Expert Review of Gastroenterology & Hepatology最新文献

Liver transplantation allocation: how can we optimize utilization of organ transplants? 肝移植分配：如何优化器官移植的利用？

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-05-30 DOI: 10.1080/17474124.2025.2514722

Thomas M Hunold, Neehar D Parikh

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 : 2025-05-29 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":"https://doi.org/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":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-29","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

From simplicity to precision: the balloon expulsion test in the diagnosis of anorectal disorders. 从简单到精确：气囊排出试验在肛肠疾病诊断中的应用。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-05-28 DOI: 10.1080/17474124.2025.2513510

Javier Chahuán, Hugo Monrroy, Mauricio Pizarro, José María Remes-Troche

{"title":"From simplicity to precision: the balloon expulsion test in the diagnosis of anorectal disorders.","authors":"Javier Chahuán, Hugo Monrroy, Mauricio Pizarro, José María Remes-Troche","doi":"10.1080/17474124.2025.2513510","DOIUrl":"https://doi.org/10.1080/17474124.2025.2513510","url":null,"abstract":"Introduction: Anorectal disorders, such as chronic constipation and fecal incontinence, significantly impact patients' quality of life. Accurate diagnosis is essential for effective treatment, and the balloon expulsion test (BET) has emerged as a simple yet valuable tool in evaluating anorectal function. Despite its simplicity, variations in technique and interpretation have led to ongoing debates regarding its diagnostic precision. To support this review, a PubMed search was conducted using the terms balloon, expulsion, test, evacuation, and disorders, focusing on the most relevant articles published over the past 25 years.Areas covered: This review explores the evolution of the BET, highlighting its role in diagnosing defecatory disorders. It examines various methodologies, standardization efforts, and the test's sensitivity and specificity compared to other diagnostic modalities like anorectal manometry and defecography.Expert opinion: The balloon expulsion test remains a cornerstone in the functional assessment of anorectal disorders due to its simplicity, cost-effectiveness, and accessibility. However, standardized protocols are essential to improve diagnostic accuracy and reproducibility. Future research should focus on refining BET techniques and integrating them with advanced diagnostic tools to enhance patient outcomes and guide personalized treatment strategies.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157610","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

Characterizing Crohn's disease phenotypes through pan-enteric capsule endoscopy. 通过泛肠胶囊内窥镜观察克罗恩病的表型特征。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-05-28 DOI: 10.1080/17474124.2025.2509800

Luca Scarallo, Giusy Russo, Paolo Lionetti, Salvatore Oliva

引用次数: 0

EUS guided gastrojejunostomy: techniques and outcomes. EUS引导下的胃空肠吻合术：技术和结果。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-05-27 DOI: 10.1080/17474124.2025.2512168

Sachin Hosahally Jayanna, Surinder Singh Rana

{"title":"EUS guided gastrojejunostomy: techniques and outcomes.","authors":"Sachin Hosahally Jayanna, Surinder Singh Rana","doi":"10.1080/17474124.2025.2512168","DOIUrl":"10.1080/17474124.2025.2512168","url":null,"abstract":"Introduction: Surgical bypass, the traditional approach for managing gastric outlet obstruction (GOO), is effective but associated with increased morbidity and short-term complications. Enteral self-expanding metal stents (SEMS) provide a safe, effective, and minimally invasive alternative to surgical bypass, though they carry an increased risk of re-interventions due to stent blockage. Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is a recently developed, novel minimally invasive procedure that serves as an alternative to enteral SEMS placement.Areas covered: We performed an electronic search in PubMed and included all the types of articles on EUS-GJ written in English language till February 2025. This review discusses both the technical details and outcomes of EUS-GJ.Expert opinion: EUS-GJ involves creating an anastomosis between the stomach and the small intestine using a lumen-apposing metal stent (LAMS). There are three basic techniques for performing EUS-GJ: the direct technique, the balloon-assisted technique, and the EPASS (EUS-guided double-balloon-occluded gastrojejunostomy bypass) technique. Among these, the free-hand direct approach is the most widely used due to its shorter procedure time and comparable technical outcomes to the other two techniques. Stent misdeployment is the most dreaded complication of EUS-GJ; however, fortunately, the majority of misdeployments can be successfully managed through rescue endoscopic methods.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-10"},"PeriodicalIF":3.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136156","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 : 2025-05-26 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":"https://doi.org/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":""},"PeriodicalIF":3.8,"publicationDate":"2025-05-26","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

