Curr. Opin. Gastroenterol. [JOURNAL]
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200 papers
Plasma exchange in acute liver failure.
Sasser HB, Koch DG
Curr Opin Gastroenterol · 2026 May · PMID 41782400 · Publisher ↗
PURPOSE OF REVIEW: Acute liver failure is a life-threatening condition that requires intensive medical management or liver transplant for survival. Plasma exchange has been investigated as a supportive intervention to pr...
PURPOSE OF REVIEW: Acute liver failure is a life-threatening condition that requires intensive medical management or liver transplant for survival. Plasma exchange has been investigated as a supportive intervention to provide a bridge to hepatic recovery or to liver transplant. This review aims to explain the physiologic rationale, provide historical context, and review recent evidence on the use of plasma exchange in acute liver failure. RECENT FINDINGS: Recent studies paint a mixed picture of plasma exchange's role in the current armamentarium for the management of acute liver failure. Although multiple meta-analyses have shown a survival benefit from plasma exchange, the results from original studies published in the interim are less consistent, with some showing a survival benefit and others not. Further, the literature on this topic is quite heterogeneous with respect to baseline patient characteristics, etiologies of acute liver failure, the dose of plasma exchange administered, and the outcomes assessed. The takeaways and limitations of recent evidence will be discussed. SUMMARY: Plasma exchange has a clear physiologic basis for use in acute liver failure, and multiple prospective studies have shown its ability to improve survival. The effectiveness of plasma exchange, however, depends on appropriate patient selection and timely initiation.
Antithrombotic and management of small bowel bleeding - time to throw caution into the wind?
Scaramella L, Cosenza A, Romero-Mascarell C … +1 more , Elli L
Curr Opin Gastroenterol · 2026 May · PMID 41700996 · Publisher ↗
PURPOSE OF REVIEW: Small bowel bleeding (SBB) represents a significant diagnostic and therapeutic challenge. The use of antithrombotic therapy (oral anticoagulants and antiplatelet agents) has led to an increase in gastr...
PURPOSE OF REVIEW: Small bowel bleeding (SBB) represents a significant diagnostic and therapeutic challenge. The use of antithrombotic therapy (oral anticoagulants and antiplatelet agents) has led to an increase in gastrointestinal bleeding events, particularly in the small bowel. The endoscopic management of SBB in patients receiving antithrombotic therapy remains a clinical dilemma . This review explores the current perspectives on the endoscopic management of SBB in patients receiving antithrombotic therapy and discusses whether the traditional cautions approach should be reconsidered. RECENT FINDINGS: Recent studies confirmed a higher diagnostic yield of small bowel capsule endoscopy (SBCE) in patients administered with antithrombotic agents, and an increased prevalence of SBB from vascular lesions. Device-assisted enteroscopy (DAE) is the reference standard for endoscopic therapy; however, rebleeding rate remains high. SUMMARY: Endoscopic management of SBB in patients receiving antithrombotic therapy remains suboptimal. Maintenance of therapy increases the diagnostic yield of SBCE; however, guidelines recommend to discontinue the therapy before DAE. This mismatch highlights a substantial disconnection between evidence and clinical practice. Prospective studies and expert consensus are needed to optimize outcomes in this population.
The alcohol-associated hepatitis treatment landscape.
Blaney H, Asgharpour A
Curr Opin Gastroenterol · 2026 May · PMID 41691535 · Publisher ↗
PURPOSE OF REVIEW: Alcohol-associated hepatitis is a severe form of alcohol-associated liver disease and is associated with a high mortality. Treatment of alcohol-associated hepatitis has historically been limited, with...
