Alpha-1 antitrypsin deficiency-associated liver disease (AATD-LD) remains underrecognized despite its significant contribution to morbidity and mortality in adults with the PiZZ genotype. Lack of standardized definitions, diagnostic criteria, and staging impedes timely diagnosis and therapeutic development. To address these gaps, a multi-disciplinary expert panel convened under the auspices of the American Gastroenterological Association in collaboration with the American Association for the Study of Liver Diseases, European Association for the Study of the Liver, and Alpha-1 Foundation to develop consensus recommendations for nomenclature, diagnosis, staging, and clinical trial endpoints in AATD-LD.

Acute pancreatitis (AP) is an inflammatory disease with a heterogeneous clinical course, ranging from mild symptoms to life-threatening complications. The platelet-to-lymphocyte ratio (PLR), an easily accessible inflammatory biomarker, has shown prognostic value in other conditions but has been understudied in AP. This review aimed to systematically evaluate the association between PLR and AP severity.

D-dimer predicts survival in patients with digestive cancers. However, comprehensive analysis focused on gastric cancer patients is lacking. This meta-analysis aimed to investigate the association of D-dimer with survival in gastric cancer patients.

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a global public health challenge that is primarily managed through lifestyle interventions, particularly diet. This network meta-analysis aimed to thoroughly evaluate the effectiveness of four different dietary patterns: Mediterranean diet (MD), intermittent fasting (IF), Dietary Approaches to Stop Hypertension (DASH), and low-fat diet (LF) in improving liver function and metabolic profiles in adults diagnosed with MAFLD.

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects children and is increasingly prevalent alongside rising childhood obesity. The MASLD spectrum spans from simple hepatic steatosis to metabolic-associated steatohepatitis (MASH), fibrosis, and cirrhosis. Despite this rising prevalence, the optimal pharmacotherapy for pediatric MASLD remains uncertain.

Inflammatory bowel disease (IBD) is a prevalent digestive disorder, influenced by various factors, particularly dietary choices and overall diet quality. Various indices assess diet quality, yet their correlation with IBD severity and symptoms remains uncertain. This systematic review examines the relationship between IBD and diet quality, as measured by the Dietary Inflammatory Index (DII), Healthy Eating Index (HEI), and Diet Quality Index (DQI).

In the era of treat-to-target (T2T), there is an urgent need for surrogate non-invasive markers to monitor patients with inflammatory bowel diseases (IBD). Fecal calprotectin (FC), a non-invasive biomarker reflecting intestinal inflammation, holds potential for improving treatment monitoring. This narrative review aims to provide an overview of the role of FC in assessing responses to biological therapies and the new small molecules.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent chronic liver condition strongly associated with overweight or obesity, often accompanied by dyslipidemia, insulin resistance, and elevated liver enzymes. Exercise is recommended as a first-line lifestyle intervention, but evidence on the effects of different modalities, frequencies, and durations on metabolic and hepatic markers remains inconsistent. This study conducted a systematic review and meta-analysis to quantify overall effects and compare intervention strategies.

Alcohol abuse is a leading cause of global health care concerns and can cause health loss, disease, and death. In addition to the liver, the pancreas is a vital organ for the metabolism of alcohol, especially nonoxidative metabolism, and alcohol abuse is the leading cause of pancreatic diseases worldwide. Epidemiologic investigations have shown that alcohol consumption is linked to a spectrum of multiple pancreatic disorders, including acute pancreatitis, chronic pancreatitis, pancreatic cancer, and diabetes. Numerous in vitro and in vivo studies have elucidated the key mechanisms related to alcohol-induced pancreatic tissue injury in recent years. Alcohol has hazardous effects on multiple organs, destroying pancreatic acinar, ductal, stellate, and β-cells. These mechanisms, mainly mediated by alcohol and alcohol metabolites, include oxidative stress, endoplasmic reticulum stress, mitochondrial dysfunction, calcium overload, premature trypsinogen activation, inflammation, and extracellular matrix remodeling, which are complex and interrelated. A deeper understanding of these processes will open new avenues for therapeutic intervention. Although behavioral strategies, such as abstinence, remain essential, pharmacologic and molecularly targeted therapies offer potential complementary approaches. Given the challenges of maintaining sustained abstinence, these adjunctive treatments are critical for slowing or preventing the progression of alcohol-driven pancreatic diseases.

