Wilderness-acquired diarrhea  is a variety of  traveler's diarrhea  in which backpackers and other outdoor enthusiasts are affected. Potential sources are contaminated food or water, or "hand-to-mouth", directly from another person who is infected. [ 1 ] [ 2 ]  Cases generally resolve spontaneously, with or without treatment, and the cause is typically unknown. The  National Outdoor Leadership School  has recorded about one incident per 5,000 person-field days by following strict protocols on hygiene and water treatment. [ 3 ]   More limited, separate studies have presented highly varied estimated rates of affliction that range from 3 percent to 74 percent of wilderness visitors. [ 1 ] [ 4 ]   One survey found that long-distance  Appalachian Trail  hikers reported  diarrhea  as their most common illness. [ 5 ]  Based on reviews of epidemiologic data and literature, some researchers believe that the risks have been over-stated and are poorly understood by the public. [ 4 ] [ 6 ] [ 7 ] [ 8 ]


The average  incubation periods  for  giardiasis  and  cryptosporidiosis  are each 7 days. [ 9 ] [ 10 ]  Certain other bacterial and viral agents have shorter incubation periods, although hepatitis may take weeks to manifest itself. The onset usually occurs within the first week of return from the field, but may also occur at any time while hiking. [ citation needed ]


Most cases begin abruptly and usually result in increased frequency, volume, and weight of stool. Typically, a hiker experiences at least four to five loose or watery bowel movements each day. Other commonly associated symptoms are nausea, vomiting, abdominal cramping, bloating, low fever, urgency, and malaise, and usually the appetite is affected. The condition is much more serious if there is blood or  mucus  in stools, abdominal pain, or high fever.  Dehydration  is a possibility. Life-threatening illness resulting from WAD is extremely rare but can occur in people with weakened immune systems. [ citation needed ]


Some people may be carriers and not exhibit symptoms. [ citation needed ]


Infectious diarrhea acquired in the wilderness is caused by various  bacteria ,  viruses , and parasites ( protozoa ). The most commonly reported are the protozoa  Giardia  and  Cryptosporidium . [ 11 ]  Other infectious agents may play a larger role than generally believed [ 4 ]  and include  Campylobacter ,  hepatitis A virus ,  hepatitis E virus , enterotoxogenic  E. coli ,  E. coli  O157:H7,  Shigella , and various other viruses. More rarely,  Yersinia enterocolitica ,  Aeromonas hydrophila , and  Cyanobacterium  may also cause disease. [ 12 ]


Giardia lamblia  cysts usually do not tolerate freezing although some cysts can survive a single freeze–thaw cycle. [ 13 ]   Cysts can remain viable for nearly three months in river water when the temperature is 10 °C and about one month at 15–20 °C in lake water.  Cryptosporidium  may survive in cold waters (4 °C) for up to 18 months, and can even withstand freezing, although its viability is thereby greatly reduced. [ 14 ]  Many other varieties of diarrhea-causing organisms, including  Shigella  and  Salmonella typhi , and hepatitis A virus, can survive freezing for weeks to months. [ 15 ]  Virologists believe all surface water in the United States and Canada has the potential to contain human viruses, which cause a wide range of illnesses including diarrhea, polio and meningitis. [ 16 ] [ 17 ] [ 18 ]  Modes of acquiring infection from these causes are limited to fecal-oral transmission, and contaminated water and food. The major factor governing pathogen content of surface water is human and animal activity in the watershed. [ 19 ]


It may be difficult to associate a particular case of diarrhea with a recent wilderness trip of a few days because incubation of the disease may outlast the trip. Studies of trips [ 2 ] [ 20 ]  that are much longer than the average incubation period, e.g. a week for  Cryptosporidium  and  Giardia , [ 9 ] [ 10 ]  are less susceptible to these errors since there is enough time for the diarrhea to occur during the trip. Other bacterial and viral agents have shorter incubation periods, although hepatitis may require weeks. [ citation needed ]


A suspected case of wilderness-acquired diarrhea may be assessed within the general context of intestinal complaints. During any given four-week period, as many as 7.2% of Americans may experience some form of infectious or non-infectious diarrhea. [ 21 ]  There are an estimated 99 million annual cases of intestinal infectious disease in the United States, [ 22 ]  most commonly from viruses, followed by bacteria and parasites, including Giardia and Cryptosporidium. There are an estimated 1.2 million U.S. cases of symptomatic giardiasis annually. [ 23 ]  However, only about 40% of cases are symptomatic. [ 24 ]


