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Topic Review
Cirrhotic Cardiomyopathy
Cirrhotic cardiomyopathy (CCM), cardiac dysfunction in end-stage liver disease in the absence of prior heart disease, is an important clinical entity that contributes significantly to morbidity and mortality. The original definition for CCM, established in 2005 at the World Congress of Gastroenterology (WCG), was based upon known echocardiographic parameters to identify subclinical cardiac dysfunction in the absence of overt structural abnormalities. Subsequent advances in cardiovascular imaging and in particular myocardial deformation imaging have rendered the WCG criteria outdated. A number of investigations have explored other factors relevant to CCM, including serum markers, electrocardiography, and magnetic resonance imaging. CCM characteristics include a hyperdynamic circulatory state, impaired contractility, altered diastolic relaxation, and electrophysiological abnormalities, particularly QT interval prolongation. It is now known that cardiac dysfunction worsens with the progression of cirrhosis. Treatment for CCM has traditionally been limited to supportive efforts, but new pharmacological studies appear promising. Left ventricular diastolic dysfunction in CCM can be improved by targeted heart rate reduction. Ivabradine combined with carvedilol improves left ventricular diastolic dysfunction through targeted heart rate reduction, and this regimen can improve survival in patients with cirrhosis. Orthotopic liver transplantation also appears to improve CCM. 
  • 575
  • 12 Oct 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.
  • 574
  • 15 Dec 2021
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.
  • 573
  • 12 Jan 2021
Topic Review
ECL Cell
The ECL cell was recognized as the cell producing histamine, taking part in the regulation of gastric acid secretion. The ECL cell carries the gastrin receptor, and gastrin regulates its function (histamine release) as well as proliferation. Long-term hypergastrinemia results in gastric neoplasia of variable malignancies, implying that gastric hypoacidity resulting in increased gastrin release will induce gastric neoplasia, including gastric cancer. Conclusions: The trophic effect of gastrin on the ECL cell has implications to the treatment with inhibitors of acid secretion.
  • 572
  • 29 Dec 2021
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.
  • 573
  • 15 Dec 2022
Topic Review
Hepatic Encephalopathy
Hepatic encephalopathy (HE) is a major complication of cirrhosis, which is associated with gut microbial composition and functional alterations.
  • 572
  • 12 Oct 2021
Topic Review
Obesity and Inflammatory Bowel Disease
Inflammatory colon diseases, which are a global health concern, include a variety of gastrointestinal tract disorders, such as inflammatory bowel disease and colon cancer. The pathogenesis of these colon disorders involves immune alterations with the pronounced infiltration of innate and adaptive immune cells into the intestines and the augmented expression of mucosal pro-inflammatory cytokines stimulated by commensal microbiota. Epidemiological studies during the past half century have shown that the proportion of obese people in a population is associated with the incidence and pathogenesis of gastrointestinal tract disorders. The advancement of understanding of the immunological basis of colon disease has shown that adipocyte-derived biologically active substances (adipokines) modulate the role of innate and adaptive immune cells in the progress of intestinal inflammation. 
  • 571
  • 30 Mar 2021
Topic Review
Polyphenols in Tea
A diet high in polyphenols is associated with a diversified gut microbiome. Tea is the second most consumed beverage in the world, after water. The health benefits of tea might be attributed to the presence of polyphenol compounds such as flavonoids (e.g., catechins and epicatechins), theaflavins, and tannins. 
  • 571
  • 18 May 2021
Topic Review
Sarcopenic Obesity
Sarcopenia was first termed in 1989 by Rosenberg et al. as a muscle loss in the aging population [19]. Although several definitions coexist, sarcopenia’s well-adopted description is an age-related process characterized by progressive loss of skeletal muscle mass and function.
  • 570
  • 18 Mar 2021
Topic Review
Diet in IBD Remission
Identification of the dietary triggers of inflammatory bowel diseases (IBD) and of a dietary regime which can be followed in the long-term by patients, is of paramount importance. Hence, we performed a comprehensive and detailed review of the literature about the role of diet in the maintenance of clinical remission in Crohn’s disease (CD) and Ulcerative colitis (UC), in both adult and paediatric patients. More specifically, we investigated:1) the efficacy of food reintroduction protocols in maintaining clinical remission in patients with CD, following induction of remission with nutritional therapies2.) the efficacy of dietary therapies, including strategies using maintenance enteral nutrition or ordinary food-based diets, on reducing clinical relapse rates in patients with CD and UC3.) the association of dietary components with the risk of developing a clinical relapse in patients with CD and UCFurthermore, we included specific study-related recommendations, which we believe should form the basis of future research studies investigating the role of diet in maintaining clinical remission in IBD.
  • 570
  • 21 Apr 2021
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