World Journal of Gastroenterology最新文献

{"title":"Diagnostic accuracy and quality of artificial intelligence models in irritable bowel syndrome: A systematic review.","authors":"Akshaya Srikanth Bhagavathula, Ahmed Mourtada Al Qady, Wafa A Aldhaleei","doi":"10.3748/wjg.v31.i23.106836","DOIUrl":"10.3748/wjg.v31.i23.106836","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) affects approximately 9%-12% of the global population, presenting substantial diagnostic challenges due to symptom subjectivity and lack of definitive biomarkers.</p><p><strong>Aim: </strong>To systematically examine the diagnostic accuracy of artificial intelligence (AI) models applied to various biomarkers in IBS diagnosis.</p><p><strong>Methods: </strong>A comprehensive search of six databases identified 18053 articles published up to May 31, 2024. Following screening and eligibility criteria, six observational studies involving 1366 participants from the United Kingdom, China, and Japan were included. Risk of bias and reporting quality were assessed using quality assessment of diagnostic accuracy studies-2, prediction model risk of bias assessment tool-AI, and transparent reporting of a multivariable prediction model for individual prognosis or diagnosis-AI tools. Key metrics included sensitivity, specificity, accuracy, and area under the curve (AUC).</p><p><strong>Results: </strong>The included studies applied AI models such as random forests, support vector machines, and neural networks to biomarkers like fecal microbiome composition, gas chromatography data, neuroimaging features, and protease activity. Diagnostic accuracy ranged from 54% to 98% (AUC: 0.61-0.99). Models using fecal microbiome data achieved the highest performance, with one study reporting 98% sensitivity and specificity (AUC = 0.99). While most studies demonstrated high methodological quality, significant variability in datasets, biomarkers, and validation methods limited meta-analysis feasibility and generalizability.</p><p><strong>Conclusion: </strong>AI models show potential to improve IBS diagnostic accuracy by integrating complex biomarkers which will aid the development of algorithms to direct treatment strategies. However, methodological inconsistencies and limited population diversity underscore the need for standardized protocols and external validation to ensure clinical applicability.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 23","pages":"106836"},"PeriodicalIF":4.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Wuling powder in the treatment of ulcerative colitis complicated by depression as a new therapy principle.","authors":"Olga V Smirnova, Aleksander Sinyakov, Edward V Kasparov","doi":"10.3748/wjg.v31.i23.106538","DOIUrl":"10.3748/wjg.v31.i23.106538","url":null,"abstract":"<p><p>The problem of ulcerative colitis (UC) is becoming increasingly relevant due to its prevalence and combination with psychological disorders. UC is associated with alterations in the intestinal microbiocenosis as one of the factors reducing tolerance to self-antigens. In addition, patients with UC often experience anxiety, depression and other negative emotional and psychological factors aggravating the course of the underlying disease. The study presented by Wang <i>et al</i> shows that the traditional Chinese medicine Wuling can exert its therapeutic effect by reversing the aberrant precursor of brain-derived neurotrophic factor (BDNF)/ BDNF signaling in mice with UC and depression. The combination of Wuling powder with mesalazine can exhibit an antidepressant effect and reduce intestinal inflammation. Undoubtedly, the study by Chinese authors deserves attention, and changes in the balance of precursor of BDNF/p75 neurotrophin receptor/sortilin and BDNF/tropomyosin receptor kinase B signaling may become a novel therapeutic target for clinical treatment and further development of research.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 23","pages":"106538"},"PeriodicalIF":4.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celastrol alleviates esophageal stricture in rats by inhibiting NLR family pyrin domain containing 3 activation.","authors":"Miao-Xin Zhang, Chi Wu, Xin-Xia Feng, Wei Tian, Ning-Hui Zhao, Pan-Pan Lu, Qiang Ding, Mei Liu","doi":"10.3748/wjg.v31.i23.106949","DOIUrl":"10.3748/wjg.v31.i23.106949","url":null,"abstract":"<p><strong>Background: </strong>The role of NLR family pyrin domain containing 3 (NLRP3) in post-endoscopic submucosal dissection (ESD) esophageal stricture remains incompletely understood. The effect of celastrol (CEL) on the prevention of esophageal strictures has not yet been investigated.</p><p><strong>Aim: </strong>To explore the effect of CEL on the prevention of esophageal stricture in rats.