Current Gastroenterology Reports最新文献_第2页

The Impact of Specialized Pro-Resolving Mediators on Disease Activity and the Risk of Associated Colorectal Carcinoma in Inflammatory Bowel Disease. 炎性肠病中特异性促解介质对疾病活动和相关结直肠癌风险的影响

Current Gastroenterology Reports Pub Date : 2025-06-24 DOI: 10.1007/s11894-025-00997-1

Jennifer Katz, Stephanie Gold, Vikram J Christian, Robert Martindale

{"title":"The Impact of Specialized Pro-Resolving Mediators on Disease Activity and the Risk of Associated Colorectal Carcinoma in Inflammatory Bowel Disease.","authors":"Jennifer Katz, Stephanie Gold, Vikram J Christian, Robert Martindale","doi":"10.1007/s11894-025-00997-1","DOIUrl":"10.1007/s11894-025-00997-1","url":null,"abstract":"Purpose of review: The purpose of this review is to explore the role of specialized pro-resolving mediators (SPMs) in the resolution of inflammation in inflammatory bowel disease (IBD) focusing on their potential therapeutic benefits in these conditions.Recent findings: IBD is characterized by chronic inflammation and mucosal barrier dysfunction, driven by a dysregulated immune response. SPMs, which are derived from polyunsaturated fatty acids, have been identified as active agents in resolving inflammation without impairing immune function. Preclinical studies indicate that SPMs can reduce intestinal inflammation, but clinical data are still limited. Moreover, SPMs may influence colorectal cancer (CRC) by modulating tumor-promoting inflammation and enhancing chemotherapy response. SPMs offer a promising approach to inflammation resolution and mucosal healing in IBD and CRC. However, further research is necessary to better understand their therapeutic potential and to establish their clinical applicability in these diseases.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474161","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}

引用次数: 0

Management of Colonic Diverticular Disease in the Older Adult. 老年人结肠憩室疾病的治疗。

Current Gastroenterology Reports Pub Date : 2025-06-21 DOI: 10.1007/s11894-025-00986-4

Hiep S Phan, Lisa L Strate

{"title":"Management of Colonic Diverticular Disease in the Older Adult.","authors":"Hiep S Phan, Lisa L Strate","doi":"10.1007/s11894-025-00986-4","DOIUrl":"10.1007/s11894-025-00986-4","url":null,"abstract":"Purpose of review: While societal guidelines help direct management of diverticulitis and diverticular bleeding broadly, our review focuses on the latest data for nuanced care of older patients affected by these conditions.Recent findings: Diverticulitis in older patients can present with non-specific symptoms so a broad work up is recommended. Once diagnosed, those with uncomplicated disease (Hinchey Class 0 or 1a) can be safely managed without antibiotics or admission depending on frailty and comorbidities. Most older patients with complicated diverticulitis (abscess, perforation or obstruction) should be hospitalized. Elective or emergent surgery for complicated disease (Hinchey Class 1b-4) is associated with higher morbidity and mortality, particularly in older patients. The risk of diverticular bleeding and re-bleeding significantly increases with age, potentially due to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and anticoagulants. Diverticular disease and its associated complications disproportionately affect older adults. Management should focus on resuscitation, having low threshold for comprehensive work up and re-evaluating medication use for comorbid conditions to prevent recurrence.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339977","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}

引用次数: 0

Navigating Endoscopic Surveillance and Management of Barrett's Esophagus in Elderly Patients: Balancing the Risks and Benefits. 老年患者Barrett食管导航内镜监测和管理：平衡风险和收益。

Current Gastroenterology Reports Pub Date : 2025-06-09 DOI: 10.1007/s11894-025-00984-6

