1
|
Sugiyama T, Kojima Y, Hirata Y, Ebi M, Yoshimine T, Adachi K, Yamaguchi Y, Izawa S, Hijikata Y, Funaki Y, Ogasawara N, Sasaki M, Ohashi W, Sobue S, Kasugai K. Urgent colonoscopy is not necessary in case of colonic diverticular bleeding without extravasation on contrast-enhanced computed tomography. Arab J Gastroenterol 2024; 25:22-27. [PMID: 37989669 DOI: 10.1016/j.ajg.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 10/09/2023] [Accepted: 11/11/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND AND AIMS Acute lower gastrointestinal bleeding (ALGIB) increase with age and the administration of antiplatelet drugs. Colonic diverticular bleeding (CDB) is the most common cause of ALGIB, and endoscopic hemostasis is an effective treatment for massive CDB. But in patients without extravasation on contrast-enhanced computed tomography (CECT), the efficacy of urgent colonoscopy (UCS) is controversial from the point of the clinical course, including rebleeding rate. We aimed to establish a potential strategy including UCS for CDB patients without extravasation on CECT. PATIENTS AND METHODS Patients from two centers treated for CDB without extravasation on CECT between July 2014 and July 2019 were retrospectively identified (n = 282). Seventy-four underwent UCS, and 208 received conservative management. We conducted two analyses. The first analysis investigates the risk factors of rebleeding rate within 5 days after administration (very early rebleeding), and no UCS (NUCS) was not the independent factor of the very early rebleeding. The second analysis is whether UCS positively influenced the clinical course after hospitalization. RESULTS The prevalence of very early rebleeding and early rebleeding (6-30 days from admission), patients requiring blood transfusion within 0-5 days and 6-30 days post-admission, and duration of hospitalization were examined as clinical course factors between UCS and NUCS group. There was no significant difference between the UCS and non-UCS groups in the clinical course factors. UCS for the CDB patients without extravasation was not improved rebleeding rate and clinical course. CONCLUSIONS UCS is not necessary in case ofCDB patient without extravasation on CECT.
Collapse
Affiliation(s)
- Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Yuki Kojima
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takaki, Kasugai, Aichi 486-8510, Japan.
| | - Yoshikazu Hirata
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takaki, Kasugai, Aichi 486-8510, Japan.
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Takashi Yoshimine
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Kazunori Adachi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| | - Satoshi Sobue
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takaki, Kasugai, Aichi 486-8510, Japan.
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
| |
Collapse
|
2
|
Adachi K, Kato S, Koshino A, Nagao K, Sugiyama T, Yoshimine T, Yamaguchi Y, Izawa S, Ohashi W, Ebi M, Funaki Y, Ogasawara N, Sasaki M, Kasugai K. A Vonoprazan, Clarithromycin, and Metronidazole Regimen as Helicobacter pylori Eradication Therapy for Patients with Penicillin Allergy in Light of Clarithromycin Resistance. Intern Med 2023; 62:2301-2306. [PMID: 36631092 PMCID: PMC10484763 DOI: 10.2169/internalmedicine.0789-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/30/2022] [Indexed: 01/13/2023] Open
Abstract
Objective Vonoprazan (VPZ), clarithromycin (CAM), metronidazole (MNZ) and VPZ, MNZ, and sitafloxacin (STFX) regimen are all established Helicobacter pylori eradication therapies for patients with penicillin allergy in Japan. However, no study has assessed the efficacy of a VPZ, CAM, and MNZ (VCM) regimen in patients with clarithromycin resistance (CAM-R). We therefore assessed the efficacy of a VCM regimen for treating H. pylori infection in patients with CAM-R and penicillin allergy. Methods Fifty-three patients with penicillin allergy who received H. pylori eradication therapy were retrospectively analyzed. Eight patients received a 7-day proton-pump inhibitor, CAM, and MNZ (PCM) regimen; 35 patients [11 CAM-R, and 10 with clarithromycin sensitivity (CAM-S)] received 7-day VCM regimens; and 10 patients received 7-day VPZ, MNZ, and STFX (VMS) regimens. A 13C-urea breath test was used to determine eradication. The efficacy of eradication was evaluated via both intention-to-treat (ITT) and per-protocol (PP) analyses. Results According to ITT and PP analyses, eradication rates (ERs) with PCM, VCM, and VMS therapies were 50.0% and 50.0%, 94.3% and 100%, and 90% and 90%, respectively. Treatment was successful in all patients with CAM-S. For patients with CAM-R, treatment was successful in 10 patients, and 1 patient discontinued treatment owing to an adverse event. According to ITT and PP analyses, ERs were 90.9% and 100% in CAM-R, and were 100% and 100% in CAM-S, respectively. Conclusion The VCM regimen for H. pylori eradication may be a viable candidate therapy for patients with penicillin allergy, regardless of CAM-R.
Collapse
Affiliation(s)
- Kazunori Adachi
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | - Shunsuke Kato
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | - Akira Koshino
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | - Kazuhiro Nagao
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | - Takashi Yoshimine
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | | | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University Hospital, Japan
| |
Collapse
|
3
|
Ogasawara N, Kasugai K, Funaki Y, Ebi M, Izawa S, Tamura Y, Kato A, Yamaguchi Y, Adachi K, Sugiyama T, Sasaki M. Relationships between body mass index and constipation, gastroesophageal reflux disease, stool forms based on the Bristol Stool Form Scale, and education level: results from an internet survey in Japan. J Clin Biochem Nutr 2023; 73:84-90. [PMID: 37534097 PMCID: PMC10390807 DOI: 10.3164/jcbn.22-143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 02/16/2023] [Indexed: 08/04/2023] Open
Abstract
Detailed evaluations of body mass index (BMI) and stool form based on the Bristol Stool Form Scale (BSFS) in individuals with constipation, gastroesophageal reflux disease (GERD), and concomitant constipation and GERD have not been performed in Japan. This study was an internet survey conducted to examine the relationships between BMI and constipation, GERD, stool forms based on the BSFS, and education level. This internet-based survey recruited participants from general public survey panels. 10,000 individuals meeting the eligibility criteria were enrolled. Questions included demographics, medical data, and assessments based on validated measures for constipation and GERD. BMI was significantly lower in males with versus without constipation. BMI was significantly higher with GERD both males and females. Mean BMI increased from the BSFS-1/2 group through the BSFS-3/4/5 to the BSFS-6/7 groups in both sexes. BMI was highest in individuals with a maximum education level of junior high school and second highest in individuals completing high school. This is the first real-world survey that closely examines the relationship between BMI and stool forms of individuals in Japan. When the BMI increased, stool forms varied from hard to watery in Japanese people. BMI was related with education level in Japan. (Trial registration: UMIN000039688).
Collapse
Affiliation(s)
- Naotaka Ogasawara
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Kunio Kasugai
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yasushi Funaki
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Masahide Ebi
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Shinya Izawa
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yasuhiro Tamura
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Aya Kato
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yoshiharu Yamaguchi
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Kazunori Adachi
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Tomoya Sugiyama
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Makoto Sasaki
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| |
Collapse
|
4
|
Yamaguchi Y, Miwa T, Murakami R, Sugimura A, Yamamoto K, Sugiyama T, Tamura Y, Izawa S, Ebi M, Funaki Y, Ogasawara N, Sasaki M, Kasugai K. A case report of olmesartan‐associated sprue‐like enteropathy: Diagnosis and healing confirmed by capsule endoscopy. DEN Open 2023; 3:e142. [PMID: 35898826 PMCID: PMC9307730 DOI: 10.1002/deo2.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 12/02/2022]
Abstract
Herein, we describe a case of olmesartan‐related sprue‐like enteropathy in which improvement in villous atrophy was confirmed by small‐bowel capsule endoscopy (CE). We successfully treated a 66‐year‐old man with a chief complaint of loose diarrhea. The patient had persistent watery diarrhea 10 times a day and experienced a weight loss of 9 kg in 3 months. An abdominal computed tomography scan showed fluid retention in the small intestine. Blood test results revealed no inflammatory reaction. Esophagogastroduodenoscopy detected villous atrophy in the stomach and duodenum. Moreover, small‐bowel CE showed villous atrophy in about two‐thirds of the small intestine. Based on other examinations, hyperthyroidism, intestinal tuberculosis, intestinal amyloidosis, and intestinal malignant lymphoma were ruled out. Therefore, the patient was suspected of having an olmesartan‐related sprue‐like disease. Early after discontinuation of medication, diarrhea symptoms improved, and a repeat CE indicated improvements in small intestinal villous atrophy. Since the patient had been administered olmesartan for a long time and CE showed villous atrophy throughout the small bowel, we suspected him of having the olmesartan‐associated sprue‐like disease. The findings of gastric mucosa atrophy on esophagogastroduodenoscopy may lead to an early diagnosis of this disease. Olmesartan‐related sprue‐like enteropathy should be considered as a differential diagnosis in patients with chronic severe watery diarrhea.
Collapse
Affiliation(s)
- Yoshiharu Yamaguchi
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Takahiro Miwa
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Ryo Murakami
- Department of Gastroenterology Tajimi City Hospital Gifu Japan
| | - Akane Sugimura
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Kazuhiro Yamamoto
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Shinya Izawa
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Masahide Ebi
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Yasushi Funaki
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Makoto Sasaki
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| | - Kunio Kasugai
- Department of Gastroenterology Aichi Medical University School of Medicine Aichi Japan
| |
Collapse
|
5
|
Ogasawara N, Funaki Y, Kasugai K, Ebi M, Tamura Y, Izawa S, Sasaki M. Overlap Between Constipation and Gastroesophageal Reflux Disease in Japan: Results From an Internet Survey. J Neurogastroenterol Motil 2022; 28:291-302. [PMID: 34801991 PMCID: PMC8978135 DOI: 10.5056/jnm21065] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/07/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND/AIMS Detailed evaluations of overlapping constipation and gastroesophageal reflux disease (GERD) have not been conducted in Japan. The REACTION-J2 study examined the overlap of these diseases in Japan. METHODS This internet-based survey recruited participants from general public survey panels. Questions included demographic and medical data and assessments based on validated measures for constipation and GERD. Associations between background factors affecting constipation/GERD overlap, disease measures, and treatment were also evaluated. RESULTS Among 10 000 survey responses received, functional constipation (Rome IV diagnostic criteria) was reported by 439 participants; chronic constipation (Japanese guidelines) by 3804 participants; and subjective constipation symptoms by 2563 participants. The number of participants with constipation/GERD overlap ranged from 73 to 1533 depending on the criteria used. Regardless of the definition used, all GERD groups had significantly higher odds of being constipated than non-GERD participants: the OR (95% CI) for all 9 combinations of definitions ranged between 1.56 (1.21, 2.01) and 2.67 (2.44, 2.92) (all P ≤ 0.001). Straining, hard stools, and sensations of incomplete evacuation and anorectal obstruction/blockage, according to chronic constipation criteria, were common. Participants with constipation/GERD overlap had poorer quality of life (P < 0.001) and worse GERD symptom scores (P < 0.001). The frequency of abnormal stools was highest (P < 0.001) in the constipation/GERD overlap group. In the overlap group, 52.4% and 26.0% used gastric and constipation medication, respectively. CONCLUSION Individuals with constipation/GERD overlap tend to have worsened symptoms and quality of life.
Collapse
Affiliation(s)
- Naotaka Ogasawara
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Yasushi Funaki
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Kunio Kasugai
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Masahide Ebi
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Yasuhiro Tamura
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Shinya Izawa
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Makoto Sasaki
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| |
Collapse
|
6
|
Fujiyoshi Y, Inoue H, Shimamura Y, Fujiyoshi MRA, Rodriguez de Santiago E, Nishikawa Y, Toshimori A, Tanabe M, Sumi K, Iwaya Y, Ono M, Izawa S, Ikeda H, Onimaru M. Comparison of scope holding sign on endoscopy and lower esophageal sphincter contraction on high‐resolution manometry: A pilot study. DEN Open 2022; 2:e50. [PMID: 35310738 PMCID: PMC8828180 DOI: 10.1002/deo2.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/18/2021] [Accepted: 08/05/2021] [Indexed: 11/30/2022]
Abstract
Objectives Lower esophageal sphincter (LES) plays a key role in gastroesophageal reflux disease (GERD) pathogenesis. In retroflexion and under sufficient insufflation, it can be seen how the lower esophagus grasps the endoscope, which we named scope holding sign (SHS). This study aimed to compare the SHS and LES pressure on high‐resolution manometry (HRM), to elucidate whether the sphincter can be visualized endoscopically. Methods This was a single‐center, prospective pilot study. Patients with symptoms of GERD, who underwent endoscopy and HRM between February 2021 and April 2021, were included. A manometry catheter and an ultra‐slim endoscope were inserted, and the resting LES pressure was measured. The lower esophagus holding (SHS‐positive) and releasing (SHS‐negative) the endoscope and catheter were observed. The LES pressures during SHS‐positive and SHS‐negative were compared. Results Eleven patients (median age: 57 years; eight men) with normal esophageal motility were analyzed. The median LES pressure in SHS‐positive was significantly higher than the resting LES pressure (40.4 [22.9–74.0] vs. 25.9 [2.0–66.7] mm Hg; p = 0.001) and the LES pressure in SHS‐negative (4.6 [1.5–9.3]; p = 0.001). Furthermore, the LES pressure in SHS‐negative was significantly lower than the resting LES pressure (4.6 [1.5–9.3] vs. 25.9 [2.0–66.7] mm Hg; p = 0.005). Conclusions This study demonstrated that the SHS parallels LES pressure, indicating that the sphincter can be observed endoscopically. This may enable us to evaluate LES function during endoscopy in patients with GERD, thus, deserving further evaluation in future studies.
