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ABSTRACT: AIM: Hepatitis A virus (HAV) is the most common cause of infectious hepatitis worldwide. Although hepatitis A cases imported from Southeast Asian countries, including the Philippines, have been reported in Japan, the molecular epidemiological data have been limited for these HAV-endemic countries. METHODS: The full-length genomic sequences of HAV isolates were determined and subjected to the phylogenetic analyses. RESULTS: The HAV isolates (HA12-0796 and HA12-0938) obtained from two Japanese patients who developed acute hepatitis A in July 2012 one month after traveling to the Philippines, where they consumed undercooked shellfish, differed by only one nucleotide (nt) over the entire genome. These HAV isolates of genotype IA were 99.1-99.5% identical within 228-237 nt to those recovered from river water in the Philippines, suggesting that the HA12-0796 and HA12-0938 isolates represent HAV circulating in the Philippines. HAV isolates belonging to one of the two IA sub-lineages (IA-2) which were implicated in some of the mini-epidemics in 2010 in Japan are hypothesized to be connected with the Philippines. In support of this speculation, the present IA isolates (HA12-0796 and HA12-0938) shared 98.8% identity over the entire genome with one IA-2 isolate (HAJIH-Fukuo10) recovered from a Japanese female who developed a domestic HAV infection during the mini-epidemics. In the phylogenetic tree constructed based on the entire genome, these three isolates (HA12-0796, HA12-0938 and HAJIH-Fukuo10) segregated into a cluster with a bootstrap value of 100%. CONCLUSION: These results indicate that HAV isolates belonging to the IA-2 lineage may have been imported from the Philippines.
Hepatology Research 04/2013; · 2.20 Impact Factor
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ABSTRACT: BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) are an effective and common treatment for chronic pain disorders, but long-term use is associated with risk of potentially life-threatening gastrointestinal adverse events (AEs). The proton pump inhibitor esomeprazole has been found to be effective for gastroprotection in NSAID users, but few long-term studies have been conducted in Japan. METHODS: This was an open-label, multicentre, single-arm, prospective 1-year study of treatment with esomeprazole (20 mg once daily) in Japanese patients (aged >=20 years) with endoscopic evidence of previous peptic ulcer and receiving daily oral NSAID therapy (at a stable dose) for a chronic condition. Eligibility was not dictated by type of oral NSAID. The primary objective was to determine long-term safety and tolerability of esomeprazole. Efficacy for prevention of peptic ulcers was also determined (Kaplan-Meier method). All statistical analyses were descriptive. RESULTS: A total of 130 patients (73.1% women, mean age 62.1 years, 43.8% Helicobacter pylori-positive) received treatment with esomeprazole in addition to long-term NSAID therapy (most commonly for rheumatoid arthritis [n=42] and osteoarthritis [n=34]). Loxoprofen, meloxicam and diclofenac were the most commonly used NSAIDs; COX-2 selective agents were used by 16.2% of patients (n=21). Long-term compliance with esomeprazole (capsule counts) was >75% for the majority of patients. Although 16.9% of patients (n=22) experienced AEs judged to be possibly related to treatment with esomeprazole, they were mostly mild and transient. The most commonly reported possibly treatment-related AEs were abnormal hepatic function, headache, increased gamma-glutamyltransferase levels and muscle spasms (2 patients each). Overall, 95.9% (95% confidence interval: 92.3, 99.4) of patients remained ulcer free at 1 year. CONCLUSION: Long-term treatment with esomeprazole (20 mg once daily) is well tolerated and efficacious for preventing ulcer recurrence in Japanese NSAID users with a history of peptic ulcer.Trail registration: ClinicalTrials.gov identifier NCT00595517.
