done. We selected patients who were referred for evaluation of refractory GERD symptoms despite>  8 weeks of at least once-daily PPI treatment. Details noted were dem...
Source: Indian Journal of Gastroenterology - May 9, 2020 Category: Gastroenterology Source Type: research

Chronic vomiting in children: Etiology, diagnosis, and management
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 8, 2020 Category: Gastroenterology Source Type: research

Dual infective burden of Helicobacter pylori and intestinal parasites: Good or bad news for the host?
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 5, 2020 Category: Gastroenterology Source Type: research

Blood transfusion is unlikely to be a source for hepatitis E virus transmission in India
ConclusionTransfusion-mediated transmission of HEV was not observed in our cohort and may be infrequent in the Indian population, where genotype 1 is the predominant HEV type. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - May 5, 2020 Category: Gastroenterology Source Type: research

Diarrhea in kidney transplant recipients: Etiology and outcome
AbstractBackground and AimDiarrhea in kidney transplant recipients influences outcome of transplantation. Data from India in this regard are sparse and do not address the differential outcome of infective and non-infective diarrhea. We studied the demographic data, laboratory findings, treatment response, disease duration, and outcome of diarrhea in kidney transplant recipients, and the differential outcome between infective and non-infective diarrhea, if any.MethodsAll kidney transplant recipients who were referred to the Division of Gastroenterology with diarrhea between June 2015 and February 2017 were prospectively inc...
Source: Indian Journal of Gastroenterology - April 29, 2020 Category: Gastroenterology Source Type: research

The effect of PNPLA3 polymorphism as gain in function mutation in the pathogenesis of non-alcoholic fatty liver disease
ConclusionThe findings suggest that there is a predominant relationship between men withPNPLA3 I148M variant with NAFLD in women. Patients with NAFLD carryingPNPLA3 rs738409 G>C variant are at higher risk of NAFLD. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - April 24, 2020 Category: Gastroenterology Source Type: research

Metabolic syndrome is not uncommon among lean non-alcoholic fatty liver disease patients as compared with those with obesity
This study aimed to investigate and compare the clinical characteristics, metabolic associations, and cardiovascular risk factors among patients having NAFLD with (body mass index [BMI] ≥ 23 kg/m2) or without obesity (BMI
Source: Indian Journal of Gastroenterology - April 20, 2020 Category: Gastroenterology Source Type: research

Acute exacerbated severe form of nonalcoholic steatohepatitis leading to acute-on-chronic liver failure: A  case series
We present three patients with uncontrolled metabolic syndrome and acute-on-chronic liver failure in whom, after meticulous evaluation, the acute event was found to be a severe and exacerbated form of nonalcoholic steatohepatitis (NASH), a novel entry in the natural history of non-alcoholic fatty liver disease. This novel disease entity was described partially, 17  years before by Caldwell et al. We discuss current literature, pertinent features, and outcomes associated with a severe form of NASH, which is associated with high mortality. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - April 14, 2020 Category: Gastroenterology Source Type: research

Gut microbiota abnormalities, small intestinal bacterial overgrowth, and non-alcoholic fatty liver disease: An emerging paradigm
AbstractEvidence accumulates to implicate a role for the gut microbiota in non-alcoholic fatty liver disease (NAFLD) —a disorder that has reached almost epidemic proportions around the globe. For some time a disturbance in the gut microbiome, small intestinal bacterial overgrowth (SIBO), has been described among patients with liver disease, in general, and in the development and progression of NAFLD to nonalcoh olic steatohepatitis (NASH), decompensated liver disease and hepatocellular cancer (HCC), in particular. More recently and permitted by the advent of high-throughput sequencing and allied molecular techni...
Source: Indian Journal of Gastroenterology - April 14, 2020 Category: Gastroenterology Source Type: research

Instructions for authors
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - April 13, 2020 Category: Gastroenterology Source Type: research

Acute respiratory distress syndrome in acute pancreatitis
AbstractDevelopment of organ failure is one of the major determinants of mortality in patients with acute pancreatitis (AP). Acute respiratory distress syndrome (ARDS) is an important cause of respiratory failure in AP and is  associated with high mortality. Pathogenesis of ARDS in AP is incompletely understood. Release of various cytokines plays an important role in development of ARDS in AP. Increased gut permeability due to various toxins, inflammatory mediators, and pancreatic enzymes potentiates lung injury by gut- lymph-lung axis leading on to increased translocation of bacterial endotoxins. Various scoring syst...
Source: Indian Journal of Gastroenterology - April 13, 2020 Category: Gastroenterology Source Type: research

