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Strain- and sex-specific differences in intestinal microhemodynamics and gut microbiota composition. 肠道微血流动力学和肠道微生物群组成的菌株和性别差异。
IF 3.6 3区 医学
Gastroenterology Report Pub Date : 2024-09-16 DOI: 10.1093/gastro/goae087
Sunjing Fu,Mengting Xu,Bing Wang,Bingwei Li,Yuan Li,Yingyu Wang,Xueting Liu,Hao Ling,Qin Wang,Xiaoyan Zhang,Ailing Li,Xu Zhang,Mingming Liu
{"title":"Strain- and sex-specific differences in intestinal microhemodynamics and gut microbiota composition.","authors":"Sunjing Fu,Mengting Xu,Bing Wang,Bingwei Li,Yuan Li,Yingyu Wang,Xueting Liu,Hao Ling,Qin Wang,Xiaoyan Zhang,Ailing Li,Xu Zhang,Mingming Liu","doi":"10.1093/gastro/goae087","DOIUrl":"https://doi.org/10.1093/gastro/goae087","url":null,"abstract":"BackgroundIntestinal microcirculation is a critical interface for nutrient exchange and energy transfer, and is essential for maintaining physiological integrity. Our study aimed to elucidate the relationships among intestinal microhemodynamics, genetic background, sex, and microbial composition.MethodsTo dissect the microhemodynamic landscape of the BALB/c, C57BL/6J, and KM mouse strains, laser Doppler flowmetry paired with wavelet transform analysis was utilized to determine the amplitude of characteristic oscillatory patterns. Microbial consortia were profiled using 16S rRNA gene sequencing. To augment our investigation, a broad-spectrum antibiotic regimen was administered to these strains to evaluate the impact of gut microbiota depletion on intestinal microhemodynamics. Immunohistochemical analyses were used to quantify platelet endothelial cell adhesion molecule-1 (PECAM-1), estrogen receptor α (ESR1), and estrogen receptor β (ESR2) expression.ResultsOur findings revealed strain-dependent and sex-related disparities in microhemodynamic profiles and characteristic oscillatory behaviors. Significant differences in the gut microbiota contingent upon sex and genetic lineage were observed, with correlational analyses indicating an influence of the microbiota on microhemodynamic parameters. Following antibiotic treatment, distinct changes in blood perfusion levels and velocities were observed, including a reduction in female C57BL/6J mice and a general decrease in perfusion velocity. Enhanced erythrocyte aggregation and modulated endothelial function post-antibiotic treatment indicated that a systemic response to microbiota depletion impacted cardiac amplitude. Immunohistochemical data revealed strain-specific and sex-specific PECAM-1 and ESR1 expression patterns that aligned with observed intestinal microhemodynamic changes.ConclusionsThis study highlights the influence of both genetic and sex-specific factors on intestinal microhemodynamics and the gut microbiota in mice. These findings also emphasize a substantial correlation between intestinal microhemodynamics and the compositional dynamics of the gut bacterial community.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"201 1","pages":"goae087"},"PeriodicalIF":3.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253943","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
Hiatal hernia: risk factors, and clinical and endoscopic aspects in gastroscopy 膈疝:风险因素以及胃镜检查中的临床和内窥镜问题
IF 3.6 3区 医学
Gastroenterology Report Pub Date : 2024-09-14 DOI: 10.1093/gastro/goae086
Naim Abu-Freha, Revital Guterman, Ruhama Elhayany, Avraham Yitzhak, Shira Sophie Hudes, Alexander Fich