PURPOSE OF REVIEW: Alcohol-associated hepatitis is a severe form of alcohol-associated liver disease and is associated with a high mortality. Treatment of alcohol-associated hepatitis has historically been limited, with few therapies demonstrating survival benefit. However, multiple promising new therapies are on the horizon, with this review highlighting recent advances in alcohol-associated hepatitis treatment. RECENT FINDINGS: Multiple new pharmacological agents targeting different mechanisms are under study for alcohol-associated hepatitis, including larsucosterol, F-652, and INT-787. Manipulation of the gut-brain axis has also been leveraged for alcohol-associated hepatitis, with use of fecal microbiota transplant and other modalities. Early liver transplantation, while not universally available, has offered improved survival with similar outcomes compared to other etiologies of liver disease. Living donor liver transplantation has also been investigated in alcohol-associated hepatitis, with promising results. While steroids still remain the mainstay of therapy, recent studies have offered nuances to their use, including use of a taper to reduce risk of infection without changing efficacy. SUMMARY: Medical management of alcohol-associated hepatitis has remained largely unchanged since the 1970 s. However, promising therapies targeting multiple aspects of pathophysiology are on the horizon, including a planned phase 3 trial for larsucosterol, an active phase 2a study with INT-787 and a planned trial using F-652.
Small-bowel capsule endoscopy - from clinic to couch: time to go green?
Lei II, Arasaradnam RP, Koulaouzidis A
Curr Opin Gastroenterol · 2026 May · PMID 41691528 · Publisher ↗
PURPOSE OF REVIEW: Small-bowel capsule endoscopy (SBCE) has transformed small-intestine diagnostics by enabling direct, noninvasive mucosal visualization. As healthcare systems increasingly prioritize value-based and sus...
PURPOSE OF REVIEW: Small-bowel capsule endoscopy (SBCE) has transformed small-intestine diagnostics by enabling direct, noninvasive mucosal visualization. As healthcare systems increasingly prioritize value-based and sustainable care, this review explores recent advances in SBCE, focusing on home-delivery models, telemedicine, artificial intelligence (AI), and environmental impact. RECENT FINDINGS: Life-cycle analyses estimate ~20 kgCO 2 per SBCE, ~18 kgCO 2 arising from patient travel. Transitioning from hospital attendance to home-delivery models can materially reduce this footprint. Feasibility studies report high acceptability for remote delivery, teleconsultation, and decentralized reading. AI-assisted reading platforms have recently shown significant reductions in reporting time, improving workflow efficiency. Rural modelling suggests travel emissions for colon capsule endoscopy (CCE) can exceed colonoscopy (~19.2 kgCO 2 e) but fall to ~5.3 kgCO 2 e with optimized courier logistics, despite >50% follow-up endoscopy rate. SUMMARY: SBCE now stands at the nexus of technological innovation, clinical utility, and environmental accountability. Its journey from hospital corridors to home settings exemplifies a diagnostic paradigm built on accessibility, efficiency, and ecological integrity. Realizing this vision requires multicentre trials that incorporate life cycle, cost-effectiveness, and patient-reported outcomes. The capsule of the future will not merely image the intestine - it will symbolize medicine's evolution toward intelligent, zero-waste diagnostics.
Irritable bowel syndrome with diarrhea: time to change practice?
Caranfil C, Bertin L, Zingone F
Curr Opin Gastroenterol · 2026 May · PMID 41656705 · Full text
PURPOSE OF REVIEW: Traditional approaches to irritable bowel syndrome with diarrhea (IBS-D) relied on extensive exclusionary testing and empiric symptom management. Recent advances in understanding neuroimmune pathophysi...
PURPOSE OF REVIEW: Traditional approaches to irritable bowel syndrome with diarrhea (IBS-D) relied on extensive exclusionary testing and empiric symptom management. Recent advances in understanding neuroimmune pathophysiology, refined diagnostic algorithms, emergence of novel biomarkers, and clarification of comparative treatment efficacy through systematic reviews necessitate evaluation of whether accumulated evidence warrants substantive changes to contemporary diagnostic and therapeutic practice in IBS-D management. RECENT FINDINGS: Diagnostic paradigms have shifted toward symptom-based approaches utilizing judicious testing informed by alarm features, with emerging biomarkers including neutrophil-to-albumin ratio, microRNA-148, and bile acid malabsorption markers showing promise. Therapeutically, tricyclic antidepressants demonstrate robust efficacy as neuromodulators, while selective serotonin reuptake inhibitors show limited benefit. Emerging neuroimmune therapies targeting mast cell activation, including histamine receptor antagonists, represent promising avenues. Low FODMAP and Mediterranean diets demonstrate substantial efficacy, while brain-gut behavioral therapies achieve clinically meaningful improvements in refractory populations through accessible delivery modalities. SUMMARY: Contemporary evidence supports fundamental practice shifts from exclusionary testing toward targeted investigation of treatable mimics and from empiric management toward mechanism-based multimodal interventions integrating neuromodulators, dietary modifications, and behavioral therapies. Optimal outcomes require individualized treatment selection informed by symptom phenotype and comorbidity profiles, ideally delivered through integrated care models combining gastroenterology, dietetic, and behavioral expertise.
