Current Opinion in Gastroenterology最新文献_第2页

Gut power for better health: microbial therapeutics. 肠道力量促进健康：微生物疗法。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-18 DOI: 10.1097/MOG.0000000000001136

Eamonn M M Quigley

{"title":"Gut power for better health: microbial therapeutics.","authors":"Eamonn M M Quigley","doi":"10.1097/MOG.0000000000001136","DOIUrl":"https://doi.org/10.1097/MOG.0000000000001136","url":null,"abstract":"Purpose of review: To critically evaluate the literature over the past year on microbial therapeutics in the management of disorders of the large intestine. The primary focus is on disorders where the microbiome has been implicated in pathophysiology, and its modulation has been a therapeutic target.Recent findings: Though widely consumed, data on the impact of probiotics and prebiotics in gastrointestinal disorders continue to pose challenges in interpretation due to shortcomings in study design; postbiotics, meanwhile, because of some logistical and regulatory advantages, are attracting attention. Though time-honored for its role in infections due to Clostridioides difficile (CDI), FMT has encountered challenges in relation to regulation leading to the appearance of highly standardized, extensively screened and rigorously prepared microbial products [defined as live biotherapeutic products (LBP)], which show great promise; two have been approved by the FDA for prevention of recurrent CDI. Outside of CDI, efforts to define a role for FMT in the management of various diseases have met with mixed results.Summary: The translation of findings in studies of microbiome composition to successful therapies has proven disappointing to date, though attempts to develop selective and targeted microbial consortia show promise and may lead the way to personalized bacteriotherapy.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132402","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

A review of techniques of third space endoscopy for gastrointestinal tumors. 胃肠肿瘤第三空间内镜检查技术综述。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-06-05 DOI: 10.1097/MOG.0000000000001113

Zaheer Nabi, D Nageshwar Reddy

{"title":"A review of techniques of third space endoscopy for gastrointestinal tumors.","authors":"Zaheer Nabi, D Nageshwar Reddy","doi":"10.1097/MOG.0000000000001113","DOIUrl":"10.1097/MOG.0000000000001113","url":null,"abstract":"Purpose of review: This review explores the evolving landscape of third-space endoscopy (TSE) techniques for the management of gastrointestinal (GI) tumors. With rapid technological advances and accumulating evidence, there is a pressing need to synthesize current knowledge and clarify the comparative utility of approaches like submucosal tunneling endoscopic resection (STER) and tunneling endoscopic submucosal dissection (ESD).Recent findings: STER is safe and effective for resection of subepithelial lesions, offering mucosal preservation, high en bloc resection rates, and reduced recovery time compared to ESE, ESD, and endoscopic full-thickness resection. Piecemeal STER is a potential alternative to surgery in managing large esophageal sub-epithelial lesions without compromising outcomes. For early epithelial neoplasms, pocket-creation and tunneling variants of ESD improve dissection speed and reduce adverse events, especially in large lesions. Comparative studies across esophagus, stomach, and colon confirm these benefits. Additionally, risk scoring systems and resection algorithms may guide personalized technique selection.Summary: STER and tunneling ESD represent significant advances in minimally invasive management of GI tumors. Incorporating these techniques into practice can enhance safety and efficacy, especially when guided by risk stratification tools. Ongoing innovation, including artificial intelligence and robotics, is likely to further refine third-space interventions in near future.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"327-332"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267808","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 ultrasound in hepatology: ushering a new era in liver disease management. 内窥镜超声在肝病中的应用：引领肝病治疗的新时代。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-06-05 DOI: 10.1097/MOG.0000000000001115

Andrada Seicean, Irina Dragomir, Bogdan Procopet

{"title":"Endoscopic ultrasound in hepatology: ushering a new era in liver disease management.","authors":"Andrada Seicean, Irina Dragomir, Bogdan Procopet","doi":"10.1097/MOG.0000000000001115","DOIUrl":"10.1097/MOG.0000000000001115","url":null,"abstract":"Purpose of review: This review aims to provide an up-to-date overview of the expanding role of endoscopic ultrasound (EUS) in endohepatology, highlighting its potential to transform the diagnostic and therapeutic landscape for liver diseases. Given the increasing complexity of liver disease management, this review discusses both established and emerging applications of EUS in liver parenchyma assessment, portal hypertension diagnosis and related complications treatment and liver biopsy techniques.Recent findings: Recent studies demonstrate that EUS can accurately assess liver fibrosis, detect focal lesions, and evaluate portal hypertension, with significant advancements in EUS-guided liver biopsy and treatment of gastric varices. Key findings include improved diagnostic accuracy with EUS-FNB over traditional methods and the potential for endoscopic ultrasound portal pressure gradient (EUS-PPG) in portal pressure measurements.Summary: EUS holds significant promise in diagnosing and treating liver diseases, with applications in assessing liver fibrosis, identifying focal liver lesions, and managing portal hypertension. Future research will likely focus on enhancing EUS's role in therapeutic procedures, such as managing portal vein thrombosis and creating intrahepatic portosystemic shunts, offering a new avenue for minimally invasive treatment options.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"298-305"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267809","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

