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Gastroenterology Insights
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Advances in the Management of Gastrointestinal and Liver Diseases
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Advances in the Management of Gastrointestinal and Liver Diseases

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

Deadline for manuscript submissions: 31 May 2026 | Viewed by 2120

Special Issue Editor

Dr. Micheal Tadros

E-Mail Website
Guest Editor
Department of Medicine, Division of Gastroenterology‐Hepatology, Albany Medical College, Albany, NY 12208, USA
Interests: gastroenterology; cholangioscopy; esophagogastric junction; biliary stones
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The Special Issue entitled "Advances in the Management of Gastrointestinal and Liver Diseases" highlights recent breakthroughs in the understanding and treatment of prevalent gastrointestinal and hepatic disorders, addressing critical challenges related to disease pathogenesis, early detection, and therapeutic innovation.

Recently, notable pharmacological progress has been made regarding metabolic-associated liver disease (MASH), hepatitis C, and the antifibrotic potential of salvianolic acid B in liver fibrosis. Significant advancements have also been achieved in the treatment of inflammatory bowel disease through the development of monoclonal antibodies such as interleukin-23 and Janus kinase (Jak) inhibitors. Additional areas of focus include irritable bowel disease, eosinophilic esophagitis, reflux, Helicobacter pylori, and peptic ulcer disease. Moreover, noteworthy advancements have been made in screening for non-alcoholic fatty liver disease (NAFLD), understanding the pathogenesis of hepatocellular carcinoma (HCC), and developing immune checkpoint blockade strategies for gastrointestinal malignancies. Furthermore, extensive progress in understanding the pathophysiology of these diseases has resulted in enhanced detection methods, risk assessment scores, and screening modalities.

This Special Issue aims to bridge the translational gaps between laboratory findings and clinical practice, emphasizing the importance of precision medicine, early diagnosis, and evidence-based strategies for the management of gastrointestinal and liver diseases. This Special Issue welcomes researchers, clinicians, and policymakers within the fields of gastroenterology, hepatology, oncology, and public health, with the aim of fostering collaborations to address unmet needs in chronic liver disease, metabolic liver disorders, gastrointestinal disorders, and gastrointestinal cancers.

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 1800 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

  • nonalcoholic fatty liver disease (NAFLD)
  • hepatocellular carcinoma (HCC)
  • intrahepatic cholangiocarcinoma (ICC)
  • liver fibrosis
  • immune checkpoint blockade
  • spectral detector CT
  • hepatogenic origin
  • gastrointestinal malignancies