The serrated pathway and colorectal cancer: what the gastroenterologist should know. 锯齿状通路与结直肠癌：胃肠病学家应该知道的。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-05-26 DOI: 10.1080/17474124.2025.2509797

Rachael Hagen, Amitabh Srivastava, Joseph C Anderson

{"title":"The serrated pathway and colorectal cancer: what the gastroenterologist should know.","authors":"Rachael Hagen, Amitabh Srivastava, Joseph C Anderson","doi":"10.1080/17474124.2025.2509797","DOIUrl":"10.1080/17474124.2025.2509797","url":null,"abstract":"Introduction: Serrated polyps can progress to colorectal cancer (CRC), through a pathway that is distinct from the conventional adenoma-carcinoma sequence. This pathway includes hyperplastic polyps (HPs), sessile serrated polyps (SSPs), and traditional serrated adenomas (TSAs).Areas covered: Our review includes the histology and pathological challenges, carcinogenesis, risk factors, detection, emerging technologies, resection, and surveillance.Expert opinion: Serrated polyp management presents many detection, diagnosis, resection, and surveillance challenges. Missed serrated polyps contribute to preventable CRCs. A new SSP detection rate benchmark will guide endoscopists with a goal when improving detection. Furthermore, new SSP-specific surveillance strategies may also aid in reducing CRC burden. Histologic differentiation remains a challenge, underscoring the need for standardized pathology practices and exploring novel ways to stratify risk independent of histology, given interobserver variation. Moreover, the clinical significance of proximal HPs requires further clarification. Which HPs < 1 cm require closer surveillance intervals? Molecular profiling may help identify markers that separate proximal low risk from high-risk HP. The best approach for resection of serrated polyps also needs to be clarified. There is also a lack of robust longitudinal outcome data to guide surveillance recommendations since current guidelines are based on low quality of evidence.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-14"},"PeriodicalIF":3.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132337","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

Innovations in the diagnosis, treatment, and management of disorders of gut-brain interaction (DGBI). 肠脑相互作用紊乱（DGBI）的诊断、治疗和管理方面的创新。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-05-21 DOI: 10.1080/17474124.2025.2508967

Patrycja Krynicka, George Koulaouzidis, Wojciech Marlicz, Anastasios Koulaouzidis

{"title":"Innovations in the diagnosis, treatment, and management of disorders of gut-brain interaction (DGBI).","authors":"Patrycja Krynicka, George Koulaouzidis, Wojciech Marlicz, Anastasios Koulaouzidis","doi":"10.1080/17474124.2025.2508967","DOIUrl":"10.1080/17474124.2025.2508967","url":null,"abstract":"Introduction: Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are the most prevalent disorders of gut-brain interaction (DGBI), frequently overlapping and associated with complex pathophysiological mechanisms. Increasing evidence implicates gut microbiota alterations in driving symptoms via immune activation, altered motility, gut vascular barrier and gut-brain axis disruption.Areas covered: This review explores the role of gut microbiota in FD and IBS pathogenesis and symptomatology. A comprehensive literature search was conducted using PubMed, EMBASE, and Google Scholar databases, including studies published between January 2013 and March 2025. Particular focus is given to microbiota-targeted therapies such as prebiotics, probiotics, synbiotics, postbiotics, and fecal microbiota transplantation (FMT). The review also discusses multidimensional treatment strategies combining dietary and lifestyle modification, cognitive-behavioral therapy, and pharmacological neuromodulation. Recent advances in diagnostic methods, including capsule-based microbiota sampling and digital tools for remote psychogastroenterology care, are highlighted.Expert opinion: Despite scientific progress, current DGBI management remains insufficiently personalized. Future approaches should integrate individualized microbiota profiling with targeted interventions and utilize innovative diagnostic and digital health technologies to enhance clinical outcomes in FD and IBS.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-14"},"PeriodicalIF":3.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101609","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

