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Topic Review
Leaky Gut Syndrome
Leaky gut syndrome- is a medical condition characterized by increased intestinal permeability which may cause chronic inflammation and contributes to pathogenesis of wide range of diseases. According to the hypothesis of leaky gut syndrome, increased intestinal permeability enables antigens to cross intestinal barrier and absorb into the bloodstream consequently trigger the immune system and cause systemic reactions. Although LGS is very popular in alternative medicine circles, there is still little evidence to support hypothesis that it is a direct cause of any widespread problems.  
  • 1.1K
  • 25 Nov 2020
Topic Review
Machine Learning in Gastroenterology/Endoscopy
Over time, machine learning (ML), a component of artificial intelligence (AI), has been implemented in a variety of medical specialties, such as radiology, pathology, gastroenterology, neurology, obstetrics and gynecology, ophthalmology, and orthopedics, with the goal of improving the quality of healthcare and medical diagnosis. In clinical gastroenterology practice, due to technological developments, estimates show that AI could have the ability to create a predictive model; for instance, it could develop an ML model that can stratify the risk in patients with upper gastrointestinal bleeding, establish the existence of a specific gastrointestinal disease, define the best treatment, and offer prognosis and prediction of the therapeutic response. In this context, by applying ML or deep learning (DL) (AI using neural networks), clinical management in gastroenterology can begin to focus on more personalized treatment centered on the patient and based on making the best individual decisions, instead of relying mostly on guidelines developed for a specific condition. Moreover, the goal of implementing these AI-based algorithms is to increase the possibility of diagnosing a gastrointestinal disease at early stage or the ability to predict the development of a particular condition in advance. Because both AI and gastroenterology encompass many subdomains, the interaction between them might take on various forms. In recent years, we have witnessed a large explosion of research in attempts to improve various fields of gastroenterology, such as endoscopy, hepatology, inflammatory bowel diseases, and many others, with the aid of ML. We also note that, because of the requirement to diagnose more patients with gastrointestinal cancers at an early stage of the disease, which is associated with curative treatment and better prognosis, many studies were developed to address improvement of the detection of these tumors with the aid of AI. The term ML, introduced for the first time in 1959 by Arthur Samuel from the IBM company, refers to an IT domain whereby a computer system can acquire the ability to “learn” by using data without specific programming and can therefore develop a predictive mathematical algorithm based on input data, using recognition of “features”. The ML “model” is subsequently able to adapt to new situations in which it becomes able to predict and make decisions.
  • 1.1K
  • 02 Feb 2021
Topic Review
Drug-Induced Liver Injury
Idiosyncratic drug-induced liver injury (DILI) is a type of hepatic injury caused by an uncommon drug adverse reaction that can develop to conditions spanning from asymptomatic liver laboratory abnormalities to acute liver failure (ALF) and death. 
  • 1.1K
  • 21 Jun 2021
Topic Review
Wilson’s Disease
Wilson disease (WD) is a rare disorder caused by mutations in ATP7B, which leads to a defective biliary excretion of copper. Subsequent gradual accumulation of copper in different organs produces an extremely variable clinical picture, which comprises hepatic, neurological psychiatric, ophthalmological, and other disturbances. WD has specific treatment, so that early diagnosis is crucial in order to avoid the progression of the disease and its devastating consequences. The clinical diagnosis of WD is based on the Leipzig scale, which considers clinical, histological, biochemical and genetic data. However, even patients with an initial WD diagnosis based on a high Leipzig score result to suffer from other condition that mimics the WD’s phenotype (Wilson-like).
  • 1.1K
  • 22 Sep 2021
Topic Review
Leaky Gut and Autoimmunity
Damage to the tissue and the ruining of functions characterize autoimmune syndromes. This review centers around leaky gut syndromes and how they stimulate autoimmune pathogenesis. Lymphoid tissue commonly associated with the gut, together with the neuroendocrine network, collaborates with the intestinal epithelial wall, with its paracellular tight junctions, to maintain the balance, tolerance, and resistance to foreign/neo-antigens. The physiological regulator of paracellular tight junctions plays a vital role in transferring macromolecules across the intestinal barrier and thereby maintains immune response equilibrium. A new paradigm has explained the intricacies of disease development and proposed that the processes can be prevented if the interaction between the genetic factor and environmental causes is barred by re-instituting the intestinal wall function. The latest clinical evidence and animal models reinforce this current thought and offer the basis for innovative methodologies to thwart and treat autoimmune syndromes.
