Recent Advances in the Management of Gastrointestinal Disorders

A special issue of Gastroenterology Insights (ISSN 2036-7422). This special issue belongs to the section "Gastrointestinal Disease".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 7931

Special Issue Editor


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Guest Editor
Department of Medicine, Division of Gastroenterology‐Hepatology, Albany Medical College, Albany, NY 12208, USA
Interests: gastroenterology; cholangioscopy; esophagogastric junction; biliary stones
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Special Issue Information

Dear Colleagues,

In recent years, great advances have been made in the field of gastroenterology. The day-to-day management of gastrointestinal disorders has significantly altered in the last decade and has affected how we undertake gastroenterological treatment, including hepatitis C treatment, spyglass, radiofrequency ablation, Hemospray, etc. However, traditional techniques for the management of such diseases are still applied today.

The aim of this Special Issue is to review recent advances in the management of gastrointestinal disorders and, simultaneously, emphasize the standard of care for such disorders. We welcome the submission of both review articles and recent research studies.

Dr. Micheal Tadros
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Gastroenterology Insights is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastrointestinal disorders
  • endoscopy

Published Papers (7 papers)

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Research

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10 pages, 621 KiB  
Article
Effect of Concomitant Use of Polaprezinc and Vonoprazan-Based Triple Therapy for Helicobacter pylori Eradication
by Yuto Suzuki, Yasumi Katayama, Yo Fujimoto, Koji Toyoda, Morio Takahashi and Masaya Tamano
Gastroenterol. Insights 2024, 15(2), 386-395; https://doi.org/10.3390/gastroent15020027 - 11 May 2024
Viewed by 389
Abstract
Background: Vonoprazan-based triple therapy has recently been reported as being more effective than proton pump inhibitors for the eradication of Helicobacter pylori (H. pylori), but it is apparent that the eradication rate could be further improved. Methods: We investigated the effect [...] Read more.
Background: Vonoprazan-based triple therapy has recently been reported as being more effective than proton pump inhibitors for the eradication of Helicobacter pylori (H. pylori), but it is apparent that the eradication rate could be further improved. Methods: We investigated the effect of the concomitant use of polaprezinc, a therapeutic agent for gastric ulcers, and vonoprazan-based seven-day triple therapy in patients with gastric ulcers compared to standard vonoprazan-based seven-day triple therapy in patients with atrophic gastritis. The regimen for the treatment of atrophic gastritis contained vonoprazan 20 mg, amoxicillin 750 mg, and clarithromycin 200 mg b.d. (VAC group) for seven days; and that for gastric ulcers contained VAC and polaprezinc 75 mg b.d. (VACP group) for seven days. Results: Between October 2021 and January 2023, 201 subjects were examined (VAC group, n = 165; VACP group, n = 36). In per-protocol (PP) analysis, the eradication rate was significantly higher in the VACP group (100%) than in the VAC group (88.2%) (p = 0.025). In patients with severe atrophic gastritis, eradication rates were significantly higher in the VACP group (100%) than in the VAC group (84.4%) in PP analysis. (p = 0.024). Conclusions: The concomitant use of polaprezinc and standard vonoprazan-based first-line eradication therapy is effective for H. pylori. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Gastrointestinal Disorders)
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11 pages, 2379 KiB  
Article
Linked Color Imaging of Barrett’s Esophageal Adenocarcinoma: Effects on Visibility
by Masahiro Saito, Tomoyuki Koike, Yuki Ohara, Yohei Ogata, Takeshi Kanno, Xiaoyi Jin, Waku Hatta, Kaname Uno, Naoki Asano, Akira Imatani and Atsushi Masamune
Gastroenterol. Insights 2024, 15(1), 145-155; https://doi.org/10.3390/gastroent15010010 - 5 Feb 2024
Viewed by 611
Abstract
Since linked color imaging (LCI) has been reported to increase the color differences in Barrett’s esophageal adenocarcinoma (BA) compared to white light imaging (WLI), a comparison of the visibility scores of various imaging techniques for BA is warranted to determine best practice standards. [...] Read more.
Since linked color imaging (LCI) has been reported to increase the color differences in Barrett’s esophageal adenocarcinoma (BA) compared to white light imaging (WLI), a comparison of the visibility scores of various imaging techniques for BA is warranted to determine best practice standards. This study is to clarify the role of LCI, blue light imaging (BLI), and WLI in the evaluation of BA. A group of 19 endoscopists, comprised of 6 experts and 13 trainees, evaluated the visibility of WLI, BLI, and LCI images in 21 superficial BA cases. Visibility scores were compared between WLI, BLI, and LCI. Visibility scores were also evaluated for lesion morphology, background Barrett’s mucosa, and circumferential location. The visibility scores of experts and trainees were analyzed for comparison. The visibility scores of LCI and BLI were 3.83 and 3.31, respectively, compared to three points for WLI. The visibility of LCI was better than that of WLI regardless of lesion morphology, color, background Barrett’s mucosa, and circumferential location. The LCI improved visibility in BA more than the WLI for both experts and trainees. LCI improved the visibility of BA independent of lesion morphology, color, background Barrett’s mucosa, circumferential location, and the endoscopist’s experience. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Gastrointestinal Disorders)
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Review

