Expert Review of Gastroenterology & Hepatology最新文献

Novel nutrition strategies in gastric and esophageal cancer.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-26 DOI: 10.1080/17474124.2025.2457444

Ellen Boyle, Jessie A Elliott

{"title":"Novel nutrition strategies in gastric and esophageal cancer.","authors":"Ellen Boyle, Jessie A Elliott","doi":"10.1080/17474124.2025.2457444","DOIUrl":"https://doi.org/10.1080/17474124.2025.2457444","url":null,"abstract":"Introduction: Advances in treatment strategies for gastric and esophageal cancer have led to improved long-term outcomes, however the local and systemic effects of tumor growth, neoadjuvant therapies and surgery, results in specific nutritional challenges. Comprehensive nutritional evaluation and support represents a core component of multidisciplinary holistic care for this patient population.Areas covered: This review provides a detailed overview of the nutritional challenges in gastric and esophageal cancer, with a focus on malignant obstruction, preoperative optimization and nutrition in survivorship. We discuss the current management options for these challenges, with an overview of the present evidence base, and detail the future therapeutic targets in nutritional support in gastric and esophageal cancer.Expert opinion: The advent of bariatric surgery to treat obesity has yielded fascinating insights into the postoperative attenuation of gut hormone signaling that underpins early satiety and persistent weight loss following gastric and esophageal cancer surgery, providing new therapeutic targets. The management of malignant dysphagia and obstruction currently lacks robust evidence, particularly in patient reported outcomes, to support an optimal strategy. The advantages of nutritional optimization in the pre- and immediate postoperative phase are well documented, but the exact regimens to optimize patient outcomes and quality of life are not clear.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comprehensive care of ulcerative colitis: new treatment strategies.

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-26 DOI: 10.1080/17474124.2025.2457451

Thanaboon Chaemsupaphan, Arteen Arzivian, Rupert W Leong

{"title":"Comprehensive care of ulcerative colitis: new treatment strategies.","authors":"Thanaboon Chaemsupaphan, Arteen Arzivian, Rupert W Leong","doi":"10.1080/17474124.2025.2457451","DOIUrl":"https://doi.org/10.1080/17474124.2025.2457451","url":null,"abstract":"Introduction: Ulcerative colitis is a chronic inflammatory condition of the colon driven by aberrant immune activation. Although advanced medical therapies form the cornerstone of ulcerative colitis management, unmet needs include failure to induce and sustain remission in a substantial proportion of patients and in managing acute severe ulcerative colitis. We review new treatment strategies that might improve patient outcomes in the management of moderate-to-severe ulcerative colitis.Areas covered: A literature search was conducted using the PubMed database, including studies published from inception to October 2024, selected for their relevance. Recognizing current limitations, this article reviews strategies to improve treatment outcomes in ulcerative colitis using advanced therapies. These approaches include early treatment initiation, dose optimization, positioning newer agents as first-line therapies, combination therapy, targeting novel therapeutic endpoints, and the management of acute severe ulcerative colitis.Expert opinion: The strategies discussed may contribute to establishing new standards of care aimed at achieving long-term remission and enhancing patient outcomes. Personalized therapy, which tailors treatment based on individual disease characteristics and risk factors, is anticipated to become a critical aspect of delivering more effective care in the future.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Are bowel purgatives useful in small bowel capsule endoscopy? 肠泻药在小肠胶囊内镜检查中有用吗？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-23 DOI: 10.1080/17474124.2025.2458168

Naoki Hosoe

引用次数: 0

AKI in ACLF: navigating the complex therapeutic puzzle. ACLF的AKI：导航复杂的治疗难题。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-23 DOI: 10.1080/17474124.2025.2456121

