Gastrointestinal Disorders

Background: Varicose veins (VVs) are an overlying manifestation of chronic venous disease, commonly occurring in the lower extremities. While typically linked to primary venous insufficiency, they can occasionally be secondary to systemic disease, e.g., malignancies, by various mechanisms such as tumor compression, hypercoagulability, and paraneoplastic syndromes. Bilateral varicose veins, as a presenting symptom of gastric cancer, are extremely rare and poorly documented. Materials and Methods: A comprehensive literature search was conducted to identify reports and studies linking varicose veins and malignancies, with particular focus on gastric cancer. The search was performed using the PubMed, Scopus, and Web of Science databases covering the last 13 years. Results: Literature Review: A review of the literature in the past decade identified publications, mostly case reports, describing associations between varicose-like venous changes and malignancies such as gastric, pancreatic, hepatic, and small-bowel tumors. The predominant mechanisms reported were inferior vena cava obstruction, tumor-related thrombosis, and paraneoplastic migratory superficial thrombophlebitis (Trousseau’s syndrome). Only a few cases involved gastric cancer as the primary site, with venous changes often being the first clinical sign. There is limited experience with gastric cancer that presents alongside bilateral collateral or varicose veins initially. Apart from the various reports having malignancies and varicose veins we also describe the case of a 50-year-old man who had extended history of bilateral lower-limb varicose veins. Severe, unexplained anaemia without obvious bleeding was discovered during examination. A biopsy verified a gastric adenocarcinoma, while upper gastrointestinal endoscopy revealed an ulcerated mass on the stomach’s greater curvature. Peritoneal dissemination was discovered with additional staging. A palliative subtotal gastrectomy was carried out because of the patient’s ongoing anaemia and suspected chronic bleeding caused by the tumour. The venous symptoms preceded any gastrointestinal issues. Conclusions: Although uncommon, malignancy should be considered in the differential diagnosis for atypical or rapidly progressing bilateral varicose veins, especially when accompanied by systemic symptoms or lab results such as unexplained anemia. Increased suspicion may lead to earlier cancer detection in some patients.

This review conducts a bibliometric analysis of scientific literature on antibiotic resistance in Helicobacter pylori (H. Pylori), aiming to map scientific production, identify trends and key themes, analyze collaboration models, and highlight research gaps to inform research priorities and guide public health policies, amidst the growing challenge of multidrug resistance affecting treatment success. Background/Objectives: H. Pylori infection is usually contracted during childhood and often becomes chronic and asymptomatic in 80–90% of cases. Eradication requires complex treatments involving proton pump inhibitors and multiple antibiotics, but success rates have declined due to increased antibiotic resistance caused by genetic mutations, efflux mechanisms, altered membrane permeability, and biofilm formation. Reports indicate an alarming increase in multidrug resistance, affecting the effectiveness of treatments. Methods: The bibliometric analysis was performed using the Web of Science Core Collection (WoS) database, which provides comprehensive bibliographic data. Filters were applied for articles in English, reducing the set to 39,879 papers. The analysis was performed using the VOSviewer program (v1.6.20) to visualize co-author networks, citations, and keyword co-occurrence, and Microsoft Excel for processing and organization. Results: Editorial Trends: Over the last decade (2016–2025), interest in this topic has increased, with over 4000 publications annually in 2020, although a slight decline was observed in 2023. Leading Contributors: China is the most prolific author, followed by the USA and Japan. Cited Articles and Key Publications: Articles by prominent authors are frequently cited in 2022 and 2023, indicating their high relevance. Bibliographic Coupling Analysis: This revealed three main thematic clusters centered around research by specific authors. Keyword Analysis: A total of 57,462 terms were identified, of which 5292 appeared at least five times; “Helicobacter pylori” was the most frequent, followed by “infection” and “eradication.” Visualized terms highlight central areas of interest, such as “risk,” “cancer,” and “resistance”. Conclusions: This bibliometric analysis underscores a rising research focus on H. pylori antibiotic resistance, with recent publications providing essential clinical guidelines and epidemiological insights into the infection’s global impact. China leads in contributions, followed by the US and Japan. Significant articles by notable authors received many citations, emphasizing their significance.

The gut microbiota greatly influences host physiology, including immune regulation, metabolic balance, and brain health. Aging is associated with alterations in the gut microbiome, including reduced microbial diversity and increased pro-inflammatory bacteria, which are linked to age-related decline and chronic diseases. This review examines the impact of the gut microbiota on key indicators of aging, including cellular senescence, mitochondrial dysfunction, alterations in gene expression, and immune system modifications. It also examines microbiome-related diseases associated with aging, including neurodegeneration, cardiovascular issues, metabolic syndrome, and frailty. Additionally, it highlights evidence-based methods to restore a youthful microbial profile. New findings suggest that certain microbial substances, including short-chain fatty acids, urolithins, and bile acids, play a role in regulating inflammation, maintaining barrier integrity, and influencing metabolism. Age-related diseases are often associated with molecular pathways driven by an imbalance in the gut microbiome. Various intervention strategies, from dietary changes and probiotics to personalized nutrition and fecal microbiota transplantation, have shown promise in reversing signs of microbial aging and improving health outcomes in both lab and human studies. Overall, the gut microbiome serves as both a marker and a regulator of healthy aging. Treatments that restore microbial balance offer hopeful ways to extend healthy living. Future studies should focus on developing long-term, multifaceted, and personalized methods to identify causal pathways and enhance microbiota-based strategies for various aging populations.