Curr. Opin. Gastroenterol. [JOURNAL]
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200 papers
Stomach and duodenum: what's current in 2025.
Shah TU
Curr Opin Gastroenterol · 2025 Nov · PMID 41025684 · Publisher ↗
Abstract loading — click title to view on PubMed.
Beyond the scope: an update on colon cancer screening tests.
Yen T, Do M, Patel SG
Curr Opin Gastroenterol · 2026 Jan · PMID 41017505 · Publisher ↗
PURPOSE OF REVIEW: Colorectal cancer (CRC) is common and rising among persons under age 50, but screening uptake is sub-optimal, particularly in 45-49 year-olds. Death from CRC can be prevented through detection and remo...
PURPOSE OF REVIEW: Colorectal cancer (CRC) is common and rising among persons under age 50, but screening uptake is sub-optimal, particularly in 45-49 year-olds. Death from CRC can be prevented through detection and removal of advanced precancerous colorectal lesions (APLS) or detection of CRC at an early stage. In this review, we cover average-risk CRC screening options and present a framework for test selection in different clinical settings. RECENT FINDINGS: The optimal CRC screening test should be highly sensitive for APLs and early stage CRC, easy to access, affordable to patient and payers, and appropriate for screening settings. Organized screening is administered systematically on the population-level, while opportunistic screening relies on individual provider-patient shared decision making. In addition to established options such as fecal immunochemical testing, multitarget stool DNA testing, and colonoscopy, novel options include stool-based RNA testing, next-generation stool-based DNA testing, and blood-based DNA testing. Although blood-based tests may be convenient, their low sensitivity for APLs can unintentionally lead to negative consequences for CRC prevention. SUMMARY: Uptake, cost, and efficacy of established and novel CRC screening tests influence the modality of choice for specific screening settings. Colonoscopy and stool-based tests should generally be first-line for CRC screening.
Laxative logic: when lifestyle is not enough.
Colbran R, Neshatian L
Curr Opin Gastroenterol · 2026 Jan · PMID 41017482 · Publisher ↗
PURPOSE OF REVIEW: Chronic constipation remains challenging to manage, particularly when lifestyle measures prove insufficient. With an expanding range of pharmacologic options available, clinicians face the task of choo...
PURPOSE OF REVIEW: Chronic constipation remains challenging to manage, particularly when lifestyle measures prove insufficient. With an expanding range of pharmacologic options available, clinicians face the task of choosing the right agent for the right patient. This review explores recent developments in prescription laxatives and their evolving role in practice. RECENT FINDINGS: Randomized controlled trials have confirmed the safety and efficacy of newer prescription laxative agents including secretagogues (linaclotide, lubiprostone, plecanatide), sodium/hydrogen exchanger isoform 3 (NHE3) inhibitors (tenapanor), serotonin 5-hydroxytryptamine receptor agonists (prucalopride), and bile acid reabsorption inhibitors (elobixibat). Each drug offers its own unique advantages, with new evidence suggesting these therapies may provide symptom relief beyond managing stool consistency alone. SUMMARY: Patients with constipation now have access to a wide range of medications, from over-the-counter osmotic and stimulant agents to prescription laxative combination strategies. This breadth allows clinicians to tailor therapy to diverse pathophysiology and symptom profiles. Yet despite this choice, real-world adherence remains poor and many patients are dissatisfied, reflecting the complexity of treating constipation and frequent mismatches between therapy and patients' most bothersome symptoms. Management should emphasize careful symptom assessment, shared decision-making, and clear expectation setting, while leveraging the available armamentarium.
Gut power for better health: microbial therapeutics.
Quigley EMM
Curr Opin Gastroenterol · 2026 Jan · PMID 40986483 · Publisher ↗
PURPOSE OF REVIEW: To critically evaluate the literature over the past year on microbial therapeutics in the management of disorders of the large intestine. The primary focus is on disorders where the microbiome has been...
