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The Advanced Role of Gastrointestinal Endoscopy for Inflammatory Disease
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The Advanced Role of Gastrointestinal Endoscopy for Inflammatory Disease

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Healthcare Quality and Patient Safety".

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 20847

Special Issue Editor

Prof. Dr. Atsushi Irisawa

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Guest Editor
Department of Gastroenterology, Dokkyo Medical University, 880, Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
Interests: endoscopic ultrasound (EUS); interventional EUS; endoscopic retrograde cholangiopancreatography (ERCP); pancreatobiliary disease; portal hypertention; GI-subeputherial lesion
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The role of gastrointestinal (GI) endoscopy is wide-ranging. Recently, with the development of equipment and the progress of techniques, GI endoscopy has come to serve a wide scope of applications, from diagnosis to treatment, for various digestive diseases. Although diagnosis and treatment for cancer in particular are extremely important roles of GI endoscopy, this Special Issue specifically examines advances in the use of GI endoscopy for inflammatory digestive diseases.

The development and progress of image-enhanced endoscopy (IEE) have been particularly useful for diagnosing various GI diseases. IEE has been applied not only to tumors but also to inflammatory diseases. Recently, some reports have described its application to reflux esophagitis, intestinal metaplasia of the stomach, and inflammatory bowel disease. It has also been applied to the diagnosis of inflammatory changes in the pancreatobiliary area. Moreover, advances in endoscopic ultrasonography (EUS) have greatly facilitated the diagnosis of inflammatory pancreatobiliary diseases, such as chronic pancreatitis and IgG4 related disease. Pathological diagnosis by EUS-guided fine-needle biopsy has been performed actively for definitive diagnosis of autoimmune pancreatitis. It is also applied as therapeutic interventional EUS for various complications associated with inflammation, such as walled-off necrosis associated with acute pancreatitis. Conventional endoscopic drainage for inflammatory biliary diseases has progressed further through the development of new devices. Consequently, endoscopy for inflammatory digestive diseases has made great progress. The editor is expecting submitted work related to "Inflammation and GI Endoscopy" conducted from various perspectives.

Prof. Atsushi Irisawa
Guest Editor

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Keywords

  • pancreatitis
  • palled-off necrosis
  • pholangitis
  • pholecystitis
  • IgG4 related disease (pancreatobiliary/gastrointestinal)
  • inflammatory bowel disease
  • ulcerative colitis
  • crohn’s disease
  • reflux esophagitis
  • eosinophilic esophagitis
  • chronic gastritis
  • viral infection of the GI tract

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Published Papers (7 papers)

