Current Gastroenterology Reports最新文献

{"title":"Recent Endoscopic Technological Advancements in Crohn's Stricture Dilation.","authors":"Andrei Savu, Michael Helou, Jamil Abdo, Scott Piechocki, Brandon Wuerth","doi":"10.1007/s11894-026-01037-2","DOIUrl":"10.1007/s11894-026-01037-2","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: Crohn’s disease (CD) often causes intestinal strictures that impair quality of life. Endoscopic balloon dilation (EBD) has long been the standard, but durability is limited. This review summarizes advances in endoscopic management, focusing on updates from 2019–2025. RECENT FINDINGS: EBD achieves high technical success (90–95%) and short-term symptom relief (70–82%) but has recurrence rates up to 78% at two years. Endoscopic stricturotomy (ES) shows superior outcomes, with > 90% technical success, ~ 15% one-year recurrence, and > 70% five-year surgery-free survival. Hybrid ES + EBD approaches and novel stents—including fully covered self-expanding, biodegradable, and lumen-apposing devices—offer options for refractory lesions. Emerging imaging (EUS, elastography, hyperspectral imaging) and AI-assisted decision-making enhance stricture assessment, though data remain preliminary. Advances in endoscopy and adjunctive technologies are shifting Crohn’s stricture management toward more precise and durable, minimally invasive therapies. Ongoing trials, including HEIST, will help define optimal strategies. </p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467230","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":"Cutting Edge Access: Needle Knife Fistulotomy for Difficult Biliary Cannulation.","authors":"Michael Helou, Ethan Steele, Andrei Savu, Allison Franz, David Liu, Nanlong Liu","doi":"10.1007/s11894-026-01038-1","DOIUrl":"10.1007/s11894-026-01038-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Endoscopic retrograde cholangiopancreatography is an advanced endoscopic procedure used mainly for the purpose of biliary intervention. During an ERCP a duodenoscope is used to assess the ampulla of Vater to inject contrast medium into the common bile duct through biliary cannulation. Biliary cannulation can be challenging, with studies showing unsuccessful biliary cannulation with standard technique greater than 10%. Needle-knife fistulotomy is a unique precut sphincterotomy technique that can assist with difficult biliary cannulation.</p><p><strong>Review of findings: </strong>Needle-knife fistulotomy has transitioned from a \"last-ditch\" technique to sometimes a primary approach in select patient populations by endoscopists. The major impetus for this change is due to consistent results showing a lower risk of post-ERCP pancreatitis compared to other pre-cut methods. This review article will go in-depth on the technique of needle-knife fistulotomy, the benefits and suspected complications of needle-knife fistulotomy compared to traditional sphincterotomy techniques and the evolution of NKF as a first-choice option for biliary cannulation.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389695","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":"Underwater Endoscopic Submucosal Dissection: Tips and Tricks.","authors":"Mia Kamiya, Makoto Nishimura, Sayaka Nagao, Arameh Mousakhanian, Natalia Zbib, Jacques Beauvais, Shirley Jiang, Yohei Ogata","doi":"10.1007/s11894-026-01034-5","DOIUrl":"10.1007/s11894-026-01034-5","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: Underwater Endoscopic Submucosal Dissection (U-ESD) is a novel technique used to overcome the limitations of conventional ESD, particularly for gravity-side and fibrotic gastrointestinal lesions. This review aims to highlight the recent advancements in U-ESD, emphasizing its practical advantages as well as challenges that should be addressed for future applications. RECENT FINDINGS: Due to the buoyancy effect created by saline, U-ESD provides natural traction as well as magnification to facilitate en bloc lesion resection without the need for additional traction devices. Recent findings, including “bubble-free” U-ESD techniques have addressed previous concerns by minimizing trapped air bubbles and visual obstruction to further advance the U-ESD method. U-ESD offers an effective and safe method for the removal of complex gastrointestinal lesions through enhanced visualization and natural traction. Although challenges such as bleeding control remain, with ongoing refinements in the technique, U-ESD may become the standard in advanced therapeutic endoscopy. </p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343902","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":"Dietary Therapy in Eosinophilic Esophagitis (EoE): A Practical Approach to Elimination.","authors":"Varan Perananthan, Diana L