Journal Description
Gastrointestinal Disorders
Gastrointestinal Disorders
is an international, open access, peer-reviewed journal on gastroenterology, published quarterly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions; authors retain copyright.
- High Visibility: indexed within Scopus, ESCI (Web of Science), FSTA, and other databases.
- Journal Rank: CiteScore - Q2 (Immunology and Microbiology (miscellaneous))
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 19.2 days after submission; acceptance to publication is undertaken in 3.9 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Reliable service: rigorous peer review and professional production.
Impact Factor:
0.8 (2024)
Latest Articles
Bicarbonate Natural Mineral Water from Source “F2 Păltiniș” Facilitates Digestion—A Pilot Study
Gastrointest. Disord. 2025, 7(3), 47; https://doi.org/10.3390/gidisord7030047 - 11 Jul 2025
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Background: Dyspeptic symptoms are very common in the general population, with an estimated prevalence of 14% to 41%, and the majority of patients experience symptoms without an organic cause for them (so-called functional dyspepsia). While the pathophysiology of functional dyspepsia remains elusive,
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Background: Dyspeptic symptoms are very common in the general population, with an estimated prevalence of 14% to 41%, and the majority of patients experience symptoms without an organic cause for them (so-called functional dyspepsia). While the pathophysiology of functional dyspepsia remains elusive, the impact of functional dyspepsia on quality of life is detrimental. The treatment involves a change in lifestyle—a healthy diet and physical activity—in combination with pharmacological treatments. However, currently, there is no standard therapy for this condition, although a nutritional approach appears to be feasible and well accepted by patients. In this context, the intake of some mineral water types might be able to play an important role. Objective: The aim of the present study was to evaluate whether the regular intake of bicarbonate natural mineral water (Aqua Carpatica from source “F2 Păltiniș”) is able to positively influence the symptomatic process of dyspepsia, promoting digestion and improving the quality of life of patients. Methods: The patients enrolled in this open-label study had diagnosis of functional dyspepsia formulated in accordance with the Rome III criteria. During the 4-week study, patients had to ingest tap water at 1.5 L/day (wash-out period: 2 weeks), and in the 2-week subsequent period, they had to ingest alkaline natural mineral water at 1.5 L/day. The primary efficacy endpoint of this study includes a statistically significant improvement (p < 0.05) in the “heartburn”, “regurgitation”, and “dyspepsia” subscales and the total Reflux Disease Questionnaire’s (RDQ) score with respect to the effects of alkaline natural mineral water. As secondary endpoints, we considered statistically significant improvements (p < 0.05) in quality-of-life scores (Psychological General Well-Being Index—Short form; PGWB-S), the patient’s self-assessment of the state of efficiency of their digestion, and their sense of post-prandial fullness, as well as the use of antacids. Results: Forty-five patients were enrolled: all were Caucasian and mostly women (25, 55.6% vs. 20 men, 44.4%), and they were aged between 25 and 75 years (50.6 ± 13.5 years; mean ± SD). The results of this preliminary study show a significant improvement in functional dyspepsia symptoms—as assessed via the RDQ—and an improvement in quality of life—as assessed using the PGWB-S score—after the intake of alkaline natural mineral water. Conclusions: This preliminary study provides clinical evidence for a recommendation of alkaline natural mineral water as a symptomatic treatment of dyspepsia.
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Open AccessArticle
Randomized Trial of Midazolam Plus Meperidine Versus Midazolam Plus Fentanyl Versus Placebo for Colonoscopic Sedation
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Miltiadis K. Moutzoukis, Ioannis V. Mitselos, Nikoletta Karavasili, Vasileios Theopistos, Alexandros Skamnelos, Dimitrios Sigounas, Varvara Pantazi, Panagiota Moschou and Dimitrios K. Christodoulou
Gastrointest. Disord. 2025, 7(3), 46; https://doi.org/10.3390/gidisord7030046 - 11 Jul 2025
Abstract
Objective: A combination of midazolam and opioid is usually used to achieve conscious sedation and analgesia during colonoscopy, but many patients may tolerate the procedure well without any sedation. This randomized trial aimed to compare the efficacy and recovery time of 3 different
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Objective: A combination of midazolam and opioid is usually used to achieve conscious sedation and analgesia during colonoscopy, but many patients may tolerate the procedure well without any sedation. This randomized trial aimed to compare the efficacy and recovery time of 3 different regimens consisting of (a) midazolam plus meperidine (b) midazolam plus fentanyl and (c) placebo. The endoscopists’ and patients’ satisfaction was assessed by an appropriate questionnaire. Methods: A total 248 consecutive, unselected patients attending outpatient colonoscopy at a University Hospital were enrolled with informed consent and were randomized to receive (a) midazolam with meperidine [group A] (b) midazolam with fentanyl [group B] or (c) placebo [group C]. Data for procedure times, perceived patient’s discomfort (using a relative patient questionnaire) and physician’s satisfaction from the procedure were collected. Patients and all endoscopy staff directly involved with the procedure except the research nurse were blinded to the regimens used. Results: The mean age of the patients was 58 ± 15 years (range 19–85 years) and 130 were males. The completion rate and time to reach cecum did not differ among the three groups. The recovery time was significantly shorter in group C (placebo, 10.4 ± 2.9 min) compared to the other groups (p < 0.000), but it was also shorter in group B (midazolam plus fentanyl, 43.0 ± 9.3 min) compared to group A (midazolam plus pethidine, 50.1 ± 9.0 min) (p = 0.001). Patients of group B (midazolam plus fentanyl) experienced less pain and discomfort than patients of group A (midazolam plus meperidine) (p = 0.02) and patients of group A experienced less pain than patients of group C (placebo). Many more patients in group B were extremely or very satisfied by the procedure(86.7%) compared to group A (59.7%) and group C (44.5%) (p = 0.001). Adverse events were mild in all groups and slightly less in group B. Conclusions: Sedation with midazolam and fentanyl was more effective, better tolerated and led to slightly faster recovery time than sedation with midazolam and meperidine. According to our findings and the literature, the most appropriate regimen for conscious sedation during colonoscopy is the combination of midazolam and fentanyl. However, both sedation regimens were proven to be effective and safe and even a significant proportion of unsedated patients could tolerate the procedure fairly well.
