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Pathogenesis, Diagnosis, and Management of Upper Gastrointestinal Disease
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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: 15 June 2025 | Viewed by 5583

Special Issue Editor

Prof. Dr. Hidekazu Suzuki

E-Mail Website
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
Special Issues, Collections and Topics in MDPI journals

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

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

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Published Papers (3 papers)

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12 pages, 1791 KiB  
Article
Characteristics of Gastrointestinal Bleeding While Taking Direct Oral Anticoagulants in Patients with Nonvalvular Atrial Fibrillation and Differences Among Drugs—A Single-Center Retrospective Cohort Study
by Naoaki Aoki, Koichiro Abe, Haruka Tokutomi, Kohei Kajita, Masayuki Sone, Taku Honda, Hitoshi Aoyagi, Akari Isono, Kumiko Konno, Ken Kozuma, Toshihiko Arizumi, Yoshinari Asaoka, Shinya Kodashima, Takatsugu Yamamoto and Atsushi Tanaka
J. Clin. Med. 2025, 14(1), 95; https://doi.org/10.3390/jcm14010095 - 27 Dec 2024
Viewed by 959
Abstract
Introduction: Direct oral anticoagulants (DOACs) are frequently used to prevent embolism in atrial fibrillation. Gastrointestinal bleeding is frequent, but its drug-specific characteristics remain unclear. This study examined the frequency and characteristics of gastrointestinal bleeding in patients with nonvalvular atrial fibrillation for different [...] Read more.
Introduction: Direct oral anticoagulants (DOACs) are frequently used to prevent embolism in atrial fibrillation. Gastrointestinal bleeding is frequent, but its drug-specific characteristics remain unclear. This study examined the frequency and characteristics of gastrointestinal bleeding in patients with nonvalvular atrial fibrillation for different DOACs. Methods: The present study included 978 patients receiving treatment with DOACs for nonvalvular atrial fibrillation between 2011 and 2018 and examined the frequencies of clinically significant events including major cardiovascular and cerebrovascular events, hemorrhagic events, or death during the first 5 years of prescription. Gastrointestinal bleeding was evaluated for the frequency, source and severity of gastrointestinal bleeding by DOAC type. Results: The median age of subjects was 73 years (interquartile range, 65–80 years), and 622 (64%) were male. The overall observation period was 2499 person-years. During this period, 102 (4.1/100 person-years) major cardiovascular events and 107 (4.3/100 person-years) clinically significant bleeding were reported, including 60 cases (2.4/100 person-years) of gastrointestinal bleeding and 37 cases (1.5/100 person-years) of all-cause mortality. Gastrointestinal bleeding accounted for more than half of all bleeding events among DOAC users, and bleeding from the lower gastrointestinal tract was more common than that from the upper gastrointestinal tract, particularly with dabigatran. No significant difference was seen in the rate of gastrointestinal bleeding by drug type. Peptic ulcer accounted for half of the events of upper gastrointestinal bleeding, all of which were severe. Conclusions: Gastrointestinal bleeding is frequent among patients taking DOACs, especially from the lower alimentary tract. The tendency was more pronounced with dabigatran. In the upper gastrointestinal tract, severe peptic ulcer bleeding is common and requires caution. Full article
(This article belongs to the Special Issue Pathogenesis, Diagnosis, and Management of Upper Gastrointestinal Disease)
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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
Viewed by 1771
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
(This article belongs to the Special Issue Pathogenesis, Diagnosis, and Management of Upper Gastrointestinal Disease)
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Other

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15 pages, 632 KiB  
Systematic Review
Artificial Intelligence for the Automatic Diagnosis of Gastritis: A Systematic Review
by Daria Claudia Turtoi, Vlad Dumitru Brata, Victor Incze, Abdulrahman Ismaiel, Dinu Iuliu Dumitrascu, Valentin Militaru, Mihai Alexandru Munteanu, Alexandru Botan, Dan Alexandru Toc, Traian Adrian Duse and Stefan Lucian Popa
J. Clin. Med. 2024, 13(16), 4818; https://doi.org/10.3390/jcm13164818 - 15 Aug 2024
Cited by 2 | Viewed by 2289
Abstract
Background and Objective: Gastritis represents one of the most prevalent gastrointestinal diseases and has a multifactorial etiology, many forms of manifestation, and various symptoms. Diagnosis of gastritis is made based on clinical, endoscopic, and histological criteria, and although it is a thorough [...] Read more.
Background and Objective: Gastritis represents one of the most prevalent gastrointestinal diseases and has a multifactorial etiology, many forms of manifestation, and various symptoms. Diagnosis of gastritis is made based on clinical, endoscopic, and histological criteria, and although it is a thorough process, many cases are misdiagnosed or overlooked. This systematic review aims to provide an extensive overview of current artificial intelligence (AI) applications in gastritis diagnosis and evaluate the precision of these systems. This evaluation could highlight the role of AI as a helpful and useful tool in facilitating timely and accurate diagnoses, which in turn could improve patient outcomes. Methods: We have conducted an extensive and comprehensive literature search of PubMed, Scopus, and Web of Science, including studies published until July 2024. Results: Despite variations in study design, participant numbers and characteristics, and outcome measures, our observations suggest that implementing an AI automatic diagnostic tool into clinical practice is currently feasible, with the current systems achieving high levels of accuracy, sensitivity, and specificity. Our findings indicate that AI outperformed human experts in most studies, with multiple studies exhibiting an accuracy of over 90% for AI compared to human experts. These results highlight the significant potential of AI to enhance diagnostic accuracy and efficiency in gastroenterology. Conclusions: AI-based technologies can now automatically diagnose using images provided by gastroscopy, digital pathology, and radiology imaging. Deep learning models exhibited high levels of accuracy, sensitivity, and specificity while assessing the diagnosis, staging, and risk of neoplasia for different types of gastritis, results that are superior to those of human experts in most studies. Full article
(This article belongs to the Special Issue Pathogenesis, Diagnosis, and Management of Upper Gastrointestinal Disease)
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