Natalie J Wilson, Cary C Cotton, Nicholas J Shaheen

{"title":"Navigating Endoscopic Surveillance and Management of Barrett's Esophagus in Elderly Patients: Balancing the Risks and Benefits.","authors":"Natalie J Wilson, Cary C Cotton, Nicholas J Shaheen","doi":"10.1007/s11894-025-00984-6","DOIUrl":"https://doi.org/10.1007/s11894-025-00984-6","url":null,"abstract":"Purpose of review: This review examines the current evidence and practical considerations for endoscopic surveillance of Barrett's esophagus (BE) in elderly patients, focusing on balancing the potential benefits and risks associated with endoscopic surveillance and eradication therapies in this population.Recent findings: Elderly patients with BE have a higher baseline prevalence of dysplasia and esophageal adenocarcinoma (EAC). Additionally, the risk of progression from BE to EAC increases with advancing age, making surveillance particularly relevant in this population. However, recent studies suggest the benefits of surveillance decline with increasing age, greater comorbidities, and reduced life expectancy. Despite increasing awareness that ongoing surveillance endoscopy may be of minimal benefit for certain patient groups, there remains a paucity of data to guide decisions regarding discontinuation of surveillance. The management of BE in elderly patients requires a careful balance between the potential benefits of endoscopic surveillance and eradication therapies and the risks and costs associated with repeated invasive procedures. Decisions to continue endoscopic surveillance in this population should be individualized, taking into account life-expectancy and comorbidities rather than focusing solely on chronological age.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246872","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}

引用次数: 0

Severe Refractory Post-Radiation Strictures: Lessons Learned from Long-term Follow-up after Combined Antegrade Retrograde Dilation. 严重难治性放射后狭窄：联合顺逆行扩张术后长期随访的经验教训。

Current Gastroenterology Reports Pub Date : 2025-05-07 DOI: 10.1007/s11894-025-00981-9

Mohamed Eisa, Amal Shine, Endashaw Omer, Matthew Heckroth, Michael Eiswerth, Vincent Nguyen, Benjamin Rogers, Paul Tennant, Stephen A McClave

{"title":"Severe Refractory Post-Radiation Strictures: Lessons Learned from Long-term Follow-up after Combined Antegrade Retrograde Dilation.","authors":"Mohamed Eisa, Amal Shine, Endashaw Omer, Matthew Heckroth, Michael Eiswerth, Vincent Nguyen, Benjamin Rogers, Paul Tennant, Stephen A McClave","doi":"10.1007/s11894-025-00981-9","DOIUrl":"https://doi.org/10.1007/s11894-025-00981-9","url":null,"abstract":"Purpose of review: Dysphagia with an identifiable stricture occurs frequently following chemoradiation therapy for head/neck cancer patients, some developing complete obliteration of the esophageal lumen. Combined Antegrade Retrograde Dilation (CARD) is designed to restore luminal patency. This paper reports how experience at one institution shaped a more effective strategy for the long-term management of this difficult patient population.Recent findings: Twenty patients, mean age 62.6 years, initially undergoing CARD procedure, subsequently required a total of 278 dilation sessions (average 13.9 sessions/patient) performed on average every 8.2 weeks (range 2.7-12.6). All patients achieved luminal patency. Complications occurred in 7 patients (35.0% of patients, 2.5% of all procedures) and included traumatic bleeding, pneumothorax, overt esophageal perforation, microscopic perforation with cervical osteomyelitis, and perforation at the gastrostomy site. Diet and dysphagia scores were ineffective at directing the schedule for maintenance dilation. The CARD procedure is effective at restoring initial esophageal patency, but must be followed closely with long-term maintenance dilation. Over a large number of dilations, complications are infrequent and difficult to predict. Their incidence may be reduced by use of prophylactic antibiotics, prior removal of a tracheoesophageal prosthesis, avoiding dilation of the gastrostomy tract, modest dilation goal, and scheduled \"stricture surveillance\" with dilations performed under fluoroscopic guidance.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977966","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}

引用次数: 0

Gas-tly Interpretations: A Case-Based Approach to the Nuances of SIBO Breath Testing. 气体解释：基于案例的SIBO呼吸测试方法的细微差别。

Current Gastroenterology Reports Pub Date : 2025-05-01 DOI: 10.1007/s11894-025-00977-5

John A Damianos, Ayah Matar, Houssam Halawi

引用次数: 0

Dietary Relationships between Obesity and Inflammatory Bowel Diseases: A Narrative Review of Diets Which May Promote Both Diseases. 肥胖和炎症性肠病之间的饮食关系：可能促进这两种疾病的饮食综述