Snyder","doi":"10.1007/s11894-026-01036-3","DOIUrl":"10.1007/s11894-026-01036-3","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: To provide an overview of current dietary elimination strategies for eosinophilic esophagitis (EoE) and propose a practical, patient-centered approach to guide dietary therapy. RECENT FINDINGS: Empiric elimination diets, including one- (1FED), two- (2FED), four- (4FED), and six-food (6FED) elimination strategies, have demonstrated varying efficacy, with broader elimination generally associated with higher histologic remission rates. Elemental diets remain the most effective but are often impractical. Allergy testing-directed diets have limited utility due to poor predictive accuracy. Recent data support a step-up approach—beginning with 1FED or 2FED and escalating as needed—as effective and better tolerated. Dietary elimination remains a cornerstone of EoE treatment. A stepwise, empiric approach that minimizes dietary burden while maintaining clinical efficacy is recommended. Personalizing diet therapy based on patient preferences and response can improve adherence and outcomes, and future research should continue refining strategies to balance efficacy, cost, and quality of life. </p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":"11"},"PeriodicalIF":4.1,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225795","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":"Expanded Indications and Role of Pancreatic Cyst/Mass Ablation.","authors":"Brianna Hamilton, Christiaan Van Der Weiden, Ruth Bell, Nirav Thosani","doi":"10.1007/s11894-026-01033-6","DOIUrl":"10.1007/s11894-026-01033-6","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: Despite advances in surgery, chemotherapy, and radiation treatments for pancreatic ductal adenocarcinoma (PDAC), 5-year mortality rates remain high. Although surgery remains the standard of care for pancreatic cancer and precancerous pancreatic lesions, many patients are not considered surgical candidates at the time of diagnosis. Therefore, alternative therapies must be explored for non-surgical patients. This article aims to do a comprehensive literature study and present the most recent information on ablative therapies, particularly endoscopic ultrasound (EUS)-guided RFA (EUS-RFA). RECENT FINDINGS: Emerging literature demonstrates that endoscopic ultrasound (EUS)-guided RFA (EUS-RFA) may reduce both primary and distant tumor growth by modifying the tumor microenvironment, promoting cytokine production, and stimulating immune activation, thereby allowing tumor reduction. Reducing tumor size can allow for surgical intervention and can even serve as an adjunct to chemotherapy or as a palliative measure. The remarkable ability to reduce tumor progression makes RFA a very promising non-surgical therapy technique that has the potential to reduce morbidity and mortality. There are several thermal ablative therapies, including radio non-surgical candidates. Emerging literature demonstrates that endoscopic ultrasound (EUS)-guided RFA (EUS-RFA) may reduce both primary and distant tumor growth by modifying the tumor microenvironment, promoting cytokine production, and stimulating immune activation, thereby allowing tumor reduction. Reducing tumor size can allow for surgical intervention and can even serve as an adjunct to chemotherapy or as a palliative measure. The remarkable ability to reduce tumor progression makes RFA a very promising non-surgical therapy technique that has the potential to reduce morbidity and mortality. </p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":"10"},"PeriodicalIF":4.1,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146206818","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 Recurrent Dysphagia after POEM and Heller Myotomy: Current Strategies and Future Directions.","authors":"Ronald Casey Turner, Anh D Nguyen, Thomas Tielleman","doi":"10.1007/s11894-026-01035-4","DOIUrl":"10.1007/s11894-026-01035-4","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: Dysphagia recurrence after myotomy for achalasia presents a complex clinical challenge. This review highlights causes of recurrent dysphagia, diagnostic strategies, and management options following laparoscopic Heller myotomy (LHM) or per-oral endoscopic myotomy (POEM). RECENT FINDINGS: Both POEM and LHM demonstrate durable efficacy, but recurrence arises from incomplete myotomy, blown-out myotomy (BOM), fundoplication-related obstruction, anatomic esophageal body abnormalities, esophageal dysmotility, or gastroesophageal reflux disease (GERD). In the diagnostic evaluation, functional lumen imaging probe (FLIP) and high-resolution manometry (HRM) provide complementary assessments of esophageal and esophagogastric junction dynamics, while timed barium esophagram (TBE) and endoscopy detect structural issues. Redo myotomy (POEM or LHM), pneumatic dilation (PD), and