About 50% to 75% of patients with Crohn's disease (CD) need bowel resection. Postoperative recurrence of CD is frequent. Here, we investigate the evolution of the mucosa-associated microbiota along the Rutgeerts score measuring endoscopic recurrence after surgery.

Secondary loss of response to ustekinumab is observed in patients with Crohn's disease (CD). Multiple dose-intensification regimens have been proposed. We aimed to test prospectively 2 different dose-intensification regimens with ustekinumab in patients with CD experiencing secondary loss of response.

Despite considerable advancements in recent decades, mortality and complications following liver resection remain high. The volume-outcome relationship has been the subject of extensive research and offers relevant potential for improvement of surgical outcomes. This review aims to examine the impact of hospital and surgeon volume on patient-relevant outcomes in liver resections and synthesize the available evidence.

Irritable Bowel Syndrome (IBS) is a highly prevalent, chronic disorder of the Gut-brain interaction associated with a high healthcare utilization burden. The treatment of IBS remains challenging due to numerous treatment options and heterogeneity in IBS symptoms. Therefore, for effective decision-making, insight into management strategies and treatment preferences of both patients and physicians is important. In our previous study, the most-preferred treatment among IBS patients was dietary intervention, subsequently pharmacotherapy and psychotherapy. However, the preferences of physicians remain unclear.

Glucagon-like peptide-1 (GLP-1) receptor agonists have metabolic and hepatic benefits in metabolic dysfunction–associated steatotic liver disease (MASLD), but their additive benefit compared to lifestyle modification only in real-world settings remains uncertain. This study compared the effects of GLP-1 agonist therapy and physical activity on body mass index (BMI) and noninvasive liver metrics in a predominantly Hispanic clinical population with MASLD.

Patients with familial adenomatous polyposis (FAP) are at increased risk of several gastrointestinal and extraintestinal cancers. Although prophylactic surgery has reduced colorectal cancer (CRC) incidence, the lifetime incidence of other cancers has increased. This study assessed the cumulative risks in Dutch FAP patients over the past decades.

Phosphatidylethanol (PEth) is a direct, objective alcohol biomarker for detecting excessive alcohol use in steatotic liver disease, including metabolic dysfunction and alcohol-associated liver disease (MetALD) and alcohol-associated liver disease (ALD). However, its use in routine clinical practice may be limited by cost and accessibility. This study aimed to develop a novel, accurate, and scalable indirect alcohol biomarker panel to screen for MetALD-ALD in general population settings.

In diagnosing type 1 autoimmune pancreatitis (AIP), serum IgG4 (sIgG4) can be false-negative. EUS-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) pathology is key for diagnosis, but clinical features’ impact on pathologic confirmation is unclear. This study analyzed their link and factors improve diagnostic accuracy.

To understand the heterogeneity of single-B cell responses to Metabolic Dysfunction-Associated Steatohepatitis (MASH), we performed Single-cell RNA sequencing (scRNA-seq) on single-B cells isolated from control and MCD-fed mice livers. Subsequent analyses included clustering, identification of differentially expressed genes (DEGs) and enrichment analysis. The expressions of high specific DEGs were validated using quantitative real-time PCR (qRT-PCR), immunofluorescence staining and function study. Four single-B cell clusters (3, 14, 16 and 20) were identified. The total number and proportion of B cells significantly decreased in MASH mice livers. In cluster 3, the decreasing Fcer2α+ mature B cells were supposed with anti-inflammatory role associated with B cell activation and differentiation of other immune cells in MASH. The DEGs (Fcer2α, Cd22, Cr2 and Fcmr) of cluster 3 were consistently downregulated in B cells cocultued with lipotoxic hepatocytes. And the portal area of livers contained fewer Fcer2α+ B cells in MASH patients and mice compared with controls. Fcer2α+ B cells attenuated lipotoxicity-driven inflammation by enhancing anti-inflammatory factor (IL-10, IL-35) secretion and inhibiting T cell inflammatory factor (IFN-γ, TNF-α, IL-17) production and proliferation. The other 3 clusters (14, 16 and 20) contained small numbers of single-B cell. Tnfrsf17+ plasmacytes (PCs) of cluster 14 were identified with the effect related to endoplasmic reticulum stress and N-Glycan biosynthesis. Klk1+ B cells of cluster 16 were implicated in regulating immune response in MASH. Apol7c+ B cells of cluster 20 participated in apoptosis, NF-κB, TNF and JAK-STAT signaling pathway in MASH. Thus, a subgroup of Fcer2α+ mature B cells, diminished in MASH, may exerted anti-inflammatory or immunosuppressive effects.

Stress-related gastric ulcer (SRGU) is a common complication among critically ill patients, and inappropriate use of stress ulcer prophylaxis (SUP) remains a global challenge in hospitalized populations.

This meta-analysis evaluates the prognostic significance of the Prognostic Nutritional Index (PNI) in colorectal cancer (CRC) patients, focusing on overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS).

Gastric cancer (GC) incidence in older adults is usually higher than in the general population. Whereas surgical resection accompanied by an extended lymphadenectomy is the current standard treatment for GC, the impact of the extent of lymphadenectomy on survival in older adult patients has not been sufficiently studied and may be associated with a higher rate of complications in this group of patients.

