Journal of gastrointestinal and liver diseases : JGLD最新文献

{"title":"The Combination of Fluocinolone Acetonide and Ketocaine Hydrochloride in the Conservative Management of Symptomatic Hemorrhoidal Disease: An Overview of Preclinical and Clinical Data.","authors":"Giuseppe Chiarioni, Stefan-Lucian Popa, Christian Lambiase, Massimo Bellini","doi":"10.15403/jgld-6306","DOIUrl":"https://doi.org/10.15403/jgld-6306","url":null,"abstract":"<p><p>Hemorrhoidal disease (HD) is a prevalent anorectal disorder that affects up to 36% of the general population. It is characterized by symptomatic enlargement and displacement of anal cushions, frequently associated with pain, bleeding, and reduced quality of life. The pathophysiology of HD includes vascular congestion, venous stasis, and vascular dilatation, promoted by increased nitric oxide activity. Inflammatory responses are considered crucial in HD, with NF-κB playing a major role. Treatment strategies for HD vary from conservative approaches to office-based and surgical interventions. Conservative therapies, such as topical agents and flavonoid-based systemic treatments, serve as the mainstay of low-grade HD management, while invasive procedures are reserved for refractory cases. Topical formulations containing fluocinolone acetonide (FLA) and ketocaine hydrochloride (KH) combine anti-inflammatory and anesthetic effects, providing rapid and sustained relief from pain, itching, and inflammation. FLA exerts potent anti-inflammatory effects by inhibiting NF-κB and induces vasoconstrictive activity by reducing nitric oxide levels, while KH provides localized analgesia by blocking sodium channels. Collectively, these agents mitigate vascular congestion, inflammation, and HD symptoms. Clinical evidence supports the efficacy of this combination in alleviating acute symptoms, reducing recurrence, and improving patient outcomes. The FLA/KH formulation provides targeted local action with minimal systemic absorption and predominantly mild and transient adverse events. Treatment with FLA/KH is an effective and well-tolerated option for managing acute HD. Furthermore, its combination with flavonoid-based supplements, which improve venous tone and reduce capillary permeability, may aid in preventing recurrence. This combined approach leverages the rapid symptom relief provided by topical agents and the long-term benefits of systemic therapies, promoting comprehensive HD management and reducing the risk of recurrence.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 3","pages":"370-380"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Occluded Uncovered Self-expanding Metal Stents in Patients with Malignant Hilar Biliary Obstruction: A Retrospective Cohort Study.","authors":"Jakub Pietrzak, Adam Przybyłkowski","doi":"10.15403/jgld-6215","DOIUrl":"https://doi.org/10.15403/jgld-6215","url":null,"abstract":"<p><strong>Background and aims: </strong>The implantation of uncovered self-expanding metal stents (UCSEMS) is an established method for the palliative treatment of malignant hilar biliary obstruction (MHBO). However, with advances in chemotherapy extending patient survival, individuals treated primarily with UCSEMS increasingly encounter overgrowth of the tumour in the stent lumen and occlusion. In this study, we aimed to compare various methods of managing occluded UCSEMS.</p><p><strong>Methods: </strong>We analyzed a cohort of 49 patients with malignant hilar biliary obstruction who were treated with UCSEMS implantation as first-line endoscopic treatment. We evaluated their follow-up data, recorded complications, and assessed the methods used to manage occluded stents: balloon cleaning, plastic stent in stent implantation, UCSEMS stent in stent implantation, fully covered self-expandable metal stent (FCSEMS) stent in stent implantation and radiofrequency ablation (RFA).</p><p><strong>Results: </strong>Technical and clinical success rates of the reinterventions were 91.2% and 61.4%, respectively. Depending on the type of revisionary drainage method used, clinical success rates were as follows: 50% for balloon cleaning only, 66% for plastic stent placement, 68% for FCSEMS stent placement, 80% for RFA with simultaneous plastic stent placement, and 80% for UCSEMS stent placement (p=0.366). The mean time to the second reintervention (second ERCP after UCSEMS placement) was 238, 201, 264, 78, and 205 days, respectively (p=0.4999). The mean interval time for all reinterventions was 48, 75, 71, 66, and 95 days, respectively (p=0.0326).