Inflammatory bowel disease (IBD) manifests systemically, yet most comorbidity studies rely on predominantly European populations. The All of Us Research Program enables investigation across demographically diverse groups.

Inverted colonic diverticulum (ICD) is a rare endoscopic finding that often mimics a sessile polyp or submucosal tumor, increasing the risk of misdiagnosis and inappropriate intervention. Accurate identification is crucial to avoid potential complications such as perforation. This case is notable for its unusual location in the cecum and its initial misdiagnosis as a gastrointestinal stromal tumor (GIST).

Liver biochemical and function tests-alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, bilirubin, prothrombin time, and albumin-are used to screen and identify people with acute and chronic liver disease. Elevations in alanine aminotransferase and aspartate aminotransferase reflect hepatocellular injury, with more urgent evaluation required when the international normalized ratio of prothrombin is prolonged and the bilirubin level elevated. An elevation in alkaline phosphatase reflects a cholestatic process and impaired bile flow. Bilirubin may be elevated with either hepatocellular or cholestatic injury. Albumin, prothrombin time, and bilirubin are tests of hepatic function. Evaluation of abnormal liver tests includes history taking with attention to metabolic risk factors, alcohol, medication, and herbal/dietary supplement, followed by an examination, to determine the etiology of liver injury, acuity of illness, and presence of complications. Abdominal imaging provides information regarding liver morphology, steatosis, biliary dilatation, and portal hypertension. Elastography provides information about fibrosis and steatosis. If no explanation for abnormal liver tests can be determined, extrahepatic causes should be investigated. Liver tests used in the estimation of hepatic fibrosis include the fibrosis-4 index and aspartate aminotransferase-to-platelet ratio index. Many proprietary tests of hepatic fibrosis incorporate liver biochemical tests. Liver tests may also be used in the assessment of prognosis, particularly in people with cirrhosis, alcohol-associated liver disease, and metabolic dysfunction-associated steatotic liver disease. Liver test elevations in critically ill patients often reflect severe hepatocellular injury, whereas liver test elevations often indicate hepatotoxicity in people receiving chemotherapy and immune checkpoint inhibitors. With the availability of many approaches to assessing the diagnosis and severity of liver disease, the role of liver biopsy has become more limited.

Constipation affects about 25% of the general population, with higher prevalence in elderly people. Many of the products used for the treatment of constipation, laxatives and drugs with this indication have undesirable effects such as dehydration, electrolyte disturbances and diarrhea or side effects that, in frail patients with comorbidities, such as the elderly, can have clinically significant consequences. For these reasons, the treatment of chronic constipation constitutes, especially in the elderly patient, a partial unmet medical need.

Endoscopic retrograde appendicitis therapy (ERAT) and its visually enhanced technique (Endoscopic direct appendicitis therapy, EDAT) represent a novel minimally invasive approach, offering advantages such as high-definition real-time visualization and precise intervention. This article reports a case of a 49-year-old male with acute appendicitis accompanied by an early abscess. CT findings suggested appendicitis with abscess formation, while EDAT exploration confirmed perforation at the appendiceal tip along with adjacent fecalith impaction, further verified by contrast imaging. During the procedure, the fecalith was extracted via EDAT, followed by irrigation of the purulent cavity and placement of a modified 7 Fr × 7 cm pancreatic stent for drainage. The patient experienced immediate symptom relief postoperatively, with serial follow-up CT scans on the procedure day, 3rd, and 7th postoperative days demonstrating gradual abscess resolution and normalized inflammatory markers, leading to discharge on day 3. A subsequent 3-month telephone follow-up revealed no recurrence of abdominal pain. This case illustrates that EDAT/ERAT can provide integrated diagnosis and definitive management for complicated appendicitis, avoiding the trauma associated with surgical intervention and offering valuable clinical insights.