{"title":"Hiatal hernia: risk factors, and clinical and endoscopic aspects in gastroscopy","authors":"Naim Abu-Freha, Revital Guterman, Ruhama Elhayany, Avraham Yitzhak, Shira Sophie Hudes, Alexander Fich","doi":"10.1093/gastro/goae086","DOIUrl":"https://doi.org/10.1093/gastro/goae086","url":null,"abstract":"Background Hiatal hernia (HH) is a common finding in gastroscopy. The aim of the present study was to investigate the frequency rate of HH among patients who underwent esophagogastroduodenoscopy (EGD) according to their age, gender, and procedural indication. Methods A multicenter, retrospective study including all EGDs was conducted across seven endoscopy departments between 2016 and 2021. Demographic information, procedural indications, and findings from the initial EGD were collected. Results Of the 162,608 EGDs examined, 96,369 (59.3%) involved female patients. HH was identified in 39,619 (24.4%) of all EGDs performed, comprising small HH in 31,562 (79.6%) and large HH in 3,547 (9.0%). The frequency of HH was 16.5% in the age group of ≤50 years and 37.3% in those aged ≥81 years. HH was diagnosed in 38.7% (11,370) of patients with heartburn/reflux symptoms, 31.5% of those with dysphagia, 28.5% of those with positive fecal occult blood tests, and 24.3% of those who would undergo bariatric surgery. Age (odds ratio 1.030), female gender (odds ratio 1.309), reflux symptoms (odds ratio 2.314), and dysphagia (odds ratio 1.470) were identified as predictors for HH. Conclusions Risk factors for HH diagnosed by EGD in symptomatic patients were shown to be advanced age, female gender, and the presence of heartburn or dysphagia.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142254004","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 portal hypertension: navigating venous hemodynamics and treatment efficacy 门静脉高压症的内窥镜超声:导航静脉血液动力学和治疗效果
IF 3.6 3区 医学
Gastroenterology Report Pub Date : 2024-09-14 DOI: 10.1093/gastro/goae082
Irina Dragomir, Cristina Pojoga, Claudia Hagiu, Radu Seicean, Bogdan Procopet, Andrada Seicean
{"title":"Endoscopic ultrasound in portal hypertension: navigating venous hemodynamics and treatment efficacy","authors":"Irina Dragomir, Cristina Pojoga, Claudia Hagiu, Radu Seicean, Bogdan Procopet, Andrada Seicean","doi":"10.1093/gastro/goae082","DOIUrl":"https://doi.org/10.1093/gastro/goae082","url":null,"abstract":"Portal hypertension-related complications increase mortality in patients, irrespective of its etiology. Classically, endoscopic ultrasound (EUS) was used to assess the portal venous system and collaterals, considering size and hemodynamic parameters, which correlate with portal hypertension (PH) and related complications. Furthermore, therapeutic EUS guides treatment interventions, such as embolization of the gastric varices through coil placement and tissue adhesive injection, yielding encouraging clinical results. Recently, the direct measurement of portal pressure, emerging as an alternative to hepatic venous pressure gradient, has shown promise, and further research in this area is anticipated. In this review, we aimed to provide a detailed description of various possibilities for diagnosing vascular anatomy and hemodynamics in PH and actual knowledge on the EUS usefulness for PH vessel-related complications. Also, future promises for this field of endo-hepatology are discussed.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"190 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269045","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
Gastric residual volume, safety, and effectiveness of drinking 250 mL of glucose solution 2-3 hours before surgery in gastric cancer patients: a multicenter, single-blind, randomized-controlled trial. 胃癌患者术前 2-3 小时饮用 250 毫升葡萄糖溶液的胃残渣量、安全性和有效性:一项多中心、单盲、随机对照试验。
IF 3.6 3区 医学
Gastroenterology Report Pub Date : 2024-09-12 DOI: 10.1093/gastro/goae077
Dongjie Yang,Xun Hou,Huafeng Fu,Wu Song,Wenqing Dong,Hu Wang,Yuantian Mao,Mengbin Li,Junqiang Chen,Yulong He
