Current Opinion in Gastroenterology最新文献_第5页

Current opinion in gastroenterology. 胃肠病学的最新观点。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-03-01 Epub Date: 2026-02-05 DOI: 10.1097/MOG.0000000000001154

David N Assis

引用次数: 0

Management of autoimmune hepatitis-related decompensated cirrhosis: current evidence and clinical decision-making. 自身免疫性肝炎相关失代偿性肝硬化的治疗：目前的证据和临床决策

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-03-01 Epub Date: 2026-01-05 DOI: 10.1097/MOG.0000000000001150

Pinelopi Arvaniti, Maria-Carlota Londoño

{"title":"Management of autoimmune hepatitis-related decompensated cirrhosis: current evidence and clinical decision-making.","authors":"Pinelopi Arvaniti, Maria-Carlota Londoño","doi":"10.1097/MOG.0000000000001150","DOIUrl":"10.1097/MOG.0000000000001150","url":null,"abstract":"Purpose of review: Autoimmune hepatitis (AIH) presenting with decompensated cirrhosis poses a major therapeutic dilemma for clinicians. Although the prompt initiation of immunosuppression (IS) can reverse disease activity and lead to the clinical resolution of decompensation, avoiding the need for liver transplantation (LT), it may also be futile or even harmful. International guidelines and cohort studies have begun to address this challenge, making it timely to synthesize available evidence and provide practical guidance for clinicians.Recent findings: Emerging data highlight that the benefit of IS in AIH-related decompensated cirrhosis is closely related to disease activity, as well as to the type and severity of decompensation. In this context, patients with \"burn-out\" cirrhosis, advanced hepatic encephalopathy and severely elevated prognostic scores have a low probability to benefit from IS and face a greater risk of developing treatment-related complications. Therefore, international guidelines emphasize individualized decision-making, integrating clinical scores and predictors of treatment benefit, as well as timely evaluation for LT.Summary: This review summarizes the current evidence and evolving recommendations for managing AIH-related decompensated cirrhosis, providing a structured approach to help clinicians identify candidates for IS and balance treatment decisions to optimize outcomes.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"75-82"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907160","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 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-03-01 Epub Date: 2026-02-05 DOI: 10.1097/MOG.0000000000001152

引用次数: 0

Clinical management and outcomes of hepatobiliary disease in the cystic fibrosis transmembrane conductance regulator modulator era. 囊性纤维化跨膜传导调节剂时代肝胆疾病的临床管理和结局。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI: 10.1097/MOG.0000000000001148

Carolena Trocchia, Lauren Lazar, Zachary M Sellers

{"title":"Clinical management and outcomes of hepatobiliary disease in the cystic fibrosis transmembrane conductance regulator modulator era.","authors":"Carolena Trocchia, Lauren Lazar, Zachary M Sellers","doi":"10.1097/MOG.0000000000001148","DOIUrl":"10.1097/MOG.0000000000001148","url":null,"abstract":"Purpose of review: Multiple cystic fibrosis transmembrane conductance regulator (CFTR) modulators are approved for the treatment of cystic fibrosis (CF) and show significant improvement in lung function, BMI, quality of life, and sweat chloride. However, their ability to impact liver disease is unclear. This review highlights the current published literature on CFTR modulators and liver health and briefly reviews considerations for clinical management of hepatobiliary disease in the CFTR modulator era.Recent findings: Currently, the primary data available on the clinical efficacy of CFTR modulators on CF hepatobiliary involvement (CFHBI) or advanced CF liver disease (aCFLD) is from small to moderate sized single-center studies, although more recently large, multicenter studies are emerging. Studies report opposing changes in aminotransferases, and mixed liver fibrosis index and elastography results. Yet, in total CFTR modulators generally do not worsen liver disease and may improve it in some individuals. Additional clinical management considerations are necessary in those on CFTR modulators who received an organ transplant or during nutritional evaluations.Summary: To better understand the possible benefit of CFTR modulator therapies on hepatobiliary health, additionally larger, longer-term, multicenter studies with sub-group phenotyping are necessary. Until then, providers should watch for liver-related adverse events, and be cognizant on how CFTR modulators may impact areas of clinical care for individuals with CF.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"90-99"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829241","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

Pathophysiology of cystic fibrosis-related liver disease. 囊性纤维化相关性肝病的病理生理学。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-03-01 Epub Date: 2025-12-29 DOI: 10.1097/MOG.0000000000001151

