The past decade has witnessed a tremendous profusion of data on the luminal contents of the gastrointestinal tract and their interactions with the host, many of which have been implicated in the pathophysiology of Disorders of Gut-Brain Interaction (DGBI). The role of food in DGBI-related symptoms has attracted much attention and while many alterations in gut microbiome composition have been described, the multitude of factors that confound study design and interpretation in DGBI has precluded the discovery of a specific microbial "signature". The complexities of the gut barrier, its immune and enteroendocrine systems, so critical to the transmission of signals from lumen to host, continue to be revealed. Along the way, concepts such as the microbiome-gut-brain axis have emerged to explain symptom generation in DGBI, forming the basis for novel diagnostic approaches and therapeutic interventions. Taken together, recent research findings have renewed interest in luminal and enteric phenomena in DGBI.

We identify three centrally mediated disorders of gastrointestinal pain in the context of epidemiology, pathophysiology, clinical evaluation and treatment, including pharmacotherapy, brain-gut behavioral therapy and neuromodulation, with emphasis on the importance of a physician-patient relationship. Centrally mediated abdominal pain syndrome is characterized by chronic continuous abdominal pain. It has two main categories: Category A, where the pain occurs without association with physiological events, while in Category B, there is a variable association of pain with physiological events. It is thought to be predominantly a result of central sensitization with altered processing of visceral pain by spinal and brain networks rather than heightened peripheral afferent nerve excitability. Abdominal migraine is newly recognized in adults with paroxysmal, stereotypical episodes of intense abdominal pain. Narcotic bowel syndrome/opioid-induced gastrointestinal hyperalgesia is characterized by the paradoxical development of, or increases in, abdominal pain associated with continuous or increasing dosages of opioids.

Gastric bronchogenic cyst constitutes a rare form of ectopic bronchogenic cyst, with an estimated incidence of less than 1 in 68,000 to 1 in 42,000. This study reported a case who was preoperatively misdiagnosed as gastrointestinal stromal tumor and reviewed the literature on gastric bronchogenic cyst to summarize its clinical features, diagnosis, treatment, pathological manifestations, and prognosis.

Multimodal profiling of inflammatory bowel disease (IBD) patient tissue and blood samples has revealed the disease spectrum in unprecedented detail, and cellular and molecular correlates of disease severity and outcome in IBD have been elaborated. Incorporating these in the clinical setting would offer a unique opportunity to increase the granularity of current clinical measures and to better assess treatment response. Remission and healing at a cellular/molecular level are also likely to have predictive value for long-term outcomes. Here, we outline a path forward to implementing the most promising molecular disease descriptors as future clinical treatment targets in IBD. We focus on the concept of cellular/molecular measures of inflammation, remission, healing, response to therapy, and target pathway engagement. Monitoring mode-of-action-specific pharmacodynamic modules in the context of disease-related resolution pathways will guide assessment of novel and existing therapies. Artificial intelligence-assisted tools will be key to enabling this development, improving reproducibility, limiting costs, and delivering fast detection.

To systematically evaluate the safety and efficacy of 2 L polyethylene glycol (PEG) versus 3 L PEG in bowel preparation for colonoscopy, and to assess whether 2 L PEG can serve as a safe and effective standard regimen.

The evidence considering the potential protective impact of statins on the mortality rate caused by colorectal cancer (CRC) is controversial. This study aimed to systematically assess the effect of statins on the survival rate of CRC patients.

Endoscopic ultrasound (EUS) has evolved from a diagnostic method for staging tumors and diagnostic tissue acquisition to a technology that has revolutionized minimally invasive endoscopic care across the disease spectrum. Recent years have witnessed a rapid advance in the number and types of procedures that are performed and in the devices that are designed to deliver EUS-guided interventions. These advances offer safer, less-invasive alternatives to traditional therapies and define disruptive technologies that are impacting patient care. The purpose of this review is to discuss the state of the art in therapeutic EUS procedures, focusing on current advances that are transforming endoscopic patient care.

