Current Opinion in Gastroenterology最新文献_第2页

Keeping current with advances in therapeutic endoscopy. 紧跟治疗性内窥镜的最新进展。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-09-01 Epub Date: 2026-08-06 DOI: 10.1097/MOG.0000000000001189

Anthony Kalloo

引用次数: 0

Hot versus cold snare polypectomy for colorectal polyps: current evidence and practical guide for decision-making. 热与冷陷阱息肉切除术治疗结直肠息肉：目前的证据和决策的实用指南。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-09-01 Epub Date: 2026-07-16 DOI: 10.1097/MOG.0000000000001187

Hsu-Hua Tseng, Han-Mo Chiu

{"title":"Hot versus cold snare polypectomy for colorectal polyps: current evidence and practical guide for decision-making.","authors":"Hsu-Hua Tseng, Han-Mo Chiu","doi":"10.1097/MOG.0000000000001187","DOIUrl":"10.1097/MOG.0000000000001187","url":null,"abstract":"Purpose of review: Colorectal polyps can be removed using cold or hot snare techniques, which differ primarily in their use of electrocautery, safety profile, and depth of resection. This review summarizes current evidence comparing cold and hot snare resection and provides a practical framework for technique selection.Recent findings: Recent guidelines and randomized trials support cold snare polypectomy (CSP) for polyps 10 mm or less because of its favorable safety profile and low risk of delayed bleeding. For 10-19 mm lesions, technique selection should be guided by histology and morphology, with hot snare polypectomy (HSP) favored for pedunculated, bulky, fibrotic, or high-risk adenomatous lesions and CSP or cold EMR increasingly supported for nondysplastic sessile serrated lesions. For large adenomatous polyps at least 20 mm, in which advanced histology is more common, hot EMR with margin treatment remains standard, where as cold EMR reduces thermal injury at the cost of higher recurrence.Summary: CSP is preferred for most diminutive and small polyps, while larger lesions require individualized selection according to histology, morphology, invasion risk, and the need for durable eradication. The goal is to choose the least injurious technique that still achieves complete and reliable resection. Long-term data are needed to define recurrence and subsequent colorectal cancer risk after different resection strategies.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"319-324"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474090","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 techniques to minimize gastroesophageal reflux during peroral endoscopic myotomy. 经口内窥镜切肌术中减少胃食管反流的内镜技术。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-09-01 Epub Date: 2026-06-08 DOI: 10.1097/MOG.0000000000001184

Bogdan Miutescu, Mouen Khashab, Rami El Abiad

{"title":"Endoscopic techniques to minimize gastroesophageal reflux during peroral endoscopic myotomy.","authors":"Bogdan Miutescu, Mouen Khashab, Rami El Abiad","doi":"10.1097/MOG.0000000000001184","DOIUrl":"10.1097/MOG.0000000000001184","url":null,"abstract":"Purpose of review: Peroral endoscopic myotomy (POEM) is an established treatment for achalasia. Sacrificing the lower esophageal sphincter (LES) improves dysphagia but compromises the gastroesophageal junction (GEJ) barrier predisposing patients to acid reflux.Recent findings: Indeed, 40-60% of patients experience abnormal esophageal acid exposure post-POEM, while clinically significant reflux esophagitis (Los Angeles grade ≥B) is observed in 20-35%. Symptom-reflux discordance is common, necessitating objective assessment with upper endoscopy and/or ambulatory reflux testing using Lyon Consensus 2.0 criteria. Critically, anatomical evaluation must exclude alternative causes of perceived gastroesophageal reflux disease (GERD), including candida esophagitis, failed myotomy or recurrent achalasia, peptic stricture, and blown-out myotomy. Proactive intra-procedural strategies during POEM to minimize reflux have included limiting myotomy length, selective circular-layer myotomy, sling fiber preservation, anterior versus posterior approach selection, and endolumenal functional lumen imaging probe (EndoFLIP)-guided refinement of myotomy, though none has demonstrated consistent reflux reduction in randomized trials. Hybrid procedures combining POEM with endoscopic fundoplication (POEM+F/POEM-F) offer same session approaches that can significantly lower objective reflux up to 3 years.Summary: For proven post-POEM GERD, staged endoscopic options, transoral incisionless fundoplication, endoscopic full-thickness plication, and antireflux mucosectomy, offer symptom improvement and proton pump inhibitor (PPI) reduction in selected patients. A structured clinical pathway integrating proactive surveillance, objective confirmation, and individualized endoscopic intervention is proposed.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"312-318"},"PeriodicalIF":2.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213225","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 emerging role of endoscopy in neurogastroenterology. 内窥镜在神经胃肠病学中的新作用。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-08-06 DOI: 10.1097/MOG.0000000000001188s

