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Topic Review
Endoscopic of the Upper Digestive Tract Management
The European Society for Gastrointestinal Endoscopy recommends immediate (<2 h, maximum 6 h after ingestion) therapeutic endoscopy for foreign bodies causing complete obstruction, sharp objects and batteries or magnets. Urgent endoscopy (<24 h) should also be performed for other esophageal foreign bodies without complete obstruction. Endoscopy of the upper digestive tract is very sensitive in detecting foreign bodies and has the advantage that therapeutic maneuvers can be performed. In addition, endoscopy may reveal pre-existing esophageal pathology leading to obstruction and any mucosal damage.
  • 711
  • 27 Mar 2023
Topic Review
Autophagy in Parenchymal and Non-Parenchymal Liver Cells
Autophagy is a highly conserved intracellular process for the ordered degradation and recycling of cellular components in lysosomes. In the liver this process is relevant for maintaining liver homeostasis, especially in conditions of hepatic insults.
  • 709
  • 17 Jan 2022
Topic Review
Pancreatic Fluid Collection
Pancreatic fluid collection (PFC) is one of the local complications that occurs after acute pancreatitis. Recently, the gold standard for management of pancreatic fluid collection has changed from aggressive debridement to a more conservative approach. Endoscopic drainage and necrosectomy are now accepted treatment approaches for patients with symptomatic walled-off pancreatic necrosis (WON). The current recommendations advocate step-up approaches for the treatment of symptomatic WON. Previous recommendations stipulated that endoscopic intervention should be delayed until more than four weeks after the onset. Recent data on early drainage have been increasing and this option might be considered in well-encapsulated cases, but the percutaneous route is preferred if the drainage is performed within two weeks after onset or in nonencapsulated cases.
  • 703
  • 20 Jan 2021
Topic Review
Intestinal Permeability and Liver Cirrhosis
An alteration of gut microbiota and their products, particularly endotoxins may play a major role in the pathogenesis of liver diseases. Gut dysbiosis caused by a high-fat diet and alcohol consumption induces increased intestinal permeability, the so-called “leaky gut.” Clinical studies have found that plasma endotoxin levels are elevated in patients with chronic liver diseases. The decreased diversity of gut microbiota in cirrhotic patients before liver transplantation is also related to a higher incidence of posttransplant infections and cognitive impairment. The exposure to endotoxins activates macrophages via toll-like receptor 4 (TLR4), leading to a greater production of proinflammatory cytokines and chemokines including tumor necrosis factor–alpha, interleukin (IL)–6, and IL-8, which play key roles in the progression of liver diseases. TLR4 is also a major receptor activated by the binding of endotoxins in hepatic stellate cells, which play a crucial role in liver fibrogenesis that could develop into hepatocarcinogenesis, suggesting the importance of the interaction between endotoxemia and TLR4 signaling as a target for preventing liver disease progression.
  • 700
  • 13 Jul 2021
Topic Review
Ultrasound for the Diagnosis of Biliary Atresia
Biliary atresia is an aggressive liver disease of infancy and can cause death without timely surgical intervention. Early diagnosis of biliary atresia is critical to the recovery of bile drainage and long-term transplant-free survival. Ultrasound is recommended as the initial imaging strategy for the diagnosis of biliary atresia. Numerous ultrasound features have been proved helpful for the diagnosis of biliary atresia. In recent years, with the help of new technologies such as elastography ultrasound, contrast-enhanced ultrasound and artificial intelligence, the diagnostic performance of ultrasound has been significantly improved.
  • 700
  • 26 Jan 2022
Topic Review
Nutrition/Exercise in Upper Gastrointestinal Cancers
Malnutrition and muscle wasting are associated with impaired physical functioning and quality of life in oncology patients. Patients diagnosed with upper gastrointestinal (GI) cancers are considered at high risk of malnutrition and impaired function. Due to continuous improvement in upper GI cancer survival rates, there has been an increased focus on multimodal interventions aimed at minimizing the adverse effects of cancer treatments and enhancing survivors’ quality of life. 
  • 698
  • 28 Sep 2021
Topic Review
CD26 Induces Colorectal Cancer Angiogenesis and Metastasis
CD26 has been reported as a marker for colorectal cancer stem cells endowed with tumor-initiating properties and capable of colorectal cancer (CRC) metastasis. This entry demonstrated the functional roles of CD26 in inducing CRC migration, invasion, angiogenesis and metastasis and identified the potential involvement of MMP1 and CAV1 in such process.
