Fabry disease is a rare X-linked lysosomal storage disorder that affects multiple organ systems, including the gastrointestinal tract. The aims were to characterize the prevalence, characteristics, and severity of gastrointestinal symptoms in patients with Fabry disease compared to the general population, and to investigate the relationships between these gastrointestinal symptoms with clinical outcomes, including disease severity (DS3), health-related quality of life, psychological distress, and pain.

To develop a CT-based decision tree model integrating clinical and imaging features for the preoperative differentiation of gastric ectopic pancreas (GEPs) and gastrointestinal stromal tumors (GISTs) with a maximum diameter of less than 3 cm.

Metabolic dysfunction-associated steatotic liver disease (MASLD) frequently coexists with chronic kidney disease, which may exacerbate adverse outcomes. The albumin-to-creatinine ratio (ACR), an established marker of renal damage, has been associated with mortality risk in this population, yet its prognostic value and potential role in related pathways remain unclear.

Transarterial chemoembolization (TACE) is a standard treatment for unresectable hepatocellular carcinoma (HCC). However, a significant proportion of patients develop conventional TACE (cTACE) refractoriness, which is associated with poor prognosis. The optimal treatment strategy for cTACE-refractory HCC remains controversial. This study aimed to evaluate the efficacy and safety of drug-eluting bead TACE (D-TACE) combined with lenvatinib versus cTACE plus lenvatinib in patients with cTACE-refractory HCC.

The global burden of colorectal cancer (CRC) has been steadily rising. However, a key knowledge gap persists regarding the HBMI-attributable burden in early-onset (EOCRC) versus late-onset (LOCRC) cases. The temporal patterns, geographic heterogeneity, and comparative trends remain poorly characterized, as prior studies often lack stratification by age of onset and detailed analysis across socio-demographic strata.

This study examined the link between red cell distribution width - coefficient of variation (RDW-CV) levels, colon cancer, and all-cause mortality in the community population.

Lesions manifesting after radiotherapy are difficult to treat. Significant inflammations often manifest at the rectal wall after radiotherapy, the rectal wall often experiences significant inflammation, and the intestinal cavity is typically in an edematous state.

Esophageal foreign bodies, especially fish bones, are common emergencies that may require surgery like thoracotomy. Psychological impacts such as pain and anxiety are often overlooked. This study explores patients’ psychological experiences during diagnosis, treatment, and recovery to inform effective interventions and improve outcomes.

In-hospital bleeding increases hospital stays and mortality. Prolonged mechanical ventilation and coagulopathy are known risk factors. Helicobacter pylori (H. pylori) is associated with upper gastrointestinal bleeding (UGIB), but its role in hospitalized patients remains unclear.

Despite widespread biologic use, more than 70% of patients with Crohn's disease require resectional surgery, most commonly of the terminal ileum. Gene expression and genetics of the neoterminal ileum at postoperative, surveillance colonoscopies highlight pathways of disease recurrence. Postoperative colonoscopy transcriptomes were interrogated to evaluate the hypothesis that specific molecular mechanisms contribute to recurrent Crohn's pathophysiology.

Acute pancreatitis (AP) is common and clinically complex, and persistent renal failure (PRF) is a severe complication. This study retrospectively analyzed 798 AP patients admitted within three days of onset and divided them into a PRF group (n = 111) and a non-PRF group (n = 687), comparing the characteristics of the two groups. Multivariate analysis showed that lactate (β = 0.340, P < 0.001, OR = 1.405) and lactate dehydrogenase (LDH, β = 0.002, P < 0.001, OR = 1.002) were significant risk factors for PRF. Stratified analysis indicated that patients with LDH ≥ 700 U/L and lactate ≥ 2 mmol/L had a higher incidence of PRF. The ROC curve analysis showed that the areas under the curve for lactate, LDH, and the combined lactate + LDH were 0.752, 0.828, and 0.866, respectively, with the highest diagnostic accuracy for the combined indicator. The characteristics of different risk groups showed that the incidence of PRF in the high-risk group was significantly higher than that in the low-risk group. The levels of lactate and LDH within 24 h of admission have a significant predictive effect on PRF in AP patients, which helps clinicians identify high-risk patients early and guide treatment decisions.

Indirect calorimetry (IC) is the gold standard for determining energy requirements. Resting energy expenditure (REE) equations could noninvasively estimate energy requirements in healthy individuals. Whether the published equations could accurately predict the REE of adults with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) remains unclear. Here, we aimed to investigate the accuracy of predicted REE in patients with NAFLD and T2DM using different equations.