Thomas Frieling

{"title":"The emerging role of endoscopy in neurogastroenterology.","authors":"Thomas Frieling","doi":"10.1097/MOG.0000000000001188s","DOIUrl":"https://doi.org/10.1097/MOG.0000000000001188s","url":null,"abstract":"Purpose of review: Purpose of the review is provision of an up-to-date literature review on the growing importance of endoscopy in neurogastroenterology and its limitations.Recent findings: Traditionally, the diagnostic role of endoscopy in neurogastroenterology lies in the initial suspicion of motility disorders and exclusion of important differential diagnoses. Endoscopy may serve also as a carrier for positioning examination devices such as the Bravo reflux-capsule to proof gastroesophageal reflux or the endoluminal functional lumen imaging probe (EndoFLIP). New interesting aspects are the resection-based and biopsy-based extraction of tissue for examination of the enteric nervous system by the full thickness resection device (FTRD) to detect structural gastrointestinal neuromuscular lesion and confocal laser endomicroscopy (CLE) to investigate potential correlations for food intolerance. Effectiveness of endoscopic therapy is dependent on whether the measured circumscribed dysfunction correlates with the symptoms and explains them. This is the case in esophageal achalasia and hypercontractile motility disorders. However, in gastropareses, the significance of endoscopic therapy is limited because of its complex pathophysiology.Summary: There is an emerging role of endoscopy in neurogastroenetrology. However, effectiveness of endoscopic therapy is dependent on careful patient selection and evidence of a circumscribed dysfunction that correlates with the symptoms and explains them.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698353","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 Dallas Consensus for performing and interpreting functional lumen imaging probe panometry: what it means for the clinician. 执行和解释功能性管腔成像探针全测量的达拉斯共识：这对临床医生意味着什么。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-04-01 DOI: 10.1097/MOG.0000000000001171

Anh D Nguyen

{"title":"The Dallas Consensus for performing and interpreting functional lumen imaging probe panometry: what it means for the clinician.","authors":"Anh D Nguyen","doi":"10.1097/MOG.0000000000001171","DOIUrl":"10.1097/MOG.0000000000001171","url":null,"abstract":"Purpose of review: Functional lumen imaging probe (FLIP) panometry is being increasingly used to evaluate esophageal motility at the time of endoscopy. This review explains how the recently published Dallas Consensus provides a standardized approach to FLIP protocol and interpretation with an updated motility classification scheme.Recent findings: Performing a high quality upper endoscopy is paramount to optimally interpreting FLIP findings as it allows for exclusion of mechanical obstruction, which can contribute to abnormal FLIP findings. A normal FLIP classification with normal esophagogastric junction (EGJ) opening and normal contractile response makes a major motility unlikely, whereas a reduced EGJ opening with diminished or contractile response patterns makes an EGJ obstruction disorder such as achalasia or esophagogastric junction outflow obstruction likely on high resolution manometry (HRM). Findings of spastic contractile response or an indeterminant EGJ opening on FLIP may require further testing with HRM and/or timed barium esophagram with tablet.Summary: Performing FLIP during endoscopy using the Dallas Consensus motility classification can help exclude or confirm an esophageal motility disorder with the potential to expedite the diagnostic workup and management for patients with esophageal symptoms.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"275-279"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596065","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 esophageal microbiome: mechanisms and clinical implications. 食道微生物群：机制和临床意义。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-03-20 DOI: 10.1097/MOG.0000000000001170

Nonyelum Ebigbo

{"title":"The esophageal microbiome: mechanisms and clinical implications.","authors":"Nonyelum Ebigbo","doi":"10.1097/MOG.0000000000001170","DOIUrl":"10.1097/MOG.0000000000001170","url":null,"abstract":"Purpose of review: Interest in the esophageal microbiome has expanded rapidly, yet its functional and clinical relevance remains incompletely defined. This review synthesizes emerging evidence on host-microbe interactions in esophageal diseases, with a focus on mechanistic pathways and translational potential.Recent findings: Recent studies demonstrate that esophageal microbes influence epithelial differentiation, barrier integrity, and inflammatory signaling in conditions such as eosinophilic esophagitis and Barrett's esophagus. Microbial metabolism, particularly bile acid transformation, links microbial composition to epithelial stress responses and neoplastic progression. In esophageal cancer, tumor-associated microbes modulate epigenetic regulation and suppress antitumor immunity. Integrative multiomics approaches have further identified microbial signatures associated with disease progression and treatment response.Summary: The esophageal microbiome influences disease pathogenesis and has potential for risk stratification and therapeutic targeting. Future progress will depend on longitudinal studies, improved functional resolution, and integration of microbial data with epithelial and immune biology to enable clinical translation.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"280-287"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500328","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 use of potassium-competitive acid blockers in the management of foregut disease. 钾竞争酸阻滞剂在前肠疾病治疗中的应用

