Publications by authors named "Hidetaka Okubo"
Objective: Reflux oesophagitis (RO) is one of the most common diseases encountered by gastroenterologists and primary care physicians. However, few epidemiological studies have investigated the association of medication use and RO. This study aimed to investigate the prevalence of RO and its risk factors, particularly with respect to medication use.
View Article and Find Full Text PDFIntroduction: Constipation is one of the most common gastrointestinal symptoms. It may compromise quality of life and social functioning and result in increased healthcare use and costs. We aimed to evaluate the prevalence and risk factors of constipation symptoms, as well as those of refractory constipation symptoms among patients who underwent colonoscopy.
View Article and Find Full Text PDFBackground: Helicobacter pylori causes peptic ulcers and accounts for over 90% of gastric cancers; however, eradication rates have been declining due to antimicrobial resistance. Vonoprazan (VPZ), a potassium-competitive acid blocker, produces rapid and profound gastric acid suppression and has shown promising effects in the improvement of H. pylori eradication rates.
View Article and Find Full Text PDFBackground: Entamoeba histolytica infection is a sexually transmitted disease in some developed countries. Asymptomatic infection often occurs and can be a source of transmission; however, limited data are available regarding the pathogenesis of E. histolytica.
View Article and Find Full Text PDFBackground: It remains unclear whether type of antiplatelet (AP) therapy, AP combination therapy, and AP continuing or switching strategy affect the risk of post-polypectomy bleeding (PPB). In this study, we sought to elucidate this risk.
Methods: We analyzed 1050 patients who underwent colonoscopic polypectomy: 525 AP users and 525 controls matched for age, sex, comorbidities, concomitant non-steroidal anti-inflammatory drugs use, and polyp characteristics who did not receive antithrombotics.
Background/aim: We evaluated the efficacy of vonoprazan (VPZ), a novel potassium-competitive acid blocker, in patients with proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD), exhibiting continued pathological esophageal acid exposure (EAE).
Methods: Despite ≥8 weeks of appropriate PPI therapy, patients with -persistent reflux symptoms and pathological EAE times (EAETs ≥4%) were invited to switch to VPZ treatment. After an 8-week-course of once-daily VPZ (20 mg), multichannel intraluminal impedance-pH (MII-pH) monitoring was repeated to compare gastric acid exposure times (GAETs), EAETs, and other reflux parameters relative to the baseline values.
Article Synopsis
- * Key factors linked to rebleeding include shock, comorbidities, and low platelet and albumin levels, while thromboembolism risks were associated with INR levels and anticoagulant management practices.
- * The research suggests that early endoscopy can be safely performed in anticoagulant users, and that careful management of anticoagulant therapy is crucial to minimize rebleeding and thromboembolism risks.
Background & Aims: We performed a retrospective cohort study of patients with and without gastrointestinal bleeding (GIB) to determine whether GIB increases the risks of thromboembolism and death.
Methods: We collected data from 522 patients with acute severe GIB and 1044 patients without GIB (control subjects, matched for age, sex, year of diagnosis, history of thromboembolism, and use of antithrombotic drugs) who underwent endoscopy at the National Center for Global Health and Medicine in Japan from January 2009 through December 2014. Hazard ratios of GIB for thromboembolism and mortality risk were estimated, adjusting for confounders.
Background And Aim: The study developed a predictive model of long-term gastrointestinal (GI) bleeding risk in patients receiving oral anticoagulants and compared it with the HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratios, Elderly, Drugs/alcohol concomitantly) score.
Methods: The study periodically followed a cohort of 508 patients taking oral anticoagulants (66 direct oral anticoagulants users and 442 warfarin users). Absence of GI bleeding at an initial examination and any subsequent GI bleeding were confirmed endoscopically.
Article Synopsis
- * In the first study, 29% of patients experienced severe LGIB, with a sharp increase to 75.7% in those scoring 5 or higher on the NOBLADS scale, showing its effectiveness in predicting outcomes.
- * The validation study confirmed the NOBLADS score's reliability, with 35% of 161 patients developing severe LGIB and a strong correlation with longer hospital stays and increased need for blood transfusions.
Aim: To elucidate the rates of recurrence and mortality in acute esophageal variceal bleeding and the associated risk factors.
Methods: A cohort of 174 patients emergently hospitalized for esophageal variceal bleeding was analyzed. All patients underwent endoscopic variceal ligation within 3 h of arrival.
Article Synopsis
- A study was conducted to compare the severity of upper gastrointestinal (GI) symptoms between HIV-infected and non-HIV-infected patients, focusing on candida and erosive esophagitis.
- Out of 6,011 enrolled patients, it was found that HIV-infected individuals reported significantly higher scores for several symptoms such as heartburn and nausea compared to their non-HIV counterparts.
- The analysis revealed that symptoms like dysphagia and odynophagia were specifically linked to candida esophagitis in non-HIV patients, while heartburn and acid regurgitation were associated with erosive esophagitis, but none of the symptoms correlated with CD4 counts in HIV patients.
