Gastroenterology

Periappendiceal red patch in UC associates with proctitis but not worse outcomes

Meta-analysis of 13 nonrandomized studies (n = 2289; PARP+ 725) found PARP more common with proctitis (OR 1.54; 95% CI 1.09–2.18). PARP was not associated with progression, medication escalation, or colectomy across pooled analyses. Moderate-to-high heterogeneity existed, so findings apply best to isolated PARP seen during endoscopic assessment. 1

Histologic normalization reduces steroid use in microscopic colitis

Retrospective cohort of 380 microscopic colitis patients found 43.2% normalized histology at first repeat colonoscopy. Histologic normalization was linked to lower odds of corticosteroid use after repeat colonoscopy (OR 0.26, 95% CI 0.13–0.53). The association was stronger in symptomatic patients and did not affect hospitalization or surgery rates. 2

Herbal/natural adjuncts with PPI therapy show modest H. pylori and microbiome signals

Systematic review of 18 studies (n = 1984) reported higher H. pylori eradication with herbal interventions (RR 1.20, 95% CI 1.14–1.27; I2 = 33%). Exploratory microbiome data suggested increased Bifidobacterium and Lactobacillus and some preservation of alpha-diversity. Heterogeneity, outcome indirectness, and variable trial quality limit routine clinical adoption. 3