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Topic Review
Drug Targeting of IBD
Inflammatory bowel diseases (IBD) are disabling, noncommunicable, progressive and incurable immune-mediated inflammatory diseases (IMIDs). Crohn’s disease (CD) and ulcerative colitis (UC) constitute the most prevalent forms of IBD. These diseases are highly prevalent worldwide, particularly in Europe and North America, and are spreading globally at an accelerated rate.
  • 680
  • 18 Aug 2021
Topic Review
Gut Microbiota and Gut–Liver Axis in Liver Disease
The gut microbiota composition is important for nutrient metabolism, mucosal barrier function, immunomodulation, and defense against pathogens. Alterations in the gut microbiome can disturb the gut ecosystem. These changes may lead to the loss of beneficial bacteria or an increase in potentially pathogenic bacteria. Furthermore, these have been shown to contribute to the pathophysiology of gastrointestinal and extra-intestinal diseases. Pathologies of the liver, such as non-alcoholic liver disease, alcoholic liver disease, cirrhosis, hepatocellular carcinoma, autoimmune hepatitis, viral hepatitis, and primary sclerosing cholangitis have all been linked to changes in the gut microbiome composition.
  • 677
  • 08 Jun 2022
Topic Review
EUS and EUS-FNA
Endoscopic ultrasonography (EUS) has greater spatial resolution than other diagnostic imaging modalities. In addition, if gallbladder lesions are found and gallbladder cancer is suspected, EUS is an indispensable modality, enabling detailed tests for invasion depth evaluation using the Doppler mode and ultrasound agents. Furthermore, for gallbladder lesions, EUS fine-needle aspiration (EUS-FNA) can be used to differentiate benign and malignant forms of conditions, such as xanthogranulomatous cholecystitis, and collect evidence before chemotherapy.
  • 675
  • 29 Mar 2022
Topic Review
Pathogenesis of Iron Overload and Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is one of the most common malignancies in both transfusion-dependent thalassemia (TDT) and non-transfusion-dependent thalassemia (NTDT). The mechanisms of iron-overloading-associated HCC development include the increased reactive oxygen species (ROS), inflammation cytokines, dysregulated hepcidin, and ferroportin metabolism.
  • 674
  • 15 Aug 2023
Topic Review
Gut-Microbiota-Derived Metabolites and Inflammatory Bowel Disease
Inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), is characterized as a chronic and recurrent inflammatory disease whose pathogenesis is still elusive. The gut microbiota exerts important and diverse effects on host physiology through maintaining immune balance and generating health-benefiting metabolites. Many studies have demonstrated that IBD is associated with disturbances in the composition and function of the gut microbiota. Both the abundance and diversity of gut microbiota are dramatically decreased in IBD patients. Furthermore, some particular classes of microbiota-derived metabolites, principally short-chain fatty acids, tryptophan, and its metabolites, and bile acids have also been implicated in the pathogenesis of IBD.
  • 673
  • 15 Dec 2022
Topic Review
Magnetic-Assisted Treatment of Liver Fibrosis
Chronic liver injury can be induced by viruses, toxins, cellular activation, and metabolic dysregulation and can lead to liver fibrosis. Hepatic fibrosis still remains a major burden on the global health systems. Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are considered the main cause of liver fibrosis. Hepatic stellate cells are key targets in antifibrotic treatment, but selective engagement of these cells is an unresolved issue. 
  • 670
  • 25 Jan 2022
Topic Review
Imaging in Portal Vein Thrombosis
The term portal vein thrombosis (PVT) refers to the complete or partial obstruction of blood flow in the portal vein, due to the presence of a thrombus in the vasal lumen. The underlying etiology of PVT remains unclear in up to 50% of children and adults. PVT, either primary or secondary to an underlying chronic liver disease, is the most common cause of prehepatic portal hypertension. On the one hand, primary PVT can be idiopathic, iatrogenic (neonatal umbilical vein catheterization), or related to an altered coagulation status. On the other hand, the progression of most chronic liver diseases leads to fibrosis, which increases sinusoid resistance and determines an abnormal elevation of portal venous pressure. The spontaneous development of a collateral circulation to divert the flow to the systemic circulation is the first observed anomaly, which itself contributes to PVT. 