Since wilderness acquired diarrhea can be caused by insufficient hygiene, contaminated water, and (possibly) increased susceptibility from vitamin deficiency, prevention methods should address these causes. [ citation needed ]


The risk of fecal-oral transmission of pathogens that cause diarrhea can be significantly reduced by good hygiene, including washing hands with soap and water after urination and defecation, and washing eating utensils with warm soapy water. [ 2 ]  Additionally a  three-bowl system  can be used for washing eating utensils. [ 1 ]


Water can be treated in the wilderness through filtering, chemical disinfectants, a portable ultraviolet light device,  pasteurizing  or boiling. [ 25 ] [ 26 ]  Factors in choice may include the number of people involved, space and weight considerations, the quality of available water, personal taste and preferences, and fuel availability. [ citation needed ]


In a study of long-distance backpacking, it was found that water filters were used more consistently than chemical disinfectants. Inconsistent use of iodine or chlorine may be due to disagreeable taste, extended treatment time or treatment complexity due to water temperature and turbidity. [ 20 ]


Because methods based on  halogens , such as iodine and chlorine, do not kill  Cryptosporidium , and because filtration misses some viruses, the best protection may require a two-step process of either filtration or coagulation- flocculation , followed by  halogenation . Boiling is effective in all situations. [ citation needed ]


Iodine resins, if combined with microfiltration to remove resistant cysts, are also a viable single-step process, but may not be effective under all conditions. New one-step techniques using  chlorine dioxide , ozone, and UV radiation may prove effective, but still require validation. [ 27 ]


Ultraviolet (UV) light for water disinfection is well established and widely used for large applications, like municipal water systems. Some hikers use small portable UV devices which meet the U.S. EPA Guide Standard and Protocol for Testing Microbiological Water Purifiers, for example, the SteriPEN. [ 28 ] [ 29 ] [ 30 ]  Another approach to portable UV water purification is  solar disinfection  (also called  sodis ). Clear water is sterilized by putting it in a clear polyethylene ( PET ) bottle and leaving it in direct sunlight for 6 hours. [ 31 ]


Different types of water sources may have different levels of contamination: [ 32 ]


Rain storms can either improve or worsen water quality. They can wash contaminants into water and stir up contaminated sediments with increasing flow, but can also dilute contaminants by adding large amounts of water. [ 32 ]


Unfortunately, there have not been any epidemiological studies to validate the above, except possibly for the case of spring water. [ 2 ]


One study suggests that on very long trips in the wilderness, taking  multivitamins  may reduce the incidence of diarrhea. [ 2 ]


WAD is typically self-limited, generally resolving without specific treatment.  Oral rehydration therapy  with rehydration salts is often beneficial to replace lost fluids and  electrolytes . Clear, disinfected water or other liquids are routinely recommended. [ citation needed ]


Hikers who develop three or more loose stools in a 24-hour period – especially if associated with  nausea ,  vomiting ,  abdominal   cramps ,  fever , or  blood in stools  – should be treated by a doctor and may benefit from antibiotics, usually given for 3–5 days. Alternatively, a single dose  azithromycin  or  levofloxacin  may be prescribed. [ 33 ]  If diarrhea persists despite therapy, travelers should be evaluated and treated for possible parasitic infection. [ citation needed ]


Cryptosporidium  can be quite dangerous to patients with compromised immune systems. Alinia (nitazoxanide) is approved by the FDA for treatment of  Cryptosporidium .


The risk of acquiring infectious diarrhea in the wilderness arises from inadvertent ingestion of pathogens. Various studies have sought to estimate diarrhea  attack rates  among wilderness travelers, and results have ranged widely. The variation of diarrhea rate between studies may depend on the time of year, the location of the study, the length of time the hikers were in the wilderness, [ 2 ] [ 34 ]
the prevention methods used, and the study methodology.