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Open AccessArticle
Differences in Health Behaviors by Survival Status and Time Since Diagnosis in Patients with Gastric or Colon Cancer
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HyoSung Cha and JooYong Park
Gastrointest. Disord. 2025, 7(3), 45; https://doi.org/10.3390/gidisord7030045 - 9 Jul 2025
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Background/Objectives: Health behavior management plays a critical role in improving outcomes for cancer survivors. This study aims to examine differences in health behaviors based on survival status and time since diagnosis among individuals with gastric or colorectal cancer. Methods: Data were
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Background/Objectives: Health behavior management plays a critical role in improving outcomes for cancer survivors. This study aims to examine differences in health behaviors based on survival status and time since diagnosis among individuals with gastric or colorectal cancer. Methods: Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES, 2014–2021). Among adults aged ≥40 years, 478 individuals diagnosed with gastric or colorectal cancer within the past 10 years were included. Participants were classified as current patients or survivors based on current disease status, and time since diagnosis was categorized as ≤3 years or >3 years. All analyses accounted for complex sample weights. Differences in health behaviors were evaluated using weighted t-tests and Rao–Scott chi-square tests, and weighted logistic regression was used to assess the association between time since diagnosis and current alcohol use. Results: Current alcohol consumption was significantly more prevalent in survivors (49.2%) than in current patients (29.9%) (p = 0.0002). Among current patients, those diagnosed more than three years earlier showed a higher drinking rate (40.9%) compared with those diagnosed within three years (25.4%) (p = 0.0411). In logistic regression analysis, time since diagnosis >3 years was associated with higher odds of alcohol consumption (OR = 2.32, 95% CI: 1.04–5.20), even after adjusting for age and sex. No significant differences were observed in smoking, aerobic activity, strength exercise, or walking. Conclusions: A longer time since diagnosis was associated with increased alcohol consumption in gastric and colorectal cancer patients, highlighting the need for sustained behavioral interventions during survivorship.
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Open AccessArticle
Predictive Factors for Recurrence of Choledocholithiasis After ERCP with Sphincterotomy in Benign Biliary Tract Disease: A Retrospective Study
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Mercedes Ibáñez-García, Juan Ramon Gómez-López, Jean Carlo Trujillo-Díaz, Pilar Concejo-Cutoli, Carlos Vaquero-Puerta and Juan Carlos Martín-del Olmo
Gastrointest. Disord. 2025, 7(3), 44; https://doi.org/10.3390/gidisord7030044 - 30 Jun 2025
Abstract
Objectives: To analyze the factors associated with recurrent choledocholithiasis following endoscopic retrograde cholangiopancreatography (ERCP) with biliary sphincterotomy (BS). Methods: A retrospective, observational, and analytical cohort study was conducted. Patients who underwent ERCP with BS for benign biliary pathology and were followed for a
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Objectives: To analyze the factors associated with recurrent choledocholithiasis following endoscopic retrograde cholangiopancreatography (ERCP) with biliary sphincterotomy (BS). Methods: A retrospective, observational, and analytical cohort study was conducted. Patients who underwent ERCP with BS for benign biliary pathology and were followed for a minimum of two years were included. Demographic and clinical data were collected, including the indication for the procedure, endoscopic findings, performance and timing of cholecystectomy (before or after ERCP), and the need for repeat procedures. Episodes of choledocholithiasis were defined as those occurring at least six months after the initial ERCP. Follow-up continued until patient death, loss of follow-up, or the conclusion of the study. Results: A total of 576 patients were included, with a mean age of 71 years and an average follow-up duration of 131 months. Sixty-nine cases of recurrent choledocholithiasis were documented (11.96%). Multivariate analysis identified the following predictive factors for recurrence: age over 50 years, bile duct dilation upon initial evaluation, history of biliary surgery, cytology sampling, placement of biliary stents, repeated ERCP, biliary diversion procedures, and cholecystectomy prior to the index ERCP. Conclusions: Biliary duct dilation, advanced age, and any previous manipulation of the biliary tree are associated with an increased risk of recurrent choledocholithiasis. Cholecystectomy performed after the initial ERCP was not associated with a reduced recurrence risk.