Reviewing the function of macrophages in liver disease. 巨噬细胞在肝脏疾病中的作用综述。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-05-21 DOI: 10.1080/17474124.2025.2508963

Lanlan Chen, Adrien Guillot, Frank Tacke

{"title":"Reviewing the function of macrophages in liver disease.","authors":"Lanlan Chen, Adrien Guillot, Frank Tacke","doi":"10.1080/17474124.2025.2508963","DOIUrl":"10.1080/17474124.2025.2508963","url":null,"abstract":"Introduction: The liver is a central metabolic organ, but is also hosting a unique immune microenvironment to sustain homeostasis and proper defense measures against injury threats in healthy individuals. Liver macrophages, mostly represented by the tissue-resident Kupffer cells and bone marrow- or monocyte-derived macrophages, are intricately involved in various aspects of liver homeostasis and disease, including tissue injury, inflammation, fibrogenesis and repair mechanisms.Areas covered: We review recent findings on defining the liver macrophage landscape and their functions in liver diseases with the aim of highlighting potential targets for therapeutic interventions. A comprehensive literature search in PubMed and Google Scholar was conducted to identify relevant literature up to date.Expert opinion: Liver macrophages orchestrate key homeostatic and pathogenic processes in the liver. Thus, targeting liver macrophages represents an attractive strategy for drug development, e.g. to ameliorate liver inflammation, steatohepatitis or fibrosis. However, translation from fundamental research to therapies remains challenging due to the versatile nature of the liver macrophage compartment. Recent and major technical advances such as single-cell and spatially-resolved omics approaches deepened our understanding of macrophage biology at a molecular level. Yet, further studies are needed to identify suitable, etiology- and stage-dependent strategies for the treatment of liver diseases.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-17"},"PeriodicalIF":3.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093259","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

Management of inflammatory bowel disease: a holistic approach beyond pharmacotherapy. 炎症性肠病的管理：超越药物治疗的整体方法。

IF 3.8 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2025-05-20 DOI: 10.1080/17474124.2025.2508970

Najwa F Mourad, Jana G Hashash, Viraj C Kariyawasam, Fadi H Mourad

{"title":"Management of inflammatory bowel disease: a holistic approach beyond pharmacotherapy.","authors":"Najwa F Mourad, Jana G Hashash, Viraj C Kariyawasam, Fadi H Mourad","doi":"10.1080/17474124.2025.2508970","DOIUrl":"10.1080/17474124.2025.2508970","url":null,"abstract":"Introduction: Inflammatory bowel diseases (IBD) management extends beyond pharmacotherapy, incorporating psychosocial support, patient education, physical activity, and dietary strategies. These components are often overlooked despite their impact on quality of life (QoL) and treatment adherence. This review explores the role of non-pharmacological strategies in optimizing IBD care.Areas covered: This article examines the significance of patient-physician communication, disease-specific education, mental health support, exercise, and diet in IBD management. A strong patient-physician relationship fosters trust and adherence to treatment. Knowledge empowers patients, improving long-term control. Psychosocial challenges, including anxiety, depression, and fatigue, further complicate disease management, highlighting the need for timely interventions. Physical activity and dietary interventions play essential roles in reducing sarcopenia and malnutrition, though standardized guidelines are lacking. Literature was reviewed to assess their effectiveness and clinical integration.Expert opinion: Holistic, multidisciplinary care should be standard in IBD management. Education, mental health screening, and structured diet and exercise plans must be integrated into routine care. Medical training should emphasize communication skills and patient-centered strategies. Future research should establish evidence-based guidelines for implementing these approaches effectively, ensuring improved long-term outcomes for IBD patients.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"1-13"},"PeriodicalIF":3.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093257","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