Inflammatory bowel disease (IBD), comprising Ulcerative Colitis and Crohn's disease, represent a chronic condition of the gastrointestinal tract characterized by an immunological alteration and weakening of mucosal barrier. Mucosal healing and inflammation resolution have emerged as critical therapeutic goals, strongly associated with sustained remission and improved clinical outcomes. Over the years, numerous studies have explored various therapeutic strategies, with increasing focus on biologics and small molecules. One of the emerging immunological targets in IBD is the interleukin 33 (IL-33) / suppression of tumorigenicity 2 (ST2) axis, which exhibits both proinflammatory and anti-inflammatory functions. Evidence from in-vitro and in-vivo studies highlights the involvement of IL-33/ST2 signaling in epithelial regeneration and mucosal healing, but also in pathogenesis of the disease. Several approaches to modulate this axis have been explored, including monoclonal antibodies, receptor antagonists, and small molecules. Concurrently, in-silico molecular design represents a promising strategy for identifying novel therapeutic agents. In particular, numerous computer-aided drug design (CADD) studies have focused on the IL-33/ST2 complex and its role in maintaining intestinal barrier function. This review provides a comprehensive overview of the IL-33/ST2 axis in IBD, on mucosal healing and potential modulation strategies, such as computational approaches.

The combination of hepatitis B immunoglobulin (HBIG) and high-barrier nucleos(t)ide analogues (hbNUCs) is widely considered the standard of care for preventing hepatitis B virus (HBV) recurrence after liver transplantation (LT). However, clinical practices in Italy remains heterogenous, particularly regarding HBIG dosage, administration intervals, formulation choice, and selection of patients eligible for hbNUCs monotherapy or short-course HBIG regimens. This modified Delphi panel aimed to characterize current Italian practices for HBV prophylaxis after LT, focusing on patient risk stratification and HBIG management.

The oncologic safety of laparoscopic-assisted surgery for synchronous colorectal cancer (SCRC), a distinct high-risk subgroup, remains under-investigated. This study aimed to compare the short-term and long-term outcomes of laparoscopic-assisted versus open surgery for SCRC.

The aim of this study was to evaluate the potential role of intestinal ultrasound scan (IUS) in predicting short-term treatment outcomes in pediatric acute severe ulcerative colitis (ASUC).

Neural networks constitute a crucial component of the tumor microenvironment that remains underexplored in pancreatic carcinogenesis. This study systematically investigated the reciprocal interactions between acinar-to-ductal metaplasia (ADM) and neural remodeling during pancreatic ductal adenocarcinoma (PDAC) initiation and progression.

Molecular phenotyping of Crohn's disease (CD) trajectories after ileocolonic resection (ICR) enables the identification of evolving disease mechanisms and related biomarker discovery. Here, we aimed at identifying a pathogenic node with predictive value for endoscopic disease recurrence after ICR in CD.

Adverse experiences during early life can disrupt gut-brain axis development, but the mechanisms linking early life stress (ELS) to long-term gastrointestinal dysmotility and pain remain unclear.

Entecavir (ETV), tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) are widely used in the treatment of chronic hepatitis B (CHB). This study aimed to investigate the blood lipid profile of CHB patients using these three drugs.

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.

The American Gastroenterological Association gathered a group of interdisciplinary experts to develop an updated Clinical Care Pathway on how to best screen for, diagnose, and treat metabolic dysfunction-associated steatotic liver disease. The complementary clinical application was also updated to reflect the changes in the clinical guidance: MASLD/MASH Clinical Care Pathway mobile application at gastro.org/MASLD.

Cirrhosis is associated with significant risk of comorbidity and early mortality. Low physical function is common in patients with cirrhosis and could predict prognosis. Cardiorespiratory fitness (CRF), determined by maximal exercise with gas exchange measurement, has proven to predict the risk of mortality and disability in other chronic diseases. In patients with cirrhosis, it could help to inform prognostic stratification to improve care and management in clinical practice. This systematic review aims to determine the association between CRF (VO2Peak, percentage of predicted VO2Peak, Anaerobic Threshold (AT)) and mortality prediction, as well as morbidity prediction in cirrhosis.

Post-pancreatectomy diabetes (type 3c diabetes) is a frequent consequence of pancreatic cancer surgery and is characterized by extreme glycemic variability, high risk of severe hypoglycemia, and a substantial impact on quality of life and nursing workload. Technological solutions such as continuous glucose monitoring (CGM) and closed-loop insulin delivery may help address these challenges.

A substantial proportion of patients with adenomatous polyposis have no germline pathogenic variant in APC. The aim of this study was to determine the prevalence of APC mosaicism in these patients with unexplained polyposis and to draft guidelines for APC mosaicism testing and surveillance.

We aimed to identify dietary and gut signals during Crohn's disease (CD) remission that differ from the healthy state to highlight targets that may improve disease control and clearance.

Evidence about the effect of artificial intelligence (AI) on upper endoscopy in multicenter, randomized controlled trials is lacking. We aimed to explore whether AI can enhance gastric neoplasm detection.

To identify independent relevant factors for chronic kidney disease (CKD) in patients with metabolic dysfunction-associated fatty liver disease (MAFLD) and to develop and validate a nomogram-based risk diagnostic model for MAFLD-CKD incorporating liver stiffness measurement (LSM).