Expert Review of Gastroenterology & Hepatology最新文献_第3页

Altered gastrointestinal motility after bariatric surgery: consequences, complications and clinical considerations. 减肥手术后胃肠运动改变：后果、并发症和临床考虑。

IF 2.5 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-03-01 Epub Date: 2025-11-25 DOI: 10.1080/17474124.2025.2593454

Gwen M C Masclee, Adrian A M Masclee

{"title":"Altered gastrointestinal motility after bariatric surgery: consequences, complications and clinical considerations.","authors":"Gwen M C Masclee, Adrian A M Masclee","doi":"10.1080/17474124.2025.2593454","DOIUrl":"10.1080/17474124.2025.2593454","url":null,"abstract":"Introduction: Bariatric surgical interventions such as laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), One-Anastomosis Gastric Bypass (OAGB) and Laparoscopic Adjustable Gastric Banding (LAGB) have proven to be effective in long-term management of obesity. These procedures result in changes in anatomy and in motor and secretory function of the gastrointestinal (GI) tract.Areas covered: This review covers the changes in gastrointestinal motility and their consequences observed after the various types of bariatric surgery. A systematic literature search on motility disorders of esophagus, stomach, small and large bowel until August 2025 was performed (PubMed).Expert opinion: Esophageal motility: a higher prevalence of dysphagia and post-obesity surgery esophageal dysfunction (POSED) is seen after bariatric surgery due to gastric restriction (intragastric high-pressure zone, esophageal outflow obstruction). Gastroesophageal reflux disease (GERD) is already common in people with obesity and may significantly increase after bariatric surgery depending on the type of procedure (LSG, not RYGB). Gastrointestinal motility: bariatric surgery results in significant acceleration of gastric emptying and of small intestinal transit (LSG > RYGB) with delay in colonic transit. Clinical considerations relevant for preoperative work-up, selection of bariatric procedure-type and postoperative follow-up of GI-motility disorders induced by bariatric surgery have been provided.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"273-288"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556311","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

Updates on intestinal failure management. 肠衰竭管理的最新进展。

IF 2.5 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1080/17474124.2026.2628008

M V Teso, T E Conley, S Lal

{"title":"Updates on intestinal failure management.","authors":"M V Teso, T E Conley, S Lal","doi":"10.1080/17474124.2026.2628008","DOIUrl":"10.1080/17474124.2026.2628008","url":null,"abstract":"Introduction: Chronic intestinal failure (CIF) is a rare condition characterized by inadequate intestinal absorption requiring long-term parenteral nutrition (PN). Given etiological shifts and expanding therapeutic options, we provide an updated review covering CIF definitions, epidemiology and multidisciplinary management in adults, based on recently published studies (2012-2025).Areas covered: We conducted a scoping review of recent literature, registry data and guideline recommendations to summarize contemporary trends in CIF.Short bowel syndrome remains the leading cause of CIF, though the etiological profile has shifted toward surgical complications and active malignancy. Advances in the multidisciplinary and multimodal management with safer PN formulations, chyme reinfusion therapy, and disease-modifying pharmacotherapies such as glucagon-like peptide-2 analogues have transformed outcomes, while intestinal transplantation is reserved for selected cases. Preventing complications and focusing on quality of life (QoL) are central to long-term management.Expert opinion: CIF prevalence continues to rise worldwide, though accurate data remain inconsistent. As patient complexity rises, long-term outcomes increasingly depend on complication prevention and centralized, multidisciplinary care delivered by expert centers. In the next five years, the convergence of pharmacological, surgical, digital and organizational innovations will enhance enteral autonomy, reduce PN-related complications and improve patients' QoL, providing a more equitable and effective model of CIF care worldwide.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"205-218"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149586","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 endoscopic therapies for patients with metabolic dysfunction-associated steatotic liver disease (MASLD). 内镜治疗在代谢功能障碍相关脂肪变性肝病（MASLD）患者中的作用

IF 2.5 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-03-01 Epub Date: 2026-02-16 DOI: 10.1080/17474124.2026.2632873