</p><p><strong>Conclusions: </strong>All techniques demonstrated high technical feasibility. While UCSEMS re-stenting and RFA with plastic stents showed promising trends in clinical success and stent patency, definitive conclusions about superiority cannot be drawn. Further multicentre prospective studies are needed to validate these findings.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 3","pages":"339-342"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apolipoproteins Levels in Fatty Liver Disease: A Systematic Review and Meta-analysis.","authors":"Rania Abdulredha, Giuseppe Guido Maria Scarlata, Micha Gruber, Daniel-Corneliu Leucuta, Stefan-Lucian Popa, Ludovico Abenavoli, Abdulrahman Ismaiel, Dan Lucian Dumitrascu","doi":"10.15403/jgld-6289","DOIUrl":"https://doi.org/10.15403/jgld-6289","url":null,"abstract":"<p><strong>Background and aims: </strong>Fatty liver disease (FLD) is a prevalent condition linked to metabolic disorders and can progress to severe liver diseases. Alterations in apolipoprotein (Apo) levels may provide valuable insights for diagnosing and managing FLD. This systematic review and meta-analysis evaluates these changes across different FLD phenotypes to evaluate their potential as diagnostic biomarkers.</p><p><strong>Methods: </strong>We evaluated studies from PubMed, EMBASE, and Scopus using a predefined search string. Predefined inclusion and exclusion criteria were applied, and the risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The main summary outcome was the mean difference (MD) in Apo levels.</p><p><strong>Results: </strong>Out of 773 initial articles, 55 studies involving 432,328 individuals were included. In NAFLD patients vs. controls, ApoA levels showed a MD of -0.029 (95% CI: -0.133, 0.075), ApoA-I had a MD of -0.064 (95%CI: -0.107, -0.021), and ApoB levels had a MD of 0.098 (95%CI: 0.076, 0.120), while ApoB100 had an MD of 0.042 (95% CI: 0.008, 0.076). For NASH vs. controls, ApoA-I levels had a MD of -0.108 (95% CI: -0.125, -0.091) and ApoB levels had a MD of 0.123 (95% CI: 0.054, 0.193), while ApoB100 had a MD of 0.042 (95% CI: -0.051,0.136). In MAFLD vs. controls, ApoA-I levels had a MD of -0.068 (95% CI: -0.124, -0.012) and ApoB a MD of 0.099 (95% CI: 0.091, 0.107). For diabetic NAFLD vs. T2DM (type 2 diabetes mellitus) without NAFLD, ApoA levels had an MD of 0.028 (95% CI: -0.147, 0.204) and ApoB levels an MD of 0.081 (95% CI: 0.040, 0.122).</p><p><strong>Conclusions: </strong>In NAFLD patients, ApoA-I levels were lower and ApoB and ApoB100 levels were higher compared to controls, with similar patterns seen in NASH patients, who also had higher ApoB levels than those with simple steatosis. MAFLD patients had elevated ApoB and ApoE levels, while overweight/obese NAFLD patients had higher ApoB levels than controls.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 3","pages":"350-361"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiota Perturbation Are Linked to Endoscopic Severity of Diverticular Disease.","authors":"Antonio Tursi, Giorgia Procaccianti, Silvia Turroni, Rudi De Bastiani, Federica D'Amico, Leonardo Allegretta, Natale Antonino, Elisabetta Baldi, Carlo Casamassima, Giovanni Casella, Mario Ciuffi, Marco De Bastiani, Lorenzo Lazzarotto, Claudio Licci, Maurizio Mancuso, Antonio Penna, Giuseppe Pranzo, Guido Sanna, Cesare Tosetti, Maria Zamparella, Marcello Picchio","doi":"10.15403/jgld-6308","DOIUrl":"https://doi.org/10.15403/jgld-6308","url":null,"abstract":"<p><strong>Background and aims: </strong>It is not known whether the gut microbiota (GM) may vary according to the endoscopic severity of diverticular disease (DD). We aimed to profile the GM in DD patients according to the severity of the diverticular inflammation and complication assessment (DICA) classification (DICA 1 vs. DICA 2 vs. DICA 3).</p><p><strong>Methods: </strong>We retrospectively assessed the GM in a population of patients with DD. We analyzed stool samples collected by fecal swab for microbiological studies. Among them, we identified DD patients in whom DD was scored according to DICA classification. The severity of the abdominal pain was measured using a 10-point visual analogue scale (VAS).