Rakhi Maiwall, Fagun Sharma

{"title":"AKI in ACLF: navigating the complex therapeutic puzzle.","authors":"Rakhi Maiwall, Fagun Sharma","doi":"10.1080/17474124.2025.2456121","DOIUrl":"10.1080/17474124.2025.2456121","url":null,"abstract":"Introduction: Acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF) is driven by the severity of systemic inflammation, acute portal hypertension driving circulatory dysfunction, hyperbilirubinemia, and toxicity of bile acids. The spectrum is mostly structural, associated with reduced response to vasoconstrictors. The progression is rapid, and need of renal replacement therapy and extracorporeal therapies may be required for the management. The development of renal failure is usually considered when defining the syndrome of ACLF.Areas covered: In the current review we discuss the pathophysiological basis, natural course, and response to the current therapeutic modalities and challenges in assessing and managing AKI in patients with ACLF. We conducted a comprehensive search of electronic databases such as PubMed, Web of Science, and Scopus using keywords like lactate, NGAL, and PHTN, as well as CRRT, PLEX, ACLF, and AKI phases for our review. Peer-reviewed English papers that addressed our issue were considered.Expert opinion: The difficulties and specific management strategies for AKI in ACLF patients are discussed emphasizing the importance of customized protocols, risk assessment guided by biomarkers, and investigation of extracorporeal therapies that target bile acids.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-16"},"PeriodicalIF":3.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An evidence-based update on the diagnosis and management of irritable bowel syndrome. 肠易激综合征诊断和治疗的循证最新进展。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-21 DOI: 10.1080/17474124.2025.2455586

Christopher J Black, Alexander C Ford

{"title":"An evidence-based update on the diagnosis and management of irritable bowel syndrome.","authors":"Christopher J Black, Alexander C Ford","doi":"10.1080/17474124.2025.2455586","DOIUrl":"https://doi.org/10.1080/17474124.2025.2455586","url":null,"abstract":"Introduction: Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction affecting 5% of the population. The cardinal symptoms are abdominal pain and altered stool form or frequency.Areas covered: Diagnosis and management of IBS. We searched the literature for diagnostic accuracy studies, randomized controlled trials, and meta-analyses. A positive diagnosis of IBS, alongside testing to exclude celiac disease, is recommended. Exhaustive investigation has a low yield. Patients should be offered traditional dietary advice. If response is incomplete, specialist dietetic guidance should be considered. Probiotics may be beneficial, but quality of evidence is poor. First-line treatment of constipation is with laxatives, with secretagogues used where these are ineffective. Anti-diarrheal drugs should be used first-line for diarrhea, with second-line drugs including 5-hydroxytryptamine-3 antagonists, eluxadoline, or rifaximin, where available. First-line treatment of abdominal pain should be with antispasmodics, with gut-brain neuromodulators prescribed second-line. Low-dose tricyclic antidepressants, such as amitriptyline, are preferred. Brain-gut behavioral therapies are effective and have evidence for efficacy in patients refractory to standard therapies.Expert opinion: Despite substantial advances, there remains scope for improvement in terms of both the diagnosis and management of IBS. Reinforcement of positive diagnostic strategies for the condition and novel treatment paradigms are required.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-16"},"PeriodicalIF":3.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Revolutionizing liver fibrosis research: the promise of 3D organoid models in understanding and treating chronic liver disease. 革命性的肝纤维化研究：三维类器官模型在理解和治疗慢性肝病方面的前景。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-20 DOI: 10.1080/17474124.2025.2455581

