Jung Hwan Oh

Jung-Hwan Oh and Moo In Park. J Neurogastroenterol Motil 2026;32:700-1. https://doi.org/10.5056/jnm26119

Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of peptic ulcers. Tegoprazan, a novel potassium-competitive acid blocker, provides rapid and potent inhibition of acid production. This study evaluated whether tegoprazan 25 mg is non-inferior to lansoprazole 15 mg in preventing NSAID-induced peptic ulcer. In this double-blind, randomized, active-controlled, multicenter phase III trial, patients requiring NSAIDs for up to 24 weeks were randomized (1:1) to the tegoprazan or the lansoprazole group. The primary endpoint was the incidence of peptic ulcer at week 24 in the per-protocol population. Secondary endpoints were NSAID-induced gastrointestinal symptom-free rates. Safety outcomes included adverse drug reactions (ADRs) and serious adverse events (SAEs). A total of 392 patients were randomized, and 269 patients were analyzed in the perprotocol set. Tegoprazan was non-inferior to lansoprazole for the prevention of gastroduodenal ulcers (p=0.0004). The heartburn-free rate at week 12 was higher in the tegoprazan group (p=0.0421), while other symptom-free rates did not differ significantly. In terms of safety, ADR and SAE rates were comparable and not significantly different. Tegoprazan was non-inferior to lansoprazole in preventing NSAID-induced peptic ulcers with excellent tolerance. Tegoprazan represents a clinically effective alternative gastroprotective therapy (ClinicalTrials.gov identifier NCT04840550).

Kyung Sik Park, Hyun-Soo Kim, Jung-Hwan Oh, Woo Chul Chung, Suck Chei Choi, Si Hyung Lee, Tae Ho Kim, Dae Young Cheung, Gwang Ho Baik, Sun Moon Kim, Hang Lak Lee, Jeong Seop Moon, Cheol Woong Choi, Chongil Sohn, Kyoung Oh Kim, Byung-Wook Kim, Hye-Kyung Jung, Da Hyun Jung, Sung Soo Kim, Moo In Park, Ju Yup Lee, Gwang Ha Kim, Hee Seok Moon, Hoonjai Chun, Ki-Nam Shim, Woon Geon Shin, Chan Hyuk Park, Taeoh Kim, Sung Woo Jung, Hyunjin Kim, Sam Ryong Jee, Keemyung Lee, Yu Kyung Cho, Sung Chul Park, Jinwoong Cho, Chealwung Huh, Hyesoo Kwon, Jun Kim, John Kim, Jong-Jae Park. Gut and Liver -0001;0:. https://doi.org/10.5009/gnl250334

Gastric cancer (GC) is the fifth most common cancer worldwide, with the highest incidence in East Asia. Although H. pylori is a well-known risk factor, carcinogenesis can occur independently of H. pylori infection, and approximately 43% of adults carry H. pylori as part of their native microbiota. This study aimed to identify potential oral and gastric microbial markers across different histological stages of GC in both H. pylori-positive and -negative patients. Buccal swabs and gastric mucosa samples were collected from patients with intestinal metaplasia, low-grade dysplasia, high-grade dysplasia, early GC, or advanced GC. Total DNA was extracted, and 16S rRNA gene amplicon sequencing was performed. Microbiome diversity generally remained stable across histological stages, with no directional shifts in community structure. Differential abundance analysis revealed higher relative abundances of Anaerostipes, Phocaeicola, and Collinsella in the gastric antrum of cancerous samples. Anaerostipes and Phocaeicola are typically enriched in the intestinal microbiota but are rarely observed in the stomach, suggesting their potential ecological and pathological relevance in gastric carcinogenesis. In H. pylori-negative patients, however, a different stage-associated abundance pattern was observed, in which Faecalibacterium, a genus predominantly associated with the intestinal environment, was less abundant in advanced gastric cancer samples than in earlier histological stages within the gastric body. These findings suggest that microbial changes during gastric cancer progression may follow different trajectories depending on H. pylori infection status. In oral samples, Haemophilus and Prevotella were more abundant in intestinal metaplasia than in low-grade dysplasia, and network analysis indicated links between Neisseria and Filifactor at oral and gastric sites. However, as the study population was limited to a single country and ethnicity, the applicability of these microbial markers should be carefully considered.

