Helicobacter pylori (H. pylori) infection is the principal cause of peptic ulcer disease, MALT lymphoma and non-cardia gastric cancer. The major advances in diagnostics and treatment, eradication success are threatened by rising antimicrobial resistance and concerns about disruption of the normal microbiome. This review summarizes current unresolved issues in H. pylori treatment, with a focus on resistance, optimal regimens, ecological impact, and emerging therapies.

This case series characterizes enema- and catheter-induced rectal injuries as an underrecognized iatrogenic cause of life-threatening lower gastrointestinal bleeding (LGIB). By focusing on elderly, high-risk patients, we highlight the diagnostic complexities and management strategies associated with these routine yet potentially catastrophic anorectal procedures.

Celiac disease is an immune-mediated enteropathy triggered by gluten ingestion. The effect of very small gluten exposures remains uncertain, contributing to international variations in food-labelling standards. Interleukin-2 rises rapidly after gluten ingestion serving as a biomarker of immune activation. We aimed to identify the lowest gluten dose that elicits a measurable interleukin-2 response and accompanying symptoms in treated celiac disease.

Immune-mediated inflammatory diseases are undergoing a paradigm shift from treatment of established pathology toward prevention in at-risk individuals. Celiac disease (CeD), driven by an aberrant immune response to dietary gluten in genetically predisposed individuals, represents an ideal model to investigate the transition from tolerance to autoimmunity. Within this framework, potential celiac disease (PCD)-defined by CeD-specific autoantibodies in the absence of villous atrophy-has emerged as a clinically relevant condition whose natural history, heterogeneity, and predictors of progression are increasingly understood. Immunologic studies reveal that PCD is characterized by a blunted T helper type 1 response, preserved regulatory pathways, reduced epithelial stress signaling, and incomplete licensing of cytotoxic intraepithelial lymphocytes, preventing tissue destruction. This distinct immunologic landscape makes PCD a unique window to dissect mechanisms underlying loss of tolerance and to explore preventive strategies. Only a subset of PCD individuals progress to active CeD, with the highest risk concentrated in the first years after seroconversion, whereas others even stop producing autoantibodies despite consuming gluten. Clinical management remains controversial, but current guidelines discourage routine gluten-free diet in asymptomatic PCD both in children and in adults. In conclusion, PCD represents a heterogeneous but highly informative condition positioned at the crossroads between genetic susceptibility and mucosal damage. The identification of reliable progression markers and the development of targeted preventive interventions could transform CeD management and contribute broadly to the understanding and prevention of organ-specific autoimmunity.

Postoperative biliary and vascular complications (including stenosis, thrombosis, and occlusion) after liver transplantation (LT) can impair graft function, increase reoperation needs, and elevate patient mortality, significantly affecting long-term survival. The clinical reference standards magnetic resonance cholangiopancreatography (MRCP) for biliary complications is expensive and time-consuming, while computed tomography angiography (CTA) for vascular complication involves ionizing radiation and allergic reaction to contrast agents, limiting their repeated use during follow-up. Ultrasound viscoelastic imaging (UVI), an affordable, non-invasive technique, could be an effective alternative. This study aims to assess the clinical value of UVI in auxiliary diagnosis of biliary and vascular complications post-LT.