BMC Gastroenterology 03/2013; 13(1):54. · 2.42 Impact Factor
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ABSTRACT: Background/Aims: To compare the endoscopic features of LDA-induced ulcers developing during secondary prophylaxis with lansoprazole (LPZ) and gefarnate (GFN). Methodology: All ulcers that had developed during prophylaxis with LPZ (15mg once daily) and GFN (50mg twice daily) in a prospective, randomized, double-blind trial, were reviewed and compared by a panel of expert endoscopists, based on endoscopic images available from the trial, to provide evidence for efficacy of LPZ versus GFN in secondary prophylaxis in patients with endoscopically confirmed ulcer scars. Results: A total of 6 and 53 patients had developed gastric or duodenal ulcers during prophylaxis with LPZ and GFN, respectively. Six gastric ulcers seen in those given LPZ were "small" and "shallow", while, of the 38 gastric ulcers seen those given GFN, 44.7% and 55.3% were "medium" or "large" and "small", respectively. Ulcers associated with blood coagula were seen only in those given GFN. Duodenal ulcers developed in 15 and 0 patients given GFN and LPZ, respectively. Conclusions: The ulcers developing during prophylaxis with GFN and LPZ varied in their features. The study findings may be useful when devising a strategy for prophylaxis of ulcers in high-risk patients receiving LDA therapy in a routine clinical setting.
Hepato-gastroenterology 03/2013; 60(124). · 0.66 Impact Factor
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Digestive Endoscopy 11/2012; 24(6):479. · 1.19 Impact Factor
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ABSTRACT: The demarcation line between the cancerous lesion and the surrounding area could be easily recognized with flexible spectral imaging color enhancement (FICE) system compared with conventional white light images. The characteristic finding of depressed-type early gastric cancer (EGC) in most cases was revealed as reddish lesions distinct from the surrounding yellowish non-cancerous area without magnification. Conventional endoscopic images provide little information regarding depressed lesions located in the tangential line, but FICE produces higher color contrast of such cancers. Histological findings in depressed area with reddish color changes show a high density of glandular structure and an apparently irregular microvessel in intervening parts between crypts, resulting in the higher color contrast of FICE image between cancer and surrounding area. Some depressed cancers are shown as whitish lesion by conventional endoscopy. FICE also can produce higher color contrast between whitish cancerous lesions and surrounding atrophic mucosa. For nearly flat cancer, FICE can produce an irregular structural pattern of cancer distinct from that of the surrounding mucosa, leading to a clear demarcation. Most elevated-type EGCs are detected easily as yellowish lesions with clearly contrasting demarcation. In some cases, a partially reddish change is accompanied on the tumor surface similar to depressed type cancer. In addition, the FICE system is quite useful for the detection of minute gastric cancer, even without magnification. These new contrasting images with the FICE system may have the potential to increase the rate of detection of gastric cancers and screen for them more effectively as well as to determine the extent of EGC.
World journal of gastrointestinal endoscopy. 08/2012; 4(8):356-61.
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ABSTRACT: Small-caliber endoscopy has lower resolution than normal-caliber endoscopy, limiting its use in routine outpatient practice. Flexible spectral imaging color enhancement (FICE) strengthens the color contrast of depressed-type early gastric cancer without magnification. The aim of the present study was to evaluate the detection of depressed-type early gastric cancer using small-caliber endoscopy with the FICE system.
Eighty-two patients diagnosed with depressed-type early gastric cancer by standard endoscopy and biopsy were evaluated by small-caliber endoscopy. FICE images and conventional images were compared. Color differences in all 82 lesions were measured between malignant lesions and the surrounding mucosa using the Commission Internationale de L'Eclairage (CIE) 1976 color space.
Most cancers were readily detected as reddish lesions on FICE images. Lines of demarcation between the malignant lesion and the surrounding mucosa were easily identified with FICE images, as such cancers could be clearly distinguished from the surrounding atrophic mucosa. Greater median color differences between malignant lesions and the surrounding mucosa were present in FICE images compared with conventional images, resulting in images with better contrast (27.2 vs 18.7, P<0.0001).
Small-caliber endoscopy with the FICE system provides better color contrast of depressed-type early gastric cancers than conventional small-caliber endoscopy, and the FICE system may facilitate the diagnosis of this type of cancer as a new endoscopic modality.