</p><p><strong>Methods: </strong>NLRP3, interleukin (IL)-1β, and IL-18 mRNA levels were measured in patients' tissues after esophageal ESD. NLRP3 expression in esophageal fibroblasts was determined using immunohistochemistry and immunofluorescence staining. Lentiviral transfection was used to induce NLRP3 overexpression and thioredoxin reductase 1 (TXNRD1) silencing. The CCK8 assay was used to determine the optimal CEL concentration. Reactive oxygen species (ROS) generation was detected <i>via</i> fluorescence and flow cytometry. Masson's trichrome staining and barium esophagography were performed to assess collagen deposition and esophageal stenosis.</p><p><strong>Results: </strong>The mRNA levels of NLRP3 and IL-1β were higher in human tissues from the ESD resection bed than in normal esophageal mucosa. NLRP3 overexpression in primary rat esophageal fibroblasts led to high collagen 1 expression. Thus, NLRP3 participated in esophageal inflammation and tissue repair after ESD. Comparable to prednisolone, CEL significantly inhibited NLRP3 activation <i>in vitro</i> and <i>in vivo</i>, and esophageal strictures were markedly alleviated. Mechanistically, CEL upregulated TXNRD1 expression and reduced ROS production, thereby inhibiting NLRP3 expression. This effect was reversed by TXNRD1 silencing. Furthermore, TXNRD1 interacted with NLRP3 and promoted its ubiquitination.</p><p><strong>Conclusion: </strong>CEL is a promising alternative therapeutic agent for the prevention of post-ESD esophageal strictures.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 23","pages":"106949"},"PeriodicalIF":4.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Hepatocellular carcinoma xenograft supports HCV replication: A mouse model for evaluating antivirals.","authors":"Srikanta Dash","doi":"10.3748/wjg.v31.i23.108472","DOIUrl":"10.3748/wjg.v31.i23.108472","url":null,"abstract":"<p><p>[This corrects the article on p. 300 in vol. 17, PMID: 21253388.].</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 23","pages":"108472"},"PeriodicalIF":4.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatocellular carcinoma in patients without cirrhosis.","authors":"Karina Sato-Espinoza, Mayra Valdivia-Herrera, Perapa Chotiprasidhi, Javier Diaz-Ferrer","doi":"10.3748/wjg.v31.i23.107100","DOIUrl":"10.3748/wjg.v31.i23.107100","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, the sixth most common cancer worldwide, and the third leading cause of cancer-related death. Cirrhosis is the predominant risk factor for HCC, driven by major etiologies including hepatitis B and C, excessive alcohol consumption, and metabolic dysfunction-associated steatotic liver disease (MASLD). While approximately 80% of HCC cases occur in patients with cirrhosis, its incidence among individuals without cirrhosis has significantly increased, particularly in developed countries, driven by the rising prevalence of MASLD. The prevalence of patients with non-cirrhotic HCC varies geographically, yet data on this subgroup remain limited. Consequently, screening and clinical management guidelines for patients with non-cirrhotic HCC are underdeveloped. Current surveillance is typically not recommended for non-cirrhotic populations, except for individuals with hepatitis B, and diagnostic criteria like Liver Imaging Reporting and Data System are designed explicitly for cirrhotic or hepatitis B-associated HCC. Furthermore, treatment strategies for non-cirrhotic HCC are often extrapolated from studies focused on patients with cirrhosis, leading to gaps in knowledge regarding treatment efficacy, survival outcomes, and etiological variability in non-cirrhotic cohorts. Thus, emerging evidence must be reviewed to guide the development of enhanced diagnostic and therapeutic strategies for patients with non-cirrhotic HCC. To address these gaps, we comprehensively reviewed the epidemiology, clinical and genetic characteristics, diagnostic modalities, and therapeutic approaches for patients with non-cirrhotic HCC.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 23","pages":"107100"},"PeriodicalIF":4.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelin A receptor in nociceptors is essential for persistent mechanical pain in a chronic pancreatitis of mouse model.","authors":"Bing Wang, Jia-Yi Ge, Jia-Ni Wu, Jia-Huan Xu, Xiao-Hua Cao, Na Chang, Xiang Zhou, Peng-Bo Jing, Xing-Jun Liu, Yong Wu","doi":"10.3748/wjg.v31.i23.103848","DOIUrl":"10.3748/wjg.v31.i23.103848","url":null,"abstract":"<p><strong>Background: </strong>Chronic pancreatitis (CP) accompanied with persistent abdominal pain represents a major clinical challenge for the symptom management in patients. Although with clear involvement of neuropathy, the detailed mechanisms underlying pain hypersensitivity associated with CP are not totally clear. The endothelin system has been reported to contribute to chronic pain and chronic inflammatory settings, and is a potential therapeutic target for the treatment of chronic pain.</p><p><strong>Aim: </strong>To evaluate the role of nociceptor-specific endothelin A receptor (ETAR) in pain hypersensitivity in a CP mouse model and its potential contributing mechanisms.