Metabolic associated fatty liver disease (MAFLD), a leading cause of chronic liver disorders globally, is closely linked with the dysbiosis of the gut. These microbial imbalances contribute to pathogenesis of MAFLD through intestinal barrier dysfunction, systemic inflammation, and hepatic fat accumulation. This review aims to provide an in-depth analysis of the complex interaction between the gut microbiome and MAFLD, through literature search of articles published in open access journals of two electronic data bases PubMed, Medline from January 2015 to May 2025. Among 602 publications identified initially, 54 studies were considered based on inclusion and exclusion criteria as per the PRISMA guidelines. The results assimilate the findings from both preclinical models and human clinical trials, highlighting the influence of probiotic strains on key metabolic pathways. Lactobacillus and Bifidobacterium species were shown to regulate lipid metabolism, normalize liver enzyme activity, reduce insulin resistance, and attenuate hepatic inflammation. These effects are mediated through multiple mechanisms, including enhancement of gut barrier integrity, modulation of bile acid metabolismsuppression of endotoxemia and modulation of gut–liver axis. By summarizing emerging insights, this review offers an updated perspective on the role of probiotic interventions as a promising adjunct strategy in the prevention and management of MAFLD.

Coeliac disease (CD) is a chronic, immune-mediated enteropathy triggered by gluten ingestion in genetically predisposed individuals carrying HLA-DQ2 and/or -DQ8 alleles. Its diagnosis traditionally combines serology and confirmatory duodenal biopsy. IgA anti-tissue transglutaminase is the first-line test, supported by endomysial antibody. Duodenal histology remains the gold standard, though limitations include patchy involvement and variability in interpretation. Recent advances have proposed biopsy-sparing approaches, whereas applicability in adults remains debated. Moreover, CD is increasingly recognized in association with autoimmune conditions, including type 1 diabetes mellitus and autoimmune thyroid disease, underscoring the importance of proactive screening. However, distinguishing true CD from potential CD or false-positive serology requires careful clinical integration and, often, biopsy confirmation. Mass screening appears to demonstrate high yield and potential cost-effectiveness compared with case-finding. However, evidence is emerging and not yet definitive, and its implementation remains limited. For patients already on a gluten-free diet, gluten challenge protocols combined with HLA genotyping enhance diagnostic accuracy. Overall, while duodenal biopsy is still pivotal in most guidelines, evolving evidence supports a tailored, less invasive approach that integrates serology, genetics, histology, and novel diagnostics to improve early detection and management of CD.

Laryngopharyngeal reflux (LPR) is reflux of gastric contents proximal to the upper esophageal sphincter and leading to a variety of symptoms including cough, dysphonia, globus, and sore throat. There is currently no diagnostic gold standard for LPR which often leads to over or under diagnosis and complicates therapeutic approach to this group of patients. This uncertainty has led to a high economic burden of the disease. The goal of this review was to present current recommendations in the diagnosis and treatment of LPR to aid in clinical decision making. There has been emerging research regarding the role of laryngeal hypersensitivity, mediated through neuronal hyperresponsiveness, autonomic dysfunction and symptom hypervigilance. Diagnosis remains a challenge, but novel biomarkers show promise. Therapeutics involve the consideration of acid suppression with an increasing emphasis on neuromodulators and external compression devices. There remains a great need for further research on both diagnostic and therapeutics to develop a gold standard for this disease.

Metabolic syndrome (MetS) is a complex and multifactorial condition that represents a major global health challenge. It is characterized by a cluster of interrelated metabolic abnormalities, including central obesity, insulin resistance, dyslipidemia, and hypertension, all of which substantially increase the risk of developing type 2 diabetes mellitus, cardiovascular diseases, and other related complications. Growing evidence underscores the pivotal role of the gut microbiota in regulating host metabolism, modulating immune responses, and influencing the chronic low-grade inflammatory state associated with MetS. Among emerging therapeutic approaches, synbiotics, defined as synergistic combinations of probiotics and prebiotics, have attracted considerable interest. Therefore, in the present narrative review, we aim to find out the feasibility and effectiveness of synbiotic supplements, as well as to evaluate their impact on people with MetS. By selectively stimulating the growth and activity of beneficial microbial taxa while directly introducing health-promoting strains, synbiotics may restore microbial balance, improve metabolic homeostasis, and attenuate inflammatory pathways. Future research should prioritize personalized nutrition strategies and microbiome-tailored interventions, taking into account individual variability in gut microbial composition and host metabolic responses. Such precision approaches could optimize synbiotic efficacy and safety, positioning them as a viable adjunctive treatment for MetS within an integrated lifestyle and pharmacological framework. Ultimately, large-scale, high-quality randomized controlled trials are essential to confirm current promising findings and to establish clear guidelines for clinical application.