Joan Llach, Anna Soria, Isabel Graupera, Andrés Cardenas

{"title":"The role of endoscopic therapies for patients with metabolic dysfunction-associated steatotic liver disease (MASLD).","authors":"Joan Llach, Anna Soria, Isabel Graupera, Andrés Cardenas","doi":"10.1080/17474124.2026.2632873","DOIUrl":"10.1080/17474124.2026.2632873","url":null,"abstract":"Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major public health challenge closely linked to obesity and metabolic syndrome. Effective, durable weight-loss strategies are needed to modify its natural history, particularly in patients at high surgical risk or with limited response to pharmacotherapy.Areas covered: This review summarizes current and emerging weight-loss approaches for MASLD, focusing on pharmacological therapies, bariatric surgery and endoscopic interventions. From an expert narrative perspective, we discuss key randomized and observational studies on endoscopic sleeve gastroplasty (ESG), cost-effectiveness analyses, and the limited evidence in patients with compensated advanced chronic liver disease (cACLD), who represent an unmet need.Expert opinion: ESG could be a promising, minimally invasive option for patients with MASLD who are ineligible for bariatric surgery or refractory to medical therapy. Early data suggest clinically meaningful weight loss, metabolic improvement, and a favorable safety profile, but long-term outcomes and direct histological benefits remain to be defined, particularly in patients with advanced fibrosis or cACLD. Combining ESG with pharmacological agents, such as GLP-1 receptor agonists, theoretically may enhance outcomes and deserves further study. Well-designed trials are required to better define the role of ESG in MASLD management and its potential integration into clinical practice.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"219-231"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146194297","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

Endoscopic considerations for patients with gastroesophageal reflux disease. 胃食管反流病患者的内镜注意事项。

IF 2.5 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-03-01 Epub Date: 2026-02-09 DOI: 10.1080/17474124.2026.2629609

Amir Farah, Amir Mari

引用次数: 0

Occult hepatitis B infection - unveiling clinical burden and new diagnostic strategies. 隐性乙型肝炎感染——揭示临床负担和新的诊断策略。

IF 2.5 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-02-01 Epub Date: 2026-01-02 DOI: 10.1080/17474124.2025.2611857

Vicente Soriano, Rocío González, Luisa Barea, Víctor Moreno-Torres, Ana Arruga, Ana Lafuente, Antonio Aguilera

{"title":"Occult hepatitis B infection - unveiling clinical burden and new diagnostic strategies.","authors":"Vicente Soriano, Rocío González, Luisa Barea, Víctor Moreno-Torres, Ana Arruga, Ana Lafuente, Antonio Aguilera","doi":"10.1080/17474124.2025.2611857","DOIUrl":"10.1080/17474124.2025.2611857","url":null,"abstract":"Introduction: Occult B infection (OBI) represents a mild form of hepatitis B characterized by low-level HBV-DNA in the absence of positive serum HBsAg. OBI is associated with liver disease and HBV transmissibility, although to a lesser extent than overt (HBsAg+) chronic hepatitis B.Areas covered: Residual HBV replication in the liver of OBI patients has been associated with i) increased risk for cirrhosis and/or liver cancer, ii) HBV transmission to recipients of organs or hemoderivates, iii) overt HBV reactivation under immunosuppression, and iv) extrahepatic manifestations.We searched PubMed with the keywords \"occult hepatitis B,\" \"occult B infection\" or \"OBI.'Expert opinion: The WHO has called for reducing 90% new HBV infections and 65% HBV-related mortality by 2030. The persistence of low-level virus replication in persons who cleared serum HBsAg is challenging. OBI misdiagnosis has emerged as a major obstacle for global HBV elimination. Efforts for unveiling OBI carriers are warranted, increasing clinical suspicion and expanding testing. New diagnostic tools, including more sensitive HBsAg and HBV-DNA tests and novel HBV-RNA and HBcrAg assays, may help unveil OBI carriers. Furthermore, point-of-care HBV-DNA assays will allow testing larger populations for OBI. New antivirals should target this form of hidden hepatitis B.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"71-80"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862558","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

Addressing current limitations of colonoscopy for colorectal cancer screening. 解决目前结肠镜检查在结直肠癌筛查中的局限性。

IF 2.5 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-02-01 Epub Date: 2026-02-10 DOI: 10.1080/17474124.2026.2628015

