​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​每双月刊出版，并就该领域的关键发展提供独特而广泛的视角，每期《当前胃肠病学观点》都包含我们专家编辑团队精心挑选的评论文章。全年出版了十二个学科——包括胃肠道感染、营养和炎症性肠病——每期还包含注释参考文献，详细说明最重要论文的优点。

Current Opinion in Gastroenterology is a bimonthly journal that offers unique perspectives on key developments in the field. Each issue features carefully selected review articles by our expert editorial team, covering twelve disciplines including gastrointestinal infections, nutrition, and inflammatory bowel disease. Additionally, each issue includes annotated references that highlight the merits of the most significant papers.

《Current Opinion in Gastroenterology》是一本每两个月出版的期刊，提供该领域关键发展的独特视角。每期都包含由我们专家编辑团队精心挑选的评论文章，涵盖包括胃肠道感染、营养和炎症性肠病在内的十二个学科。此外，每期还附有注释参考文献，详细说明最重要论文的优点。

Current Opinion in Gastroenterology

Morbid obesity is associated with a high prevalence of psychopathological conditions that might have an impact on postsurgery outcomes. This review summarizes recent data about psychological disorders in obese patients before and after bariatric surgery as well as the assessment and impact of these factors on postsurgery outcomes.Psychological health and quality of life were found to improve after bariatric surgery. Weight loss could not be clearly related to any specific psychological condition prior to surgery, but the presence of more than one psychiatric condition might play a role. A multi-intervention treatment, including approaches for lifestyle changes after bariatric surgery showed positive long-term results in term of weight loss and weight loss maintenance. Recent studies focused on eating behavior changes following bariatric surgery providing important information on the topic of eating disorders after bariatric surgery.Psychological assessment before bariatric surgery and systematic follow-up are necessary to guarantee optimal weight loss and weight loss maintenance. The field of psychological factors in bariatric surgery is still in need of controlled randomized prospective trials to better understand relation between psychological presurgery conditions and surgical outcomes. Self-monitoring and cognitive behavioral programs could prevent weight regain.

Zoltan Pataky

Isabelle Carrard

Alain Golay

Psychological factors and weight loss in bariatric surgery

心理因素与减重手术中的体重减轻

Purpose of review The chronic inflammatory bowel diseases (IBD), Crohn's disease, and ulcerative colitis, are associated with an increased risk of symptomatic Clostridium difficile infection (CDI). CDI may also masquerade as an IBD flare and complicate IBD management. This review provides a comprehensive overview of the epidemiology, diagnosis, and treatment of CDI in IBD patients. Recent findings CDI remains common in IBD with complications including flares in disease activity, recurrent CDI episodes, and prolonged hospital stays. Newer IBD therapeutics including vedolizumab, ustekinumab, and tofacitinib are less likely to cause severe CDI. A high index of suspicion, rapid testing via a two-step method, and prompt treatment with vancomycin or fidaxomicin are paramount to managing CDI in IBD patients. Strategies to prevent recurrent CDI (rCDI) include the monoclonal antibody bezlotoxumab as well as fecal microbiota transplantation (FMT). FMT has a robust profile of safety and effectiveness in preventing rCDI in adults and children. Summary Clinicians must remain vigilant in the prompt diagnosis and treatment of CDI in IBD patients. Corticosteroids, unnecessary antibiotics, and ongoing colonic inflammatory disease are modifiable risk factors. Improved infection control measures, newer IBD medications, and using effective CDI treatments will facilitate a reduced burden of severe CDI and complications for IBD patients.

Tamara Alhobayb

Matthew A. Ciorba

Clostridium difficile in inflammatory bowel disease

炎症性肠病中的艰难梭菌

Purpose of review Gallstone disease is a major epidemiologic and economic burden worldwide, and the most frequent form is cholesterol gallstone disease. Recent findings Major pathogenetic factors for cholesterol gallstones include a genetic background, hepatic hypersecretion of cholesterol, and supersaturated bile which give life to precipitating cholesterol crystals that accumulate and grow in a sluggish gallbladder. Additional factors include mucin and inflammatory changes in the gallbladder, slow intestinal motility, increased intestinal absorption of cholesterol, and altered gut microbiota. Mechanisms of disease are linked with insulin resistance, obesity, the metabolic syndrome, and type 2 diabetes. The role of nuclear receptors, signaling pathways, gut microbiota, and epigenome are being actively investigated. Summary Ongoing research on cholesterol gallstone disease is intensively investigating several pathogenic mechanisms, associated metabolic disorders, new therapeutic approaches, and novel strategies for primary prevention, including lifestyles.

