Current Opinion in Gastroenterology最新文献_第6页

All in my head or all in my gut? An update on irritable bowel syndrome. 全在脑子里还是全在肚子里？肠易激综合征的最新进展。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-01-01 Epub Date: 2025-10-22 DOI: 10.1097/MOG.0000000000001141

Amy T Woods, Alexander C Ford, Christopher J Black

{"title":"All in my head or all in my gut? An update on irritable bowel syndrome.","authors":"Amy T Woods, Alexander C Ford, Christopher J Black","doi":"10.1097/MOG.0000000000001141","DOIUrl":"10.1097/MOG.0000000000001141","url":null,"abstract":"Purpose of review: Irritable bowel syndrome (IBS) has a considerable impact on patients and healthcare systems. IBS is a disorder of brain-gut interaction with numerous biopsychosocial factors involved, including early life experiences, previous gastrointestinal infections, and coexisting mood disorders. An understanding of the role of the gut-brain axis in symptom generation is vital to enable delivery of holistic care.Recent findings: We explore psychological mechanisms, such as coexisting anxiety and depression, adverse life experiences, and somatisation and how these impact symptom severity. There is evidence for psychological therapies, such as cognitive behavioural therapy or gut-directed hypnotherapy, in IBS. We go on to summarise gut-based mechanisms, such as abnormal motility, visceral hypersensitivity, inflammation, and dysbiosis. Efficacious treatments targeting these include antidiarrhoeals, laxatives, antispasmodics, drugs acting on ion channels or serotonin, gut-brain neuromodulators, and treatments targeting the microbiota or inflammation. Finally, we consider emerging evidence from models describing distinct IBS phenotypes and their potential to facilitate a more integrated approach to identify best treatment options.Summary: For many patients with IBS, both brain and gut mechanisms must be considered within the context of the biopsychosocial model to enable effective delivery of holistic and personalised care.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"52-58"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349685","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. 社论。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-01-01 Epub Date: 2025-12-04 DOI: 10.1097/MOG.0000000000001143

Anusha Shirwaikar Thomas

引用次数: 0

Laxative logic: when lifestyle is not enough. 通便逻辑：当生活方式不够时。

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.0000000000001137

Rachel Colbran, Leila Neshatian

{"title":"Laxative logic: when lifestyle is not enough.","authors":"Rachel Colbran, Leila Neshatian","doi":"10.1097/MOG.0000000000001137","DOIUrl":"10.1097/MOG.0000000000001137","url":null,"abstract":"Purpose of review: Chronic constipation remains challenging to manage, particularly when lifestyle measures prove insufficient. With an expanding range of pharmacologic options available, clinicians face the task of choosing the right agent for the right patient. This review explores recent developments in prescription laxatives and their evolving role in practice.Recent findings: Randomized controlled trials have confirmed the safety and efficacy of newer prescription laxative agents including secretagogues (linaclotide, lubiprostone, plecanatide), sodium/hydrogen exchanger isoform 3 (NHE3) inhibitors (tenapanor), serotonin 5-hydroxytryptamine receptor agonists (prucalopride), and bile acid reabsorption inhibitors (elobixibat). Each drug offers its own unique advantages, with new evidence suggesting these therapies may provide symptom relief beyond managing stool consistency alone.Summary: Patients with constipation now have access to a wide range of medications, from over-the-counter osmotic and stimulant agents to prescription laxative combination strategies. This breadth allows clinicians to tailor therapy to diverse pathophysiology and symptom profiles. Yet despite this choice, real-world adherence remains poor and many patients are dissatisfied, reflecting the complexity of treating constipation and frequent mismatches between therapy and patients' most bothersome symptoms. Management should emphasize careful symptom assessment, shared decision-making, and clear expectation setting, while leveraging the available armamentarium.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"33-42"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187433","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

Brighter days ahead: the shifting landscape of IBD therapy. 光明的未来：IBD治疗前景的转变。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-01-01 Epub Date: 2025-10-10 DOI: 10.1097/MOG.0000000000001139