Digestive Endoscopy 07/2012; 24(4):231-6. · 1.19 Impact Factor
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ABSTRACT: We report a case of main pancreatic duct (MPD)-type intraductal papillary mucinous neoplasms of the pancreas (IPMNs), in whom
diagnostic imaging modalities showed abnormal findings after 4 episodes of acute pancreatitis. The patient was 51years old
at his first admission for acute pancreatitis. He experienced two more episodes of acute pancreatitis, though repeated computed
tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) showed no abnormality to explain the cause of the
pancreatitis. After 3½ years from his first episode of pancreatitis, CT and endoscopic ultrasonography revealed pancreatic
duct dilation of the pancreas head. Seven years after the first admission, a second ERCP and intraductal ultrasonography revealed
a partially dilated MPD with papillary tumors. He underwent pancreaticoduodenectomy, and the pathological diagnosis was intraductal
papillary mucinous adenoma with moderate atypia. This case suggests that acute pancreatitis can precede visualized IPMNs.
Therefore, acute recurrent pancreatitis with unknown etiology should be followed up for the possibility of IPMNs, in order
to detect neoplastic changes in the early stage to provide a better prognosis for the patient.
KeywordsIntraductal papillary mucinous neoplasms of the pancreas–Acute pancreatitis–Endoscopic retrograde cholangiopancreatography–Endoscopic ultrasonography
Clinical Journal of Gastroenterology 05/2012; 4(5):307-312.
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Digestive Endoscopy 05/2012; 24(3):195-6. · 1.19 Impact Factor
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ABSTRACT: The endoscopic appearance of gastric antral vascular ectasia (GAVE) can be easily misinterpreted as inflammatory changes of
gastric mucosa. We report on a case of GAVE that had been missed by conventional transnasal endoscopy but was diagnosed by
flexible spectral imaging color enhancement (FICE) with a transnasal endoscope. A 45-year-old woman with severe anemia presented
with a 1-month history of increasing fatigue. She was previously diagnosed as having acute antral gastritis by conventional
transnasal endoscopy (EG 530N2) because of the presence of reddish mucosal changes on the entire antral rugal fold. However,
the FICE images produced using a combination of new processor system (VP4450) and new small-caliber endoscope (EG 530NW),
did not show reddish mucosal changes on the entire rugal fold, but gave a clear image of dilated vessels associated with GAVE
distinct from the surrounding normal mucosa on the same fold. These findings are useful to differentiate GAVE from ordinary
gastritis. The lesions of GAVE were managed with a combination of focal pulse and spray-painting techniques to obliterate
the bulk of the disease in two sessions of argon plasma coagulation therapy. Three months later, the patient recovered from
iron deficiency anemia with an oral medication of iron tablets.
KeywordsFICE–GAVE–Transnasal endoscopy
Clinical Journal of Gastroenterology 04/2012; 4(1):15-18.
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ABSTRACT: Current conventional endoscopy often misses flat early gastric cancers (0–IIb) because they are sometimes invisible. We experienced
a case of small flat early gastric cancer that had been missed by normal-caliber conventional endoscopy. By small-caliber
endoscope, conventional endoscopy showed a subtle reddish change of gastric mucosa, but the image with flexible spectral imaging
color enhancement clearly showed a flat reddish lesion with 10mm diameter, distinct from the surrounding mucosa. Flat early
gastric cancer was suspected even though the lesion was not clearly described by conventional endoscopy. Histological examination
of biopsy specimen revealed atypical glands. Endoscopic submucosal dissection of the lesion was performed. Pathological examination
of the resected specimen confirmed well-differentiated adenocarcinoma localized in the mucosal layer without any depression
or protrusion compared with the surrounding mucosa, consistent with the endoscopic finding. The small flat early gastric cancer
became clearly visible with the new endoscopic technology.
KeywordsFICE-Flat early gastric cancer-Subtle mucosal change
Clinical Journal of Gastroenterology 04/2012; 3(2):88-91.
