Govind Makharia

All India Institute of Medical Sciences | AIIMS · Department of Gastroenterology and Human Nutrition

Background/aims: Evidence on predictors of primary nonresponse (PNR), and secondary loss of response (SLR) to anti-tumor necrosis factor (anti-TNF) agents in inflammatory bowel disease is scarce from Asia. We evaluated clinical/biochemical/molecular markers of PNR/SLR in ulcerative colitis (UC) and Crohn's disease (CD). Methods: Inflammatory bow...

Background: The pattern of practice regarding the diagnosis, dietary counselling and follow-up of patients with celiac disease (CeD) varies between practice to practice. Methods: A web-based questionnaire based on review of literature, group discussions and expert group meetings was developed to understand the practice of CeD in India. The quest...

Background: The information on seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among patients with inflammatory bowel disease (IBD) and its comparison to healthy controls is sparse. We compared the seroprevalence rates in patients with IBD and healthy controls (HCs). Methods: Patients with IBD and HCs (co...

Background Intestinal crypts form a pristine gut biogeographical niche, homing the intestinal stem cells and being the closest neighbors to underlying lamina propria. Initially believed to be sterile, the crypt lumen was recently shown to inhabit a conserved microbial population. However, the identity of the crypt-associated microbiota (CAM) remain...

Background Supplementation with exclusive enteral nutrition (EEN) in addition to standard of care with intravenous corticosteroids (SOC) augments the steroid response in patients with acute severe ulcerative colitis (ASUC). EEN is known to alter gut microbial composition. The present study identifies changes in gut microbiota driven by EEN in patie...

Trimethylamine (TMA) is produced by the intestinal microbiota as a by-product of metabolism of dietary precursors. TMA has been implicated in various chronic health conditions. However, the effect of TMA in the colon and the underlying mechanism was not clear. In this study, TMA exhibited toxic effects in vitro as well as in vivo. TMA-induced oxida...

Introduction: A subset of patients with celiac disease (CeD) has liver involvement in the form of hypertransaminasemia, liver cirrhosis, and autoimmune hepatitis. We conducted a systematic review with meta-analyses to determine the pooled prevalence of CeD in patients with cryptogenic cirrhosis, all-cause cirrhosis, cryptogenic hypertransaminasemi...

Background: Anti-tumor necrosis factor (anti-TNF) monoclonal antibody, infliximab, is the primary therapeutic modality for patients with Crohn's disease (CD) and ulcerative colitis (UC), refractory to conventional therapy. Biosimilars of infliximab have been shown to have equivalent efficacy to originator infliximab. We compared the safety and eff...

ABSTRACT Background: IgA anti-tissue transglutaminase-2 antibody (anti-TG2Ab) deposits in intestinal and extraintestinal organs have been used to link the respective pathological changes in these organs with celiac disease (CeD). Aims: To know if parts of intestine other than the duodenum, such as esophagus, stomach, and colon, have any pathology r...

Facebook (FB) is the most popular online networking platform. There are several FB pages dedicated to spreading awareness about the Celiac disease (CD). To get the latest information , a huge number of CD patients follow Celiac disease Facebook (CD-FB) pages. Such pages frequently post beneficial information. However, very less is known if they pro...

The use of smartphone-based applications as a telenutrition tool could redefine the nutritional management of IBD. We developed and validated a digital health platform in the form of a smartphone application for the nutritional assessment of IBD patients. Our team of gastroenterolo-gists and dieticians at the All-India Institute of Medical Sciences...

Citrulline is a non-protein amino acid, which is synthesized from glutamine in the small intestinal enterocytes. It is involved in three important metabolic pathways, including the de novo synthesis of arginine in the kidney, intrahepatic transformation of ammonia to urea, and nitric oxide synthesis. Since citrulline is synthesized mainly by entero...

Background and Aims COVID-19 is associated with long-term gastrointestinal sequelae; however, prospective longitudinal data are sparse. We prospectively studied the frequency, spectrum and risk factors of post infection functional gastro-intestinal disorders/disorders of gut-brain interaction (PI-FGID/DGBI) following COVID-19. Methods 320 cases wi...

Background The information on the risk of thromboembolism (TE) in inflammatory bowel disease (IBD) and its predictors are lacking, especially from developing countries. The present study evaluated the prevalence, predictors, and prognosis of TE in IBD.Methods This case–control study included 35 patients with IBD (ulcerative colitis [UC, n = 25]; Cr...

Background Gut microbiota modulation via faecal microbiota transplantation (FMT)is known to induce long lasting clinical as well as endoscopic remission in patients with UC. The present study aims to identify microbial and metabolomic changes in the faecal as well mucosal niches, in response to FMT in patients with UC. Methods 28 patients with mil...

