Background/Aims: Chronic constipation is prevalent yet under-diagnosed across Asia, compromising quality of life and burdening healthcare systems. Cultural stigma, varied diets, and limited access to standardized diagnostic tools delay timely care. Methods: The Bali Chronic Constipation Roundtable in November 2024, brought together experts from 11 Asian countries. The group reviewed epidemiological data, analyzed multinational questionnaire on clinical practice pattern, and conducted structured discussions to identify key barriers and propose region-specific recommendations. Results: Chronic constipation prevalence varies across Asia, ranging from 1.8% in India to 16.6% in Japan, with women and the elderly disproportionately affected. Under-reporting persists owing to cultural taboos and widespread self treatment with laxatives and traditional medications. Although the Rome IV criteria remains the global standard, they may not fully reflect Asian symptom profiles, and diagnosis is limited by scarce motility laboratories. First line therapies such as dietary-fiber optimization and osmotic laxatives are widely available, but newer pharmacotherapies (prucalopride, linaclotide, lubiprostone, and elobixibat) remain costly and unevenly accessible. Biofeedback for dyssynergic defecation is underutilized due to limited availability. Experts recommend expanded regional research on to refine diagnostic criteria, coupled with enhanced physician education and public awareness. They advocate accessibility to second-line and novel therapies that incorporate culturally attuned regional guidelines, and improved access to gastrointestinal motility testing. Conclusions The Bali Chronic Constipation Roundtable highlighted Asia’s need for region specific diagnostics and management. Addressing diagnostic and treatment gaps will improve outcomes, while ongoing researcher clinician policy collaboration must standardize guidelines, advance research, and ensure equitable care across Asia.

Helicobacter pylori infection—although its overall prevalence has declined over time—remains a major cause of peptic ulcer disease and gastric cancer, particularly among older adults in aging societies such as Japan. While eradication therapy is known to reduce the gastric cancer risk, its use in older adults is often complicated by comorbidities, polypharmacy, altered drug metabolism, and limited life expectancy. This review summarizes current perspectives on the management of H. pylori infection in older patients, based on Japanese clinical practice and recent evidence. Older individuals frequently have long-standing infections accompanied by advanced gastric atrophy and intestinal metaplasia, which may adversely affect diagnostic accuracy and therapeutic outcomes. Diagnostic evaluation is further complicated by severe mucosal atrophy and the frequent use of acid-suppressive medications, requiring careful interpretation of test results and, in some cases, correlation with endoscopic findings. In Japan, vonoprazan-based eradication regimens have become the standard of care because of their high efficacy and pharmacological stability regardless of CYP2C19 genotype. Available data indicate that eradication therapy is generally safe and well tolerated in older patients, with adverse event rates comparable to those observed in younger populations. Eradication therapy is highly recommended for disease-specific indications (e.g., peptic ulcer) and for primary prevention of gastric cancer. Overall, older age alone should not be considered a contraindication to eradication therapy; rather, treatment decisions should be based on a comprehensive assessment of comorbidities, concomitant medications, the patient’s functional status, and the patient’s preferences.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

In this study, we aimed to develop foods with antitumor and complementary effects against cisplatin (CDDP)-resistant bladder cancer. UMUC3, a human bladder cancer cell line was exposed to CDDP and cultured over a prolonged period to prepare UMUC3-CR, a CDDP-resistant subline. Androgen receptor mRNA expression was high in the UMUC3-CR subline. Genistein and vitamin C suppressed UMUC3-CR tumor growth. Additionally, the liberal intake of cheese in parental cell UMUC3-transplanted mice was associated with prolonged survival. Therefore, we created konjac jelly (KIK300) containing soy milk, cheese, and vitamin C as the main ingredients. Liberal administration of KIK300 to UMUC3-CR-transplanted mice suppressed tumor growth and reduced vascular endothelial growth factor mRNA expression. Furthermore, we observed no weight loss in the animals, their skin condition improved, and exercise capacity was improved. In conclusion, this study suggests that KIK300 may show antitumor and complementary effects on CDDP-resistant bladder cancer.

Gastric cancer remains one of the most common causes of cancer-related death worldwide, although the incidence is declining gradually. The primary risk factor for gastric cancer is Helicobacter pylori infection. The Kyoto global consensus report recommends eradication of H. pylori in all infected patients. However, because it is difficult to stratify the risk of carcinogenesis among patients with a history of H. pylori infection, annual endoscopic surveillance is performed for everyone after eradication. This review summarizes the current approaches used to screen for novel molecules that could assist in the diagnosis of gastric cancer and reduce mortality. Most well-studied molecules are tissue protein biomarkers expressed by the gastric epithelium and associated with metaplasia-dysplasia-carcinoma sequences. Other strategies focus on the origin of cancer stem cell-related markers, such as CD44, and immune reaction-related markers, such as matrix metallopeptidases. Noninvasive methods such as blood-based approaches are more attractive. Serum pepsinogen levels predict the severity of gastric mucosal atrophy before H. pylori eradication, whereas plasma ghrelin levels are associated with atrophy even after eradication.Cell-free DNAs and RNAs are attractive tools for the early detection of cancer. These ideas could lead to the development of more personalized strategies for cancer prevention based on cuttingedge technologies.