- Incomplete Intestinal Metaplasia as a High-Risk Clinical Phenotype in Gastric Carcinogenesis: Implications for Surveillance and Management. [Review]Digestion. 2026 Aug 18; :1-34. [Online ahead of print]D
- CONCLUSIONS: This review synthesizes current evidence on IIM as a high-risk transitional phenotype in gastric carcinogenesis. We detail its cellular origins, primarily from spasmolytic polypeptide-expressing metaplasia (SPEM) via chief cell reprogramming (paligenosis), and its characteristic hybrid molecular signature. Diagnostically, definitive subtyping relies on histochemical staining (e.g., AB-PAS), as conventional endoscopy and histology lack sufficient precision, highlighting a barrier to routine risk stratification. Epidemiologically, IIM is associated with a 4- to 11-fold increased risk of gastric cancer compared to CIM. While Helicobacter pylori eradication may induce partial regression, patients with IIM retain a significant residual cancer risk, necessitating ongoing surveillance. Emerging endoscopic techniques (e.g., narrow-band imaging) and molecular biomarkers (including DMBT1, AQP5, TROP2, and OLFM4) show promise for improving in vivo detection and risk assessment, with combinatorial biomarker strategies potentially better capturing IIM's hybrid phenotype. Current classification systems have limitations, including the frequent coexistence of subtypes and a lack of validated biomarkers for precise risk stratification.1、IIM is a biologically unstable, transitional lesion with a markedly elevated risk of progression to gastric adenocarcinoma, warranting its distinction from CIM in clinical practice. 2、 Reliance on specialized pathology for diagnosis limits widespread risk stratification, creating an urgent need for reliable endoscopic predictors and validated molecular biomarkers. 3、Even after successful H. pylori eradication, patients with IIM require long-term endoscopic surveillance due to persistent cancer risk. Future strategies must integrate IIM subtyping into personalized surveillance protocols to enhance gastric cancer prevention.
- Publisher Full Text (DOI)
- Clinicopathological Characteristics of Endoscopically Detected and Undetected Lesions in Hereditary Diffuse Gastric Cancer. [Journal Article]Digestion. 2026 Aug 05; :1-28. [Online ahead of print]D
- CONCLUSIONS: Lesions in the U gastric region are particularly challenging to detect endoscopically, especially when they are small. Improved detection may require advancements in high-resolution and image-enhanced endoscopy, AI-assisted image analysis, and optimized observation techniques. These improvements may enable earlier diagnosis and intervention, ultimately leading to better outcomes for patients with HDGC.
- Publisher Full Text (DOI)
- Retraction Statement. [Journal Article]
- The article "Identification of LGR5 and TFF2 as Biomarkers in High-Risk Chronic Atrophic Gastritis: From Multi-Omics Mining to Clinical Validation" [Digestion. 2026; https://doi.org/10.1159/000549887] by Qingqing Zhang, Di Wu, Fengyun Guo, Shengnan Yang, Lijing Bao, Ruiying Zhang and Ping Wang has been retracted by the Publisher and the Editor.Post-publication concerns were raised regarding the i…
- PMC Free PDF
- Dynamic Changes in Circulating and Tissue Biomarkers and Therapeutic Response to HER2/PD-1 Dual Blockade in HER2-Positive Gastric Cancer. [Journal Article]Digestion. 2026 Jul 21; :1-13. [Online ahead of print]D
- CONCLUSIONS: Integrated ctDNA and immune biomarker monitoring may provide prognostic information for dual HER2/PD-1 blockade therapy. Serial molecular profiling enables early resistance detection and identifies evolutionary patterns that may inform therapeutic strategies, though prospective validation is required.
- Publisher Full Text (DOI)
- Extraintestinal Manifestations Have a Negative Impact on Quality of Life of Patients Living with Inflammatory Bowel Disease. [Journal Article]Digestion. 2026 Jul 18; :1-6. [Online ahead of print]D
- CONCLUSIONS: Patients with IBD and EIMs had worse quality of life compared to those without EIMs regardless of IBD activity.
- Publisher Full Text (DOI)
- Directional Bias in Polyp Detection during Colonoscopy: A Prospective Observational Study. [Journal Article]Digestion. 2026 Jul 01; :1-11. [Online ahead of print]D
- CONCLUSIONS: Polyp detection during colonoscopic withdrawal demonstrates a consistent directional bias, with the ULD functioning as a region of relatively reduced detection frequency. Awareness of this intrinsic limitation and deliberate inspection of the ULD may help optimize visual inspection patterns during colonoscopy.
- Publisher Full Text (DOI)
- Prospective Validation of Magnified Endoscopic Examination with Image-Enhanced Endoscopy as an Optical Biopsy for Differentiating Superficial Duodenal Epithelial Tumor and Non-Neoplastic Lesion in Duodenum. [Journal Article]Digestion. 2026 Jun 29; :1-11. [Online ahead of print]D
- CONCLUSIONS: This prospective validation showed that IEE-ME, applied through a structured algorithm, enables highly accurate and noninvasive differentiation between SDETs and NNLs. Given its excellent NPV and accuracy, this approach may serve as an optical biopsy method that reduces the need for conventional biopsies in clinical practice.