  • 1.1K
  • 05 Jan 2021
Topic Review
Oral Semaglutide
The gastrointestinal tract secretes gut hormones in response to food consumption, and some of these stimulate insulin secretion. Glucagon-like peptide-1 (GLP-1) is an incretin peptide hormone released from the lower digestive tract that stimulates insulin secretion, suppresses glucagon secretion, and decreases hunger. GLP-1 receptor agonist (GLP-1RA) mimics the action of endogenous GLP-1, consequently reversing hyperglycemia and causing weight reduction, demonstrating its efficacy as an antidiabetic and antiobesity agent. Previously restricted to injection only, the invention of the absorption enhancer sodium N-(8-[2-hydroxybenzoyl]amino) caprylate resulted in the development of oral semaglutide, the first ingestible GLP-1RA. Oral semaglutide demonstrated its efficacy in glycemic management and body weight loss with a low risk of hypoglycemia as a monotherapy and in combination with other hypoglycemic medications in its clinical trial programs named Peptide Innovation for Early Diabetes Treatment. Consistent with other injectable GLP-1RAs, gastrointestinal side effects were often reported. Additionally, cardiovascular safety was established by demonstrating that oral semaglutide was not inferior to placebo in terms of cardiovascular outcomes. Thus, oral semaglutide represents a novel treatment option that is particularly well-suited for patients with type 2 diabetes and/or obesity.
  • 1.0K
  • 13 Oct 2021
Topic Review
Magnesium Oxide in Constipation
Magnesium oxide has been widely used as an osmotic laxative for a long time especially in East Asia. 
  • 1.0K
  • 04 Mar 2021
Topic Review
Tissue Biopsy-Based MSI Testing
Colorectal cancer (CRC) is the third most commonly-diagnosed cancer in the world and ranked second for cancer-related mortality in humans. Microsatellite instability (MSI) is an indicator for Lynch syndrome (LS), an inherited cancer predisposition, and a prognostic marker which predicts the response to immunotherapy. A recent trend in immunotherapy has transformed cancer treatment to provide medical alternatives that have not existed before. It is believed that MSI-high (MSI-H) CRC patients would benefit from immunotherapy due to their increased immune infiltration and higher neo-antigenic loads. MSI testing such as immunohistochemistry (IHC) and PCR MSI assay has historically been a tissue-based procedure that involves the testing of adequate tissue with a high concentration of cancer cells, in addition to the requirement for paired normal tissues. The invasive nature and specific prerequisite of such tests might hinder its application when surgery is not an option or when the tissues are insufficient. The application of next-generation sequencing, which is highly sensitive, in combination with liquid biopsy, therefore, presents an interesting possibility worth exploring. This review aimed to discuss the current body of evidence supporting the potential of liquid biopsy as a tool for MSI testing in CRC.
  • 1.0K
  • 16 Nov 2021
Topic Review
Risk Factors of Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract. It is characterized by relapses and remissions, thus requiring lifelong treatment. 
  • 1.0K
  • 21 Jun 2022
Topic Review
Classification and Diagnosis of Acute Pancreatitis
The pancreas is a glandular organ that is responsible for the proper functioning of the digestive and endocrine systems, and therefore, it affects the condition of the entire body. Consequently, it is important to effectively diagnose and treat diseases of this organ. According to clinicians, pancreatitis—a common disease affecting the pancreas—is one of the most complicated and demanding diseases of the abdomen. The classification of pancreatitis is based on clinical, morphologic, and histologic criteria. Medical doctors distinguish, inter alia, acute pancreatitis (AP), the most common causes of which are gallstone migration and alcohol abuse.
  • 1.0K
  • 30 Aug 2022
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