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Open AccessArticle
Mediterranean Diet and Health-Related Quality of Life in Patients with Celiac Disease
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Emmanuel Psylinakis, Nikolaos Thalassinos, Aikaterini-Maria Dafouli, Maria Kanaki, Alexios Manidis, Anastasia G. Markaki and Aspasia Spyridaki
Gastrointest. Disord. 2025, 7(3), 43; https://doi.org/10.3390/gidisord7030043 - 27 Jun 2025
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Background/Objectives: Celiac disease (CD) is an immune-mediated condition triggered by gluten ingestion in genetically predisposed individuals, requiring lifelong adherence to a strict gluten-free diet (GFD). Despite dietary compliance, many patients with CD experience impaired health-related quality of life (HRQoL). Emerging evidence suggests that
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Background/Objectives: Celiac disease (CD) is an immune-mediated condition triggered by gluten ingestion in genetically predisposed individuals, requiring lifelong adherence to a strict gluten-free diet (GFD). Despite dietary compliance, many patients with CD experience impaired health-related quality of life (HRQoL). Emerging evidence suggests that dietary quality may influence HRQoL. Although the Mediterranean diet (MD) is linked to multiple health benefits, its role in CD management remains underexplored. This study aimed to investigate the relationship between MD adherence and HRQoL in adults with CD. Methods: In this cross-sectional study, adherence to the MD was assessed using the MedDiet Score. HRQoL was evaluated using the Short Form-12 (SF-12), measuring the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Results: The study enrolled 100 individuals with CD and 100 age- and sex-matched healthy controls. The mean MedDiet Score (MDS) was 30.4 ± 3.9 for patients and 30.7 ± 5.0 for controls (p = 0.709), with moderate adherence in most participants. The patients had significantly lower PCS scores (43.80 ± 4.99) compared to controls (45.45 ± 4.76; p = 0.015), while the MCS scores did not differ significantly (42.12 ± 8.05 vs. 42.79 ± 6.56; p = 0.738). In individuals with CD, the MedDiet Score was positively correlated with MCS12 (ρ = 0.302, p = 0.002), but not with PCS12 (ρ = 0.059, p = 0.562). Conclusions: Adherence to the MD is associated with better mental health outcomes in individuals with CD. Promoting a Mediterranean-style GFD may offer a holistic approach to enhancing well-being in this population.
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Open AccessCommunication
Clinically Based Cetuximab Re-Challenge in Patients with RAS Wild-Type Metastatic Colorectal Cancer and Retrospective Analysis of Liquid Biopsies—Preliminary Data
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Zhasmina Mihaylova, Stoyan Bichev, Alexey Savov and Maria Radanova
Gastrointest. Disord. 2025, 7(3), 42; https://doi.org/10.3390/gidisord7030042 - 25 Jun 2025
Abstract
Background: Anti-EGFR therapy, combined with chemotherapy, represents the standard therapeutic approach for triple wild-type (KRAS/NRAS and BRAF), left-sided, microsatellite stable (MSS) metastatic colorectal cancer (mCRC). However, acquired resistance develops in approximately 50% of patients. This study evaluated the efficacy
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Background: Anti-EGFR therapy, combined with chemotherapy, represents the standard therapeutic approach for triple wild-type (KRAS/NRAS and BRAF), left-sided, microsatellite stable (MSS) metastatic colorectal cancer (mCRC). However, acquired resistance develops in approximately 50% of patients. This study evaluated the efficacy of anti-EGFR therapy re-challenge and analyzed circulating tumor DNA (ctDNA) for potential resistance mechanisms. Methods: Eleven patients with triple wild-type, MSS, HER2-negative, left-sided mCRC were included. All patients received Cetuximab with chemotherapy as the first-line treatment, with three patients subsequently receiving Cetuximab re-challenge. Twenty-one plasma samples were collected at baseline and at each response assessment for retrospective ctDNA analysis using next-generation sequencing with a 16-gene panel. Results: Genetic alterations were detected in only 14.2% of ctDNA samples. In one re-challenge patient, the KRAS: c.35G>A mutation appeared during progression. No RAS mutations were identified in four patients who progressed on first-line Cetuximab treatment. Conclusions: This preliminary study suggests that clinically based anti-EGFR re-challenge may benefit selected mCRC patients. The low detection rate of resistance-conferring mutations indicates potential alternative resistance mechanisms beyond RAS pathway alterations. Our findings, while limited by sample size and the retrospective design of ctDNA testing, contribute to the growing evidence supporting anti-EGFR re-challenge strategies in mCRC management.