Collapse
Affiliation(s)
- Yusuke Fujiyoshi
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | - Haruhiro Inoue
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | - Yuto Shimamura
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | | | - Enrique Rodriguez de Santiago
- Department of Gastroenterology and Hepatology Hospital Universitario Ramón y Cajal, Universidad de Alcalá Madrid Spain
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) Madrid Spain
| | - Yohei Nishikawa
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | - Akiko Toshimori
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | - Mayo Tanabe
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | - Kazuya Sumi
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | - Yugo Iwaya
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | - Masashi Ono
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | - Shinya Izawa
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | - Haruo Ikeda
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| | - Manabu Onimaru
- Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan
| |
Collapse
|
7
|
Ogasawara N, Ono S, Sugiyama T, Adachi K, Yamaguchi Y, Izawa S, Ebi M, Funaki Y, Sasaki M, Kasugai K. Small-Intestinal Metastasis from Lung Carcinoma. Case Rep Gastroenterol 2022; 16:195-200. [PMID: 35528768 PMCID: PMC9035918 DOI: 10.1159/000523663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/11/2022] [Indexed: 11/19/2022] Open
Abstract
A 62-year-old man was referred to our hospital because of abdominal pain. Computed tomography revealed an approximately 7-cm-diameter tumor in the left abdomen with metastatic lymph nodes, an approximately 1-cm-diameter round tumor in contact with the subclavian artery in the apical lobe of the right lung, and mediastinal lymph node enlargement in contact with the superior vena cava. Esophagogastroduodenoscopy and colonoscopy revealed no abnormalities. Double-balloon endoscopy revealed a whole circumferential ulcer in the jejunum approximately 20 cm from the ligament of Treitz. Biopsy analysis of an ulcer specimen revealed a poorly differentiated carcinoma. Immunohistochemical staining of the specimen showed that it was positive for thyroid transcription factor 1 and cytokeratin 7 and negative for cytokeratin 20, GATA-binding protein 3, caudal-type homeobox protein 2, and paired box 8. Positron emission tomography revealed positive findings in the small-intestinal tumor, nearby mesenteric lymph nodes, lymph nodes around the abdominal aorta, lung tumor, and mediastinal lymph node in the apical lobe of the right lung. Accordingly, the patient was diagnosed as having a lung carcinoma with small-intestinal metastasis (T1b, N3, M1c; cStage IVB). Pathological examination helped distinguish the primary small-intestinal tumor from the metastatic small-intestinal tumor and detect the tumor origin.
Collapse
|
8
|
Ebi M, Nagao K, Sugiyama T, Yamamoto K, Saito T, Kurahashi S, Yamaguchi Y, Adachi K, Tamura Y, Izawa S, Funaki Y, Ogasawara N, Sasaki M, Tsuzuki T, Kasugai K. Gastric Plexiform Fibromyxoma Resected Using Nonexposed Endoscopic Wall-Inversion Surgery: A Case Report. Case Rep Gastroenterol 2022; 16:159-164. [PMID: 35528766 PMCID: PMC9035921 DOI: 10.1159/000522411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/25/2022] [Indexed: 11/19/2022] Open
Abstract
Gastric plexiform fibromyxoma is extremely rare. In our case, upper gastrointestinal endoscopy of a 41-year-old woman patient revealed a 1-cm submucosal tumor (SMT) in the greater curvature of the lower body of the stomach. On contrast-enhanced computed tomography, the tumor was hypervascular in the arterial phase with continuous enhancement in the post-venous phase. On endoscopic ultrasonography, it had a low echo pattern. The preoperative diagnosis was a gastric SMT with a rich vasculature; however because the biosy specimen did not contain tumor tissue, a malignant tumor could not be excluded. The patient underwent nonexposed endoscopic wall-inversion surgery (NEWS), and the tumor was completely resected. Immunohistochemical examination revealed that the tumor was positive for D2-40 and α-smooth muscle actin, but negative for c-kit, discovered on gastrointestinal stromal tumor-1, desmin, S100, Melan-A, signal transducer and activator of transcription 6, insulinoma-associated protein 1, CXCL13, ETS transcription factor, follicular dendritic cell, anaplastic lymphoma kinase, human melanoma black, h-caldesmon, and CD1a, 10, 21, 23, 31, 34, 68, and 163. Approximately, 1–2% of the tumor cell nuclei were Ki-67-positive. Finally, we diagnosed the tumor as a plexiform fibromyxoma. In conclusion, NEWS is an effective method for the treatment of SMTs with a diameter of <3 cm.
Collapse
Affiliation(s)
- Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
- *Masahide Ebi,
| | - Kazuhiro Nagao
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kazuhiro Yamamoto
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Takuya Saito
- Department of Gastroenterological Surgery, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shintaro Kurahashi
- Department of Gastroenterological Surgery, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kazunori Adachi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| |
Collapse
|
9
|
Yamamoto S, Ohashi W, Yamaguchi Y, Inamoto S, Koshino A, Sugiyama T, Nagao K, Tamura Y, Izawa S, Ebi M, Usami J, Hamano K, Izumi J, Wakita Y, Funaki Y, Ogasawara N, Sasaki M, Maekawa M, Kasugai K. Background factors involved in the epidemiology of functional constipation in the Japanese population: a cross-sectional study. Biopsychosoc Med 2022; 16:8. [PMID: 35272692 PMCID: PMC8908559 DOI: 10.1186/s13030-022-00237-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 02/21/2022] [Indexed: 11/12/2022] Open
Abstract
Background Functional constipation (FC), a functional bowel disorder with symptoms of constipation, has considerable impact on quality of life. As data regarding its prevalence and epidemiology are lacking, this study aimed to evaluate the prevalence, population composition, lifestyle, quality of life, and clinical characteristics of these individuals by comparing people with and without FC. These parameters were also compared among individuals with strong and weak awareness of constipation. Methods An internet survey was conducted among 10,000 individuals aged 20–69 years from the general Japanese population; they were registered with an internet survey company. The following data were obtained: age, sex, educational history, occupation, residence, history of other diseases, lifestyle (including smoking/drinking habits using the Japanese Health Practice Index, medication use, symptoms of constipation according to the Rome III criteria, stool types according to the Bristol stool scale, and use of laxatives, including the place of purchase and cost per month or acceptable cost per month. The 8-item Short Form Health Survey Questionnaire was also used; FC was diagnosed based on Rome III criteria. All respondents were classified according to their awareness of constipation (i.e. strong or weak), and their characteristic features were compared. Results The data of 3000 respondents were evaluated; 262 (8.7%) had FC, which was common among older adults, women, and homemakers. FC was associated with changes in the frequency of bowel movement, sensation of incomplete or scanty evacuation, and the use of manual maneuvers; these are consequential clinical symptoms of FC. These individuals frequently skipped breakfast, had insufficient sleep, had more severe constipation, and had purchased laxatives in pharmacies or online more often than those without FC. A strong awareness of constipation was significantly more prevalent among women and homemakers. A history of anemia and cardiovascular disease was significantly more frequent in the strong awareness group, whereas a history of hypertension was more frequent in the weak awareness group. Conclusions Appropriate and comprehensive management should be provided for FC, based on the understanding of its characteristic features and considering the symptoms and lifestyle.
Collapse
Affiliation(s)
- Sayuri Yamamoto
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan. .,Division of General Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan.
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University, Nagakute, Aichi Prefecture, Japan
| | - Yoshiharu Yamaguchi
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Shunsuke Inamoto
- Division of General Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Akira Koshino
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Tomoya Sugiyama
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Kazuhiro Nagao
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Yasuhiro Tamura
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Shinya Izawa
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Masahide Ebi
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Jun Usami
- Division of General Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Koichi Hamano
- Division of General Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Junko Izumi
- Division of General Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Yoshinori Wakita
- Division of General Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Yasushi Funaki
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Naotaka Ogasawara
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Makoto Sasaki
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Masato Maekawa
- Division of General Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| | - Kunio Kasugai
- Division of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi Prefecture, 480-1195, Japan
| |
Collapse
|
10
|
Yamamoto S, Kawamura Y, Yamamoto K, Yamaguchi Y, Tamura Y, Izawa S, Nakagawa H, Wakita Y, Hijikata Y, Ebi M, Funaki Y, Ohashi W, Ogasawara N, Sasaki M, Maekawa M, Kasugai K. Internet Survey of Japanese Patients With Chronic Constipation: Focus on Correlations Between Sleep Quality, Symptom Severity, and Quality of Life. J Neurogastroenterol Motil 2021; 27:602-611. [PMID: 34642281 PMCID: PMC8521473 DOI: 10.5056/jnm20135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/14/2020] [Accepted: 02/18/2021] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Chronic constipation and lifestyle factors can affect sleep quality. We evaluated the relationship between chronic constipation and sleep in the Japanese population. Methods This cross-sectional internet-based survey included 3000 subjects with constipation, classified according to sleep status (good/poor). Primary endpoints were Bristol stool form scale (BSFS) score and correlations between sleep disorder criteria of the Pittsburgh Sleep Quality Index (PSQI) and sleep status (good/poor sleep). Secondary endpoints included correlations between quality of life (QOL) and mood, medical, lifestyle, and sleep factors. Results The proportion of participants with BSFS category 4 (normal stool) was significantly higher in the good sleep group (P < 0.001). Sleep disturbance (P < 0.05), sleep quality, and duration, use of hypnotic medication, and daytime dysfunction of PSQI (all P < 0.001) significantly correlated with poor sleep. In the poor sleep group, QOL was significantly worse and anxiety and depression levels were significantly higher (all P < 0.001) compared with the good sleep group. Anemia and smoking (both P < 0.05), recent body weight increases, and poor eating habits (all P < 0.001) were significantly higher in the poor sleep group. Male sex, onset associated with change in frequency of stools, sensation of incomplete evacuation for at least 25% of defecations, and manual maneuvers to facilitate at least 25% of defecations correlated with poor sleep. Conclusions Subjects with constipation and poor sleep experienced severe symptoms and had poor QOL. These data support the need for a multifocal treatment approach, including lifestyle advice and pharmacotherapy.
Collapse
Affiliation(s)
- Sayuri Yamamoto
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yurika Kawamura
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Kazuhiro Yamamoto
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yoshiharu Yamaguchi
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yasuhiro Tamura
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Shinya Izawa
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Hiroaki Nakagawa
- Division of General Medicine, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yoshinori Wakita
- Division of General Medicine, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yasutaka Hijikata
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Masahide Ebi
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yasushi Funaki
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Naotaka Ogasawara
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Makoto Sasaki
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Masato Maekawa
- Division of General Medicine, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| | - Kunio Kasugai
- Division of Gastroenterology, Aichi Medical University School of Medicine, Yazakokarimata, Nagakute, Aichi, Japan
| |
Collapse
|
11
|
Inoue H, Fujiyoshi MRA, Toshimori A, Fujiyoshi Y, Shimamura Y, Tanabe M, Nishikawa Y, Mochizuki Y, Sakaguchi T, Kimura R, Izawa S, Ikeda H, Onimaru M, Uragami N. Unified magnifying endoscopic classification for esophageal, gastric and colonic lesions: a feasibility pilot study. Endosc Int Open 2021; 9:E1306-E1314. [PMID: 34466352 PMCID: PMC8367430 DOI: 10.1055/a-1499-6638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 04/20/2021] [Indexed: 02/06/2023] Open
Abstract
Background and study aims Image-enhanced magnifying endoscopy allows optimization of the detection and diagnosis of lesions found in the gastrointestinal tract. Current organ-specific classifications are well-accepted by specialized endoscopists but may pose confusion for general gastroenterologists. To address this, our group proposed the Unified Magnifying Endoscopic Classification (UMEC) which can be applied either in esophagus, stomach, or colon. The aim of this study was to evaluate the diagnostic performance and clinical applicability of UMEC. Patients and methods A single-center, feasibility pilot study was conducted. Two endoscopists with experience in magnifying narrow band imaging (NBI), blinded to white-light and non-magnifying NBI findings as well as histopathological diagnosis, independently reviewed and diagnosed all images based on UMEC. In brief, UMEC is divided into three categories: non-neoplasia, intramucosal neoplasia, and deep submucosal invasive cancer. The diagnostic performance of UMEC was assessed while using the gold standard histopathology as a reference. Results A total of 303 gastrointestinal lesions (88 esophageal squamous lesions, 90 gastric lesions, 125 colonic lesions) were assessed. The overall accuracy for both endoscopists in the diagnosis of esophageal squamous cell cancer, gastric cancer, and colorectal cancer were 84.7 %, 89.5 %, and 83.2 %, respectively. The interobserver agreement for each organ, Kappa statistics of 0.51, 0.73, and 0.63, was good. Conclusions UMEC appears to be a simple and practically acceptable classification, particularly to general gastroenterologists, due to its good diagnostic accuracy, and deserves further evaluation in future studies.