PURPOSE OF REVIEW: To critically evaluate the literature over the past year on microbial therapeutics in the management of disorders of the large intestine. The primary focus is on disorders where the microbiome has been implicated in pathophysiology, and its modulation has been a therapeutic target. RECENT FINDINGS: Though widely consumed, data on the impact of probiotics and prebiotics in gastrointestinal disorders continue to pose challenges in interpretation due to shortcomings in study design; postbiotics, meanwhile, because of some logistical and regulatory advantages, are attracting attention. Though time-honored for its role in infections due to Clostridioides difficile (CDI), FMT has encountered challenges in relation to regulation leading to the appearance of highly standardized, extensively screened and rigorously prepared microbial products [defined as live biotherapeutic products (LBP)], which show great promise; two have been approved by the FDA for prevention of recurrent CDI. Outside of CDI, efforts to define a role for FMT in the management of various diseases have met with mixed results. SUMMARY: The translation of findings in studies of microbiome composition to successful therapies has proven disappointing to date, though attempts to develop selective and targeted microbial consortia show promise and may lead the way to personalized bacteriotherapy.
Updates in endoscopic hemostasis for nonvariceal gastroduodenal bleeding.
Zaver HB, McGrath MS, Wang AY
Curr Opin Gastroenterol · 2025 Nov · PMID 40986477 · Publisher ↗
PURPOSE OF REVIEW: To provide an updated overview of the management of nonvariceal upper gastrointestinal bleeding, focusing on recent advancements in endoscopic hemostasis techniques and evidence-based clinical practice...
PURPOSE OF REVIEW: To provide an updated overview of the management of nonvariceal upper gastrointestinal bleeding, focusing on recent advancements in endoscopic hemostasis techniques and evidence-based clinical practices. RECENT FINDINGS: Recent studies and societal guidance emphasize the importance of early triage, restrictive transfusion strategies, and the integration of risk stratification tools for management of nonvariceal upper gastrointestinal bleeding. Notable advancements in endoscopic modalities for hemostasis include cap-assisted clips, noncontact thermal therapies, and the expansion of available topical hemostatic agents. SUMMARY: Effective nonvariceal upper gastrointestinal bleeding management requires a multidisciplinary approach that prioritizes early resuscitation, risk assessment, and the use of evolving endoscopic technologies to achieve optimal hemostasis.
Kupffer cells are central to mitigating intravascular infections.
Oliveira FRMB, Kubes P
Curr Opin Gastroenterol · 2025 Nov · PMID 40986476 · Publisher ↗
PURPOSE OF REVIEW: Kupffer cells (KCs), the resident liver macrophages, are absolutely critical in immune surveillance and intravascular pathogen eradication. This mini-review highlights KCs' contributions to host protec...
PURPOSE OF REVIEW: Kupffer cells (KCs), the resident liver macrophages, are absolutely critical in immune surveillance and intravascular pathogen eradication. This mini-review highlights KCs' contributions to host protection of intravascular infections. RECENT FINDINGS: KCs, uniquely originated and self-renewing, demonstrate remarkable functional plasticity and trained immunity. KCs are frontline responders in infections: they phagocytose microorganisms but can succumb to certain infections. We highlight some of the recent findings in this regard. SUMMARY: Understanding KCs' complex interactions with diverse pathogens is key to improving treatment modalities in infection. Future research, needs to focus on how certain pathogens evade KCs and how we can aid these macrophages in eradicating microbes. A move towards humanized KC models in vivo and in vitro incorporating key environmental factors such as shear flow and unique sinusoidal components will be essential to unravel their comprehensive roles.
Modern concepts of small intestinal bacterial overgrowth.
Barlow GM, Pimentel M
Curr Opin Gastroenterol · 2025 Nov · PMID 40960427 · Full text
PURPOSE OF REVIEW: Small intestinal bacterial overgrowth (SIBO) has been a recognized condition for more than half a century. Early descriptions of SIBO were based on the concept of colonic bacteria "backing up" into the...