</p><p><strong>Results: </strong>The GM of 71 DD patients [49 (69.0%) were scored as DICA1, 18 (25.4%) as DICA2, and 4 (5.6%) as DICA3 was analysed. The three groups did not differ in alpha diversity, but significantly separated in the PCoA of beta diversity (p=0.018). Taxonomically, DICA1 group was characterized by higher relative abundances of the phylum Actinobacteriota, the families Erysipelatoclostridiaceae and Bacteroidaceae, and the genera Lachnospiraceae ND3007 group and Bacteroides (p≤0.1); DICA2 group was mainly discriminated by higher proportions of Streptococcaceae (p=0.018); DICA3 group was mainly discriminated by the phylum Bacteroidota, the families Prevotellaceae and Succinivibrionaceae, and the genera Prevotella, Alloprevotella and Dialister (p≤0.045). Stratifiyng patients by abdominal pain severity, only for the DICA2 group the PCoA of beta diversity showed a significant separation between the moderate and severe groups (p=0.024), with the latter also showing higher alpha diversity (p=0.05). Taxonomically, the severe group was enriched in the families Enterobacteriaceae and Erysipelotrichaceae, and the genera Megasphaera and Veillonella, while depleted in Sutterellaceae and Blautia compared to the moderate group (p≤0.08).</p><p><strong>Conclusions: </strong>GM in DD may vary according to endoscopic disease severity and clinical characteristics. Such associations may improve patient stratification and clinical management.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 3","pages":"317-322"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior reversible encephalopathy syndrome due to thrombotic thrombocytopenic purpura in a liver-transplant patient treated with tacrolimus.","authors":"Christos Damaskos, Nikolaos Garmpis, Anna Garmpi, Dimitrios Dimitroulis, Efstathios A Antoniou","doi":"10.15403/jgld-6219","DOIUrl":"https://doi.org/10.15403/jgld-6219","url":null,"abstract":"","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 3","pages":"409-410"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Irritable Bowel Syndrome: The Role of Digital Health Technologies.","authors":"Arjuna Priyadarsin De Silva, Krishanni Prabagar, Madunil Anuk Niriella, Hithanadura Janaka De Silva","doi":"10.15403/jgld-6189","DOIUrl":"10.15403/jgld-6189","url":null,"abstract":"<p><p>Functional Gastrointestinal Disorders (FGIDs), including conditions such as irritable bowel syndrome (IBS) and functional dyspepsia, affect millions worldwide, significantly impairing quality of life and increasing healthcare utilization. These disorders are multifactorial and complex, with several subtypes, making diagnosis and management challenging. This review explores the emerging role of digital health technologies and artificial intelligence(AI) in transforming FGID diagnosis and treatment. We focus on wearable devices, capsule-based diagnostics, mobile health applications, and AI-powered virtual assistants, highlighting how these innovations address the limitations of traditional investigative and management approaches. Additionally, we assess the impact of these digital advancements on patient outcomes, healthcare efficiency, and real-time symptom monitoring. Finally, we examine the challenges associated with data privacy, accuracy, and reliability in digital health solutions and propose future directions for technological advancements in FGID management.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 3","pages":"275-278"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intramucosal colonic carcinoma arising in a sessile serrated lesion: supporting evidence for the serrated pathway.","authors":"Antonio Pérez Serena, Daisy Paola Martínez Betancourt","doi":"10.15403/jgld-6349","DOIUrl":"https://doi.org/10.15403/jgld-6349","url":null,"abstract":"","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 3","pages":"414-415"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune checkpoint-induced esophagitis: diagnostic challenges and clinical implications.","authors":"Shriraj Patel, Michael Makar, Rouenne Seeley, Jinhong