The use of ciprofol for endoscopic sedation is relatively recent; however, no definitive conclusions have been drawn regarding its optimal dose. This study evaluated the optimal ciprofol dose for sedated endoscopy using a network meta-analysis.

Pancreatic cancer (PC), a malignancy with poor prognosis, demands innovative diagnostic strategies for early detection. Current methods, such as endoscopic ultrasound and blood-based biomarkers, face limitations in accessibility, invasiveness, and accuracy, particularly for early-stage disease. Saliva, a non-invasive biofluid enriched with metabolites and proteins, offers promise as a diagnostic medium.

Unresectable advanced or recurrent gastric and gastroesophageal junction (GC/GEJ) cancers carry poor prognoses, and several programmed death-1 (PD-1) inhibitors have shown clinical activity. However, no head-to-head trial has compared their relative efficacy and safety. This network meta-analysis aimed to evaluate and rank PD-1–based regimens in this setting.

To compare the diagnostic accuracy of gadoxetate disodium enhanced MRI (EOB-MRI) and contrast-enhanced CT (CE-CT) in the detection of colorectal cancer liver metastases (CRLM).

At present, the specific mechanism by which Helicobacter pylori (H. pylori) infection leads to gastric cancer (GC) is not clear. This study aims to systematically evaluate the correlation between H. pylori infection and the risk of GC, obesity and esophageal diseases by collecting and analyzing existing relevant studies, update the existing evidence-based medical evidence, and provide evidence to inform the etiology-based prevention and treatment of GC, obesity and esophageal diseases and further clinical research.

C-reactive protein (CRP) has begun to be used in clinical practice to predict the prognosis of cancer patients, but evidence on its prognostic role remains inconsistent. We performed a systematic review and meta-analysis to investigate the prognostic value of postoperative CRP among patients with gastric cancer.

This research aimed to estimate the prognostic value of the platelet-to-lymphocyte ratio (PLR) in colorectal cancer (CRC) patients receiving chemotherapy.

Eosinophilic gastrointestinal diseases (EGIDs) are chronic inflammatory diseases driven by eosinophil-predominant pathologic infiltration in the gastrointestinal tract. The nomenclature system divides EGIDs into eosinophilic esophagitis (EoE) and non-EoE EGIDs based on whether the inflammation is restricted to the esophagus or involves other gastrointestinal segments. EGIDs are rapidly becoming a focus in gastroenterology due to a continuous increase in incidence and prevalence rates during the past 30 years and no plateau observed to date, particularly for EoE. The evolving epidemiology of EGIDs has been associated with numerous early life and environmental risk factors. The understanding of the natural history of EGIDs has also matured in recent years, with identification of a progression from inflammation to remodelling with fibrosis in EoE and recognition of mucosal, muscle layer, and serosal involvement with a continuous, progressive, or relapsing/remitting course in non-EoE EGIDs. The landscape of pharmacologic treatment for EGIDs has also expanded considerably. Proton pump inhibitors, swallowed topical corticosteroids, elimination diets, and dupilumab are currently recommended for EoE. Systemic or topical corticosteroids, elimination diets, proton pump inhibitors, and some biologic agents have shown efficacy in non-EoE EGIDs, mainly in observational studies, and several novel agents designed for EGIDs are under investigation. The present review discusses recent advances in the epidemiology, natural history, and risk factors of EoE and non-EoE EGIDs. The review also presents an update of treatment strategies according to the latest clinical guidelines and provides an overview of knowledge gaps to inform future research directions.

Previous studies have shown an increase in obesity prevalence in the inflammatory bowel disease (IBD) population. The popularity of Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RAs) has increased in recent years due to their effectiveness in weight management. In this comprehensive review, we evaluate the efficacy of GLP-1 RAs in the management of obesity in patients with IBD.

This American Gastroenterological Association (AGA) living guideline is intended to support practitioners in the pharmacologic management of moderate-to-severely active Crohn's disease (CD).

The rapid development of therapies for eosinophilic esophagitis (EoE), particularly involving biologics and small molecules, has prompted questions about their roles within current treatment algorithms. We aimed to examine the relative efficacy of novel biologics, small molecules and topical steroids by evaluating clinical, endoscopic, and histological improvements.