Stomach Ulcer (Peptic Ulcer)

Researchers are evaluating the effectiveness and safety of a 7-day treatment combining vonoprazan, high-dose amoxicillin, and bismuth (VAB-7) to treat Helicobacter pylori infection. This infection can cause chronic stomach inflammation and increase risks for ulcers, lymphoma, and gastric cancer. The study compares this shorter regimen with the standard 14-day vonoprazan and high-dose amoxicillin dual therapy (VA-14) due to concerns about antibiotic resistance and the need for more effective treatments. Participants are randomly assigned to one of two groups. The experimental group receives vonoprazan 20 mg twice daily, amoxicillin 1 g three times daily, and bismuth 220 mg twice daily for 7 days. The control group receives vonoprazan 20 mg twice daily and amoxicillin 1 g three times daily for 14 days. The study explores whether adding bismuth can improve eradication rates in a shorter treatment course. During the study, researchers monitor participants for Helicobacter pylori eradication using a urea breath test conducted 4 to 6 weeks after treatment. They also assess patient adherence, adverse events during treatment days, and cost-effectiveness. Follow-up assessments occur shortly after treatment completion to evaluate safety and compliance. The total study duration for each participant varies based on their assigned treatment group.

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 conducting the GENESIS clinical study to map the HLA genomic region in the Greek population and explore its possible links with various underlying diseases. This non-interventional, multicenter study aims to provide a pilot map of genetic variation in HLA that may be useful in medical research and clinical applications related to selected diseases. The study plans to include 12,000 participants over a total duration of 36 months. Each participant will attend one visit at a participating site during which they will provide demographic data, lifestyle information such as smoking and alcohol use, blood pressure measurements, details on diagnosed diseases and treatments, and recent laboratory test results if available. Buccal swab samples will be collected from each participant to extract DNA for HLA genotyping analysis. Selected samples will undergo further whole genome sequencing to investigate associations with autoimmune diseases. Participants will receive a personalized ancestry report after analysis completion. During the study visit, data collection includes demographic and health information, as well as laboratory and clinical test results from the past year. The genetic material from buccal swabs will be stored and processed for genetic analysis. Researchers will measure allele frequency of HLA alleles in the Greek population and assess the prevalence and risk associations of selected HLA-related diseases. The study's total duration is 36 months with results available at the end of this period.

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.

Frailty is a common condition in older adults that can increase the risk of poor health outcomes such as falls, hospital stays, and death. This research aims to study how assessing frailty before a colonoscopy might affect patient satisfaction and the number of colonoscopies avoided. The study is a prospective randomized controlled trial involving patients over 65 years old at Princess Alexandra Hospital, comparing a personalized approach using a frailty assessment to standard care. Participants will be randomly assigned to one of two groups. One group will receive a personalized approach that includes a frailty assessment using tests like grip strength, sit-to-stand timing, balance, and gait speed, along with questionnaires about medical conditions. The gastroenterologist will discuss the results and risks with the patient to help decide about having a surveillance colonoscopy. The other group will receive standard care, which involves discussing the benefits and risks of colonoscopy without the frailty assessment. During the study, participants will complete satisfaction questionnaires at the time of consultation and within weeks after any colonoscopy procedure. Researchers will track how many patients choose to avoid colonoscopy after receiving information and will monitor colorectal cancer-related complications and other causes of death within five years. The study will assess how the personalized approach may impact decision-making and patient satisfaction with outpatient services related to colonoscopy care.

Researchers are evaluating a combined screening and follow-up management approach for gastrointestinal tumors. This study aims to explore and assess the feasibility and cost-effectiveness of screening for esophagus, stomach, and colorectal cancers in a population-based, multicenter setting. The trial includes participants aged 45 to 70 years and will observe outcomes over a 10-year follow-up period. Participants are divided into groups undergoing different screening methods. Group one receives gastroscopy, colonoscopy, fecal occult blood test (FIT), Helicobacter pylori antigen test, RNF180 and SEPTIN9 gene methylation tests, along with an investigation of various risk factors such as past diseases, lifestyle habits, family cancer history, and reproductive status. Group two undergoes risk factor investigation, FIT, and Helicobacter pylori antigen stool test; if positive, further gene methylation tests and possibly colonoscopy are conducted. Control groups matched by spouse or sibling undergo only risk factor investigations. During the study, participants provide information on medical history, lifestyle habits, and family cancer history. Screening tests including endoscopies, stool tests, and gene methylation analyses are performed as specified. Researchers will monitor the detection of cancer or precancerous lesions over 10 years, tracking health outcomes and the effectiveness of combined screening. Safety and adherence are observed throughout the follow-up.

Researchers are evaluating the effectiveness and cost-efficiency of early remote interventions for patients with severe, chronic, or relapsing gastrointestinal symptoms that lack clear explanation and who are waiting for care in an integrated clinic. The study uses a two-stage randomization to compare different approaches, aiming to improve symptom management, identify which patients respond best to certain treatments, and assess acceptance of new care models. About 200 patients will initially have their symptoms and wheat intolerance assessed remotely. Participants who continue to experience symptoms after initial assessment will be randomly assigned to one of four pre-consultation interventions: a standardized dietician-supervised program, an exercise program, internet-delivered cognitive behavior therapy, or no intervention. Following this, they will be randomized again to receive either a consultant-led outpatient clinic consultation or care in an integrated clinic, depending on their response to the pre-consultation intervention. Throughout the study, participants will be regularly assessed using a structured gastrointestinal symptoms score and quality of life measures, collected at multiple time points up to 44 weeks. Additional evaluations include anxiety and depression scales, microbiome analysis, and acceptance of care models by patients and staff. Cost-effectiveness will also be tracked. The total participation involves remote interventions, clinical consultations, and multiple assessments over time to monitor symptoms, quality of life, and treatment impact.

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.