Despite of the widespread use of hydrogen and methane breath test, the variability in testing protocols, gas measurement techniques, and interpretation criteria continues to challenge the reproducibility and comparability across centers, especially in the Asia-Pacific region. The Asian Neurogastroenterology and Motility Association hence presents the first Asian monograph guiding application and interpretation of breath test. The monograph was formulated according to the framework of indications, preparatory process, performance, and interpretation of results, as well as future direction for research.
Liver cirrhosis,characterized by diffuse hepatocytes necrosis,insufficient regeneration of hepatocytes,angiogenesis,severe fibrosis and the formation of pseudolobules,is a progressive chronic hepatic disease induced by a variety of causes.It is clinically characterized by liver function damage and portal hypertension,and many complications may occur in the late stage.Based on the update relevant guidelines,experts′ consensus,and research advances on the diagnosis and treatment of cirrhosis,Chinese Society of Gastroenterology of Chinese Medical Association established a consensus aiming to standardize the clinical diagnosis and treatment of liver cirrhosis and guide clinical practice.This consensus contains 43 statements on the etiology,pathology and pathogenesis,clinical manifestations,major complications,diagnosis,treatment,prognosis and chronic disease management of liver cirrhosis.Since several guidelines and experts′consensus on the complications of liver cirrhosis have been published,this consensus focuses on the research progress of liver cirrhosis itself.
深在性囊性胃炎(GCP)是一种罕见的以胃黏膜下腺体囊性增生为特征的胃部病变，常见病变部位为胃窦和胃体，累及胃体、胃窦多部位的GCP病例罕有报道。本文报道1例胃体、胃窦部多发GCP且伴有高级别上皮内瘤变患者的诊治经过，以期提高临床医师对该病的认识。
Objective:To compare the difference between gas volume score (GVS) method and combination of computed tomography (CT) image and calculation formula method (hereinafter referred to as CT method) in the detection of gastrointestinal gas volume in functional dyspepsia (FD) patients.Methods:From December 1, 2021 to June 30, 2022, 27 FD patients (FD group) who visited the Department of Gastroenterology and Hepatology of Tianjin Medical University General Hospital were enrolled. At the same period, 30 healthy controls were selected from the database of check-up center as the healthy control group. All the participants of the two groups underwent erect plain abdominal X-ray and abdominal CT scan. The GVS and CT methods were used to calculate and compare gastrointestinal gas volume between two groups of patients, as well as patients with FD subtypes (postprandial distress syndrome (PDS), epigastric pain syndrome (EPS), and PDS overlapping with EPS). Independent sample t-test and one-way ANOVA were used for statistical analysis. Results:Based on the GVS method, the gas volume of gastric cavity, small intestine and colorectum of FD group were 0.04±0.01, 0.06±0.01 and 0.06±0.01, respectively; and those of the healthy control group were 0.04±0.01, 0.05±0.01 and 0.05±0.01, respectively. The gas volume of small intestine and colorectum of FD group were higher than those of the healthy control group, and the differences were statistically significant( t=3.48 and 4.40, P=0.001 and <0.001). The gas volume of gastric cavity, small intestine and colorectum of FD patients with subtypes of PDS, EPS, and PDS overlapping with EPS were 0.04±0.01, 0.04±0.01 and 0.05±0.00, 0.06±0.01, 0.06±0.01 and 0.05±0.00, and 0.06±0.01, 0.06±0.01 and 0.06±0.01, respectively. There were no significant difference in the gas volume of gastric cavity, small intestine and colorectum among different subtypes ( all P>0.05 ). Based on the CT method, the gas volume of gastric cavity, small intestine and colorectum of FD group were (17 090.89±4 437.40) mm 3, (32 597.53±7 865.86) mm 3 and (49 010.20±12 972.42) mm 3, respectively; and those of the healthy control group were (13 424.43±5 211.86) mm 3, (33 567.93±9 157.23) mm 3 and (39 036.22±6 343.27) mm 3, respectively. The gas volume of gastric cavity and colorectum of FD group were higher than those of the healthy control group, and the differences were statistically significant( t=2.84 and 3.75, P=0.006 and 0.001). The gas volume of gastric cavity, small intestine and colorectum of FD patients with subtypes of PDS, EPS, and PDS overlapping with EPS were (18 464.03±4 088.57) mm 3, (14 560.97±3 771.26) mm 3 and (16 806.17±4 299.60) mm 3, (31 820.79±7 022.77) mm 3, (30 604.84±8 343.10) mm 3 and (37 140.05±8 276.58) mm 3, and (47 447.66±14 047.00) mm 3, (49 645.73±9 527.73) mm 3 and (51 181.96±16 836.97) mm 3, respectively. The gastric gas volume of FD patients with subtype of PDS was higher than that of FD patients with subtype of EPS, and the difference was statistically significant ( t=2.24, P=0.038). Conclusions:The volume of gastrointestinal gas of FD patients is higher than that of healthy controls. Gas accumulation in the gastric cavity of FD patients with subtype of PDS is more significant than that of FD patients with subtype of EPS. The CT method may assist physicians in calculating the gas volume in the gastrointestinal tract (especially in stomach) of FD patients more accurately.
Gastrointestinal motility disorders are common diseases in the clinical practice of gastroenterologists. For patients suspected of gastrointestinal motility disorders, the role of gastrointestinal motility examination is becoming more and more prominent. Gastrointestinal motility examination can provide diagnostic clues to common symptoms for gastroenterologists. The diagnosis and treatment of gastrointestinal motility disorders are the core elements of the gastrointestinal motility centers. The establishment of a fully equipped diagnostic and treatment center for gastrointestinal motility disorders is a prerequisite for effectively carrying out sub-specialties of gastrointestinal motility. In order to standardize the establishment of diagnostic and treatment centers for gastrointestinal motility disorders in China, the standards are hereby formulated.