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Open AccessArticle
Ultrastructural Evidence of Interactions Between Eosinophils and Mast Cells in Gastric Cancer: Considerations in AllergoOncology Research
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Rosario Caruso, Valerio Caruso and Luciana Rigoli
Gastrointest. Disord. 2025, 7(3), 41; https://doi.org/10.3390/gidisord7030041 - 20 Jun 2025
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Background/Objectives: AllergoOncology is a new field of study that investigates the relationship between allergic inflammation and cancer. Mast cells and eosinophils are two critical players in allergy reactions, where they can interact and release bioactive granules. The electron microscope is an indispensable tool
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Background/Objectives: AllergoOncology is a new field of study that investigates the relationship between allergic inflammation and cancer. Mast cells and eosinophils are two critical players in allergy reactions, where they can interact and release bioactive granules. The electron microscope is an indispensable tool for analyzing membrane contacts and degranulation patterns in mast cells and eosinophils. The aim of the present ultrastructural study is to analyze the interactions between tumor-associated eosinophils and mast cells (TATEM) in nine cases of gastric cancer. Methods: Seventy-two gastric cancer samples were analyzed using light microscopy, and nine cases exhibiting TATEM were selected for additional examination by transmission electron microscopy. Results: In seven cases, there was direct interaction between non-activated eosinophils and mast cells demonstrating piecemeal degranulation and/or exocytosis. In cases 8 and 9, both cell types showed more advanced stages of degranulation. Mast cells exhibited either massive degranulation (anaphylactic type) or signs of recovery, while eosinophils displayed cytolysis, with or without extracellular trap formation (ETosis). The concurrent activation of both cell types may indicate a collaborative immune response that could affect tumor behavior. There was a trend toward an association with low-stage (I-II) gastric cancer in patients with TATEM, but this difference was not statistically significant (p = 0.06). Conclusions: This work is the first investigation to present ultrastructural evidence of the intimate relationship between degranulating mast cells and cytolytic eosinophils, with or without ETosis, in gastric cancer. These findings support the emerging field of AllergoOncology, which examines the role of allergy-like immune responses in tumor immunity.
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Open AccessSystematic Review
Impact of Vascular Variations of Superior Mesenteric Artery During Complete Mesocolic Excision for Right Colon Cancer
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Gennaro Mazzarella, Diego Coletta, Edoardo Maria Muttillo, Biagio Picardi, Stefano Rossi, Alessandro Scorsi, Simona Meneghini, Bruno Cirillo, Gioia Brachini, Marco Assenza, Andrea Mingoli and Irnerio Angelo Muttillo
Gastrointest. Disord. 2025, 7(2), 40; https://doi.org/10.3390/gidisord7020040 - 5 Jun 2025
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Background: Looking for anomalies and vascular control gains a central role in colon cancer surgery. Complete mesocolic excision (CME) presents technical challenges, primarily due to the considerable variability in the arterial configuration of the right colon. The importance of understanding colonic vascular anatomy
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Background: Looking for anomalies and vascular control gains a central role in colon cancer surgery. Complete mesocolic excision (CME) presents technical challenges, primarily due to the considerable variability in the arterial configuration of the right colon. The importance of understanding colonic vascular anatomy has become more prominent with the adoption of this surgical technique. The aim of this study is to systematically review the vascular anatomical variations in the superior mesenteric artery (SMA) in the setting of extended lymphadenectomy for CME in right colon cancer and to show its impact in clinical practice. Methods: A systematic review of the literature on Medline (PubMed), Web of Science (WOS), and Scopus was performed according to PRISMA guidelines. The following criteria were set for inclusion: (1) studies reporting minimally invasive (robotic, laparoscopic, and hybrid techniques) or open CME/D3 lymphadenectomy; (2) studies reporting patients with right-sided colon cancer; (3) studies reporting the description or illustration of SMA variations. The methodological quality of all included studies was evaluated using the Newcastle–Ottawa Scale (NOS). Results: After the literature search, 800 studies were recorded, 31 studies underwent full-text reviews, and 9 studies met the inclusion criteria. All studies reported vascular variations in SMA, and the total number of patients was 813. No intraoperative complications were reported. In 6.4% of patients, post-operative bleeding occurred. Conclusions: Vascular anatomical variations are not a rare entity. In experienced centers, vascular anomalies are not associated with an increase in complications, both in traditional open and minimally invasive surgery (MIS). However, in MIS, full access to central vessels and intraoperative vascular control, moderate retraction, safety maneuvers, and accurate vascular dissection are mandatory.
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Open AccessReview
Innovations in Minimally Invasive Management of Esophageal Atresia and Tracheoesophageal Fistula
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Adrian Surd, Rodica Muresan, Carmen Iulia Ciongradi, Lucia Maria Sur, Lia Oxana Usatiuc, Kriszta Snakovszki, Camelia Munteanu and Ioan Sârbu
Gastrointest. Disord. 2025, 7(2), 39; https://doi.org/10.3390/gidisord7020039 - 3 Jun 2025
Abstract
Background and Aims: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are rare but serious congenital anomalies requiring early surgical intervention. Over the past two decades, minimally invasive surgical (MIS) approaches—particularly thoracoscopic repair—have gained traction, aiming to reduce postoperative morbidity while maintaining surgical efficacy.
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Background and Aims: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are rare but serious congenital anomalies requiring early surgical intervention. Over the past two decades, minimally invasive surgical (MIS) approaches—particularly thoracoscopic repair—have gained traction, aiming to reduce postoperative morbidity while maintaining surgical efficacy. Objective: This narrative review provides a comprehensive overview of the evolution and current status of MIS techniques for EA/TEF, assessing their clinical outcomes, technical challenges, and implications for patient care. Methods: A structured literature search was conducted to identify clinical studies, reviews, and reports on thoracoscopic, robotic-assisted, and endoscopic approaches to EA/TEF. Emerging adjuncts, including tissue engineering, botulinum toxin use, and magnet-assisted anastomosis, were also reviewed. Results: Thoracoscopic repair has demonstrated comparable anastomotic success rates to open surgery (approximately 85–95%) with significantly reduced rates of musculoskeletal complications, such as scoliosis and chest wall deformities (reported in less than 10% of cases, compared to up to 40% in open approaches). Robotic-assisted and endoscopic-assisted techniques have enabled improved visualization and precision in anatomically challenging cases, although their use remains limited to high-resource centers with specialized expertise. Common postoperative complications include anastomotic stricture (30–50%), gastroesophageal reflux disease (35–70%), and respiratory morbidity, necessitating long-term multidisciplinary follow-up. Recent innovations in simulation-based training and bioengineered adjuncts have facilitated safer MIS adoption in neonates. Conclusions: Minimally invasive techniques have improved the surgical management of EA/TEF, though challenges remain regarding technical complexity, training, and resource availability. Continued innovation and collaborative research are essential for advancing care and ensuring optimal outcomes for affected infants.
