Pathogenesis, Diagnosis, and Management of Upper Gastrointestinal Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 December 2024 | Viewed by 436

Special Issue Editor


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Guest Editor
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
Interests: gastroesophageal reflux disease; esophageal cancer; eosinophilic esophagitis; chronic gastritis; gastric cancer; peptic ulcer; gastric MALT lymphoma; colorectal cancer; functional dyspepsia; IBS; IBD
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Special Issue Information

Dear Colleagues,

In the field of upper gastrointestinal disorders, with the remarkable progress in endoscopy and the discovery of H. pylori, morphological diagnosis, pharmacological treatment, and endoscopic treatment have made great progress in benign and malignant diseases. For this reason, it may even be thought that research and development in this area are no longer necessary. However, in reality, lesions and diseases that cannot be seen with the naked eye or endoscopically remain latent. Regarding functional gastrointestinal disorders without organic disease (e.g., FGIDs and DGBI), eosinophilic esophagitis, eosinophilic gastritis, autoimmune gastritis, and even esophageal motility disorders such as achalasia and jackhammer esophagus, there are many unresolved questions. From this point of view, pathological research with regard to the susceptibility to diseases of the upper gastrointestinal tract, paying attention to the brain–gut interaction and the cooperative relationship with the gastrointestinal luminal environment (gastrointestinal microbiota, dietary factors, etc.), as well as genetic analysis using multilayer omics, etc., it is necessary to establish diagnostics that make full use of microbial flora analysis or artificial intelligence. It is also necessary to establish highly specific and targeted molecular therapeutics.

In this Special Issue, we would like to see new attempts to boldly tackle various problems in the upper gastrointestinal tract from multiple angles.

Prof. Dr. Hidekazu Suzuki
Guest Editor

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Keywords

  • esophagus
  • stomach
  • duodenum
  • DGBI
  • FGIDs
  • Helicobacter
  • eosinophilic esophagitis

Published Papers (1 paper)

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Research

11 pages, 459 KiB  
Article
Single-Arm, Prospective, Interventional Study of Helicobacter pylori Eradication Rescue Therapy with Rifabutin, Metronidazole, and Vonoprazan
by Soichiro Sue, Ryosuke Ikeda, Aya Ikeda, Hiroki Sato, Hiroaki Kaneko, Kuniyasu Irie and Shin Maeda
J. Clin. Med. 2024, 13(13), 3774; https://doi.org/10.3390/jcm13133774 - 27 Jun 2024
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Abstract
Background and Objective: Rescue Helicobacter pylori eradication can be challenging. Rifabutin (RBT) demonstrates high activity against Helicobacter pylori and is incorporated into various rescue eradication regimens. This exploratory study was performed to evaluate the efficacy and safety of a rescue regimen comprising RBT, [...] Read more.
Background and Objective: Rescue Helicobacter pylori eradication can be challenging. Rifabutin (RBT) demonstrates high activity against Helicobacter pylori and is incorporated into various rescue eradication regimens. This exploratory study was performed to evaluate the efficacy and safety of a rescue regimen comprising RBT, metronidazole (MNZ), and vonoprazan (VPZ). Methods: This prospective, single-center, single-arm, interventional study was performed in Japan. Eligible patients were those who underwent failed primary eradication treatment (7-day treatment with three drugs: VPZ or a proton pump inhibitor [PPI], amoxicillin [AMPC], and clarithromycin) and secondary eradication treatment (7-day treatment with three drugs: VPZ or a PPI, AMPC, and MNZ) and those who were unable to receive first- and second-line therapy because of penicillin allergy. Twenty Helicobacter pylori-positive patients were treated with RBT (150 mg twice daily), MNZ (250 mg twice daily), and VPZ (20 mg twice daily) for 10 days (RBT-MNZ-VPZ therapy). Eradication success was evaluated using the urea breath test. Drug susceptibility test results were available in 16 patients. This study is registered in the Japan Registry of Clinical Trials (jRCT031220504). Results: The intention-to-treat (ITT) and per-protocol (PP) eradication rates of RBT-MNZ-VPZ therapy were 70% (90% confidence interval [CI]: 49.2%–86.0%) and 72.2% (95% CI: 50.2%–88.4%), respectively. In the MNZ-susceptible subgroup, the ITT (n = 8) and PP (n = 7) eradication rates were 100% (90% CI: 68.8%–100%) and 100% (90% CI: 65.2%–100%). In the MNZ-resistant subgroup, the ITT (n = 8) and PP (n = 7) eradication rates were both 62.5% (90% CI: 28.9%–88.9%). All infections were RBT-susceptible. Conclusions: These findings suggest that RBT-MNZ-VPZ therapy may be a promising rescue regimen, especially in MNZ- and RBT-susceptible infections or patients with penicillin allergy. Full article
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