PURPOSE OF REVIEW: Small intestinal bacterial overgrowth (SIBO) has been a recognized condition for more than half a century. Early descriptions of SIBO were based on the concept of colonic bacteria "backing up" into the small intestine. This was based on techniques using unprotected aspiration catheters and earlier culture techniques. Recent advances in breath testing, small bowel sampling, culture techniques, and next generation sequencing have helped expand our understanding of SIBO. RECENT FINDINGS: "SIBO" is now understood to encompass at least three different types of overgrowth including SIBO, intestinal methanogen overgrowth (IMO) and intestinal sulfide overproduction (ISO). Each has their own unique microbial profile. In addition, next generation sequencing has revealed that SIBO is not a migration of colonic flora into the small intestine, but rather overgrowth of two predominant species/strains from phylum Proteobacteria ( Escherichia coli and Klebsiella ). Lastly, results from next generation sequencing of the stool and small intestinal microbiomes have validated breath testing as a diagnostic tool. SUMMARY: Together, these advances have allowed the identification of key microbes in overgrowth syndromes, uncovering their relationships to conditions such as irritable bowel syndrome, and paving the way for the development of novel customized treatment options in the future.
Advances in diagnosis and therapy for upper gastrointestinal Crohn's disease.
Sahyoun L, Gaidos JKJ
Curr Opin Gastroenterol · 2025 Nov · PMID 40923941 · Publisher ↗
PURPOSE OF REVIEW: Crohn's disease is a chronic, relapsing and remitting inflammatory process that can involve the entire length of the gastrointestinal tract. Upper gastrointestinal involvement (UGI) in Crohn's disease...
PURPOSE OF REVIEW: Crohn's disease is a chronic, relapsing and remitting inflammatory process that can involve the entire length of the gastrointestinal tract. Upper gastrointestinal involvement (UGI) in Crohn's disease is present in up to 15% of patients and can present as a diagnostic challenge given nonspecific symptoms and overlapping disease entities. This review provides an update on diagnosing and risk stratifying UGI-CD. RECENT FINDINGS: Literature suggests the use of imaging modalities (such as video capsule endoscopy, cross-sectional imaging and intestinal ultrasound) to help identify proximal inflammation when clinical suspicion for UGI involvement exists based on symptoms and patient factors. Additionally, proximal disease involvement has been associated with increased disease severity, a higher prevalence of strictures and an increased risk for surgery. First-line therapies are corticosteroids and antitumor necrosis factor therapies if systemic treatment is needed based on disease severity. For stricturing disease, endoscopic balloon dilation, strictureplasty, surgical resection or bypass can be considered for medically refractory or recurrent disease. SUMMARY: As the prevalence and progression of UGI-CD is still understudied due to its variable definition, presentation and incidence, the development of a standardized approach to diagnosis could aid in determining the overall prevalence and most effective treatments.
Potassium-competitive acid blockers.
Davis TA, Gyawali CP
Curr Opin Gastroenterol · 2025 Nov · PMID 40923937 · Publisher ↗
PURPOSE OF REVIEW: Acid suppression is the mainstay of management of common foregut disorders, including gastroesophageal reflux disease (GERD), peptic ulcer disease and Helicobacter pylori infection. Drawbacks of standa...
PURPOSE OF REVIEW: Acid suppression is the mainstay of management of common foregut disorders, including gastroesophageal reflux disease (GERD), peptic ulcer disease and Helicobacter pylori infection. Drawbacks of standard management with proton pump inhibitors (PPIs) include acid lability requiring enteric coating, slow onset of effect, lack of suppression of nocturnal acid breakthrough, and need for administration before meals. RECENT FINDINGS: Potassium-competitive acid blockers (PCABs) are a novel class of acid suppressants that are effective in the management of symptomatic and erosive GERD, peptic ulcer disease and H. pylori infection. Administration before meals is not needed, and these agents achieve profound acid suppression right from the first dose, with control of daytime as well as nocturnal acid. In randomized controlled trials, PCABs are noninferior and often superior to PPIs, especially in healing of advanced grade esophagitis and eradication of treatment-naive as well as refractory H. pylori. The safety profile of PCABs over 10 years of use is reassuring, although profound acid suppression may contribute to hypergastrinemia and increased risk of gastrointestinal infections. SUMMARY: As PCABs become available in many countries around the globe, real-world use will allow further research to determine the clinical niche of these acid-suppressive agents.