Umashanker Navik, Sumeet Kumar Singh, Amit Khurana, Ralf Weiskirchen

{"title":"Revolutionizing liver fibrosis research: the promise of 3D organoid models in understanding and treating chronic liver disease.","authors":"Umashanker Navik, Sumeet Kumar Singh, Amit Khurana, Ralf Weiskirchen","doi":"10.1080/17474124.2025.2455581","DOIUrl":"https://doi.org/10.1080/17474124.2025.2455581","url":null,"abstract":"Introduction: Liver fibrosis, marked by excessive extracellular matrix deposition, is a significant consequence of chronic liver injuries from various conditions. It can progress to end-stage liver disease, with liver transplantation often being the only treatment option. Recent advancements in 3D-organoid technology have transformed liver disease research by providing models that mimic the human liver's physiological environment, offering insights into mechanisms of fibrosis and potential therapies.Areas covered: This report highlights cellular and molecular factors leading to liver fibrosis and the limitations of 2D in vitro models in replicating complex liver dynamics. It emphasizes the advantages of 3D-liver organoids as promising tools for advancing research and drug discovery, providing greater accuracy than traditional models. Additionally, it discusses recent advancements in the development and future applications of liver organoids in fibrosis research.Expert opinion: Liver organoids currently lack cellular diversity and essential features such as vascular, neuronal, microbiome, and immune responses, limiting their effectiveness in mature fibrosis models. Addressing these shortcomings through bioengineering advancements and emerging technologies like CRISPR/Cas9 will enhance the utility of liver organoids.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-6"},"PeriodicalIF":3.8,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Modulating the microbiome in chronic liver diseases - current evidence on the role of fecal microbiota transplantation. 调节慢性肝病中的微生物群——粪便微生物群移植作用的最新证据。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-16 DOI: 10.1080/17474124.2025.2450707

Srishti Saha, Bernd Schnabl

{"title":"Modulating the microbiome in chronic liver diseases - current evidence on the role of fecal microbiota transplantation.","authors":"Srishti Saha, Bernd Schnabl","doi":"10.1080/17474124.2025.2450707","DOIUrl":"10.1080/17474124.2025.2450707","url":null,"abstract":"Introduction: The gut microbiota has a complex relationship with the human host and is key to maintaining health. Disruption of the healthy diverse gut microbial milieu plays an important role in the pathogenesis of several diseases including Clostridioides difficile infection (CDI), inflammatory bowel disease, irritable bowel syndrome, alcohol-related liver disease and metabolic-dysfunction associated steatotic liver disease (MASLD). Fecal microbiota transplantation (FMT) is highly effective in treating CDI, though its utility in other diseases is still being explored.Areas covered: In this narrative review, we explore the role of gut microbiota in liver diseases, focusing on key changes in the microbial composition and function. We summarize current evidence on the role of FMT, identifying gaps in current research and outlining future directions for investigation. We comprehensively searched PubMed through 15 October 2024 to identify relevant studies.Expert opinion: While data from available studies shows promise, more research is necessary before we can use FMT for liver diseases. Key areas that require further study are - determining the optimal FMT regimen for each disease, establishing efficacy and safety with larger clinical trials, ensuring safe and equitable access to the FMT product and mechanistic insights into the reasons for success or failure of FMT.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-12"},"PeriodicalIF":3.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of noninvasive biomarkers for monitoring cell injury in advanced liver fibrosis. 无创生物标志物在监测晚期肝纤维化细胞损伤中的作用。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-09 DOI: 10.1080/17474124.2025.2450717

Riccardo Righetti, Felice Cinque, Keyur Patel, Giada Sebastiani

{"title":"The role of noninvasive biomarkers for monitoring cell injury in advanced liver fibrosis.","authors":"Riccardo Righetti, Felice Cinque, Keyur Patel, Giada Sebastiani","doi":"10.1080/17474124.2025.2450717","DOIUrl":"10.1080/17474124.2025.2450717","url":null,"abstract":"Introduction: Accurate and reliable diagnosis and monitoring of hepatic fibrosis is increasingly important given the variable natural history in chronic liver disease (CLD) and expanding antifibrotic therapeutic options targeting reversibility of early-stage cirrhosis. This highlights the need to develop more refined and effective noninvasive techniques for the dynamic assessment of fibrogenesis and fibrolysis.Areas covered: We conducted a literature review on PubMed, from 1 December 1970, to 1 November 2024, to evaluate and compare available blood-based and imaging-based noninvasive tools for hepatic fibrosis diagnosis and monitoring. Simple scores such as FIB-4 and NAFLD fibrosis score are suitable for excluding significant or advanced fibrosis, while tertiary centers should adopt complex scores and liver stiffness measurement as part of a secondary diagnostic and more comprehensive evaluation. Moreover, the advent of multiomics for high-resolution molecular profiling, and integration of artificial intelligence for noninvasive diagnostics holds promise for revolutionizing fibrosis monitoring and treatment through novel biomarker discovery and predictive omics-based algorithms.Expert opinion: The increased shift toward noninvasive diagnostics for liver fibrosis needs to align with personalized medicine, enabling more effective, tailored management strategies for patients with liver disease in the future.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-16"},"PeriodicalIF":3.8,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interventions to improve bowel cleansing in colonoscopy. 改善结肠镜检查中肠道清洁的干预措施。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-08 DOI: 10.1080/17474124.2025.2450699