  • 667
  • 11 Nov 2022
Topic Review
Dietary Interventions for Complementing Celiac Disease and Beyond
Celiac Disease (CeD) is a chronic small intestinal immune-mediated enteropathy caused by ingesting dietary gluten proteins in genetically susceptible individuals. CeD is one of the most common autoimmune diseases, affecting around 1.4% of the population globally. The only acceptable treatment for CeD is strict, lifelong adherence to a gluten-free diet (GFD). However, in some cases, GFD does not alter gluten-induced symptoms. In addition, strict adherence to a GFD reduces patients’ quality of life and is often a socio-economic burden. Therefore, dietary and non-dietary interventions are investigated. This entry concentrates on the recent research on the degradation of gluten through enzymes, the modulation of the microbiome, and the different types of “biotics” strategies, from probiotics to the less explored “viromebiotics” as possible beneficial complementary interventions for CeD management and other less understood gluten-related disorders beyond the GFD.
  • 667
  • 03 Jan 2023
Topic Review
IBS and IBD
Irritable bowel syndrome (IBS) is a functional heterogenous disease with a multifactorial pathogenesis. It is characterized by abdominal pain, discomfort, and alteration in gut motility. The occurrence of similar symptoms was observed in patients in clinical remission of inflammatory bowel diseases (IBD) that is Crohn’s disease (CD) and ulcerative colitis (UC), which pathogenesis is also not fully understood. IBS and IBD seem to be quite separate entities, but still, they do share some similarities. First, their symptoms overlap to some extent: They both may include abdominal pain, bloating, diarrhea, and watery stools, which can make it difficult to distinguish between these disorders. However, pain in IBS results from tension in the intestinal wall and can be relieved by defecation, while in IBD, it is more constant, and it may result from inflammatory cytokines impacting on afferent nerve firing. Moreover, in the case of IBD, there are so-called “alarm symptoms”, such as fever, weight and appetite loss, bloody stool, vomiting, or anemia, which are absent in IBS. Second, despite the fact that extracolonic symptoms may appear in the course of both diseases, in IBS, they are more general and include, for example, nausea or dyspepsia, while they seem to be more serious and disabling in IBD—they may affect joints, eyes, skin or liver. Furthermore, the epidemiology is slightly different—IBS may occur at any age and is seen more often in women, while IBD appear mainly in young adults between 15 and 30 years old and remain gender-neutral—as mentioned earlier. Phenotypic differences are also clear—in IBS, visibly normal mucosa is observed. On the contrary, in IBD, inflammation, ulcerations, fibrosis, and structuring can be seen during colonoscopy with the naked eye. The pathogenesis of IBS and IBD is not completely understood; however, it is believed to be multifactorial. In both cases, it may include not only environmental and psychological factors (such as stress, depression, negative life events) but also genetic factors, enduring submucosal inflammation, and other changes involving the gut–brain axis and alteration in gut microbiota.
  • 666
  • 12 Jan 2021
Topic Review
Fecal Microbiota Transplantation
Among all the methods available to achieve this purpose, fecal microbiota transplantation (FMT) is one of the most promising, being able to directly reshape the recipient’s gut microbial communities.
  • 665
  • 16 Jun 2021
Topic Review
Gastrointestinal-Bleeding between NOACs and VKAs
Non-vitamin K antagonist oral anticoagulants (NOACs) are more commonly used to prevent atrial fibrillation (AF) patients from thromboembolic events than vitamin K antagonists (VKAs). However, the gastrointestinal bleeding (GIB) risk in the Asian AF patients associated with NOACs in comparison with VKAs remained unaddressed.
  • 664
  • 15 Jan 2021
Topic Review
Artificial Intelligence for Gastrointestinal Diseases
The development of convolutional neural networks has achieved impressive advances of machine learning in recent years, leading to an increasing use of artificial intelligence (AI) in the field of gastrointestinal (GI) diseases. AI networks have been trained to differentiate benign from malignant lesions, analyze endoscopic and radiological GI images, and assess histological diagnoses, obtaining excellent results and high overall diagnostic accuracy. Nevertheless, there data are lacking on side effects of AI in the gastroenterology field, and high-quality studies comparing the performance of AI networks to health care professionals are still limited.
  • 664
  • 24 Sep 2021
Topic Review
Acute Coronary Syndromes and Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) induces a process of systemic inflammation, sharing common ground with acute coronary syndromes (ACS). Growing evidence points towards a possible association between IBD and an increased risk of ACS.