Collapse
Affiliation(s)
- Haruhiro Inoue
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | | | - Akiko Toshimori
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Yusuke Fujiyoshi
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Yuto Shimamura
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Mayo Tanabe
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Yohei Nishikawa
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Yuichiro Mochizuki
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Takuki Sakaguchi
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Ryusuke Kimura
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Shinya Izawa
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Haruo Ikeda
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Manabu Onimaru
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Naoyuki Uragami
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| |
Collapse
|
12
|
Tanabe A, Adachi K, Yamaguchi Y, Izawa S, Yamamoto S, Hijikata Y, Ebi M, Funaki Y, Ogasawara N, Goto C, Sasaki M, Kasugai K. Gut Environment and Dietary Habits in Healthy Japanese Adults and their Association with Bowel Movement. Digestion 2021; 101:706-716. [PMID: 31434096 DOI: 10.1159/000501961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/07/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Constipation is a common symptom that impairs the quality of life (QOL). This study aimed to investigate the relationship between bowel movement and gut microbiota and dietary intake. METHODS To investigate correlations among bowel movement, food intake, and gut environment, 60 healthy Japanese participants were recruited. Bowel movement was assessed using the Bristol stool form scale (BSFS) and constipation scoring system (CSS). Dietary habit was assessed with a self-administered questionnaire wherein the food intake frequency was classified into 8 categories for 72 food/food groups. Gut microbiota was analyzed using terminal restriction fragment length polymorphism analysis. RESULTS The constipation rate was significantly higher in females than in males. The QOL was significantly impaired in the constipated group. The fecal count of Bacteroides was decreased and that of Clostridium cluster IV was increased in participants with constipation. The BSFS score was negatively associated with the fecal count of Clostridium cluster XI and positively associated with the fecal count of Clostridium cluster XVIII and consumption of green tea. The total CSS score was positively associated with the fecal Prevotella count and negatively associated with fecal acetate levels and consumption of vegetables. Discriminant analysis estimated that constipation could be predicted correctly in 83% (p < 0.001) of the participants based on fecal microbiota and fecal short-chain fatty acids. DISCUSSION/CONCLUSION Bowel movement was strongly affected by gut environment and food intake in Japanese participants. Improvement in dietary habits could promote bowel movement through the improvement of the environment in the gut, resulting in ameliorated QOL issues in healthy adults.
Collapse
Affiliation(s)
- Atsushi Tanabe
- Department of Gastroenterology, Tajimi City Hospital, Tajimi, Japan
| | - Kazunori Adachi
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshiharu Yamaguchi
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinya Izawa
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Sayuri Yamamoto
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasutaka Hijikata
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Masahide Ebi
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasushi Funaki
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Naotaka Ogasawara
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Chiho Goto
- Department of Health and Nutrition, Faculty of Health and Human Life, Nagoya Bunri University, Inazawa, Japan
| | - Makoto Sasaki
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan,
| | - Kunio Kasugai
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| |
Collapse
|
13
|
Fujiyoshi Y, Inoue H, Abad MRA, Rodriguez de Santiago E, Nishikawa Y, Sakaguchi T, Toshimori A, Shimamura Y, Tanabe M, Sumi K, Kimura R, Izawa S, Ikeda H, Onimaru M. Importance of second-look endoscopy after per-oral endoscopic myotomy for safe postoperative management. Dig Endosc 2021; 33:364-372. [PMID: 32544261 DOI: 10.1111/den.13770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/07/2020] [Accepted: 06/10/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Per-oral endoscopic myotomy (POEM) is a safe and effective treatment for achalasia and esophageal motility disorders. The role of second-look endoscopy (SE) on postoperative day 1 has not been examined. This study aimed to evaluate the findings and need of SE after POEM. METHODS This is a single-center, retrospective study. All consecutive patients who underwent POEM and SE on postoperative day 1 between December 2017 and September 2019 were included. The primary endpoint was the rate of newly-detected adverse events (nAE) during SE that required endoscopic intervention or deviation from the normal postoperative course. Multivariate logistic regression was used to identify predictors of nAE. RESULTS Four-hundred-ninety-seven patients (mean age, 50.3 years; female, 49.9%) were included. SE identified abnormal findings in a total of 71 patients (14.3%). nAE which required endoscopic intervention or deviation from the normal postoperative course were identified in 12 patients (2.4%): eight (1.6%) entry site dehiscence; two (0.4%) submucosal hemorrhage or hematoma; and two (0.4%) dehiscence of an intraoperative perforation site after endoclip closure. Other findings such as mucosal thermal damage without perforation and small submucosal hematoma were found in 54 patients (10.9%) and five patients (1.0%), respectively. Multivariate analysis showed that longer operation time and intraoperative adverse events (AE) were associated with clinically significant nAE during SE. CONCLUSIONS Second-look endoscopy can detect and treat nAE that may lead to severe AE. Thus, SE should be highly considered before starting oral ingestion in all cases, and especially in those who present an intraoperative AE and longer operation time.
Collapse
Affiliation(s)
- Yusuke Fujiyoshi
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Haruhiro Inoue
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | | | - Enrique Rodriguez de Santiago
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.,Department of Gastroenterology and Hepatology Hospital Universitario Ramon y Cajal, University of Alcala IRYCIS, Madrid, Spain
| | - Yohei Nishikawa
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Takuki Sakaguchi
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Akiko Toshimori
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Yuto Shimamura
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Mayo Tanabe
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Kazuya Sumi
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Ryusuke Kimura
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Shinya Izawa
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Haruo Ikeda
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Manabu Onimaru
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| |
Collapse
|
14
|
Yamaguchi Y, Nakagawa M, Nakagawa S, Nagao K, Inoue S, Sugiyama T, Izawa S, Hijikata Y, Ebi M, Funaki Y, Ogasawara N, Sasaki M, Kasugai K. Rapidly Progressing Aseptic Abscesses in a Patient with Ulcerative Colitis. Intern Med 2021; 60:725-730. [PMID: 32999240 PMCID: PMC7990631 DOI: 10.2169/internalmedicine.5733-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Aseptic abscesses (AAs) are extraintestinal manifestations of inflammatory bowel disease (IBD). IBD-associated AAs are rare in Japan. We treated a 45-year-old man with ulcerative colitis (UC)-associated AAs. During remission, multiple progressive abscesses were detected in the spleen; he underwent splenectomy because an infectious disease was suspected. Although his condition improved temporarily after splenectomy, a large liver abscess was noted, and a diagnosis of UC-associated AAs was made. Granulocytapheresis (GCAP) and infliximab (IFX) administration resolved the abscess. This is the first reported case of UC-associated AAs in a Japanese patient treated by splenectomy, GCAP, and IFX.
Collapse
Affiliation(s)
- Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Marie Nakagawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Shoko Nakagawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kazuhiro Nagao
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Satoshi Inoue
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| |
Collapse
|
15
|
Kawamura Y, Funaki Y, Yoshimine T, Tamura Y, Yamamoto S, Izawa S, Hayakawa T, Ebi M, Murotani K, Ogasawara N, Sasaki M, Kasugai K. Characteristics and Predictive Factor of Helicobacter pylori-Associated Functional Dyspepsia in Japanese Patients. Digestion 2020; 100:277-285. [PMID: 30630185 DOI: 10.1159/000496101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/07/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIM Helicobacter pylori (HP) eradication therapy was first recommended as pharmacotherapy for functional dyspepsia (FD). However, the mechanism and effect of eradication on FD symptom improvement have not been fully investigated. This study aimed to investigate the pathology of patients with HP-associated FD, and predictive factors for HP-associated FD. METHODS Ninety-seven patients with chronic gastritis caused by HP infection were divided into the group with FD symptoms and the group -without FD symptoms. Patient backgrounds, QOL, gastric mucosal atrophy severity, and serum pepsinogen (PG) value were compared between the 2 groups. Twelve months after eradication, those factors were evaluated between HP-associated FD and HP-non-associated FD, and predictive factors of HP-associated FD were analyzed. RESULTS The FD-positive group existed in 45 (46.3%) out of 97 patients. Twelve months after eradication, there were 34 patients (75.6%) in the HP-associated FD. The mean PG I value in the HP-associated FD was significantly lower than that in the HP-non-associated FD, while the PG II values in the HP-associated FD tended to be lower than those in the HP-non-associated FD. QOL in the HP-associated FD significantly improved after HP eradication. On multivariate logistic regression analysis, it was found that PG II value was a significant predictive factor for FD symptom improvement in the HP-associated FD. CONCLUSION HP eradication is an effective initial therapy for FD. PG II value is considered a predictive factor for FD symptom improvement through HP eradication.
Collapse
Affiliation(s)
- Yurika Kawamura
- Department of Gastroenterology Aichi Medical University, Nagakute, Japan
| | - Yasushi Funaki
- Department of Gastroenterology Aichi Medical University, Nagakute, Japan,
| | - Takashi Yoshimine
- Department of Gastroenterology Aichi Medical University, Nagakute, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology Aichi Medical University, Nagakute, Japan
| | - Sayuri Yamamoto
- Department of Gastroenterology Aichi Medical University, Nagakute, Japan.,Yuri Clinic, Chitagun, Japan
| | - Shinya Izawa
- Department of Gastroenterology Aichi Medical University, Nagakute, Japan
| | | | - Masahide Ebi
- Department of Gastroenterology Aichi Medical University, Nagakute, Japan
| | - Kenta Murotani
- Biostatistics Center, Graduate School of Medicine, Kurume University, Fukuoka, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology Aichi Medical University, Nagakute, Japan
| | - Makoto Sasaki
- Department of Gastroenterology Aichi Medical University, Nagakute, Japan
| | - Kunio Kasugai
- Department of Gastroenterology Aichi Medical University, Nagakute, Japan
| |
Collapse
|
16
|
Funaki Y, Ogasawara N, Kawamura Y, Yoshimine T, Tamura Y, Izawa S, Tsuyuki T, Ebi M, Sasaki M, Kasugai K. Markedly Effective Steroid Treatment of Three Patients with Allergy-related Jackhammer Esophagus. Intern Med 2020; 59:633-639. [PMID: 31708550 PMCID: PMC7086336 DOI: 10.2169/internalmedicine.3865-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 09/19/2019] [Indexed: 12/19/2022] Open
Abstract
We experienced marked efficacy with steroid treatment of three patients with jackhammer esophagus (JHE). An esophageal biopsy revealed eosinophilic esophagitis (EoE) in two patients. One of the patients without EoE had eosinophilia and an increased serum immunoglobulin E level, and endoscopic ultrasonography revealed thickening of the esophageal muscularis propria. Esophageal manometry was used to diagnose all cases of JHE. Treatment consisted of steroid administration, which improved the symptoms and resolved the esophageal muscularis propria thickening in all patients. The esophageal manometry findings also normalized following treatment. Allergic diseases, including EoE, were assumed to have caused JHE.
Collapse
Affiliation(s)
- Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yurika Kawamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Takashi Yoshimine
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Takuji Tsuyuki
- Department of Surgical Pathology, Aichi Medical University School of Medicine, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| |
Collapse
|
17
|
Sugiyama T, Sasaki M, Nakagawa S, Inoue S, Adachi K, Yoshimine T, Yamaguchi Y, Tamura Y, Izawa S, Hijikata Y, Ebi M, Mizuno M, Yamamoto S, Funaki Y, Ogasawara N, Goto C, Kasugai K. The association among enterobacterial flora, dietary factors, and prognosis in patients with ulcerative colitis. J Clin Biochem Nutr 2020; 66:152-157. [PMID: 32231412 DOI: 10.3164/jcbn.19-90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/04/2019] [Indexed: 12/16/2022] Open
Abstract
The role of enterobacterial flora in the onset and progression of inflammatory bowel diseases is a topic of considerable interest. Here, we assessed the association among enterobacterial flora, dietary factors, and ulcerative colitis (UC) progression. Forty-six patients with UC who were diagnosed as being in remission were enrolled. We collected each patient's stool sample one or two days before diagnostic colonoscopy. After colonoscopy, we observed the patients for one year and then retrospectively divided them into two groups: remission (n = 39) and relapse (n = 7) groups, depending on whether the relapse occurred during the follow-up period, and analyzed the relationship among patient characteristics, dietary factors, enterobacterial flora, and UC relapse. Overall, there were no significant differences in bacterial community populations between the remission and relapse groups, except that the order Lactobacillales was detected at a significantly higher rate in the relapse than in the remission group (100% vs 71.4%, p<0.05). Vitamin C intake was significantly higher in the remission than in the relapse group (p<0.05). Although there were no obvious differences in enterobacterial flora between the remission and relapse groups, there was a relationship among enterobacterial flora, diet, and UC progression. Given that the enterobacterial flora was only analyzed at the initiation of the study, we conclude that in future analyses, enterobacterial flora should be sampled at numerous time points to examine its role in UC progression. Further long-term longitudinal studies examining enterobacterial flora, dietary factors, and UC progression are also required.