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ABSTRACT: We describe a case of interspousal transmission of hepatitisC virus (HCV) infection after 30years of marriage which was
confirmed by gene analysis. A 60-year-old man was referred to our hospital because of severe hepatic dysfunction. Laboratory
findings showed that HCV-Ab titer and qualitative Amplicor HCV were both positive in low levels. Because the patient regularly
consumes various health foods, it was initially difficult to rule out drug-induced hepatopathy, but the patient was diagnosed
with acute hepatitisC when HCV antibody titer increased 4months later. Because his wife also tested positive for HCV antibody,
interspousal transmission was suspected, and gene analysis was performed. Both husband and wife had HCV 1b, and the base sequence
homology of 1087 base pairs (bp) in the NS5B region was 98.6% (99.4% at the amino acid level). In addition, upon analysis
of the E1 and E2 junctional region sequence (268bp) including hypervariable region 1 (HVR-1), a close relationship (89.2–99.6%)
between clones obtained from each spouse was observed, thus confirming that the source of infection was his wife. Thorough
medical history taking suggested that sexual intercourse was the most likely route of infection. In previous large-scale clinical
studies, the frequency of HCV infection between married couples has been extremely low, but it is important to obtain informed
consent regarding the potential risk of infection.
Clinical Journal of Gastroenterology 04/2012; 3(1):50-56.
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Masayuki Arashiro,
Kiichi Satoh,
Hiroyuki Osawa,
Mitsuyo Yoshizawa,
Hidetoshi Nakano,
Hironari Ajibe,
Yoshimasa Miura,
Toru Yoshida,
Tomosuke Hirasawa,
Hironori Yamamoto, Kentaro Sugano
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ABSTRACT: Esophageal lymphangioma is a very rare disease. We report a case of esophageal lymphangioma successfully treated with endoscopic
submucosal dissection (ESD), which yielded definitive histological diagnosis and symptom relief. ESD offers a better option
for definitive diagnosis as well as complete resection of large esophageal lymphangiomas with flat configuration.
KeywordsEsophageal lymphangioma-Endoscopic mucosal resection-Endoscopic submucosal dissection
Clinical Journal of Gastroenterology 04/2012; 3(3):140-143.
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Choitsu Sakamoto, Kentaro Sugano,
Shinichi Ota,
Nobuhiro Sakaki,
Shin’ichi Takahashi,
Yukio Yoshida,
Taku Tsukui,
Hiroyuki Osawa,
Yukihiro Sakurai,
Junji Yoshino, [......],
Koji Yakabi,
Tsutomu Chiba,
Tooru Shimosegawa,
Jane E. Sheehan,
Susana Perez-Gutthann,
Takuhiro Yamaguchi,
David W. Kaufman,
Tsugumichi Sato,
Kiyoshi Kubota,
Akira Terano
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ABSTRACT: ObjectiveStudies in Western populations have shown the association of nonsteroidal anti-inflammatory drugs (NSAIDs) and upper gastrointestinal bleeding (UGIB). The role of Helicobacter pylori infection in NSAIDs-related UGIB remains to be studied. We conducted a case-control study in Japan to investigate these related topics.MethodsCases of UGIB due to duodenal or gastric ulcer, or gastritis were identified in 14 study hospitals in various areas of Japan. For each case, two controls were identified from population registries in the same district. Information on drugs and other risk factors was obtained from 175 cases and 347 controls by telephone interviews. Anti-H. pylori antibody in the urine was measured in a single laboratory for all the cases and 225 controls.ResultsThe odds ratio (OR) of UGIB was 5.5 for aspirin and 6.1 for other NSAIDs (NANSAIDs) (p<0.01). The OR for regular use was higher than for occasional use both for aspirin (7.7 vs 2.0) and NANSAIDs (7.3 vs 4.1). Loxoprofen (5.9), frequently used in Japan as a safe ‘prodrug’, was significantly associated with UGIB. The odds ratio for H. pylori infection was 4.9 and the relative excess risk due to the interaction between H. pylori and the use of NSAID was 1.2 (95% CI: −5.8–8.1).ConclusionNSAIDs including loxoprofen increase the risk of UGIB in Japan as in Western countries, with a similar magnitude of association. There was no evidence of biological interaction between NSAIDs and H. pylori infection.
