Current Gastroenterology Reports最新文献

{"title":"Artificial Intelligence for Diagnosis of Esophageal Manometry: A Narrative Review.","authors":"Ernesto Robalino Gonzaga, Juliana J Madej, Nitin Ahuja","doi":"10.1007/s11894-026-01052-3","DOIUrl":"10.1007/s11894-026-01052-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>High-resolution manometry (HRM), the gold standard for diagnosing esophageal motility disorders, remains constrained by inter-rater variability, limited access to expert esophagologists, and inadequate training infrastructure. Many gastroenterology fellowship programs provide insufficient motility training, and dedicated expert centers remain geographically concentrated. Emerging Artificial intelligence (AI) tools have the potential to automate diagnosis, and augment clinician interpretive capacity and democratizing expert-level motility assessment.</p><p><strong>Recent findings: </strong>Twenty-two studies encompassing over 5,000 patients were synthesized across three overlapping developmental phases: early machine learning for feature extraction and classification; deep learning deployed toward automated pattern recognition and motility classification and emerging multimodal and large language model-based frameworks augmenting clinical interpretation and decision-making, with diagnostic accuracies ranging from 71 to 97%. AI integration of multimodal manometric data may reveal pressure signatures imperceptible to human visual inspection, pointing toward phenotypes beyond the Chicago Classification. No study has yet demonstrated improved patient outcomes. AI's role in motility training remains largely unexplored. The AI-clinician partnership represents the most promising trajectory for esophageal manometry interpretation in coming years. AI-augmented interpretation has the potential to eliminate the two-tier diagnostic gap between academic and community practice, to accelerate trainee competency through scalable AI-supervised case libraries, and to uncover physiologic phenotypes beyond human interpretation.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Surface Gastric Mapping Improves Diagnosis of Gastric Motility Disorders.","authors":"Jarongkorn Sirimongkolkasem, Christopher N Andrews, Gregory O'Grady","doi":"10.1007/s11894-026-01049-y","DOIUrl":"10.1007/s11894-026-01049-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic gastroduodenal symptoms affect > 7% of adults, yet current diagnostic frameworks are challenged by limited mechanistic specificity, weak symptom correlation, and variable reproducibility. This review evaluates how body surface gastric mapping (BSGM), a non-invasive technology combining high-resolution gastric myoelectrical recording with validated symptom profiling, may improve the diagnosis and management of gastric motility disorders.</p><p><strong>Recent findings: </strong>BSGM employs a high-resolution 64-electrode array to derive validated biomarkers of gastric motor function, including rhythm stability, frequency, and amplitude, alongside standardised digital symptom and psychometric profiling. A recent international consensus ('Auckland Classification v1.0'), derived from over 50 published studies and 4,500 + clinical tests, defined six BSGM phenotypes encompassing putative mechanisms of neuromuscular dysfunction, visceral hypersensitivity, centrally-mediated symptoms, and small bowel contributions. BSGM significantly increases diagnostic yield for motility disorders and appears synergistic with gastric emptying testing in joint studies. Observational data currently indicate that BSGM-guided management changes clinical decisions in ~ 80% of patients and is associated with reduced healthcare utilisation. Key benefits include capability to aid discrimination of motor vs sensory disorders, with specific phenotypes provisionally linked to differential treatment responses. Paediatric studies show concordant phenotype patterns, with BSGM dysrhythmia identified as a more severe phenotype. BSGM provides mechanism-based phenotyping that extends gastroduodenal evaluation beyond symptom classifications and gastric emptying status. Prospective validation of phenotype-guided treatment algorithms is now underway, and integrated multimodal diagnostic frameworks incorporating BSGM alongside complementary investigations are likely to reshape the clinical approach to these challenging disorders.