Agostino Di Ciaula

David Q.-H. Wang

Piero Portincasa

An update on the pathogenesis of cholesterol gallstone disease

胆固醇胆石病发病机制的研究进展

The Management of inflammatory bowel disease (IBD) has evolved with the introduction and widespread adoption of biologic agents; however, the advent of artificial intelligence technologies like machine learning and deep learning presents another watershed moment in IBD treatment. Interest in these methods in IBD research has increased over the past 10 years, and they offer a promising path to better clinical outcomes for IBD patients.Developing new tools to evaluate IBD and inform clinical management is challenging because of the expansive volume of data and requisite manual interpretation of data. Recently, machine and deep learning models have been used to streamline diagnosis and evaluation of IBD by automating review of data from several diagnostic modalities with high accuracy. These methods decrease the amount of time that clinicians spend manually reviewing data to formulate an assessment.Interest in machine and deep learning is increasing in medicine, and these methods are poised to revolutionize the way that we treat IBD. Here, we highlight the recent advances in using these technologies to evaluate IBD and discuss the ways that they can be leveraged to improve clinical outcomes.

Fatima Zulqarnain

S. Fisher Rhoads

Sana Syed

Machine and deep learning in inflammatory bowel disease

机器学习和深度学习在炎症性肠病中的应用

Biliary diseases are a group of disease affecting biliary tract, including immune-mediated primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). With limited treatment options, PBC and PSC may lead to liver cirrhosis.Emerging evidence has shown the participation of gut microbiota in the etiology of PBC and PSC. Patients with PBC and PSC exhibit alterations in gut microbiota composition. Dysfunctional gut barrier facilitates the translocation of possible pathogenic bacteria and derived metabolites. Along with molecular mimicry between host and bacterial antigen, these factors result in aberrant auto-immune activation, and subsequently lead to liver injury. Though the precise mechanism has not been fully elucidated, studies investigating the role of gut microbiota in pathogenesis of PBC and PSC have inspired novel biomarkers and therapeutic strategies.In this review, recent evidence on the alteration of intestinal microbiota and possible mechanistic and therapeutic applications are discussed, predominantly focusing on PSC and PBC.

Qiyun Xia

Qiaoyan Liu

Xiong Ma

Intestinal microbiota in biliary diseases

The University of Chicago Medical Center: The University of Chicago Medicine, Chicago, Illinois, USA Correspondence to Russell D. Cohen, MD, FACG, AGAF, The University of Chicago Medicine, 5841 S. Maryland Ave., MC 4076, Chicago IL, 60637, US. E-mail: [email protected]

Russell D. Cohen

Editorial

社论

Purpose of review We will review the current management of colonic perforations, with particular emphasis on iatrogenic perforations caused by colonoscopy, the leading etiology. We will focus on recently developed endoscopic techniques and technologies that obviate morbid emergency surgery (the standard management approach in years past). Recent findings Colonic perforations are rare but potentially fatal complications of both diagnostic and therapeutic colonoscopy resulting in death in approximately 5% of cases with the mortality increasing with delay in diagnosis and treatment. As novel endoscopic techniques and tools have flourished in recent years, our approach to management of these perforations has evolved. With the availability of newer tools such as over the scope clips, enhanced through the scope clips and novel endoscopic suturing devices, colonic perforations can be managed effectively in many or most patients without the morbidity of surgical interventions. Summary With expanding use of colonoscopy, inadvertent outcomes such as perforations are bound to increase as well. Early diagnosis permits minimally invasive, nonsurgical, endoscopic management in most cases if the expertise and tools are available. Centers with high colonoscopy volumes including therapeutic procedures would be well served to invest in the requisite technologies and expertise.