Current Gastroenterology Reports Pub Date : 2025-04-30 DOI: 10.1007/s11894-025-00980-w

Andrew Szilagyi, Jonathan Wyse, Jennifer Abdulezer

{"title":"Dietary Relationships between Obesity and Inflammatory Bowel Diseases: A Narrative Review of Diets Which May Promote Both Diseases.","authors":"Andrew Szilagyi, Jonathan Wyse, Jennifer Abdulezer","doi":"10.1007/s11894-025-00980-w","DOIUrl":"https://doi.org/10.1007/s11894-025-00980-w","url":null,"abstract":"Purpose of review: The pandemic of obesity preceded global spread of Inflammatory Bowel diseases by almost 2 decades. A pathogenic relationship has been described between obesity and inflammatory bowel diseases, but Crohn`s disease may be selectively impacted. The role of diet in pathogenesis has also gained significant support in the last few decades. This review explores dietary relationships to account for epidemiological observations. Quantifiable indices for diets have been described including a glycemic index, inflammatory indices and levels of food processing. Meta-analyses have been published which examine each for effects on obesity and co-morbidities as well as Crohn's disease and ulcerative colitis. This review suggests that ultra-processed foods provide the best link between obesity and Crohn's disease explaining epidemiological observations. However, the other 2 types of dietary indices likely contribute to ulcerative colitis as well as to co-morbidities related to both obesity and inflammatory bowel diseases. The term ultra-processed foods cover a large number of additives and extensive work is needed to define individual or combined harmful effects. Furthermore, the interactions among the 3 main indices need clarification in order to precisely apply therapeutic diets to both diseases (obesity and inflammatory bowel disease).","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961749","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}

引用次数: 0

Future of Endoscopy in Surveillance of Esophageal Varices. 内镜在食管静脉曲张监测中的应用前景。

Current Gastroenterology Reports Pub Date : 2025-03-29 DOI: 10.1007/s11894-025-00976-6

Carlos Moctezuma-Velazquez, Juan G Abraldes

{"title":"Future of Endoscopy in Surveillance of Esophageal Varices.","authors":"Carlos Moctezuma-Velazquez, Juan G Abraldes","doi":"10.1007/s11894-025-00976-6","DOIUrl":"10.1007/s11894-025-00976-6","url":null,"abstract":"Purpose of review: tTo assess the evolving role of endoscopy assessment for esophageal varices in cirrhosis.Recent findings: The approach to screening endoscopy for varices has significantly changed in the last 10 years with the refinement of non-diagnostic tests. Non-invasive diagnostic methods have reduced the need of upper endoscopies for variceal screening in patients with compensated cirrhosis, focusing primarily on those with ambiguous risk assessments or contraindications to non-selective beta-blockers (NSBBs). In contrast, decompensated cirrhosis patients require more frequent endoscopic evaluations due to their heightened risk of complications and the potential benefit of combination therapy (NSBBs + variceal ligation). In patients with hepatocellular carcinoma (HCC) the performance of non-invasive tests is suboptimal and most patients require endoscopy. Emerging applications of artificial intelligence (AI) can assist in patient triage and the interpretation of endoscopic findings, potentially improving care. Further research is essential to validate these technologies within clinical practice and optimize their integration into patient management strategies.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742168","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}

引用次数: 0

Decoding Abdominal Pain in Constipation-predominant Irritable Bowel Syndrome and Functional Constipation: Mechanisms and Managements. 解码便秘为主的肠易激综合征和功能性便秘的腹痛：机制和管理。

Current Gastroenterology Reports Pub Date : 2025-03-17 DOI: 10.1007/s11894-025-00967-7