Anna Palmiotti, Anna Bertolini, Romina Fiorotto

{"title":"Pathophysiology of cystic fibrosis-related liver disease.","authors":"Anna Palmiotti, Anna Bertolini, Romina Fiorotto","doi":"10.1097/MOG.0000000000001151","DOIUrl":"10.1097/MOG.0000000000001151","url":null,"abstract":"Purpose of review: Cystic fibrosis liver disease (CFLD) is a significant nonpulmonary complication of cystic fibrosis, affecting approximately 5-10% of patients. It encompasses a spectrum of hepatic abnormalities ranging from mild, transient elevations in liver enzymes to advanced CFLD (aCFLD), which is marked by clinically relevant portal hypertension due to cirrhotic or noncirrhotic liver pathology. This review focuses on aCFLD as the clinically meaningful form of the disease and summarizes recent mechanistic insights into its pathogenesis that may inform the development of targeted therapeutic strategies.Recent findings: CFLD pathogenesis has been traditionally linked to defective bile secretion. Emerging evidence, however, highlights additional contributors, including cholangiocyte immune dysregulation, gut dysbiosis, and intestinal barrier dysfunction, which together promote hepatic inflammation. Furthermore, recent studies underscore the role of vascular alterations independent of cirrhosis, specifically noncirrhotic portal hypertension, as the main clinical feature in aCFLD. These findings support a multifactorial, multihit model of disease in the pathogenesis of CFLD.Summary: The complex interplay of these factors suggests that effective treatment for aCFLD may require a multifaceted approach. Advances in understanding the gut-liver axis and vascular contributions provide new therapeutic targets. Future research should focus on validating these findings and evaluating the efficacy of cystic fibrosis transmembrane conductance regulator modulators and microbiome-targeted treatments in altering the course of CFLD.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"83-89"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858863","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

Mechanistic insights into pancreatic duct pressure: from basic physiology to translational implications. 机制洞察胰管压力：从基本生理学到翻译意义。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-03-01 Epub Date: 2026-01-22 DOI: 10.1097/MOG.0000000000001147

Jianing Li, Li Wen, Aiming Yang

{"title":"Mechanistic insights into pancreatic duct pressure: from basic physiology to translational implications.","authors":"Jianing Li, Li Wen, Aiming Yang","doi":"10.1097/MOG.0000000000001147","DOIUrl":"10.1097/MOG.0000000000001147","url":null,"abstract":"Purpose of review: This review summarizes recent advances in pancreatic ductal hypertension (PDH), emphasizing its pathophysiological mechanisms, clinical relevance across pancreatic diseases, and progress in noninvasive assessment. The aim is to highlight translational insights that may improve patient selection for intervention and guide long-term management strategies.Recent findings: Evidence indicates that PDH contributes not only to pain in chronic pancreatitis but also to exocrine insufficiency, diabetes, and complications such as post-ERCP pancreatitis (PEP) and recurrent acute pancreatitis (RAP). Pancreatic stellate cells (PSCs) are central to fibrosis and are directly activated by pressure, reinforcing disease progression. Traditional methods of measuring pancreatic duct pressure rely on invasive manometry, microtransducer catheters, or pancreatic fistulae, all with inherent risks. Recent translational advances, particularly magnetic resonance cholangiopancreatography (MRCP) integrated with computational fluid dynamics modeling, have demonstrated the feasibility of noninvasive pancreatic duct pressure (PDP) estimation with strong concordance to endoscopic retrograde cholangiopancreatography-based manometry and symptom relief.Summary: These advances emphasize the critical role of accurate pressure assessment in identifying patients with true ductal hypertension who are most likely to benefit from decompression. Noninvasive measurement offers a promising strategy to limit unnecessary interventions and to delineate the direct contribution of ductal pressure to exocrine, endocrine, and related disorders. Validation in larger cohorts and high-risk populations will be essential.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"100-105"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042164","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

Colon chaos: when drugs turn against your gut. 结肠混乱：当药物对你的肠道不利时。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-01-01 Epub Date: 2025-11-05 DOI: 10.1097/MOG.0000000000001142

