Expert Review of Gastroenterology & Hepatology最新文献

Assessment and management of portal hypertension in patients with MASLD: advances and caveats. 门静脉高压在MASLD患者中的评估和管理：进展和警告。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-12 DOI: 10.1080/17474124.2025.2530605

Diego Rojo, Alba Jiménez-Masip, Laura Pagès, Juan Bañares, Clara Sabiote, María Martínez-Gómez, Laia Aceituno, M Serra Cusidó, M Teresa Salcedo-Allende, Zyanya Calixto, Mònica Pons, Joan Genescà, Juan M Pericàs

{"title":"Assessment and management of portal hypertension in patients with MASLD: advances and caveats.","authors":"Diego Rojo, Alba Jiménez-Masip, Laura Pagès, Juan Bañares, Clara Sabiote, María Martínez-Gómez, Laia Aceituno, M Serra Cusidó, M Teresa Salcedo-Allende, Zyanya Calixto, Mònica Pons, Joan Genescà, Juan M Pericàs","doi":"10.1080/17474124.2025.2530605","DOIUrl":"10.1080/17474124.2025.2530605","url":null,"abstract":"Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly gaining relevance both as a public health issue and a clinical challenge. The development of portal hypertension in MASLD challenges traditional paradigm that it arises only in the context of cirrhosis.Areas covered: This review explores the understanding of portal hypertension in MASLD, addressing recent advances in pathophysiology, diagnosis, and potential therapeutic approaches. Particular attention is given to studies that highlight non-cirrhotic contributors to increased portal pressure. Pathogenic mechanisms, as well as advances in noninvasive diagnostic tools are discussed, focusing on their utility in identifying early hemodynamic changes and stratifying the risk of clinical complications. A comprehensive literature search was conducted using PubMed and major databases, including studies published up to April 2025.Expert opinion: The future of MASLD management lies in early detection, improved noninvasive risk stratification, and personalized treatment strategies. Advances in technology and artificial intelligence will likely enhance diagnostic precision while ongoing research into molecular mechanisms and portal hypertension may enable earlier and effective therapeutic interventions.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-15"},"PeriodicalIF":3.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583499","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

Letter to the editor: vitamin B12 deficiency and use of proton pump inhibitors: a systematic review and meta-analysis. 致编辑的信：维生素B12缺乏症和质子泵抑制剂的使用：系统回顾和荟萃分析。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-10 DOI: 10.1080/17474124.2025.2530602

Santiago Barón Gutiérrez, Jonathan Camilo Ramírez Cruz

引用次数: 0

Autoimmune gastritis: an organ-specific disease or a model of systemic autoimmunity? Parallels, divergences, and emerging insights. 自身免疫性胃炎：器官特异性疾病还是全身性自身免疫模型？相似之处、分歧和新见解。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-07 DOI: 10.1080/17474124.2025.2522284

Sara Massironi

{"title":"Autoimmune gastritis: an organ-specific disease or a model of systemic autoimmunity? Parallels, divergences, and emerging insights.","authors":"Sara Massironi","doi":"10.1080/17474124.2025.2522284","DOIUrl":"10.1080/17474124.2025.2522284","url":null,"abstract":"Introduction: Autoimmune gastritis (AIG) is traditionally classified as an organ-specific autoimmune disease; however, emerging evidence highlights its immunological overlap with systemic autoimmunity, warranting a reevaluation of its pathophysiological framework.Areas covered: This review delineates the immunopathogenic basis of AIG, with particular emphasis on the breakdown of central and peripheral tolerance, the predominance of autoreactive CD4+ T-cell subsets, and the contributions of Th1 and Th17 cytokine profiles. The role of humoral immunity, including autoantibodies as potential biomarkers, is critically appraised. Literature was selected through a targeted search of PubMed and Scopus, prioritizing mechanistic studies, translational research, and recent therapeutic advances, covering the period from January 2000 to March 2025.Expert opinion: AIG represents a paradigm of localized autoimmunity with systemic immunological features, including cytokine dysregulation and epitope spreading. Although serologic markers are valuable for screening, their prognostic utility remains limited. Therapeutic approaches currently focus on complication prevention rather than immune modulation. Future research should prioritize the identification of predictive biomarkers of disease progression and the development of targeted immunotherapies aimed at restoring immune tolerance and preserving gastric mucosal integrity.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-9"},"PeriodicalIF":3.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332728","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

Reply to letter to the Editor: Vitamin B12 deficiency and use of proton pump inhibitors: a systematic review and meta-analysis. 回复编辑：维生素B12缺乏症和质子泵抑制剂的使用：系统回顾和荟萃分析。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-07 DOI: 10.1080/17474124.2025.2530608

Arup Choudhury, Vishal Sharma

引用次数: 0

Could modulating the esophageal microbiome be the answer for eosinophilic esophagitis treatment? 食管微生物群的调节能否成为嗜酸性食管炎治疗的答案？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-06 DOI: 10.1080/17474124.2025.2530606