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39 pages, 916 KiB  
Review
The Pathogenesis of Pancreatitis and the Role of Autophagy
by Ioannis Tsomidis, Argyro Voumvouraki and Elias Kouroumalis
Gastroenterol. Insights 2024, 15(2), 303-341; https://doi.org/10.3390/gastroent15020022 - 22 Apr 2024
Viewed by 880
Abstract
The pathogenesis of acute and chronic pancreatitis has recently evolved as new findings demonstrate a complex mechanism operating through various pathways. In this review, the current evidence indicating that several mechanisms act in concert to induce and perpetuate pancreatitis were presented. As autophagy [...] Read more.
The pathogenesis of acute and chronic pancreatitis has recently evolved as new findings demonstrate a complex mechanism operating through various pathways. In this review, the current evidence indicating that several mechanisms act in concert to induce and perpetuate pancreatitis were presented. As autophagy is now considered a fundamental mechanism in the pathophysiology of both acute and chronic pancreatitis, the fundamentals of the autophagy pathway were discussed to allow for a better understanding of the pathophysiological mechanisms of pancreatitis. The various aspects of pathogenesis, including trypsinogen activation, ER stress and mitochondrial dysfunction, the implications of inflammation, and macrophage involvement in innate immunity, as well as the significance of pancreatic stellate cells in the development of fibrosis, were also analyzed. Recent findings on exosomes and the miRNA regulatory role were also presented. Finally, the role of autophagy in the protection and aggravation of pancreatitis and possible therapeutic implications were reviewed. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Gastrointestinal Disorders)
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22 pages, 1874 KiB  
Review
GLP-1RA Essentials in Gastroenterology: Side Effect Management, Precautions for Endoscopy and Applications for Gastrointestinal Disease Treatment
by Justin Wan, Caesar Ferrari and Micheal Tadros
Gastroenterol. Insights 2024, 15(1), 191-212; https://doi.org/10.3390/gastroent15010014 - 18 Feb 2024
Viewed by 1664
Abstract
Amidst the obesity and type II diabetes mellitus (T2DM) epidemics, glucagon-like peptide-1 receptor agonists (GLP-1RAs) stand out as a promising therapeutic ally, achieving notable success in glycemic control and weight management. While GLP-1RAs’ positive clinical outcomes are commendable, they introduce significant gastrointestinal (GI) [...] Read more.
Amidst the obesity and type II diabetes mellitus (T2DM) epidemics, glucagon-like peptide-1 receptor agonists (GLP-1RAs) stand out as a promising therapeutic ally, achieving notable success in glycemic control and weight management. While GLP-1RAs’ positive clinical outcomes are commendable, they introduce significant gastrointestinal (GI) challenges, emphasizing the pivotal role of gastroenterologists in understanding and managing these implications. Physicians should be vigilant of potential complications if endoscopy is indicated and considered. A protocol coined “The Three E’s: Education, Escalation, and Effective Management” is essential as the first defense against GLP-1RA-induced dyspepsia, necessitating routine GI consultations. Awareness and intervention of potential aspiration due to GLP-1RA-induced gastroparesis are vital in clinical management. Furthermore, the evolving recognition of GLP-1RAs’ beneficial effects on non-alcoholic steatohepatitis (NASH) suggests gastroenterologists will increasingly prescribe them. Thus, a comprehensive understanding of pharmacological properties and potential GI complications, including the undetermined cancer risk landscape, becomes paramount. This review accentuates the nuances of GLP-1RA therapy from a gastroenterological lens, juxtaposing the therapeutic potential, manageable side effects, and circumstantial challenges, ensuring that GI specialists remain at the forefront of holistic care in obesity and T2DM management. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Gastrointestinal Disorders)
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23 pages, 18097 KiB  
Review
Differential Diagnoses and Management Approaches for Gastric Polyposis
by Masaya Iwamuro, Seiji Kawano and Motoyuki Otsuka
Gastroenterol. Insights 2024, 15(1), 122-144; https://doi.org/10.3390/gastroent15010009 - 27 Jan 2024
Viewed by 1251
Abstract
Multiple gastric polyps are observed in various polyposis syndromes and conditions associated with polypoid lesion development in the stomach. Polyposis syndromes often occur concurrently with specific malignant tumors and can manifest at any point in an individual’s lifespan, thus explaining the diversity in [...] Read more.
Multiple gastric polyps are observed in various polyposis syndromes and conditions associated with polypoid lesion development in the stomach. Polyposis syndromes often occur concurrently with specific malignant tumors and can manifest at any point in an individual’s lifespan, thus explaining the diversity in surveillance methods. Furthermore, genetic counseling and surveillance are essential not only for the patients themselves but also for their blood relatives. Therefore, the accurate diagnosis and appropriate surveillance of multiple gastric polyps are crucial for improving patient outcomes. This review aims to provide essential information on such lesions along with representative endoscopic images of familial adenomatous polyposis, Peutz-Jeghers syndrome, Cowden syndrome, Cronkhite-Canada syndrome, juvenile polyposis syndrome, gastric adenocarcinoma and proximal polyposis of the stomach, neuroendocrine tumors in autoimmune gastritis, proton pump inhibitor-related gastric mucosal changes, and multiple submucosal heterotopic glands. We wish for this review to serve as a valuable resource for endoscopists seeking to deepen their comprehension of gastric polyposis. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Gastrointestinal Disorders)
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11 pages, 582 KiB  
Review
Terlipressin for the Prevention and Treatment of Renal Decline in Hepatorenal Syndrome: A Drug Profile
by Ahlam Ayyad and Rami A. Al-Horani
Gastroenterol. Insights 2023, 14(4), 420-430; https://doi.org/10.3390/gastroent14040031 - 28 Sep 2023
Viewed by 1553
Abstract
Hepatorenal syndrome stands as one of several potential triggers of acute kidney injury in individuals grappling with either acute or persistent liver ailments. The nature of the decline in kidney function has led to the identification of two variants of hepatorenal syndrome. In [...] Read more.
Hepatorenal syndrome stands as one of several potential triggers of acute kidney injury in individuals grappling with either acute or persistent liver ailments. The nature of the decline in kidney function has led to the identification of two variants of hepatorenal syndrome. In cases where terlipressin therapy is accessible, the initial approach involves administering terlipressin alongside albumin. Terlipressin, a synthetic analog of vasopressin, boasts double the preference for vasopressin V1 receptors compared to V2 receptors. The FDA granted approval to terlipressin in September 2022, demonstrating its intrinsic activity, although a significant portion of its function arises from its transformation into lysine vasopressin. This article provides a comprehensive examination of terlipressin’s various pharmacodynamic and pharmacokinetic facets, as well as its clinical utility, aiming to keep the scientific community well informed about its safe and efficient utilization. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Gastrointestinal Disorders)
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Other