{"title":"Gastric residual volume, safety, and effectiveness of drinking 250 mL of glucose solution 2-3 hours before surgery in gastric cancer patients: a multicenter, single-blind, randomized-controlled trial.","authors":"Dongjie Yang,Xun Hou,Huafeng Fu,Wu Song,Wenqing Dong,Hu Wang,Yuantian Mao,Mengbin Li,Junqiang Chen,Yulong He","doi":"10.1093/gastro/goae077","DOIUrl":"https://doi.org/10.1093/gastro/goae077","url":null,"abstract":"BackgroundCarbohydrate drinking 2-3 hours before surgery has been widely adopted in colorectal operations. However, there is little direct evidence regarding its application in gastric cancer surgery. We aimed to evaluate the gastric residual volume, safety, and effectiveness of drinking 250 mL of 5% glucose solution 2-3 hours before elective gastric cancer surgery.MethodsWe conducted an investigator-initiated, multicenter, randomized-controlled, parallel group, and equivalence trial. Eighty-eight patients with gastric adenocarcinoma were randomized into study or control group. Patients in the control group followed the traditional routine of 6-8 hours preoperative fasting, while those in the study group drank 250 mL of 5% glucose solution 2-3 hours before surgery. Immediately following tracheal intubation, gastric contents were aspirated through gastroscopy. The primary outcome was preoperative gastric residual volume.ResultsEighty-three patients were eventually analysed in the study (42 in the study group and 41 in the control group). Two groups were comparable at baseline characteristics. There were no statistical differences in residual gastric fluid volumes (35.86 ± 27.13 vs 27.70 ± 20.37 mL, P = 0.135) and pH values (2.81 ± 1.99 vs 2.66 ± 1.68, P = 0.708) between the two groups. Preoperative discomfort was significantly more decreased in the study group than in the control group (thirst score: 1.49 ± 1.23 vs 4.14 ± 2.07, P < 0.001; hunger score: 1.66 ± 1.18 vs 3.00 ± 2.32, P = 0.007). There was no statistical difference in the incidence of postoperative complications (19.05% vs 17.07%, P = 0.815).ConclusionsDrinking 250 mL of 5% glucose solution 2-3 hours before surgery in elective gastric cancer patients shows benefits in lowering thirst and hunger scores without increasing gastric residual volume and perioperative complications.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"63 1","pages":"goae077"},"PeriodicalIF":3.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253945","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
β-arrestin1 protects intestinal tight junction through promoting mitofusin 2 transcription to drive parkin-dependent mitophagy in colitis. β-arrestin1通过促进mitofusin 2转录驱动结肠炎中依赖于parkin的有丝分裂来保护肠道紧密连接。
IF 3.8 3区 医学
Gastroenterology Report Pub Date : 2024-09-06 eCollection Date: 2024-01-01 DOI: 10.1093/gastro/goae084
Shuyun Wu, Huiling Liu, Jiazhi Yi, Minyi Xu, Jie Jiang, Jin Tao, Bin Wu
{"title":"β-arrestin1 protects intestinal tight junction through promoting mitofusin 2 transcription to drive parkin-dependent mitophagy in colitis.","authors":"Shuyun Wu, Huiling Liu, Jiazhi Yi, Minyi Xu, Jie Jiang, Jin Tao, Bin Wu","doi":"10.1093/gastro/goae084","DOIUrl":"10.1093/gastro/goae084","url":null,"abstract":"<p><strong>Background: </strong>Intestinal barrier defect is an essential inflammatory bowel disease (IBD) pathogenesis. Mitochondrial dysfunction results in energy deficiency and oxidative stress, which contribute to the pathogenesis of IBD. β-arrestin1 (ARRB1) is a negative regulator that promotes G protein-coupled receptors desensitization, endocytosis, and degradation. However, its role in maintaining the intestinal barrier remains unclear.</p><p><strong>Methods: </strong>Dextran sulfate sodium-induced colitis was performed in ARRB1 knockout and wild-type mice. Intestinal permeability and tight junction proteins were measured to evaluate the intestinal barrier. Mitochondria function and mitophagic flux in mice and cell lines were detected. Finally, the interaction between ARRB1 and mitofusin 2 was investigated by co-immunoprecipitation and dual luciferase assay.