Journal of gastrointestinal and liver diseases : JGLD最新文献

Functional Gastrointestinal Disorders (FGIDs), including conditions such as irritable bowel syndrome (IBS) and functional dyspepsia, affect millions worldwide, significantly impairing quality of life and increasing healthcare utilization. These disorders are multifactorial and complex, with several subtypes, making diagnosis and management challenging. This review explores the emerging role of digital health technologies and artificial intelligence(AI) in transforming FGID diagnosis and treatment. We focus on wearable devices, capsule-based diagnostics, mobile health applications, and AI-powered virtual assistants, highlighting how these innovations address the limitations of traditional investigative and management approaches. Additionally, we assess the impact of these digital advancements on patient outcomes, healthcare efficiency, and real-time symptom monitoring. Finally, we examine the challenges associated with data privacy, accuracy, and reliability in digital health solutions and propose future directions for technological advancements in FGID management.

Gut microbiota (GM) is a complex microenvironment characterised by intricate interactions, which might play a pivotal role in the pathogenesis of many autoimmune diseases, including celiac disease (CD). DDysbiosis of gut bacteria can have a wide range of effects; however, whether it is a cause or a consequence of certain diseases and how it evolves during disease progression remains an area of active research. Celiac disease patients appear to have characteristic microbiota patterns, including low levels of beneficial species and high levels of potentially pathogenic species. The use of pro-, pre-, syn- and post-biotics to modulate the GM requires more systematic investigation, to determine the impact of specific species, the optimal dosage and the treatment duration needed to achieve desired results without adverse reactions. Additionally, osteoporosis in the course of CeD ease warrants further investigation. Many factors may contribute to its pathogenesis, including GM. This review summarizes recent literature concerning the role of GM in CeD, highlighting both consistent findings and areas of ongoing debate.

Background and aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 32.4% of the global population and is a major cause of chronic liver disease and cardiometabolic complications. Early detection is challenging due to limitations of conventional obesity indices like body mass index (BMI) and waist circumference (WC), which do not account for age- and sex-specific adiposity variations. The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index, integrating BMI, age, and gender, may offer a better measure of body fat percentage, but its utility in MASLD prediction is unexplored. We aimed to evaluate the predictive value of the CUN-BAE index for MASLD and to compare it with conventional obesity indices.

Methods: 1,003 participants from Guang'anmen Hospital were recruited (2023-2024). MASLD diagnosis was based on established criteria, and participants underwent clinical and laboratory assessments. Logistic regression models were used to determine the association between the CUN-BAE index and MASLD, with predictive performance assessed using area under the receiver operating characteristic curve (AUROC).

Results: Among 949 participants, 555 (58.5%) had MASLD. The CUN-BAE index showed a significant positive association with MASLD risk (Model 3: OR=1.16, 95%CI: 1.12-1.20, p<0.001). Its AUROC (0.677) surpassed BMI (0.612) and WC (0.598), especially in women (AUROC=0.809 vs. BMI=0.721, WC=0.698) compared to men (AUROC=0.664 vs. BMI=0.603, WC=0.591). A dose-response relationship was observed, with increased CUN-BAE levels correlating with higher MASLD risk beyond a threshold of 29.097.

Conclusions: The CUN-BAE index is a robust predictor of MASLD, outperforming BMI and WC, particularly in women. It captures age- and gender-specific adiposity variations, enhancing its utility as a non-invasive screening tool. Future research should focus on longitudinal validation and integrating additional metabolic parameters.

The therapeutic application of Pancrelipase spans several key gastroenterological conditions, ranging from chronic pancreatitis to genetic disorders such as cystic fibrosis. Consequently, pancreatic enzyme replacement therapy (PERT) is applicable in a variety of clinical settings, managing pancreatic insufficiency. Beyond chronic pancreatitis, PERT has also shown effectiveness in addressing malabsorption associated with pancreatic surgery, gastrointestinal malignancies, and various dysmetabolic conditions. This review aims to provide a comprehensive overview of the therapeutic applications of PERT and its clinical role in managing both surgical and non-surgical conditions, beyond chronic pancreatitis. PERT has proven crucial in improving patient outcomes, addressing gastrointestinal symptoms, and supporting long-term health in patients with pancreatic insufficiency. While more research, particularly from randomized controlled trials, is required to optimize dosing strategies and establish standardized PERT protocols, clinicians should consider tailoring PERT to individual patient needs based on the available evidence across various clinical scenarios.