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(This article belongs to the Special Issue Pediatric Gastrointestinal Endoscopy and Surgery: Current Challenges and Future Directions)
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Open AccessArticle
Impact of Fundoplication Surgery and Multidisciplinary Approach on Quality of Life in Children with Neurological Impairment and Gastroesophageal Reflux Disease
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Alessandro Raffaele, Francesco De Leo, Emanuele Cereda, Thomas Foiadelli, Valentina Motta, Salvatore Savasta, Marco Brunero, Gloria Pelizzo, Romano Piero Giovanni, Luigi Avolio, Gian Battista Parigi, Giovanna Riccipetitoni and Mirko Bertozzi
Gastrointest. Disord. 2025, 7(2), 38; https://doi.org/10.3390/gidisord7020038 - 28 May 2025
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Background: Neurologically impaired children often face severe gastroesophageal reflux disease (GERD), feeding difficulties, and related challenges, profoundly impacting their quality of life (QoL) and that of their caregivers. Surgery is often necessary to alleviate symptoms in this population, and the success of surgical
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Background: Neurologically impaired children often face severe gastroesophageal reflux disease (GERD), feeding difficulties, and related challenges, profoundly impacting their quality of life (QoL) and that of their caregivers. Surgery is often necessary to alleviate symptoms in this population, and the success of surgical treatment, along with the achievement of clinical endpoints, must also consider the impact on QoL. The aim of this study is to evaluate the impact of fundoplication surgery on the QoL of both children and caregivers. Methods: All patients treated between 2010 and 2023 at the Pediatric Surgery Department of San Matteo Hospital in Pavia were included in the study. The modified 1996 O’Neill questionnaire was identified as a suitable model for a QoL survey. QoL assessments included caregiver-reported outcomes using validated questionnaires, focusing on physical, psychological, and social domains. Patients with a follow-up period of less than 12 months were excluded. As a secondary outcome, we evaluated the satisfaction of patients treated after 2020 who received integrated care through a multidisciplinary outpatient clinic. Results: Among the 77 patients, 42 were treated between 2010 and 2021. Of these, 16 participated in pre- and post-operative QoL evaluations, showing significant improvements in GERD resolution, feeding ease, and caregiver stress. From 2020, 35 patients benefited from a multidisciplinary approach; 12 underwent robotic fundoplication. Feeding ease scores improved significantly (mean increase from 37.5 to 84.2; p < 0.001), while caregiver stress scores decreased by 35% (p < 0.01). Conclusions: The combination of surgical and multidisciplinary interventions significantly enhances QoL for SNI children and their families. Integrated care models provide a framework for addressing complex needs and should be prioritized in clinical practice.
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Open AccessCase Report
Acute Mesenteric Ischemia with Air Embolism in the Superior Mesenteric Artery: A Rare Case and a Literature Review
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Concetta Timpanaro, Lorenzo Musmeci, Francesco Tiralongo, Pietro Valerio Foti, Stefania Tamburrini, Corrado Ini’, Davide Giuseppe Castiglione, Rosita Comune, Mariapaola Tiralongo, Francesco Vacirca, Stefano Palmucci and Antonio Basile
Gastrointest. Disord. 2025, 7(2), 37; https://doi.org/10.3390/gidisord7020037 - 23 May 2025
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Background: Acute mesenteric ischemia (AMI) is a potentially life-threatening condition that requires prompt diagnosis and treatment. The presence of air within the arterial lumen, particularly in the abdomen, is an uncommon finding with varied etiologies. This case report presents a unique instance of
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Background: Acute mesenteric ischemia (AMI) is a potentially life-threatening condition that requires prompt diagnosis and treatment. The presence of air within the arterial lumen, particularly in the abdomen, is an uncommon finding with varied etiologies. This case report presents a unique instance of AMI with air in the superior mesenteric artery (SMA), highlighting the complexities in diagnosis and management. Case presentation: An 89-year-old male with a history of smoking, hypertension, dyslipidemia, and atrial fibrillation presented with chest pain and underwent coronary angiography for suspected anterior ST-elevation myocardial infarction (STEMI). Following successful thromboaspiration and admission to the coronary care unit, he developed severe abdominal pain. A contrast-enhanced computed tomography (CECT) scan revealed a thromboembolic occlusion in the SMA, along with air filling in the SMA and its branches. An endovascular thrombectomy was performed, but the patient died the next day due to complications related to AMI and metabolic acidosis. Conclusions: This case underscores the challenges in diagnosing and managing AMI, particularly when accompanied by unusual imaging findings such as air within the SMA. The presence of air in the arterial system raises questions about its origin and clinical significance in the context of AMI. Further research is needed to understand the mechanisms and implications of this rare phenomenon, which may have implications for refining diagnostic and therapeutic strategies for AMI.