The  National Outdoor Leadership School  (NOLS), which emphasizes strict hand-washing techniques, water disinfection and washing of common cooking utensils in their programs, reports that gastrointestinal illnesses occurred at a rate of only 0.26 per 1000 program days. [ 35 ]  In contrast, a  survey of long-distance  Appalachian Trail   hikers found more than half  the respondents reported at least one episode of diarrhea that lasted an average of two days. (Infectious diarrhea may last longer than an average of two days; certain forms of non-infectious diarrhea, caused by diet change etc., can be of very brief duration).  Analysis of this survey found occurrence of diarrhea was positively associated with the duration of exposure in the wilderness. During any given four-week period, as many as 7.2% of Americans may experience some form of infectious or non-infectious diarrhea. [ 21 ]  A number of behaviors each individually reduced the incidence of diarrhea: treating water; routinely washing hands with soap and water after defecation and urination; cleaning cooking utensils with soap and warm water; and taking multi-vitamins. [ 2 ] [ 20 ]


A variety of pathogens can cause infectious diarrhea, and most cases among backpackers appear to be caused by bacteria from  feces . A study at Grand Teton National Park found 69% of diarrhea affected visitors had no identifiable cause, that 23% had diarrhea due to  Campylobacter  and 8% of patients with diarrhea had  giardiasis . Campylobacter enteritis occurred most frequently in young adults who had hiked in wilderness areas and drunk untreated surface water in the week prior. [ 36 ]  Another study tested 35 individuals before and after a trip to the Desolation Wilderness of California. Giardia cysts were found in fecal samples from two people after the trip, but they were asymptomatic. A third person was empirically treated for symptoms of giardiasis. [ 37 ]


Fecal-oral transmission may be the most common vector for wilderness acquired diarrhea. There are differing opinions regarding the importance of routine disinfection of water during relatively brief backcountry visits. [ 6 ] [ 4 ] [ 7 ]


Infection by fecal coliform bacteria, which indicate fecal pollution, are more common than giardiasis. [ 38 ]  Risks are highest in surface water near trails used by  pack animals  and cattle pastures. [ 39 ] [ 40 ]


Most samples of backcountry water in the Desolation Wilderness in California have found very low or no  Giardia  cysts. [ 37 ]  The infectious dose of giardia, however, is very low, with about 2% chance of infection from a single cyst. [ 41 ]  Also, very few studies have addressed the issue of transient contamination. According to one researcher, the likely model for the risk of  Giardia  from wilderness water is pulse contamination, that is, a brief period of high cyst concentration from fecal contamination. [ 7 ] [ 42 ]


Diarrhea acquired in the wilderness or other remote areas is typically a form of  infectious diarrhea , itself classified as a type of  secretory diarrhea . These are all considered forms of  gastroenteritis . The term may be applied in various remote areas of non-tropical developed countries (U.S., Canada, western Europe, etc.), but is less applicable in developing countries, and in the tropics, because of the different  pathogens  that are most likely to cause infection. [ 7 ]


Alimentary Pharmacology & Therapeutics  is a bimonthly  peer-reviewed   medical journal  concerned with the effects of drugs on the human gastrointestinal and hepato-biliary systems, particularly with relevance to clinical practice. The journal publishes original papers concerned with all aspects of basic and clinical  pharmacology ,  pharmacokinetics , and the therapeutic use of  drugs  in the alimentary tract including the liver, gall bladder, and pancreas. [ 1 ]  Its  editors  are J. M. Rhodes and C. W. Howden. [ 2 ]


This article about a  pharmacology   journal  is a  stub . You can help Wikipedia by  expanding it .


This article about a  medical journal  is a  stub . You can help Wikipedia by  expanding it .


The American Journal of Gastroenterology  is a  peer-reviewed   medical journal  owned by the  American College of Gastroenterology . It has been published by  Lippincott Williams & Wilkins  since 2019 and was previously published by  Nature Research , [ 1 ]  Blackwell and (before 2004)  Elsevier . [ 2 ]


The  Canadian Journal of Gastroenterology and Hepatology  is a  peer-reviewed   medical journal  covering all aspects of  gastroenterology  and  liver disease . It is published by the  Hindawi Publishing Corporation , after having been sold by  Pulsus Group  in 2015.  It was the official journal of the  Canadian Association of Gastroenterology  and the  Canadian Association for the Study of the Liver , who divested from the journal in December 2016 after the sale to Hindawi. It was established in 1987 as the  Canadian Journal of Gastroenterology  and obtained its current name in 2014.