Prabin Sharma

Stavros N. Stavropoulos

Endoscopic management of colonic perforations

结肠穿孔的内镜治疗

Purpose of review Multiple endoscopic ultrasound (EUS) guided therapeutic interventions have been developed for the management of benign and malignant pancreaticobiliary and gastrointestinal luminal pathology. Recent high-quality evidence is increasingly validating these interventions and positioning them within evidence-based therapeutic algorithms. Recent findings Here we review therapeutic EUS-guided interventions including pancreatic fluid collection drainage, gastroenterostomy, biliary drainage, pancreatic duct drainage and gallbladder drainage. The most up-to-date high-quality evidence supporting these interventions is presented including comparative data with other conventional treatment options. Newer emerging interventions such as tumor ablation are also reviewed. Current controversies and future avenues for research are discussed. The key role of EUS-guided interventions in managing pancreaticobiliary pathology in patients with a surgically altered anatomy is highlighted. Summary Multiple EUS therapeutic interventions have evolved from experimental or rescue options to now well established first- and second-line interventions over other endoscopic, percutaneous and surgical alternatives with the support of high-quality data. Further research is needed to better optimize patient selection and guide long term postintervention follow-up.

George Wahba

Jeffrey H. Lee

Updates on therapeutic endoscopic ultrasound

治疗性内镜超声的最新进展

Purpose of review The contributions of intestinal barrier loss, that is, increased permeability, to multiple disorders, including inflammatory bowel disease (IBD), have been a topic of speculation for many years, and the literature is replete with conclusions based on correlation and speculation. The goal of this article is to critically review recent advances in mechanistic understanding of barrier regulation and the evidence for and against contributions of intestinal barrier loss to disease pathogenesis. Recent findings It is now recognized that intestinal permeability reflects the combined effects of two distinct routes across tight junctions, which form selectively permeable seals between adjacent epithelial cells, and mucosal damage that leads to nonselective barrier loss. These are referred to as pore and leak pathways across the tight junction and an unrestricted pathway at sites of damage. Despite advances in phenotypic and mechanistic characterization of three distinct permeability pathways, development of experimental agents that specifically target these pathways, and remarkable efficacy in preclinical models, pathway-targeted therapies have not been tested in human subjects. Summary After decades of speculation, therapeutic interventions that target the intestinal barrier are nearly within reach. More widespread use of available tools and development of new tools that discriminate between pore, leak, and unrestricted pathway permeabilities and underlying regulatory mechanisms will be essential to understanding the local and systemic consequences of intestinal barrier loss.

Kushal Saha

Yin Zhou

Jerrold R. Turner

Tight junction regulation, intestinal permeability, and mucosal immunity in gastrointestinal health and disease

紧密连接调控、肠道通透性及黏膜免疫在胃肠健康与疾病中的作用

Purpose of review Antibiotics are a cornerstone of modern medicine, but antibiotic consumption can have depleting effects on the gut microbiota, potentially leading to gastrointestinal symptoms and other diseases, namely Clostridioides difficile infection. Because nutrition is a major driver of gut microbiota diversity and function, here we explore the current evidence on the potential of diets in alleviate the deleterious effects of antibiotics consumed during infections. Recent findings Beneficial nutrients can enhance the symbiotic effect of the gut microbiota with the host, supporting anti-inflammatory responses and maintaining tight junction integrity. Short-chain fatty acids have been shown to positively affect the immune response, reducing the severity of C. difficile infection, whereas high-fibre diets have been shown to promote faster recovery of the gut microbiota after antibiotic therapy. Summary The role of nutrition during infection is gaining momentum, with key findings exploring the effect of some nutrients in limiting the severity of infections and helping the microbiota recover from antibiotic-induced dysbiosis. Although this field is in its infancy, these findings open the possibility of personalised nutrition as a way of restoring microbiome diversity. But more work is needed to identify the most effective types and combinations of nutrients to achieve this.

Abbreviation	Curr. Opin. Gastroenterol.
Journal Impact	2.78
Quartiles(Global)	GASTROENTEROLOGY & HEPATOLOGY(Q2)

ISSN	0267-1379, 1531-7056
h-index	95

Publication Information	Publisher: Lippincott Williams and Wilkins，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1990，Proportion of original research papers: 0.00%，Self Citation Rate:0.00%， Gold OA Rate: 4.20%
Average review cycle	网友分享经验：较慢,6-12周
Average recruitment ratio	网友分享经验：一般

Current Opinion in Gastroenterology

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