</p><p><strong>Results: </strong>We identified that ARRB1 protected the intestinal tight junction barrier against experimental colitis <i>in vivo</i>. ARRB1 deficiency was accompanied by abnormal mitochondrial morphology, lower adenosine triphosphate (ATP) production, and severe oxidative stress. <i>In vitro</i>, the knockdown of ARRB1 reduced ATP levels and mitochondrial membrane potential while increasing reactive oxygen species levels and oxidative stress. Upon ARRB1 ablation, mitophagy was inhibited, accompanied by decreased LC3BII, phosphatase and tension homologue-induced protein kinase1 (PINK1), and parkin, but increased p62 expression. Mitophagy inhibition via PINK1 siRNA or mitochondrial division inhibitor 1 impaired ARRB1-mediated tight junction protection. The interaction of ARRB1 with E2F1 activated mitophagy by enhancing the transcription of mitofusin 2.</p><p><strong>Conclusions: </strong>Our results suggest that ARRB1 is critical to maintaining the intestinal tight junction barrier by promoting mitophagy. These results reveal a novel link between ARRB1 and the intestinal tight junction barrier, which provides theoretical support for colitis treatment.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae084"},"PeriodicalIF":3.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156612","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
The involvement of oral bacteria in inflammatory bowel disease. 口腔细菌与炎症性肠病的关系。
IF 3.8 3区 医学
Gastroenterology Report Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI: 10.1093/gastro/goae076
Bingjie Xiang, Jun Hu, Min Zhang, Min Zhi
{"title":"The involvement of oral bacteria in inflammatory bowel disease.","authors":"Bingjie Xiang, Jun Hu, Min Zhang, Min Zhi","doi":"10.1093/gastro/goae076","DOIUrl":"10.1093/gastro/goae076","url":null,"abstract":"<p><p>Microorganisms play an important role in the pathogenesis of inflammatory bowel disease (IBD). The oral cavity, the second-largest microbial niche, is connected to the gastro-intestinal tract. Ectopic gut colonization by oral microbes is a signature of IBD. Current studies suggest that patients with IBD often report more oral manifestations and these oral issues are closely linked with disease activity. Murine studies have indicated that several oral microbes exacerbate intestinal inflammation. Moreover, intestinal inflammation can promote oral microbial dysbiosis and the migration of oral microbes to the gastro-intestinal tract. The reciprocal consequences of oral microbial dysbiosis and IBD, specifically through metabolic alterations, have not yet been elucidated. In this review, we summarize the relationship between oral bacteria and IBD from multiple perspectives, including clinical manifestations, microbial dysbiosis, and metabolic alterations, and find that oral pathogens increase anti-inflammatory metabolites and decrease inflammation-related metabolites.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae076"},"PeriodicalIF":3.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074457","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
Challenges and insights in Alagille syndrome: a case report. 阿拉吉尔综合征的挑战与启示:病例报告。
IF 3.8 3区 医学
Gastroenterology Report Pub Date : 2024-08-22 eCollection Date: 2024-01-01 DOI: 10.1093/gastro/goae081
Ricardo A Caravantes, Daniela Saenz, Juan P Cóbar, Zoe Kleiman
{"title":"Challenges and insights in Alagille syndrome: a case report.","authors":"Ricardo A Caravantes, Daniela Saenz, Juan P Cóbar, Zoe Kleiman","doi":"10.1093/gastro/goae081","DOIUrl":"10.1093/gastro/goae081","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae081"},"PeriodicalIF":3.8,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037674","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
The evolving role of non-invasive assessment for liver fibrosis. 无创肝纤维化评估的作用不断发展。
IF 3.8 3区 医学
Gastroenterology Report Pub Date : 2024-08-22 eCollection Date: 2024-01-01 DOI: 10.1093/gastro/goae080
Peng Wang, Calvin Q Pan, Yali Liu, Jing Zhang
{"title":"The evolving role of non-invasive assessment for liver fibrosis.","authors":"Peng Wang, Calvin Q Pan, Yali Liu, Jing Zhang","doi":"10.1093/gastro/goae080","DOIUrl":"10.1093/gastro/goae080","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae080"},"PeriodicalIF":3.8,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037675","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