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13381385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition and Sarcopenia in Gastrointestinal Motility Disorders: Mechanisms, Assessment, and Management.","authors":"Madeline Berschback, Jithinraj Edakkanambeth Varayil, Jessica Stout","doi":"10.1007/s11894-026-01048-z","DOIUrl":"10.1007/s11894-026-01048-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Malnutrition and sarcopenia are increasingly recognized as clinically meaningful but underappreciated components of gastrointestinal (GI) motility disorders. This review examines the prevalence, pathophysiology, assessment, and clinical care of malnutrition in the context of patients with GI motility disease.</p><p><strong>Recent findings: </strong>Emerging data demonstrate a high burden of malnutrition in GI motility conditions, including gastroparesis and chronic intestinal pseudo-obstruction. Mechanisms include reduced oral intake, restrictive eating patterns, malabsorption, inflammation, and physical deconditioning. Novel approaches to assessment, incorporating muscle mass and function, highlight limitations of weight-based metrics alone. Multidisciplinary care remains vital to caring for this patient population. Sarcopenia and malnutrition are modifiable and underrecognized contributors to morbidity in GI motility disorders. Implementing screening and multidisciplinary, nutrition-focused interventions may improve patient-centered outcomes and should be integrated into clinical care and future research.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Common Bile Duct Stones: Current Approaches and Evolving Endoscopic Strategies.","authors":"Mohammad Shahzaib Qadir, Eisha Saadat","doi":"10.1007/s11894-026-01046-1","DOIUrl":"10.1007/s11894-026-01046-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review evaluates the evolving management strategies for common bile duct stones (CBDSs), focusing on standard endoscopic techniques, advanced intraductal interventions for refractory stones, and contemporary minimally invasive surgical options.</p><p><strong>Recent findings: </strong>While endoscopic retrograde cholangiopancreatography with sphincterotomy remains the cornerstone of therapy, recent evidence highlights the efficacy and safety of endoscopic papillary large balloon dilation and single-operator cholangioscopy-guided lithotripsy for difficult and refractory stones. Concurrently, laparoscopic common bile duct exploration has proven effective as a single-stage definitive treatment, demonstrating safety and stone clearance outcomes equivalent to the traditional two-stage endoscopic-surgical approach. The management of CBDSs has shifted from a rigid, standardized protocol to a highly tailored clinical algorithm. No single gold-standard strategy is applicable to every scenario. Optimal outcomes are achieved through a flexible, multidisciplinary approach that customizes intervention based on stone characteristics, patient anatomy, and available institutional expertise.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solitary Rectal Ulcer Syndrome Revisited: A Comprehensive Narrative Review.","authors":"Krishanni Prabagar, Pramodh Chitral Chandrasinghe, S Janaki De S Hewavisenthi, Arjuna P de Silva, Madunil A Niriella","doi":"10.1007/s11894-026-01045-2","DOIUrl":"10.1007/s11894-026-01045-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Solitary rectal ulcer syndrome (SRUS) is a gastrointestinal disorder with a varied range of clinical, endoscopic and histological features. It is often misdiagnosed as inflammatory bowel disease or rectal malignancy. This review aims to outline a practical approach to diagnosing and managing SRUS.</p><p><strong>Recent findings: </strong>The aetiology remains unclear, with contributing factors such as mucosal prolapse, ischemia, paradoxical puborectalis contraction, and digital trauma. Diagnosis involves a comprehensive approach, including clinical history, digital rectal examination, endoscopy, histopathology, and physiological studies. Treatment includes lifestyle modifications, biofeedback therapy, topical agents, sclerotherapy, and surgical intervention for refractory cases. Ongoing surveillance is necessary, especially in patients at high risk for recurrence. Management of SRUS should be individualised and multidisciplinary, particularly in patients with psychiatric comorbidities or during pregnancy, where invasive interventions are minimised. Further research and standardised treatment protocols for SRUS are needed.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Microbiome and Esophageal Disease: Where Are We Now?","authors":"Ping He, Ellen Stein","doi":"10.1007/s11894-026-01044-3","DOIUrl":"10.1007/s11894-026-01044-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>The microbiome in the esophagus has been an area of early active investigation. In the past 5 years, advancements in next-generation sequencing and computational analysis have provided a more detailed picture of the esophageal microbiome. This review will examine the most recent advances in the past 5 years on the study of microbiome changes in healthy and diseased esophagus to better understand the link between microbiome and esophageal diseases, potentially leading to new prevention or treatment strategies.