emerging techniques, such as per-oral plication of the esophagus (POPE), offer targeted therapy with favorable safety and symptom improvement. Recurrent dysphagia is multifactorial, requiring comprehensive esophageal evaluation. Advanced diagnostics and minimally invasive interventions expand therapeutic options, particularly in end-stage disease. </p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":"9"},"PeriodicalIF":4.1,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194270","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":"Reproductive Health in Young and Adolescent Females with Inflammatory Bowel Disease.","authors":"Erica J Brenner, Bianca A Allison, Catalina Berenblum Tobi, Camilia Kamoun, Vidhya Krishnan, Hilary K Michel","doi":"10.1007/s11894-026-01032-7","DOIUrl":"10.1007/s11894-026-01032-7","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: This manuscript addresses high-yield topics related to sexual and reproductive health (SRH) in adolescents and young women with inflammatory bowel disease (IBD) including puberty, menstruation, contraception, fertility, pregnancy, preventive care, and counseling strategies. RECENT FINDINGS: Adolescent and young women with IBD are at risk for delayed puberty, menstrual cycle disorders, unintended pregnancy, and cervical cancer. Active disease or a history of intra-abdominal surgery can negatively impact fertility and pregnancy outcomes. With appropriate screening, counseling and education, and shared decision making, providers can optimize both IBD and SRH outcomes. Further research in needed to specifically understand the role of pre-conception counseling in the adolescent setting, optimal management of menstrual cycle disorders in women with IBD, and the safety of newer medications during pregnancy. </p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":"8"},"PeriodicalIF":4.1,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12904935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178131","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":"Expanded Indications in Advanced Endoscopic Resection of Malignant Gastrointestinal Lesions.","authors":"Fredy Nehme, George M Wahba, Phillip S Ge","doi":"10.1007/s11894-025-01029-8","DOIUrl":"10.1007/s11894-025-01029-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Endoscopic resection (ER) has transformed the management of early gastrointestinal (GI) malignancies by offering curative treatment with low morbidity and organ preservation. Traditionally restricted to mucosal disease with negligible risk of lymph node metastasis (LNM), recent advances in technique and risk stratification have prompted a re-evaluation of ER indications for esophageal, gastric, and colorectal cancers. This review summarizes the oncologic rationale, current evidence, and emerging technologies supporting the safe expansion of ER indications across GI malignancies.</p><p><strong>Recent finding: </strong>s: Refined histopathologic criteria, enhanced en-bloc resection through endoscopic submucosal dissection, and the introduction of endoscopic full-thickness resection have expanded curative resection to select early GI malignancies previously considered surgical. Clinical outcomes from large series demonstrate comparable long-term survival to surgery when rigorous selection and surveillance criteria are applied, while minimizing morbidity. Molecular biomarkers, artificial intelligence (AI)-based predictive models, and sentinel node mapping are promising tools to further improve risk assessment for occult LNM. Expansion of ER indications for early GI cancers is feasible and increasingly practiced in expert centers with outcomes approximating those of surgical resection. Ongoing integration of precision diagnostics, molecular profiling, and AI-driven risk models promises to further refine patient selection. However, widespread adoption should proceed within structured, evidence-based frameworks to prevent undertreatment of potentially curable disease and maintain oncologic integrity.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":"7"},"PeriodicalIF":4.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12868057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112709","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":"Risk Factors and Outcomes of Immunoglobulin A Vasculitis in Patients with Inflammatory Bowel Disease and vice versa: A Systematic Review of the current literature.","authors":"Samer A Al-Shbailat, Shahd Alqato, Asem Y Alkhalaileh, Rand Suleiman, Sadeen Zein Eddin, Alyaman Karajeh, Raghad G Al-Shbeilat, Rama Hussein, Hamzeh Hatamleh, Jaber H Jaradat, Khaled Alsagarat, Laila K Asfour","doi":"10.1007/s11894-025-01027-w","DOIUrl":"10.1007/s11894-025-01027-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>This systematic review sought to thoroughly investigate the relationship between Inflammatory Bowel Disease (IBD) and Immunoglobulin A Vasculitis (IgAV), pinpointing both factors that increase risk and those that provide protection, laying the groundwork for future studies on specific treatments approaches to enhance the wellbeing of patients with IgAV and / or IBD.