Objective: Helicobacter pylori (Hp) infection is one of the most common infections in the world. There are studies showing that the prevalence of Hp has decreased over the years. In this study, while trying to determine the prevalence of patients diagnosed with Hp histopathologically in our region and the change in this prevalence over the years, it was also tried to determine the relationship between endoscopic diagnosis and Hp and the change in this relationship over the years. Methods: Patients who underwent esophagogastroduodenoscopy at the Adnan Menderes University Gastroenterology Endoscopy Unit between 1998 and 2000 and 2018 and 2020 were included in the study. Helicobacter pylori status and endoscopic diagnoses were recorded in the patients. Helicobacter pylori was detected histopathologically. Results: A total of 6622 patients, 3791 between 1998 and 2000 and 2831 between 2018 and 2020, were included in the study. Heliobacter pylori positivity rate was 49.5% between 1998 and 2000, and 27.3% between 2018 and 2020 (P .0001). While Hp positivity rate was 78.1% in bulber ulcer, 54.4% in gastric ulcer, and 34.3% in gastric cancer between 1998 and 2000, this rate was found to be 32.3% in bulber ulcer, 38.1% in gastric ulcer, and 8.3% in gastric cancer between 2018 and 2020. (P=.0001, P=.004, P=.012). Conclusion: In this study, we found that the prevalence of Hp decreased from 49.5% to 27.3% in 20 years in our region. This decrease was observed in all endoscopic diagnoses, and the decreases were statistically significant. In the decrease of Hp prevalence, in addition to eradication treatment, we think that factors such as improved sanitation conditions and increased education/socioeconomic level also play a role.

Esophageal necrosis, also known as necrotizing esophagitis or black esophagus, was first described in 1990. The incidence of this condition has been reported in various studies to range between 0.014% and 0.0125%. The mortality rate of esophageal necrosis can be as high as 32%. Additionally, esophageal necrosis is among the rare causes of upper gastrointestinal bleeding. Management primarily involves addressing underlying causes and providing supportive care. The mortality rate remains high due to the severity of the condition.

Background/Aims: The study aimed to compare the effectiveness and safety of vedolizumab (VDZ) and ustekinumab (UST) in patients with ulcerative colitis (UC) previously exposed to biologic therapy and to determine whether prior biologic exposure affects treatment outcomes. Materials and Methods: In this multicenter retrospective study, data from 420 patients treated at 14 centers with VDZ (n = 260) or UST (n = 160) between 2020 and 2024 were analyzed. Outcomes included steroid-free clinical remission (SFCR), clinical remission (CR), treatment persistence, and adverse events at weeks 14-16, 52, and 104. Inverse probability of treatment weighting was used to adjust for baseline differences between treatment groups. Results: In the weighted cohort, rates of SFCR and CR were comparable between treatments at weeks 14-16 and 52 (P > .05). At week 104, SFCR rates did not differ significantly between treatment groups, whereas VDZ was associated with higher CR rates (adjusted odds ratio [aOR] = 0.66; 95% CI = 0.45-0.91). In subgroup analyses, VDZ was associated with higher CR and SFCR rates among patients with 1 prior biologic exposure, whereas UST was associated with higher CR (aOR = 1.86; 95% CI = 1.10-3.16) and SFCR (aOR = 1.79; 95% CI = 1.05-3.09) rates at week 52 among patients with 2 or more prior biologic exposures. Treatment persistence was significantly higher with UST (aOR = 1.82; 95% CI = 1.36-2.44). Safety profiles were comparable between treatment groups. Conclusion: VDZ and UST demonstrated broadly comparable effectiveness in biologic-experienced UC. The higher CR rate favoring VDZ at week 104 should be interpreted cautiously given the lack of a significant difference in SFCR rate and limitations of long-term followup assessment. Exploratory subgroup findings suggest that UST may have a potential role in patients who were heavily pretreated. These findings may inform hypotheses regarding individualized treatment sequencing. Cite this article as: Araz F, Sezgin O, Barutçu S, et al. Comparative effectiveness of vedolizumab and ustekinumab in biologicexperienced ulcerative colitis: A real-world multicenter study from the GÜNTÜRK group. Turk J Gastroenterol.Published online October 5, 2026. doi: 10.5152/tjg.2026.26102.

