Gastric Ulcer

Gastric cancer is a serious health issue worldwide, with Chile experiencing some of the highest death rates. Helicobacter pylori infection is common among Chilean adults and is the main cause of gastric cancer. This research focuses on early detection and treatment of H. pylori infection in adolescents aged 14 to 18, aiming to reduce gastric damage and improve health outcomes by using a "screen and treat" strategy in areas with moderate to high gastric cancer rates. The study begins by screening up to 1000 asymptomatic adolescents in three Chilean cities to identify those persistently infected with H. pylori. Those confirmed with persistent infection will be randomly assigned to receive either a 14-day antimicrobial treatment including lansoprazole, amoxicillin, clarithromycin, and metronidazole, or no treatment. A group of 60 non-infected adolescents will also be followed for comparison. The study includes pre-treatment and multiple post-treatment evaluations over 18 months. Participants will undergo repeated urea breath tests to monitor infection status, gastroenterological exams, and collection of blood and stool samples to measure biomarkers of gastric damage and analyze gut microbiome changes. Researchers will assess the success of eradication therapy, reinfection rates, clinical signs of gastric disease, and changes in antimicrobial resistance and gut microbiota diversity. The total follow-up period includes regular check-ups up to 18 months post-treatment, with additional monitoring of non-infected participants.

Researchers are evaluating a new AI-assisted Mobile Capsule Gastroscopy (MCG) system designed to detect various gastric diseases, including gastric cancer and precancerous lesions, in elderly and high-risk individuals. Gastric diseases pose a significant health challenge worldwide, especially in China, where gastric cancer has high incidence and mortality rates. Early detection through screening is crucial, as prompt treatment can greatly improve survival rates. This study aims to assess the effectiveness and practicality of MCG in community health centers for these populations. The MCG system includes a disposable capsule and a wireless portable receiver, allowing participants to complete the examination independently by following video instructions on a smartphone app and adjusting their body position to guide the capsule. An AI algorithm monitors gastric coverage in real time, and the video is accessible on the smartphone and can be uploaded for remote diagnosis. This non-invasive and user-friendly system does not require expensive magnetic navigation, making it suitable for widespread use in community settings. The study is part of a public health screening program targeting 10,000 elderly and high-risk residents. Participants will provide demographic and medical history data, undergo laboratory tests and MCG examination, and may receive esophagogastroduodenoscopy (EGD) and biopsies if needed. Short-term follow-up will monitor capsule excretion and any adverse events up to 14 days after MCG, while long-term follow-up will continue annually for five years to track gastric disease incidence and survival. Researchers will evaluate detection rates, safety, examination quality, patient satisfaction, and cost-effectiveness of the MCG system to inform future gastric disease prevention strategies.

Researchers are evaluating the effectiveness of four different treatment plans for Helicobacter pylori infection in Chinese children aged 6 to 18 years. This study aims to identify which regimen is best by comparing triple therapy, sequential therapy, bismuth quadruple therapy, and concomitant therapy. The study also investigates bacterial resistance, gene factors, and changes in gut microbiota to help develop new guidelines for treating this infection in children. Participants are randomly assigned to one of four groups receiving either triple therapy, sequential therapy, bismuth quadruple therapy, or concomitant therapy over a 14-day period. Each treatment group uses specific combinations of medications, including combinations of Omeprazole, Amoxicillin, Clarithromycin, Metronidazole, and Colloidal Bismuth Subcitrate. The study measures Helicobacter pylori eradication rates 4 to 6 weeks after treatment completion. Children in the study undergo tests including a 13C-urea breath test to confirm infection clearance. Researchers also assess side effects at 2 and 4 to 6 weeks after treatment, monitor changes in gut microbiome diversity at multiple time points, and analyze genes related to drug metabolism and bacterial virulence before therapy. Patient medication compliance is checked two weeks after treatment. The trial continues until the end of 2025, with detailed monitoring of treatment impact and safety.