Malek Shatila, Yinghong Wang, Anusha Shirwaikar Thomas

{"title":"Colon chaos: when drugs turn against your gut.","authors":"Malek Shatila, Yinghong Wang, Anusha Shirwaikar Thomas","doi":"10.1097/MOG.0000000000001142","DOIUrl":"10.1097/MOG.0000000000001142","url":null,"abstract":"Purpose of review: Immune-mediated diarrhea and colitis (IMDC) is a very common and severe toxicity to immune checkpoint inhibition that has generated a lot of scientific interest. The current guidelines do not capture the most recent literature on this disease entity, and few reviews if any have been published that describe the advances made in our understanding of IMDC. As more and more patients are being treated with immune checkpoint inhibitors (ICIs), it becomes essential to optimize treatment algorithms for ICI-related toxicities, especially IMDC.Recent findings: In our review, we discuss the findings of recent studies on IMDC epidemiology including incidence and risk factors, evaluation and treatment modalities, and surveillance and long-term outcomes. We note that while much has been learned regarding disease epidemiology and the utility of stool biomarkers over clinical symptoms, there remains a paucity of data where IMDC treatment options and long-term IMDC outcomes and surveillance is concerned.Summary: Our results highlight the most recent advances in our knowledge of IMDC and allow us to propose a management algorithm that improves on prior guidelines for IMDC by incorporating new study findings.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"59-65"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460389","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

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

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-01-01 Epub Date: 2025-09-17 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":"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":"14-18"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","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

Beyond the scope: an update on colon cancer screening tests. 超出范围：结肠癌筛查测试的最新进展。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-01-01 Epub Date: 2025-09-24 DOI: 10.1097/MOG.0000000000001138

Timothy Yen, Minh Do, Swati G Patel

{"title":"Beyond the scope: an update on colon cancer screening tests.","authors":"Timothy Yen, Minh Do, Swati G Patel","doi":"10.1097/MOG.0000000000001138","DOIUrl":"10.1097/MOG.0000000000001138","url":null,"abstract":"Purpose of review: Colorectal cancer (CRC) is common and rising among persons under age 50, but screening uptake is sub-optimal, particularly in 45-49 year-olds. Death from CRC can be prevented through detection and removal of advanced precancerous colorectal lesions (APLS) or detection of CRC at an early stage. In this review, we cover average-risk CRC screening options and present a framework for test selection in different clinical settings.Recent findings: The optimal CRC screening test should be highly sensitive for APLs and early stage CRC, easy to access, affordable to patient and payers, and appropriate for screening settings. Organized screening is administered systematically on the population-level, while opportunistic screening relies on individual provider-patient shared decision making. In addition to established options such as fecal immunochemical testing, multitarget stool DNA testing, and colonoscopy, novel options include stool-based RNA testing, next-generation stool-based DNA testing, and blood-based DNA testing. Although blood-based tests may be convenient, their low sensitivity for APLs can unintentionally lead to negative consequences for CRC prevention.Summary: Uptake, cost, and efficacy of established and novel CRC screening tests influence the modality of choice for specific screening settings. Colonoscopy and stool-based tests should generally be first-line for CRC screening.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"2-13"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187502","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

Minimally invasive, maximum impact: advances in the application of colonic stents. 微创，最大影响：结肠支架的应用进展。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-01-01 Epub Date: 2025-11-06 DOI: 10.1097/MOG.0000000000001146

Filippos Koutroumpakis, Emmanuel Coronel

{"title":"Minimally invasive, maximum impact: advances in the application of colonic stents.","authors":"Filippos Koutroumpakis, Emmanuel Coronel","doi":"10.1097/MOG.0000000000001146","DOIUrl":"10.1097/MOG.0000000000001146","url":null,"abstract":"Purpose of review: Malignant colorectal obstruction (MCO) is a common and life-threatening presentation of colorectal cancer, traditionally managed with emergency surgery associated with high morbidity and high stoma rates. Self-expanding metal stents (SEMS) have emerged as an important alternative for both palliation and as a bridge to curative resection. This review summarizes recent advances in indications, technical aspects, and emerging applications of colonic stenting, highlighting its role in modern multidisciplinary care.Recent findings: Current evidence supports the use of SEMS as one of the first-line palliative approaches in selected patients, providing rapid symptom relief and reducing the need for permanent stomas. In carefully selected patients, colonic SEMS can convert urgent high-risk operations into planned resections, facilitating minimally invasive approaches, though concerns remain regarding perforation risk and long-term oncologic outcomes. Increasing operator expertise, device innovation, and technical advances continue to improve safety and success rates. Beyond malignancy, expanding applications include refractory benign strictures, diverticular obstruction, and the use of lumen-apposing metal stents (LAMS) in inflammatory bowel disease and anastomotic complications.Summary: Colonic stenting has emerged as a valuable alternative to surgery for the management of MCO and is being investigated in select benign conditions, though broader adoption requires further evidence. Future research should refine patient selection, compare stenting with surgical alternatives, and clarify long-term outcomes.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"19-24"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460374","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