Liver fibrosis is a common outcome of chronic liver disease, characterized by accumulating extracellular matrix proteins. Aims: While the gold standard in the assessment of liver fibrosis remains liver biopsy, non-invasive methods have been increasingly used for estimating liver fibrosis. This study aims at contributing to our understanding of the role of leptin,vitamin D, APRI, and FIB-4 in the progression of liver disease. For this purpose, we evaluate the clinical significance of leptin, vitamin D, APRI, and FIB-4 in cirrhotic patients with different ratios of steatosis and in cirrhotic pateints with different grades of hepatocellular carcinoma. We compare the performance of simple biochemical scores (FIB-4 and APRI) with leptin and vitamin D. Also, We identified the proteins in the serum of liver fibrosis and showed the role of these proteins in the pathogenesis of liver fibrosis. Also, we identified the relationship between leptin and vitamin D with extracellular matrix proteins using bioinformatics analysis.

The optimal timing for direct endoscopic necrosectomy (DEN) after endoscopic ultrasound (EUS)-guided transmural drainage of symptomatic necrotizing pancreatitis remains unknown. We hypothesized that immediate DEN after EUS-guided drainage might reduce the time to disease resolution compared with a drainage-oriented step-up approach.

Anastomotic stricture (AS) is a common complication following low-level anastomosis of the colon and rectum in rectal cancer (RC) surgery. The aim of this study is to evaluate whether intraoperative stay sutures combined with postoperative anal dilatation reduce the incidence of AS after low anterior resection with defunctioning stoma.

This article defines diagnostic criteria, and reviews clinical evaluation and management of fecal incontinence, anorectal pain, dyssynergic defecation (DD), and rectal hyposensitivity and hypersensitivity. Diagnostic evaluation includes anorectal manometry, balloon expulsion test (BET), anal ultrasound, magnetic resonance imaging, defecography and neurophysiology testing. FI is defined as recurrent uncontrolled passage of fecal material for 3 months. Management includes antidiarrheals, Kegels exercise, biofeedback therapy, dextranomer injection, surgery, sacral nerve stimulation and translumbosacral neuromodulation therapy (TNT). Anorectal pain lasting seconds to minutes is defined as proctalgia fugax whereas pain lasting more than 30 minutes with puborectalis tenderness is defined as levator ani syndrome. Biofeedback and TNT may be useful. DD is defined by both symptoms of difficult defecation and objective evidence of dyssynergia. Biofeedback therapy is efficacious in DD. Rectal sensory disorders are defined by both anorectal symptoms and increased (hyposensitivity) or decreased (hypersensitivity) sensory thresholds during rectal balloon distension, and sensory biofeedback is useful.

This article describes the development of the Rome V adult and pediatric diagnostic questionnaires. Important updates from the Rome IV versions included improved response scaling, new questions to diagnose 3 additional adult DGBI and 14 additional pediatric DGBI (compared to the Rome IV questionnaires), extra questions to clarify the context of DGBI symptoms for research purposes, and the addition of anatomical images to enhance response accuracy. The performance of the Rome V adult questionnaire was tested in Internet surveys in 15 countries, and the pediatric questionnaires in 4 countries. The results indicate that the new questionnaires generally identify DGBI to a similar degree and with the same demographic patterns as the prior Rome IV versions. The Rome V Questionnaire Committee concluded that these new diagnostic questionnaire versions are well suited for epidemiologic and clinical research of DGBI in the Rome V era for both adult and pediatric populations.

Dysfunctional Gallbladder Disorder (DGBD) and Sphincter of Oddi Disorder (SOD) are possible causes of abdominal pain, biliary obstruction, and acute pancreatitis, and are often invoked when a structural etiology is not obvious. Diagnosis was traditionally based on gallbladder scintigraphy and sphincter of Oddi manometry, both of which have fallen out of favor and are no longer part of the Rome diagnostic criteria. For DGBD, the presence of typical biliary pain and persistence of symptoms despite watchful waiting, and for SOD, objective evidence of biliary obstruction and pancreatitis are now central to the diagnosis. With growing recognition that these disorders have traditionally been over-diagnosed and their treatments - which are risky - have been overused, the approach to cholecystectomy and endoscopic retrograde cholangiopancreatography has become progressively more restrictive. This trend continues in Rome V, although predictors of response to therapy, especially for biliary and pancreatic SOD, are desperately needed.

Rome V provides updated criteria for pediatric disorders of gut-brain interaction (DGBI), replacing age-based subdivisions with a classification based on regions and symptom patterns: abdominal pain disorders, defecation and anorectal disorders, and discomfort disorders. New entities were introduced including biliary pain syndrome, centrally mediated abdominal pain syndrome, functional abdominal bloating, and proctalgia fugax. The term "infantile colic" has been replaced with "infant distress syndrome." Existing criteria for irritable bowel syndrome, functional constipation, and nonretentive fecal incontinence were revised to improve diagnostic clarity and reflect current clinical understanding. Rome V also acknowledges that DGBIs may coexist with other conditions producing gastrointestinal symptoms. These updates are intended to support a more consistent diagnostic framework and guide appropriate management strategies for children and adolescents.

The digestive tract plays a key role in maintaining homeostasis and the general well-being of the human body via complex physiological functions. These gastrointestinal functions include motility; mixing of ingesta with pancreatic, biliary, and enteric secretions; absorption of digested nutrients; and disposal of undigested residues. Such processes usually occur without conscious perception. However, about 30-40% of the general population complain of digestive symptoms, often triggered by meal intake. Most of these people will be labelled as having a disorder of gut-brain interaction (DGBI). The pathophysiology of DGBI is complex, and not only involves bidirectional dysregulation of gut-brain interaction (via the gut-brain axis) but also microbial dysbiosis within the gut, altered mucosal immune function, increased epithelial barrier permeability, visceral hypersensitivity, and abnormal gastrointestinal motility. In this article, normal physiology and pathophysiology of GI function, and processes underlying symptom generation are reviewed. This article provides a thorough appraisal of symptom profiles, pathogenesis and functional tests of the wide array of DGBI.