Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease. N-acetylcysteine (NAC) has demonstrated antioxidant and hepatoprotective effects in non-alcoholic steatohepatitis. This study evaluated the impact of high-dose NAC on oxidative stress, insulin resistance, and liver-related outcomes in non-diabetic MASLD patients.

Predicting outcomes of primary sclerosing cholangitis (PSC) by reliable and simple tools is an unmet need. Retrospective studies have suggested that liver stiffness measurement (LSM) by vibration-controlled transient elastography (Fibroscan®) can predict outcomes. We aimed to validate the prognostic value of LSM statics and determine the relevance of LSM dynamics in a large, prospective, cohort study.

Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are widely used in psychiatry for mood and anxiety disorders but remain underexplored in chronic gastrointestinal conditions such as inflammatory bowel disease (IBD) and disorders of gut-brain interaction (DGBI). This review synthesizes emerging evidence on their potential therapeutic role, focusing on shared neurobiological and immunometabolic mechanisms within the bidirectional microbiota-gut-brain axis. We reviewed preclinical and clinical studies investigating SSRIs and SNRIs in IBD and DGBI, emphasizing neuroimmune, enteric, and microbial pathways relevant to disease modulation. SSRIs and SNRIs inhibit serotonin (SERT) and norepinephrine (NET) transporters, increasing central 5-HT and NE signaling across corticolimbic and autonomic networks. These effects enhance neuroplasticity and BDNF activity, reduce microglial activation and proinflammatory cytokines, and partially normalize hypothalamic-pituitary-adrenal (HPA) axis reactivity. Peripherally, epithelial, and enteric SERT blockade elevates luminal 5-HT, activating 5-HT<inf>3</inf> and 5-HT<inf>4</inf> receptors that promote motility, secretion, and sensory modulation. Both classes also enhance vagal antiinflammatory tone and tighten epithelial barrier integrity by suppressing nuclear factor kappa (NF-κB) signaling and increasing interleukin 10 (IL-10). Through integrated central, enteric, and immune actions, SSRIs and SNRIs can influence mood, pain perception, gut motility, and mucosal inflammation, key determinants of symptom burden in IBD and DGBI. SSRIs and SNRIs hold promise as multimodal modulators of the microbiota-gut-brain axis, bridging psychiatric and gastroenterological care. However, mechanistic preclinical studies and rigorously designed, adequately powered randomized trials are needed to define causal pathways, optimal dosing, and patient stratification strategies.

Escherichia coli Nissle (EcN) 1917 is a Gram-negative bacterium currently used as probiotic in the management of infectious gastroenteritis and ulcerative colitis (UC). We evaluated the effect of administration of EcN on the composition of the gut microbiota and on intestinal permeability in patients affected by UC.

Colorectal cancer (CRC) exhibits high morbidity and mortality globally among malignant tumors. Early diagnosis and treatment can improve prognosis. Previously, tumor size was considered correlated with colorectal cancer invasion. However, whether small CRCs exhibit lower aggressiveness remains uncertain. To investigate the endoscopic features and risk factors for deep submucosal invasion in early, non-pedunculated CRCs with a diameter < 2 cm, and to establish a preliminary nomogram to inform clinical diagnosis and treatment.

Autoimmune pancreatitis (AIP) is a rare chronic form of pancreatitis mediated by autoimmune mechanisms. Evidence regarding the diagnostic performance of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) in AIP remains limited. This study aimed to estimate the pooled diagnostic accuracy of EUS-FNB in patients with AIP.

Accurate risk stratification in Stage II colorectal cancer is essential for treatment decision-making, as current guidelines recommend adjuvant chemotherapy only for patients with a high risk of relapse. We aimed to develop and validate an artificial intelligence-based approach for automated invasive front assessment to improve prognostic stratification in this population.

Inflammatory markers are routinely used in the evaluation of inflammatory bowel disease (IBD). Red blood cell distribution width (RDW) has previously been proposed as a potential biomarker in the evaluation of IBD. This meta-analysis and systematic review challenges the utility of RDW in IBD evaluation.

Granular cell tumor (GCT) is a benign Schwannian neoplasm that only exceptionally arises in the pancreas. Because of its infiltrative growth pattern, pancreatic GCT may radiologically mimic pancreatic ductal adenocarcinoma (PDAC).

Endoscopic variceal ligation (EVL) - induced ulcer bleeding is a rare but potentially life-threatening complication. While the incidence following elective and emergency EVL has been reported, semi-elective procedures performed during hospitalization for acute decompensation of cirrhosis have not been separately examined. Additionally, real-world data on endoscopic treatment strategies, hemostasis rates and outcomes are scarce.

