Celiac disease (CD) is an immune-mediated enteropathy characterized by histopathological changes, such as villous atrophy and chronic inflammation, often assessed using the Marsh classification. The systemic immune-inflammation index (SII), a novel inflammatory biomarker, has been increasingly investigated in chronic inflammatory diseases, including CD. This study aims to evaluate the relationship between SII and histopathological progression in CD, as classified by the Marsh scores, and to assess other hematological and inflammatory parameters. A retrospective analysis was conducted on 115 biopsy-confirmed CD patients from 2 hospitals between February 2022 and November 2023. Demographic, clinical, and laboratory data were analyzed, and SII values were calculated. Statistical comparisons were performed across Marsh stages. SII levels did not significantly differ among Marsh groups (p = 0.408). However, the Marsh Grade 3a group exhibited higher median SII values compared to others. Hemoglobin (Hb) levels showed significant differences across Marsh stages (p = 0.012), with a notable decrease in Marsh Grade 3c. Other parameters, such as ESR and CRP, showed no significant variation across groups. While SII shows potential as an inflammatory marker, its limited association with histological stages suggests a need for larger, prospective studies to validate its utility in clinical practice.

Background/Aims: There are studies with different results on improving effectiveness and patient comfort by increasing lumen disten tion through positioning during colonoscopy. In our study, we aimed to compare colonoscopy outcomes and post-procedural patient comfort in the left-lateral and right-lateral positions. Materials and Methods: A total of 231 patients who underwent screening colonoscopy were included. Patients were randomized to either the left-lateral or the right-lateral position. Patient age, sex, comorbidities, body mass index (BMI) values, times to reach the cecum, ileum intubation rates, total procedure times, and colonoscopy findings were compared. Pain and discomfort after the procedure were evaluated and compared with the visual analog scale (VAS) scores at 30 minutes, 6 hours, and 24 hours. Results: Colonoscopy was performed in the left-lateral position in 129 patients and in the right-lateral position in 102. The distributions of age, sex, comorbidities, and BMI values were similar in both groups. The time to reach the cecum and the total procedure time were similar in both groups. There were no significant differences in the findings detected by colonoscopy. There was no significant difference in the post-procedural VAS scores. Conclusion: This study failed to show a difference in colonoscopy outcomes and postprocedural discomfort between the left- and right lateral positions. Cite this article as: Ergin M, Yumuşak Ergin G, Kıvrakoğlu F, İbiş M. The effects of positioning during colonoscopy on effıcacy and post-procedure comfort. Turk J Gastroenterol. 2025;36(3):174-182.

Background and Objectives: The clinical significance of gastrointestinal (GI) tract wall thickening incidentally detected on abdominal imaging remains unclear. This study aimed to examine the relationship between GI tract wall thickening seen in imaging and what is found during endoscopy, as well as to explore how hemoglobin, C-reactive protein (CRP), and albumin levels can help predict the presence of malignancy. Materials and Methods: In this retrospectively designed study, 209 patients were included who were found to have GI tract wall thickening on radiological imaging and underwent endoscopy within 90 days. Endoscopic findings and laboratory data were recorded. Patients were compared based on the presence or absence of malignancy, and a receiver operating characteristic analysis was performed. Results: Malignancy was detected in 8.5% and 10.9% of the upper and lower GI tract cases, respectively. In patients with upper GI tract malignancy, hemoglobin levels were significantly lower and CRP levels were higher (p < 0.001 and p = 0.015, respectively). Similarly, in lower GI tract malignancy, hemoglobin levels were lower (p = 0.033), whereas CRP did not show a significant difference (p = 0.115). Cut-off values were determined as 11.8 g/dL for hemoglobin and 40.75 g/L for albumin, and both were found to have high negative predictive values. Conclusions: GI tract wall thickening detected radiologically is clinically significant and should be further investigated endoscopically. Certain biochemical parameters may aid in ruling out malignancy; however, endoscopy remains essential for definitive diagnosis.

