Current Opinion in Gastroenterology最新文献_第4页

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-05-01 Epub Date: 2025-04-03 DOI: 10.1097/MOG.0000000000001093

引用次数: 0

Panenteric capsule endoscopy in gastrointestinal bleeding - time to change old habits? 泛肠胶囊内镜下消化道出血——该改旧习惯了吗？

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-05-01 Epub Date: 2025-02-12 DOI: 10.1097/MOG.0000000000001088

Francesco Segatta, Silvia Paggi, Franco Radaelli, Emanuele Rondonotti

{"title":"Panenteric capsule endoscopy in gastrointestinal bleeding - time to change old habits?","authors":"Francesco Segatta, Silvia Paggi, Franco Radaelli, Emanuele Rondonotti","doi":"10.1097/MOG.0000000000001088","DOIUrl":"10.1097/MOG.0000000000001088","url":null,"abstract":"Purpose of review: Capsule endoscopy (CE) is an effective tool for small bowel evaluation. Recent technical advancements, including long-lasting batteries and enhanced optics, have enabled featured capsules (panenteric capsules, PCs) to potentially assess the entire gastrointestinal (GI) tract. The PC provides a potential easy-to-use, comprehensive, single-device approach for evaluating GI bleeding patients. This review critically examines the potential role of PC in patients with GI bleeding by highlighting benefits, limitations, open issues, and future challenges.Recent findings: Evidence on PC for GI bleeding patients remains limited. Two retrospective studies and one recent prospective trial consistently show that when used in the workup of GI bleeding patients, PC is safe, feasible, achieves high diagnostic yield (both in the small and large bowel), and potentially reduces the need for unnecessary colonoscopies. Nevertheless, current challenges include the need for extensive bowel preparation, incomplete colon evaluation, and limited access to trained readers.Summary: The PC holds promise for optimizing the diagnostic workup of GI bleeding patients. However, significant challenges remain. Robust clinical trials comparing standard diagnostic methods to PC-based workup are needed before the adoption of PC in managing bleeding patients in clinical practice.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"139-145"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494481","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 gluten and wheat in irritable bowel syndrome and noncoeliac gluten or wheat sensitivity. 麸质和小麦在肠易激综合征和非乳糜泻麸质或小麦敏感性中的作用。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-05-01 Epub Date: 2025-02-17 DOI: 10.1097/MOG.0000000000001090

Tom van Gils, Magnus Simrén

{"title":"The role of gluten and wheat in irritable bowel syndrome and noncoeliac gluten or wheat sensitivity.","authors":"Tom van Gils, Magnus Simrén","doi":"10.1097/MOG.0000000000001090","DOIUrl":"10.1097/MOG.0000000000001090","url":null,"abstract":"Purpose of review: The role of gluten and wheat in irritable bowel syndrome (IBS) is unclear, whereas it plays a key-role in the diagnosis and treatment of noncoeliac gluten or wheat sensitivity (NCGWS). This review aims to provide the most recent insights in pathophysiological mechanisms and to summarize the evidence for a gluten- or wheat-free diet in IBS and NCGWS.Recent findings: The exact role of gluten and wheat in IBS and NCGWS pathophysiological mechanisms remains complex. However, recent findings suggest a role for antigliadin antibodies to identify those IBS patients who may benefit from a gluten-free diet and low levels of fecal calprotectin to differentiate IBS and NCGWS. The importance of gut-brain interactions in self-reported gluten sensitive individuals was shown by a strong nocebo effect, although a role of gluten could not be excluded. Evidence for a gluten-free diet remains debatable in both conditions, whereas a wheat-free diet may have more potential, especially in NCGWS.Summary: IBS and NCGWS are two closely related conditions with a complex and largely unrevealed pathophysiology. The role of gluten may have been overestimated in the past, but it is likely that certain wheat components, along with gut-brain interactions, play a role in both conditions.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"164-174"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505760","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

Advancing care in malignant gastric outlet obstruction: a contemporary review of management strategies. 推进恶性胃出口梗阻的护理：当代管理策略回顾。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-04-24 DOI: 10.1097/MOG.0000000000001101