European Journal of Clinical Pharmacology 04/2012; 62(9):765-772. · 2.85 Impact Factor
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Naoyuki Nishimura,
Kiichi Tamada,
Shinichi Wada,
Akira Ohashi,
Hisashi Hatanaka,
Katsuyuki Nakazawa,
Norikatsu Numao,
Aya Kitamura,
Kiichi Satoh,
Hironori Yamamoto, Kentaro Sugano
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ABSTRACT: A 51-year-old woman was admitted to our department because of upper abdominal pain. The serum IgG4 concentration was elevated,
and abdominal computed tomography revealed diffuse enlargement of the pancreas associated with a large cyst, measuring 8cm
in diameter. Endoscopic retrograde cholangiopancreatography revealed narrowing of the main pancreatic duct (from the body
to the tail), narrowing of the intrapancreatic bile duct, and dilatation of the bile ducts. The patient was given a diagnosis
of autoimmune pancreatitis (AIP) associated with a pancreatic pseudocyst and intrapancreatic bile duct stenosis. Oral steroid
therapy resulted in reduced pancreatic swelling, complete disappearance of the pancreatic cyst, and an improvement in biliary
stenosis. AIP is rarely associated with pancreatic cyst, and only 13 cases, including ours, have been reported to date. In
our patient, intense inflammation apparently led to cyst formation in association with AIP, which responded remarkably to
corticosteroid therapy. Correct diagnosis of AIP associated with a pancreatic pseudocyst might save patients from undergoing
unnecessary endoscopic and surgical procedures.
Clinical Journal of Gastroenterology 04/2012; 2(3):199-203.
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Francis Ka-Leung Chan,
Shinya Goto,
Ming-Shiang Wu,
Maria Teresa B Abola,
Khay Guan Yeoh,
Bambang Sutrisna,
Siew Siang Chua,
Varocha Mahachai,
Thana Turajane,
Brian Wu,
Qing Yu Zeng, Kentaro Sugano
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ABSTRACT: We established a working group to examine the burden of atherothrombotic and musculoskeletal diseases in Asia and made recommendations for safer prescribing of nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin.
By using a modified Delphi process, consensus was reached among 12 multidisciplinary experts from Asia. Statements were developed by the steering committee after a literature review, modified, and then approved through 3 rounds of anonymous voting by using a 6-point scale from A+ (strongly agree) to D+ (strongly disagree). Agreement (A+/A) by ≥ 80% of panelists was defined a priori as consensus.
We identified unique aspects of atherothrombotic and musculoskeletal diseases in Asia. Asia has a lower prevalence of degenerative arthritis and coronary artery disease than Western countries. The age-adjusted mortality of coronary artery disease is lower in Asia; cerebrovascular accident has higher mortality than coronary artery disease. Ischemia has replaced hemorrhage as the predominant pattern of cerebrovascular accident. Low-dose aspirin use is less prevalent in Asia than in Western countries. Traditional Chinese medicine and mucoprotective agents are commonly used in Asia, but their efficacy is not established. For Asian populations, little is known about complications of the lower gastrointestinal tract from use of NSAIDs and underutilization of gastroprotective agents. Our recommendations for preventing ulcer bleeding among users of these drugs who are at high risk for these complications were largely derived from Asian studies and are similar to Western guidelines.
By using an evidence-based, multidisciplinary approach, we have identified unique aspects of musculoskeletal and atherothrombotic diseases and strategies for preventing NSAID-related and low-dose aspirin-related gastrointestinal toxicity in Asia.
Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 04/2012; 10(7):753-60. · 5.64 Impact Factor
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Hiroto Miwa,
Uday C Ghoshal,
Sutep Gonlachanvit,
Kok-Ann Gwee,
Tiing-Leong Ang,
Full-Young Chang,
Kwong Ming Fock,
Michio Hongo,
Xiaohua Hou,
Udom Kachintorn, [......],
Kwang Jae Lee,
Ching-Liang Lu,
Sanjiv Mahadeva,
Soichiro Miura,
Hyojin Park,
Poong-Lyul Rhee, Kentaro Sugano,
Ratha-Korn Vilaichone,
Benjamin Cy Wong,
Young-Tae Bak
[show abstract]
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ABSTRACT: Environmental factors such as food, lifestyle and prevalence of Helicobacter pylori infection are widely different in Asian countries compared to the West, and physiological functions and genetic factors of Asians may also be different from those of Westerners. Establishing an Asian consensus for functional dyspepsia is crucial in order to attract attention to such data from Asian countries, to articulate the experience and views of Asian experts, and to provide a relevant guide on management of functional dyspepsia for primary care physicians working in Asia.
Consensus team members were selected from Asian experts and consensus development was carried out using a modified Delphi method. Consensus teams collected published papers on functional dyspepsia especially from Asia and developed candidate consensus statements based on the generated clinical questions. At the first face-to-face meeting, each statement was reviewed and e-mail voting was done twice. At the second face-to-face meeting, final voting on each statement was done using keypad voting system. A grade of evidence and a strength of recommendation were applied to each statement according to the method of the GRADE Working Group.
Twenty-nine consensus statements were finalized, including 7 for definition and diagnosis, 5 for epidemiology, 9 for pathophysiology and 8 for management. Algorithms for diagnosis and management of functional dyspepsia were added.
This consensus developed by Asian experts shows distinctive features of functional dyspepsia in Asia and will provide a guide to the diagnosis and management of functional dyspepsia for Asian primary care physicians.
Journal of neurogastroenterology and motility 04/2012; 18(2):150-68.
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Kentaro Sugano,
Teiji Kontani,
Shinichi Katsuo,
Yoshinori Takei,
Nobuhiro Sakaki,
Kiyoshi Ashida,
Yuji Mizokami,
Masahiro Asaka,
Shigeyuki Matsui,
Tatsuya Kanto,
Satoshi Soen,
Tsutomu Takeuchi,
Hideyuki Hiraishi,
Naoki Hiramatsu
[show abstract]
[hide abstract]
ABSTRACT: Low-dose lansoprazole has not been intensively evaluated for its efficacy in the prevention of recurrent gastric or duodenal ulcers in patients receiving long-term non-steroidal anti-inflammatory drug (NSAID) therapy for pain relief in such diseases as rheumatoid arthritis, osteoarthritis, and low back pain.
This multi-center, prospective, double-blind, randomized, active-controlled study involving 99 sites in Japan was designed to compare the efficacy of lansoprazole (15 mg daily) with gefarnate (50 mg twice daily). Patients with a history of gastric or duodenal ulcers who required long-term NSAID therapy were randomized to receive lansoprazole 15 mg daily (n = 185) or gefarnate 50 mg twice daily (n = 181) and followed up for 12 months or longer prospectively.
The cumulative incidence of gastric or duodenal ulcer at days 91, 181, and 361 from the start of the study was calculated by the Kaplan-Meier method as 3.3, 5.9, and 12.7%, respectively, in the lansoprazole group versus 18.7, 28.5, and 36.9%, respectively, in the gefarnate group. The risk for ulcer development was significantly (log-rank test, P < 0.0001) lower in the lansoprazole group than in the gefarnate group, with the hazard ratio being 0.2510 (95% CI 0.1400-0.4499). A long-term follow-up study showed an acceptable safety profile for low-dose lansoprazole therapy, with diarrhea as the most frequent adverse event.
Lansoprazole was superior to gefarnate in reducing the risk of gastric or duodenal ulcer recurrence in patients with a definite history of gastric or duodenal ulcers who required long-term NSAID therapy.