Celiac disease (CeD) is a chronic gluten-induced enteropathy with plethoric manifestations. The typical manifestations of CeD such as chronic diarrhea and malabsorption are widely recognized, however, many patients have atypical manifestations like iron deficiency anemia, idiopathic short stature, hypertransaminesemia or infertility, etc. These pat...

The Asia-Pacific region has the largest number of cases of colorectal cancer (CRC) and one of the highest levels of mortality due to this condition in the world. Since the publishing of two consensus recommendations in 2008 and 2015, significant advancements have been made in our knowledge of epidemiology, pathology and the natural history of the a...

Background Stricturing Crohn’s disease (CD) is difficult to manage medically with limited treatment options, anti-tumor necrosis factor (TNF) therapy being the first-line therapy. Although thiopurines are also recommended first-line treatment option for maintenance of remission in steroid-dependent CD, evidence on their use in stricturing CD is lac...

Objective Microbiome and dietary manipulation therapies are being explored for treating ulcerative colitis (UC). We aimed to examine the efficacy of multidonor faecal microbiota transplantation (FMT) and anti-inflammatory diet in inducing remission followed by long-term maintenance with anti-inflammatory diet in patients with mild-moderate UC. Des...

Background: While celiac disease (CeD) is considered to affect primarily the small intestine, pathological changes in other parts of the gastrointestinal tract (GIT) are also known to occur. IgA anti-tissue transglutaminase-2 antibody (anti-TG2 Ab) deposits at the site of involvement is one of the methods to establish CeD-related tissue pathology....

Purpose: Withdrawal of thiopurines after remission is associated with an increased risk of relapse in patients with inflammatory bowel disease (IBD). However, long-term data on thiopurine withdrawal is limited, especially from developing countries where the cost of long-term therapy poses a significant burden on patients. Methods: Patients with...

Background Patients with celiac disease (CeD) can commonly present with symptoms of dyspepsia. We conducted a systematic review and meta-analysis of the present literature to assess the prevalence of CeD in patients diagnosed with dyspepsia.Methods We searched MEDLINE and EMBASE databases for the keywords: celiac disease, coeliac disease, anti-glia...

Coeliac disease is an immune‐mediated disease caused by ingestion of gluten in genetically susceptible individuals. Coeliac disease has been thought to affect mainly people of European origin but subsequently many studies revealed that it affects people living in North America, Oceania, South America, Asia as well as Africa. The global pooled serop...

Background: H. pylori-associated gastritis in patients from the high-altitude area of Ladakh showed severe gastritis, mucosal nodularity, atrophy, and cancer in comparison to those from North India. This study served to analyze if differences in the H. pylori virulence genotypes decide the extent of gastric mucosal inflammation. Methods: Fifty g...

Extra-pulmonary tuberculosis accounts for one fifth of patients with tuberculosis and 7% to 10% of them have abdominal tuberculosis. Abdominal tuberculosis is characterized by infection by tubercle bacilli of either peritoneum, intestine or abdominal lymph nodes. Intestinal tuberculosis most commonly involves ileocecum because of relative stasis, a...

Background: Histological changes induced by gluten in the duodenal mucosa of patients with non-coeliac gluten sensitivity (NCGS) are poorly defined. Objectives: To evaluate the structural and inflammatory features of NCGS compared to controls and coeliac disease (CeD) with milder enteropathy (Marsh I-II). Methods: Well-oriented biopsies of 262 cont...

Background/aims: Intestinal tuberculosis (ITB) and Crohn's disease (CD) frequently present with a diagnostic dilemma because of similar presentation. Interferon-gamma release assay (IGRA) has been used in differentiating ITB from CD, but with sparse reports on its diagnostic accuracy in tuberculosis endemic regions and this study evaluated the sam...

Background Anti‐tumor necrosis factor (anti‐TNF) therapy use in patients with inflammatory bowel disease (IBD) leads to an increased risk of tuberculosis (TB) reactivation despite latent tuberculosis (LTB) screening, especially in TB endemic regions. Aim We evaluated the effect of stringent screening strategy and LTB prophylaxis on TB reactivation...

Touraine-Solente-Gole syndrome is a rare, autosomal dominant multisystem disorder arising from dysregulated prostaglandin synthesis due to underlying genetic defects. Early symptoms are related to skin and soft tissue involvement (coarse facial features, widening of wrists, etc) and may thus be overlooked unless a careful physical examination is ca...

Background: Thiopurines are widely used to maintain remission in both Ulcerative Colitis (UC) and Crohn's Disease (CD). Reported effectiveness and tolerability rates have been variable across studies. There are only sparse data in Asian population regarding the long-term efficacy and safety of thiopurines. Methods: Records of 5351 patients follo...

Gluten ataxia is a rare immune-mediated neurological disorder caused by the ingestion of gluten. The diagnosis is not straightforward as antibodies are present in only up to 38% of patients, but often at lower titers. The symptoms of ataxia may be mild at the onset but lead to permanent damage if remain untreated. It is characterized by damage to t...