Patients with inflammatory bowel disease (IBD) often require hospitalization for medically refractory IBD or IBD-related complications. However, despite the increasing availability of effective medical therapies, inpatient IBD care remains challenging, as evidenced by the variation in hospital-acquired complications, delays in surgery, and high 30-day readmission rates. Therefore, this Clinical Practice Update Expert Review is intended to provide Best Practice Advice on the evaluation and management of hospitalized adult patients with IBD. We have developed Best Practice Advice statements to address 13 key clinical issues.

Very early onset inflammatory bowel disease (VEO-IBD) is a rare, severe condition with over 80 monogenic causes. These often resist conventional therapies, necessitating targeted treatments such as biologics and hematopoietic stem cell transplantation (HSCT). This study aimed to systematically review therapeutic outcomes.

Developing inflammatory bowel disease (IBD) affects platelet counts (PLT), which are involved in blood coagulation. However, the predictive or diagnostic utility of platelet characteristics in assessing IBD disease activity of inflammatory bowel disease. We conducted thisremains unknown. This meta-analysis was conducted to quantitatively evaluate changes in platelet parameters during the active phase of IBD using a large sample size.

Pancreatitis, a debilitating disease, is orchestrated by many etiological factors. Besides the known causal genes, including PRSS1, SPINK1, CPA1, CFTR, etc., of late, TRPV6 has emerged as a new candidate in the list. We aimed to investigate the role of TRPV6 and its genetic variations in the etiopathology of pancreatitis.

Laparoscopic repair of gastroduodenal perforation has been widely used in clinical practice. With the advent of barbed sutures, the position of traditional absorbable sutures has been challenged, but the superiority of one over the other in terms of clinical outcomes remains unclear.

Endoscopic ultrasound (EUS) has evolved from a diagnostic imaging tool into a versatile platform that enables high-precision access, sampling, and therapy across gastrointestinal and hepatobiliary diseases. This review summarizes recent advances that are reshaping diagnostic practice and theragnostics. In chronic pancreatitis, EUS remains central when cross-sectional imaging is equivocal; secretin-stimulated endoscopic pancreatic function testing can complement morphology, although discordant results limit standalone certainty. For pancreatic cancer, secretin-stimulated duodenal pancreatic-juice collection enables "liquid biopsy" analyses-including methylated DNA markers and extracellular-vesicle microRNAs-that augment carbohydrate antigen 19-9 and may enhance early detection and cyst surveillance. In endohepatology, EUS-guided portal pressure gradient measurement and liver biopsy offer accurate, same-session assessment with strong safety profiles. Adjunctive imaging-contrast-enhanced EUS and elastography-improves lesion characterization and targeting. Tissue acquisition has shifted toward end-cutting fine-needle biopsy needles, optimized by fanning/torque techniques, wet-suction, and macroscopic/visual on-site evaluation, reducing passes while preserving molecular adequacy. Artificial intelligence is emerging across workflows-from differentiating pancreatic lesions and staging to automating standardized photodocumentation and reporting-and is being explored for needle-based confocal laser endomicroscopy image interpretation. For pancreatic cysts, glucose, selected genomics (eg, KRAS/GNAS and targeted panels), and through-the-needle biopsy refine diagnosis. Finally, EUS-obtained tissue now seeds organoids, patient-derived xenografts, and organotypic slice cultures to test individualized therapies. Collectively, these innovations move EUS beyond "see and biopsy" toward detect, predict, and personalize.

Inflammatory bowel diseases (IBD) are chronic inflammatory conditions of the gastrointestinal tract. Clinical studies of IBD robustly show elevated interleukin 1β (IL-1β) levels in intestinal tissue, implicating the NLR family pyrin domain containing 3 (NLRP3) inflammasome, which controls IL-1β secretion in myeloid cells. In this study, we aimed to ground potential NLRP3 involvement in IBD in molecular evidence from human studies.

Few studies describe gut microbiome signatures in treatment-naïve new-onset inflammatory bowel disease (IBD). We present a novel secondary bioinformatic reanalysis of sequence outputs mapped to the latest microbial taxonomy.

Hepatopancreatobiliary (HPB) diseases, encompassing hepatobiliary and pancreatic disorders, pose substantial global health challenges due to their high morbidity and mortality rates. Recent research highlights the crucial role of the biliary microbiome in the development of these diseases.