Symptom burden in chronic liver disease. 慢性肝病的症状负担。
IF 3.8 3区 医学
Gastroenterology Report Pub Date : 2024-08-09 eCollection Date: 2024-01-01 DOI: 10.1093/gastro/goae078
Ammar Hassan, Ivonne Hurtado Diaz De Leon, Elliot B Tapper
{"title":"Symptom burden in chronic liver disease.","authors":"Ammar Hassan, Ivonne Hurtado Diaz De Leon, Elliot B Tapper","doi":"10.1093/gastro/goae078","DOIUrl":"10.1093/gastro/goae078","url":null,"abstract":"<p><p>Chronic liver disease (CLD) is a significant contributor to global mortality. For people who are living with CLD, however, there is a substantial and often overlooked burden of physical and psychological symptoms that significantly affect health-related quality of life. CLD frequently presents with a multitude of interrelated and intricate symptoms, including fatigue, pruritus, muscle cramps, sexual dysfunction, and falls. Increasingly, there is interest in studying and developing interventional strategies to provide a more global approach to managing these complex patients. Moreover, in addition to established guidelines for the management of conventional complications, such as ascites and hepatic encephalopathy, there have been efforts in developing evidence-based guidance for the treatment of the more subjective yet still problematic elements. This review will address the management of these less \"classical\" but nonetheless important symptoms.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae078"},"PeriodicalIF":3.8,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141918105","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
Advances in the management of complications from cirrhosis. 肝硬化并发症的治疗进展。
IF 3.8 3区 医学
Gastroenterology Report Pub Date : 2024-08-05 eCollection Date: 2024-01-01 DOI: 10.1093/gastro/goae072
Jasleen Singh, Mark Ebaid, Sammy Saab
{"title":"Advances in the management of complications from cirrhosis.","authors":"Jasleen Singh, Mark Ebaid, Sammy Saab","doi":"10.1093/gastro/goae072","DOIUrl":"10.1093/gastro/goae072","url":null,"abstract":"<p><p>Cirrhosis with complications of liver decompensation and hepatocellular carcinoma (HCC) constitute a leading cause of morbidity and mortality worldwide. Portal hypertension is central to the progression of liver disease and decompensation. The most recent Baveno VII guidance included revision of the nomenclature for chronic liver disease, termed compensated advanced chronic liver disease, and leveraged the use of liver stiffness measurement to categorize the degree of portal hypertension. Additionally, non-selective beta blockers, especially carvedilol, can improve portal hypertension and may even have a survival benefit. Procedural techniques with interventional radiology have become more advanced in the management of refractory ascites and variceal bleeding, leading to improved prognosis in patients with decompensated liver disease. While lactulose and rifaximin are the preferred treatments for hepatic encephalopathy, many alternative treatment options may be used in refractory cases and even procedural interventions such as shunt embolization may be of benefit. The approval of terlipressin for the treatment of hepatorenal syndrome (HRS) in the USA has improved the way in which HRS is managed and will be discussed in detail. Malnutrition, frailty, and sarcopenia lead to poorer outcomes in patients with decompensated liver disease and should be addressed in this patient population. Palliative care interventions can lead to improved quality of life and clinical outcomes. Lastly, the investigation of systemic therapies, in particular immunotherapy, has revolutionized the management of HCC. These topics will be discussed in detail in this review.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae072"},"PeriodicalIF":3.8,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894883","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
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