Priority stratification for colonoscopy based on two-sample faecal immunochemical test screening: results from a cross-sectional study at an endoscopy clinic in Japan.

Objectives: Little has been reported on the yield and characteristics of colorectal neoplasia detected by the two-sample faecal immunochemical test (FIT), particularly the difference between subjects with two-positive results on the two-sample FIT and those with one-positive results. We aimed to assess risk stratification among patients with positive two-sample FIT to prioritise colonoscopy.

Design: A retrospective cross-sectional study.

Inverse time trends of peptic ulcer and reflux esophagitis show significant association with reduced prevalence of infection.

Introduction: Recent prevalence and trends of gastric/duodenal ulcer (GU/DU) and reflux esophagitis (RE) are inadequate.

Methods: We reviewed the records of consecutive 211,347 general population subjects from 1991 to 2015.

Results: During the 25 years, the prevalence of GU and DU has gradually decreased (from 3.

Efficacy of repeat review with flexible spectral imaging color enhancement in patients with no findings by capsule endoscopy.

Background/aim: The efficacy of flexible spectral imaging color enhancement (FICE) ch. 1 (F1) for the detection of ulcerative lesions and angioectasias in the small intestine with capsule endoscopy (CE) has been reported. In the present study, we evaluated whether F1 could detect incremental findings in patients with no findings in a standard review mode.

Endoscopic gastric atrophy is strongly associated with gastric cancer development after Helicobacter pylori eradication.

Background: Risk factors for gastric cancer during continuous infection with Helicobacter pylori have been well documented; however, little has been reported on the risk factors for primary gastric cancer after H. pylori eradication. We conducted a retrospective, endoscopy-based, long-term, large-cohort study to clarify the risk factors for gastric cancer following H.

Association Between Colorectal Cancer and Atherosclerotic Diseases: A Study Using a National Inpatient Database in Japan.

Background: Both colorectal neoplasms and atherosclerosis can be induced by common visceral fat accumulation. However, the association between these diseases at the advanced stage, colorectal cancer and cardiovascular/cerebrovascular diseases, has not been elucidated.

Aims: This study aimed to investigate the association between colorectal cancer and vascular diseases in relation to obesity and metabolic disorders, using a nationwide database of hospitalized patients in Japan.

Gastric cancer diagnosed after Helicobacter pylori eradication in diabetes mellitus patients.

Background: Helicobacter pylori infection is the most important risk factor for gastric cancer, for which eradication therapy is commonly performed. However, gastric cancer is sometimes discovered after successful eradication of H. pylori.

Association between colorectal polyps and hypertension treatment.

Objective: Patients who take drugs regularly are increasing, not least due to metabolic and orthopedic diseases. In the present study we aimed to investigate the association between the use of drugs, such as non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin, and colorectal polyps diagnosed based on colonoscopic findings.

Methods: In total, 1318 consecutive patients who underwent total colonoscopy for the first time were cross-sectionally analyzed.

Risk factors for small bowel angioectasia: The impact of visceral fat accumulation.

Aim: To investigate visceral fat accumulation in association with the risk of small bowel angioectasia.

Methods: We retrospectively investigated 198 consecutive patients who underwent both capsule endoscopy and CT for investigation of obscure gastrointestinal bleeding (OGIB) from January 2009 to September 2013. The visceral fat area (VFA) and subcutaneous fat area were measured by CT, and information on comorbidities, body mass index, and medications was obtained from their medical records.

Neutrophil infiltration and the distribution of intestinal metaplasia is associated with metachronous gastric cancer following endoscopic submucosal dissection.

Background: Endoscopic submucosal dissection (ESD) of early gastric cancer is a minimally invasive procedure. However, the risk for metachronous cancers after successful cancer treatment remains high and the risk factors for metachronous cancers have not been elucidated.

Objective: To evaluate the risk factors for metachronous gastric cancers after ESD with a long-term follow-up.

Trend and risk factors of diverticulosis in Japan: age, gender, and lifestyle/metabolic-related factors may cooperatively affect on the colorectal diverticula formation.

Background: Despite the marked increase of diverticulosis, its risk factors have not been adequately elucidated. We therefore aim to identify significantly associated factors with diverticulosis. We also aim to investigate the present state of diverticulosis in Japan.

Distribution of intestinal metaplasia as a predictor of gastric cancer development.

Background And Aim: Helicobacter pylori, gastritis, and intestinal metaplasia (IM) are known risk factors for gastric cancer. In the present study, we conducted a cohort study to evaluate the predictive value of the distribution of IM for gastric cancer development.

Methods: We conducted a retrospective cohort study at a university hospital.

Impact of fecal occult blood on obscure gastrointestinal bleeding: observational study.

Aim: To elucidate the association between small bowel diseases (SBDs) and positive fecal occult blood test (FOBT) in patients with obscure gastrointestinal bleeding (OGIB).

Methods: Between February 2008 and August 2013, 202 patients with OGIB who performed both capsule endoscopy (CE) and FOBT were enrolled (mean age; 63.6 ± 14.

Characterization of a new small bowel adenocarcinoma cell line and screening of anti-cancer drug against small bowel adenocarcinoma.