Article Synopsis
- The study examined the safety and effectiveness of early colonoscopy (within 24 hours of admission) compared to elective colonoscopy (after 24 hours) for acute lower gastrointestinal bleeding.
- Using data from 538 patients and propensity score matching, the researchers found no significant differences in adverse events or mortality between the two groups.
- However, early colonoscopy led to higher detection of bleeding sources and shorter hospital stays (10 days vs. 13 days), indicating its potential benefits in emergency cases.
Aim: To investigate the factors associated with transfusion, further bleeding, and prolonged length of stay.
Methods: In total, 153 patients emergently hospitalized for diverticular bleeding who were examined by colonoscopy were prospectively enrolled. Patients in whom the bleeding source was identified received endoscopic treatment such as clipping or endoscopic ligation.
Background: There are limited data on the safety of colonoscopy in patients with lower gastrointestinal bleeding (LGIB). We examined the various adverse events associated with colonoscopy in acute LGIB compared with non-GIB patients.
Methods: Emergency hospitalized LGIB patients (n = 161) and age- and gender-matched non-GIB controls (n = 161) were selected.
Article Synopsis
- The study investigates long-term trends and risk factors for candida esophagitis (CE) among HIV-infected and non-HIV-infected patients, analyzing data from over 80,000 patients who underwent endoscopy between 2002 and 2014.
- CE prevalence was found to be 1.7% overall, with higher rates in HIV-infected (9.8%) versus non-HIV-infected (1.6%) patients, showing an increase in non-HIV patients and a decrease in HIV patients over time.
- Risk factors for CE included older age, HIV infection, corticosteroid use, and low CD4 counts in HIV patients, while factors like smoking and acetaminophen use showed marginal associations, but
Visceral fat accumulation affects risk of colonic diverticular hemorrhage.
Int J Colorectal Dis
October 2015
Purposes: Factors other than antithrombotic drugs associated with diverticular bleeding remain unknown. Visceral adiposity contributes to atherosclerosis and may affect arteriolar change at the diverticulum. We investigated whether visceral adipose tissue (VAT) measured by computed tomography (CT) is a risk factor for diverticular bleeding.
View Article and Find Full Text PDFBackground: This study aims to investigate the association between body mass index (BMI) or intra-abdominal fat measured by computed tomography (CT) and bowel symptoms.
Method: A cohort of 958 Japanese adults who underwent colonoscopy and CT and completed questionnaires after excluding colorectal diseases was analyzed. Six symptoms (constipation, diarrhea, loose stools, hard stools, fecal urgency, and incomplete evacuation) using a 7-point Likert scale were evaluated between baseline and second questionnaire for test-retest reliability.
Background And Aim: Visceral adiposity is a strong determinant of insulin resistance, which decreases cholecystokinin response sensitivity, and increases cholesterol saturation in the gallbladder bile; thus, it potentially relates to gallstone disease development. We aimed to investigate whether visceral fat measured by computed tomography (CT) is a risk factor for gallstone disease.
Methods: A cohort of 717 participants undergoing CT and ultrasonography was analyzed.
Background: The clinical significance of performing computed tomography (CT) for acute lower gastrointestinal bleeding (LGIB) remains unknown. This study aimed to evaluate the role of urgent CT in acute LGIB settings.
Methods: The cohort comprised 223 patients emergently hospitalized for LGIB who underwent early colonoscopy within 24 h of arriving at the hospital, including 126 who underwent CT within 3 h of arrival.
Background: It remains unclear whether diverticulosis, absent inflammation, is responsible for chronic bowel symptoms. We examined the association between bowel symptoms and asymptomatic diverticulosis.
Method: This case-control study included 543 patients with diverticulosis and 1086 age and sex-matched controls (1:2) without diverticulosis on screening colonoscopy.
Article Synopsis
- The study examined how proton-pump inhibitors (PPIs) influence the risk of lower gastrointestinal bleeding (LGIB) and their interactions with various common medications such as NSAIDs, aspirin, clopidogrel, and warfarin.
- Researchers analyzed data from 355 patients with LGIB and over 8,200 non-bleeding patients, assessing factors like age, alcohol use, and drug exposure through colonoscopy.
- Findings revealed that PPI use had no significant association with an increased risk of LGIB, regardless of the specific type of PPI or concurrent use of other medications.
Background And Aim: Visceral fat contributes to insulin resistance and atherosclerosis. We retrospectively investigated whether abdominal fat accumulation, as measured by computed tomography, is a risk of ischemic colitis and related clinical outcomes.
Materials And Methods: Outpatient-onset ischemic colitis patients (n = 58) and age- and sex-matched controls (n = 58) underwent colonoscopy and computed tomography.
Aim: To determine the effect of discontinuing non-steroidal antiinflammatory drugs (NSAIDs) on recurrence in long-term follow-up patients with colonic diverticular bleeding (CDB).
Methods: A cohort of 132 patients hospitalized for CDB examined by colonoscopy was prospectively enrolled. Comorbidities, lifestyle, and medications (NSAIDs, low-dose aspirin, antiplatelet agents, anticoagulants, acetaminophen, and corticosteroids) were assessed.