Aastha Bharwad, Eric Yoon, Brooks D Cash

{"title":"Addressing current limitations of colonoscopy for colorectal cancer screening.","authors":"Aastha Bharwad, Eric Yoon, Brooks D Cash","doi":"10.1080/17474124.2026.2628015","DOIUrl":"10.1080/17474124.2026.2628015","url":null,"abstract":"Introduction: Colonoscopy is widely accepted as the gold standard modality for colorectal cancer (CRC) screening and polyp surveillance. Colonoscopy has been shown to decrease the incidence and mortality of CRC and is the ground truth test to which new and alternative CRC screening modalities are compared. In the U.S., more than 15 million colonoscopies are performed yearly for CRC screening, and the procedure is accepted as safe and effective. However, there are important limitations of colonoscopy for CRC screening that remain unresolved and continue to limit the maximal usefulness of this procedure.Areas covered: This article will highlight some of the recognized limitations of colonoscopy for CRC screening, including high costs, access and compliance barriers, preparation difficulties, complications, and performance variability.Expert opinion: Colonoscopy is the gold-standard test for CRC screening but is subject to significant limitations. There have been important efforts directed toward mitigating the limitations of colonoscopy for CRC screening, and these efforts have the potential to expand and enhance the use of colonoscopy as a CRC screening test in the future.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"107-117"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118323","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

Multiparametric intestinal ultrasound in inflammatory bowel diseases: a narrative review. 炎症性肠病的多参数肠超声：叙述综述。

IF 2.5 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-02-01 Epub Date: 2026-02-16 DOI: 10.1080/17474124.2026.2624595

Giovanni Cataletti, Daniele Gridavilla, Marta Casella, Gabriele Natalello, Giovanni Maconi

{"title":"Multiparametric intestinal ultrasound in inflammatory bowel diseases: a narrative review.","authors":"Giovanni Cataletti, Daniele Gridavilla, Marta Casella, Gabriele Natalello, Giovanni Maconi","doi":"10.1080/17474124.2026.2624595","DOIUrl":"10.1080/17474124.2026.2624595","url":null,"abstract":"Introduction: Multiparametric intestinal ultrasound (MPUS) has emerged as a valuable, noninvasive tool for the diagnosis, monitoring, and phenotyping of inflammatory bowel diseases (IBD), offering real-time assessment of bowel wall structure, vascularity, and stiffness.Areas covered: This review discusses the latest advancements in intestinal ultrasound, including contrast-enhanced ultrasound (CEUS), elastography, and ultrasound microvascular imaging (UMI). These techniques enhance the characterization of inflammation and fibrosis, help differentiate between inflammatory and fibrotic strictures, detect complications such as abscesses or phlegmons, and monitor therapeutic response. The narrative is based on a comprehensive analysis of recent literature identified through a PubMed search conducted up to September 2025. with a focus on clinical applicability, technical methodology, and current evidence supporting each modality.Expert opinion: MPUS represents a transformative evolution in IBD imaging, particularly in point-of-care and longitudinal disease management. Despite its strong potential, widespread adoption is limited by technical variability, operator dependency, and lack of standardization. Future integration into clinical practice will require multicenter validation, standardized protocols, and training programs. The development of AI-assisted tools and targeted CEUS may soon elevate MPUS from a structural to a functional and molecular imaging modality, opening the door to personalized, precision-based IBD care.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"135-146"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112640","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 impact of a multidisciplinary team evaluation on the diagnosis and management of acute and chronic pancreatitis in a tertiary referral center. 多学科团队评估对三级转诊中心急性和慢性胰腺炎诊断和管理的影响。

IF 2.5 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-02-01 Epub Date: 2026-02-23 DOI: 10.1080/17474124.2026.2629615

Gaetano Lauri, Matteo Tacelli, Gabriele Capurso

{"title":"The impact of a multidisciplinary team evaluation on the diagnosis and management of acute and chronic pancreatitis in a tertiary referral center.","authors":"Gaetano Lauri, Matteo Tacelli, Gabriele Capurso","doi":"10.1080/17474124.2026.2629615","DOIUrl":"10.1080/17474124.2026.2629615","url":null,"abstract":"Background: Multidisciplinary team meetings (MTM) are crucial in benign conditions such as acute pancreatitis (AP) and chronic pancreatitis (CP). Our aim was to evaluate the impact of MTM on the diagnosis and management of AP and CP in a tertiary referral center.Research design and methods: This retrospective study analyzed 232 patients with AP/CP discussed with biweekly MTM (10/2020-06/2024). The patients were classified according to etiology or complication management, recording diagnostic and therapeutic outcomes over six months.Results: Of 536 referred patients, 232 were analyzed (142 AP, 90 CP). In AP subgroup, MTM revised etiology in 34.4% of cases and identified a cause in 45.5% of idiopathic AP. MTM also ensured successful management of AP complications in 100% of cases, including endoscopic or surgical interventions for pseudocysts and walled-off necrosis. In CP, the diagnosis was revised in 38.9%, with a cause identified in 45.5% of idiopathic cases. MTM effectively guided CP complication management, with 55% of cases managed surgically and 10% endoscopically. MTM identified 6 cases of low-grade pancreatic intraepithelial neoplasia and 9 previously undiagnosed pancreatic ductal adenocarcinomas (PDAC) across both cohorts.Conclusions: In high-volume centers, MTM enhance diagnostic accuracy and optimize the tailored management of benign pancreatic diseases.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"191-199"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164557","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