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Open AccessCase Report
Triple Synchronous Colorectal Cancer: An Extremely Rare Case Underscoring the Need for Careful Perioperative Evaluation
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Phu Van La, Diep Ngoc Nguyen, Dien Minh Tran, Tu Tuan Duong, Minh Thanh Phuoc Tran, Phuc Vinh La, Minh Nhat Thanh Le, Cong Phi Dang and Vu Anh Doan
Gastrointest. Disord. 2025, 7(2), 36; https://doi.org/10.3390/gidisord7020036 - 23 May 2025
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Synchronous colorectal cancer (SCRC) is characterized by the simultaneous occurrence of two or more primary colorectal malignancies, diagnosed either preoperatively, intraoperatively, or within six months postoperatively. The rare prevalence of SCRC makes it an uncommon scenario among colorectal malignancies. Since the majority of
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Synchronous colorectal cancer (SCRC) is characterized by the simultaneous occurrence of two or more primary colorectal malignancies, diagnosed either preoperatively, intraoperatively, or within six months postoperatively. The rare prevalence of SCRC makes it an uncommon scenario among colorectal malignancies. Since the majority of SCRC patients have been reported to have two concurrent malignancies, triple synchronous malignancies are extremely rare. We report the case of a 65-year-old male individual presenting with a history of abdominal pain, anemia, anorexia, and unintentional weight loss. He was diagnosed with synchronous colorectal cancer with three distinct tumors: two located in the splenic flexure and sigmoid colon, respectively, and another in the rectum that caused partial obstruction. This case highlights the importance of intraoperative evaluation and an appropriate choice of surgical intervention in colorectal cancer. The early identification and proper management of multiple colorectal cancers remain essential for better survival rates.
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Open AccessReview
Home Biofeedback Training for Pelvic Floor Disorders: Is There Hope for Hopeless Patients?
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Marek Vojtko, Peter Banovcin, Martin Duricek, Jakub Hoferica and Peter Liptak
Gastrointest. Disord. 2025, 7(2), 35; https://doi.org/10.3390/gidisord7020035 - 19 May 2025
Abstract
The most common anorectal disorders are fecal incontinence, functional anorectal pain, and functional defecation disorders. They are often presented by overlapping symptoms with various degrees of severity. Therefore, a personalized approach to the patient is crucial for diagnosing and determining the prognosis of
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The most common anorectal disorders are fecal incontinence, functional anorectal pain, and functional defecation disorders. They are often presented by overlapping symptoms with various degrees of severity. Therefore, a personalized approach to the patient is crucial for diagnosing and determining the prognosis of the disease. Biofeedback training is appropriate to consider when the motoric function disorder is known, the patient could learn voluntary control of response, and this could further lead to an improvement in the condition. Biofeedback is recommended for short-term and long-term treatment of constipation in adults and fecal incontinence in adults. It could also be considered for treatment of specific cases of anorectal pain. As office biofeedback is often time-consuming and comes with a substantially high cost, there is an emerging trend of home biofeedback administration. However, only a few significant studies have been published on this new approach. Although comprehensive data are needed to evaluate the proper strategy and development of various treatment protocols for different types of defecation disorders, home biofeedback therapy offers a potentially effective tool in the personalized treatment of defecation disorders.
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(This article belongs to the Topic Advances in Gastrointestinal and Liver Disease: From Physiological Mechanisms to Clinical Practice)
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Open AccessArticle
Acceptability of a Protein Oral Nutritional Supplement with Xanthan Gum in Patients with Neuromuscular Diseases and Dysphagia: A Cross-Sectional Study
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Federica Felloni, Luca Costantini and Michela Coccia
Gastrointest. Disord. 2025, 7(2), 34; https://doi.org/10.3390/gidisord7020034 - 7 May 2025
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Background/Objectives: Oropharyngeal dysphagia (OD) is a prevalent symptom in patients with neuromuscular diseases (NMDs) and increases the risk of aspiration and malnutrition. Malnutrition is frequent in these patients and is not only related to dysphagia, but also generates a vicious circle that
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Background/Objectives: Oropharyngeal dysphagia (OD) is a prevalent symptom in patients with neuromuscular diseases (NMDs) and increases the risk of aspiration and malnutrition. Malnutrition is frequent in these patients and is not only related to dysphagia, but also generates a vicious circle that may result in worsening muscle atrophy and weakness. Texture modification is required to ensure safe and efficient swallowing. This study evaluates the acceptability of a ready-to-mix oral nutritional supplement (ONS) containing high-quality protein and a xanthan-based thickener in patients with OD and NMDs. Methods: This cross-sectional study includes adult patients with NMDs and OD who received a xanthan gum-based protein ONS. Patients completed a questionnaire to rate their satisfaction with the ONS. Results: Seventy-two patients were included (median age = 56 years; 51% were males). The percentage of patients with moderate-to-severe OD who rated the taste, consistency, and product quality as acceptable-to-very-satisfactory (score 3–5) were 76%, 80%, and 84%, respectively. After three months, 93% of patients continued consuming the ONS. Conclusions: Our findings support that the use of protein xanthan gum-based ONS can be as a palatable and an effective nutritional intervention, given their high satisfaction and acceptance rates among patients with NMDs and OD.