Current opinion in gastroenterology.
Assis DN
Curr Opin Gastroenterol · 2026 Mar · PMID 41640187 · Publisher ↗
Abstract loading — click title to view on PubMed.
Editorial introduction.
Curr Opin Gastroenterol · 2026 Mar · PMID 41640186 · Publisher ↗
Abstract loading — click title to view on PubMed.
Dietary therapy for small bowel Crohn's disease.
Baharad Y, Engel T, Ben-Horin S
Curr Opin Gastroenterol · 2026 May · PMID 41612628 · Publisher ↗
PURPOSE OF REVIEW: This review highlights the emerging role of dietary interventions for Crohn's disease (CD). RECENT FINDINGS: An overview of clinical data on dietary strategies for management of CD is presented, includ...
PURPOSE OF REVIEW: This review highlights the emerging role of dietary interventions for Crohn's disease (CD). RECENT FINDINGS: An overview of clinical data on dietary strategies for management of CD is presented, including exclusive enteral nutrition, the Crohn's disease exclusion diet (CDED) and the Mediterranean diet, among others. The methodological challenges in performing dietary randomized trials are outlined, including the difficulty in blinding, the multiple components inherent to food interventions and the heterogeneous nature of even 'similar' dietary constituents, collectively making it hard to delineate the responsible mechanism for any observed effect. We also review the data on food supplements explored for this CD treatment, such as vitamin D, omega-3 and combination curcumin-QingDai (CurQD). Novel strategies to integrate personalized nutrition with pharmacologic therapy are discussed and may ultimately improve disease control and patients' long term prognosis and quality of life. Dietary interventions as preventive measures in patients at risk of developing CD are particularly appealing, but are still backed only by association studies, thereby mandating further research before they can be strongly endorsed. SUMMARY: Emerging evidence suggests a range of dietary interventions as potentially effective and safe strategies for management of small bowel CD.
Mechanistic insights into pancreatic duct pressure: from basic physiology to translational implications.
Li J, Wen L, Yang A
Curr Opin Gastroenterol · 2026 Mar · PMID 41576420 · Full text
PURPOSE OF REVIEW: This review summarizes recent advances in pancreatic ductal hypertension (PDH), emphasizing its pathophysiological mechanisms, clinical relevance across pancreatic diseases, and progress in noninvasive...
PURPOSE OF REVIEW: This review summarizes recent advances in pancreatic ductal hypertension (PDH), emphasizing its pathophysiological mechanisms, clinical relevance across pancreatic diseases, and progress in noninvasive assessment. The aim is to highlight translational insights that may improve patient selection for intervention and guide long-term management strategies. RECENT FINDINGS: Evidence indicates that PDH contributes not only to pain in chronic pancreatitis but also to exocrine insufficiency, diabetes, and complications such as post-ERCP pancreatitis (PEP) and recurrent acute pancreatitis (RAP). Pancreatic stellate cells (PSCs) are central to fibrosis and are directly activated by pressure, reinforcing disease progression. Traditional methods of measuring pancreatic duct pressure rely on invasive manometry, microtransducer catheters, or pancreatic fistulae, all with inherent risks. Recent translational advances, particularly magnetic resonance cholangiopancreatography (MRCP) integrated with computational fluid dynamics modeling, have demonstrated the feasibility of noninvasive pancreatic duct pressure (PDP) estimation with strong concordance to endoscopic retrograde cholangiopancreatography-based manometry and symptom relief. SUMMARY: These advances emphasize the critical role of accurate pressure assessment in identifying patients with true ductal hypertension who are most likely to benefit from decompression. Noninvasive measurement offers a promising strategy to limit unnecessary interventions and to delineate the direct contribution of ductal pressure to exocrine, endocrine, and related disorders. Validation in larger cohorts and high-risk populations will be essential.