Serotonin (5-hydroxytryptamine [5-HT]) is a key regulator of gastrointestinal function and exerts its effects through a diversity of 5-HT receptors. In the gut, 5-HT is released primarily by enterochromaffin cells, which act as specialized epithelial chemo- and mechanosensors. In humans, 5-HT modulates gastric sensorimotor function, and animal studies suggest that it is involved in enteric neurogenesis. Altered serotonergic signaling is increasingly recognized as an important contributor to the pathophysiology of gastric motility disorders and, therefore, represents an important therapeutic target. Although early serotonergic agents such as cisapride were withdrawn due to safety concerns, newer receptor-specific ligands have become available, broadening the therapeutic landscape and underscoring the need for an updated synthesis of serotonergic pathways and therapies in gastric motility disorders. For the management of gastroparesis, 5-HT4 agonists are the most consistently supported serotonergic agents in international guidelines, with evidence for improving gastric emptying and symptoms, and 5-HT3 antagonists are used primarily for symptomatic control of nausea and vomiting. In functional dyspepsia, serotonergic therapies may be selectively considered for off-label use based on the symptom profile, including mirtazapine (a 5-HT2 antagonist) in patients with early satiety and weight loss, and buspirone (a 5-HT1A agonist) in those with early satiety, postprandial fullness, or bloating. Although selective serotonin reuptake inhibitors and serotonin-noradrenaline reuptake inhibitors are not recommended for use in gastroparesis or functional dyspepsia, their potential role warrants further investigation, particularly given their established efficacy in conditions with chronic pain. Large, controlled trials evaluating the efficacy of serotonergic agents in gastroparesis and functional dyspepsia remain lacking, but recent developments highlight the continued relevance of serotonergic modulation. Recent data on naronapride, a newer 5-HT4 agonist, suggest that more selective agents may offer a clinically relevant benefit, while mitigating cardiovascular safety risks associated with earlier agents. By integrating molecular, physiological, and clinical data, this review aims to clarify the relevance of serotonergic signaling in gastric physiology and motility disorders, define its therapeutic applications, and identify the key remaining evidence gaps.

Non-alcoholic fatty liver disease (NAFLD) is a global public health crisis linked to elevated all-cause and cardiovascular mortality. The neutrophil-to-high-density lipoprotein ratio (NHR) is an emerging inflammatory-lipid biomarker that integrates systemic inflammation and lipid dysregulation. However, its prognostic value for long-term mortality in NAFLD remains undetermined.

Hyperlipidemic pancreatitis (HLP) carries a considerable clinical and economic burden. This retrospective study examined how abnormal blood lipid levels relate to hospitalization cost and disease severity in patients with HLP, with the aim of informing risk stratification and lipid management in clinical practice.

Non-neoplastic digestive system diseases (NNDSD) are highly prevalent among middle-aged and older adults and represent a substantial global health burden. Dynapenic abdominal obesity (DAO), a clinical phenotype characterized by low muscle strength (dynapenia) combined with abdominal obesity, has been associated with a range of chronic diseases. However, the prospective association between DAO and incident NNDSD has not yet been elucidated. This study aimed to examine the prospective association between DAO and the risk of new-onset NNDSD.

Metabolically-dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and is strongly influenced by genetic susceptibility. Among the identified genetic variants, the patatin-like phospholipase domain-containing protein 3 (PNPLA3) rs738409 (I148M) polymorphism has been consistently associated with hepatic steatosis and disease progression. However, previous meta-analyses included fewer studies, limited ethnic diversity, and insufficient investigation of between-study heterogeneity. This study aimed to comprehensively evaluate the association between the PNPLA3 rs738409 polymorphism and MASLD susceptibility.

Feeding intolerance (FI) remains diagnostically challenging because of nonspecific symptoms and overlap with multiple gastrointestinal conditions. This study investigated the association between peripheral eosinophilia and FI in preterm infants with exploratory evaluation of necrotizing enterocolitis (NEC) and cow's milk protein-related gastrointestinal disease in relation to eosinophilia.

Unexplained chronic cholestasis (UCC) in adults is traditionally interpreted as a hepatocellular or canalicular disorder; however, a subset of patients may instead exhibit a cholangiopathy-driven phenotype. Uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) plays a key role in bilirubin conjugation and bile composition. The heterozygous UGT1A1 c.41_40dup variant, classically associated with Gilbert Syndrome (GS), is frequently observed in individuals without overt GS. In this setting, reduced UGT1A1 activity has been associated with the production of a bile characterized by an increased proportion of bilirubin monoglucuronide (BMG) and a reduced proportion of bilirubin diglucuronide (BDG). The present study investigates whether this variant contributes to a bile composition-driven cholangiopathic phenotype characterized by chronic biliary epithelial injury.

Evidence for ustekinumab (UST) in pediatric inflammatory bowel disease (IBD) is limited, particularly in patients who do not respond to anti-tumor necrosis factor (anti-TNF) therapy. We conducted a meta-analysis to evaluate the efficacy and safety of UST in pediatric IBD after anti-TNF failure.

The management of difficult pancreatobiliary duct stones remains challenging, particularly in patients with large or impacted stones, unfavorable anatomy, or prior failed endoscopic interventions. Peroral cholangioscopy-guided laser lithotripsy has emerged as a promising therapeutic approach; however, real-world data from consecutive single-center experiences are limited. This study aimed to describe the technical feasibility, procedural outcomes, and safety of cholangioscopy-guided laser lithotripsy in patients with difficult pancreatobiliary duct stones.

To compare the detection performance of three automated fecal methods for common gastrointestinal parasites and assess the analytical validity of the KU-F50 centrifugal sedimentation method.