  • 697
  • 07 Feb 2022
Topic Review
Oxidative Stress in Alcoholic Liver Disease
Alcoholic liver disease (ALD) is characterized by the injury, inflammation, and scarring in the liver owing to excessive alcohol consumption. Currently, ALD is a leading cause for liver transplantation. Therefore, extensive studies (in vitro, in experimental ALD models and in humans) are needed to elucidate pathological features and pathogenic mechanisms underlying ALD. Notably, oxidative changes in the liver have been recognized as a signature trait of ALD. Progression of ALD is linked to the generation of highly reactive free radicals by reactions involving ethanol and its metabolites. Furthermore, hepatic oxidative stress promotes tissue injury and, in turn, stimulates inflammatory responses in the liver, forming a pathological loop that promotes the progression of ALD. Accordingly, accumulating further knowledge on the relationship between oxidative stress and inflammation may help establish a viable therapeutic approach for treating ALD. 
  • 695
  • 19 Apr 2022
Topic Review
The Applications of Colonic Transendoscopic Enteral Tubing
The limitation of traditional delivery methods for fecal microbiota transplantation (FMT) gave birth to colonic transendoscopic enteral tubing (TET) to address the requirement of frequent FMTs. Colonic TET as a novel endoscopic intervention has received increasing attention in practice since 2015 in China. Emerging studies from multiple centers indicate that colonic TET is a promising, safe, and practical delivery method for microbial therapy and administering medication with high patient satisfaction.
  • 693
  • 06 Feb 2023
Topic Review
Leaky Gut and Fatty Liver
Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and the leading cause of chronic liver disease in pediatric and adult populations living in industrialized countries. NAFLD encompasses steatosis and nonalcoholic steatohepatitis (NASH), and it is characterized by perivenular and lobular inflammation. Progression to fibrosis and cirrhosis are the primary complications of NAFLD. Based on a recent meta-analysis, one in four people in Europe, the United States, and Asia have NAFLD.
  • 691
  • 09 Aug 2021
Topic Review
Cancer-Associated Fibroblasts in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is one of the most prevalent cancers worldwide and the fourth leading cause of cancer-related death globally. Tumor cells recruit and remodel various types of stromal and inflammatory cells to form a tumor microenvironment (TME), which encompasses cellular and molecular entities, including cancer-associated fibroblasts (CAFs), tumor-associated macrophages (TAMs), tumor-associated neutrophils (TANs), immune cells, myeloid-derived suppressor cells (MDSCs), immune checkpoint molecules and cytokines that promote cancer cell growth, as well as their drug resistance. HCC usually arises in the context of cirrhosis, which is always associated with an enrichment of activated fibroblasts that are owed to chronic inflammation. 
  • 691
  • 23 Feb 2023
Topic Review
Helicobacter pylori and Respiratory Diseases
Helicobacter pylori (H. pylori) is a Gram-negative bacterium involved in the development of gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue. Unexplained iron deficiency anemia, idiopathic thrombocytopenic purpura and vitamin B12 deficiency have also been related to H. pylori infection, whereas for other extra-gastric diseases, the debate is still open. In this entry, we evaluate and discuss the potential involvement of H. pylori infection in the pathogenesis of several respiratory diseases.
  • 690
  • 28 Sep 2021
Topic Review
Oxidative Stress-Induced Senescence during Non-Alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease is characterized by disturbed lipid metabolism and increased oxidative stress. These conditions lead to the activation of different cellular response mechanisms, including senescence. Cellular senescence constitutes an important response to injury in the liver. Researches show that chronic oxidative stress can induce senescence, and this might be a driving mechanism for NAFLD progression, aggravating the disturbance of lipid metabolism, organelle dysfunction, pro-inflammatory response and hepatocellular damage. In this context, the modulation of cellular senescence can be beneficial to ameliorate oxidative stress-related damage during NAFLD progression.
  • 690
  • 06 Jun 2022
Topic Review
Diagnosis of Serous Cystadenoma
Incidental pancreatic cysts are highly prevalent, with management dependent on the risk of malignant progression. Serous cystadenomas (SCAs) are the most common benign pancreatic cysts seen on imaging. They have typical morphological patterns but may also show atypical features that mimic precancerous and cancerous cysts.