Colonoscopy in obese patients: challenges and emerging solutions.
Badurdeen D, Huang Y, Acosta A
Curr Opin Gastroenterol · 2025 Sep · PMID 40772523 · Publisher ↗
PURPOSE OF REVIEW: The rising prevalence of obesity, now affecting over 40% of U.S. adults, poses critical implications for colorectal cancer screening, as obesity increases the risk of both colorectal adenomas and cance...
PURPOSE OF REVIEW: The rising prevalence of obesity, now affecting over 40% of U.S. adults, poses critical implications for colorectal cancer screening, as obesity increases the risk of both colorectal adenomas and cancer. Despite these elevated risks, patients with obesity have lower colonoscopy screening participation and face unique barriers that compromise procedural quality. This review aims to highlight the challenges encountered during colonoscopy in obese patients and examine emerging solutions that may enhance screening effectiveness and patient outcomes. RECENT FINDINGS: Obesity is associated with suboptimal bowel preparation, prolonged cecal intubation times, lower adenoma detection rates, and increased sedation-related complications. These challenges stem from altered gastrointestinal physiology, body habitus, and comorbid conditions. Recent innovations in bowel preparation strategies, sedation protocols, and endoscopic technologies-such as robotic-assisted colonoscopy and artificial intelligence-enhanced visualization-have demonstrated promise in addressing these limitations. Institutional initiatives, including tailored protocols and endoscopy team training, are also contributing to improved outcomes. SUMMARY: As obesity rates climb, adapting colonoscopy practices to meet the needs of this population is essential. Incorporating evidence-based strategies and emerging technologies can help overcome procedural barriers, improve detection rates, and reduce disparities in colorectal cancer screening. Continued research and guideline refinement are needed to optimize care delivery for patients with obesity.
Gastrointestinal endoscopy: keeping up with the times.
Kalloo A
Curr Opin Gastroenterol · 2025 Sep · PMID 40772522 · Publisher ↗
Abstract loading — click title to view on PubMed.
The management of small bowel Crohn's disease in older age.
Shakweh E, Hart A
Curr Opin Gastroenterol · 2025 Sep · PMID 40768162 · Publisher ↗
PURPOSE OF REVIEW: The prevalence of inflammatory bowel disease (IBD) amongst older adults (≥60 years old) is rising, encompassing individuals with a preexisting diagnosis and those newly diagnosed. Projections estimate...
PURPOSE OF REVIEW: The prevalence of inflammatory bowel disease (IBD) amongst older adults (≥60 years old) is rising, encompassing individuals with a preexisting diagnosis and those newly diagnosed. Projections estimate that by 2030, one-third of patients with IBD will be older adults. Managing older adults with IBD poses unique challenges, including frailty, multimorbidity and polypharmacy. This review summarises the approach to managing older adults with small bowel Crohn's disease (SBCD), a distinct IBD sub-type. RECENT FINDINGS: The 2024 "State of IBD care in the United Kingdom (UK)" report revealed a median delay of 8 months from onset of Crohn's disease symptoms to diagnosis. Diagnostic delay in Crohn's disease is associated with stricturing and penetrating complications. Diagnostic challenges in SBCD include its insidious presentation in older adults and the poor utility of calprotectin as a biomarker, with a positive predictive value of only 23.1% with a calprotectin over 200 μg/g. Management should be tailored to patient preference and frailty, given the paucity of evidence pertaining to nutritional, medical and surgical treatment approaches in older adults. SUMMARY: Older adults with IBD represent a heterogenous cohort. Optimising the recruitment of older adults to clinical trials and stratifying outcomes according to frailty are key research priorities.