Li","doi":"10.15403/jgld-6143","DOIUrl":"https://doi.org/10.15403/jgld-6143","url":null,"abstract":"","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 3","pages":"411-413"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celiac Disease and Gut Microbiota: What Do We Know so Far?","authors":"Lida Mentesidou, Melpomeni Peppa, Konstantinos Douros, Afroditi Kourti, Dafni Moriki, Smaragdi Fessatou","doi":"10.15403/jgld-6100","DOIUrl":"https://doi.org/10.15403/jgld-6100","url":null,"abstract":"<p><p>Gut microbiota (GM) is a complex microenvironment characterised by intricate interactions, which might play a pivotal role in the pathogenesis of many autoimmune diseases, including celiac disease (CD). DDysbiosis of gut bacteria can have a wide range of effects; however, whether it is a cause or a consequence of certain diseases and how it evolves during disease progression remains an area of active research. Celiac disease patients appear to have characteristic microbiota patterns, including low levels of beneficial species and high levels of potentially pathogenic species. The use of pro-, pre-, syn- and post-biotics to modulate the GM requires more systematic investigation, to determine the impact of specific species, the optimal dosage and the treatment duration needed to achieve desired results without adverse reactions. Additionally, osteoporosis in the course of CeD ease warrants further investigation. Many factors may contribute to its pathogenesis, including GM. This review summarizes recent literature concerning the role of GM in CeD, highlighting both consistent findings and areas of ongoing debate.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 3","pages":"362-369"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clínica Universidad de Navarra-Body Adiposity Estimator Index as A Predictor of Metabolic Dysfunction-associated Steatotic Liver Disease: A Large-scale Cross-sectional Analysis.","authors":"Ziwen Zhuo, Hongye Peng, Xiaoxian Ye, Ziwei Guo, Jiuchong Wang, Wenliang Lv","doi":"10.15403/jgld-6188","DOIUrl":"https://doi.org/10.15403/jgld-6188","url":null,"abstract":"<p><strong>Background and aims: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 32.4% of the global population and is a major cause of chronic liver disease and cardiometabolic complications. Early detection is challenging due to limitations of conventional obesity indices like body mass index (BMI) and waist circumference (WC), which do not account for age- and sex-specific adiposity variations. The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index, integrating BMI, age, and gender, may offer a better measure of body fat percentage, but its utility in MASLD prediction is unexplored. We aimed to evaluate the predictive value of the CUN-BAE index for MASLD and to compare it with conventional obesity indices.</p><p><strong>Methods: </strong>1,003 participants from Guang'anmen Hospital were recruited (2023-2024). MASLD diagnosis was based on established criteria, and participants underwent clinical and laboratory assessments. Logistic regression models were used to determine the association between the CUN-BAE index and MASLD, with predictive performance assessed using area under the receiver operating characteristic curve (AUROC).</p><p><strong>Results: </strong>Among 949 participants, 555 (58.5%) had MASLD. The CUN-BAE index showed a significant positive association with MASLD risk (Model 3: OR=1.16, 95%CI: 1.12-1.20, p<0.001). Its AUROC (0.677) surpassed BMI (0.612) and WC (0.598), especially in women (AUROC=0.809 vs. BMI=0.721, WC=0.698) compared to men (AUROC=0.664 vs. BMI=0.603, WC=0.591). A dose-response relationship was observed, with increased CUN-BAE levels correlating with higher MASLD risk beyond a threshold of 29.097.</p><p><strong>Conclusions: </strong>The CUN-BAE index is a robust predictor of MASLD, outperforming BMI and WC, particularly in women. It captures age- and gender-specific adiposity variations, enhancing its utility as a non-invasive screening tool. Future research should focus on longitudinal validation and integrating additional metabolic parameters.</p>","PeriodicalId":94081,"journal":{"name":"Journal of gastrointestinal and liver diseases : JGLD","volume":"34 3","pages":"323-330"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}