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-03-30 DOI: 10.1097/MOG.0000000000001173

Megan B Ghai, Joshua A Sloan

引用次数: 0

The end of 'leaky gut': pathway-specific mechanistic approaches to barrier restoration. “漏肠”的终结：屏障修复的途径特异性机制方法。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-04-08 DOI: 10.1097/MOG.0000000000001174

Ziru Sha, Asha Bhardwaj, Jerrold R Turner

{"title":"The end of 'leaky gut': pathway-specific mechanistic approaches to barrier restoration.","authors":"Ziru Sha, Asha Bhardwaj, Jerrold R Turner","doi":"10.1097/MOG.0000000000001174","DOIUrl":"10.1097/MOG.0000000000001174","url":null,"abstract":"Purpose of review: For over 50 years, increased intestinal permeability has been associated with diverse inflammatory and systemic diseases. Yet the oversimplified concept of 'leaky gut' as a singular phenomenon has limited both mechanistic understanding and therapeutic development.Recent findings: It is now recognized that intestinal permeability occurs via two molecularly distinct, differentially regulated trans-tight junction pathways, while a tight junction-independent unrestricted pathway allows flux at sites of epithelial damage. The pore pathway is a high-conductance, size-selective and charge-selective flux route that mediates ion and water flux. Its upregulation can be either protective, as in infectious enterocolitis, or pathogenic, as in immune-mediated disease or, as shown recently, in sepsis. Myosin light chain kinase activation enhances flux across the leak pathway, a low-conductance macromolecular flux route, that promotes progression of immune-mediated diseases. Recently developed molecularly targeted, pathway-specific approaches to barrier restoration are effective and can outperform current therapies without the complications of broad immunosuppression.Summary: The evolving pathway-resolved framework transforms intestinal barrier biology from a descriptive science into mechanism-specific therapeutic approaches that have promise as independent agents and as complements to available immune-targeted therapies.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"231-238"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678441","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

Inflammatory bowel diseases 2026: form, function and therapeutic considerations for the epithelial barrier. 炎症性肠病2026：上皮屏障的形式、功能和治疗考虑。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-06-04 DOI: 10.1097/MOG.0000000000001179

Matthew A Ciorba

引用次数: 0

Retrograde cricopharyngeus dysfunction: what the gastroenterologist should know. 逆行环咽功能障碍：胃肠病学家应该知道的。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-07-01 Epub Date: 2026-05-20 DOI: 10.1097/MOG.0000000000001177

Jerome R Lechien, Robert W Bastian

{"title":"Retrograde cricopharyngeus dysfunction: what the gastroenterologist should know.","authors":"Jerome R Lechien, Robert W Bastian","doi":"10.1097/MOG.0000000000001177","DOIUrl":"10.1097/MOG.0000000000001177","url":null,"abstract":"Purpose of review: To review current literature about retrograde cricopharyngeus dysfunction (R-CPD) etiology, pathophysiology, clinical presentation and management.Recent findings: R-CPD is a clinical condition characterized by inability to burp that is often associated with a variety of other gastrointestinal symptoms. Limited data suggest that R-CPD may affect up to 22% of the general population, with 13% experiencing severely troublesome symptoms. Symptoms usually begin in childhood, though diagnosis typically occurs many years later after prolonged symptom burden. Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LPRD) are strongly associated with R-CPD, with prevalence rates ranging from 28 to 58% across studies, suggesting either that GERD and LPRD contribute to the development of R-CPD or vice versa , with R-CPD producing prolonged elevations in esophageal pressure and esophageal stretching that contribute to the development of GERD and LPRD. Family history is present in 28% of cases, suggesting possible genetic predisposition. Botulinum toxin injection (BTI) into the cricopharyngeal sphincter represents the primary therapeutic option, achieving up to 92.5% overall initial success rate using various approaches, including in-office transcervical (EMG-guided), transnasal, and operating room esophagoscopy techniques. Younger age, higher botulinum toxin doses, and operative esophagoscopy under general anesthesia have been associated with better treatment outcomes. Symptom recurrence occurs in 4-45% of patients, with mean recurrence intervals between 6 and 8 months.Summary: R-CPD represents an underrecognized but potentially common condition with significant impact on quality-of-life. BTI demonstrates high efficacy with an acceptable safety profile. Standardized diagnostic criteria, treatment protocols, and comprehensive pediatric studies for R-CPD remain sorely needed.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"263-274"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984185","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