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Research

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11 pages, 731 KiB  
Article
The Risk of Bleeding in Small/Straight Esophageal Varices with Red Color Sign on Endoscopy: A Retrospective Analysis from the Natural Course
by Kazunori Nagashima, Atsushi Irisawa, Ken Kashima, Fumi Sakuma, Takahito Minaguchi, Akira Yamamiya, Akane Yamabe, Koki Hoshi, Keiichi Tominaga, Makoto Iijima and Kenichi Goda
Healthcare 2022, 10(7), 1193; https://doi.org/10.3390/healthcare10071193 - 26 Jun 2022
Cited by 1 | Viewed by 4708
Abstract
Red color sign-positive (RC-positive) esophageal varices present a high bleeding risk, necessitating prophylactic treatment. Among RC-positive esophageal varices, those classified morphologically as small straight varices (Form level 1: F1) are difficult to treat. Moreover, the appropriate time for therapeutic intervention remains undefined. This [...] Read more.
Red color sign-positive (RC-positive) esophageal varices present a high bleeding risk, necessitating prophylactic treatment. Among RC-positive esophageal varices, those classified morphologically as small straight varices (Form level 1: F1) are difficult to treat. Moreover, the appropriate time for therapeutic intervention remains undefined. This study assessed the bleeding risk in RC-positive F1 esophageal varices. After extracting 541 cases of F1 esophageal varices diagnosed during 1 January 2012–29 February 2020, 76 cases of RC-positive F1 esophageal varices were divided into two groups in terms of treatment intervention at diagnosis: 49 cases with (treatment group) and 27 cases without (follow-up group). We assessed the bleeding rates, bleeding-associated factors, and early-bleeding-associated factors. The treatment group’s bleeding rate was 10% (5/49). The follow-up group’s bleeding rate was 78% (21/24). The subsequent bleeding rate was low in the treatment group (p < 0.001). The median period of sustained absence of bleeding was longer in the treatment group than in the follow-up group (1156 [274–1582] days vs. 105 [1–336] days; p < 0.001). In the follow-up group, a significant number of bleedings had varices that included a hematocystic spot (HCS) as RC or combined with RC (p = 0.017). Early bleeding occurred often in varices that included HCS or combined with RC (p = 0.024). Red wale marking (RWM) only was not a factor of early bleeding (p = 0.012). In conclusion, RC-positive varices should be treated even as F1 varices. Patients with RWM only show the possibility of not accepting early treatment intervention. A fast response is crucially important in HCS cases because of its associated bleeding and early bleeding. Full article
(This article belongs to the Special Issue The Advanced Role of Gastrointestinal Endoscopy for Inflammatory Disease)
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10 pages, 507 KiB  
Article
Efficacy and Safety of Peroral Endoscopic Myotomy for Esophageal Achalasia and Achalasia-Related Diseases in Patients Aged 75 Years and Over
by Jun Nakamura, Takuto Hikichi, Minami Hashimoto, Mika Takasumi, Tsunetaka Kato, Ryoichiro Kobashi, Takumi Yanagita, Rei Suzuki, Mitsuru Sugimoto, Yuki Sato, Hiroki Irie, Tadayuki Takagi, Masao Kobayakawa and Hiromasa Ohira
Healthcare 2021, 9(12), 1668; https://doi.org/10.3390/healthcare9121668 - 1 Dec 2021
Cited by 3 | Viewed by 1870
Abstract
Peroral endoscopic myotomy (POEM) has become a popular treatment for esophageal achalasia and other esophageal motility disorders. However, its efficacy and safety in elderly patients are unclear. To clarify that, we reviewed the medical records of patients who underwent POEM in our hospital. [...] Read more.
Peroral endoscopic myotomy (POEM) has become a popular treatment for esophageal achalasia and other esophageal motility disorders. However, its efficacy and safety in elderly patients are unclear. To clarify that, we reviewed the medical records of patients who underwent POEM in our hospital. A total of 11 patients who underwent POEM for esophageal achalasia (n = 10) and jackhammer esophagus (n = 1) were included. Procedural success, defined as the completion of an esophageal and gastric myotomy, was 100%. Clinical success, defined as an Eckardt score of 3 or less, without the use of additional treatments at 2 months, was 100%. The median Eckardt score significantly decreased after the POEM (baseline vs. 2 months after POEM; 7 (2–8) vs. 0 (0–1), p < 0.01). In the second and third years, the cumulative treatment effect maintenance rate was 88.9%. All patients taking antithrombotic agents had safe operations with the temporary discontinuation of these agents. There were four adverse events (two pneumoperitoneum, one mucosal injury, and one pneumonia), all of which improved with fasting or antibiotics. In conclusion, POEM is an effective and safe treatment for esophageal achalasia and achalasia-related diseases in patients aged 75 years and over. Full article
(This article belongs to the Special Issue The Advanced Role of Gastrointestinal Endoscopy for Inflammatory Disease)
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10 pages, 1074 KiB  
Article
Analysis of Endoscopic Evaluation Reliability for Ulcerative Colitis in Histological Remission
by Mimari Kanazawa, Keiichi Tominaga, Akira Yamamiya, Takanao Tanaka, Shoko Watanabe, Takeshi Sugaya, Keiichiro Abe, Akira Kanamori, Takahiro Arisaka, Koki Hoshi, Makoto Iijima, Kenichi Goda, Yasuo Haruyama and Atsushi Irisawa
Healthcare 2021, 9(11), 1405; https://doi.org/10.3390/healthcare9111405 - 20 Oct 2021
Cited by 1 | Viewed by 1952
Abstract
The Mayo endoscopic subscore (MES) is a major endoscopic scoring system used to assign a status of mucosal inflammation and disease activity to patients with ulcerative colitis (UC). Using interobserver reliability (IOR), this study clarified the difficulties for endoscopic observers imposed by MES [...] Read more.
The Mayo endoscopic subscore (MES) is a major endoscopic scoring system used to assign a status of mucosal inflammation and disease activity to patients with ulcerative colitis (UC). Using interobserver reliability (IOR), this study clarified the difficulties for endoscopic observers imposed by MES parameters used for the endoscopic evaluation of UC in histological remission. First, 42 endoscopists of four observer groups examined each MES parameter, which were evaluated from endoscopically obtained images of 100 cases as Grade 0 or 1 of the Nancy histological index of histopathological inflammation. Then, IOR was assessed using multiple κ statistics for each finding of MES. The results showed that IOR among all the observers was slight or fair for all the parameters, indicating a low IOR. The experts of the UC practice group had “moderate” or higher IOR for seven of the nine parameters, whereas “slight” or “fair” results were found for all parameters by the trainee group. The IOR for each MES parameter was calculated separately for the observer groups. All the groups showed “slight” or “fair” for “Erythema” and “Decreased vascular pattern”. Large differences between the endoscopists were found in the IOR for the MES parameters in UC in histological remission. Even among UC practice experts, the IOR was low for “Erythema” and “Decreased vascular pattern”. Full article
(This article belongs to the Special Issue The Advanced Role of Gastrointestinal Endoscopy for Inflammatory Disease)
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Review