Adrianna Wierzbicka, Tilak Shah

{"title":"Advancing care in malignant gastric outlet obstruction: a contemporary review of management strategies.","authors":"Adrianna Wierzbicka, Tilak Shah","doi":"10.1097/MOG.0000000000001101","DOIUrl":"https://doi.org/10.1097/MOG.0000000000001101","url":null,"abstract":"Purpose of review: The aim of this review is to summarize the most pertinent data on management of malignant gastric outlet obstruction (MGOO), with an emphasis on recent updates.Recent findings: Traditionally, options to restore luminal patency in patients with MGOO were surgical gastrojejunostomy (SGJ) and endoscopic insertion of an enteral stent. The latter was reserved for patients with poor performance status or anticipated survival less than 2 months. Endoscopic gastroenterostomy (EUS-GE) is a newer technique that aims to mimic a SGJ and involves placement of a lumen apposing metal stent (LAMS) from the stomach directly into the jejunum. In a recent randomized trial of EUS-GE vs. enteral stent, the former was associated with reduced re-interventions, improved stent patency, and improved patient reported eating habits. Recent publications suggest that EUS-GE may offer substantial advantages over S-GJ; a randomized trial is currently underway. Venting gastrostomy may be the most suitable option for patients with markedly impaired gastric motility or with multiple luminal obstructions.Summary: MGOO is a debilitating late complication of advanced upper gastrointestinal malignancies, resulting from blockage or mechanical compression of the distal stomach, pyloric antrum or duodenum. Various modalities are currently available, and should be tailored to patient's expectations, underlying cause, life expectancy, and functional status.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041852","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

Assessing patient-reported outcomes in primary sclerosing cholangitis: an update. 评估原发性硬化性胆管炎患者报告的预后：最新进展。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-03-01 Epub Date: 2025-01-13 DOI: 10.1097/MOG.0000000000001075

Donna M Evon, Bryce B Reeve

{"title":"Assessing patient-reported outcomes in primary sclerosing cholangitis: an update.","authors":"Donna M Evon, Bryce B Reeve","doi":"10.1097/MOG.0000000000001075","DOIUrl":"10.1097/MOG.0000000000001075","url":null,"abstract":"Purpose of review: Patient-reported outcome (PRO) measures validated in primary sclerosing cholangitis (PSC) are needed for clinical trials. This review describes the recent US Food & Drug Administration (FDA) Patient-Focused Drug Development (PFDD) guidelines, existing PRO measures used in PSC studies, and the design of PSC-specific symptom measures adherent with the guidelines.Recent findings: FDA released updated guidance reflecting best practices for the design and evaluation of clinical outcome assessments (including PROs) and the design of trial endpoints. Two recent systematic reviews (2018, 2020) identified multiple PRO measures used in PSC studies, with two additional measures published since. Of these, four were developed in samples inclusive of PSC patients and six have been psychometrically evaluated in PSC. Published evidence to sufficiently support alignment with the recent guidance is sparse. We review the design of three symptom measures for PSC to illustrate alignment with FDA guidance, including qualitative and quantitative studies to provide evidence for their validity for use in adult PSC trials.Summary: Investigators planning to use PRO measures as study endpoints for PSC need to be adherent with the recent FDA guidelines and build the evidence base to support the measure as fit-for-purpose as an endpoint for clinical trials.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"59-66"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015666","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

Editorial introduction. 编辑介绍。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-03-01 Epub Date: 2025-02-06 DOI: 10.1097/MOG.0000000000001073

引用次数: 0

Effect of low birth weight and preterm delivery on the development of childhood celiac disease: a systematic review and meta-analysis on observational studies. 低出生体重和早产对儿童乳糜泻发展的影响：观察性研究的系统回顾和荟萃分析

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-03-01 Epub Date: 2025-01-02 DOI: 10.1097/MOG.0000000000001074

Mansour Bahardoust, Ali Delpisheh, Shabnam Rashidi, Meisam Haghmoradi, Babak Goodarzy, Reza Mahdian Jouybari

{"title":"Effect of low birth weight and preterm delivery on the development of childhood celiac disease: a systematic review and meta-analysis on observational studies.","authors":"Mansour Bahardoust, Ali Delpisheh, Shabnam Rashidi, Meisam Haghmoradi, Babak Goodarzy, Reza Mahdian Jouybari","doi":"10.1097/MOG.0000000000001074","DOIUrl":"10.1097/MOG.0000000000001074","url":null,"abstract":"Purpose of review: Whether low birth weight (LBW) and preterm delivery (PD) are associated with the risk of developing celiac disease (CD) in children remains unclear. This systematic review and meta-analysis aimed to evaluate the association between LBW and PD with CD development in children.Recent findings: We searched PubMed, Embase, Scopus, Web of Science, and Google Scholar databases based on the Mesh terms to find observational studies that investigated the association of LBW and PD with CD development in children up to July 18, 2024. This systematic review was based on the PRISMA 2020 checklist. Heterogeneity between studies was assessed with Cochran's Q and I2 tests. Meta-regression was used to control heterogeneity. Publication bias was evaluated using Egger's test. Finally, ten studies involving 3 434 290 participants were included. Based on 10 studies, the pooled prevalence of LBW was 6.4 per 1000 children with CD. A pooled estimate of ten studies did not show a significant relationship between LBW and the risk of developing CD in children [odds ratio (OR): 0.96, 95% confidence interval (CI): 0.76, 1.16, I 2 : 67.9%, P : 0.001). Also, the pooled estimate of six studies did not show a significant relationship between PD and the risk of developing CD in children (OR: 0.98, 95% CI: 0.81, 1.16, I2 : 67.5%, P : 0.001).Summary: We found no evidence of an association between LBW and PD with the risk of developing CD in children.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"87-95"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958358","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

