ObjectivePrevious studies have presented conflicting results on Western diets and the risk of inflammatory bowel disease (IBD). This study aimed to evaluate the role of a pre‐illness Western dietary pattern in the development of IBD.MethodsThe Western dietary pattern was defined as that met at least two of the following, either a high intake of refined grains, red and processed meat, animal protein, animal fats or high‐fat dairy products, or with a low consumption of fruit and vegetables. Four medical databases (PubMed, EMBASE, the Cochrane Library and the China National Knowledge Infrastructure) were searched to identify all relevant references. Risk estimate and corresponding 95% confidence interval (CI) were pooled using a random‐effects model.ResultsNine studies (seven case‐control studies and two prospective cohorts) were included, with a total of 1491 IBD cases and 53 089 controls. A Western dietary pattern was associated with a risk of all IBD (relative risk [RR] 1.92, 95% CI 1.37‐2.68) and separately with Crohn's disease (CD) (RR 1.72, 95% CI 1.01‐2.93) and ulcerative colitis (UC) (RR 2.15, 95% CI 1.38‐3.34). Subgroup analysis by region showed that a Western dietary pattern was associated with the risk of CD and UC for studies performed in Europe (RR 2.25, 95% CI 1.44‐3.50 for CD; RR 2.65, 95% CI 1.61‐4.36 for UC). The pooled RR was 2.26 (95% CI 1.42‐3.59) in the pediatric CD subgroup.ConclusionThis meta‐analysis indicates that a pre‐illness Western dietary pattern may increase the risk of developing CD and UC.

Crohn's disease (CD) is a chronic and relapsing–remitting inflammatory disorder of the gastrointestinal tract. Approximately 70% of patients inevitably develop fibrosis‐associated intestinal stricture after 10 years of CD diagnosis, which seriously affects their quality of life. Current therapies play limited role in preventing or reversing the process of fibrosis and no specific anti‐fibrotic therapy is yet available. Nearly half of patients thus have no alternative but to receive surgery. The potential mechanisms of intestinal fibrosis remain poorly understood; extracellular matrix remodeling, aberrant immune response, intestinal microbiome imbalance and creeping fat might exert fundamental influences on the multiple physiological and pathophysiological processes. Recently, the emerging new diagnostic techniques have markedly promoted an accurate assessment of intestinal stricture by distinguishing fibrosis from inflammation, which is crucial for guiding treatment and predicting prognosis. In this review, we concisely summarized the key studies published in the year 2020 covering pathogenesis, diagnostic modalities, and therapeutic strategy of intestinal stricture. A comprehensive and timely review of the updated researches in intestinal stricture could provide insight to further elucidate its pathogenesis and identify novel drug targets with anti‐fibrotic potentiality.

Background Administration of iodinated contrast is common but may be associated with contrast-induced acute kidney injury (CI-AKI), particularly in at-risk patients. There is no recent systematic review of potentially modifiable risk factors. Methods We searched MEDLINE, Embase and the Cochrane Database of Systematic Reviews (to 30 th June 2019) for observational studies assessing risk factors associated with CI-AKI. Twelve potentially modifiable risk factors were finally included in this thematic review and meta-analysis. Random or fixed meta-analysis was performed to derive the adjusted odds ratio (aOR), and the population attributable risk (PAR) was calculated for each risk factor globally and by region. Findings We included 157 studies (2,297,863 participants). The global incidence of CI-AKI was 5.4%. The potentially modifiable risk factors included high contrast volume (PAR 33%), eight cardiovascular risk factors (diuretic use, multivessel coronary artery disease, acute coronary syndrome, hypertension, hypotension, heart failure, reduced left ventricular ejection fraction and intra-aortic balloon pump use) (combined PAR 76.2%) and three noncardiovascular risk factors (renal dysfunction, diabetes mellitus and anaemia) (combined PAR 47.4%) with geographical differences. Bubble chart of the 12 risk factors Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): National Science Foundation of China