Management of autoimmune hepatitis-related decompensated cirrhosis: current evidence and clinical decision-making.
Arvaniti P, Londoño MC
Curr Opin Gastroenterol · 2026 Mar · PMID 41492195 · Publisher ↗
PURPOSE OF REVIEW: Autoimmune hepatitis (AIH) presenting with decompensated cirrhosis poses a major therapeutic dilemma for clinicians. Although the prompt initiation of immunosuppression (IS) can reverse disease activit...
PURPOSE OF REVIEW: Autoimmune hepatitis (AIH) presenting with decompensated cirrhosis poses a major therapeutic dilemma for clinicians. Although the prompt initiation of immunosuppression (IS) can reverse disease activity and lead to the clinical resolution of decompensation, avoiding the need for liver transplantation (LT), it may also be futile or even harmful. International guidelines and cohort studies have begun to address this challenge, making it timely to synthesize available evidence and provide practical guidance for clinicians. RECENT FINDINGS: Emerging data highlight that the benefit of IS in AIH-related decompensated cirrhosis is closely related to disease activity, as well as to the type and severity of decompensation. In this context, patients with "burn-out" cirrhosis, advanced hepatic encephalopathy and severely elevated prognostic scores have a low probability to benefit from IS and face a greater risk of developing treatment-related complications. Therefore, international guidelines emphasize individualized decision-making, integrating clinical scores and predictors of treatment benefit, as well as timely evaluation for LT. SUMMARY: This review summarizes the current evidence and evolving recommendations for managing AIH-related decompensated cirrhosis, providing a structured approach to help clinicians identify candidates for IS and balance treatment decisions to optimize outcomes.
Pathophysiology of cystic fibrosis-related liver disease.
Palmiotti A, Bertolini A, Fiorotto R
Curr Opin Gastroenterol · 2026 Mar · PMID 41461020 · Full text
PURPOSE OF REVIEW: Cystic fibrosis liver disease (CFLD) is a significant nonpulmonary complication of cystic fibrosis, affecting approximately 5-10% of patients. It encompasses a spectrum of hepatic abnormalities ranging...
PURPOSE OF REVIEW: Cystic fibrosis liver disease (CFLD) is a significant nonpulmonary complication of cystic fibrosis, affecting approximately 5-10% of patients. It encompasses a spectrum of hepatic abnormalities ranging from mild, transient elevations in liver enzymes to advanced CFLD (aCFLD), which is marked by clinically relevant portal hypertension due to cirrhotic or noncirrhotic liver pathology. This review focuses on aCFLD as the clinically meaningful form of the disease and summarizes recent mechanistic insights into its pathogenesis that may inform the development of targeted therapeutic strategies. RECENT FINDINGS: CFLD pathogenesis has been traditionally linked to defective bile secretion. Emerging evidence, however, highlights additional contributors, including cholangiocyte immune dysregulation, gut dysbiosis, and intestinal barrier dysfunction, which together promote hepatic inflammation. Furthermore, recent studies underscore the role of vascular alterations independent of cirrhosis, specifically noncirrhotic portal hypertension, as the main clinical feature in aCFLD. These findings support a multifactorial, multihit model of disease in the pathogenesis of CFLD. SUMMARY: The complex interplay of these factors suggests that effective treatment for aCFLD may require a multifaceted approach. Advances in understanding the gut-liver axis and vascular contributions provide new therapeutic targets. Future research should focus on validating these findings and evaluating the efficacy of cystic fibrosis transmembrane conductance regulator modulators and microbiome-targeted treatments in altering the course of CFLD.
Clinical management and outcomes of hepatobiliary disease in the cystic fibrosis transmembrane conductance regulator modulator era.
Trocchia C, Lazar L, Sellers ZM
Curr Opin Gastroenterol · 2026 Mar · PMID 41442752 · Publisher ↗
PURPOSE OF REVIEW: Multiple cystic fibrosis transmembrane conductance regulator (CFTR) modulators are approved for the treatment of cystic fibrosis (CF) and show significant improvement in lung function, BMI, quality of...
