Current Gastroenterology Reports最新文献

{"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":"<p><strong>Purpose of review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p>","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}

{"title":"Rumination Syndrome, Supragastric Belching, and Abdominophrenic Dyssynergia: How to Diagnose and Treat?","authors":"Sydney Pomenti, David A Katzka","doi":"10.1007/s11894-025-00971-x","DOIUrl":"10.1007/s11894-025-00971-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Supragastric belching (SGB), rumination syndrome (RS), and abdominophrenic dyssynergia are often misunderstood and underdiagnosed syndromes. Better understanding of these conditions is needed to increase recognition and guide treatment.</p><p><strong>Recent findings: </strong>Diagnosis is typically made by history and physical examination though supplementary evaluations can be considered in difficult to diagnose cases. These diseases are unique in that their optimal therapies are behavioral and focused entirely on the basic physiology of breathing techniques. Once one of these syndromes is recognized, the change in life for these patients can be formidable. As a result, recognition and proper treatment of these syndromes is essential for the gastroenterologist.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613837","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":"Challenges to Optimizing Nutrition in Children With Cystic Fibrosis.","authors":"Charles B Chen, Jill A Granneman, Sanu R Yadav","doi":"10.1007/s11894-025-00969-5","DOIUrl":"10.1007/s11894-025-00969-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Cystic fibrosis is a chronic condition that has significant effects on the nutritional status of pediatric patients. Malnutrition is frequently encountered in this population and has been shown to contribute to poor pulmonary and overall disease outcomes. This article will provide an overview of the physiologic and psychosocial challenges toward attaining optimal nutrition in pediatric cystic fibrosis patients.</p><p><strong>Recent findings: </strong>Newer therapies such as CFTR modulators have played significant roles in improving the nutritional status of patients with cystic fibrosis. There is also a greater focus on becoming more aware of psychosocial and cultural barriers in the care of cystic fibrosis patients. Many challenges exist in optimizing nutritional support including but not limited to the patient's clinical manifestations and disease severity, caregiver ability, and access to care. Both gastrointestinal and non-gastrointestinal disorders lead to insufficient caloric intake, increased loss and metabolic needs, and micronutrient and macronutrient deficiency. Social factors including stressful patient and caregiver relationships and altered body image also contribute to poor nutritional status.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572340","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":"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":"<p><strong>Purpose of review: </strong>The current review aims to summarize the benefits and limitations of the novel multicancer detection tests (MCD) for diagnosing gastrointestinal (GI) malignancies.</p><p><strong>Recent findings: </strong>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.</p>","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}

{"title":"Update on Pediatric Hepatitis C Infection.","authors":"Johanna Ferreira, Shari Sheflin-Findling","doi":"10.1007/s11894-024-00955-3","DOIUrl":"10.1007/s11894-024-00955-3","url":null,"abstract":"<p><strong>Purposeof review: </strong>Hepatitis C virus (HCV) infections continue to steadily increase in the United States and remain a major public health challenge. This review aims to provide a comprehensive overview of HCV infection in children, focusing on recent advancements in screening, diagnosis, and treatment.</p><p><strong>Recent findings: </strong>Effective screening strategies, including universal screening of pregnant women and nucleic acid testing for all perinatally exposed infants at 2 to 6 months of age, have been implemented to identify infected individuals early. Direct-acting antiviral agents have revolutionized treatment, offering high cure rates for children of all ages. Despite significant progress, challenges remain in achieving HCV elimination. These include the need for improved access to testing and treatment, as well as ongoing efforts to develop a preventive vaccine. Continued research and implementation of effective strategies are essential to reduce the burden of HCV infection.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11870864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522811","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":"Global Prevalence of Anxiety in Gastroenterology and Hepatology Outpatients: A Systematic Review and Meta-Analysis.","authors":"Ben Storer, Monique Holden, Kelly Ann Kershaw, Taylor A Braund, Cassandra Chakouch, Matthew James Coleshill, Sam Haffar, Samuel Harvey, Gemma Sicouri, Jill Newby, Michael Murphy","doi":"10.1007/s11894-025-00963-x","DOIUrl":"10.1007/s11894-025-00963-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Many patients with chronic health conditions experience anxiety, which can have significant implications on physical health outcomes and quality of life. This systematic review and meta-analysis aimed to examine the prevalence of anxiety in gastroenterology and hepatology outpatients, across factors such as physical health condition, type of anxiety, and patient demographics, with the intention to support clinicians in providing effective patient care.