</p><p><strong>Methods: </strong>Oral gavage delivery of dibutyltin dichloride (DBTC) was used to induce CP in mice. A conditional knockout (CKO) strain which specifically delete ETAR in dorsal root ganglion (DRG) nociceptive neurons was generated. Abdominal pain hypersensitivity associated with CP and other behaviors were evaluated. The size of mouse gallbladder was measured and pancreatic histopathology was examined to validate the CP model. Calcitonin gene-related peptide expression and immune cells in the innervated DRGs and spinal cord were also examined. Calcium imaging in dissociated DRG neurons was performed to investigate the excitability of affected nociceptive neurons.</p><p><strong>Results: </strong>Specific deletion of endothelin receptor type A gene in nociceptive DRG neurons did not affect basal abdominal thermal and mechanical pain threshold in mice. Abdominal mechanical pain hypersensitivity was persistent in DBTC-treated WT mice but was significantly reduced in DBTC-treated CKO mice. DBTC treatment did not affect mouse nociceptive responses to heat and cold stimuli, as well as motor functions and anxiety-like behaviors of mice. DBTC treatment induced severe pancreatic inflammation and obvious gallbladder enlargement in wild type (WT) mice, but less in CKO mice. DBTC-induced increase of calcitonin gene-related peptide- and induction of brown adipocytes 1-positive signals in the DRG and spinal cord in WT mice were remarkably attenuated in CKO mice. DRG neurons from CKO mice exhibited less excitability and sensitivity in response to endothelin-1 exposure than those from WT mice.</p><p><strong>Conclusion: </strong>DBTC intragastric administration in mice produced a convenient and reliable animal model for studying abdominal pain associated with CP. ETAR-dependent endothelin signaling in nociceptors is important for the development of persistent abdominal mechanical hypersensitivity in mice.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 23","pages":"103848"},"PeriodicalIF":4.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of treatment strategies for submucosal tumors originating from the muscularis propria at esophagogastric junction or cardia.","authors":"Ah Young Lee, Sun Gyo Lim, Joo Young Cho, Seokhwi Kim, Kee Myung Lee, Sung Jae Shin, Choong-Kyun Noh, Gil Ho Lee, Hoon Hur, Sang-Uk Han, Sang-Yong Son, Jeong Ho Song","doi":"10.3748/wjg.v31.i23.106261","DOIUrl":"10.3748/wjg.v31.i23.106261","url":null,"abstract":"<p><strong>Background: </strong>The spectrum of gastric submucosal tumors (SMTs) in the upper gastrointestinal system ranges from non-neoplastic to malignant lesions, with gastrointestinal stromal tumors exhibiting inherent malignant potential. However, the diagnosis of SMTs remains challenging, and treatment methods, especially for tumors located at the cardia or esophagogastric junction (EGJ), are not well established. Minimally invasive techniques - such as endoscopic submucosal dissection (ESD), submucosal tunneling endoscopic resection (STER), and laparoscopic wedge resection (LWR) - have been developed for these lesions. However, comparative data on their feasibility, safety, and clinical outcomes in these locations remain limited.</p><p><strong>Aim: </strong>To compare ESD, STER, and LWR for SMTs at the EGJ or cardia, focusing on procedural feasibility.</p><p><strong>Methods: </strong>This single-center retrospective study included patients with SMTs less than 45 mm from the muscularis propria, growing intraluminally at the EGJ or cardia, and treated with ESD, STER, or LWR between July 2014 and September 2022. The primary outcome was relapse-free survival during follow-up.</p><p><strong>Results: </strong>The median age (interquartile range) was 53.0 (40.0-57.5), 43.0 (39.0-57.0), and 56.0 (43.0-64.0) years for ESD, STER, and LWR, respectively. The median follow-up time (interquartile range) was 60.0 (26.5-66.5), 24.0 (13.0-38.0), and 35.0 (21.0-60.0) months. LWR had the largest tumors (30.0 mm) and the highest rate of high-risk gastrointestinal stromal tumors (68.0%, <i>P</i> < 0.001). Tumor recurrence occurred in one LWR patient (4.0%, <i>P</i> = 0.600). <i>En bloc</i> and macroscopic resection rates were 100% (<i>P</i> = 1.000), but microscopic resection rates differed (<i>P</i> = 0.021). Significant minor complications occurred in 5 patients (10.0%), all grade IIIa. Tumor location (cardia/fundus, <i>P</i> = 0.006) and prolonged procedure time (<i>P</i> < 0.001) were significantly associated with complications.</p><p><strong>Conclusion: </strong>ESD, STER, and LWR are effective for SMTs at the EGJ and cardia, with minor complications associated with tumor location and procedure time, and comparable recurrence rates.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 23","pages":"106261"},"PeriodicalIF":4.