Editorial introduction.
Curr Opin Gastroenterol · 2024 Nov · PMID 40729646 · Publisher ↗
Abstract loading — click title to view on PubMed.
Evolving techniques in the endoscopic evaluation and management of pancreas cystic lesions.
Maloof T, Karaisz F, Abdelbaki A … +2 more , Perumal KD, Krishna SG
Curr Opin Gastroenterol · 2025 Sep · PMID 40682403 · Full text
PURPOSE OF REVIEW: Accurate diagnosis of pancreatic cystic lesions (PCLs) is essential to guide appropriate management and reduce unnecessary surgeries. Despite multiple guidelines in PCL management, a substantial propor...
PURPOSE OF REVIEW: Accurate diagnosis of pancreatic cystic lesions (PCLs) is essential to guide appropriate management and reduce unnecessary surgeries. Despite multiple guidelines in PCL management, a substantial proportion of patients still undergo major resections for benign cysts, and a majority of resected intraductal papillary mucinous neoplasms (IPMNs) show only low-grade dysplasia, leading to significant clinical, financial, and psychological burdens. This review highlights emerging endoscopic approaches that enhance diagnostic accuracy and support organ-sparing, minimally invasive management of PCLs. RECENT FINDINGS: Recent studies suggest that endoscopic ultrasound (EUS) and its accessory techniques, such as contrast-enhanced EUS and needle-based confocal laser endomicroscopy, as well as next-generation sequencing analysis of cyst fluid, not only accurately characterize PCLs but are also well tolerated and cost-effective. Additionally, emerging therapeutics such as EUS-guided radiofrequency ablation (RFA) and EUS-chemoablation are promising as minimally invasive treatments for high-risk mucinous PCLs in patients who are not candidates for surgery. SUMMARY: Accurate diagnosis of PCLs remains challenging, leading to many patients undergoing unnecessary surgery. Emerging endoscopic imaging biomarkers, artificial intelligence analysis, and molecular biomarkers enhance diagnostic precision. Additionally, novel endoscopic ablative therapies offer safe, minimally invasive, organ-sparing treatment options, thereby reducing the healthcare resource burdens associated with overtreatment.
Hypertriglyceridemic pancreatitis: perspectives from China.
Fan Z, Li J, Wu D
Curr Opin Gastroenterol · 2025 Sep · PMID 40682402 · Full text
PURPOSE OF REVIEW: This review aims to summarize the recent developments in hypertriglyceridemic acute pancreatitis (HTG-AP) research in China, focusing on its increasing prevalence, pathophysiology, prognosis, and novel...
PURPOSE OF REVIEW: This review aims to summarize the recent developments in hypertriglyceridemic acute pancreatitis (HTG-AP) research in China, focusing on its increasing prevalence, pathophysiology, prognosis, and novel treatment strategies, emphasizing the relevance of these findings in clinical practice and research. RECENT FINDINGS: Recent studies have highlighted a rising incidence of HTG-AP in China, especially among young males, linked to dietary and lifestyle changes. Key research has identified lipoprotein metabolism abnormalities and genetic factors as predictors of recurrence. Advances in treatment include the combination of low-molecular-weight heparin, insulin, and plasma exchange, showing improved outcomes compared to traditional methods. Additionally, the use of traditional Chinese medicine has shown promise in managing inflammation and improving patient recovery. SUMMARY: These findings emphasize the importance of early diagnosis, personalized treatment strategies, and integrated approaches in managing HTG-AP. Chinese research has made significant strides in understanding the pathophysiology and treatment of HTG-AP, which may influence both national healthcare strategies and global management of the condition.
Idiopathic recurrent acute pancreatitis: current and future approaches to management.