Gassan Kassim, Jessica R Philpott

{"title":"Brighter days ahead: the shifting landscape of IBD therapy.","authors":"Gassan Kassim, Jessica R Philpott","doi":"10.1097/MOG.0000000000001139","DOIUrl":"10.1097/MOG.0000000000001139","url":null,"abstract":"Purpose of review: The field of inflammatory bowel disease (IBD) continues to evolve at an unprecedented rate as the past decades have borne witness to the complete transformation of our approach to IBD and its care. Despite that, we continue to face major challenges, including rising incidence, shifting demographics, financial toxicity, as well as a frequently encountered therapeutic ceiling. This review aims to highlight the main factors driving the shifting landscape of IBD therapy.Recent findings: Many steps are being taken to improve efficacy and raise the therapeutic ceiling. Mounting evidence from clinical trials suggests that the use of various dual advanced therapies is well tolerated and may increase overall efficacy. Novel therapeutic mechanisms are being explored, including various novel oral agents as well as antihuman tumor necrosis factor-like cytokine A (anti-TL1A) antibodies with their novel antifibrotic potential. Delivery of care is also being optimized and refined with greater emphasis on early diagnosis, early effective therapy, treating to target and monitoring objective outcomes, therapeutic drug monitoring, and more effective use of current therapies. Greater recognition of the impact of IBD on patients beyond the disease itself is driving the spread of a patient-centric, multidisciplinary team-based approach to IBD care.Summary: As we continue to refine and deepen our understanding of IBD, the landscape of IBD therapy continues to shift and evolve as it aims to meet the needs of IBD patients with hope for brighter days ahead.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"25-32"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294296","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 mucosal resection or endoscopic submucosal dissection: choosing the right tool to a polyp-free colon. 内镜下粘膜切除或内镜下粘膜剥离：选择合适的工具切除无息肉结肠。

IF 2.8 3区医学

Current Opinion in Gastroenterology Pub Date : 2026-01-01 Epub Date: 2025-10-13 DOI: 10.1097/MOG.0000000000001140

George M Wahba, Fredy Nehme, Phillip S Ge

{"title":"Endoscopic mucosal resection or endoscopic submucosal dissection: choosing the right tool to a polyp-free colon.","authors":"George M Wahba, Fredy Nehme, Phillip S Ge","doi":"10.1097/MOG.0000000000001140","DOIUrl":"10.1097/MOG.0000000000001140","url":null,"abstract":"Purpose of review: Endoscopic resection is now the standard of care for the management of colorectal polyps. With increased training and expertise in endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), it is important to recognize their complementary roles, as well as their individual strengths and limitations.Recent findings: Here, we draw upon the experience of a real patient scenario to provide a case-based review on EMR and ESD. We will review evidence-based technical refinements to EMR which have improved procedural safety and decreased recurrence rates, as well as how expanded access to ESD and enhanced training has resulted in improvements in outcomes and adverse events. Finally, we will discuss how lesion, patient, and endoscopist factors influence the overall endoscopic resection strategy.Summary: EMR and ESD are complementary tools in the modern endoscopic resection toolkit, and the correct resection strategy draws upon a deep understanding of the tools available and is individualized based upon patient, endoscopist, and lesion characteristics.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"43-51"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294299","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

Kupffer cells are central to mitigating intravascular infections. 库普弗细胞是缓解血管内感染的核心。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-11-01 Epub Date: 2025-07-30 DOI: 10.1097/MOG.0000000000001128

Filipe Rodolfo Moreira Borges Oliveira, Paul Kubes

引用次数: 0

Endobariatrics in the era of glucagon-like peptide-1 receptor agonists: evolving roles, evidence, and integration. 胰高血糖素样肽-1受体激动剂时代的内分泌：进化的作用、证据和整合。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-11-01 Epub Date: 2025-10-02 DOI: 10.1097/MOG.0000000000001134

Farnoosh Vahedi, Meghna Yalamanchi, Danny Issa

{"title":"Endobariatrics in the era of glucagon-like peptide-1 receptor agonists: evolving roles, evidence, and integration.","authors":"Farnoosh Vahedi, Meghna Yalamanchi, Danny Issa","doi":"10.1097/MOG.0000000000001134","DOIUrl":"https://doi.org/10.1097/MOG.0000000000001134","url":null,"abstract":"Purpose of review: We review and summarize current evidence-based management strategies in the field of endobariatrics (EBT) for the management of obesity during a time of rapidly expanding pharmacologic options, particularly with rising popularity of glucagon-like peptide-1 (GLP-1) receptor agonists (RAs).Recent findings: National trends show increased use of GLP-1 RAs in obesity management. EBT are minimally invasive endoscopic therapies that offer durable weight loss with low complications rates. Patient comorbidities, socioeconomic factors, and adherence are critical considerations in treatment selection. Emerging data suggest that combining GLP-1 RAs with EBTs may yield synergistic effects.Summary: A growing array of treatment options are available in the management of obesity. Personalized, combination therapy that integrates mechanism-based interventions with pharmacotherapy may optimize long-term outcomes for sustained weight loss. Multidisciplinary approach remains essential for delivering comprehensive multidisciplinary care.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":"41 6","pages":"380-388"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193920","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