</p><p><strong>Recent findings: </strong>The microbiome has a key set of baseline parameters in the usual or non-diseased esophageal lumen. There are measurable changes in the baseline microbiome species of different disease phenotypes including eosinophilic esophagitis, gastroesophageal reflux disease, Barrett's esophagus and achalasia. Some studies suggest that certain microbiome features may even be associated with worse outcomes. Dysbiosis of esophageal microbiome is implicated in various esophageal disorders, including GERD, Barrett's esophagus, EoE, and achalasia. However, confounding factors such as antibiotic use, PPI use, dietary habits, and geographic location influence microbiome variability and make the standardized study of this field challenging. The next phase of research will need to include more focus on larger scale studies with reproducible parameters. As some features of the microbiome are associated with disease progression, there are multiple new avenues of intervention potentially available with an improved understanding of the human esophageal microbiome.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13176034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fermented Durian Tempoyak as a Source of Probiotics for Colorectal Cancer Prevention through Gut Microbiome Modulation.","authors":"Wing Soon Ng, Nancy Choon-Si Ng, Rebecca Shin-Yee Wong, Bey Hing Goh","doi":"10.1007/s11894-026-01043-4","DOIUrl":"10.1007/s11894-026-01043-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Colorectal cancer (CRC) remains a major global and Malaysian public health concern, with increasing recognition of gut dysbiosis as a contributor to colorectal tumorigenesis. This review examines fermented durian tempoyak as a culturally relevant, probiotic-rich traditional food with potential application in CRC prevention through gut microbiome modulation.</p><p><strong>Recent findings: </strong>Dysbiosis may promote CRC through disruption of gut barrier integrity, chronic mucosal inflammation, immune dysregulation, reactive oxygen species (ROS)-mediated DNA damage, and altered microbial metabolism leading to carcinogenic metabolites such as secondary bile acids and hydrogen sulphide. Tempoyak commonly contains lactic acid bacteria, particularly Lactiplantibacillus plantarum, as well as Limosilactobacillus fermentum and Levilactobacillus brevis. Preclinical evidence suggests that related LAB strains can attenuate NF-κB, MAPK, STAT3, IL-17, and COX-2-associated inflammatory pathways, reduce immune-cell infiltration and oxidative stress, restore mucus and tight junction proteins, modulate bile acid metabolism, and reduce tumor burden in CRC or colitis-associated CRC models. Current evidence supports the mechanistic plausibility of tempoyak-associated LABs as microbiome-based agents for CRC chemoprevention. However, direct evidence using tempoyak-derived strains remains limited, and translation is constrained by strain-specific effects, microbial variability, sensory acceptability, safety and standardisation issues, and uncertain LAB viability after cooking. Future studies should prioritise strain characterisation, starter culture standardisation, probiotic stabilisation strategies, CRC-specific preclinical models, and well-designed human trials in high-risk populations.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Practical Guide to Incorporating Novel Barrett's Screening/Surveillance Tools into Clinical Practice.","authors":"Brian E White, Alexandra L Strauss Starling","doi":"10.1007/s11894-026-01041-6","DOIUrl":"10.1007/s11894-026-01041-6","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: Barrett’s esophagus (BE) is the only known precursor for esophageal adenocarcinoma. Patients diagnosed in endoscopy-based screening and surveillance programs have improved outcomes, but there are many limitations with current screening and surveillance paradigms. This review examines novel technologies aimed at improving current BE screening and surveillance strategies. RECENT FINDINGS: BE risk stratification algorithms have decent discriminatory performance but are cumbersome to implement. Non-endoscopic screening tools, including swallowable cell collection devices, have shown good sensitivity and cost-effectiveness. Early studies of serum biomarkers, such as microRNA