Safety and use of IBD therapies during pregnancy and lactation. 妊娠和哺乳期IBD治疗的安全性和使用。

IF 2.5 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-02-01 Epub Date: 2026-01-13 DOI: 10.1080/17474124.2026.2615447

L G Rabinowitz, A Gade, T Deyhim, J D Feuerstein

{"title":"Safety and use of IBD therapies during pregnancy and lactation.","authors":"L G Rabinowitz, A Gade, T Deyhim, J D Feuerstein","doi":"10.1080/17474124.2026.2615447","DOIUrl":"10.1080/17474124.2026.2615447","url":null,"abstract":"Introduction: Inflammatory bowel disease (IBD) commonly affects young women and frequently overlaps with peak reproductive years. Despite this overlap, there remains limited data on the safety and efficacy of IBD treatments during pregnancy and lactation, and many gastroenterology trainees report limited exposure to managing pregnant patients with IBD. Optimal management of IBD in pregnancy ideally starts before conception, with a goal of at least 3 months of steroid-free remission. The preconception period is critical for patient education and therapeutic optimization for patients with IBD. Optimized management during pregnancy and lactation is necessary to prevent adverse maternal and fetal outcomes.Areas covered: In this review, we discuss latest evidence on the safety and efficacy of available IBD therapies during conception, pregnancy, and lactation. Medications discussed include 5-aminosalicylates, biologic therapies, calcineurin inhibitors, Janus kinase inhibitors, corticosteroids, immunomodulators, and sphingosine 1-phosphate receptor modulators.Expert opinion: While most IBD therapies can be safely continued during pregnancy and lactation. Patient education during the preconception period is critical for maintenance of remission during pregnancy and postpartum. Evidence-based research and representation of pregnant patients with IBD in future studies are necessary to address existing knowledge gaps to optimize maternal and neonatal outcomes.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"81-92"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951759","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

Leucine-rich alpha-2 glycoprotein as a blood biomarker in inflammatory bowel disease: clinical implications and future perspectives. 富亮氨酸α -2糖蛋白作为炎症性肠病的血液生物标志物：临床意义和未来展望

IF 2.5 3区医学

Expert Review of Gastroenterology & Hepatology Pub Date : 2026-02-01 Epub Date: 2026-02-18 DOI: 10.1080/17474124.2026.2628012

Takayuki Yamamoto

{"title":"Leucine-rich alpha-2 glycoprotein as a blood biomarker in inflammatory bowel disease: clinical implications and future perspectives.","authors":"Takayuki Yamamoto","doi":"10.1080/17474124.2026.2628012","DOIUrl":"10.1080/17474124.2026.2628012","url":null,"abstract":"Introduction: Reliable biomarkers for monitoring inflammatory bowel disease (IBD) remain an unmet clinical need, particularly in patients receiving biologic therapies where C-reactive protein (CRP) responses may be attenuated. Leucine-rich alpha-2 glycoprotein (LRG) is a novel acute-phase reactant regulated by multiple cytokines, potentially less dependent on interleukin-6 than CRP.Areas covered: This narrative review synthesizes recent Japanese real-world data and emerging international literature on LRG, outlining its biological characteristics, early clinical applications, and evidence in ulcerative colitis and Crohn's disease. Key topics include correlations with clinical, endoscopic, and histologic activity; proposed cutoff values; comparisons with conventional biomarkers; diagnostic performance in small bowel disease; and its role in therapeutic monitoring, including postoperative assessment.Expert opinion: LRG shows strong correlations with mucosal and transmural inflammation across IBD phenotypes, retains sensitivity in biologic-treated patients or those with normal CRP, and predicts treatment response. Its rapid turnaround and noninvasive nature make it well suited to treat-to-target strategies. However, most evidence originates from Japan, limiting generalizability until confirmed in large, multicenter international cohorts. Broader adoption will require assay standardization, validation across diverse populations, and integration into composite indices to optimize individualized care. If validated globally, LRG could transform precision monitoring and enhance outcomes in clinical practice.","PeriodicalId":12257,"journal":{"name":"Expert Review of Gastroenterology & Hepatology","volume":" ","pages":"147-156"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118271","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