Collapse
Affiliation(s)
- Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Shoko Nakagawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Satoshi Inoue
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Kazunori Adachi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Takashi Yoshimine
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Mari Mizuno
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Sayuri Yamamoto
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Chiho Goto
- Department of Health and Nutrition, Faculty of Health and Human Life, Nagoya Bunri University, 365 Maeda, Inazawa-city, Inazawa, Aichi 492-8520, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| |
Collapse
|
18
|
Funaki Y, Ogasawara N, Kawamura Y, Yoshimine T, Tamura Y, Izawa S, Ebi M, Sasaki M, Kasugai K. Effects of acotiamide on functional dyspepsia patients with heartburn who failed proton pump inhibitor treatment in Japanese patients: A randomized, double-blind, placebo-controlled crossover study. Neurogastroenterol Motil 2020; 32:e13749. [PMID: 31612597 DOI: 10.1111/nmo.13749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/19/2019] [Accepted: 09/27/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Functional dyspepsia (FD) and non-erosive reflux disease (NERD) are gastrointestinal disorders that often overlap. In this randomized, double-blind, placebo-controlled crossover study, the effects of adding acotiamide to treatment with proton pump inhibitors (PPI) were investigated in FD patients with heartburn who failed PPI treatment, corresponding to PPI-resistant NERD. METHODS The subjects included 16 FD patients with heartburn who failed PPI treatment, and they were administered acotiamide or a placebo for 28 days. After suspending medication for 28 days, the trial drug and placebo were crossed over and administered for 28 days. Before the study began and after each administration period, high-resolution impedance manometry (HRiM) was performed, and the modified frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) questionnaire was administered. KEY RESULTS Postprandial fullness in the FD assessment and all modified FSSG items were significantly lower in the acotiamide group than in the placebo group. Esophagogastric junction pressure was significantly higher in the acotiamide group. The distal contractile integral (DCI) pressure and the highest DCI pressure both increased significantly in the acotiamide group. Moreover, in the acotiamide group, the frequency of abnormal primary peristalsis decreased to normal levels; complete bolus transit (CBT), an indicator of esophageal clearance, increased; and CBT time decreased. CONCLUSIONS & INFERENCES Acotiamide was considered to improve upper gastrointestinal functions not only in the stomach but also in the esophagus. Adding acotiamide to PPI therapy appears to improve upper abdominal symptoms in FD patients with heartburn who failed PPI treatment.
Collapse
Affiliation(s)
- Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Yurika Kawamura
- Department of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Takashi Yoshimine
- Department of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University, Nagakute, Japan
| |
Collapse
|
19
|
Kawamura Y, Yamamoto S, Funaki Y, Ohashi W, Yamamoto K, Ozeki T, Yamaguchi Y, Tamura Y, Izawa S, Hijikata Y, Ebi M, Ogasawara N, Sasaki M, Kasugai K. Internet survey on the actual situation of constipation in the Japanese population under 70 years old: focus on functional constipation and constipation-predominant irritable bowel syndrome. J Gastroenterol 2020; 55:27-38. [PMID: 31428873 PMCID: PMC6942565 DOI: 10.1007/s00535-019-01611-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/02/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND In Japan, the prevalence of constipation-predominant irritable bowel syndrome (IBS-C) and functional constipation (FC) diagnosed by the Rome III criteria is unclear, as are the demographic profile, quality of life (QOL), and habits of persons with IBS-C or FC. METHODS We performed an internet survey of constipation. After extracting 3000 persons fitting the composition of the general Japanese population, we investigated demographic factors, lifestyle, defecation, and laxatives. IBS-C and FC were diagnosed by Rome III criteria. Respondents also completed the Japanese IBS severity index (IBS-SI-J), Japanese IBS QOL scale (IBS-QOL-J), SF-8, Hospital Anxiety and Depression Scale (HADS), and Japanese Health Practice Index (JHPI). RESULTS There were 262 respondents with FC (8.73%) [73 men and 189 women; mean age: 49.8 ± 13.1 years; mean body mass index (BMI): 21.0 ± 3.3 g/m2] and 149 respondents with IBS-C (4.97%) (76 men and 73 women; mean age; 41.6 ± 13.7 years; mean BMI: 20.8 ± 3.0 kg/m2). Total IBS-QOL-J score were significantly lower in the IBS-C group than the FC group. With regard to SF-8, score of mental component summary (MCS) was significantly lower in the IBS-C group. The total IBS-SI-J score and item scores, except for satisfactory defecation, were significantly higher in the IBS-C group than the FC group. HADS showed a significant increase of anxiety and depression in both the groups, and the JHPI revealed insufficient sleep. CONCLUSIONS In Japan, among the population of under 70 years old, the prevalence of IBS-C and FC (Rome III criteria) was 4.97% and 8.76%, respectively. IBS-C caused more severe symptoms than FC, resulting in impairment of QOL.
Collapse
Affiliation(s)
- Yurika Kawamura
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Sayuri Yamamoto
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Yasushi Funaki
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University School of Medicine, Aichi, Japan
| | - Kazuhiro Yamamoto
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Tomonori Ozeki
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Yoshiharu Yamaguchi
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Yasuhiro Tamura
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Shinya Izawa
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Yasutaka Hijikata
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Masahide Ebi
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Naotaka Ogasawara
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Makoto Sasaki
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| | - Kunio Kasugai
- Division of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195 Aichi Japan
| |
Collapse
|
20
|
Shinmura T, Adachi K, Yamaguchi Y, Izawa S, Hijikata Y, Ebi M, Funaki Y, Ogasawara N, Sasaki M, Kasugai K. Vonoprazan-Based Triple-Therapy Could Improve Efficacy of the Tailored Therapy of Helicobacter pylori Infection. JGLD 2019; 28:389-395. [DOI: 10.15403/jgld-222] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 08/14/2019] [Indexed: 12/15/2022]
Abstract
Background and Aims: The prevalence of clarithromycin resistant bacteria is increasing, and the effectiveness of Helicobacter pylori (H. pylori) triple therapy is gradually decreasing in Japan. Vonoprazan, a potassiumcompetitive acid blocker, has been reported for its effectiveness in eradicating H. pylori. We aimed to evaluate the efficacy of tailored vonoprazan-based triple therapy in patients with H. pylori. This study is the first to compare the efficacy of vonoprazan-based tailored triple therapy to that of vonoprazan-based conventional therapy.
Method: This retrospective cohort study evaluated the treatment efficacy in 920 patients. Of these, 541 received conventional and 379 received tailored therapy. Successful eradication was confirmed by a negative 13C-urea breath test 6–8 weeks following completion of H. pylori eradication therapy, and the data were evaluated using the Chi-square test, or Fisher’s exact test, as appropriate.
Results: The eradication rate of tailored therapy was 90% and 96.3% by intent-to-treat analysis and per protocol analysis, respectively, which was significantly higher than the 85% and 90.2% found for conventional therapy (p < 0.05 and p < 0.001, respectively). Amoxicillin- or clarithromycin-resistant bacteria did not affect treatment outcomes. By univariate and multivariate analysis, both amoxicillin- and clarithromycin-resistant bacteria and conventional therapy were detected as risk factors for eradication failure (odds ratio = 6.267, 95% CI [1.056–119.924], p < 0.05, and odd ratio =3.113, 95% confidence interval [1.688–6.160], p < 0.001, by multivariate analysis).
Conclusion: Vonoprazan-based triple therapy could be a more effective treatment for H. pylori infection than conventional therapy when combined with a therapy regimen tailored according to bacterial antibiotic susceptibility.
Collapse
|
21
|
Kasugai K, Yamamoto S, Kawamura Y, Adachi K, Yamaguchi Y, Tamura Y, Izawa S, Hijikata Y, Ebi M, Funaki Y, Ogasawara N, Sasaki M. [Internet survey of the actual situation of constipation in Japanese general population REACTION-J:Research for Actual Situation of Constipation in the Japanese]. Nihon Shokakibyo Gakkai Zasshi 2019; 116:913-926. [PMID: 31708504 DOI: 10.11405/nisshoshi.116.913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Although chronic constipation is highly prevalent, its definition remains unclear. Therefore, the prevalence varies depending on reports, and the understanding of actual situations is unclear. Hence, we performed an internet survey on constipation among the Japanese general population to study the background factors and actual situations. Preliminary study on the awareness of constipation was conducted among 10000 people in which 9523 of them was asked if they had constipation at the time of the survey. In this population, 51.5% realized that they had constipation. Multivariate analysis showed the significant association of constipation to age, sex, and past histories or complications of diabetes, hemorrhoids, and cerebrovascular diseases. In a main research composed of 3000 general Japanese population, approximately 30.9% of the subjects reported the use of laxatives to treat constipation, and 43.8% of them were found to use irritant laxatives. Moreover, 67.5% of the subjects purchased laxatives at a pharmacy. The frequency of bowel movement less than 3 times per week was manifested in 36.3% of the subjects, and more than once per week in 21.4%. The percentage of hard (Bristol Stool Form Scale [BSFS] Type 1-2), normal (BSFS Type 3-5), and diarrhea stools (BSFS Type 6-7) was 33.1%, 60.0%, and 6.9%, respectively. The quality of life (QOL) of the subjects with hard and diarrhea stools evaluated by SF-8 was significantly lower than that of those with normal stools. Furthermore, the actual monthly cost for the therapeutic drugs used for treating constipation was less than 1000 yen in 75% of the subjects. Analysis of the IBS-QOL-J indicated that the ≥5000 yen payable group had the lowest satisfaction of defecation among the study groups. At present, many Japanese patients with constipation have not been receiving enough treatment for constipation. Therefore, appropriate medication by physicians as well as instruction to patients is required.
Collapse
Affiliation(s)
- Kunio Kasugai
- Division of Gastroenterology, Aichi Medical University School of Medicine
| | - Sayuri Yamamoto
- Division of Gastroenterology, Aichi Medical University School of Medicine
| | - Yurika Kawamura
- Division of Gastroenterology, Aichi Medical University School of Medicine
| | - Kazunori Adachi
- Division of Gastroenterology, Aichi Medical University School of Medicine
| | | | - Yasuhiro Tamura
- Division of Gastroenterology, Aichi Medical University School of Medicine
| | - Shinya Izawa
- Division of Gastroenterology, Aichi Medical University School of Medicine
| | - Yasutaka Hijikata
- Division of Gastroenterology, Aichi Medical University School of Medicine
| | - Masahide Ebi
- Division of Gastroenterology, Aichi Medical University School of Medicine
| | - Yasushi Funaki
- Division of Gastroenterology, Aichi Medical University School of Medicine
| | - Naotaka Ogasawara
- Division of Gastroenterology, Aichi Medical University School of Medicine
| | - Masato Sasaki
- Division of Gastroenterology, Aichi Medical University School of Medicine
| |
Collapse
|
22
|
Ebi M, Ochiai T, Sugiyama T, Yamamoto K, Adachi K, Yamaguchi Y, Tamura Y, Izawa S, Hijikata Y, Yamamoto S, Funaki Y, Ogasawara N, Sasaki M, Kasugai K. Endoscopic resection of gangliocytic paraganglioma of the duodenum: a case report. Clin J Gastroenterol 2019; 13:203-208. [PMID: 31535284 DOI: 10.1007/s12328-019-01043-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/01/2019] [Indexed: 11/26/2022]
Abstract
Duodenal gangliocytic paragangliomas are extremely rare. A 79-year-old woman underwent gastrointestinal endoscopy for screening prior to resection of gallbladder carcinoma. Gastrointestinal endoscopy revealed a 5-mm submucosal tumor in the second portion of the duodenum. Contrast-enhanced computed tomography revealed no tumor or metastasis. Endoscopic ultrasonography revealed low echo pattern of the tumor. Histopathological examination of the biopsy specimen revealed proliferation of three types of cells (epithelioid cells, spindle cells, and ganglion cells). Immunohistochemical examination revealed that the tumor was positive for S-100 and synaptophysin. The preoperative diagnosis was gangliocytic paraganglioma. The tumor was completely resected by endoscopic mucosal resection (EMR). In conclusion, an early stage of gangliocytic paraganglioma of the duodenum could be resected using EMR.