The journal is abstracted and indexed in:


According to the  Journal Citation Reports , the journal has a 2016  impact factor  of 2.147. [ 5 ]


Clinical and Experimental Gastroenterology   is a  peer-reviewed   medical journal  covering research in  gastroenterology . The journal was established in 2008 and is published by  Dove Medical Press . [ 1 ]


Clinical and Translational Gastroenterology  is a monthly  peer-reviewed   open access   medical journal  covering  gastroenterology . It was established in 2010 and is published by  Springer Nature  on behalf of the  American College of Gastroenterology , of which it is the official online journal. It is also the  sister journal  of the  American Journal of Gastroenterology . [ 1 ]  According to the  Journal Citation Reports , the journal has a 2020  impact factor  of 4.488. [ 2 ]  According to 2018, it ranked 20th out of 84th in the category of  Gastroenterology & Hepatology . and making it the highest-impact open access journal in this category. [ 3 ]


Clinical Gastroenterology and Hepatology  is a monthly  peer-reviewed   medical journal  published by  Elsevier  on behalf of the  American Gastroenterological Association . It was established in January 2003. [ 1 ]  According to the  Journal Citation Reports , the journal has a 2021  impact factor  of 13.576. [ 2 ]


Digestive Diseases and Sciences , formerly known as the  American Journal of Digestive Diseases , is a monthly peer-reviewed journal focusing on gastroenterology and hepatology. It is published by  Springer Science+Business Media  and the editor-in-chief is Jonathan Kaunitz ( David Geffen School of Medicine ). According to the  Journal Citation Reports , the journal has a 2021  impact factor  of 3.487 (2021) and a 5-year  impact factor  of 3.522.


Endoscopy  is a monthly  peer-reviewed   medical journal  published by  Thieme Medical Publishers  on behalf of the  European Society of Gastrointestinal Endoscopy . The journal covers all aspects of  gastrointestinal   endoscopy  and also publishes ESGE guidelines and an annual review of the most recent literature,  Endoscopy Essentials . Since 2013, the  editor-in-chief  has been Peter D. Siersema ( University Medical Center Utrecht ).


The journal is abstracted and indexed in  Index Medicus / MEDLINE / PubMed , [ 1 ]   Current Contents /Clinical Medicine, [ 2 ]  Current Contents/Life Sciences, [ 2 ]   Science Citation Index , [ 2 ]   Embase , [ 3 ]  and  Scopus . [ 4 ]  According to the  Journal Citation Reports , the journal has a 2020  impact factor  of 7.341. [ 5 ]


The  European Journal of Gastroenterology & Hepatology  is a  peer-reviewed   medical journal  covering the fields of  gastroenterology  and  hepatology . It was established in 1989 and is published by  Lippincott Williams & Wilkins . The  editors-in-chief  are Joost PH Drenth ( Radboud University Medical Center ) and Didier Lebrec. [ 1 ]  According to the  Journal Citation Reports , the journal has a 2020  impact factor  of 2.251. [ 2 ]


Expert Review of Gastroenterology & Hepatology  is a  peer-reviewed   medical journal  covering all aspects of  gastroenterology  and  hepatology . It was established in 2007 and is published by  Informa .


According to the  Journal Citation Reports , the journal has a 2018  impact factor  of 2.991. [ 1 ]


Gastroenterology  is the official  medical journal  of the  American Gastroenterological Association . Its first issue was published in 1943. It is currently published by  Elsevier . According to the  Journal Citation Reports , the journal has a 2020  impact factor  of 22.682, ranking it 4th among 92 journals in the category "Gasteroenterology & Hepatology". [ 1 ]


Gastrointestinal Endoscopy  is a monthly  peer-reviewed   medical journal  covering  gastroenterology , especially as relating to  endoscopy . It is published by  Elsevier  and the official publication of the  American Society for Gastrointestinal Endoscopy . The  editor-in-chief  is Douglas G. Adler, MD, FASGE.


The journal was established as the  Bulletin of the American Gastroscopic Society , was continued as the  Bulletin of Gastroscopy and Esophagoscopy  from 1959 to 1961, then as the  Bulletin of Gastrointestinal Endoscopy  until 1965 when it obtained its current name. [ 1 ]


The journal is abstracted and indexed in  Index Medicus / MEDLINE / PubMed , [ 2 ]   Current Contents /Clinical Medicine, [ 3 ]  Current Contents/Life Sciences, [ 3 ]   Science Citation Index , [ 3 ]   Embase , [ 4 ]  and  Scopus . [ 5 ]  According to the  Journal Citation Reports , the journal has a 2021  impact factor  of 10.396. [ 6 ]


Gastrointestinal Nursing  is a monthly  peer-reviewed   nursing journal  covering research and clinical work on the practice of  gastrointestinal   nursing . It is published by MA Healthcare. It is indexed in  Scopus . [ 1 ]


This article about a  nursing journal  is a  stub . You can help Wikipedia by  expanding it .