Researchers are evaluating the effectiveness of human placental membrane products combined with standard care for treating nonhealing diabetic foot ulcers and venous leg ulcers. This multicenter, prospective, controlled trial follows a rescue design where patients who do not heal with standard care in a related trial may receive one of the study products. Patients must meet specific medical criteria for cellular or matrix-like products as outlined by Medicare guidelines. Participants are randomly assigned to receive one of several human amniotic membrane allograft products—Tri-Membrane Wrap™, Membrane Wrap™, Membrane Wrap-Lite™, or Membrane Wrap-Hydro™—along with standard care. These products are applied weekly until the ulcer heals or up to a maximum of 12 weeks. The trial includes a rescue phase for those who fail to heal in the standard care arm of a previous related study. During the study, participants attend weekly visits for treatment application and monitoring. Researchers will assess wound closure percentage within 1 to 12 weeks as the primary outcome. Secondary measures include time to wound closure, area reduction, adverse events, quality of life improvements, and pain levels for those with significant pain. The total participation period may last up to 12 weeks, with regular evaluations to track healing and safety.

Researchers are evaluating the effectiveness of low volume Transanal Irrigation (TAI) using the Qufora IrriSedo MiniGo device combined with standard conservative treatments compared to conservative treatment alone for patients with Low Anterior Resection Syndrome (LARS). This condition affects individuals who have undergone surgery for rectal cancer. The study aims to assess improvements in clinical symptoms of LARS over a three-month period. Participants are divided into two groups: one receiving low volume TAI with the MiniGo device plus standard conservative care, which includes dietary management, counseling, and prescribed medications excluding suppositories and physiotherapy; and another group receiving only the standard conservative treatments. The study includes follow-ups at 6 weeks, 3 months, and up to 12 months to monitor various outcomes. During the study, participants will be regularly assessed using the LARS score to measure symptom changes, quality of life questionnaires (EORTC QLQ-C30 and QLQ-CR29), incontinence scores, patient satisfaction, treatment compliance, bowel management time, and healthcare resource usage. Data will be collected at multiple intervals including 6 weeks, 3 months, 6 months, 9 months, and 12 months to thoroughly evaluate the treatment impact and patient preferences.

Researchers are evaluating the safety of vonoprazan exposure during pregnancy by comparing outcomes for pregnant women who take vonoprazan with those who do not but may use other treatments for similar conditions. The study focuses on maternal, fetal, and infant health, particularly monitoring for congenital malformations and various pregnancy outcomes related to erosive esophagitis, heartburn, symptomatic non-erosive gastroesophageal reflux disease, and Helicobacter pylori infection. The study includes two groups: pregnant women exposed to vonoprazan and those not exposed but possibly treated with other medications for related conditions. Vonoprazan is given as an oral tablet. Participants are observed from conception through pregnancy outcome, and infants are followed for up to 12 months after birth to assess health and development. Participants will provide consent and authorize their healthcare providers to share relevant data. Researchers will track major and minor congenital malformations, spontaneous abortion, stillbirth, elective termination, preterm birth, small gestational age at delivery, postnatal growth deficiencies, and developmental delays. Follow-up includes monitoring pregnancy outcomes and infant development for up to one year after birth, ensuring comprehensive safety evaluation over time.

Researchers are studying nutritional support strategies for critically ill patients with impaired gastrointestinal function, focusing on how to best achieve energy and protein intake goals. The study investigates the use of enteral nutrition alone versus a combination of enteral nutrition and supplemental parenteral nutrition (SPN) in patients who have impaired gastric emptying and reduced intestinal absorption. This research addresses the challenge of feeding intolerance and malnutrition in intensive care patients and explores muscle mass and function as important factors in nutrition efficacy. The study randomly assigns patients with diagnosed gastrointestinal dysfunction to one of two groups: one receiving gradual increases in enteral nutrition based on tolerance, and the other receiving a mix of enteral trophic feeding plus SPN to meet nutritional targets. Nutritional needs are monitored daily by indirect calorimetry, and gastrointestinal function is assessed with ultrasound gastric residual volume and a paracetamol absorption test. The SPN group aims to reach 80% of nutritional goals by day five, while the enteral nutrition group aims for full caloric intake as tolerated. Participants are monitored through various evaluations including muscle thickness via ultrasound, lean body mass by bioelectrical impedance analysis, and muscle strength with a handgrip dynamometer at admission and on days 10 and 15. The study measures daily calorie and protein intake adequacy, metabolic markers, and clinical outcomes such as mortality up to 28 days. Nutritional status, muscle function, and energy utilization are carefully assessed throughout the study to understand the impact of the tailored feeding protocols.