Colonoscopy in obese patients: challenges and emerging solutions. 肥胖患者的结肠镜检查：挑战和新兴的解决方案。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-08-07 DOI: 10.1097/MOG.0000000000001116

Dilhana Badurdeen, Yuting Huang, Andres Acosta

{"title":"Colonoscopy in obese patients: challenges and emerging solutions.","authors":"Dilhana Badurdeen, Yuting Huang, Andres Acosta","doi":"10.1097/MOG.0000000000001116","DOIUrl":"https://doi.org/10.1097/MOG.0000000000001116","url":null,"abstract":"Purpose of review: The rising prevalence of obesity, now affecting over 40% of U.S. adults, poses critical implications for colorectal cancer screening, as obesity increases the risk of both colorectal adenomas and cancer. Despite these elevated risks, patients with obesity have lower colonoscopy screening participation and face unique barriers that compromise procedural quality. This review aims to highlight the challenges encountered during colonoscopy in obese patients and examine emerging solutions that may enhance screening effectiveness and patient outcomes.Recent findings: Obesity is associated with suboptimal bowel preparation, prolonged cecal intubation times, lower adenoma detection rates, and increased sedation-related complications. These challenges stem from altered gastrointestinal physiology, body habitus, and comorbid conditions. Recent innovations in bowel preparation strategies, sedation protocols, and endoscopic technologies-such as robotic-assisted colonoscopy and artificial intelligence-enhanced visualization-have demonstrated promise in addressing these limitations. Institutional initiatives, including tailored protocols and endoscopy team training, are also contributing to improved outcomes.Summary: As obesity rates climb, adapting colonoscopy practices to meet the needs of this population is essential. Incorporating evidence-based strategies and emerging technologies can help overcome procedural barriers, improve detection rates, and reduce disparities in colorectal cancer screening. Continued research and guideline refinement are needed to optimize care delivery for patients with obesity.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"41 5","pages":"313-318"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796034","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 management of small bowel Crohn's disease in older age. 老年小肠克罗恩病的治疗

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-07-30 DOI: 10.1097/MOG.0000000000001126

Eathar Shakweh, Ailsa Hart

{"title":"The management of small bowel Crohn's disease in older age.","authors":"Eathar Shakweh, Ailsa Hart","doi":"10.1097/MOG.0000000000001126","DOIUrl":"10.1097/MOG.0000000000001126","url":null,"abstract":"Purpose of review: The prevalence of inflammatory bowel disease (IBD) amongst older adults (≥60 years old) is rising, encompassing individuals with a preexisting diagnosis and those newly diagnosed. Projections estimate that by 2030, one-third of patients with IBD will be older adults. Managing older adults with IBD poses unique challenges, including frailty, multimorbidity and polypharmacy. This review summarises the approach to managing older adults with small bowel Crohn's disease (SBCD), a distinct IBD sub-type.Recent findings: The 2024 \"State of IBD care in the United Kingdom (UK)\" report revealed a median delay of 8 months from onset of Crohn's disease symptoms to diagnosis. Diagnostic delay in Crohn's disease is associated with stricturing and penetrating complications. Diagnostic challenges in SBCD include its insidious presentation in older adults and the poor utility of calprotectin as a biomarker, with a positive predictive value of only 23.1% with a calprotectin over 200 μg/g. Management should be tailored to patient preference and frailty, given the paucity of evidence pertaining to nutritional, medical and surgical treatment approaches in older adults.Summary: Older adults with IBD represent a heterogenous cohort. Optimising the recruitment of older adults to clinical trials and stratifying outcomes according to frailty are key research priorities.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"369-376"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790571","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

Genetic testing for pancreatic cancer screening: ready for prime time? 基因检测用于胰腺癌筛查：准备好了吗？

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-07-14 DOI: 10.1097/MOG.0000000000001121