Gut  is a monthly  peer-reviewed   medical journal  on  gastroenterology  and  hepatology . It is the journal of the  British Society of Gastroenterology  and is published by  BMJ . As of 2010, [update]  the  editor-in-chief  is  Emad El-Omar .


Gut  was established in 1960 and covers  original research  on the  gastrointestinal tract ,  liver ,  pancreas , and  biliary tract . The journal has annual supplements covering the presentations from the British Society of Gastroenterology Annual General Meeting. British Society of Gastroenterology  clinical practice guidelines  are also published as supplements to the journal. As of March 2010, [update]  subscribers to  Gut  also receive a copy of  Frontline Gastroenterology .


Gut  is abstracted and indexed by  Medline ,  Science Citation Index ,  Current Contents /Clinical Medicine, Current Contents/Life Sciences,  Excerpta Medica ,  BIOSIS Previews  and  Scopus . According to the  Journal Citation Reports , its 2023  impact factor  is 23.1, ranking it fifth out of 143 journals in the category "Gastroenterology and Hepatology". [ 1 ]


According to the  Web of Science , some highly cited articles in  Gut  are:


Hepatitis Monthly  is a monthly  peer-reviewed   open access   medical journal  published by Brieflands Publishing, formerly known as  Kowsar Publishing . [ 1 ]  Kowsar was included on  Beall's List  prior to the list's shutdown in 2017. [ 2 ]  The journal was established in 2002 by Seyed-Moayed Alavian, who is the journal's  editor-in-chief .


The journal is abstracted and indexed in  CAB Abstracts , [ 3 ]   CINAHL , [ 4 ]   EBSCO databases , [ 5 ]   Embase , [ 6 ]   Science Citation Index Expanded , [ 7 ]  and  Scopus . [ 8 ]  According to the  Journal Citation Reports , the journal has a 2018  impact factor  of 1.578. [ 9 ]


In August 2017, the  United States National Library of Medicine , which manages the  PubMed Central  database, determined that the journal did not satisfy their Scientific Quality Standard, and delisted the journal. [ 10 ]


Hepatology  is a  peer-reviewed   medical journal  of  hepatology . It is published monthly by  John Wiley & Sons  on behalf of the  American Association for the Study of Liver Diseases . The journal was established in 1981 and the  editor-in-chief  is  David E Cohen  ( Weill Cornell Medical ).


The journal is abstracted and indexed in the following databases:


According to  Journal Citation Reports , the journal's 2020  impact factor  is 17.425, ranking it 6th out of 92 journals in the category "Gastroenterology & Hepatology". [ 1 ]


The  Indian Journal of Gastroenterology  is a  peer-reviewed  bimonthly  medical journal  covering  gastroenterology . It is published by the  Indian Society of Gastroenterology  and is indexed and abstracted in  Index Medicus ,  MEDLINE , and  Excerpta Medica .


The journal was established in 1982. Past  editors-in-chief  include F.P. Antia, S.R. Naik, and Philip Abraham. The journal publishes Editorials, Original Articles, Review Articles, Short Reports, Clinical Case Reports, Case Snippets, Debates and Letters.


Inflammatory Bowel Diseases  is a monthly  peer-reviewed   medical journal  covering all aspects of  inflammatory bowel disease . It was established in 1995 and is published by  Oxford University Press . [ 1 ]  It is the official journal of the  Crohn's & Colitis Foundation . The  editor-in-chief  is Fabio Cominelli ( Case Western Reserve University ). [ 2 ]  According to the  Journal Citation Reports , the journal has a 2021  impact factor  of 7.29, ranking it 22nd out of 93 journals in the category "Gastroenterology & Hepatology". [ 3 ]


Intestinal Research  is a quarterly  peer-reviewed   open access   medical journal  covering the fields of  intestinal diseases  (especially  inflammatory bowel disease ). It is published by the  Korean Association for the Study of Intestinal Diseases  in collaboration with the  Asian Organization for Crohn's and Colitis ,  Chinese Society of IBD ,  Japanese Society for IBD ,  Taiwan Society of IBD , and  Colitis Crohn's Foundation (India) . The  editor-in-chief  is Toshifumi Hibi ( Kitasato University ). The journal was established in 2003 and published semiannually; as of 2012 it appears quarterly. Originally published in Korean with abstracts in English, the journal is now published exclusively in English.