Collapse
Affiliation(s)
- Masahide Ebi
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
| | - Tomoko Ochiai
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Tomoya Sugiyama
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Kazuhiro Yamamoto
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Kazunori Adachi
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Yoshiharu Yamaguchi
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Yasuhiro Tamura
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Shinya Izawa
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Yasutaka Hijikata
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Sayuri Yamamoto
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Yasushi Funaki
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Naotaka Ogasawara
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Makoto Sasaki
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Kunio Kasugai
- Departments of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| |
Collapse
|
23
|
Ebi M, Sakamoto K, Inoue S, Ozeki T, Kimura M, Kondo R, Sugiyama T, Yamamoto K, Adachi K, Yoshimine T, Yamaguchi Y, Tamura Y, Izawa S, Hijikata Y, Funaki Y, Ogasawara N, Sasaki M, Kasugai K. Esophageal Leiomyosarcoma Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration Biopsy and Cured with Surgical Resection. Intern Med 2019; 58:2479-2483. [PMID: 31118374 PMCID: PMC6761329 DOI: 10.2169/internalmedicine.2219-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Esophageal leiomyosarcomas are rare. We herein present the case of an 82-year-old patient who underwent upper gastrointestinal endoscopy, which revealed a submucosal tumor of 30 mm in diameter that was in contact with the esophagus. Endoscopic ultrasound-guided fine needle aspiration biopsy was performed and the histopathological findings indicated esophageal leiomyosarcoma. Surgical resection was performed. On histopathological examination, the tumor was found to consist of spindle cells with deep chromatin nuclei. The tumor was finally diagnosed as esophageal leiomyosarcoma. We were able to diagnose early-stage esophageal leiomyosarcoma using endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA). EUS-FNA is mostly recommended as a diagnostic tool for esophageal submucosal tumors.
Collapse
Affiliation(s)
- Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kazumasa Sakamoto
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Satoshi Inoue
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Tomonori Ozeki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Mikitoshi Kimura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Riki Kondo
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kazuhiro Yamamoto
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kazunori Adachi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Takashi Yoshimine
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| |
Collapse
|
24
|
Ogasawara N, Yamaguchi Y, Takahama T, Adachi K, Suzuki M, Izawa S, Ebi M, Funaki Y, Sasaki M, Kasugai K. Radiofrequency catheter ablation-induced gastroparesis successfully treated with administration of mosapride citrate: two case reports. Clin J Gastroenterol 2019; 13:182-185. [PMID: 31456172 DOI: 10.1007/s12328-019-01038-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 08/19/2019] [Indexed: 11/30/2022]
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia, and radiofrequency catheter ablation (RFCA) for pulmonary vein isolation is a well-established therapeutic modality for AF. Transient gastroparesis rarely complicates RFCA. We report two cases of RFCA-induced transient gastroparesis, effectively treated with mosapride citrate administration. Case 1. Computed tomography (CT) performed 4 days after RFCA revealed marked gastric dilatation without any gastric or intestinal obstruction. The patient was fasting and was administered mosapride citrate (5 mg thrice a day). The patient's symptoms improved 6 days later, and CT revealed no gastric dilatation. Esophagogastroduodenoscopy revealed gastric peristalsis without residual food in the stomach. Case 2. CT performed 8 days after RFCA revealed marked gastric dilatation without any gastric or intestinal obstruction. The patient was fasting and was administered pantothenic acid (500 mg/day intravenously for 7 days). However, symptoms persisted, and CT revealed residual food in the stomach. The patient was subsequently administered mosapride citrate (5 mg thrice a day). The patient's symptoms improved 4 days later, and contrast-enhanced gastric X-ray using amidotrizoate meglumine revealed gastric peristalsis, passage of amidotrizoate meglumine into the duodenum, and no gastric dilatation. Mosapride citrate is useful to treat RFCA-induced gastroparesis.
Collapse
Affiliation(s)
- Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
| | - Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Takuya Takahama
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Kazunori Adachi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Manami Suzuki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| |
Collapse
|
25
|
Yoshimine T, Funaki Y, Kawamura Y, Tamura Y, Izawa S, Ebi M, Ogasawara N, Murotani K, Sasaki M, Kasugai K. Convenient Method of Measuring Baseline Impedance for Distinguishing Patients with Functional Heartburn from those with Proton Pump Inhibitor-Resistant Endoscopic Negative Reflux Disease. Digestion 2019; 99:157-165. [PMID: 30179879 DOI: 10.1159/000490790] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 06/08/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Combined 24-h intraesophageal pH-multichannel intraluminal impedance (24MII-pH) used for assessing gastroesophageal reflux disease by measuring baseline impedance (BI) requires a 24-h measuring period. In the present study, we developed a quick method of measuring BI and evaluated its usefulness in classifying patients with proton pump inhibitor (PPI)-refractory non-erosive reflux diseases (NERD) as having functional heartburn (FH) or endoscopic-negative reflux disease (ENRD). METHODS Ninety-one NERD patients without esophageal motility disorder underwent 24MII-pH monitoring while on a PPI. The measurements of the mean nocturnal BI (MNBI) and short MNBI were assessed at 3 times (at about 1: 00, 2: 00, and 3: 00 am) for 10 min and 30 s respectively. The measurement of the simple mean BI (MBI) was performed once 30 s at about 11: 00 am. RESULTS Ninety-one patients were divided into 2 groups: 59 with ENRD and 32 with FH. The cutoff, specificity, and sensitivity for distinguishing patients with FH were as follows: MNBI, 2,874.1 Ω, 72%, and 72%; short MNBI, 2,857.6 Ω, 74%, and 84%; and simple MBI, 2,874.1 Ω, 86%, and 78% respectively. CONCLUSION Measuring the simple MBI is a quick method and is useful for distinguishing patients with FH from those in a cohort with PPI-refractory NERD.
Collapse
Affiliation(s)
- Takashi Yoshimine
- Departments of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Yasushi Funaki
- Departments of Gastroenterology, Aichi Medical University, Nagakute,
| | - Yurika Kawamura
- Departments of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Yasuhiro Tamura
- Departments of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Shinya Izawa
- Departments of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Masahide Ebi
- Departments of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Naotaka Ogasawara
- Departments of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Kenta Murotani
- Center for Clinical Research, Aichi Medical University, Nagakute, Japan
| | - Makoto Sasaki
- Departments of Gastroenterology, Aichi Medical University, Nagakute, Japan
| | - Kunio Kasugai
- Departments of Gastroenterology, Aichi Medical University, Nagakute, Japan
| |
Collapse
|
26
|
Nakagawa S, Okaniwa N, Mizuno M, Sugiyama T, Yamaguchi Y, Tamura Y, Izawa S, Hijikata Y, Ebi M, Ogasawara N, Funaki Y, Sasaki M, Kasugai K. Treatment Adherence in Patients with Ulcerative Colitis Is Dependent on the Formulation of 5-Aminosalicylic Acid. Digestion 2019; 99:133-139. [PMID: 30179881 DOI: 10.1159/000489878] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/07/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS It is unclear whether 5-aminosalicylic acid (5-ASA) formulation is associated with treatment adherence in ulcerative colitis (UC). Thus, we aimed to investigate the adherence rate after switching from 5-ASA tablets to granules. METHODS This prospective study included 121 UC outpatients treated using 5-ASA tablets. They were grouped based on choice: Group 1 (continued with tablets) and Group 2 (switched to granules without regimen change). Group 2 was further divided into Group 3 (returned to tablets) and Group 4 (continued with granules). The patients completed a self-administered questionnaire regarding the treatment. The primary endpoint was change in adherence after switching to granules. RESULTS Seventy-nine patients continued with tablets, while 42 patients switched to granules. The adherence rate to the tablet was not significantly different between Group 1 and 2 before switching. In Group 2, switching to granules did not affect adherence. However, in Group 4, adherence significantly improved after switching to granules. Group 3 showed no significant change in adherence before and after switching from tablets. Full-time work and difficulty taking tablets were significant predictors of continuing with granules in Group 4. CONCLUSION Patients who continued with 5-ASA granules showed significantly increased adherence, suggesting that patient-tailored drug formulations improved treatment adherence.
Collapse
Affiliation(s)
- Shoko Nakagawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Noriko Okaniwa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Mari Mizuno
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute,
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| |
Collapse
|
27
|
Adachi K, Ogasawara N, Tamura Y, Izawa S, Hijikata Y, Ebi M, Satou A, Funaki Y, Sasaki M, Kasugai K. [Mucosa-associated lymphoid tissue lymphoma of the appendix concomitant with appendicitis:a case report]. Nihon Shokakibyo Gakkai Zasshi 2019; 116:660-667. [PMID: 31406071 DOI: 10.11405/nisshoshi.116.660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
An 82-year-old man with abdominal pain was admitted to our hospital. Laboratory tests revealed the following:white blood cells, 14300/μl;serum hemoglobin level, 12.9g/dl;serum C-reactive protein level, 0.38mg/dl;and negative anti-Helicobacter pylori immunoglobulin G test. Abdominal computed tomography revealed a tumor in the appendix along with multiple swollen lymph nodes. Colonoscopy revealed a submucosal tumor (SMT) of approximately 30mm in diameter with central ulceration. However, a tumor tissue specimen could not be obtained for biopsy;thus, the tumor could not be diagnosed. In esophagogastroduodenoscopy, abnormalities or gastric mucosal atrophy was not observed. A rapid urease test yielded negative results. Hence, endoscopic ultrasound-guided fine needle aspiration for the SMT was recommended;however, the patient preferred to undergo a definitive surgery to establish exact diagnosis. Therefore, right hemicolectomy and lymph node dissection (D3) were performed. Histopathologically, the resected tumor specimen showed atypical lymphocytes. Additionally, immunohistochemical evaluation demonstrated positive staining of the tumor cells for CD20 and BCL2 and negative staining for CD34, CD4, CD10, and BCL6. The tumor was finally diagnosed as a stage II2 mucosa-associated lymphoid tissue lymphoma (Lugano classification). Postoperatively, the patient received chemotherapy with four cycles of rituximab based on his age and activities of daily living.
Collapse
Affiliation(s)
- Kazunori Adachi
- Department of Gastroenterology, Aichi Medical University School of Medicine
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine
| | - Akira Satou
- Department of Pathology, Aichi Medical University School of Medicine
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine
| |
Collapse
|
28
|
Sugiyama T, Ebi M, Ochiai T, Kurahashi S, Saito T, Onishi K, Yamamoto K, Inoue S, Adachi K, Yoshimine T, Yamaguchi Y, Tamura Y, Izawa S, Hijikata Y, Funaki Y, Ogasawara N, Sasaki M, Kasugai K. Gastric schwannoma with high accumulation on fluorodeoxyglucose-positron emission tomography resected by non-exposed endoscopic wall-inversion surgery. Clin J Gastroenterol 2019; 13:50-54. [PMID: 31270750 DOI: 10.1007/s12328-019-01014-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/27/2019] [Indexed: 12/13/2022]
Abstract
Gastric schwannoma is a relatively rare tumor arising from Auerbach plexus in the muscle layer of the gastric wall, and constitutes 0.1% to 0.2% of all gastric tumors and 5% of benign non-epithelium-related gastric tumors. We report the case of a 49-year-old woman in whom upper gastrointestinal endoscopy revealed an approximately 2-cm submucosal tumor on the anterior wall of the fornix of the stomach. Contrast-enhanced computed tomography revealed a homogeneously enhanced lesion (~ 17 mm) in the upper third of the stomach as well as a lesion (~ 25 mm) on the left kidney that was strongly enhanced in the early phase. An 18F-fluorodeoxyglucose positron emission tomography scan revealed high accumulation that is characteristic of gastric tumors. The possibility of malignancy was not completely excluded, and the gastric tumor was resected by non-exposed endoscopic wall-inversion surgery. The patient was discharged with a good prognosis 5 days after surgery. In conclusion, non-exposed endoscopic wall-inversion surgery is a minimally invasive and effective method for resecting small gastric submucosal tumors (diameters < 3 cm) for which preoperative diagnosis is difficult.