PURPOSE OF REVIEW: Multiple cystic fibrosis transmembrane conductance regulator (CFTR) modulators are approved for the treatment of cystic fibrosis (CF) and show significant improvement in lung function, BMI, quality of life, and sweat chloride. However, their ability to impact liver disease is unclear. This review highlights the current published literature on CFTR modulators and liver health and briefly reviews considerations for clinical management of hepatobiliary disease in the CFTR modulator era. RECENT FINDINGS: Currently, the primary data available on the clinical efficacy of CFTR modulators on CF hepatobiliary involvement (CFHBI) or advanced CF liver disease (aCFLD) is from small to moderate sized single-center studies, although more recently large, multicenter studies are emerging. Studies report opposing changes in aminotransferases, and mixed liver fibrosis index and elastography results. Yet, in total CFTR modulators generally do not worsen liver disease and may improve it in some individuals. Additional clinical management considerations are necessary in those on CFTR modulators who received an organ transplant or during nutritional evaluations. SUMMARY: To better understand the possible benefit of CFTR modulator therapies on hepatobiliary health, additionally larger, longer-term, multicenter studies with sub-group phenotyping are necessary. Until then, providers should watch for liver-related adverse events, and be cognizant on how CFTR modulators may impact areas of clinical care for individuals with CF.
PBC-AIH variant syndrome: emerging new terminology and a new approach to diagnosis and management.
Sebode M, Gerussi A
Curr Opin Gastroenterol · 2026 Mar · PMID 41432137 · Publisher ↗
PURPOSE OF REVIEW: This review summarizes the recent developments of one of the most controversial entities in hepatology, variant syndromes of primary biliary cholangitis (PBC) with characteristics of autoimmune hepatit...
PURPOSE OF REVIEW: This review summarizes the recent developments of one of the most controversial entities in hepatology, variant syndromes of primary biliary cholangitis (PBC) with characteristics of autoimmune hepatitis (AIH). RECENT FINDINGS: Recently a consensus process was initiated to find agreement on the terminology, diagnostic criteria and treatment recommendations for patients with PBC-AIH variant syndromes. The concept and terminology of a variant syndrome, with one component of either AIH or PBC dominating over the other, is currently preferred. No single test can establish the diagnosis of a variant syndrome, only a combination of biochemical, serological and/or histological tests can support the diagnosis. If classical PBC is dominating, histology is mandatory for the diagnosis of a PBC-AIH variant syndrome. Treatment of PBC-AIH variants is based on a combination of ursodeoxycholic acid and immunosuppression. Since the prognosis of a PBC-AIH variant syndrome seems to be worse than the prognosis of classical PBC, the diagnosis of PBC-AIH must not be missed. SUMMARY: The recent consensus process on PBC-AIH variant syndromes does not provide answers to all questions regarding this entity. Rather, it serves as a starting point for future studies to confirm or even challenge the current consensus.
Editorial.
Shirwaikar Thomas A
Curr Opin Gastroenterol · 2026 Jan · PMID 41343255 · Publisher ↗
Abstract loading — click title to view on PubMed.
Minimally invasive, maximum impact: advances in the application of colonic stents.
Koutroumpakis F, Coronel E
Curr Opin Gastroenterol · 2026 Jan · PMID 41198065 · Publisher ↗
PURPOSE OF REVIEW: Malignant colorectal obstruction (MCO) is a common and life-threatening presentation of colorectal cancer, traditionally managed with emergency surgery associated with high morbidity and high stoma rat...