  • 690
  • 07 Dec 2023
Topic Review
Bile Acid Diarrhoea
Bile acid diarrhoea (BAD) is a widespread gastrointestinal disease that presents as chronic watery diarrhoea as well as bloating and abdominal pain. This condition is often misdiagnosed as irritable bowel syndrome and is estimated to affect 1% of the United Kingdom population alone. BAD is associated with excessive bile acid synthesis secondary to a gastrointestinal or idiopathic disorder (also known as primary BAD). Current treatment includes diet changes and bile acid sequestrant medication.
  • 689
  • 19 May 2021
Topic Review
Dysregulation of the Gut Barrier Function during ALD
Chronic alcohol consumption and alcohol-associated liver disease (ALD) represent a major public health problem worldwide. Only a minority of patients with an alcohol-use disorder (AUD) develop severe forms of liver disease (e.g., steatohepatitis and fibrosis) and finally progress to the more advanced stages of ALD, such as severe alcohol-associated hepatitis and decompensated cirrhosis. Emerging evidence suggests that gut barrier dysfunction is multifactorial, implicating microbiota changes, alterations in the intestinal epithelium, and immune dysfunction. This failing gut barrier ultimately allows microbial antigens, microbes, and metabolites to translocate to the liver and into systemic circulation. Subsequent activation of immune and inflammatory responses contributes to liver disease progression.
  • 688
  • 09 Mar 2022
Topic Review
Esophageal and Gastric Tumors
Gastric and esophageal tumors are diverse neoplasms that involve mucosal and submucosal tissue layers and include squamous cell carcinomas, adenocarcinomas, spindle cell neoplasms, neuroendocrine tumors, marginal B cell lymphomas, along with less common tumors. The worldwide burden of esophageal and gastric malignancies is significant, with esophageal and gastric cancer representing the ninth and fifth most common cancers, respectively. The approach to diagnosis and staging of these lesions is multimodal and includes a combination of gastrointestinal endoscopy, endoscopic ultrasound, and cross-sectional imaging. Likewise, therapy is multidisciplinary and combines therapeutic endoscopy, surgery, radiotherapy, and systemic chemotherapeutic tools. Future directions for diagnosis of esophageal and gastric malignancies are evolving rapidly and will involve advances in endoscopic and endosonographic techniques including tethered capsules, optical coherence tomography, along with targeted cytologic and serological analyses. 
  • 686
  • 23 Feb 2021
Topic Review
Virtual Chromoendoscopy in Capsule Endoscopy
Video capsule endoscopy (VCE) is a minimally invasive endoscopic modality, which was initially introduced for the investigation of the small intestine, but currently a range of capsules are available that can facilitate the inspection of the entire GI tract.
  • 686
  • 17 Aug 2022
Topic Review
The Role of CH-EUS in Interventional EUS
Over the last decades, contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) has emerged as an important diagnostic tool for the diagnosis and differentiation of several gastrointestinal diseases. The key advantage of CH-EUS is that the influx and washout of contrast in the target lesion can be observed in real time, accurately depicting microvasculature. CH-EUS is established as an evidence-based technique complementary to B-mode EUS to differentiate solid appearing structures, to characterize mass lesions, and to improve the staging of gastrointestinal and pancreatobiliary cancer. In the last few years, interest has increased in the use of CH-EUS in interventional procedures such as tissue acquisition, tumor ablation, biliary drainage, and the management of pancreatic fluid collections.
  • 685
  • 02 Nov 2021
Topic Review
Dietary Fibers in Inflammatory Bowel Diseases
Inflammatory bowel diseases (IBDs) are chronic, progressive, immune-mediated diseases of the intestinal tract. The main subtypes of IBDs are Chron’s disease (CD) and ulcerative colitis (UC). The etiology is still unclear, but there are genetic, environmental and host-related factors that contribute to the development of these diseases. Literature has shown that dietary therapy is the cornerstone of IBD treatment in terms of management of symptoms, relapse and care of the pathology. IBD patients show that microbiota dysbiosis and diet, especially dietary fiber, can modulate its composition. These patients are more at risk of energy protein malnutrition than the general population and are deficient in micronutrients. So far, no dietary component is considered responsible for IBD and there is not a specific therapeutic diet for it. 
  • 681
  • 02 Dec 2022
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