Giovanni A Roldan, Christopher Tricarico, Robert S Brown
Alcohol-associated liver disease (ALD) poses a significant global health burden and is a leading cause of liver-related morbidity and mortality. ALD encompasses a spectrum of disease states ranging from asymptomatic steatosis to acute hepatitis and cirrhosis. Alcohol use disorder (AUD) significantly increases the risk of developing ALD, and insight into AUD can provide a more complete understanding of ALD and the patients affected by these interrelated diseases. Accurate and timely identification of AUD, even in primary care, through validated screening tools combined with blood tests and imaging techniques facilitates early detection of ALD. Although liver transplantation (LT) remains the most effective treatment for end-stage ALD, patient outcomes post-LT have evolved because of shifting perspectives on ALD transplant eligibility, comprehensive pre-LT evaluations, and advancements in post-LT ALD detection. Nonetheless, addressing disparities in LT practices for ALD is paramount for ensuring equitable access to this life-saving intervention. This article offers an updated synopsis of ALD definitions, screening methodologies, and contemporary management approaches, particularly in the context of LT.
{"title":"Alcohol Use Disorder and Alcohol-Associated Liver Disease: New Definitions, Screening, and Treatment.","authors":"Giovanni A Roldan, Christopher Tricarico, Robert S Brown","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Alcohol-associated liver disease (ALD) poses a significant global health burden and is a leading cause of liver-related morbidity and mortality. ALD encompasses a spectrum of disease states ranging from asymptomatic steatosis to acute hepatitis and cirrhosis. Alcohol use disorder (AUD) significantly increases the risk of developing ALD, and insight into AUD can provide a more complete understanding of ALD and the patients affected by these interrelated diseases. Accurate and timely identification of AUD, even in primary care, through validated screening tools combined with blood tests and imaging techniques facilitates early detection of ALD. Although liver transplantation (LT) remains the most effective treatment for end-stage ALD, patient outcomes post-LT have evolved because of shifting perspectives on ALD transplant eligibility, comprehensive pre-LT evaluations, and advancements in post-LT ALD detection. Nonetheless, addressing disparities in LT practices for ALD is paramount for ensuring equitable access to this life-saving intervention. This article offers an updated synopsis of ALD definitions, screening methodologies, and contemporary management approaches, particularly in the context of LT.</p>","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 11","pages":"662-671"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease, is a major global health issue and a leading cause of chronic liver disease. The prevalence of MASLD is increasing globally, with the disease in some patients progressing to metabolic dysfunction-associated steatohepatitis (MASH), which significantly raises the risk of fibrosis, cirrhosis, and adverse outcomes. Accurate identification of patients with at-risk MASH, defined as MASH with a fibrosis stage of 2 or higher, is critical for timely intervention and management. Although liver biopsy remains the gold standard for diagnosing MASH, its invasive nature, potential complications, and variability in interpretation necessitate the implementation of noninvasive tests (NITs). NITs hold the potential for reducing reliance on liver biopsies, enhancing early diagnosis, and improving patient management of chronic liver disease. Continued research and validation are essential to optimize these tools for clinical application. This article explores current NITs, including imaging biomarkers, combined imaging and serum biomarkers, advanced biomarkers and composite scores, as well as artificial intelligence-based approaches, which also show promise in improving the accuracy of noninvasive at-risk MASH detection.
{"title":"Noninvasive Assessment to Identify Patients With At-Risk Metabolic Dysfunction-Associated Steatohepatitis.","authors":"Markos Kalligeros, Pojsakorn Danpanichkul, Mazen Noureddin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease, is a major global health issue and a leading cause of chronic liver disease. The prevalence of MASLD is increasing globally, with the disease in some patients progressing to metabolic dysfunction-associated steatohepatitis (MASH), which significantly raises the risk of fibrosis, cirrhosis, and adverse outcomes. Accurate identification of patients with at-risk MASH, defined as MASH with a fibrosis stage of 2 or higher, is critical for timely intervention and management. Although liver biopsy remains the gold standard for diagnosing MASH, its invasive nature, potential complications, and variability in interpretation necessitate the implementation of noninvasive tests (NITs). NITs hold the potential for reducing reliance on liver biopsies, enhancing early diagnosis, and improving patient management of chronic liver disease. Continued research and validation are essential to optimize these tools for clinical application. This article explores current NITs, including imaging biomarkers, combined imaging and serum biomarkers, advanced biomarkers and composite scores, as well as artificial intelligence-based approaches, which also show promise in improving the accuracy of noninvasive at-risk MASH detection.</p>","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 11","pages":"672-677"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring Alcohol Use Disorder and Alcohol-Associated Liver Disease.","authors":"Gary R Lichtenstein","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 11","pages":"647"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Early Surgery for Patients With Ileal Crohn's Disease.","authors":"Geert D'Haens","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 11","pages":"688-690"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Highlights From the Recent AASLD Practice Guidelines on Noninvasive Assessment of Hepatic Fibrosis and Steatosis.","authors":"Richard K Sterling","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 9","pages":"554-556"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Insights Into Resection for Esophageal Adenocarcinoma.","authors":"David M Poppers","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 9","pages":"557-559"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathan A Salazar, Jeffrey D Goldsmith, Athos Bousvaros, Michaela Tracy
{"title":"Cytomegalovirus Colitis in a Patient With Ulcerative Colitis With Loss of Corticosteroid Response Upon Upadacitinib Initiation.","authors":"Jonathan A Salazar, Jeffrey D Goldsmith, Athos Bousvaros, Michaela Tracy","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 9","pages":"546-549"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tian Li, Manar Al Jawish, Dilhana Badurdeen, Andree H Koop
Noncardiac chest pain is a challenging condition often encountered by primary care providers, emergency medicine physicians, and gastroenterologists. It is frequently accompanied by persistent symptoms, diagnostic uncertainty, decreased quality of life, and high health care burden. Gastroesophageal reflux disease is the most common esophageal cause followed by functional chest pain, and at least half of patients with noncardiac chest pain have psychiatric comorbidities such as anxiety or depression. Management is focused on identification of an underlying cause to target treatment and address psychiatric comorbidities. This article discusses the evaluation and management of the common gastrointestinal causes of noncardiac chest pain.
{"title":"Diagnosis and Management of Noncardiac Chest Pain.","authors":"Tian Li, Manar Al Jawish, Dilhana Badurdeen, Andree H Koop","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Noncardiac chest pain is a challenging condition often encountered by primary care providers, emergency medicine physicians, and gastroenterologists. It is frequently accompanied by persistent symptoms, diagnostic uncertainty, decreased quality of life, and high health care burden. Gastroesophageal reflux disease is the most common esophageal cause followed by functional chest pain, and at least half of patients with noncardiac chest pain have psychiatric comorbidities such as anxiety or depression. Management is focused on identification of an underlying cause to target treatment and address psychiatric comorbidities. This article discusses the evaluation and management of the common gastrointestinal causes of noncardiac chest pain.</p>","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 9","pages":"533-541"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diagnosing and Treating Noncardiac Chest Pain.","authors":"Gary R Lichtenstein","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":52498,"journal":{"name":"Gastroenterology and Hepatology","volume":"20 9","pages":"511"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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