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

Jump to: Review, Other

8 pages, 259 KB  
Article
Comparative Effects of Flurbiprofen—Lidocaine Spray Versus Lidocaine Spray Alone as Topical Pharyngeal Anesthesia Before Unsedated Upper Gastrointestinal Endoscopy
by Ciocîrlan Mihai, Busuioc Denisa, Pasăre Mihaela, Bilous Dana, Buză Bogdan and Vlăduț Cătălina
Gastroenterol. Insights 2025, 16(3), 31; https://doi.org/10.3390/gastroent16030031 - 26 Aug 2025
Abstract
Objectives: Esophagogastroduodenoscopy (EGD) performed with topical pharyngeal anesthesia presents less adverse events and post-procedural impairment associated with sedation. The aim of this study was to evaluate if by combining Flurbiprofen and Lidocaine sprays for topical pharyngeal anesthesia there is an improvement in [...] Read more.
Objectives: Esophagogastroduodenoscopy (EGD) performed with topical pharyngeal anesthesia presents less adverse events and post-procedural impairment associated with sedation. The aim of this study was to evaluate if by combining Flurbiprofen and Lidocaine sprays for topical pharyngeal anesthesia there is an improvement in patient tolerance and endoscopist satisfaction in comparison to using Lidocaine spray alone. Methods: We conducted a single center, double blind, randomized controlled trial designed to compare unsedated EGD using topical Flurbiprofen spray (Strepsils Intensive®) plus Lidocaine spray versus Lidocaine spray alone. We assessed patients’ tolerance and endoscopist satisfaction through a 0 to 10 points visual numerical rating scale. Results: A total of 36 patients were included and randomized in two equal groups: Lidocaine and Flurbiprofen spray group (FL) and Lidocaine spray group (L). No significant differences were found amongst groups for patient discomfort score (FL 5.33 ± 2.42, L 5.56 ± 2.12, p = 0.708), pain score (FL 1.77 ± 2.17, L 1.89 ± 0.74, p = 0.119), gag reflex intensity score (FL 1.61 ± 0.82, L 1.83 ± 0.68, p = 0.418), patient satisfaction score (FL 7.78 ± 2.46, L 7.22 ± 1.78, p = 0.428), and endoscopist satisfaction score (FL 7.5 ± 2.87, L 7.58 ± 1.45, p = 0.312). Conclusions: During unsedated EGD, both Lidocaine plus Strepsils spray and Lidocaine spray alone were safe and well tolerated. The combination of Flurbiprofen and Lidocaine did not significantly improve patients’ level of discomfort, pain, gag reflex, and satisfaction and endoscopist satisfaction. Full article
(This article belongs to the Special Issue Advances in the Management of Gastrointestinal and Liver Diseases)
13 pages, 873 KB  
Article
Impact of Endoscopic Band Ligation on Gastric Complications Associated with Portal Hypertension
by Maria Luisa Gambardella, Giulia Fabiano, Rocco Spagnuolo, Rosanna De Marco, Ileana Luppino, Giusi Franco, Francesco Rettura, Mario Verta, Francesco Luzza and Ludovico Abenavoli
Gastroenterol. Insights 2025, 16(3), 28; https://doi.org/10.3390/gastroent16030028 - 6 Aug 2025
Viewed by 659
Abstract
Background/Objectives: Clinically significant portal hypertension (CSPH) in cirrhotic patients impacts mortality rates and quality of life. CSPH increases the risk of systemic decompensation and could predispose to the deterioration of portal hypertension (PH)–gastric complications, such as portal hypertensive gastropathy (PHG) and portal hypertensive [...] Read more.
Background/Objectives: Clinically significant portal hypertension (CSPH) in cirrhotic patients impacts mortality rates and quality of life. CSPH increases the risk of systemic decompensation and could predispose to the deterioration of portal hypertension (PH)–gastric complications, such as portal hypertensive gastropathy (PHG) and portal hypertensive polyps (PHPs). In the management of CSPH with high-risk varices, endoscopic band ligation (EBL) is effective in preventing variceal bleeding. However, this procedure has several drawbacks, ranging from its inability to treat PH to the potential development of significant PH–gastric complications. The aim of our study is to evaluate endoscopic changes in PHG, PHPs, and gastric varices before and after the obliteration of esophageal varices, highlighting the potential risks of EBL. Methods: We retrospectively evaluated forty-four patients who underwent EBL for esophageal varices in emergency and elective settings, according to Baveno VII guidelines. We assessed the presence and severity of PHG, the status of gastric varices, and the number of PHPs before and after the eradication of esophageal varices. We used Fisher’s exact test and t-tests to compare the endoscopic and clinical-laboratory data statistically. A p-value < 0.05 was considered statistically significant. Results: This study found that after the eradication of varices, there was a significant worsening of PHG in 28 patients (63%) compared to before the procedure (p < 0.05). The condition remained stable in 14 patients (31%). However, it is worth noting that 90% of the patients exhibited severe PHG at baseline. Additionally, the absence of ascites and the non-administration of beta blockers at baseline were independent risk factors for worsening PHG (p < 0.05). Along with the deterioration of PHG, three patients (7%) developed gastric varices, all classified as type 1 gastroesophageal varices, and in two patients (4.5%), PHPs were formed. In particular, out of these two cases, the number of PHPs increased from one to two compared to the baseline. Conclusions: Our study underscores the association of EBL with a general worsening of PH–gastric complications and the protective effect of beta blockers in this context. Despite these promising results, future studies are needed to assess whether the worsening of PH–gastric complications is sustained over time and whether it is associated with a deterioration in clinical outcomes in patients with cirrhosis. Such evidence could help guide a more informed therapeutic decision between EBL and beta blockers. Full article
(This article belongs to the Special Issue Advances in the Management of Gastrointestinal and Liver Diseases)
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Review