Background: Optimal outcomes in acute severe ulcerative colitis (ASUC) are related to time-bound management based upon early prediction of response to intravenous (IV) steroids. In an earlier study, we described the All India Institute of Medical Sciences (AIIMS) index (baseline Ulcerative Colitis Endoscopic Index of Severity [UCEIS] ≥ 7 and day 3...

Background The patients with positive celiac disease (CeD) specific serology, but no evidence of intestinal inflammation are defined as potential celiac disease (PCeD) patients. About one-third of PCeD patients develop intestinal inflammation over time. The present study investigated the metabolome of small intestinal biopsies, blood plasma, and ur...

Malabsorption is referred to as a state of inability to absorb and transport the absorbed dietary nutrients. Maldigestion is defined as a state of deficiency of digestive enzymes, including the gastric and pancreatic juices and bile salt, resulting in the impaired breakdown of dietary nutrients to absorbable monosaccharides, disaccharides, oligosac...

Background/aims: Existing therapeutic options for complicated Crohn's disease (CD) like biologics and surgery are limited by inadequate long-term efficacy, cost, and adverse effects. Tissue hypoxia is important in CD pathogenesis and may be ameliorated with hyperbaric oxygen therapy (HBOT). We assessed the efficacy and tolerability of HBOT in smal...

Cronkhite–Canada syndrome is a rare non-hereditary disease characterized by gastrointestinal hamartomatous polyposis and protein-losing enteropathy. The presenting symptoms are onychodystrophy, skin pigmentation, alopecia, weight loss, and diarrhea. Diagnosis is suggested by a combination of clinical, imaging, and endoscopy findings, and histology...

Background Anti-tumour necrosis factor (anti-TNF) therapy use in patients with inflammatory bowel disease (IBD) leads to increased risk of tuberculosis (TB) reactivation despite LTB screening, especially in TB endemic regions. We evaluated the effect of stringent screening strategy and latent tuberculosis (LTB) prophylaxis on TB reactivation. Meth...

Background Withdrawal of thiopurines after remission has been shown to be associated with an increased risk of relapse in patients with inflammatory bowel disease. However, long-term data on thiopurine withdrawal is limited especially from developing countries. Methods We retrospectively analyzed data of patients with IBD on thiopurine monotherapy...

Background Thiopurines are widely used to maintain remission in both ulcerative colitis (UC) and Crohn’s Disease (CD). Reported effectiveness and tolerability rates have been variable across studies. Moreover, there are only sparse data in the Asian population regarding the long-term efficacy and safety of azathioprine (AZT). Methods Records of 53...

Background Introduction-Telenutrition with digital health platforms is the future step towards improving patient care in patients with inflammatory bowel disease(IBD). Additionally, it offers an advantage of conducting multicenter longitudinal dietary intervention studies. Aim-To develop and validate a digital health platform for patients with IBD...

Background Exclusive enteral nutrition (EEN) acts as an adjunctive therapy to intravenous corticosteroids in patients with ASUC. Recently reported by Sahu et.al., patients with ASUC undergoing EEN showed reduced corticosteroid failure rates compared with standard-of-care (SOC) group1. While the mechanism of action of EEN is unclear, EEN is known to...

Background The information on seroprevalence rates of COVID-19 infection among patients with inflammatory bowel disease (IBD) and its comparison to healthy controls is sparse. We compared the seroprevalence rates in immunocompromised and immunocompetent IBD patients and healthy controls. Methods Patients with IBD under follow-up at the IBD clinic,...

Background Inflammatory bowel disease (IBD) including Ulcerative Colitis (UC) and Crohn’s Disease (CD) is characterized by remitting/relapsing course. A proportion of patients with UC, and almost all patients with CD require long-term immunosuppression to maintain endoscopic and clinical remission and prevent disease progression. The present study...

Background Crohn’s disease (CD) and intestinal tuberculosis (ITB) are chronic granulomatous inflammatory disorders characterized by a compromised mucosal immunity. Even with diverging etiologies, CD and ITB presents an uncanny resemblance in clinical manifestation resulting in diagnostic dilemma. The gut microbiota regulates myriad of gut mucosal i...

Background: Symptomatic evaluation using Eckardt score and achalasia-specific health-related quality-of-life and physiological evaluation using timed barium examination (TBE) and high-resolution manometry is integral to the diagnosis of achalasia. However, the correlation of physiological outcomes with symptomatic outcomes and their role in routin...

THE EFFECT OF SOCIAL MEDIA TO THE BRAND AWARENESS OF A PRODUCT OF A COMPANY ON STUDENTS

Happiness is an emotional state characterized by feeling of joy, satisfaction, contentment and fulfillment. The two key components of happiness are the balance of emotions and life satisfaction. According to World Happiness Report 2021, India ranked 139 out of 149 countries on the basis of happiness index. India is set to become the world's younges...