Singh P, Mahapatra SJ, Garg PK
Curr Opin Gastroenterol · 2025 Sep · PMID 40682397 · Publisher ↗
PURPOSE OF REVIEW: Idiopathic recurrent acute pancreatitis (IRAP) is a clinically relevant condition with a high likelihood of progression to chronic pancreatitis (CP) in 20-50% of patients. This review outlines the impo...
PURPOSE OF REVIEW: Idiopathic recurrent acute pancreatitis (IRAP) is a clinically relevant condition with a high likelihood of progression to chronic pancreatitis (CP) in 20-50% of patients. This review outlines the importance of early diagnosis of IRAP and potential upcoming therapies to halt disease progression. It highlights a potential therapeutic window in the natural history of IRAP. RECENT FINDINGS: Despite advancements in diagnostic modalities, identifying a definitive aetiology remains challenging in a significant proportion of cases. Current approaches emphasize structured, stepwise evaluation including metabolic, genetic, and structural factors. Emerging therapies aim to target inflammation, trypsin activation, and pancreatic fibrosis. SUMMARY: While diagnostic tools have improved, therapeutic options remain limited in IRAP. Early identification of modifiable risk factors, use of advanced imaging, and application of evolving treatment strategies may offer an opportunity to prevent the transition from IRAP to CP. Future research must focus on validating disease-modifying treatments and optimizing individualized management strategies.
Updates in endoscopic management of pain in chronic pancreatitis.
Rainho AM, Battel OC, Shami VM
Curr Opin Gastroenterol · 2025 Sep · PMID 40682393 · Publisher ↗
PURPOSE OF REVIEW: This manuscript reviews recent updates on the management of pain in chronic pancreatitis, an entity that remains difficult to manage. In a time when opioid use disorder is on the rise, advanced endosco...
PURPOSE OF REVIEW: This manuscript reviews recent updates on the management of pain in chronic pancreatitis, an entity that remains difficult to manage. In a time when opioid use disorder is on the rise, advanced endoscopists should be aware of the nonopioid options available to patients to help manage their pain. RECENT FINDINGS: Although there is no standardized approach in the management of pain in chronic pancreatitis, societal guidelines and recommendations have recently been updated to help guide physicians in this matter. However, the available endoscopic approaches have remained relatively unchanged in recent years. Studies are underway to determine whether one endoscopic approach is superior to another, depending on the suspected mechanism of pain. SUMMARY: Endoscopic management of pain in chronic pancreatitis remains challenging given the complex mechanisms at play. Surgery remains the most effective durable approach, though with significantly more morbidity and mortality compared to endoscopic options, which include endoscopic retrograde cholangiopancreatography (ERCP), extracorporeal shock wave lithotripsy (ESWL), pancreatoscopy-directed lithotripsy, and endoscopic ultrasound-guided celiac plexus block (EUS-CPB), depending on the predominant suspected cause of pain.
Pancreatic duct calculi: pathophysiology and management.
Bush N, Tandan M
Curr Opin Gastroenterol · 2025 Sep · PMID 40682392 · Publisher ↗
PURPOSE OF REVIEW: Pancreatic ductal calculi (PDC) are a defining feature of chronic pancreatitis and contribute significantly to morbidity through pain and ductal obstruction. This review provides a timely update on the...
PURPOSE OF REVIEW: Pancreatic ductal calculi (PDC) are a defining feature of chronic pancreatitis and contribute significantly to morbidity through pain and ductal obstruction. This review provides a timely update on the evolving understanding of PDC pathogenesis and highlights current and emerging strategies for their management. RECENT FINDINGS: Stone formation in chronic pancreatitis is multifactorial, involving altered pancreatic juice composition, reduced lithostatic proteins, genetic predispositions, and environmental risk factors such as alcohol and smoking. Advances in endoscopic techniques, particularly the combination of extracorporeal shock wave lithotripsy (ESWL) and endoscopic retrograde cholangiopancreatography (ERCP), have improved ductal clearance and symptom control. Pancreatoscopy-guided lithotripsy is gaining traction in complex cases. Surgical options such as longitudinal pancreatojejunostomy and head resection remain vital in patients with extensive disease or failed endoscopic therapy, with evidence supporting superior long-term pain relief when performed early. SUMMARY: Management of PDC requires a multidisciplinary, personalized approach. Endoscopic therapy is the first-line intervention in most cases, while surgery offers durable benefits in select patients. Future directions include identifying biomarkers for early intervention, refining patient selection, and exploring pharmacological strategies to prevent stone formation and recurrence.