Collapse
Affiliation(s)
- Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
| | - Tomoko Ochiai
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Shintaro Kurahashi
- Department of Gastroenterological Surgery, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Takuya Saito
- Department of Gastroenterological Surgery, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Kentaro Onishi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Kazuhiro Yamamoto
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Satoshi Inoue
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Kazunori Adachi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Takashi Yoshimine
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| |
Collapse
|
29
|
Adachi K, Sugiyama T, Yamaguchi Y, Tamura Y, Izawa S, Hijikata Y, Ebi M, Funaki Y, Ogasawara N, Goto C, Sasaki M, Kasugai K. Gut microbiota disorders cause type 2 diabetes mellitus and homeostatic disturbances in gut-related metabolism in Japanese subjects. J Clin Biochem Nutr 2019; 64:231-238. [PMID: 31138957 PMCID: PMC6529700 DOI: 10.3164/jcbn.18-101] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 12/20/2018] [Indexed: 12/25/2022] Open
Abstract
Few studies have investigated the host-microbe metabolic axis in people with type 2 diabetes mellitus (T2DM). This study aimed to determine and compare the nutrient intakes and metabolic markers and to elucidate the relationships among these factors in Japanese T2DM patients and control individuals. Fifty-nine Japanese T2DM patients and 59 matched healthy control individuals participated in this study. We examined the differences regarding the participants’ dietary habits, microbiota, and fecal short-chain fatty acids, and analyzed the relationships between the gut microbiota and blood metabolic markers in the T2DM patients and the control subjects. The T2DM patients consumed more carbohydrates, and had lower fecal propionate and butyrate concentrations, larger fecal populations of Bifidobacterium spp. and bacteria of the order Lactobacillales, and smaller fecal Bacteroides spp. populations than the control individuals. In the T2DM patients, the level of Bifidobacterium spp. correlated negatively with the carbohydrate intake and the level of bacteria of the order Lactobacillales correlated negatively with the protein intake. T2DM patients have gut dysbiosis that may contribute to disease onset and influence its prognosis. Furthermore, homeostatic disturbances in the gut-related metabolism may underlie the pathogenesis of T2DM.
Collapse
Affiliation(s)
- Kazunori Adachi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Chiho Goto
- Department of Health and Nutrition, Faculty of Health and Human Life, Nagoya Bunri University
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| |
Collapse
|
30
|
Shimozato A, Sasaki M, Ogasawara N, Funaki Y, Ebi M, Tamura Y, Izawa S, Hijikata Y, Yamaguchi Y, Kasugai K. Risk Factors for Delayed Ulcer Healing after Endoscopic Submucosal Dissection of Gastric Neoplasms. J Gastrointestin Liver Dis 2018; 26:363-368. [PMID: 29253050 DOI: 10.15403/jgld.2014.1121.264.kas] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS With improved technology, the size of artificial ulcers after endoscopic submucosal dissection (ESD) has increased. The aim of our study was to examine the risk factors for delayed gastric ulcer healing after ESD, including the possible benefit of potassium-competitive acid blocker (P-CAB) treatment. METHODS The primary outcome was the rate of healing of the artificial ulcers induced by ESD at 8 weeks post intervention. Design - retrospective case series. Setting - Aichi Medical University Hospital. Patients - patients who underwent ESD for gastric neoplasm, between April 2015 and March 2017. Intervention - ESD, with a follow-up endoscopic examination at 8 weeks post-ESD. Univariate and multivariate analyses were used to identify the independent risk factors for delayed healing. RESULTS Of the 73 gastric neoplasms included in the analysis, delayed ulcer healing was identified in 21.9%. Dyslipidemia (p=0.04), ESD procedure time (p=0.003) and artificial ulcer size (p<0.001) were identified as risk factors for delayed healing, with location in the lower third of the stomach [Odds ratio (OR) 6.76; p=0.016] and artificial ulcer size (OR, 1.18; p=0.024) retained as independent risk factors. A cut-off ulcer size of 854 mm2 was predictive of delayed healing, with a sensitivity of 29.8% and specificity of 87.5%. For large ulcers, the rate of healing of 70% with vonoprazan was higher than the rate of 47.6% with proton pump inhibitors (PPIs), although this difference was not significant. CONCLUSION For artificial ulcers after ESD with a resection diameter >35 mm, it might be desirable to use PPIs for >8 weeks or P-CAB.
Collapse
Affiliation(s)
- Akihiro Shimozato
- Department of Gastroenterology, Aichi Medical University School of Medicine Aichi, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine Aichi, Japan.
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine Aichi, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine Aichi, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine Aichi, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine Aichi, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine Aichi, Japan
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine Aichi, Japan
| | - Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine Aichi, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine Aichi, Japan
| |
Collapse
|
31
|
Ebi M, Inoue S, Sugiyama T, Yamamoto K, Adachi K, Yoshimine T, Yamaguchi Y, Tamura Y, Izawa S, Hijikata Y, Funaki Y, Ogasawara N, Sasaki M, Kasugai K. A Small Bowel Ulcer due to Clopidogrel with Cytomegalovirus Enteritis Diagnosed by Capsule and Double-Balloon Endoscopy. Case Rep Gastroenterol 2018; 12:303-310. [PMID: 30022920 PMCID: PMC6047549 DOI: 10.1159/000490096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 05/07/2018] [Indexed: 12/17/2022] Open
Abstract
We report the first case of small bowel ulcers due to clopidogrel in a 74-year-old man. He presented with diarrhea and melena after having been taking low-dose aspirin (LDA) and clopidogrel. There was no evidence of bleeding in the stomach, duodenum, or colon. Capsule endoscopy showed multiple ulcers and erosions in the small intestine. Double-balloon endoscopy revealed multiple ulcers throughout the ileum. Examination of the biopsy specimen showed cytomegalovirus infection. His LDA was discontinued and he was prescribed ganciclovir. However, the small bowel ulcers were aggravated. Therefore, clopidogrel was discontinued. The small bowel ulcers subsequently healed completely, forming scars.
Collapse
Affiliation(s)
- Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Satoshi Inoue
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kazuhiro Yamamoto
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kazunori Adachi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Takashi Yoshimine
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshiharu Yamaguchi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| |
Collapse
|
32
|
Funaki Y, Kaneko H, Kawamura Y, Yoshimine T, Tamura Y, Izawa S, Ebi M, Ogasawara N, Sasaki M, Kasugai K. Impact of Comorbid Irritable Bowel Syndrome on Treatment Outcome in Non-Erosive Reflux Disease on Long-Term Proton Pump Inhibitor in Japan. Digestion 2018. [PMID: 28641289 DOI: 10.1159/000477801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS Irritable bowel syndrome (IBS) frequently coexists with non-erosive reflux disease (NERD). Efficacy of long-term proton pump inhibitor (PPI) treatment on NERD with or without IBS is controversial. The impact of comorbid IBS in NERD on quality of life (QOL) remains uncertain. We verified the hypothesis that NERD patients with IBS symptoms demonstrated poor responses to long-term PPI treatments, deteriorated QOL, and high frequency of psychological deviations in Japan. METHODS In all, 141 NERD patients who had been taking PPIs for more than 6 months were enrolled and analyzed. Patient profiles were assessed by GerdQ, IBS Severity Index (IBSSI-J)/Gastrointestinal Symptoms Rating Scale (GSRS)/SF-8, and Hospital Anxiety and Depression Scale (HADS). RESULTS IBS existed in 37 out of 141 NERD patients. Patients with IBS (the positive-IBS group) demonstrated significantly higher frequencies of extant reflux symptoms than those without IBS (64.9 vs. 40.4%). In the positive-IBS group, 40.5% were classified as middle grade by IBSSI-J. The SF-8 and GSRS scores in this group were significantly lower than those without IBS (the negative-IBS group). Prevalence of depression and anxiety by HADS in the positive-IBS group was significantly higher than that in the negative-IBS group. CONCLUSION These results proved the hypothesis that considering comorbid IBS among NERD patients on long-term PPI seems recommended in Japan.
Collapse
Affiliation(s)
- Yasushi Funaki
- Department of Gastroenterology, Division of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Ogasawara N, Yoshimine T, Noda H, Kondo Y, Izawa S, Shinmura T, Ebi M, Funaki Y, Sasaki M, Kasugai K. Clinical risk factors for delayed bleeding after endoscopic submucosal dissection for colorectal tumors in Japanese patients. Eur J Gastroenterol Hepatol 2016; 28:1407-1414. [PMID: 27512926 DOI: 10.1097/meg.0000000000000723] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) is a curative, standard therapy for colorectal neoplasms. Some studies have investigated the risk factors for perforation during colorectal ESD. However, few studies have assessed the risk factors for delayed bleeding after colorectal ESD. We studied patients undergoing ESD for colorectal epithelial neoplasms to identify the risk factors for post-ESD bleeding. PATIENTS AND METHODS We studied 124 consecutive patients undergoing ESD for colorectal epithelial neoplasms. To identify risk factors for delayed bleeding post-ESD, recurrent bleeding post-ESD was compared with patient-related and tumor-related factors. RESULTS Delayed bleeding after ESD occurred in 10 (8.1%) lesions of 124 colorectal tumors, and the median time from the end of ESD to the onset of bleeding was 18.5 h. Delayed bleeding was significantly higher in tumors located in rectums than in colons (P=0.021), and the number of occurrences of arterial bleeding during ESD was significantly higher in the delayed bleeding group than in the nondelayed bleeding group (P=0.002). The procedure time was significantly longer in the delayed bleeding group than in the nondelayed bleeding group (P=0.012). On multivariate logistic regression analysis, tumor location (odds ratio, 10.13; 95% confidence interval, 1.18-87.03; P=0.035) and three or more occurrences of arterial bleeding during ESD (odds ratio, 6.86; 95% confidence interval, 1.13-41.5; P=0.036) were significant independent risk factors for delayed bleeding. CONCLUSION The presence of lesions in the rectum and three or more arterial bleeding occurrences during ESD were risk factors for post-ESD bleeding. Patients with these risk factors should be followed up carefully after ESD for colorectal epithelial neoplasms.
Collapse
Affiliation(s)
- Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Noda H, Ogasawara N, Tamura Y, Kondo Y, Izawa S, Ebi M, Funaki Y, Sasaki M, Kasugai K. Successful Endoscopic Submucosal Dissection of a Large Terminal Ileal Lipoma. Case Rep Gastroenterol 2016; 10:506-511. [PMID: 27843426 PMCID: PMC5091281 DOI: 10.1159/000448886] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 08/02/2016] [Indexed: 12/13/2022] Open
Abstract
A 78-year-old woman who had recurrent right lower abdominal pain for about 1 year underwent computed tomography (CT) because of a follow-up observation 1 year after right breast cancer surgery. CT revealed a tumor in the colon. The patient was referred to our hospital for detailed examinations. An abdominal CT showed a low-density tumor of approximately 30 mm in the ascending colon, and the CT density inside the tumor was same as that of fatty tissues. A subsequent colonoscopy showed a submucosal tumor (SMT) in the proximal ascending colon developing from the terminal ileum. A colonoscopic ultrasonography revealed that the SMT was a high-echoic mass mainly localized in the submucosal layer. Based on the findings from CT, colonoscopy, and colonoscopic ultrasonography, the SMT was diagnosed as a pedunculated lipoma originating from the terminal ileum and treated with endoscopic submucosal dissection (ESD) because of recurrent abdominal pain. The 40-mm tumor was resected en bloc without complications. ESD may be more appropriate than polypectomy and surgery for removal of small intestinal tumors, because ESD allows direct visualization of the cutting line and exactly dissects the submucosal layers without damaging the muscular layers. ESD is a potentially useful treatment to remove intestinal lipomas.
Collapse
Affiliation(s)
- Hisatsugu Noda
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshihiro Kondo
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| |
Collapse
|
35
|
Noda H, Noguchi S, Yoshimine T, Goji S, Adachi K, Tamura Y, Izawa S, Ebi M, Yamamoto S, Ogasawara N, Funaki Y, Sasaki M, Kasugai K. A Novel Potassium-Competitive Acid Blocker Improves the Efficacy of Clarithromycin-containing 7-day Triple Therapy against Helicobacter pylori. JGLD 2016; 25:283-8. [DOI: 10.15403/jgld.2014.1121.253.7hp] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Background & Aims: In Japan, 7-day triple therapy for Helicobacter pylori including clarithromycin (CAM) was approved in 2000. However, antibiotic resistance subsequently reduced this rate to an unacceptable level (70%). Vonoprazan, an orally bioavailable potassium-competitive acid blocker (P-CAB), was approved in Japan in 2014. This could improve eradication rates by increasing the intragastric pH, thus increasing bacterial antibiotic susceptibility. This study compared the efficacy of 7-day triple therapies that included CAM and vonoprazan or proton pump inhibitor (PPI).
Methods: We prospectively analyzed H. pylori eradication rates in 146 patients receiving 7-day triple therapy containing P-CAB (April 2015 to September 2015), and in a retrospective cohort of 1,305 patients who received 7-day triple therapy containing a PPI (April 2011 to September 2015).
Results: H. pylori was eradicated in a significantly higher number of P-CAB-treated patients (89.7% [131/146]) than PPI-treated patients (73.9% [965/1305]; p < 0.05). The eradication rates in P-CAB-treated CAM-sensitive and CAM-resistant bacteria were 100% (44/44) and 87.5% (28/32), respectively, which were significantly higher than the corresponding rates in PPI-treated patients (88.0% [22/25] and 53.8% [7/13], p < 0.05).Conclusion: P-CAB improved the efficacy of CAM-containing 7-day triple therapy and would be a valuable first-line treatment for H. pylori infection.
Key words: – – – .