Current approach to diagnosis and management of low-phospholipid associated cholelithiasis syndrome. 目前低磷脂相关性胆石症综合征的诊断和治疗方法。

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-03-01 Epub Date: 2025-01-06 DOI: 10.1097/MOG.0000000000001077

Pierre-Antoine Soret, Olivier Chazouillères, Christophe Corpechot

{"title":"Current approach to diagnosis and management of low-phospholipid associated cholelithiasis syndrome.","authors":"Pierre-Antoine Soret, Olivier Chazouillères, Christophe Corpechot","doi":"10.1097/MOG.0000000000001077","DOIUrl":"10.1097/MOG.0000000000001077","url":null,"abstract":"Purpose of review: Low phospholipid-associated cholelithiasis (LPAC) syndrome is a rare genetic form of intrahepatic cholesterol lithiasis, affecting mainly young adults. This review describes the recent advances in genetic and clinical characterization, diagnosis and management of LPAC syndrome.Recent findings: Recent publications report data from several retrospective cohorts. These cohorts describe the main clinical features, the most frequent radiological lesions, complications, the results of biliary endoscopic procedures and the prognosis associated with LPAC syndrome.Summary: LPAC syndrome has been linked to a partial defect in the ATP binding cassette subfamily B member 4 ( ABCB4 ) gene encoding the canalicular phospholipid transporter multidrug resistance protein 3, but this mechanism would explain only half the cases, or even fewer. This syndrome is characterized by the appearance of cholelithiasis at an abnormally early age (before 40) and by the persistence of biliary symptoms after cholecystectomy. The diagnosis is usually confirmed by an ultrasound scan of the liver, which reveals the presence of intrahepatic microlithiasis, as evidenced by comet-tail images or microspots along the intrahepatic bile ducts. Ursodeoxycholic acid, at a daily dose of 5-15 mg/kg, is the reference treatment. If not performed prior to diagnosis, cholecystectomy should be avoided wherever possible. In complicated or refractory forms, endoscopic biliary intervention may be necessary.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"67-73"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958356","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 deep response to ursodeoxycholic acid in primary biliary cholangitis - should it be the new clinical standard? 熊去氧胆酸深度反应对原发性胆管炎的影响——是否应作为新的临床标准？

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-03-01 Epub Date: 2025-01-03 DOI: 10.1097/MOG.0000000000001076

Adrielly Martins, Cynthia Levy

{"title":"The impact of deep response to ursodeoxycholic acid in primary biliary cholangitis - should it be the new clinical standard?","authors":"Adrielly Martins, Cynthia Levy","doi":"10.1097/MOG.0000000000001076","DOIUrl":"10.1097/MOG.0000000000001076","url":null,"abstract":"Purpose of review: This review explores the emerging concept of \"deep response\" in primary biliary cholangitis (PBC), defined by the normalization of biochemical markers, particularly alkaline phosphatase and bilirubin. It examines its potential as a new standard for disease management and its implications for long-term patient outcomes, health policies, and clinical decision-making.Recent findings: Recent studies suggest that achieving a deep response significantly improves long-term outcomes in some patients with PBC. In particular, a significant complication-free survival gain was observed among patients who at baseline were at high risk for disease progression. However, limitations in data and the variability in patient populations pose challenges for universal adoption of this standard.Summary: Deep biochemical response represents a promising new standard for optimizing PBC management, offering measurable goals for clinicians and potentially improved long-term outcomes for patients. However, further research is necessary to better define the appropriate biochemical thresholds, understand the risks of overprescribing, and identify patient subgroups that are most likely to benefit from this strategy. A balanced, patient-centered approach incorporating deep response into comprehensive management could improve care for high-risk PBC patients.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"74-80"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958300","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

Hepatic metabolism and ketone production in metabolic dysfunction-associated steatotic liver disease. 代谢功能障碍相关脂肪变性肝病的肝脏代谢和酮生成

IF 2.6 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-03-01 Epub Date: 2025-01-02 DOI: 10.1097/MOG.0000000000001079

Eric P Plaisance

引用次数: 0