Journal of Gastroenterology 03/2012; 47(5):540-52. · 4.16 Impact Factor
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Lars Agréus,
Ernst J Kuipers,
Limas Kupcinskas,
Peter Malfertheiner,
Francesco Di Mario,
Marcis Leja,
Varocha Mahachai,
Niv Yaron,
Martijn van Oijen,
Guillermo Perez Perez,
Massimo Rugge,
Jukka Ronkainen,
Mikko Salaspuro,
Pentti Sipponen, Kentaro Sugano,
Joseph Sung
[show abstract]
[hide abstract]
ABSTRACT: Atrophic gastritis (AG) results most often from Helicobacter pylori (H. pylori) infection. AG is the most important single risk condition for gastric cancer that often leads to an acid-free or hypochlorhydric stomach. In the present paper, we suggest a rationale for noninvasive screening of AG with stomach-specific biomarkers.
The paper summarizes a set of data on application of the biomarkers and describes how the test results could be interpreted in practice.
In AG of the gastric corpus and fundus, the plasma levels of pepsinogen I and/or the pepsinogen I/pepsinogen II ratio are always low. The fasting level of gastrin-17 is high in AG limited to the corpus and fundus, but low or non-elevated if the AG occurs in both antrum and corpus. A low fasting level of G-17 is a sign of antral AG or indicates high intragastric acidity. Differentiation between antral AG and high intragastric acidity can be done by assaying the plasma G-17 before and after protein stimulation, or before and after administration of the proton pump inhibitors (PPI). Amidated G-17 will rise if the antral mucosa is normal in structure. H. pylori antibodies are a reliable indicator of helicobacter infection, even in patients with AG and hypochlorhydria.
Stomach-specific biomarkers provide information about the stomach health and about the function of stomach mucosa and are a noninvasive tool for diagnosis and screening of AG and acid-free stomach.
Scandinavian journal of gastroenterology 02/2012; 47(2):136-47. · 2.08 Impact Factor
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Hiroto Miwa,
Uday Chand Ghoshal,
Kwong Ming Fock,
Sutep Gonlachanvit,
Kok-Ann Gwee,
Tiing-Leong Ang,
Full-Young Chang,
Michio Hongo,
Xiaohua Hou,
Udom Kachintorn, [......],
Kwang Jae Lee,
Ching-Liang Lu,
Sanjiv Mahadeva,
Soichiro Miura,
Hyojin Park,
Poong-Lyul Rhee, Kentaro Sugano,
Ratha-korn Vilaichone,
Benjamin C Y Wong,
Young-Tae Bak
[show abstract]
[hide abstract]
ABSTRACT: Environmental factors such as food, lifestyle and prevalence of Helicobacter pylori infection are widely different in Asian countries compared with the West, and physiological functions and genetic factors of Asians may also be different from those of Westerners. Establishing an Asian consensus for functional dyspepsia is crucial in order to attract attention to such data from Asian countries, to articulate the experience and views of Asian experts, and to provide a relevant guide on management of functional dyspepsia for primary care physicians working in Asia.
Consensus team members were selected from Asian experts and consensus development was carried out by using a modified Delphi method. Consensus teams collected published papers on functional dyspepsia especially from Asia and developed candidate consensus statements based on the generated clinical questions. At the first face-to-face meeting, each statement was reviewed and e-mail voting was done twice. At the second face-to-face meeting, final voting on each statement was done using a keypad voting system. A grade of evidence and strength of recommendation were applied to each statement according to the method of the GRADE Working Group.
Twenty-nine consensus statements were finalized, including seven for definition and diagnosis, five for epidemiology, nine for pathophysiology, and eight for management. Algorithms for diagnosis and management of functional dyspepsia were added. Conclusions: This consensus developed by Asian experts shows distinctive features of functional dyspepsia in Asia and will provide a guide to the diagnosis and management of functional dyspepsia for Asian primary care physicians.
Journal of Gastroenterology and Hepatology 12/2011; 27(4):626-41. · 2.87 Impact Factor
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Gastrointestinal endoscopy 09/2011; 74(5):1157-61. · 6.71 Impact Factor