Abbreviations: CAM: clarithromycin; CAM-R: clarithromycin- resistant; CAM-S: clarithromycin-sensitive; OR: odds ratio; P-CAB: potassium-competitive acid blocker; PPI: proton pump inhibitor.
Collapse
|
36
|
Noda H, Ogasawara N, Sugiyama T, Yoshimine T, Tamura Y, Izawa S, Kondo Y, Ebi M, Funaki Y, Sasaki M, Kasugai K. The Influence of Snare Size on the Utility and Safety of Cold Snare Polypectomy for the Removal of Colonic Polyps in Japanese Patients. J Clin Med Res 2016; 8:662-6. [PMID: 27540440 PMCID: PMC4974836 DOI: 10.14740/jocmr2646w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2016] [Indexed: 12/17/2022] Open
Abstract
Background Cold snare polypectomy (CSP) has been recently reported to be useful for the removal of small colonic polyps. However, the relationship between the histologically complete resection rate and snare size used during CSP has not been reported. Our aim was to assess the utility of CSP. Methods We analyzed the histologically complete resection rates and the frequency of complications for 175 colon polyps removed by CSP. Moreover, we examined the histologically complete resection rate associated with different snare sizes used during CSP. Results There was no significant difference in the histologically complete resection rate between endoscopic mucosal resection (EMR) (60.9%) and CSP (53.1%). There were also no significant differences in the frequency of complications including perforation and postoperative bleeding between EMR (perforation: none; postoperative bleeding: two patients) and CSP (perforation: none; postoperative bleeding: none). Histological examination revealed that the complete resection rate of CSP using a short snare (61.6%) was significantly higher than that of CSP using a long snare (44.9%; P < 0.05). There were no significant differences in the frequency of complications between CSP using the short snare and that using the long snare. Conclusions CSP is a safe, useful method for the removal of colonic polyps. CSP using the short snare improved the histologically complete resection rates compared to the long snare. Future studies to further assess the utility of CSP are required.
Collapse
Affiliation(s)
- Hisatsugu Noda
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| | - Naotaka Ogasawara
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| | - Tomoya Sugiyama
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| | - Takashi Yoshimine
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| | - Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| | - Shinya Izawa
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| | - Yoshihiro Kondo
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| | - Masahide Ebi
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| | - Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| | - Makoto Sasaki
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| | - Kunio Kasugai
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, Japan
| |
Collapse
|
37
|
Hirose T, Hasegawa J, Izawa S, Enoki H, Suzuki Y, Kuzuya M. P-161: Geriatric conditions that predict mortality and hospitalization in dependent older people living in long term care facilities. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30261-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
38
|
Tamura Y, Funaki Y, Izawa S, Iida A, Yamaguchi Y, Adachi K, Ogasawara N, Sasaki M, Kaneko H, Kasugai K. Pathophysiology of functional heartburn based on Rome III criteria in Japanese patients. World J Gastroenterol 2015; 21:5009-5016. [PMID: 25945016 PMCID: PMC4408475 DOI: 10.3748/wjg.v21.i16.5009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 11/21/2014] [Accepted: 01/16/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the pathophysiology of functional heartburn (FH) in Japanese patients.
METHODS: A total of 111 patients with proton pump inhibitor (PPI)-refractory non-erosive gastroesophageal reflux disease underwent intraesophageal pressure testing and 24-h multichannel intraluminal impedance-pH (24MII-pH) testing. The patients also completed several questionnaires while they were receiving the PPI treatment, including the questionnaire for the diagnosis of reflux disease (QUEST), the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG), the gastrointestinal symptoms rating scale (GSRS), SF-36, and the Cornell Medical Index (CMI). The subjects were classified into FH and endoscopy-negative reflux disease (ENRD) groups based on the Rome III criteria.
RESULTS: Thirty-three patients with esophageal motility disorder were excluded from this study, while 22 patients with abnormal esophageal acid exposure time (pH-POS) and 34 with hypersensitive esophagus (HE) were included in the ENRD group. The FH group included 22 patients with no reflux involvement. Sex, age, and body mass index did not differ significantly between the groups. The mean SF-36 values were < 50 (normal) for all scales in these groups, with no significant differences. The GSRS scores in these groups were not different and showed overlap with other gastrointestinal symptoms. The QUEST and the FSSG scores did not differ significantly between the groups. Neuroticism was diagnosed using the CMI questionnaire in 17 of the 78 included subjects within the pH-POS (n = 4), HE (n = 8), and FH (n = 5) groups, with no significant differences.
CONCLUSION: Clinical characteristics of the FH and PPI-refractory ENRD groups were similar. Therefore, esophageal function should be examined via manometry and 24MII-pH testing to differentiate between them.
Collapse
|
39
|
Tamura Y, Funaki Y, Adachi K, Noda H, Izawa S, Iida A, Ogasawara N, Miyaji M, Sasaki M, Kasugai K. A Patient with Vigorous Achalasia and Rapid Enlargement of an Epiphrenic Esophageal Diverticulum. Intern Med 2015; 54:1609-12. [PMID: 26134191 DOI: 10.2169/internalmedicine.54.4506] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 47-year-old man was found to have a 3-cm epiphrenic esophageal diverticulum on an upper gastrointestinal (UGI) barium study. He developed the symptoms of heartburn approximately 12 months later. UGI endoscopy indicated non-erosive gastroesophageal reflux disease (NERD) and an epiphrenic esophageal diverticulum. A proton pump inhibitor (PPI) did not relieve the symptoms. An UGI barium study at that time showed that the epiphrenic esophageal diverticulum had enlarged to 7 cm, and esophageal manometry showed findings of achalasia and diffuse esophageal spasm (DES), thus vigorous achalasia was diagnosed. Resection of the epiphrenic esophageal diverticulum, myotomy, and fundoplication (the Heller-Dor procedure) were successfully performed and no postoperative symptoms were encountered.
Collapse
Affiliation(s)
- Yasuhiro Tamura
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Izawa S, Funaki Y, Iida A, Tokudome K, Tamura Y, Ogasawara N, Sasaki M, Kasugai K. The role of gastroesophageal reflux in relation to symptom onset in patients with proton pump inhibitor-refractory nonerosive reflux disease accompanied by an underlying esophageal motor disorder. Digestion 2014; 89:61-7. [PMID: 24458115 DOI: 10.1159/000356222] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The symptom improvement rate is low with proton pump inhibitors (PPIs) in nonerosive reflux disease (NERD). The underlying pathogenic mechanism is complex. Esophageal motility disorders (EMDs) are thought to be a factor, but their prevalence, type, symptoms and the role played by gastroesophageal reflux (GER) in symptom onset have not been fully investigated. AIM To investigate the role of GER in symptom onset in PPI-refractory NERD patients with EMDs. METHODS This study comprised 76 patients with PPI-refractory NERD. Manometry was performed during PPI treatment and patients were divided into an EMD group and normal motility (non-EMD) group. Then, multichannel intraluminal impedance-pH monitoring was performed and medical interviews were conducted. RESULTS Nineteen patients (25%) had an EMD. Data were compared between 17 patients, excluding 2 with achalasia and 57 non-EMD patients. No significant differences were observed between groups in 24-hour intraesophageal pH <4 holding time (HT), mean number of GER episodes or mean number of proximal reflux episodes. The reflux-related symptom index (≥50%) showed a relationship between reflux and symptoms in 70.5% of EMD patients and 75% of non-EMD patients. In the EMD group, the score for FSSG (Frequency Scale for the Symptoms of GERD) question (Q)10 was significantly correlated with the number of GER episodes (r = 0.58, p = 0.02) and the number of proximal reflux episodes (r = 0.63, p = 0.02). In addition, the score for Q9 tended to be correlated with the number of GER episodes (r = 0.44, p = 0.06). CONCLUSION Our results suggest that some PPI-refractory NERD patients have EMDs, and that GER plays a role in symptom onset.
Collapse
Affiliation(s)
- Shinya Izawa
- Department of Internal Medicine, Division of Gastroenterology, Aichi Medical University School of Medicine, Nagakute, Japan
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Funaki Y, Iida A, Shimozato A, Yamaguchi J, Tanabe A, Tamura Y, Izawa S, Ogasawara N, Sasaki M, Kasugai K. [A case of diffuse esophageal spasm successfully treated by steroid therapy]. Nihon Shokakibyo Gakkai Zasshi 2014; 111:1774-1781. [PMID: 25195962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A 53-year-old man was admitted to our hospital with anterior chest pain and difficulty swallowing. Computed tomography revealed significant esophageal wall thickening. Esophageal intraluminal manometry revealed uncoordinated contraction and strong peristaltic pressure associated with the chest pain. The patient was subsequently diagnosed with diffuse esophageal spasm (DES). His serum immunoglobulin E level was high, and peripheral blood eosinophilia was observed. No eosinophilic infiltration was detected in the esophageal mucosa on endoscopic biopsy. It was presumed that this case of DES was induced by allergic disease. Treatment with 30 mg of oral prednisolone led to a prompt resolution of symptoms;the thickness of the esophageal wall decreased, and the simultaneous contractions disappeared. However, given the presence of a strong peristaltic wave, nutcracker esophagus (NE) was also suspected. This was a rare case of atypical DES induced by allergic disease and associated with NE.
Collapse
Affiliation(s)
- Yasushi Funaki
- Division of Gastroenterology, Department of Internal Medicine, Aichi Medical University School of Medicine
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Ito Y, Sasaki M, Noguchi S, Yamaguchi S, Okaniwa N, Tanabe A, Noda H, Yanamoto K, Tamura Y, Kondo Y, Masui R, Izawa S, Iida A, Mizuno M, Ogasawara N, Funaki Y, Kasugai K. Effect of aspirin cessation before endoscopy in Japanese patients with low-dose-aspirin-associated gastroduodenal mucosal injury. United European Gastroenterol J 2014; 1:259-64. [PMID: 24917970 DOI: 10.1177/2050640613491254] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 04/28/2013] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of upper gastrointestinal injury by low-dose aspirin (LDA) has increased. OBJECTIVE We aimed to clarify the risk factors and prevention strategies associated with LDA-induced gastroduodenal ulcer in Japanese patients. METHODS A retrospective study involving 284 LDA users who underwent oesophagogastroduodenoscopy between January and December 2010 were included. We investigated the patients' clinical characteristics and endoscopic findings. RESULTS Of 284 patients, 29 (10.2%) had gastro and/or duodenal ulcers. Male gender, peptic ulcer history, abdominal symptoms, half-dose proton pump inhibitors (PPIs), complete-dose PPIs, and nonsteroidal anti-inflammatory drugs were significantly associated with LDA-induced gastro and/or duodenal ulcers: odds ratio (95% confidence interval) 3.62 (1.06-12.27), 6.60 (1.84-23.62), 3.06 (1.12-8.40), 0.16 (0.03-0.94), 0.07 (0.01-0.61), and 9.68 (1.64-57.18), respectively. PPI significantly reduced gastric ulcers and/or duodenal ulcers (p = 0.03). The modified Lanza score for gastric mucosal lesion in the LDA cessation group was significantly lower than in the LDA noncessation group (0.53 vs. 1.02; p = 0.008). CONCLUSIONS Half-dose PPIs as well as complete-dose PPIs were effective for preventing LDA-induced gastric and/or duodenal ulcers. The cessation of LDA before endoscopy may lead to an underestimation of LDA-induced gastric injury.
Collapse
Affiliation(s)
- Yoshitsugu Ito
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Makoto Sasaki
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Seiji Noguchi
- Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Noriko Okaniwa
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Atsushi Tanabe
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hisatsugu Noda
- Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Yasuhiro Tamura
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshihiro Kondo
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ryuta Masui
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinya Izawa
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akihito Iida
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Mari Mizuno
- Aichi Medical University School of Medicine, Nagakute, Japan
| | | | - Yasushi Funaki
- Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kunio Kasugai
- Aichi Medical University School of Medicine, Nagakute, Japan
| |
Collapse
|
43
|
Izawa S, Enoki H, Hasegawa J, Hirose T, Kuzuya M. Factors associated with deterioration of mini nutritional assessment-short form status of nursing home residents during a 2-year period. J Nutr Health Aging 2014; 18:372-7. [PMID: 24676317 DOI: 10.1007/s12603-013-0400-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE A number of other studies have been conducted to verify the Mini Nutritional Assessment (MNA) or the MNA short form (MNA-SF) as a nutritional assessment/screening tool in various clinical settings or communities. However, there are few longitudinal studies using these tools to analyze which factors affect the incidence of deteriorating nutritional status. We tried to identify the factors associated with deterioration of MNA-SF status of nursing home residents during a 2-year period. METHODS Participants were 392 people with a mean age of 84.3 in 12 nursing homes in Japan. The factors associated with deterioration in MNA-SF categories during the study period compared to stable/improved MNA-SF categories were identified. RESULTS At baseline, 19.9% of the participants were malnourished and 60.2% were at risk of malnutrition, according to the MNA-SF classification. After 2 years, 66.3% participants maintained and 6.1% participants improved their nutritional status according to the MNA-SF classification, while 27.6% showed deterioration in MNA-SF status. Stepwise logistic-regression procedure indicated that basic ADL impairment and hospitalization during the follow-up period were associated with declining MNA-SF status. CONCLUSIONS Poor basic ADL status and hospitalization during the follow-up period were associated with malnutrition and risk of malnutrition as assessed by MNA-SF of nursing homes residents during a 2-year period.