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances in machine learning for precision diagnosis and treatment of esophageal disorders.","authors":"Shao-Wen Liu, Peng Li, Xiao-Qing Li, Qi Wang, Jin-Yu Duan, Jin Chen, Ru-Hong Li, Yang-Fan Guo","doi":"10.3748/wjg.v31.i23.105076","DOIUrl":"10.3748/wjg.v31.i23.105076","url":null,"abstract":"<p><p>The complex pathophysiology and diverse manifestations of esophageal disorders pose challenges in clinical practice, particularly in achieving accurate early diagnosis and risk stratification. While traditional approaches rely heavily on subjective interpretations and variable expertise, machine learning (ML) has emerged as a transformative tool in healthcare. We conducted a comprehensive review of published literature on ML applications in esophageal diseases, analyzing technical approaches, validation methods, and clinical outcomes. ML demonstrates superior performance: In gastroesophageal reflux disease, ML models achieve 80%-90% accuracy in potential of hydrogen-impedance analysis and endoscopic grading; for Barrett's esophagus, ML-based approaches show 88%-95% accuracy in invasive diagnostics and 77%-85% accuracy in non-invasive screening. In esophageal cancer, ML improves early detection and survival prediction by 6%-10% compared to traditional methods. Novel applications in achalasia and esophageal varices demonstrate promising results in automated diagnosis and risk stratification, with accuracy rates exceeding 85%. While challenges persist in data standardization, model interpretability, and clinical integration, emerging solutions in federated learning and explainable artificial intelligence offer promising pathways forward. The continued evolution of these technologies, coupled with rigorous validation and thoughtful implementation, may fundamentally transform our approach to esophageal disease management in the era of precision medicine.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 23","pages":"105076"},"PeriodicalIF":4.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of lymphangiogenesis by platelet as novel therapeutic approaches for liver cirrhosis and portal hypertension.","authors":"Jian-Fu Li, Qing-Bo Wang, Yu-Kai Li, Yu-Bo Liang, Xing-Ming Chen, Qi-Yu Lu, Yang Ke","doi":"10.3748/wjg.v31.i23.107554","DOIUrl":"10.3748/wjg.v31.i23.107554","url":null,"abstract":"<p><p>This letter comments on the recently published article in the <i>World Journal of Gastroenterology</i>, in which the authors demonstrated a strong link between lymphangiogenesis and the process of platelet adherence, aggregation, and activation by employing a rat model of liver cirrhosis caused by bile duct ligation (BDL). The authors applied both gain and loss of function approach by using platelet-rich plasma and vascular endothelial growth factor 3 receptor inhibitor MAZ-51 to activate and inhibit angiogenetic signaling in BDL rat model, respectively, to verify the crucial function of lymphangiogenesis in the development of liver cirrhosis and portal hypertension (PHT). In clinical practice, platelet transfusion has been applied to improve liver function in patients suffering from chronic liver disease and cirrhosis. Therefore, this study provides support for the application of platelet transfusion or pharmacological intervention of lymphangiogenesis as novel therapeutic approaches for liver cirrhosis and PHT.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 23","pages":"107554"},"PeriodicalIF":4.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastroparesis, a diabetic complication causing further, even serious, complications: How to prevent its worsening?","authors":"Mauro Bortolotti","doi":"10.3748/wjg.v31.i23.104932","DOIUrl":"10.3748/wjg.v31.i23.104932","url":null,"abstract":"<p><p>Gastroparesis is a severe diabetic complication, caused by a progressive multifactorial enteric neuropathy. To make an early diagnosis in patients at risk of diabetic gastroparesis is crucial for slow down its progression towards full-blown disease source of further complications and requesting effective, but unsafe, drugs as well as invasive surgical treatments. This aim can be achieved by detecting its first signal represented by the gastric emptying (GE) delay, by using, among the tests to measure GE, the simple, safe, reliable, and easily available one, that is real-time ultrasonography, possibly done annually. Once the GE delay has been identified, it is necessary to evaluate with endoluminal functional lumen imaging probe or manometry whether it depends on pylorospasm, which should be treated by means of non-surgical endoscopic therapies. If, instead, it depends on initial gastropathy, detected by electrogastrograhic body surface gastric mapping, it should be treated with the safest prokinetic drugs and with the newly emerging treatments, thus distancing heavy medical and surgical treatments, while waiting for future solutions.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 23","pages":"104932"},"PeriodicalIF":4.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}