Genetic testing for pancreatic cancer screening: ready for prime time?
Whitcomb DC
Curr Opin Gastroenterol · 2025 Sep · PMID 40682389 · Publisher ↗
PURPOSE OF REVIEW: Pancreatic ductal adenocarcinoma (PDAC) has a dismal 13% 5-year survival rate, necessitating early detection and personalized treatment. This review evaluates whether germline genetic testing, integrat...
PURPOSE OF REVIEW: Pancreatic ductal adenocarcinoma (PDAC) has a dismal 13% 5-year survival rate, necessitating early detection and personalized treatment. This review evaluates whether germline genetic testing, integrated with clinical decision support (CDS) tools, is ready for widespread use in PDAC screening. We focus on its potential to identify high-risk individuals (HRIs) beyond those with strong family histories to complex risk and biomarkers, stratifying patients into low-risk and high-risk virtual populations for targeted surveillance. RECENT FINDINGS: Germline genetic testing identifies pathogenic variants linked to hereditary cancer syndromes (HCS), enabling multiorgan surveillance and precision oncology (e.g., PARP inhibitors for BRCA2 mutations). Polygenic risk scores (PRS) combined with clinical markers like new-onset diabetes (NOD) increase the positive predictive value (PPV) for PDAC (e.g., 86.7% in high-PRS quintiles). Genetic testing also adjusts for biomarker variability (e.g., CA19-9 levels via FUT2/FUT3 genotyping) and optimizes chemotherapy through pharmacogenetics, reducing toxicity. Comprehensive platforms integrating genetic, clinical, and biomarker data enhance early detection and risk stratification. SUMMARY: Genetic testing is ready for prime time in PDAC screening. It stratifies patients into low-risk (no surveillance) and high-risk (surveillance warranted) groups, improving early detection, outcomes, and cost-effectiveness, thus transforming PDAC prognosis through targeted intervention.
Endoscopic ultrasound in hepatology: ushering a new era in liver disease management.
Seicean A, Dragomir I, Procopet B
Curr Opin Gastroenterol · 2025 Sep · PMID 40493456 · Publisher ↗
PURPOSE OF REVIEW: This review aims to provide an up-to-date overview of the expanding role of endoscopic ultrasound (EUS) in endohepatology, highlighting its potential to transform the diagnostic and therapeutic landsca...
PURPOSE OF REVIEW: This review aims to provide an up-to-date overview of the expanding role of endoscopic ultrasound (EUS) in endohepatology, highlighting its potential to transform the diagnostic and therapeutic landscape for liver diseases. Given the increasing complexity of liver disease management, this review discusses both established and emerging applications of EUS in liver parenchyma assessment, portal hypertension diagnosis and related complications treatment and liver biopsy techniques. RECENT FINDINGS: Recent studies demonstrate that EUS can accurately assess liver fibrosis, detect focal lesions, and evaluate portal hypertension, with significant advancements in EUS-guided liver biopsy and treatment of gastric varices. Key findings include improved diagnostic accuracy with EUS-FNB over traditional methods and the potential for endoscopic ultrasound portal pressure gradient (EUS-PPG) in portal pressure measurements. SUMMARY: EUS holds significant promise in diagnosing and treating liver diseases, with applications in assessing liver fibrosis, identifying focal liver lesions, and managing portal hypertension. Future research will likely focus on enhancing EUS's role in therapeutic procedures, such as managing portal vein thrombosis and creating intrahepatic portosystemic shunts, offering a new avenue for minimally invasive treatment options.
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