Jingyuan Luo, Qianqian Xu, Shujun Xu, Lixiang Zhai, Chun-Su Yuan, Zhaoxiang Bian

{"title":"Decoding Abdominal Pain in Constipation-predominant Irritable Bowel Syndrome and Functional Constipation: Mechanisms and Managements.","authors":"Jingyuan Luo, Qianqian Xu, Shujun Xu, Lixiang Zhai, Chun-Su Yuan, Zhaoxiang Bian","doi":"10.1007/s11894-025-00967-7","DOIUrl":"10.1007/s11894-025-00967-7","url":null,"abstract":"Purpose of review: Abdominal pain in constipation-predominant irritable bowel syndrome (IBS-C) and functional constipation (FC) remains a difficult clinical challenge due to unclear pathophysiological mechanisms and limited pain-targeted treatments. This review critically evaluates the evidence on the underlying pain mechanisms in IBS-C and/or FC and explores management strategies, their limitations, and future directions.Recent findings: Most research on constipation-related pain is based on IBS-C patients or animal models, with limited studies focusing on FC. Visceral hypersensitivity, serotonin dysregulation, gut-brain axis dysfunction, and central/peripheral nervous system alterations are implicated in IBS-C pain, while FC pain is less studied and may be primarily linked to colonic distension and motility dysfunction. Management strategies include 5-HT4 agonists, GC-C agonists, chloride channel activators, psychological therapies, probiotics and complementary medicine. Despite available treatment options, managing abdominal pain in IBS-C and FC remains challenging due to heterogeneous pathophysiology and limited targeted therapies. While some interventions provide symptomatic relief, there is no universally effective treatment for abdominal pain across all patients. Future research should focus on identifying pain-specific biomarkers, refining diagnostic criteria, and integrating multi-omics data and neuroimaging techniques to better distinguish pain mechanisms in IBS-C versus FC and develop more precise, patient-centered interventions.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647602","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}

引用次数: 0

Multicancer Detection (MCD) Testing in Gastrointestinal Cancers: An Evolving Tool for Early Diagnosis. 胃肠道癌症的多癌检测（MCD）测试：一种不断发展的早期诊断工具。

Current Gastroenterology Reports Pub Date : 2025-03-06 DOI: 10.1007/s11894-025-00970-y

Aditya K Ghosh, Kyle R Stephens, Prem A Kandiah, Ryan T Hurt, Elizabeth A Gilman

{"title":"Multicancer Detection (MCD) Testing in Gastrointestinal Cancers: An Evolving Tool for Early Diagnosis.","authors":"Aditya K Ghosh, Kyle R Stephens, Prem A Kandiah, Ryan T Hurt, Elizabeth A Gilman","doi":"10.1007/s11894-025-00970-y","DOIUrl":"10.1007/s11894-025-00970-y","url":null,"abstract":"Purpose of review: The current review aims to summarize the benefits and limitations of the novel multicancer detection tests (MCD) for diagnosing gastrointestinal (GI) malignancies.Recent findings: Traditional cancer screening methods can reduce deaths in malignancies involving the GI tract. For GI cancers, screening options vary by type and often involve invasive techniques with limited sensitivity. MCDs offer a promising, non-invasive (simple blood draw) alternative by analyzing biomarkers such as cell-free DNA and RNA using advanced techniques and machine learning to detect cancers across multiple organ sites. Large studies like the PATHFINDER trial and THUNDER study have demonstrated the feasibility and accuracy of MCD assays in identifying cancer signals, with high sensitivity and specificity in some GI organs that lack routine screening tests (e.g., liver, pancreas, and stomach). Despite these advancements, MCD testing faces challenges, including high costs, lack of FDA approval, false positives, and limited data on clinical utility in reducing cancer-specific mortality. MCD should not be a substitute for age-appropriate cancer screenings but may complement existing methods, particularly for cancers with no current screening tools, such as cholangiocarcinoma and pancreatic cancer. Clinicians need to discuss the limitations of MCDs, including the potential for overdiagnosis, patient anxiety, and financial burden due to insurance coverage gaps. MCD is a promising, non-invasive test that can augment traditional cancer screening. As the role of MCD in cancer detection evolves, further research is essential to establish how it will be integrated into clinical practice, ensuring informed, shared decision-making with patients.","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566319","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}

引用次数: 0

Update on Pediatric Hepatitis C Infection. 小儿丙型肝炎感染的最新情况。

Current Gastroenterology Reports Pub Date : 2025-02-28 DOI: 10.1007/s11894-024-00955-3

Johanna Ferreira, Shari Sheflin-Findling

引用次数: 0