Slow transit constipation (STC), a subtype of functional constipation characterized by delayed colonic transit (> 72 h), imposes substantial physical and psychological burdens.

Non-anemic iron deficiency is common in patients with ulcerative colitis; however, it may be underestimated and untreated, negatively impacting the quality of life. Therefore, this study aimed to investigate factors associated with non-anemic iron deficiency in Japanese patients with ulcerative colitis.

This evidence-based practical review is focused on the clinical features, investigations, and treatment of hemorrhoids, chronic anal fissures, dyssynergic defecation (DD), and fecal incontinence (FI), which are arguably the most common benign anorectal diseases encountered by gastroenterologists. These diseases are associated with bowel disturbances, which should be evaluated preferably with questionnaires, and with anal weakness and/or DD, often evident on a thorough digital rectal examination. Fissures and DD are closely linked to constipation, whereas FI is typically associated with diarrhea. For most patients with mild symptoms, lifestyle changes, dietary adjustments, and/or pharmacotherapy suffice. Some patients require tests to rule out serious diseases; assess anorectal functions, which are discussed in detail; and to identify structural abnormalities, such as rectoceles, which are occasionally clinically significant. Treatments are applied stepwise, starting with conservative therapy with simpler treatments when feasible (eg, rubber band ligation for grade I-II hemorrhoids), with surgery, usually excisional hemorrhoidectomy, being reserved for more severe disease; for anal fissures, topical therapy using a calcium channel antagonist or nitroglycerine, followed by botulinum toxin and, less frequently, lateral internal sphincterotomy for chronic fissures. Anorectal biofeedback therapy is effective for managing DD and, together with bowel modifiers tailored to the specific symptoms (ie, constipation and/or diarrhea), is also used for FI. Biofeedback therapy is not widely accessible, and many patients are treated by pelvic floor physical therapists. For FI, minimally invasive options include sacral neuromodulation and anal dextranomer injection, with colostomy or anal sphincteroplasty now rarely required. Surgical interventions must balance long-term effectiveness with potential risks. Key topics for future research are proposed.

Although Helicobacter pylori screen-and-treat has demonstrated effectiveness in preventing gastric cancer (GC), the impact on other diseases, such as peptic ulcer disease (PUD), dyspepsia, and gastric lymphomas, is often overlooked in guidelines and policy-analyses. This study quantifies the disease burden attributable to H pylori beyond GC.

Serum alpha-fetoprotein (AFP) is a key component of hepatocellular carcinoma (HCC) screening, but its test characteristics are uncertain as alcohol-associated liver disease (ALD) and metabolic dysfunction-associated steatotic liver disease (MASLD) rates increase.

Neuroendocrine tumors (NETs) represent a heterogeneous group of neoplasms with diverse biological and clinical behavior, and gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are the most common subtype. This review provides an overview of GEP-NETs, with a focus on incidence trends, pathologic classification, diagnostic strategies, therapeutic advances, and the role of endoscopy in diagnosis and management of GEP-NETs. Incidence rates of GEP-NETs have significantly increased over recent decades, largely due to improved diagnostic modalities and increased use of endoscopy, although environmental factors may be at play as well. Pathologic grading and classification, based on the 2022 World Health Organization criteria, remain essential in defining prognosis and therapeutic options, and advanced imaging modalities like somatostatin receptor positron emission tomography scans enable precise localization and staging. Therapeutic approaches vary by tumor grade, stage, and localization, from an increasing role for endoscopic management of indolent tumors to surgical resection for certain higher-risk subtypes and for resectable metastatic disease. Novel treatments, including somatostatin analogs, radioligand therapy, mammalian target of rapamycin inhibitors, and antiangiogenic agents, have shown significant efficacy in advanced and metastatic disease. Future research is needed to identify molecular markers to refine diagnostic accuracy and personalize treatment strategies, thereby improving long-term outcomes for GEP-NET patients. Additionally, research is needed to better define GEP-NET subtypes that are appropriate for endoscopic therapy as well as to understand long-term outcomes after endoscopic resection. Given the important role that endoscopy has in the diagnosis and management of GEP-NETs, increased recognition of and knowledge about these tumors is critical for the gastroenterology community.

Functional constipation is a common disorder of the gut-brain interaction characterized by infrequent bowel movements and hard stools, which substantially affects patients' quality of life. Supplementation with gut microbiome-targeted prebiotics is a promising non-pharmacological alternative to current treatments.

Previous studies have typically focused on the effect of high preoperative serum creatinine (SCr) levels on the prognosis of hepatocellular carcinoma (HCC) patients but have often ignored the role of low SCr levels. This study aimed to assess the impact of low SCr levels on HCC patient prognosis.