</p><p><strong>Recent findings: </strong>There is a new and quickly expanding body of literature on this subject, indicating a rising interest in it. Recent research has sought to investigate the connection between newly emerged viruses, such as COVID-19, or medications like Anti-Tumor Necrosis Factor Alpha (anti-TNF-α), and the development, progression, and treatment approaches of IgAV in IBD patients, and vice versa. Certain recent research is centered on a particular age groups or the condition of the initial illness. IgAV has been observed for numerous years following the diagnosis of IBD, displaying manifestations in the skin, joints, kidneys, and gastrointestinal tract. IBD encompassing Crohn's disease and ulcerative colitis, and IgAV share immunological overlaps via dysregulated IgA production, genetic loci like HLA-DQA1/DQB1, and environmental triggers such as infections amid gut dysbiosis. IgAV often emerges as an IBD sequela or anti-TNF-α therapy complication, with TNF blockade potentially disrupting B-cell maturation, fostering Gd-IgA1 complexes, and neutrophil-driven inflammation. (31) studies encompassing (83) patients with co-occurring IBD and IgAV, predominantly males (60.2%) and younger individuals with confirmed dual diagnoses (95.2%). Compared to UC, more severe CD phenotypes and extended disease duration correlate with increased IgAV risk. Anti-TNF inhibitors appear to substantially contribute to IgAV onset in IBD patients. Most affected individuals develop IBD initially, followed by IgAV, whereas only a minority experience IBD subsequent to IgAV diagnosis. Ceasing anti-TNF-α therapy post-IgAV diagnosis may lead to IgAV resolution but could also trigger disease recurrence. The study's limited sample size has hindered the researchers from reaching conclusions via a meta-analysis. Additionally, the criteria utilized for IBD diagnosis have displayed inconsistency across all studies. Patients with IBD are at higher risk of developing IgAV, thus a high level of suspicion and prompt diagnostic assessment are crucial. To date, there have been no previous systematic reviews or meta-analyses highlighting a link between IgAV and IBD. Therefore, this systematic review is a pivotal endeavor to elucidate the complex relationship between these conditions, shaping future research in this area.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":"6"},"PeriodicalIF":4.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017676","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":"Fecal Microbiota Transplantation in 2025: Two Steps Forward, One Step Back.","authors":"Charles B Miller, Geoffrey A Bader, Carl L Kay","doi":"10.1007/s11894-025-01030-1","DOIUrl":"10.1007/s11894-025-01030-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes the history and current landscape of fecal microbiota transplantation (FMT), with an emphasis on use of the therapy for Clostridioides difficile infection (CDI), inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS). We clarify indications, evidence, and current recommendations for FMT-highlighting major advances and minor setbacks that have led to the state of FMT in 2025.</p><p><strong>Recent findings: </strong>After decades of steady progress, the U.S. Food and Drug Administration (FDA) approved the first FMT-based therapies: fecal microbiota, live-jslm and fecal microbiota spores, live-brpk-in 2022 and 2023, respectively. The 2024 American Gastroenterological Association (AGA) Practice Guideline on Fecal Microbiota-Based Therapies for Select Gastrointestinal Diseases made specific recommendations for conventional FMT and these FDA-approved therapies for multiple CDI presentations, as well as for IBD and IBS. Conventional FMT remains an option for CDI; however, OpenBiome's halt of shipped, frozen FMT preparations on December 31, 2024, has made access more challenging in 2025. Although first reported almost seventy years ago, extensive efforts over the last two decades have placed FMT in routine algorithms for many patients with CDI. While understanding of the intestinal microbiome's role in other gastrointestinal conditions is expanding, and FMT may modulate these pathways, additional evidence is needed before FMT becomes routine outside CDI.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"28 1","pages":"5"},"PeriodicalIF":4.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12799677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965120","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}