</p><p><strong>Recent findings: </strong>Several recent systematic reviews have been published investigating rates of anxiety in different outpatient settings, and have found consistently high rates across the dermatology, endocrinology, cardiology and respiratory/sleep medicine fields, ranging between 25.1% and 30.3%. Whilst there are established links between gastroenterology and hepatology conditions with anxiety, there has yet to be a study estimating the overall global prevalence of anxiety in this outpatient setting. PubMed, Embase, Cochrane and PsycINFO databases were searched from database inception to January 2023 for studies reporting anxiety in gastroenterology and hepatology outpatients ≥ 16 years of age. Prevalence was extracted from self-report questionnaires, diagnostic interviews, and records. The final meta-analysis included 81 studies, with 28,334 participants. Pooled prevalence of anxiety was 31.2% (95% CI 28.2%-34.4%). Subgroup analyses identified significant differences in prevalence across anxiety type, with health anxiety showing the highest prevalence at 23.7%, followed by generalised anxiety 14.5%, specific phobia 12.5%, panic disorder/agoraphobia 12.2%, social anxiety 11.3%, post-traumatic stress disorder 4.9%, and obsessive-compulsive disorder 4.2%. No other significant differences were found. Anxiety is thus common amongst gastroenterology and hepatology outpatients, and so it is important that careful consideration be given to the identification and management of anxiety in these settings.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514695","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":"Diagnosis and Management of Long-term Gastrointestinal Complications in Pediatric Esophageal Atresia/Tracheoesophageal Fistula.","authors":"Delia O'Shea, Elle Quinn, William Middlesworth, Julie Khlevner","doi":"10.1007/s11894-025-00968-6","DOIUrl":"10.1007/s11894-025-00968-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>Esophageal atresia/tracheoesophageal fistula (EA/TEF) causes gastrointestinal (GI) complications that can begin in infancy and extend into adulthood. The etiology of these is frequently multifactorial, and they can adversely affect feeding, growth, respiratory health, and overall quality of life. This review highlights the importance of early diagnosis, multidisciplinary surveillance, and individualized treatment strategies to effectively manage these complications and improve long-term outcomes for affected children.</p><p><strong>Recent findings: </strong>Recent studies have focused on the development of evidence-based surveillance protocols to optimally manage the numerous observed EA/TEF-associated digestive complications. Many of these complications stem from the combination of gastroesophageal dysmotility and mechanical obstruction inherent to EA/TEF and its surgical management, and include gastroesophageal reflux disease, feeding difficulties, dysphagia, eosinophilic esophagitis, and pulmonary consequences of aspiration. Management of GI complications in children with EA/TEF requires careful, multidisciplinary evaluation and treatment, incorporating dietary modifications, feeding therapy, pharmacotherapy, and surgical and endoscopic interventions.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491159","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":"Virtual Reality and Augmented Reality Use Cases in Gastroenterology.","authors":"Yigit Yazarkan, Gamze Sonmez, Muhammet Enes Gurses, Mete Ucdal, Cem Simsek","doi":"10.1007/s11894-025-00962-y","DOIUrl":"10.1007/s11894-025-00962-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Virtual reality (VR) and augmented reality (AR) are emerging technologies with significant potential in medical education and therapeutic interventions, particularly within gastroenterology. This review aims to explore the current applications of VR and AR in enhancing endoscopy training, procedural skills, and patient comfort, while also identifying their role in non-pharmacological pain management and pre-procedure education.