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12 pages, 294 KB  
Review
Targeting Advanced Pancreatic Ductal Adenocarcinoma: A Practical Overview
by Chiara Citterio, Stefano Vecchia, Patrizia Mordenti, Elisa Anselmi, Margherita Ratti, Massimo Guasconi and Elena Orlandi
Gastroenterol. Insights 2025, 16(3), 26; https://doi.org/10.3390/gastroent16030026 - 30 Jul 2025
Viewed by 749
Abstract
Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest solid tumors, with a five-year overall survival rate below 10%. While the introduction of multi-agent chemotherapy regimens has improved outcomes marginally, most patients with advanced disease continue to have limited therapeutic options. Molecular [...] Read more.
Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest solid tumors, with a five-year overall survival rate below 10%. While the introduction of multi-agent chemotherapy regimens has improved outcomes marginally, most patients with advanced disease continue to have limited therapeutic options. Molecular profiling has uncovered actionable genomic alterations in select subgroups of PDAC, yet the clinical impact of targeted therapies remains modest. This review aims to provide a clinically oriented synthesis of emerging molecular targets in PDAC, their therapeutic relevance, and practical considerations for biomarker testing, including current FDA and EMA indications. Methods: A narrative review was conducted using data from PubMed, Embase, Scopus, and international guidelines (NCCN, ESMO, ASCO). The selection focused on evidence published between 2020 and 2025, highlighting molecularly defined PDAC subsets and the current status of targeted therapies. Results: Actionable genomic alterations in PDAC include KRAS G12C mutations, BRCA1/2 and PALB2-associated homologous recombination deficiency, MSI-H/dMMR status, and rare gene fusions involving NTRK, RET, and NRG1. While only a minority of patients are eligible for targeted treatments, early-phase trials and real-world data have shown promising results in these subgroups. Testing molecular profiling is increasingly standard in advanced PDAC. Conclusions: Despite the rarity of targetable mutations, systematic molecular profiling is critical in advanced PDAC to guide off-label therapy or clinical trial enrollment. A practical framework for identifying and acting on molecular targets is essential to bridge the gap between precision oncology and clinical management. Full article
(This article belongs to the Special Issue Advances in the Management of Gastrointestinal and Liver Diseases)

Other

Jump to: Research, Review

16 pages, 2292 KB  
Systematic Review
Ileal Bile Acid Transporter Inhibitors for Adult Patients with Autoimmune Cholestatic Liver Diseases: A Systematic Review and Meta-Analysis
by Igor Boechat Silveira, Rodolfo Augusto Assis Rezende, Carlos Alberto Monteiro Leitão Neto, Yohanna Idsabella Rossi, Marina de Assis Bezerra Cavalcanti Leite and Guilherme Grossi Lopes Cançado
Gastroenterol. Insights 2025, 16(3), 30; https://doi.org/10.3390/gastroent16030030 - 25 Aug 2025
Viewed by 144
Abstract
Background: Autoimmune cholestatic liver diseases (AICLDs), including primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), are characterized by progressive biliary injury and cholestasis, leading to an impaired quantity/quality of life. Pruritus affects 20–70% of patients and is often refractory to current treatments. [...] Read more.
Background: Autoimmune cholestatic liver diseases (AICLDs), including primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), are characterized by progressive biliary injury and cholestasis, leading to an impaired quantity/quality of life. Pruritus affects 20–70% of patients and is often refractory to current treatments. Ileal bile acid transporter (IBAT) inhibitors reduce bile acid reabsorption and may alleviate cholestatic pruritus. This systematic review and meta-analysis evaluates their efficacy and safety in adults with AICLD. Methods: Following PRISMA guidelines, we systematically searched PubMed, Embase, and Cochrane-CENTRAL for studies assessing IBAT inhibitors in adult AICLD patients with pruritus for ≥12 weeks. The primary outcome was the change in the 5-D Pruritus Scale. Secondary outcomes included sleep quality, serum bile acids, liver biochemistry, and safety. Heterogeneity was assessed using Cochrane Q and I2 statistics. Results: Three studies (n = 180) met inclusion criteria, including two RCTs and one single-arm study. Patients (78% female; 85% PBC; 77% linerixibat) showed a significant pruritus reduction (MD = −4.93, 95%CI [−6.26, −3.59], p < 0.0001), accompanied by improved sleep quality (MD = −8.12, 95%CI [−13.54, −2.70], p = 0.0033). Serum bile acids, FGF19, and autotaxin decreased significantly, with increased C4 levels. AST and GGT declined, while ALP, ALT, and bilirubin remained stable. Adverse events occurred in 89.7%, mainly diarrhea (22.7%), nausea (12.2%), and abdominal pain (18.2%); serious events were rare (2.2%). Conclusions: IBAT inhibitors significantly reduce pruritus and improve sleep in AICLD, with a favorable safety profile. These findings support their potential as a novel therapeutic option for cholestatic pruritus in adults with AICLD. Full article
(This article belongs to the Special Issue Advances in the Management of Gastrointestinal and Liver Diseases)
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