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Open AccessReview
Updates in Gastroesophageal Reflux Disease Management: From Proton Pump Inhibitors to Dietary and Lifestyle Modifications
by
Jakov Ivan Bucan, Tamara Braut, Antea Krsek, Vlatka Sotosek and Lara Baticic
Gastrointest. Disord. 2025, 7(2), 33; https://doi.org/10.3390/gidisord7020033 - 30 Apr 2025
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Gastroesophageal reflux disease (GERD) is a common chronic gastrointestinal disorder that greatly influences patients’ quality of life and represents a growing public health concern. Characterized by typical and atypical symptoms, GERD encompasses a range of clinical phenotypes and is associated with complications such
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Gastroesophageal reflux disease (GERD) is a common chronic gastrointestinal disorder that greatly influences patients’ quality of life and represents a growing public health concern. Characterized by typical and atypical symptoms, GERD encompasses a range of clinical phenotypes and is associated with complications such as erosive esophagitis and Barrett’s esophagus. This review intends to provide a thorough overview of current scientific knowledge on the etiological factors, risk determinants, and pathophysiology of GERD, while exploring diagnostic challenges and therapeutic approaches. Proton pump inhibitors (PPIs) remain the mainstay of medical therapy; however, concerns regarding their long-term safety have encouraged interest in adjunctive and alternative strategies. Emerging pharmacological agents, plant-based treatments, and integrative approaches rooted in traditional medicine offer promising modalities for enhanced management. Additionally, dietary and lifestyle modifications such as weight control, meal timing, and avoidance of trigger foods, are essential components of effective care. A multidisciplinary framework incorporating pharmacological, nutritional, and behavioral strategies is emphasized as the most reliable path toward personalized and sustainable GERD management. This review further aims to synthesize current therapeutic modalities and evolving perspectives in the treatment of GERD.
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Open AccessArticle
Microbiota and Diabetes: Decoding the Gut-Metabolism Link in a Single-Center Study
by
Nicoleta Mihaela Mindrescu, Cristian Guja, Viorel Jinga, Sorina Ispas, Antoanela Curici, Rucsandra Elena Danciulescu Miulescu, Andreea Nelson Twakor and Anca Pantea Stoian
Gastrointest. Disord. 2025, 7(2), 32; https://doi.org/10.3390/gidisord7020032 - 29 Apr 2025
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Background: The relationship between gut microbiota and metabolic health has garnered significant attention in recent years. In this study, we aim to explore the intricate link between gut microbiota and metabolic outcomes, with a focus on lifestyle factors such as smoking, diet,
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Background: The relationship between gut microbiota and metabolic health has garnered significant attention in recent years. In this study, we aim to explore the intricate link between gut microbiota and metabolic outcomes, with a focus on lifestyle factors such as smoking, diet, and living environment. Materials and Methods: We investigated the gut microbiota and metabolic profiles of adult patients with type 2 diabetes, all receiving metformin therapy, to assess how lifestyle factors impact metabolic health. Key metabolic parameters and body composition indices were measured, alongside gut microbiota composition. Results: Our cohort included 30 patients, and we identified significant associations between smoking and adverse body composition changes, as well as dietary patterns favoring plant-based foods correlating with improved metabolic outcomes. Urban participants displayed distinct microbiota profiles and metabolic markers compared to their rural counterparts, highlighting the potential influence of environmental factors. Conclusions: The current data does not directly demonstrate a causal link between metformin usage and specific changes in gut microbiota composition. These findings align with the existing literature while providing novel insights into specific population dynamics. Future research should focus on longitudinal studies and interventions targeting the gut microbiota to further unravel its therapeutic potential.
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Open AccessEditorial
Factors Affecting Disease Activity in Children and Adults with Inflammatory Bowel Disease: An Exploration of Pro-Inflammatory and Anti-Inflammatory Elements
by
Angharad Vernon-Roberts and Andrew S. Day
Gastrointest. Disord. 2025, 7(2), 31; https://doi.org/10.3390/gidisord7020031 - 29 Apr 2025
Abstract
For children and adults with inflammatory bowel disease (IBD), the overarching aim of clinical management is the induction and maintenance of remission, with mucosal healing as a key target outcome [...]