This research aims to understand who teaches gastrointestinal (GI) surgical procedures to senior general surgery residents during their training and to assess the residents' comfort level with performing both common and complex GI procedures. It also seeks to explore the need and interest for an Advanced Surgical GI fellowship among these senior residents. The study is observational and focuses on fourth and fifth year general surgery residents in accredited programs in the United States. The study involves an anonymous survey to collect information about the training sources for advanced GI surgical procedures and how confident senior surgical residents feel in performing these procedures after residency. There are no experimental treatments; instead, the survey gathers data regarding training experiences and residents' self-reported competence. The survey aims to provide insights into residency training and fellowship interest over a one-year period. Participants will complete the anonymous survey, sharing their experiences and comfort levels with GI surgery training. Researchers will analyze this information to better understand training adequacy and fellowship needs. The primary outcome measure is the training of senior general surgical residents over one year. No medical procedures or interventions are performed as part of this study, and participation involves only survey completion.

Researchers are studying gut and digestive health by evaluating changes before and after using a dietary supplement system for eight weeks. This study focuses on adults aged 18 to 80 years who have self-reported gastrointestinal symptoms. The goal is to understand how the supplement affects gut microbiota, inflammation, immune activity, and digestive function, which are important for overall health and well-being. Participants will take a dietary supplement system consisting of two products, PhytoPower 1 and PhytoPower 2, daily for eight weeks. They will mix one stick pack of each product into 16 fluid ounces of water and drink it each morning, with or without food. The study is open-label and single-arm, meaning all participants receive the supplement while maintaining their usual diet and lifestyle. During the study, participants will provide stool samples at the beginning and end to measure various biomarkers related to gut microbial diversity, inflammation, immune activity, digestion, and intestinal barrier integrity. They will also complete questionnaires about gastrointestinal symptoms and digestive well-being at several points throughout the study. Safety and tolerability will be monitored by tracking adverse events and compliance, with the total participation lasting eight weeks.

Researchers are conducting a prospective observational cohort study to compare the incidence of gastric cancer and the progression of gastric precancerous lesions among groups with different Helicobacter pylori (Hp) genetic subtypes. The study focuses on adults aged 40 and older who have a baseline negative gastric endoscopy and are either carriers of high-risk Hp SNP subtypes, non-high-risk subtypes, or are Hp negative. The goal is to understand how these genetic differences impact gastric cancer risk over time. Participants are followed prospectively in three groups: those who are Hp positive with high-risk SNP subtypes, those Hp positive with non-high-risk SNP subtypes, and those who are Hp negative. The study does not involve any treatment but monitors the natural progression of gastric conditions associated with these groups. Follow-up assessments occur over a period of up to 10 years, with primary and secondary outcomes measured at 3, 5, and 10 years. During the study, participants undergo baseline and follow-up examinations to monitor the incidence of gastric cancer and the development of precancerous lesions such as atrophic gastritis and intestinal metaplasia. Researchers also examine how factors like age, gender, diet, smoking, alcohol use, and family history might interact with Hp genetic risk. The primary outcome focuses on the difference in gastric cancer incidence among the groups during a 3-year follow-up, while secondary outcomes consider longer-term incidence and lesion progression. Participants' safety and ability to continue in the study are monitored throughout the follow-up period.