Crohn’s disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract, most frequently the ileocecal region. Esophageal involvement is rare in adults and may present with atypical endoscopic findings. A 50-year-old male patient diagnosed with Crohn’s disease presented with severe diarrhea, nausea, and retrosternal pain. Ileocolonoscopy findings were normal. Upper endoscopy revealed a black-gray membranous appearance in the middle and distal esophagus, suggestive of acute esophageal necrosis. Magnetic resonance enterography showed diffuse small bowel wall thickening consistent with disease activation. Infliximab therapy was initiated, resulting in clinical improvement and complete endoscopic resolution within 3 months. Esophageal involvement in Crohn’s disease is rare and may mimic acute esophageal necrosis. Anti-TNF therapy can provide clinical and endoscopic remission in such atypical cases.

Acute pancreatitis is defined as inflammation of the pancreas gland accompanied by abdominal pain and elevated levels of amylase and lipase. The reported annual incidence of acute pancreatitis varies between 4.9 and 35 per 100 000 people. Annular pancreas is a rare cause of acute pancreatitis. The incidence of annular pancreas varies between 5 and 15 per 100 000. It presents with different clinical symptoms and can cause nausea, vomiting, cholangitis, and pancreatitis. In this case report, we present one case showing that the etiology of acute pancreatitis is annular pancreas.

Evidence regarding endoscopic retrograde cholangiopancreatography (ERCP) in adults in their 90s and 100s remains limited, and chronological age may not adequately reflect procedural vulnerability. We compared ERCP strategy and short-term outcomes across advanced age strata and included a contemporary younger reference cohort. This retrospective cohort included 48 patients aged ≥80 years undergoing ERCP for choledocholithiasis or stone-related acute cholangitis between 2023 and 2025: 80–89 years (n = 20), 90–99 years (n = 21), and ≥100 years (n = 7). A reference group of 15 consecutive patients aged <80 years treated during the same period under the same eligibility criteria was added. Only the first eligible ERCP per patient during the study period was analyzed as the index procedure; subsequent ERCPs were outcomes rather than additional observations. Clinical Frailty Scale (CFS), stone burden, treatment strategy, drainage, adverse events, intensive care use, and 30-day mortality were analyzed using nonparametric and Fisher–Freeman–Halton methods. Frailty–outcome analyses were restricted to the ≥80-year primary cohort and were exploratory and unadjusted. Median CFS was 4.0, 4.5, 6.0, and 8.0 in the <80, 80–89, 90–99, and ≥100-year groups, respectively (p < 0.001). Complete index stone clearance was 93.3%, 90.0%, 76.2%, and 71.4% (p = 0.358), while stenting was used in 6.7%, 10.0%, 33.3%, and 42.9% (p = 0.055). Successful biliary drainage remained 100%, 95.0%, 95.2%, and 100% (p = 1.000). Repeat ERCP occurred in 0%, 0%, 14.3%, and 28.6% (p = 0.027), and median length of stay increased from 3 to 4, 5, and 6 days (p < 0.001). Within the ≥80-year cohort, higher CFS remained associated with failed index clearance, stenting, post-procedure ICU requirement, and 30-day mortality in exploratory analyses. ERCP achieved high biliary drainage rates across age strata, including centenarians. The small younger reference cohort provided clinical context, while the ≥80-year analyses continued to show increasing frailty and more frequent staged management in the oldest groups. The retrospective design, small reference cohort, sparse events, and strong age–frailty correlation preclude causal or independent prognostic claims.