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9 pages, 486 KiB  
Review
Viral Infection in Esophageal, Gastric, and Colorectal Cancer
by Takeshi Yamashina, Masaaki Shimatani, Masahiro Takeo, Kotaro Sasaki, Masahiro Orino, Natsuko Saito, Hironao Matsumoto, Takeshi Kasai, Masataka Kano, Shunsuke Horitani, Kimi Sumimoto, Toshiyuki Mitsuyama, Takafumi Yuba, Toshihito Seki and Makoto Naganuma
Healthcare 2022, 10(9), 1626; https://doi.org/10.3390/healthcare10091626 - 26 Aug 2022
Cited by 2 | Viewed by 2267
Abstract
The human gastrointestinal tract, which constitutes the digestive system, contains a large number of virus particles that maintain organizational homeostasis and health. Conversely, viral pathogens have also attracted attention for their involvement in the pathogenesis of certain cancers, including gastrointestinal cancers. To aid [...] Read more.
The human gastrointestinal tract, which constitutes the digestive system, contains a large number of virus particles that maintain organizational homeostasis and health. Conversely, viral pathogens have also attracted attention for their involvement in the pathogenesis of certain cancers, including gastrointestinal cancers. To aid prevention and treatment of these cancers, the relevance of gastrointestinal viral factors as potential risk factors needs to be carefully investigated. This review summarizes and discusses the available literature on the relationship between the development of esophageal, gastric, and colorectal cancers and their corresponding viruses. This review reveals that research on the association between colorectal cancer and viruses, in particular, is still in its infancy compared to the association between HPV and esophageal cancer and between EBV and gastric cancer. Full article
(This article belongs to the Special Issue The Advanced Role of Gastrointestinal Endoscopy for Inflammatory Disease)
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14 pages, 686 KiB  
Review
Clinical Characteristics of ICI-Related Pancreatitis and Cholangitis Including Radiographic and Endoscopic Findings
by Ryota Nakano, Hideyuki Shiomi, Aoi Fujiwara, Kohei Yoshihara, Ryota Yoshioka, Shoki Kawata, Shogo Ota, Yukihisa Yuri, Tomoyuki Takashima, Nobuhiro Aizawa, Naoto Ikeda, Takashi Nishimura, Hirayuki Enomoto and Hiroko Iijima
Healthcare 2022, 10(5), 763; https://doi.org/10.3390/healthcare10050763 - 20 Apr 2022
Cited by 11 | Viewed by 3238
Abstract
The indications for immune checkpoint inhibitors (ICIs) have expanded to include carcinomas of various organs. However, as ICI therapy expands, the management of immune-related adverse events (irAEs) has become a problem. ICI-related pancreatitis and cholangitis are relatively rare irAEs. Although some patients with [...] Read more.
The indications for immune checkpoint inhibitors (ICIs) have expanded to include carcinomas of various organs. However, as ICI therapy expands, the management of immune-related adverse events (irAEs) has become a problem. ICI-related pancreatitis and cholangitis are relatively rare irAEs. Although some patients with ICI-related pancreatitis and cholangitis are asymptomatic and do not require treatment, there have been reports of patients who did not respond to immunosuppressive therapy and died. Thus, the pathogenesis of ICI-related pancreatitis and cholangitis should be clarified immediately. Currently, the role of endoscopy in the diagnosis and treatment of inflammatory pancreatic and biliary duct diseases is becoming increasingly important. In this review, we summarize clinical characteristics as well as radiographic and endoscopic findings of ICI-related pancreatitis and cholangitis. Full article
(This article belongs to the Special Issue The Advanced Role of Gastrointestinal Endoscopy for Inflammatory Disease)
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15 pages, 678 KiB  
Review
A Review of Potential Role of Capsule Endoscopy in the Work-Up for Chemotherapy-Induced Diarrhea
by Takayuki Ando, Miho Sakumura, Hiroshi Mihara, Haruka Fujinami and Ichiro Yasuda
Healthcare 2022, 10(2), 218; https://doi.org/10.3390/healthcare10020218 - 24 Jan 2022
Cited by 3 | Viewed by 2976
Abstract
Chemotherapy-induced diarrhea (CID) is a common, severe side effect of chemotherapy, immunotherapy, and targeted therapy. Because patients are more prone to continuing chemotherapy if they do not suffer from CID, appropriate diagnosis and monitoring of this disease are essential. However, suitable monitoring methods [...] Read more.
Chemotherapy-induced diarrhea (CID) is a common, severe side effect of chemotherapy, immunotherapy, and targeted therapy. Because patients are more prone to continuing chemotherapy if they do not suffer from CID, appropriate diagnosis and monitoring of this disease are essential. However, suitable monitoring methods are yet to be developed. To date, several studies have shown that small-bowel capsule endoscopy (SBCE) is useful in visualizing the entire small intestinal mucosa and detecting small intestinal abnormalities, including bleeding, malignant tumors, and mucosal injury, associated with the use of nonsteroidal anti-inflammatory drugs and low-dose aspirin. Currently, limited studies have evaluated the small intestinal mucosa using SBCE in patients receiving fluoropyrimidine-based chemotherapy or immune checkpoint inhibitors. These studies have reported that small intestinal mucosal injury is common in patients with severe fluoropyrimidine-induced diarrhea. SBCE might be a useful screening method for the early detection of enterocolitis induced by immune checkpoint inhibitors. SBCE may be a powerful tool for the diagnosis and monitoring of CID, and understanding its indication, contraindication, and capsule-retention risk for each patient is important for clinicians. Full article
(This article belongs to the Special Issue The Advanced Role of Gastrointestinal Endoscopy for Inflammatory Disease)
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Other