PURPOSE OF REVIEW: Malignant colorectal obstruction (MCO) is a common and life-threatening presentation of colorectal cancer, traditionally managed with emergency surgery associated with high morbidity and high stoma rates. Self-expanding metal stents (SEMS) have emerged as an important alternative for both palliation and as a bridge to curative resection. This review summarizes recent advances in indications, technical aspects, and emerging applications of colonic stenting, highlighting its role in modern multidisciplinary care. RECENT FINDINGS: Current evidence supports the use of SEMS as one of the first-line palliative approaches in selected patients, providing rapid symptom relief and reducing the need for permanent stomas. In carefully selected patients, colonic SEMS can convert urgent high-risk operations into planned resections, facilitating minimally invasive approaches, though concerns remain regarding perforation risk and long-term oncologic outcomes. Increasing operator expertise, device innovation, and technical advances continue to improve safety and success rates. Beyond malignancy, expanding applications include refractory benign strictures, diverticular obstruction, and the use of lumen-apposing metal stents (LAMS) in inflammatory bowel disease and anastomotic complications. SUMMARY: Colonic stenting has emerged as a valuable alternative to surgery for the management of MCO and is being investigated in select benign conditions, though broader adoption requires further evidence. Future research should refine patient selection, compare stenting with surgical alternatives, and clarify long-term outcomes.
Colon chaos: when drugs turn against your gut.
Shatila M, Wang Y, Shirwaikar Thomas A
Curr Opin Gastroenterol · 2026 Jan · PMID 41198062 · Publisher ↗
PURPOSE OF REVIEW: Immune-mediated diarrhea and colitis (IMDC) is a very common and severe toxicity to immune checkpoint inhibition that has generated a lot of scientific interest. The current guidelines do not capture t...
PURPOSE OF REVIEW: Immune-mediated diarrhea and colitis (IMDC) is a very common and severe toxicity to immune checkpoint inhibition that has generated a lot of scientific interest. The current guidelines do not capture the most recent literature on this disease entity, and few reviews if any have been published that describe the advances made in our understanding of IMDC. As more and more patients are being treated with immune checkpoint inhibitors (ICIs), it becomes essential to optimize treatment algorithms for ICI-related toxicities, especially IMDC. RECENT FINDINGS: In our review, we discuss the findings of recent studies on IMDC epidemiology including incidence and risk factors, evaluation and treatment modalities, and surveillance and long-term outcomes. We note that while much has been learned regarding disease epidemiology and the utility of stool biomarkers over clinical symptoms, there remains a paucity of data where IMDC treatment options and long-term IMDC outcomes and surveillance is concerned. SUMMARY: Our results highlight the most recent advances in our knowledge of IMDC and allow us to propose a management algorithm that improves on prior guidelines for IMDC by incorporating new study findings.
All in my head or all in my gut? An update on irritable bowel syndrome.
Woods AT, Ford AC, Black CJ
Curr Opin Gastroenterol · 2026 Jan · PMID 41128459 · Publisher ↗
PURPOSE OF REVIEW: Irritable bowel syndrome (IBS) has a considerable impact on patients and healthcare systems. IBS is a disorder of brain-gut interaction with numerous biopsychosocial factors involved, including early l...
PURPOSE OF REVIEW: Irritable bowel syndrome (IBS) has a considerable impact on patients and healthcare systems. IBS is a disorder of brain-gut interaction with numerous biopsychosocial factors involved, including early life experiences, previous gastrointestinal infections, and coexisting mood disorders. An understanding of the role of the gut-brain axis in symptom generation is vital to enable delivery of holistic care. RECENT FINDINGS: We explore psychological mechanisms, such as coexisting anxiety and depression, adverse life experiences, and somatisation and how these impact symptom severity. There is evidence for psychological therapies, such as cognitive behavioural therapy or gut-directed hypnotherapy, in IBS. We go on to summarise gut-based mechanisms, such as abnormal motility, visceral hypersensitivity, inflammation, and dysbiosis. Efficacious treatments targeting these include antidiarrhoeals, laxatives, antispasmodics, drugs acting on ion channels or serotonin, gut-brain neuromodulators, and treatments targeting the microbiota or inflammation. Finally, we consider emerging evidence from models describing distinct IBS phenotypes and their potential to facilitate a more integrated approach to identify best treatment options. SUMMARY: For many patients with IBS, both brain and gut mechanisms must be considered within the context of the biopsychosocial model to enable effective delivery of holistic and personalised care.
Endoscopic mucosal resection or endoscopic submucosal dissection: choosing the right tool to a polyp-free colon.