Background/Aims: The aim of this study is to investigate whether the creeping fat (CF) finding evaluated by computed tomography (CT)can be used as a noninvasive marker to predict disease prognosis. Materials and Methods: The study comprised 128 Crohn’s patients, aged 18-70, who had CT scanning for a variety of reasons. Patients were retrospectively analyzed in 3 groups (31 patients with operation due to stenosis, 39 patients with unoperated stenosis, and 44 patients without stenosis). The CF Index BSACR (bowel surface area coverage ratio), CF density, and visceral-subcutaneous fat ratio (VSFR) findings were evaluated by CT compared between the groups. Results: The median VSFR was higher in the stenosed group compared to the non-stenosed group (0.7 vs 0.4; P = .003). The CF index BSACR was 37.5% (27.1% vs 18.2%; P = .001), and the rate of those with a CF index BSACR above 37.5% was higher in those with stenosis compared to those without. The odds of stenosis were 17.07 times (odds ratio [OR] = 17.07; P = .007) higher in those with a CF index BSACR of 37.5% and 184.57 times (OR = 184.57; P = .001) higher in those with a CF index BSACR of 50% or more compared to those with no involvement or a CF index BSACR of 25% or less. Conclusion: The CF index correlated with stricturing disease and may be a noninvasive radiologic marker that predicts disease prognosis. Cite this article as: Demiral N, Özdemir FAE, Kıvrakoğlu F, et al. Can creeping fat be a prognostic factor in Crohn’s disease? Turk J Gastroenterol. 2025;36(12):834-843.

Giriş ve Amaç: Serum iskemi modifiye albümin, iskemi ve oksidatif stresi göstermede kullanılan faydalı bir belirteçtir. Bu çalışmada serum iskemi modifiye albümin ve iskemi modifiye albümin tabanlı modellerin karaciğer fibrozisini öngörmede rolünün değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 2013-2016 tarihleri arasında kronik karaciğer hastalığı ön tanısıyla karaciğer biyopsisi yapılan hastalar dahil edildi. Hastaların biyopsileri tek bir patolog tarafından değerlendirildi. Fibrozis derecelerine göre hastalar sınıflandırıldı. Tüm olguların hemogram parametreleri, kreatinin, aspartat aminotransferaz, alanin aminotransferaz, total bilirübin, direk bilirübin, albümin, iskemi modifiye albümin ve iskemi modifiye albümin oranı düzeyleri değerlendirildi. Bulgular: Çalışmaya karaciğer biyopsisi yapılan toplam 34 olgu alındı. Fibrozis deresine göre 15 olgu hafif, 15 olgu orta ve 4 olgu ileri fibrozis grubundaydı. Gruplar arasında ortalama iskemi modifiye albümin ve iskemi modifiye albümin oranı düzeyleri anlamlı farklı saptandı (sırasıyla; p = 0.031, p = 0.044). Gruplar arası değerlendirmede ileri fibrozis grubunda ortalama iskemi modifiye albümin ve iskemi modifiye albümin oranı; orta ve hafif fibrozis grubuna göre anlamlı farklı saptandı (sırasıyla; p = 0.009 ve p = 0.026, p = 0.014 ve p = 0.029). Hafif ve orta fibrozis grupları arasında ortalama iskemi modifiye albümin ve iskemi modifiye albümin oranı açısından anlamlı farklılık saptanmadı (sırasıyla, p = 0.545 ve p = 0.673). Sonuç: Karaciğer hastalıklarında ileri evre fibrozisi göstermede iskemi modifiye albümin ve iskemi modifiye albümin oranı etkin bir serum belirteci olarak kullanılabilir.

Aims: This investigation sought to evaluate the potential associations between circulating A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-7, and ADAMTS-12 protein concentrations and the degree of structural hepatic fibrosis observed in patients with chronic hepatitis B (CHB).Methods: This retrospective descriptive study included a cohort of 77 patients diagnosed with CHB, alongside 30 age-matched healthy participants. We utilized a sandwich enzyme-linked immunosorbent assay methodology to quantify the serum concentrations of both ADAMTS-7 and ADAMTS-12 in all study subjects. Fibrosis stage was assessed through liver biopsy, graded by the Ishak scoring system. Statistical analyses were conducted to compare groups and to evaluate the correlation between biomarker levels and fibrosis stage.Results: Compared with the healthy control group, patients with CHB exhibited significantly reduced serum concentrations of ADAMTS-7 and ADAMTS-12. However, no significant differences emerged between mild and advanced fibrosis.Conclusion: Serum ADAMTS-7 and ADAMTS-12 levels are significantly reduced in patients with CHB compared to healthy controls. However, since they do not differentiate between mild and advanced fibrosis, they have limited clinical utility as non invasive biomarkers for staging fibrosis severity. These reductions may reflect a generalized response to chronic viral infection rather than the specific extent of fibrotic tissue.