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8 pages, 843 KiB  
Case Report
Endoscopic Diagnosis of Biliary Stricture Combined with Digital Cholangioscope: A Case Series
by Seiichiro Fukuhara, Eisuke Iwasaki, Atsuto Kayashima, Yujiro Machida, Hiroki Tamagawa, Shintaro Kawasaki, Masayasu Horibe, Shutaro Hori, Yuta Abe, Minoru Kitago, Haruhiko Ogata and Takanori Kanai
Healthcare 2022, 10(1), 12; https://doi.org/10.3390/healthcare10010012 - 22 Dec 2021
Cited by 2 | Viewed by 2486
Abstract
The endoscopic diagnosis of biliary tract lesions is applied as a non-invasive method; however, its diagnostic accuracy is not yet high. Moreover, digital cholangioscopy is used for directly visualizing the inside of the bile duct, resulting in a more precise biopsy. We present [...] Read more.
The endoscopic diagnosis of biliary tract lesions is applied as a non-invasive method; however, its diagnostic accuracy is not yet high. Moreover, digital cholangioscopy is used for directly visualizing the inside of the bile duct, resulting in a more precise biopsy. We present the case series of the outcomes of diagnosis using digital cholangioscopy in patients who underwent cholangioscopy for the evaluation of biliary stenosis in our department between January 2014 and March 2021. The controls were those who underwent a biopsy for biliary stenosis with conventional endoscopic retrograde cholangiopancreatography (ERCP). Background data for each case were collected, and the clinical outcomes by biopsy were evaluated, focusing on the accuracy of the diagnosis. Cholangioscopy was performed in 15 cases, while a conventional biopsy by ERCP was performed in 172 cases. Nine of 15 cases (60.0%) were diagnosed with cholangiocarcinoma. The number of specimens obtained through conventional ERCP and cholangioscopy was 2.5 ± 1.3 and 3.3 ± 1.5, respectively (p = 0.043). The diagnostic accuracy of conventional ERCP and cholangioscopy were 65.7% (113 of 172 cases) and 100%, respectively, which was significantly higher in the group with cholangioscopy. Digital cholangioscopy is useful when the diagnosis of the biliary stricture using the conventional ERCP method is difficult. Full article
(This article belongs to the Special Issue The Advanced Role of Gastrointestinal Endoscopy for Inflammatory Disease)
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