Sonia Facchin, Erica Bonazzi, Antonietta Tomasulo, Luisa Bertin, Greta Lorenzon, Daria Maniero, Fabiana Zingone, Romilda Cardin, Brigida Barberio, Matteo Ghisa, Edoardo Vincenzo Savarino

{"title":"Could modulating the esophageal microbiome be the answer for eosinophilic esophagitis treatment?","authors":"Sonia Facchin, Erica Bonazzi, Antonietta Tomasulo, Luisa Bertin, Greta Lorenzon, Daria Maniero, Fabiana Zingone, Romilda Cardin, Brigida Barberio, Matteo Ghisa, Edoardo Vincenzo Savarino","doi":"10.1080/17474124.2025.2530606","DOIUrl":"10.1080/17474124.2025.2530606","url":null,"abstract":"Introduction: The oral and esophageal microbiota are gaining recognition for their significance in managing Eosinophilic Esophagitis (EoE). They serve as diagnostic biomarkers and therapeutic targets.Areas covered: The primary goal of EoE treatment is to alleviate symptoms such as dysphagia, heartburn, nausea, and chest pain. These symptoms are often associated with dysfunction of the esophageal barrier, closely linked to the esophageal microbiota. The composition of the esophageal microbiota can be affected by pharmacological treatments, particularly proton pump inhibitors, corticosteroids, and dietary interventions suggested for EoE management. As a result, the intestinal microbiota may also be influenced by these pharmacological approaches. Emerging research points to the potential of probiotic treatments as a complementary option to pharmacological therapy in the management of EoE. Publications linking 'EoE' to 'microbiome-microbiota' from 2013 to 2025 have been considered.Expert opinion: Further investigation into probiotics could expand the range of therapeutic options available alongside conventional treatments, potentially improving EoE remission rates, enhancing patient compliance, and reducing treatment-related side effects.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-9"},"PeriodicalIF":3.8,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567336","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

Psychosocial care needs of emerging adults with inflammatory bowel disease. 新发炎症性肠病成人的心理社会护理需求

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-03 DOI: 10.1080/17474124.2025.2529208

Stephen A Lieto, Tim Hewitt, Laurie Keefer

{"title":"Psychosocial care needs of emerging adults with inflammatory bowel disease.","authors":"Stephen A Lieto, Tim Hewitt, Laurie Keefer","doi":"10.1080/17474124.2025.2529208","DOIUrl":"10.1080/17474124.2025.2529208","url":null,"abstract":"Introduction: Inflammatory bowel disease (IBD) is a life-long illness that is increasing in prevalence and incidence, disproportionately among young adults. The diagnosis often coincides with emerging adulthood, a critical developmental stage when young adults face formative life changes such as independent living, finalization of education and career path, redefining relationships with parents, the pursuit of romantic relationships, marriage, and parenthood. A diagnosis of IBD during emerging adulthood can have significant impacts on these domains.Areas covered: Current research supports incorporating comprehensive psychosocial care for emerging adults dealing with IBD. These dimensions include the mental health needs of patients, the social needs and barriers of living with IBD, the impact chronic illness has on intimate relationships and family planning, and the impact on career and finances. Literature search was conducted using online databases including PubMed, Google Scholar, and OpenEvidence.Expert review: By addressing the psychosocial needs of IBD patients, healthcare providers can empower emerging adults to navigate the challenges of chronic illness and achieve personal and professional fulfillment. Review of published literature demonstrates that comprehensive, compassionate care during this vulnerable period can improve patient outcomes, resilience, and quality of life, enabling young adults with IBD to lead successful and meaningful lives.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-8"},"PeriodicalIF":3.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552790","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

Early portal hypertension in metabolic dysfunction-associated steatotic liver disease: a concise review. 代谢功能障碍相关脂肪变性肝病的早期门静脉高压症：简要回顾

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-01 Epub Date: 2025-06-14 DOI: 10.1080/17474124.2025.2519163

Iván López-Méndez, Eva Juárez-Hernández, Juan Pablo Soriano-Márquez, Misael Uribe, Graciela Castro-Narro

{"title":"Early portal hypertension in metabolic dysfunction-associated steatotic liver disease: a concise review.","authors":"Iván López-Méndez, Eva Juárez-Hernández, Juan Pablo Soriano-Márquez, Misael Uribe, Graciela Castro-Narro","doi":"10.1080/17474124.2025.2519163","DOIUrl":"10.1080/17474124.2025.2519163","url":null,"abstract":"Introduction: In the metabolic dysfunction-associated steatotic liver disease (MASLD) scenario, more and more evidence has emerged indicating that MASLD patients can develop portal hypertension (PH), which has a direct impact on the prognosis of the disease and represents a significant challenge during the clinical approach.Areas covered: There are different explanations for early PH pathophysiology in patients with MASLD, among which are dysbiosis, microthrombosis, impairments in inflammatory mediators, sinusoid-level alterations in the liver architecture, genetic factors, and so on. Currently, we have evidence in animal models and humans demonstrating that all these factors could be modulated or modified; unfortunately, we are far from translating these results into clinical scenarios. The early PH phenomenon only occurs in 20% patients with MASLD. This review aims to describe the current evidence from the pathophysiological and treatment point of view, as well as the implications in the clinical care of patients with MASLD presenting early PH.Expert opinion: Although the presence of PH in these patients has a significant clinical impact, the traditional diagnostic approach may not be the best option; other diagnostic tools have been studied, and perhaps, at some point, they can be added to the treatment algorithms of these patients.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"755-765"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274588","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

