Publication Name	World Journal of Gastroenterology
Manuscript ID	123964
DOI	10.3748/wjg.123964
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Correspondence
Article Title	Letter to the Editor: Rhubarb enema for acute pancreatitis - encouraging gut-immune signals with unconfirmed clinical benefit
Manuscript Source	Unsolicited Manuscript
All Author List	Sheng-Yu Huang, Xing-Wei Zhao, Qiu-Ting Li, Zi-Xu Ye and Chun-Xiang Zhang
Funding Agency and Grant Number
Corresponding Author	Chun-Xiang Zhang, Dean, Professor, Department of Cardiology, Basic Medicine Research Innovation Center for Cardiometabolic Diseases, SOUTHWEST MEDICAL UNIVERSITY, Department of Cardiology, The Affiliated Hospital, Southwest Medical University, No. 1, Section 1, Xianglin Road, Luzhou, Sichuan, 646000, China. zcxteam@163.com,Key Laboratory of Medical Electrophysiology, Ministry of Education & Medical Electrophysiological Key Laboratory of Sichuan Province, Institute of Cardiovascular Research, Southwest Medical University, Luzhou, Sichuan, 646000, China. zcxteam@163.com,Basic Medicine Research Innovation Center for Cardiometabolic Diseases, Ministry of Education, Southwest Medical University, Luzhou, Sichuan, 646000, China. zcxteam@163.com,Nucleic Acid Medicine of Luzhou Key Laboratory, Southwest Medical University, Luzhou, Sichuan, 646000, China. zcxteam@163.com, Luzhou 646000, Sichuan Province, China. zcxteam@163.com
Key Words	Acute pancreatitis; Rhubarb enema; Gut-immune axis; Th17 cells; IL-17A; Intra-abdominal pressure; Randomized controlled trial; Patient-centered outcomes
Core Tip	Rhubarb enema has shown promising intestinal-immune regulatory signals in acute pancreatitis, including a decrease in pro-inflammatory factors, a downregulation of the Th17/IL-17A pathway, an increase in IL-10, and an improvement in intra-abdominal pressure. However, recent randomized controlled studies have not shown a significant reduction in all-cause mortality at 28 days, and the actual event rate is lower than expected, with a relatively specific study population, which limits the certainty and generalizability of the conclusions. Rhubarb enema should currently be regarded as a potentially promising but unproven adjunctive intervention rather than a standard treatment that can immediately change clinical practice. Its clinical value still needs to be further verified in standardized procedures, clear stratified populations, and patient-centered hard endpoints.
Citation	Huang SY, Zhao XW, Li QT, Ye ZX, Zhang CX. Letter to the Editor: Rhubarb enema for acute pancreatitis - encouraging gut-immune signals with unconfirmed clinical benefit. World J Gastroenterol 2026; In press DOI: https://doi.org/10.3748/wjg.123964
PDF	123964-in-press.pdf

Received	2026-06-02 07:36
Peer-Review Started	2026-06-02 07:37
First Decision by Editorial Office Director
Return for Revision	2026-06-23 02:24
Revised	2026-06-27 11:23
Publication Fee Transferred
Second Decision by Editor	2026-07-13 02:36
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-07-13 08:11
Articles in Press	2026-07-13 08:11
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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