Antonio Z Gimeno-García, Davinia Sacramento-Luis, Rashika Ashok-Bhagchandani, David Nicolás-Pérez, Manuel Hernández-Guerra

{"title":"Interventions to improve bowel cleansing in colonoscopy.","authors":"Antonio Z Gimeno-García, Davinia Sacramento-Luis, Rashika Ashok-Bhagchandani, David Nicolás-Pérez, Manuel Hernández-Guerra","doi":"10.1080/17474124.2025.2450699","DOIUrl":"10.1080/17474124.2025.2450699","url":null,"abstract":"Introduction: Suboptimal bowel preparation adversely affects colonoscopy quality, increases healthcare costs, and prolongs waiting time. The primary contributing factors include poor tolerance to the preparation solutions, noncompliance with prescribed instructions, and suboptimal efficacy of the bowel cleansing solution itself.Areas covered: This review examined the predictive factors associated with suboptimal bowel preparation and discussed interventions aimed at improving bowel cleansing. It also provides evidence-based practical algorithms supplemented by insights from our own clinical experience. Relevant topics were reviewed using resources from the PubMed database.Expert opinion: Although current bowel preparation protocols are effective for the majority of patients, a significant proportion still present challenges for optimal preparation. These patients may benefit from personalized strategies tailored to the specific causes of preparation failure. Conducting a thorough interview is crucial for identifying the reasons for failure, particularly in patients who have previously experienced suboptimal preparation during colonoscopy. In colonoscopy-naïve patients, it is essential to assess the risk of suboptimal preparation. In both cases, interventions should be customized to either address the identified causes in the former group or employ preventive strategies to reduce the likelihood of failure in the latter.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-13"},"PeriodicalIF":3.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The TL1A inhibitors in IBD: what's in the pot? TL1A抑制剂在IBD中的作用是什么？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-01-08 DOI: 10.1080/17474124.2025.2450795

F Lusetti, C Bezzio, A De Bernardi, M Dota, G Manes, S Saibeni

{"title":"The TL1A inhibitors in IBD: what's in the pot?","authors":"F Lusetti, C Bezzio, A De Bernardi, M Dota, G Manes, S Saibeni","doi":"10.1080/17474124.2025.2450795","DOIUrl":"https://doi.org/10.1080/17474124.2025.2450795","url":null,"abstract":"Introduction: Inflammatory bowel diseases (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), present ongoing challenges despite advances in pathophysiological understanding and therapeutic options. Current therapies often fail to achieve sustained remission, necessitating exploration of novel treatment targets.Areas covered: This review explores the role of Tumor Necrosis Factor-like cytokine 1A (TL1A) and its receptor DR3 in IBD pathogenesis, detailing their involvement in mucosal homeostasis and immune modulation. Recent studies on TL1A inhibitors highlight their potential in mitigating inflammation and fibrosis in IBD.Expert opinion: TL1A inhibition emerges as a promising therapeutic strategy, supported by encouraging outcomes in clinical trials for moderate to severe IBD. Future research may elucidate TL1A's broader impact on immunity, epithelial integrity and fibrosis, offering new avenues for therapeutic intervention and biomarker discovery. Ongoing phase 3 trials are pivotal in assessing TL1A inhibitors as effective and safe treatments for IBD. Additionally, exploration of TL1A's role in fibrosis-associated complications and its potential as a biomarker for treatment response holds promise for personalized medicine approaches. Consideration of TL1A inhibition in concurrent immune-mediated inflammatory diseases suggests broader therapeutic implications beyond gastrointestinal manifestations of IBD.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-11"},"PeriodicalIF":3.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0