This study evaluates the clinical significance of the gastric emptying time (GET) in patients with functional dyspepsia (FD). This retrospective study included 89 patients who visited the clinic with indigestion between 2021 and 2022. FD was diagnosed and categorized into 3 subtypes: postprandial distress syndrome, epigastric pain syndrome, and overlap type, following the Rome IV criteria. GET was assessed using ^99mTc scintigraphy. The stomach remnant was measured 1 and 2 hours after ingesting a technetium-99m labeled egg, and the time required for the remnant to decrease by half (T_1/2) was calculated. Of the 89 patients studied, 46 were diagnosed with FD. The remaining 43 patients, who did not meet the Rome IV criteria, were included as the control group. Patients with FD exhibited a higher incidence of smoking, a higher body mass index, and a higher incidence of diabetes than the non-FD group. GET and T_1/2 did not show significant differences between the 2 groups (P = 0.240 and P = 0.126, respectively). However, the FD group exhibited a smaller gastric retention rate than the non-FD group at all time points. In the subtype analysis, GET and T_1/2 were not significantly different among the 3 subtypes (P = 1.000 and P = 0.173, respectively). Diabetes mellitus, current smoking status, elevated body mass index, and younger age were significantly associated with FD. GET did not significantly differ among FD patients or its subtypes, despite a lower gastric retention rate in FD patients.

Objectives: The standard first-line treatment for Helicobacter pylori infection typically involves proton pump inhibitors, amoxicillin, and clarithromycin (PAC), yet the eradication success rates are not entirely satisfactory. Recognizing bismuth’s antibacterial properties and its potential to enhance antibiotic efficacy, this study compared the eradication success rates of a 7-day course of PAC with bismuth (PACB) versus PAC alone in patients with clarithromycin-susceptible H. pylori infections.Methods: We conducted a retrospective review at Eunpyeong St. Mary’s Hospital involving 499 patients with confirmed clarithromycin-susceptible H. pylori infection. These patients were treated either with PACB or PAC for 7 days. Clarithromycin resistance-associated point mutations were evaluated using reverse transcriptase polymerase chain reaction. Successful eradication was confirmed by a negative 13C-urea breath test.Results: Of the patients, 261 received PACB therapy, and 238 received PAC therapy. The intention-to-treat analysis showed eradication success rates of 82.8% (216/261) for PACB and 89.1% (212/238) for PAC (p=0.093). The per-protocol analysis revealed eradication rates of 85.3% (215/252) for PACB and 90.5% (210/232) for PAC (p=0.081). The incidence of adverse effects was similar between the two groups, with 41.3% (104/252) in the PACB group and 34.1% (79/232) in the PAC group (p=0.102).Conclusions: Adding bismuth to the standard 7-day PAC regimen did not significantly increase eradication rates in patients with clarithromycin-susceptible H. pylori infections compared to PAC alone.

Abnormal Opening in Hypopharynx by Screening Upper Endoscopy

INTRODUCTION: Zastaprazan is a potent potassium-competitive acid blocker developed to treat gastroesophageal reflux disease. The aim of this study was to evaluate the efficacy and safety of zastaprazan compared with esomeprazole in patient with erosive esophagitis (EE). METHODS: A phase III, multicenter, randomized, double-blind, noninferiority clinical study was conducted with 300 subjects with confirmed EE. Subjects were randomized to receive zastaprazan 20 mg or esomeprazole 40 mg once daily up to 8 weeks. The primary end point was the cumulative proportion of subject with healed EE confirmed by endoscopy at week 8. The secondary end points included the healing rate at week 4, symptom response, and quality of life assessment. Safety profiles and serum gastrin levels were also assessed. RESULTS: In the full analysis set, the cumulative healing rate at week 8 were 97.92% (141/144) for zastaprazan and 94.93% (131/138) ( P = 0.178) for esomeprazole. The healing rate at week 4 in the zastaprazan group was higher than the esomeprazole group (95.14% [137/144] vs 87.68% [121/138]; P = 0.026). There was no significant difference between groups in healing rates (the per-protocol set) at week 8 and week 4, symptom responses, quality of life assessments, and safety profiles. In addition, serum gastrin levels increased during treatment in both groups, with a significant difference between the 2 groups ( P = 0.047), but both decreased after treatment. DISCUSSION: An 8-week therapy of zastaprazan 20 mg is noninferior to esomeprazole 40 mg in subjects with predominantly low-grade EE. The healing rate at week 4 appears to be higher for zastaprazan than esomeprazole.

Chul-Hyun Lim, Jung-Hwan Oh. Gut and Liver -0001;0:. https://doi.org/10.5009/gnl230453