Advances in diagnosis and therapy for upper gastrointestinal Crohn's disease. 上消化道克罗恩病的诊断和治疗进展。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-11-01 Epub Date: 2025-08-01 DOI: 10.1097/MOG.0000000000001129

Laura Sahyoun, Jill K J Gaidos

{"title":"Advances in diagnosis and therapy for upper gastrointestinal Crohn's disease.","authors":"Laura Sahyoun, Jill K J Gaidos","doi":"10.1097/MOG.0000000000001129","DOIUrl":"10.1097/MOG.0000000000001129","url":null,"abstract":"Purpose of review: Crohn's disease is a chronic, relapsing and remitting inflammatory process that can involve the entire length of the gastrointestinal tract. Upper gastrointestinal involvement (UGI) in Crohn's disease is present in up to 15% of patients and can present as a diagnostic challenge given nonspecific symptoms and overlapping disease entities. This review provides an update on diagnosing and risk stratifying UGI-CD.Recent findings: Literature suggests the use of imaging modalities (such as video capsule endoscopy, cross-sectional imaging and intestinal ultrasound) to help identify proximal inflammation when clinical suspicion for UGI involvement exists based on symptoms and patient factors. Additionally, proximal disease involvement has been associated with increased disease severity, a higher prevalence of strictures and an increased risk for surgery. First-line therapies are corticosteroids and antitumor necrosis factor therapies if systemic treatment is needed based on disease severity. For stricturing disease, endoscopic balloon dilation, strictureplasty, surgical resection or bypass can be considered for medically refractory or recurrent disease.Summary: As the prevalence and progression of UGI-CD is still understudied due to its variable definition, presentation and incidence, the development of a standardized approach to diagnosis could aid in determining the overall prevalence and most effective treatments.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"426-431"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024652","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 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-11-01 Epub Date: 2025-04-23 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":"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":"409-415"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","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

Modern concepts of small intestinal bacterial overgrowth. 小肠细菌过度生长的现代概念。

IF 2.5 3区医学

Current Opinion in Gastroenterology Pub Date : 2025-11-01 Epub Date: 2025-09-22 DOI: 10.1097/MOG.0000000000001135

Gillian M Barlow, Mark Pimentel

{"title":"Modern concepts of small intestinal bacterial overgrowth.","authors":"Gillian M Barlow, Mark Pimentel","doi":"10.1097/MOG.0000000000001135","DOIUrl":"10.1097/MOG.0000000000001135","url":null,"abstract":"Purpose of review: Small intestinal bacterial overgrowth (SIBO) has been a recognized condition for more than half a century. Early descriptions of SIBO were based on the concept of colonic bacteria \"backing up\" into the small intestine. This was based on techniques using unprotected aspiration catheters and earlier culture techniques. Recent advances in breath testing, small bowel sampling, culture techniques, and next generation sequencing have helped expand our understanding of SIBO.Recent findings: \"SIBO\" is now understood to encompass at least three different types of overgrowth including SIBO, intestinal methanogen overgrowth (IMO) and intestinal sulfide overproduction (ISO). Each has their own unique microbial profile. In addition, next generation sequencing has revealed that SIBO is not a migration of colonic flora into the small intestine, but rather overgrowth of two predominant species/strains from phylum Proteobacteria ( Escherichia coli and Klebsiella ). Lastly, results from next generation sequencing of the stool and small intestinal microbiomes have validated breath testing as a diagnostic tool.Summary: Together, these advances have allowed the identification of key microbes in overgrowth syndromes, uncovering their relationships to conditions such as irritable bowel syndrome, and paving the way for the development of novel customized treatment options in the future.","PeriodicalId":50607,"journal":{"name":"Current Opinion in Gastroenterology","volume":" ","pages":"399-408"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076504","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