Background: Lactose intolerance (LI) appears usually in later ages when the lactase enzyme becomes deficient or absent in the small intestine. Conflicting results have been reported in the literature about the association of lactose intolerance with various gastrointestinal malignancies. Hence, our aim was to study the association between LI, colon cancer (CCa), and gastric cancer (GC) using a large database. Methods: A cross-sectional study was performed using the National Inpatient Sample (NIS) database between 2004 and 2014. We identified adult patients (18-90 years) who were diagnosed with LI (study group) using appropriate International Classification of Diseases, Ninth Revision (ICD-9) codes. The control group comprised patients who did not have a diagnosis of LI. We identified the diagnosis of CCa and GC in both study and control groups using the ICD-9 codes. Univariable and multivariable logistic regression analyses were performed to assess the association between LI, CCa, and GC. Results: The total population comprised 71,360,501 patients, of which 57,909 (0.08%) were diagnosed with LI. LI patients were older (62 vs 51 years) with more females (61.5% vs 60.1%) and less African American patients (11.8% vs 14.3%) (p <0.0001 for all). In addition, LI patients had more smoking (12.4% vs 12%) and obesity (15% vs 8.9%). On the other hand, patients in the LI group had less alcohol use (3.8% vs 4.2%) (p <0.0001). After adjusting for the age, gender, race, smoking, alcohol, obesity, and inflammatory bowel disease, the LI group had a slightly lower rate of CCa (OR 0 .974, 95%CI 0.906-1.048, p = 0.486) and a lower rate of GC (OR: 0.993, 95%CI 0.924-1.068, p =0.853); however, the results were not statistically significant. Conclusion: Patients with lactose intolerance may have a lower risk of colon and gastric cancer. However, these findings were not statistically significant. Further studies are needed to understand this association.

Background: Pancreatic stents (PSs) play a crucial role in the management of pancreatic duct obstructions, particularly in the context of endoscopic retrograde cholangiopancreatography (ERCP). However, stent migration remains a significant complication, leading to risks such as pancreatitis, pancreatic duct stenosis, and abscess formation. This study aims to evaluate the efficacy of various endoscopic techniques for retrieving proximally migrated or broken pancreatic stents, highlighting optimal strategies for improving patient outcomes. Methods: A retrospective multicenter review was conducted across six hospitals from 2016 to 2024. Patients with proximally migrated or broken pancreatic stents referred for endoscopic retrieval after failed attempts at other facilities were included. Demographic data, stent characteristics, and retrieval techniques were analyzed. Endoscopic methods included SpyGlass forceps, SpyGlass baskets, Soehendra retriever stents, balloon sweeps, flower baskets, and extension pancreatic sphincterotomy. Procedural success, retrieval times, and post-procedural outcomes were assessed. Results: Twelve patients underwent endoscopic retrieval, including two with broken stents. All procedures were successful, with retrieval times averaging 30 to 45 min. Two patients developed pancreatic duct narrowing, requiring balloon dilation. All patients had new stents placed to maintain duct patency, and no major complications were observed. Follow-up evaluations confirmed complete resolution of migration-related issues, with all stents removed. Conclusions: Endoscopic retrieval of migrated pancreatic stents is highly effective, with specialized techniques ensuring a 100% success rate in this study. Early intervention and the selection of appropriate retrieval methods are critical in minimizing complications. Further research is needed to refine retrieval strategies and standardize protocols to enhance clinical outcomes.

Bobak Moazzami, Dariush Shahsavari, Zohyra E. Zabala, Raguraj Chandradevan, Navkiran Randhawa, Catarina Cutter, Humberto Sifuentes, and Subbaramia Sridhar. Korean J Gastroenterol 2025;85:506-16. https://doi.org/10.4166/kjg.2025.050

Cardiac dysphagia is a rare cause of dysphagia due to an enlarged left atrium compressing the esophagus. We describe three patients (ages 70, 71, and 31) with past medical histories of advanced heart disease who presented with diverse clinical manifestations of dysphagia. Recognition of cardiac dysphagia is important to prevent unnecessary esophageal interventions. Multimodal evaluation with barium swallow, esophageal manometry, endoscopy, and cardiac imaging facilitates diagnosis and management. These cases highlight the importance of considering cardiac causes of dysphagia in patients with severe underlying heart disease.