Collapse
Affiliation(s)
- S Izawa
- S. Izawa, Department of Health and Nutrition, Faculty of Psychological and Physical Science, Aichi Gakuin University,12 Araike, Iwasaki-cho, Nisshin, Aichi 470-0195, Japan. TEL: +81-561-73-1111; FAX: +81-561-73-1142. E-mail address:
| | | | | | | | | |
Collapse
|
44
|
Ogasawara N, Izawa S, Mizuno M, Tanabe A, Ozeki T, Noda H, Takahashi E, Sasaki M, Yokoi T, Kasugai K. Gastric calcifying fibrous tumor removed by endoscopic submucosal dissection. World J Gastrointest Endosc 2013; 5:457-460. [PMID: 24044047 PMCID: PMC3773860 DOI: 10.4253/wjge.v5.i9.457] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 07/01/2013] [Accepted: 08/06/2013] [Indexed: 02/05/2023] Open
Abstract
The World Health Organization describes calcifying fibrous tumors (CFTs) as rare, benign lesions characterized by hypocellular, densely hyalinized collagenization with lymphoplasmacytic infiltration. These tumors rarely involve the gastrointestinal (GI) tract. A routine endoscopic upper gastrointestinal screen detected a 10-mm submucosal tumor (SMT) in the lesser curvature of the lower corpus of the stomach of an apparently healthy, 37-year-old woman with no history of Helicobacter pylori infection. Endoscopic ultrasonography (EUS) localized the internally isoechoic, homogeneous SMT mainly within the submucosa. Malignancy was ruled out using endoscopic submucosal dissection (ESD). A pathological examination confirmed complete resection of the SMT, and defined a hypocellular, spindle-cell tumor with a densely hyalinized, collagenous matrix, scattered lymphoplasmacytic aggregates as well as a few psammomatous, dystrophic calcified foci. The mass was immunohistochemically positive for vimentin and negative for CD117 (c-kit protein), CD34, desmin, smooth muscle actin (SMA) and S100. Therefore, the histological findings were characteristic of a CFT. To date, CFT resection by ESD has not been described. This is the first case report of a gastric calcifying fibrous tumor being completely resected by ESD after endoscopic ultrasonography.
Collapse
|
45
|
Ito Y, Sasaki M, Funaki Y, Ogasawara N, Mizuno M, Iida A, Izawa S, Masui R, Kondo Y, Tamura Y, Yanamoto K, Noda H, Tanabe A, Okaniwa N, Yamaguchi Y, Kasugai K. Nonsteroidal anti-inflammatory drug-induced visible and invisible small intestinal injury. J Clin Biochem Nutr 2013; 53:55-9. [PMID: 23874071 PMCID: PMC3705150 DOI: 10.3164/jcbn.12-116] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 01/28/2013] [Indexed: 12/14/2022] Open
Abstract
Permeation of the small intestinal mucosa is a key mechanism in the induction of enteropathy. We investigated the effect of rebamipide in healthy subjects with diclofenac-induced small intestinal damage and permeability. In this crossover study, each treatment period was 1 week with a 4-week washout period. Diclofenac (75 mg/day) and omeprazole (20 mg/day) plus rebamipide (300 mg/day) or placebo were administered. Capsule endoscopy and a sugar permeability test were performed on days 1 and 7 in each period. Ten healthy subjects were enrolled. Small intestinal injuries were observed on day 7 in 6 of 10 subjects in both groups. Urinary excretion of administered lactulose increased from 0.30% to 0.50% of the initial dose during the first treatment period in the placebo group, and from 0.13% to 0.33% in the rebamipide group. Despite recovery from small-intestinal mucosal damage, the increased permeability in both groups resulted in sustained high levels of lactulose (0.50% to 1.06% in the placebo group and 0.33% to 1.12% in the rebamipide group) through the 4-week washout period. Diclofenac administration induced enteropathy and hyperpermeability of the small intestine. The sustained hyperpermeability during the washout period may indicate the presence of invisible fragility.
Collapse
Affiliation(s)
- Yoshitsugi Ito
- Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Hijikata Y, Ogasawara N, Sasaki M, Mizuno M, Masui R, Kondo Y, Izawa S, Ito Y, Noda H, Kasugai K. Endoscopic submucosal dissection with sheath-assisted counter traction using a novel sheath for early gastric cancers. ACTA ACUST UNITED AC 2013; 59:353-6. [PMID: 21940372 DOI: 10.5754/hge11458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS Endoscopic submucosal dissection (ESD) is technically demanding and requires considerable skill. We previously described sheath-assisted counter traction ESD that uses simple materials and methods to improve cutting line visualization. We recently improved counter-traction of the submucosal layer using a novel chemically treated sheath that reduces slippage and maintains traction, and investigated the utility of the novel sheath for ESD. METHODOLOGY Forty-three and 25 consecutive patients with early gastric carcinomas were treated by standard ESD and traction ESD assisted with novel sheaths, respectively. The mean duration of procedures relative to tumor size and location, as well as complications after ESD between the two groups were compared. RESULTS The mean duration of ESD procedures for lesions =20mm in diameter was significantly reduced using the novel sheath. The mean duration of procedures for all locations of resected tumors in the stomach was significantly reduced using the novel sheath. However, no perforation and delayed bleeding developed after treatment with the novel sheath. CONCLUSIONS Sheath-assisted counter traction ESD by the novel sheath was technically simpler and thus less time-consuming regardless of the location of lesions, especially when =20mm in diameter. The traction ESD with the novel sheath is safe and not invasive, and it can be universally applied to standard ESD.
Collapse
Affiliation(s)
- Yasutaka Hijikata
- Department of Gastroenterology, Aichi Medical University School of Medicine, Aichi, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Funaki Y, Tokudome K, Izawa S, Tamura Y, Kondo Y, Iida A, Mizuno M, Ogasawara N, Sasaki M, Kasugai K. Comparison of the effect of a single dose of omeprazole or lansoprazole on intragastric pH in Japanese participants: a two-way crossover study. J Chin Med Assoc 2013; 76:131-4. [PMID: 23497964 DOI: 10.1016/j.jcma.2012.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 07/03/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND It is known that the pharmacokinetic profile of proton pump inhibitors (PPIs) after postprandial administration may differ among PPIs. The purpose of this study was to compare the inhibitory effects of gastric acid secretion by PPIs administered after a meal, based on a 24-hour intragastric pH monitoring. METHODS Ten healthy men who provided written informed consent participated in the study. They were given a 20-mg omeprazole tablet and a 30-mg lansoprazole orally dispersing tablet in a two-way crossover manner. At baseline, the anti-HP-IgG antibody levels in blood and the pepsinogen (PG) I/II ratio were measured. Participants were given a standardized meal and 200 mL of water at 9:30 am, 13:30 pm, and 18.30 pm. Participants took the PPI after breakfast. RESULTS Two of the ten participants tested positive for Helicobacter pylori infection. The PG I/II ratio indicated negative gastric atrophy in all the participants. The percentage 24-hour intragastric pH > 4 holding times (median, range) with omeprazole and lansoprazole were 29.3, 19.3-50.0% and 27.8, 13.0-42.3%, respectively, which shows that with the administration of omeprazole, the pH was maintained at >4 for a longer period (p < 0.05). Each median intragastric pH value per hour at 3, 17, and 18 hours after a dose of omeprazole was significantly higher than that of lansoprazole (p < 0.05). CONCLUSION Compared with lansoprazole, a single postprandial dose of omeprazole showed a more rapid and sustained acid-inhibitory effect.
Collapse
Affiliation(s)
- Yasushi Funaki
- Department of Gastroenterology, Aichi Medical University, School of Medicine, Aichi, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Hakamata Y, Izawa S, Sato E, Komi S, Murayama N, Moriguchi Y, Hanakawa T, Inoue Y, Tagaya H. 1603 – Stress hormone and neuropsychological functioning predict attention bias towards threat in healthy individuals. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76601-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
49
|
Ozeki T, Ogasawara N, Izawa S, Mizuno M, Yanamoto K, Noda H, Okaniwa N, Tanabe A, Sasaki M, Kasugai K. Protein-losing enteropathy associated with collagenous colitis cured by withdrawal of a proton pump inhibitor. Intern Med 2013; 52:1183-7. [PMID: 23728552 DOI: 10.2169/internalmedicine.52.0232] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 63-year-old woman was admitted with symptoms of watery diarrhea and generalized edema lasting for five months. She had been administered 15 mg/day of lansoprazole. Laboratory findings revealed severe hypoproteinemia with normal liver, renal, thyroid and adrenal functions and no proteinuria. Colonoscopy revealed edematous mucosa, minor diminished vascular transparency and apparent longitudinal linear lacerations. The histopathological findings were compatible with a diagnosis of collagenous colitis (CC). Protein leakage from the colon was identified on (99m)Tc-human serum albumin scintigraphy. The results indicated CC associated with protein-losing enteropathy. Discontinuing lansoprazole ameliorated the watery diarrhea and generalized edema, increased the serum albumin level and improved the hypoproteinemia.
Collapse
Affiliation(s)
- Tomonori Ozeki
- Department of Gastroenterology, Aichi Medical University School of Medicine, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Tokudome K, Funaki Y, Sasaki M, Izawa S, Tamura Y, Iida A, Ogasawara N, Konagaya T, Tokura Y, Kasugai K. Efficacy of endoluminal gastroplication in Japanese patients with proton pump inhibitor-resistant, non-erosive esophagitis. World J Gastroenterol 2012; 18:5940-7. [PMID: 23139611 PMCID: PMC3491602 DOI: 10.3748/wjg.v18.i41.5940] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 07/16/2012] [Accepted: 07/18/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the efficacy, safety, and long-term outcomes of endoluminal gastroplication (ELGP) in patients with proton pump inhibitor (PPI)-resistant, non-erosive reflux disease (NERD).
METHODS: The subjects were NERD patients, diagnosed by upper endoscopy before PPI use, who had symptoms such as heartburn or reflux sensations two or more times a week even after 8 wk of full-dose PPI treatment. Prior to ELGP, while continuing full-dose PPI medication, patients’ symptoms and quality of life (QOL) were assessed using the questionnaire for the diagnosis of reflux disease, the frequency scale for symptoms of gastro-esophageal reflux disease (FSSG), gastrointestinal symptoms rating scale, a 36-item short-form. In addition, 24-h esophageal pH monitoring or 24-h intraesophageal pH/impedance (MII-pH) monitoring was performed. The Bard EndoCinchTM was used for ELGP, and 2 or 3 plications were made. After ELGP, all acid reducers were temporarily discontinued, and medication was resumed depending on the development and severity of symptoms. Three mo after ELGP, symptoms, QOL, pH or MII-pH monitoring, number of plications, and PPI medication were evaluated. Further, symptoms, number of plications, and PPI medication were evaluated 12 mo after ELGP to investigate long-term effects.
RESULTS: The mean FSSG score decreased significantly from before ELGP to 3 and 12 mo after ELGP (19.1 ± 10.5 to 10.3 ± 7.4 and 9.3 ± 9.9, P < 0.05, respectively). The total number of plications decreased gradually at 3 and 12 mo after ELGP (2.4 ± 0.8 to 1.2 ± 0.8 and 0.8 ± 1.0, P < 0.05, respectively). The FSSG scores in cases with no remaining plications and in cases with one or more remaining plications were 4.4 and 2.7, respectively, after 3 mo, and 2.0 and 2.8, respectively, after 12 mo, showing no correlation to plication loss. On pH monitoring, there was no difference in the percent time pH < 4 from before ELGP to 3 mo after. Impedance monitoring revealed no changes in the number of reflux episodes or the symptom index for reflux events from before ELGP to 3 mo after, but the symptom sensitivity index decreased significantly 3 mo after ELGP (16.1 ± 12.9 to 3.9 ± 8.3, P < 0.01). At 3 mo after ELGP, 6 patients (31.6%) had reduced their PPI medication by 50% or more, and 11 patients (57.9%) were able to discontinue PPI medication altogether. After 12 mo, 3 patients (16.7%) were able to reduce the amount of PPI medication by 50% or more, and 12 patients (66.7%) were able to discontinue PPI medication altogether. A high percentage of cases with remaining plications had discontinued PPIs medication after 3 mo, but there was no difference after 12 mo. No serious complications were observed in this study.
CONCLUSION: ELGP was safe, resulted in significant improvement in subjective symptoms, and allowed less medication to be used over the long term in patients with PPI-refractory NERD.
Collapse
|