The  Journal of Clinical and Translational Hepatology  is a monthly  peer-reviewed   medical journal  covering  hepatology  established in 2013. It is owned by the Second Affiliated Hospital of  Chongqing Medical University  and published on their behalf by  Xia & He Publishing . The  editors-in-chief  are Hong Ren (The Second Affiliated Hospital of Chongqing Medical University), George Y. Wu ( University of Connecticut Health Center ), and Harry Hua-Xiang Xia (The First Affiliated Hospital of  Guangdong Pharmaceutical University ).


According to the  Journal Citation Reports , the journal has a 2022 impact factor of 3.6. [ 3 ]


Journal of Clinical Gastroenterology  is a  peer-reviewed   medical journal  covering  gastroenterology  and  hepatology , published by  Lippincott Williams & Wilkins . It was established in 1979 and the current  editor-in-chief  is Ronnie Fass, MD ( Case Western Reserve University School of Medicine ).


The journal is abstracted and indexed in: [ 1 ] [ 2 ]


According to the  Journal Citation Reports , the journal has a 2013  impact factor  of 3.186. [ 3 ]


The  Journal of Crohn's and Colitis  is a monthly  peer-reviewed   medical journal  covering  inflammatory bowel diseases . [ 1 ]  It was established in 2007 and was originally published by  Elsevier , [ 2 ]  but has been published by  Oxford University Press  since January 2015. [ 1 ]  It is the official journal of the  European Crohn's and Colitis Organisation . The  editor-in-chief  is Laurence J. Egan ( NUI Galway ). The journal has a 2022  impact factor  of 8.0. [ 3 ] [ 4 ] [ 5 ]  In 2022, it was ranked 7th by Scimago journal rankings in the field of Gastroenterology and Hepatology. [ 6 ]


Journal of Hepatology  is a  peer-reviewed   scientific journal  that was established in 1985 by  Munksgaard International Publishers .  A supplement,  Journal of Hepatology Supplement  was also published in 1985, but ceased in the same year.


Elsevier  took over publication in 2001. The journal is currently edited by Paolo Angeli and is published on a monthly basis. It is associated with the  European Association for the Study of the Liver .


Journal of Hepatology  is abstracted and indexed the following bibliographic databases: [ 1 ]


According to the  Journal Citation Reports , the journal has a 2021  impact factor  of 30.083. [ 2 ]


Liver International  is a bimonthly  peer-reviewed   medical journal  covering  hepatology . It was established in 1981 under the title  Liver , obtaining its current name in 2003. [ 1 ]  It is published by  John Wiley & Sons  on behalf of the  International Association for the Study of the Liver , of which it is the official journal. The  editor-in-chief  is Luca Valenti. According to the  Journal Citation Reports , the journal has a 2021  impact factor  of 8.754, ranking it 18th out of 93 journals in the category "Gastroenterology & Hepatology". [ 2 ]


Neurogastroenterology & Motility  is a bimonthly  peer-reviewed   medical journal  covering  neurogastroenterology  and  gastrointestinal motility . It was established in 1989 as the  Journal of Gastrointestinal Motility , obtaining its current name in 1994, and is published by  Wiley-Blackwell . It is the official journal of the  European Society of Neurogastroenterology and Motility , as well as the  American Neurogastroenterology and Motility Society . The  editors-in-chief  are Gianrico Farrugia ( Mayo Clinic ), Magnus Simren ( Sahlgrenska University Hospital ), and Gary Mawe ( University of Vermont ).


According to the  Journal Citation Reports , the journal has a 2013  impact factor  of 3.424. [ 1 ]


The  Scandinavian Journal of Gastroenterology  is a monthly  peer-reviewed   medical journal  covering the field of  gastroenterology . It is published by  Informa  and was established in 1966. The  editor in chief  is Helge Waldum. According to the  Journal Citation Reports , the journal has a 2013  impact factor  of 2.329. [ 1 ]


World Journal of Gastroenterology  is a weekly  peer-reviewed   open access   medical journal  that covers research in  gastroenterology . It was established in 1995 and is published by  Baishideng Publishing Group . [ 1 ]  The  editor-in-chief  is Andrzej S. Tarnawski ( California State University, Long Beach ).


In 2004, the journal was delisted from the  Journal Citation Reports  for excessive self-citation, [ 6 ]  but it was restored to this index in 2008, at which time its  impact factor  was determined to be 2.081. [ 7 ]  According to the  Journal Citation Reports , the journal has a 2020 impact factor of 5.742, ranking it 28th out of 92 journals in the category "Gastroenterology and Hepatology". [ 8 ]