</p><p><strong>Recent findings: </strong>Extensive research has been conducted on the use of VR and AR in surgical and neurological fields, but their application in gastroenterology is still evolving. VR simulators provide realistic training environments, contributing to improved procedural skills and patient care. Additionally, VR has been shown to reduce patient discomfort and serve as an alternative to sedation during procedures like colonoscopies. AR, specifically in colonoscopies, has demonstrated potential in enhancing polyp detection by overlaying real-time digital information, leading to better diagnostic accuracy. Studies also suggest that VR can improve patient outcomes in functional gastrointestinal disorders and enhance pre-procedure education, increasing patient satisfaction. VR and AR hold significant promise in gastroenterology by advancing both educational and procedural practices. These technologies offer cost-effective, patient-friendly solutions that improve diagnostic accuracy and patient outcomes. Continued research is essential to fully realize the benefits of VR and AR in gastroenterology, as these tools become more prevalent in clinical practice.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457195","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":"A Review of Exocrine Pancreatic Insufficiency in Children beyond Cystic Fibrosis and the Role of Endoscopic Direct Pancreatic Function Testing.","authors":"Akash Pandey, Devendra Mehta, Karoly Horvath","doi":"10.1007/s11894-025-00959-7","DOIUrl":"10.1007/s11894-025-00959-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Common indications to evaluate exocrine pancreatic function in children include chronic diarrhea, steatorrhea, failure to thrive, cystic fibrosis and those with chronic abdominal pain due to chronic pancreatitis where imaging studies are normal [1]. Exocrine Pancreatic Insufficiency (EPI) has a spectrum of severity. In children often remains an underdiagnosed condition, particularly in its mild, partial, and isolated enzyme deficiency forms. The purpose of this review is to help understand the different varieties of EPI including isolated pancreatic enzyme deficiencies as possible causes of malnutrition and growth failure in pediatric patients.</p><p><strong>Recent findings: </strong>Among the indirect diagnostic methods, the fecal elastase-1 (FE-1) testing is the most widely used one. While it has good sensitivity and specificity in severe pancreatic damage, like cystic fibrosis in children, its performance in the diagnosis of mild, partial, and isolated enzyme deficiencies is poor. Direct pancreatic function testing performed during endoscopy (ePFT), has emerged as a more sensitive and specific method for assessing all forms of exocrine pancreatic function. Notably, recent guidelines from the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) emphasize the importance of ePFT in pediatric patients.  Most of the pediatric practitioners taught that the pancreas has only two diseases, cystic fibrosis and pancreatitis. They are missing the fact that pancreas, like other digestive organs, can have different, many times secondary, dysfunctions that influence the growth of children. Most pediatric gastroenterologists still use the fecal elastase-1 (FE-1) test, however, this lacks sufficient specificity and sensitivity [2-5] especially in patients with mild or early pancreatic disease or those with isolated enzyme deficiencies [5]. The most accurate diagnostic modality to explore these conditions is ePFT. In this review we highlighted the critical importance of direct pancreatic function testing. Enhancing clinical awareness and incorporating direct testing methods can ultimately improve outcomes for affected children.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457193","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":"Advanced Endoscopy: Future Training Perspectives and Tracks.","authors":"Zubair Khan, Kambiz Kadkhodayan","doi":"10.1007/s11894-025-00961-z","DOIUrl":"10.1007/s11894-025-00961-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Since the introduction of ERCP and EUS in the 1980s, the field of advanced endoscopy has witnessed significant growth, necessitating formalized fellowship training to ensure competency and patient safety. This article reviews the history and development of Advanced Endoscopy Fellowship (AEF) training in North America, outlining current challenges such as variability in training standards, case volume, and faculty expertise.</p><p><strong>Recent findings: </strong>General gastroenterology fellowships with apprenticeship model training in advanced endoscopic procedures have been insufficient, prompting the establishment of Advanced Endoscopy Fellowship (AEF) programs across North America. There are emerging trends in interventional endoscopy training, such as competency-based education (CBE), simulation-based training (SBT), and video-based training (VBT). There are new pathways for specialized modular and robotic training and non-traditional routes for EUS and ERCP skill acquisition. Variability across AEF programs remains concerning. This highlights the need for expanded regulatory efforts by organizations like ASGE. Advanced endoscopy training continues to evolve with innovative educational models. However, addressing variability, resource constraints, and employment challenges will be essential to meet the expanding procedural demands of this field and improve patient outcomes.</p>","PeriodicalId":10776,"journal":{"name":"Current Gastroenterology Reports","volume":"27 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432509","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}