David C Whitcomb

{"title":"Genetic testing for pancreatic cancer screening: ready for prime time?","authors":"David C Whitcomb","doi":"10.1097/MOG.0000000000001121","DOIUrl":"10.1097/MOG.0000000000001121","url":null,"abstract":"Purpose of review: Pancreatic ductal adenocarcinoma (PDAC) has a dismal 13% 5-year survival rate, necessitating early detection and personalized treatment. This review evaluates whether germline genetic testing, integrated with clinical decision support (CDS) tools, is ready for widespread use in PDAC screening. We focus on its potential to identify high-risk individuals (HRIs) beyond those with strong family histories to complex risk and biomarkers, stratifying patients into low-risk and high-risk virtual populations for targeted surveillance.Recent findings: Germline genetic testing identifies pathogenic variants linked to hereditary cancer syndromes (HCS), enabling multiorgan surveillance and precision oncology (e.g., PARP inhibitors for BRCA2 mutations). Polygenic risk scores (PRS) combined with clinical markers like new-onset diabetes (NOD) increase the positive predictive value (PPV) for PDAC (e.g., 86.7% in high-PRS quintiles). Genetic testing also adjusts for biomarker variability (e.g., CA19-9 levels via FUT2/FUT3 genotyping) and optimizes chemotherapy through pharmacogenetics, reducing toxicity. Comprehensive platforms integrating genetic, clinical, and biomarker data enhance early detection and risk stratification.Summary: Genetic testing is ready for prime time in PDAC screening. It stratifies patients into low-risk (no surveillance) and high-risk (surveillance warranted) groups, improving early detection, outcomes, and cost-effectiveness, thus transforming PDAC prognosis through targeted intervention.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"333-338"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668899","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

Avoiding the complications of endoscopic retrograde cholangiopancreatography. 内窥镜逆行胆管造影并发症的避免。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-05-02 DOI: 10.1097/MOG.0000000000001103

Syed Matthew Kodilinye, Yasutoshi Shiratori, Anthony N Kalloo

{"title":"Avoiding the complications of endoscopic retrograde cholangiopancreatography.","authors":"Syed Matthew Kodilinye, Yasutoshi Shiratori, Anthony N Kalloo","doi":"10.1097/MOG.0000000000001103","DOIUrl":"10.1097/MOG.0000000000001103","url":null,"abstract":"Purpose of review: To review the literature within the past 5 years on risk factors and prophylactic measures for avoiding the complications of endoscopic retrograde cholangiopancreatography (ERCP), including post-ERCP pancreatitis (PEP), post-ERCP cholangitis, bleeding, and perforation.Recent findings: Despite advances in endoscopic technique and numerous clinical trials, complications of ERCP still occur frequently, particularly PEP. Recent findings are concentrated in the PEP domain and include the following: the discovery of pancreatic steatosis as a potential novel risk factor, machine learning models to predict PEP, combination prophylactic strategies including rectal NSAIDs, aggressive intravenous fluid hydration and pancreatic duct stents, potential novel pharmacotherapies, and enhanced endoscopic techniques for difficult biliary cannulation.Summary: Endoscopists should be familiar with the complications of ERCP and prophylactic strategies. PEP carries a significant morbidity and economic burden, but its occurrence is par for the course when performing ERCP. Future studies should concentrate on elucidating further the pathophysiology of PEP and predicting cases that result in severe complications (severe if hospitalization was greater than 10 days along with the presence of pseudocyst, pancreatic necrosis, need for percutaneous drainage or surgery, or death).","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"306-312"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129487","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

My approach to managing the acute endoscopic perforation. 我处理急性内窥镜穿孔的方法。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-06-04 DOI: 10.1097/MOG.0000000000001114

Kasenee Tiankanon, Saowanee Ngamruengphong

引用次数: 0

Gastrointestinal endoscopy: keeping up with the times. 胃肠内镜：与时俱进。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-08-07 DOI: 10.1097/MOG.0000000000001117

Anthony Kalloo

引用次数: 0

Hypertriglyceridemic pancreatitis: perspectives from China. 高甘油三酯血症性胰腺炎：来自中国的观点。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-09-01 Epub Date: 2025-07-17 DOI: 10.1097/MOG.0000000000001123

Zhengyang Fan, Jianing Li, Dong Wu

{"title":"Hypertriglyceridemic pancreatitis: perspectives from China.","authors":"Zhengyang Fan, Jianing Li, Dong Wu","doi":"10.1097/MOG.0000000000001123","DOIUrl":"10.1097/MOG.0000000000001123","url":null,"abstract":"Purpose of review: This review aims to summarize the recent developments in hypertriglyceridemic acute pancreatitis (HTG-AP) research in China, focusing on its increasing prevalence, pathophysiology, prognosis, and novel treatment strategies, emphasizing the relevance of these findings in clinical practice and research.Recent findings: Recent studies have highlighted a rising incidence of HTG-AP in China, especially among young males, linked to dietary and lifestyle changes. Key research has identified lipoprotein metabolism abnormalities and genetic factors as predictors of recurrence. Advances in treatment include the combination of low-molecular-weight heparin, insulin, and plasma exchange, showing improved outcomes compared to traditional methods. Additionally, the use of traditional Chinese medicine has shown promise in managing inflammation and improving patient recovery.Summary: These findings emphasize the importance of early diagnosis, personalized treatment strategies, and integrated approaches in managing HTG-AP. Chinese research has made significant strides in understanding the pathophysiology and treatment of HTG-AP, which may influence both national healthcare strategies and global management of the condition.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"348-354"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668900","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}

引用次数: 0