  • 664
  • 15 Dec 2021
Topic Review
Cross-Sectional Imaging Instead of Colonoscopy
Recently, cross-sectional imaging techniques have been increasingly shown as reliable tools for assessing Inflammatory bowel diseases (IBD) activity. While computed tomography (CT) is hampered by radiation risks, routine implementation of magnetic resonance enterography (MRE) for close monitoring is limited by its costs, low availability and long examination time. Novel magnetic resonance imaging (MRI)-based techniques, such as diffusion-weighted imaging (DWI), can overcome some of these weaknesses and have been shown as valuable options for IBD monitoring. Bowel ultrasound (BUS) is a noninvasive, highly available, cheap, and well accepted procedure that has been demonstrated to be as accurate as CS and MRE for assessing and monitoring disease activity in IBD. Furthermore, as BUS can be quickly performed at the point-of-care, it allows for real-time clinical decision making.
  • 663
  • 25 Jan 2022
Topic Review
Celiac Disease and Type 1 Diabetes Mellitus
Celiac disease (CeD) is associated with type 1 diabetes mellitus (T1DM), and both have the same genetic background. Type 1 diabetes mellitus (T1DM), an autoimmune disease, is caused by insulin deficiency due to destruction of the insulin-producing pancreatic beta cells.
  • 660
  • 25 Jun 2023
Topic Review
Surgical Management of Pancreatic Neuroendocrine Tumours (pNETs)
Pancreatic neuroendocrine tumours (pNETs) are a group of rare neoplasms with an incidence of 1–2/100,000 inhabitants/year. They represent 2% of all pancreatic neoplasms and are characterized by a great heterogeneity according to their genetic or sporadic origin, their functional or non-functional character, their degree of locoregional or systemic invasion and their single or multiple localization. The reference curative treatment is surgical resection of the pancreatic tumor in specialized high-volume centres, after a multidisciplinary discussion involving surgeons, oncologists, radiologists and pathologists.
  • 660
  • 14 Jan 2022
Topic Review
Microbiome in the Pathogenesis of Inflammatory Bowel Disease
The microbiome of patients with inflammatory bowel disease (IBD) is characterized by bacterial dysbiosis (i.e., an imbalance of pathogenic and commensal bacteria). Bacterial diversity has been shown to be reduced during active inflammation in IBD.
  • 659
  • 12 Jul 2022
Topic Review
CtDNA for Colorectal Cancer
Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths worldwide. While there have been significant developments in the treatments for patients with metastatic CRC in recent years, improving outcomes in the adjuvant setting has been more challenging. Recent technological advances in circulating tumour DNA (ctDNA) assay with the ability to detect minimal residual disease (MRD) after curative intent surgery will fundamentally change how we assess recurrence risk and conduct adjuvant trials. Studies in non-metastatic CRC have now demonstrated the prognostic impact of ctDNA analysis after curative intent surgery over and above current standard of care clinicopathological criteria.
  • 658
  • 03 Feb 2021
Topic Review
Anti-TNFs in Pediatric Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a chronic immune-mediated condition that affects the gastrointestinal tract. The incidence of the disease in children is increasing. However, most clinical trials in this disease have been carried out in adults, and the results have been extrapolated with minimal changes to determine treatment in children. Pediatric IBD (pIBD) is characterized by various factors, including a more severe phenotype than adult diseas. Since IBD is a chronic autoimmune disease, patients diagnosed during childhood live longer with the illness and consequently need treatment for longer. Biological drugs and, more specifically, anti-TNF drugs such as infliximab and adalimumab have proven efficient for treatment of IBD in adults and in children. However, the use of biological drugs differs between children and adults with IBD. For instance, the time between diagnosis and initiation of biological treatment is shorter in children than in adults. In addition, not all the biological drugs approved for adult IBD are approved for children. 
  • 658
  • 17 Nov 2021
Topic Review
Crohn’s Disease and Intestinal Cancers
Crohn's Disease (CD) is a chronic, relapsing–remitting disease, which can affect the entire gastrointestinal tract with transmural inflammation. It is characterized by a progressive course with damage accumulation and onset of complications. CD patients have an increased risk of both intestinal and extra-intestinal cancers compared to the general population and chronic inflammation has been identified as the main risk factor for cancerization.
  • 657
  • 10 May 2021
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