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(This article belongs to the Special Issue Factors Affecting Disease Activity in Children and Adults with Inflammatory Bowel Disease: An Exploration of Pro-Inflammatory and Anti-Inflammatory Elements)
Open AccessArticle
Whole-Exome Sequencing Identified Molecular Variants Linked to the Progression of Gastric Precancerous Lesions in Patients from Southwestern Colombia—An Exploratory Approach
by
Lizeth Mejia-Ortiz, Jovanny Zabaleta, Jone Garai, Luis Eduardo Bravo and Andres Castillo
Gastrointest. Disord. 2025, 7(2), 30; https://doi.org/10.3390/gidisord7020030 - 25 Apr 2025
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Background/Objectives: This study aimed to identify molecular variants associated with the progression of gastric precancerous lesions in a follow-up study conducted on patients from Southwestern Colombia. Methods: Whole-exome sequencing (WES) was performed on patients enrolled in the Colombian chemoprevention trial, who
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Background/Objectives: This study aimed to identify molecular variants associated with the progression of gastric precancerous lesions in a follow-up study conducted on patients from Southwestern Colombia. Methods: Whole-exome sequencing (WES) was performed on patients enrolled in the Colombian chemoprevention trial, who were classified into two groups—progression and regression—based on changes in the severity of their gastric precancerous lesions over 16 years of follow-up. The bioinformatics pipeline included steps for quality control, mapping, variant calling, filtering, and annotation. Associations between molecular variants and lesion progression were analyzed using Fisher’s exact test and the Cochran–Armitage trend test. Additionally, functional impact and pathway enrichment analyses were performed for variants that showed significant associations. Results: Thirty-eight molecular variants from thirty-seven participants were associated with the progression of gastric precancerous lesions. These variants were found in tumor suppressor genes like CDKN2A and CDK4, which are involved in cell cycle regulation and apoptosis. Additionally, variants were identified in extracellular matrix regulators such as COL23A1, LAMA2, and TNR. Other noteworthy findings included variants in FLT1, which is linked to VEGF signaling in angiogenesis, and APOB, which is involved in modulating inflammatory responses. Furthermore, alterations in genes associated with the hemostatic system, such as FGA and F5, underscored the connection between hemostasis and carcinogenesis. Conclusions: This exploratory analysis highlighted some molecular variants that may affect the function, structure, and expression of key proteins involved in cancer development, contributing to the progression of gastric precancerous lesions.
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Open AccessArticle
Endoscopic Suturing for Defect Closure in the Upper Gastrointestinal Tract: A Retrospective Cohort Study
by
Apostolis Papaefthymiou, Nasar Aslam, Benjamin Norton, Andrea Telese, Charles Murray, Alberto Murino, Gavin Johnson, Roberto Simons-Linares and Rehan Haidry
Gastrointest. Disord. 2025, 7(2), 29; https://doi.org/10.3390/gidisord7020029 - 23 Apr 2025
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Background: The increasing availability of gastrointestinal (GI) interventions has raised the need to treat luminal defects. Endoscopic suturing (ES) is a minimally invasive technique that is used for a wide range of indications. This retrospective cohort study aimed to evaluate the performance of
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Background: The increasing availability of gastrointestinal (GI) interventions has raised the need to treat luminal defects. Endoscopic suturing (ES) is a minimally invasive technique that is used for a wide range of indications. This retrospective cohort study aimed to evaluate the performance of ES in treating upper GI defects. Materials and Methods: Data from a tertiary centre were collected for patients undergoing ES to treat upper GI defects. The primary outcome was long-term outcomes, defined as the successful sutures deployment. Secondary outcomes included technical success, immediate clinical success (confirmation of closure at the time of the procedure), recurrence, and complications. Descriptive statistics and x2 test were used to calculate the rates of the outcomes and assess any link between independent variables and results. Results: Forty-two procedures were performed on 25 patients between 2018 and 2023. The mean age was 55 (±16.2) years, and 56% were female. The long-term clinical success rate was 69.6% (16/23), the technical success rate was 88.1% (37/42), and the immediate clinical success rate was 91.9% (34/37), with only two (4.8%) adverse events. The overall recurrence rate was 61.8% (21/34). Technical success was higher in the esophagus (92.3%), and stomach (100%) (p = 0.002), and immediate clinical success was more likely in patients with leaks (88.9%) or fistula (95.2%) compared to perforation (50%; p = 0.005). Conclusions: ES demonstrated high rates of technical and immediate clinical success for defect closure in the upper GI tract, with low rates of complications. The benefit is most prominently seen among patients with leaks and fistulas in the stomach and esophagus.
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Open AccessReview
Microbiome Dysbiosis as a Driver of Neurodegeneration: Insights into Alzheimer’s and Parkinson’s Diseases
by
Ana Jagodic, Antea Krsek, Lou Marie Salomé Schleicher and Lara Baticic
Gastrointest. Disord. 2025, 7(2), 28; https://doi.org/10.3390/gidisord7020028 - 2 Apr 2025
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Microbiome dysbiosis—an imbalance in gut microbial communities—has emerged as a critical factor in the pathogenesis of neurological disorders, particularly Alzheimer’s and Parkinson’s diseases. This review examines the role of gut microbiota in neurodegeneration, emphasizing how dysbiosis disrupts gut–brain communication through mechanisms such as
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Microbiome dysbiosis—an imbalance in gut microbial communities—has emerged as a critical factor in the pathogenesis of neurological disorders, particularly Alzheimer’s and Parkinson’s diseases. This review examines the role of gut microbiota in neurodegeneration, emphasizing how dysbiosis disrupts gut–brain communication through mechanisms such as impaired gut permeability, systemic inflammation, and neuroinflammation. The gastrointestinal and central nervous systems interact bidirectionally, with microbial metabolites like short-chain fatty acids playing a pivotal role in maintaining gut and brain health. Dysbiotic shifts in microbial composition can compromise the blood–brain barrier, enabling inflammatory molecules to alter brain biochemistry and potentially accelerate neurodegenerative processes. Additionally, this review explores therapeutic strategies—including probiotics, prebiotics, and dietary modifications—designed to restore microbial balance, reduce neuroinflammation, and slow disease progression. Further research is essential to refine microbiome-targeted therapies and fully elucidate their potential in managing neurodegenerative diseases.
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