Correlation between insulin resistance and liver histology in patients with nonalcoholic steatohepatitis with and without obesity
AbstractIntroductionInsulin resistance (IR) plays a central role in pathogenesis of nonalcoholic steatohepatitis (NASH). The aim of this study was to correlate histopathological grading and IR in overweight/obese patients with NASH as compared with lean NASH.MethodsPatients with NASH who underwent liver biopsy between January 2012 and December 2012 were included. Anthropometric, clinical, and biochemical features, necro-inflammatory grades, and fibrosis stage on liver biopsies were scored according to Brunt and non-alcoholic fatty liver disease (NAFLD) activity score (NAS).ResultsOf 42 patients, 33 (78.6%) had body mass in...
Source: Indian Journal of Gastroenterology - March 28, 2020 Category: Gastroenterology Source Type: research

Natural history, risk factors, and outcome of hepatopulmonary syndrome in pediatric liver diseases
AbstractBackgroundLimited pediatric literature is available regarding hepatopulmonary syndrome (HPS) especially in subjects with biliary atresia (BA) despite its proven prognostic significance. Thus, we aimed to study the natural history, risk factors, and outcome of HPS in BA and other chronic liver disease (CLD) subjects.MethodsAll children (BA and other non-BA CLDs) older than 6  months of age were included in the study. HPS was diagnosed on the basis of standard international criteria. Also, fractional exhaled nitric oxide (FeNO) was measured at baseline.ResultsDuring the study period from January 2017 to December...
Source: Indian Journal of Gastroenterology - March 18, 2020 Category: Gastroenterology Source Type: research

The predictive value of the hepatorenal index for detection of impaired glucose metabolism in patients with non-alcoholic fatty liver disease
ConclusionUltrasonographically acquired HRI has a significant predictive impact on the detection of prediabetes and diabetes in patients with NAFLD. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - March 17, 2020 Category: Gastroenterology Source Type: research

Body mass index –based controlled attenuation parameter cut-offs for assessment of hepatic steatosis in non-alcoholic fatty liver disease
AbstractBackground and AimIn patients with liver disease, etiology and body mass index (BMI) affects controlled attenuation parameter (CAP) assessment using FibroScan. We aimed to assess the performance characteristics of CAP for hepatic steatosis in patients with non-alcoholic fatty liver disease (NAFLD) stratified into obese (BMI ≥ 30 kg/m2) and non-obese (BMI
Source: Indian Journal of Gastroenterology - March 17, 2020 Category: Gastroenterology Source Type: research

Computed tomography –based evaluation of segmental variation of liver density and its implications
ConclusionSegment IV b seems to be the most vulnerable site for fat deposition; focal lesions here should be carefully evaluated. Segments II, III and VII seem to closely represent MHD. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - March 10, 2020 Category: Gastroenterology Source Type: research

Treatment of non-alcoholic fatty liver disease — Current perspectives
AbstractTherapeutics aimed at treating non-alcoholic fatty liver disease (NAFLD) target the pathogenic process from deranged metabolism leading to steatosis to cell stress and death, leading to a cascade of inflammation and fibrosis, ultimately culminating into cirrhosis. The development of drugs for management of NAFLD has bloomed over the past decade, although at present there is no approved pharmacological agent for its management. Not all patients with the disease progress to cirrhosis and decompensation; hence, treatment specifically is provided for those with a high risk of progression such as those with biopsy-prove...
Source: Indian Journal of Gastroenterology - March 9, 2020 Category: Gastroenterology Source Type: research

Epidemiology of non-alcoholic fatty liver disease in Asia
AbstractThe growing burden of non-alcoholic fatty liver disease (NAFLD) parallels the increasing prevalence of obesity in Asia. The overall prevalence of NAFLD in Asia is now estimated to be 29.6% and may have surpassed that in Western populations. NAFLD increases with increasing age and is closely associated with metabolic syndrome. Ethnic differences exist in the prevalence of NAFLD, but the underlying factors are unclear. There were initial concerns about lean NAFLD being associated with more severe liver disease and increased mortality, but subsequent studies suggested otherwise. Only some NAFLD patients progress to de...
Source: Indian Journal of Gastroenterology - March 9, 2020 Category: Gastroenterology Source Type: research

Lowering the threshold of statistical significance in gastroenterology trials
AbstractA multidisciplinary international cohort of 72 expert statisticians and researchers recently proposed lowering thep value threshold from 0.05 to 0.005 to mitigate distortion of trial results and decrease bias. We hereby explored how a change to thep value threshold may alter the statistical significance of primary endpoints in gastroenterology (GE) randomized control trials (RCTs). We analyzed RCTs published in the 20 highest ranked GE and medicine journals. For each trial, we extracted thep values for the corresponding primary endpoints. We retrieved 233 RCTs, of which 159 were included in the final analysis yield...
Source: Indian Journal of Gastroenterology - March 4, 2020 Category: Gastroenterology Source Type: research