assays, have yielded promising results but warrant further validation. WATS-3D appears to increase dysplasia yield among patients undergoing surveillance. Tissue-based biomarkers may assist in risk stratification. Novel, non-endoscopic technologies have the potential to enrich the BE screening population and improve outcomes, although most require further validation. Collaboration with primary care providers is critical to maximize the impact of such interventions. </p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Endoscopic Ultrasound in the Diagnosis and Management of Congenital Gastrointestinal and Pancreaticobiliary Conditions.","authors":"Inna Novak, Samuel Bitton","doi":"10.1007/s11894-026-01040-7","DOIUrl":"10.1007/s11894-026-01040-7","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: This review synthesizes current literature on the use of Endoscopic ultrasound (EUS) in congenital gastrointestinal (GI) conditions. Special emphasis is placed on pediatric applications, where EUS is increasingly recognized as both feasible and safe. RECENT FINDINGS: EUS has transformed the evaluation and management of congenital anomalies affecting the GI tract and pancreaticobiliary system, and has been shown to be safe and effective in the pediatric population. By combining high-resolution imaging with the ability to perform real-time interventions, EUS addresses diagnostic uncertainties that historically required cross-sectional imaging or invasive surgery. EUS offers precise diagnostics, minimally invasive evaluation, and therapeutic guidance in pediatric patients, potentially avoiding surgical intervention. Larger pediatric multicenter registries are needed to further validate its use in children. Widespread adoption remains limited by the scarcity of EUS-trained pediatric gastroenterologists and the lack of specialized equipment designed for small children. </p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Complaints After Fundoplication: Rapid Review and Evidence Mapping.","authors":"Alberto Aiolfi, Davide Bona, Francesco Cammarata, Moustafa Elshafei, Cristina Ogliari, Carmelo Scarpignato, Luigi Bonavina","doi":"10.1007/s11894-026-01039-0","DOIUrl":"10.1007/s11894-026-01039-0","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: Fundoplication is still the cornerstone of surgical intervention for patients with gastroesophageal reflux disease unresponsive to medical management. While generally successful in resolving typical symptoms and improving patients’ quality of life, post-fundoplication symptoms unrelated to anatomical failure occur in a notable proportion of individuals. These complaints include persistent dysphagia, gas-bloat syndrome, delayed gastric emptying, dumping syndrome, chest pain, and diarrhea. Advances in physiological research has contributed to a more comprehensive understanding of the pathogenesis, prevention, and management of these postoperative symptoms. FINDINGS: This review synthesizes recent literature regarding gastrointestinal functional complaints following fundoplication, with emphasis on pathophysiology, diagnostic approaches, and evidence-based management strategies. Post-fundoplication complaints may be associated with incomplete preoperative work-up, untailored surgical procedure, defective surgical technique, or pre-existing disorders. Persistent dysphagia, gas-bloat syndrome, delayed gastric emptying, diarrhea, chest pain, and dumping syndrome are reported in up to 50%, 50%, 40%, 20%, 20%, and < 1% of patients, respectively. Various contributing factors have been identified, including defective esophageal motility and functional reserve, decrease of the fundic accommodation reflex, technical aspects of fundoplication and cruroplasty, iatrogenic injury to the vagus nerve, and exacerbation of pre-existing irritable bowel symptoms. Complete preoperative workup, patient’s education, and intraoperative EndoFLIP impedance planimetry have the potential to mitigate the incidence of persistent symptoms. The integration of artificial intelligence and machine learning algorithms offers promise for risk stratification and may enhance the prediction of postoperative functional outcomes. Functional gastrointestinal complaints are commonly encountered following fundoplication and can influence surgical outcomes, potentially impacting patients quality of life and overall satisfaction. A comprehensive knowledge of the underlying pathophysiological mechanisms is essential for optimizing patient selection, refining surgical approaches, planning targeted management strategies, and enhancing long-term functional results. </p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}