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Topic Review
Intestinal Ultrasound in Luminal Crohn’s Disease
Crohn’s disease (CD) is a chronic autoimmune disease with increasing worldwide prevalence. Small bowel involvement, either in isolation or with colonic disease, occurs in approximately 90% of patients with typical findings including ulceration, inflammation, and strictures. The current gold standard for CD activity assessment is ileocolonoscopy, however, resource constraints and the invasive nature of this assessment make this difficult to perform frequently. The recent selecting therapeutic targets in inflammatory bowel disease two (STRIDE-2) guidelines have highlighted the increasing importance of using noninvasive modalities to evaluate CD activity. Several imaging techniques can accurately assess the small bowel, including computed tomography, magnetic resonance imaging, and ultrasound. Cross-sectional imaging modalities such as magnetic resonance enterography (MRE) and computed tomography enterography (CTE).
  • 304
  • 20 Oct 2022
Topic Review
Management of Fibro-Stenosing Crohn’s Disease
Fibro-stenosing Crohn’s disease (CD) is a common disease presentation that leads to impaired quality of life and often requires endoscopic treatments or surgery. Managing the treatment of individuals with fibro-stenosing CD is challenging and requires a multidisciplinary team comprising a gastroenterologist, a colorectal surgeon, and a radiologist to evaluate the appropriate strategy. The optimal therapeutic approach changes according to the features of the stenosis (i.e., location, length, angulation), the presence of any associated complications (i.e., fistula, abscess, dysplasia), and the patient’s preference.
  • 304
  • 10 May 2023
Topic Review
Transoral Outlet Reduction for Roux-en-Y Gastric Bypass
Obesity is a chronic relapsing disease of global pandemic proportions. In this context, an increasing number of patients are undergoing bariatric surgery, which is considered the most effective weight loss treatment for long-term improvement in obesity-related comorbidities. One of the most popular bariatric surgeries is the Roux-en-Y gastric bypass (RYGB).
  • 304
  • 15 Jun 2023
Topic Review
Endoscopic and Surgical Management of Stricturing Crohn’s Disease
Crohn’s disease (CD) is a systemic disease, primarily affecting the gastro-intestinal tract, of which the etiology has not been clarified. Genetic and environmental factors are indicated to contribute to CD development. CD may affect any part of the digestive tract, whereas disease behavior may change over time and progress to fibrostenotic and penetrating disease. It is estimated that approximately 40% of CD patients will develop naïve symptomatic strictures (e.g., intestinal obstruction), whereas it is not uncommon for the development of anastomotic strictures. Diagnosis <40 years of age, need for steroids at diagnosis, small bowel involvement, and smoking has been associated with stricturing CD. Symptoms of stricturing CD may include nausea, vomiting, abdominal cramping, and abdominal flatulence, leading to decreased quality of life.
  • 302
  • 06 May 2022
Topic Review
Natural Coumarin Derivatives Used for Intestinal Anti-Inflammatory Drugs
Coumarin derivatives modulating the Nrf2 signaling pathway and displaying simultaneous intestinal anti-inflammatory activities, effects potentially useful in the management of intestinal inflammatory processes. Coumarin derivatives modulating the Nrf2 signaling pathway and displaying intestinal anti-inflammatory activity include simple coumarins, linear and angular furanocoumarins from plant origin, and coumarin derivatives produced by the fermentative process performed by gut microbiota on the plant-derived products commonly used in human feeding.
  • 302
  • 25 Apr 2023
Topic Review
Primary Sclerosing Cholangitis-Associated Cholangiocarcinoma
Cholangiocarcinoma (CCA) is the most common malignancy in patients with primary sclerosing cholangitis (PSC), accounting for 2–8% of cases and being the leading cause of death in these patients. The majority of PSC-associated CCAs (PSC-CCA) develop within the first few years after PSC diagnosis. Older age and male sex, as well as concomitant inflammatory bowel disease (IBD) or high-grade biliary stenosis, are some of the most relevant risk factors. PSC-CCA pathogenesis is characterised by peculiar molecular and genetic features, being a distinct disease from the novo CCA. There has been a significant push to develop innovative strategies for PSC-CCA early diagnosis and surveillance. 
  • 301
  • 23 Oct 2023
Topic Review
γδ T Cells in Hepatocellular Carcinoma Immunotherapy
Hepatocellular carcinoma (HCC) remains a global health challenge with limited treatment options and a poor prognosis for advanced-stage patients. Recent advancements in cancer immunotherapy have generated significant interest in exploring novel approaches to combat HCC. One such approach involves the unique and versatile subset of T cells known as γδ T cells. γδ T cells represent a distinct subset of T lymphocytes that differ from conventional αβ T cells in terms of antigen recognition and effector functions. They play a crucial role in immunosurveillance against various malignancies, including HCC.
  • 301
  • 30 Jan 2024
Topic Review
Reevaluating Therapeutic Use of Antibiotics in Liver Cirrhosis
Impairments in liver function lead to different complications. As chronic liver disease progresses (CLD), hypoalbuminemia and alterations in bile acid compositions lead to changes in gut microbiota and, therefore, in the host–microbiome interaction, leading to a proinflammatory state. Alterations in gut microbiota composition and permeability, known as gut dysbiosis, have important implications in CLD; alterations in the gut–liver axis are a consequence of liver disease, but also a cause of CLD. Furthermore, gut dysbiosis plays an important role in the progression of liver cirrhosis and decompensation, particularly with complications such as hepatic encephalopathy and spontaneous bacterial peritonitis.
  • 299
  • 26 Sep 2023
Topic Review
Nutritional Factors Benefit Postmenopausal Women with NAFLD
Nonalcoholic fatty liver disease (NAFLD) is a prevalent condition among postmenopausal women that can lead to severe liver dysfunction and increased mortality. There is also growing evidence that specific nutritional factors may help to prevent or treat NAFLD. For example, supplementation with vitamins C, D, and E may exert beneficial effects on liver health or related metabolic features, primarily through their antioxidant and anti-inflammatory properties. Coffee consumption is inversely associated with a number of liver-related conditions, including slower progression of fibrosis, lower transaminase levels, and decreased liver-related mortality, and some of these positive effects may be due to caffeine. Caffeine has also been shown to improve features of metabolic syndrome, including hepatic injury in high carbohydrate, high-fat-diet-fed rat; increase energy expenditure; and reduce total body, trunk, and visceral fat or fat mass. 
  • 299
  • 21 Jun 2023
Topic Review
Diabetes Mellitus and Gut Microbiota
The gut microbiota is a complex ecosystem consisting of bacteria, fungi, archaea, and viruses living in symbiosis with the human organism. This collection of bacteria, archaea, and eukaryotes that colonize the digestive system has developed this fascinating symbiotic relationship with its host over thousands of years, characterized by a complex mutually beneficial interaction.
  • 296
  • 02 Mar 2023
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