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18 pages, 818 KiB  
Systematic Review
Left Ventricular Diastolic Dysfunction Defined Using the 2016 ASE Criteria and Mortality after a Liver Transplant in Patients with End-Stage Liver Disease: A Systematic Review
by Carlos E. González-Martínez, Diego Regalado-Ceballos, Samantha Medrano-Juárez, Airam Regalado-Ceballos, Isaí E. Hernández-Padilla, José R. Azpiri-López, Homero Nañez-Terreros and Linda E. Muñoz-Espinosa
Gastroenterol. Insights 2023, 14(4), 653-670; https://doi.org/10.3390/gastroent14040044 - 12 Dec 2023
Viewed by 826
Abstract
Left ventricular diastolic dysfunction (LVDD) is a hallmark of cirrhotic cardiomyopathy and has been linked to a poorer quality of life and worse outcomes in patients with end-stage liver disease. Its impact on survival after a liver transplant (LT) is not known, especially [...] Read more.
Left ventricular diastolic dysfunction (LVDD) is a hallmark of cirrhotic cardiomyopathy and has been linked to a poorer quality of life and worse outcomes in patients with end-stage liver disease. Its impact on survival after a liver transplant (LT) is not known, especially when using current diagnostic criteria to define LVDD. We conducted a systematic review and meta-analysis of the current published literature on mortality after a LT in patients with LVDD. We searched for articles in PubMed, Scopus, EMBASE, Web of Science, and the COCHRANE Central database. We included cohort studies that compared post-transplant outcomes between cirrhotic patients with and without LVDD. Our primary outcome of interest was all-cause mortality after a LT in relation to the presence of LVDD per the 2016 American Society of Echocardiography criteria. A total of 1029 articles were screened during the selection process. Two studies included in the meta-analysis showed no significant difference in mortality, but there was high heterogeneity. A narrative review of other studies that classified diastolic function (DD) using different criteria was also performed, revealing an association with worse outcomes in these patients. High-quality prospective studies using current criteria are needed to confirm these findings. Full article
(This article belongs to the Special Issue Recent Advances in the Management of Gastrointestinal Disorders)
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