Wahba GM, Nehme F, Ge PS
Curr Opin Gastroenterol · 2026 Jan · PMID 41086286 · Publisher ↗
PURPOSE OF REVIEW: Endoscopic resection is now the standard of care for the management of colorectal polyps. With increased training and expertise in endoscopic mucosal resection (EMR) and endoscopic submucosal dissectio...
PURPOSE OF REVIEW: Endoscopic resection is now the standard of care for the management of colorectal polyps. With increased training and expertise in endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), it is important to recognize their complementary roles, as well as their individual strengths and limitations. RECENT FINDINGS: Here, we draw upon the experience of a real patient scenario to provide a case-based review on EMR and ESD. We will review evidence-based technical refinements to EMR which have improved procedural safety and decreased recurrence rates, as well as how expanded access to ESD and enhanced training has resulted in improvements in outcomes and adverse events. Finally, we will discuss how lesion, patient, and endoscopist factors influence the overall endoscopic resection strategy. SUMMARY: EMR and ESD are complementary tools in the modern endoscopic resection toolkit, and the correct resection strategy draws upon a deep understanding of the tools available and is individualized based upon patient, endoscopist, and lesion characteristics.
Brighter days ahead: the shifting landscape of IBD therapy.
Kassim G, Philpott JR
Curr Opin Gastroenterol · 2026 Jan · PMID 41086285 · Publisher ↗
PURPOSE OF REVIEW: The field of inflammatory bowel disease (IBD) continues to evolve at an unprecedented rate as the past decades have borne witness to the complete transformation of our approach to IBD and its care. Des...
PURPOSE OF REVIEW: The field of inflammatory bowel disease (IBD) continues to evolve at an unprecedented rate as the past decades have borne witness to the complete transformation of our approach to IBD and its care. Despite that, we continue to face major challenges, including rising incidence, shifting demographics, financial toxicity, as well as a frequently encountered therapeutic ceiling. This review aims to highlight the main factors driving the shifting landscape of IBD therapy. RECENT FINDINGS: Many steps are being taken to improve efficacy and raise the therapeutic ceiling. Mounting evidence from clinical trials suggests that the use of various dual advanced therapies is well tolerated and may increase overall efficacy. Novel therapeutic mechanisms are being explored, including various novel oral agents as well as antihuman tumor necrosis factor-like cytokine A (anti-TL1A) antibodies with their novel antifibrotic potential. Delivery of care is also being optimized and refined with greater emphasis on early diagnosis, early effective therapy, treating to target and monitoring objective outcomes, therapeutic drug monitoring, and more effective use of current therapies. Greater recognition of the impact of IBD on patients beyond the disease itself is driving the spread of a patient-centric, multidisciplinary team-based approach to IBD care. SUMMARY: As we continue to refine and deepen our understanding of IBD, the landscape of IBD therapy continues to shift and evolve as it aims to meet the needs of IBD patients with hope for brighter days ahead.
Endobariatrics in the era of glucagon-like peptide-1 receptor agonists: evolving roles, evidence, and integration.
Vahedi F, Yalamanchi M, Issa D
Curr Opin Gastroenterol · 2025 Nov · PMID 41025685 · Publisher ↗
PURPOSE OF REVIEW: We review and summarize current evidence-based management strategies in the field of endobariatrics (EBT) for the management of obesity during a time of rapidly expanding pharmacologic options, particu...
PURPOSE OF REVIEW: We review and summarize current evidence-based management strategies in the field of endobariatrics (EBT) for the management of obesity during a time of rapidly expanding pharmacologic options, particularly with rising popularity of glucagon-like peptide-1 (GLP-1) receptor agonists (RAs). RECENT FINDINGS: National trends show increased use of GLP-1 RAs in obesity management. EBT are minimally invasive endoscopic therapies that offer durable weight loss with low complications rates. Patient comorbidities, socioeconomic factors, and adherence are critical considerations in treatment selection. Emerging data suggest that combining GLP-1 RAs with EBTs may yield synergistic effects. SUMMARY: A growing array of treatment options are available in the management of obesity. Personalized, combination therapy that integrates mechanism-based interventions with pharmacotherapy may optimize long-term outcomes for sustained weight loss. Multidisciplinary approach remains essential for delivering comprehensive multidisciplinary care.
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