Belching, bloating, and flatulence: pitfalls and challenges in evaluating and managing symptoms of intestinal gas and how to avoid them. 打嗝、腹胀和胀气：评估和管理肠道气体症状的陷阱和挑战以及如何避免它们。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-01 Epub Date: 2025-06-08 DOI: 10.1080/17474124.2025.2514239

Madunil Anuk Niriella, Hishali Dahami Jayasundara, Vajira Tharanga Samarawickrama, Krishanni Prabagar, Hithanadura Janaka De Silva

{"title":"Belching, bloating, and flatulence: pitfalls and challenges in evaluating and managing symptoms of intestinal gas and how to avoid them.","authors":"Madunil Anuk Niriella, Hishali Dahami Jayasundara, Vajira Tharanga Samarawickrama, Krishanni Prabagar, Hithanadura Janaka De Silva","doi":"10.1080/17474124.2025.2514239","DOIUrl":"10.1080/17474124.2025.2514239","url":null,"abstract":"Introduction: Belching, bloating, and flatulence are common complaints that significantly affect quality of life. Although these often arise from benign functional disorders, their underlying mechanisms are multifactorial, involving disordered motility, visceral hypersensitivity, and psychological influences.Areas covered: A selective literature search was conducted across electronic databases (PubMed, MEDLINE, Embase, and Cochrane Library) to identify relevant publications on intestinal gas related symptoms. Randomized controlled trials, meta-analyses, systematic reviews, evidence-based clinical practice guidelines and selected expert consensus statements and narrative reviews were included.This narrative review highlights common diagnostic and therapeutic pitfalls in managing gas-related symptoms, including failure to recognize alarm features, misclassifying symptoms, excessive investigations, and inappropriate treatment choices. It discusses intestinal gas's physiological basis, challenges distinguishing pathological from normal symptoms, and provides a framework for evidence-based evaluation and treatment.Expert opinion: Effective management requires a structured, individualized approach incorporating thorough clinical assessment, dietary evaluation, psychological screening, and judicious use of noninvasive tests. Neglect of psychosocial contributors often lead to suboptimal care. Personalised strategies such as breath testing, low FODMAP diet, microbiota-targeted therapies, and cognitive-behavioral interventions can improve outcomes. Enhancing clinician education and fostering interdisciplinary collaboration is essential to bridging the gap between current evidence and clinical practice.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"805-815"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173264","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 position of anti-tumor necrosis factor agents for the treatment of adult patients with Crohn's disease. 抗肿瘤坏死因子药物在成人克罗恩病治疗中的地位

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-01 Epub Date: 2025-06-28 DOI: 10.1080/17474124.2025.2511148

Stephen B Hanauer, Byong Duk Ye, Raymond K Cross, Silvio Danese, Geert D'Haens, Jinah Jung

{"title":"The position of anti-tumor necrosis factor agents for the treatment of adult patients with Crohn's disease.","authors":"Stephen B Hanauer, Byong Duk Ye, Raymond K Cross, Silvio Danese, Geert D'Haens, Jinah Jung","doi":"10.1080/17474124.2025.2511148","DOIUrl":"10.1080/17474124.2025.2511148","url":null,"abstract":"Introduction: Tumor Necrosis Factor α (TNF) is a significant systemic inflammatory cytokine in several immune-mediated inflammatory diseases (IMIDs) including inflammatory bowel disease (IBD, Crohn's disease (CD), and ulcerative colitis) and was the first target approved for biologic therapy in IBD.Areas covered: This article reviews the efficacy and safety of antiTNF agents for the treatment of CD including specific conditions (e.g. perianal fistula, prevention of post-operative recurrence), and practical approaches to managing antiTNF therapy (e.g. combination with immunosuppressants, early introduction of antiTNF treatment, and therapeutic drug monitoring (TDM)). This review is based on data from randomized controlled trials, real-world evidences and comparative studies gathered over the past 25 years.Expert opinion: Anti-TNF agents have revolutionized treatment of IBD and other IMIDs. Early introduction of treatment, concurrent use of immunomodulators, and TDM are associated with improved clinical outcomes. Anti-TNF agents are preferred for subpopulations of CD including patients with perianal CD, extraintestinal manifestations, and postoperative prevention of CD. Biosimilars have increased access to anti-TNF agents and lowered overall costs. Future studies are needed to determine which agents are most likely to be efficacious and safe for subpopulations with CD.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"725-743"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142073","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

Complicated diverticulitis: medical management or segmental resection? 复杂性憩室炎：内科治疗还是节段性切除？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-07-01 Epub Date: 2025-06-17 DOI: 10.1080/17474124.2025.2519162

Antonio Tursi

引用次数: 0