- Publisher Full Text (DOI)
- Accurate Imaging Diagnosis of Small Pancreatic Carcinoma/High-Grade Pancreatic Intraepithelial Neoplasia Using Combined Indirect Imaging Findings. [Journal Article]Digestion. 2026 Jun 24; :1-12. [Online ahead of print]D
- CONCLUSIONS: FPPA was a significant indirect imaging finding for diagnosing EPC using CT, MRI, and endoscopic retrograde pancreatography, whereas BPD dilation around an irregular MPD caliber was associated with EPC only in univariate analysis. The combination of characteristic indirect imaging findings may improve diagnostic performance, particularly specificity. This imaging-based diagnostic approach may facilitate early detection of EPC.
- Publisher Full Text (DOI)
- Restoration of Gut Microbiota Dysbiosis by a Probiotic Lactobacillus paragasseri OLL2716 in Patients Being Treated with Low-Dose Aspirin and Acid-Suppressive Agents. [Journal Article]Digestion. 2026 Jun 23; :1-13. [Online ahead of print]D
- CONCLUSIONS: Increased Enterobacteriaceae abundance was found in both ileal lavage of the ASAs+LDA group and feces of the ASAs group. This increase in the abundance of potentially pathogenic bacteria was restored by a probiotic LG21 strain. These findings suggest that LG21 may modulate gut microbiota, particularly Enterobacteriaceae, which could be associated with its beneficial effects on LDA-induced small bowel injury.
- Publisher Full Text (DOI)
- Adverse Events after Colorectal Polypectomy in Patients with Amyloidosis: Risk Assessment Using Propensity Score Matching. [Journal Article]Digestion. 2026 Jun 22; :1-11. [Online ahead of print]D
- CONCLUSIONS: Amyloidosis was independently associated with increased IPPB risk after colorectal polypectomy. Muscularis mucosae deposition and EMR may help identify higher-risk lesions in amyloidosis, and CSP may be considered when feasible to reduce bleeding risk.
- Publisher Full Text (DOI)
- Prognostic Effect of MES 1 Inflammatory Extent on Remission Maintenance in Ulcerative Colitis. [Journal Article]Digestion. 2026 Jun 12; :1-9. [Online ahead of print]D
- CONCLUSIONS: The remission maintenance rate decreases as the extent of MES 1 inflammation increases in patients in remission. Even mild but extensive inflammation may increase the risk of relapse. Treatment strategies should incorporate consideration of the inflammation extent.
- Publisher Full Text (DOI)
- Cold Sensation and Gastric Accommodation in Functional Dyspepsia: An Exploratory Study of Autonomic Function. [Journal Article]Digestion. 2026 Jun 11; :1-14. [Online ahead of print]D
- CONCLUSIONS: Cold sensation was more prevalent in patients with FD and was associated with reduced baseline autonomic activity. However, its association with gastric accommodation was attenuated after accounting for FD status, suggesting that cold sensation may represent a disease-related phenotype rather than an independent determinant of postprandial tolerance.
- Publisher Full Text (DOI)
- Fully Automated Detection of Pancreaticobiliary Maljunction Based on 3D Magnetic Resonance Cholangiopancreatography Using Deep Learning. [Journal Article]Digestion. 2026 Jun 09; :1-10. [Online ahead of print]D
- CONCLUSIONS: The proposed deep learning model demonstrates high accuracy in automated PBM detection on MRCP images, offering potential to improve diagnostic efficiency and reduce interobserver variability.
- Publisher Full Text (DOI)
- Comparative Effectiveness of Hangeshashinto and Ramosetron for the Treatment of Irritable Bowel Syndrome with Diarrhea. [Journal Article]Digestion. 2026 Jun 01; :1-11. [Online ahead of print]D
- CONCLUSIONS: In this exploratory real-world analysis, hangeshashinto showed short-term symptom improvement similar to ramosetron, and combination therapy was associated with lower follow-up symptom scores than ramosetron monotherapy in propensity score-adjusted analyses. However, given the retrospective design, small sample size, and inconsistent findings across analytical approaches, these results should be interpreted cautiously and warrant confirmation in larger prospective studies.
- Publisher Full Text (DOI)
- Association between Maternal and Paternal History of Chronic Constipation and Its Development: A Brief Report. [Journal Article]Digestion. 2026 May 29; :1-6. [Online ahead of print]D
- CONCLUSIONS: Both maternal and paternal histories of CC were similarly associated with CC. However, this association may be largely driven by unmeasured shared environmental factors and should be interpreted cautiously.
- Publisher Full Text (DOI)