Coeliac disease is a systemic disorder characterized by immune-mediated enteropathy, which is caused by gluten ingestion in genetically susceptible individuals. The clinical presentation of coeliac disease is highly variable and ranges from malabsorption through solely extra-intestinal manifestations to asymptomatic. As a result, the majority of pa...

A gluten-free diet (GFD) is the current standard of care for all patients with celiac disease (CeD) including its classic, nonclassic, and silent forms, as well as for dermatitis herpetiformis, gluten ataxia, and nonceliac gluten sensitivity. Following a GFD involves restricting certain food items, thus care must be taken to ensure a balanced diet...

Celiac disease was once thought to affect people from European origin only but subsequently it was recognized that it affects Caucasians living in North America, Oceania, and even South America. Celiac disease is now known to affect non-Caucasian populations including Africans and Asians. Therefore, celiac disease has now become a global disease an...

Celiac disease (CD) is a systemic disorder characterized by immune-mediated enteropathy caused by gluten ingestion in genetically susceptible individuals. CD is now established as a global disease with a worldwide prevalence of ~ 1%, however, population-based prevalence data is lacking from several countries. The population-based data suggest that...

Background Growth retardation is an important feature of celiac disease (CeD) that can lead to the failure of attainment of potential adult height. There is lack of data on the spectrum of height in treatment-naïve patients with CeD, with normal expected height at one end and short stature at the other.Methods We performed a retrospective analysis...

To the Editors, We read with interest the insightful study by Grossberg et al, highlighting a wide variation in adherence to guidelines on dysplasia surveillance and chromoendoscopy (CE).¹ No previous study has explored attitudes and perceptions towards IBD dysplasia surveillance from India, despite literature suggesting similar IBD-associated colo...

AimsLockdown and restricted mobility due to the pandemic of corona virus disease 2019 (COVID-19) has severely affected the continuity of healthcare of patients with acute and chronic diseases. We evaluated the impact of COVID-19 on the adherence to gluten-free diet (GFD), symptom control, and quality of life (QOL) in patients with celiac disease (C...

Aim To estimate acute gastrointestinal injury (AGI) in critically ill children and association of its severity with mortality. Methods In a prospective cohort study, critically ill children (1 month–18 years) were enrolled. Gastrointestinal symptoms over the first week of admission were classified into AGI grades 1 through 4, using a paediatric ad...

Background Based on recent research reports, dysbiosis and improper concentrations of microbial metabolites in the gut may result into the carcinogenesis of colorectal cancer. Recent advancement also highlights the involvement of bacteria and their secreted metabolites in the cancer causation. Gut microbial metabolites are functional output of the...

Climate change has been described as the greatest public health threat of the 21st century. It has significant implications for digestive health. A multinational team with representation from all continents, excluding Antarctica and covering 18 countries, has formulated a commentary which outlines both the implications for digestive health and ways...

Background and Aim: While celiac disease (CeD) is considered to affect primarily the small intestine, pathological changes of other parts of the gastrointestinal tract (GIT) are also known. However, there is no established method to diagnose the extra-intestinal pathologies in CeD. IgA anti-tissue transglutaminase 2 antibody (anti-TG2 Ab) deposits...

Sarcopenia and visceral fat independently predict poor outcomes in Crohn’s disease (CD). However, combined influence of these parameters on outcomes is unknown, and was investigated in the present study. This retrospective study evaluated skeletal muscle index (SMI-cross-sectional area of five skeletal muscles normalized for height), visceral and s...

Aim: We conducted this network meta-analysis to compare the efficacy and safety of targeted pharmacotherapies and fecal microbial transplantation (FMT). Patients & methods: Nineteen studies were included and there was only one head-to-head randomized controlled trial (adalimumab vs vedolizumab). Results: All interventions, including FMT, were super...

Human progress during the last 100 years came at a huge cost to the environment. As we face the challenge of a warming climate, many measures of GI health are already problematic. The impact of climate change will be felt most severely in lower-income countries, which already struggle to deliver care. Climate change will pose significant additional...

Background and Aim Human Leukocyte Antigen DQ (HLA-DQ) genotypes play a permissive role in the genesis of celiac disease (CeD). In this case–control study, we used next-generation sequencing to determine HLA-DQA1 and ~DQB1 genotypes and haplotypes associated with CeD in Indian patients. Methods HLA-DQA1 and ~DQB1 loci were amplified, using long-ra...

Gluten-free (GF) diet is the only reliable treatment for patients with celiac disease (CeD), but data on the extent of gluten contamination in GF food available in India is scanty. We evaluated gluten content in labeled, imported, and non-labeled GF food products currently available in the Indian market. Overall, 794 processed and commercially avai...