Rodenticidal hepatotoxicity: Raised plasma Von Willebrand factor levels predict in-hospital survival and preliminary report of the outcome of Von Willebrand factor reducing management protocol
ConclusionsHigh VWF levels predict poor outcome in rodenticide-induced hepatotoxicity. VWF reduction may be useful in such patients. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - February 19, 2020 Category: Gastroenterology Source Type: research

Paradigm shift in the management of bile duct strictures complicating living donor liver transplantation
ConclusionA paradigm shift in the approach to management of biliary strictures complicating LDLT is proposed whereby a multidimensional definition of FSO can help in reliable patient selection for endotherapy and improve patient outcome as a whole. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - February 17, 2020 Category: Gastroenterology Source Type: research

Endoscopic ultrasound –guided celiac plexus neurolysis improves pain in gallbladder cancer
AbstractIntroductionIn gallbladder cancer (GBC), nearly 80% of patients present with pain in the upper abdomen. Narcotic analgesics are usually effective in relieving cancer pain, but induce adverse effects. Celiac plexus neurolysis (CPN) is an effective alternative to reduce pain caused by upper abdominal cancer; however, no published data is available on endoscopic ultrasound –guided celiac plexus neurolysis (EUS-CPN) for pain relief in GBC.MethodsPatient with unresectable GBC with upper abdominal pain of severity ≥ 3 on visual analogue scale (VAS), not responding to non-steroidal anti-inflammatory drugs ...
Source: Indian Journal of Gastroenterology - February 17, 2020 Category: Gastroenterology Source Type: research

Correction to: An in vitro and clinical dose-finding study of antifoaming effects of simethicone during colonoscopy
In the above article, due to probable typo error with the picture and legend, the correct Fig. 1 and the Legend to the Fig. 1 is printed here: (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - February 7, 2020 Category: Gastroenterology Source Type: research

Acknowledgements
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - February 5, 2020 Category: Gastroenterology Source Type: research

Outcomes of submucosal tunneling endoscopic resection in upper gastrointestinal sub-epithelial tumors
ConclusionSTER is a safe and efficacious procedure for sub-epithelial tumors in the upper GI tract. Novel strategies need to be developed to ensure en bloc removal of large lesions. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - January 30, 2020 Category: Gastroenterology Source Type: research

Safety and efficacy of early image-guided percutaneous interventions in acute severe necrotizing pancreatitis: A single-center retrospective study
This study aimed to evaluate efficacy and safety of early image-guided percutaneous interventions in management of acute severe necrotizing pancreatitis.MethodsA single-center retrospective study was performed after obtaining Institutional review board approval for analyzing hospital records of patients with acute necrotizing pancreatitis from January 2012 to July 2017. Seventy-eight consecutive patients with necrotizing pancreatitis and acute necrotic collections (ANC) were managed with percutaneous catheter drainage (PCD) and catheter-directed necrosectomy, in early phase of the disease (
Source: Indian Journal of Gastroenterology - January 30, 2020 Category: Gastroenterology Source Type: research

Fecal incontinence and rectal prolapse
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - January 30, 2020 Category: Gastroenterology Source Type: research

Endoscopic ultrasound-guided anal sphincteroplasty for fecal incontinence in women: A pilot study
This study was done to evaluate endoscopic ultrasound-guided overlapping sphincteroplasty to ensure completeness of sphincter repair intraoperatively and also to protect the integrity of neurovascular bundles. Between January 2014 and October 2015, 15 consecutive women with damaged anal sphincters, who underwent endoscopic ultrasound-guided overlapping sphincteroplasty, were prospectively evaluated (group 1). A control group of seven women, who had undergone classical sphincteroplasty between August 2012 and December 2013, was retrospectively identified (group 2). Perioperative outcomes, anal manometry findings, and fecal ...
Source: Indian Journal of Gastroenterology - January 30, 2020 Category: Gastroenterology Source Type: research

Correction to: Diet and inflammatory bowel disease: The Asian Working Group guidelines
The recommendations 31 which recommend “VSL#3®”, refer only to the product used in the cited literature and equivalent products independent from the present product labelings. This product is now known by the generic name “De Simone Formulation”. (Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - January 28, 2020 Category: Gastroenterology Source Type: research

Basket impaction during the extraction of a pancreatic ductal stone
(Source: Indian Journal of Gastroenterology)
Source: Indian Journal of Gastroenterology - January 28, 2020 Category: Gastroenterology Source Type: research