Small bowel adenocarcinoma (SBA) is a rare, aggressive malignancy with a poor prognosis, and the mechanisms of carcinogenesis in SBA remain unclear. Our aims were to investigate the molecular mechanisms underlying SBA and to identify treatments by establishing and characterizing an SBA cell line and performing anti-cancer drug screening. SIAC1 cells, established from jejunal SBA, showed epithelial characteristics and formed organoids in 3D culture.

Factors affecting in-hospital mortality in patients with lower gastrointestinal tract bleeding: a retrospective study using a national database in Japan.

Background: Bleeding of the lower gastrointestinal tract requires hospitalization and can cause in-hospital death in the most serious cases; however, only a few studies have evaluated in-hospital death from bleeding of the lower gastrointestinal tract. The aim of this study was to investigate the in-hospital mortality of patients with bleeding of the lower gastrointestinal tract and elucidate the factors associated with it using a large-scale database.

Methods: We analyzed a nationwide database in Japan retrospectively.

Randomized controlled trial comparing the efficacy of mosapride plus omeprazole combination therapy to omeprazole monotherapy in gastroesophageal reflux disease.

Objective: We investigated whether the prokinetic activity of mosapride, a 5-hydroxytryptamine 4 receptor agonist, in combination with proton pump inhibitor (PPI) would ameliorate symptoms of gastroesophageal reflux disease (GERD) in Japanese patients.

Methods: Patients who experienced reflux symptoms more than twice weekly were eligible for this study. In all, 60 patients were randomized to receive mosapride 5 mg thrice daily combined with omeprazole 10 mg once daily (GO group), or omeprazole alone (O group) for 4 weeks.

Pulse-wave velocity, the ankle-brachial index, and the visceral fat area are highly associated with colorectal adenoma.

Background: Although both colorectal neoplasms and atherosclerosis may be induced by visceral fat accumulation, no association between these factors has yet been elucidated.

Methods: Among Japanese participants in our colonoscopic screening and annual surveillance programs, asymptomatic subjects were investigated. Visceral fat area was measured by computed tomography, and the ankle-brachial index and pulse-wave velocity (markers of systemic atherosclerosis) were also estimated.

Sonographic detection of a patency capsule prior to capsule endoscopy: case report.

To avoid retention of the capsule used in capsule endoscopy (CE), the patency capsule (PC), a self-disintegrating sham capsule, is administered prior to CE in patients suspected of small intestinal stenosis. If the PC is excreted intact within 30 hours of ingestion, the patient can undergo CE without retention. However, if the PC is not excreted within 30 hours, its location must be confirmed as in either the small intestine or the colon because of the potential for small intestinal stenosis in the former case.

Irsogladine improves small-intestinal injuries in regular users of nonsteroidal anti-inflammatory drugs.

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) cause a high frequency of mucosal injuries in the small intestine. However, no reliable intervention, other than cessation of NSAIDs, has been established.

Objective: To evaluate whether irsogladine maleate reduces these injuries while continuing NSAID therapy.

Utility of single and double balloon endoscopy in patients with difficult colonoscopy: a randomized controlled trial.

Aim: To compare the utility of single-balloon colonoscopy (SBC) or double-balloon colonoscopy (DBC) for difficult colonoscopies.

Methods: Between August 2008 and June 2010, patients in whom total colonoscopy failed within 30 min of insertion were assigned randomly to undergo either SBC or DBC. No sedatives were used.

Feasibility of spiral enteroscopy in Japanese patients: study in two tertiary hospitals.

Background And Aim: Despite recent advances in enteroscopy, such as balloon enteroscopy, accessing the small intestine remains challenging. Spiral enteroscopy is a novel technique in which an endoscope is fitted with a rotating overtube that has a soft spiral fin at the tip. Whereas spiral enteroscopy is beginning to be carried out in Western countries, it is not common in many Asian countries.

Feasibility of a new self-expandable metallic stent for patients with malignant colorectal obstruction.

Aim: Stent migration due to peristalsis of the colon is one of the unresolved complications of colonic self-expandable metallic stent (SEMS) placement. Axial force (AF), a recovery force of the stent to a straight position after bending, has been considered a factor influencing the conformability of the digestive tract. An uncovered SEMS (Niti-S Enteral Colonic Uncovered Stent, D-type; Taewoong, Inc.

Efficacy of flexible spectral imaging color enhancement on the detection of small intestinal diseases by capsule endoscopy.

Objective: The aim of this study was to estimate the efficacy of flexible spectral imaging color enhancement (FICE) on the detection of small intestinal diseases by capsule endoscopy (CE).

Methods: Six individuals without significant lesions and 18 patients with following diseases were selected: four tumors, five angioectasias, seven ulcerative diseases, one ulcerative lesion and tumor and one ulcerative lesion and angioectasia. Three endoscopists reviewed all CE videos on standard and three types of FICE modes and compared their sensitivity and specificity for detection of small intestinal diseases.

Successful treatment of early-stage jejunum adenocarcinoma by endoscopic mucosal resection using double-balloon endoscopy: a case report.

Small bowel adenocarcinoma (SBA) has generally been considered to have a poor prognosis because of nonspecific presentations and difficulties in detection of the disease. The advent of capsule endoscopy (CE) and double-balloon endoscopy (DBE) makes it possible to access to the small intestine for endoscopic interventions. We describe a successful case of early jejunum adenocarcinoma completely resected by endoscopic mucosal resection (EMR) using double-balloon endoscopy (DBE).