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Gastrointestinal Diseases: Clinical Challenges and Management
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Gastrointestinal Diseases: Clinical Challenges and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (20 February 2026) | Viewed by 9077

Special Issue Editors

Dr. Anusha Shirwaikar Thomas

E-Mail Website
Guest Editor
Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Interests: internal medicine; gastroenterology; gastrointestinal diseases
Dr. Yinghong Wang

E-Mail Website
Guest Editor
Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Interests: cancer immunotherapy-related GI toxicity; colitis; inflammatory bowel disease; fecal microbiota transplantation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The goal of this Special Issue, “Gastrointestinal Diseases: Clinical Challenges and Management”, is to provide a comprehensive overview of frequently encountered gastrointestinal (GI) disorders in clinical practice at a cancer center. This encompasses a breadth of disorders and conditions that providers should be proficient in while caring for these patients, namely (a) GI bleeding in patients with cancer, (b) GI motility disorders in patients with malignancy, (c) nutrition in malignancy, (d) functional bowel disorders in patients with cancer, (e) drug-induced luminal GI toxicity, (f) drug-induced liver injury, (g) prevention, diagnosis, and treatment of clostridium difficile infection in patients with cancer, (h) large bowel obstruction in patients with colonic malignancies, (i) obstructive jaundice, and (j) colon cancer prevention and surveillance.

There have been significant advances in understanding the etiopathogenesis of these disorders to guide therapeutics, which are often tailored to care for this unique patient population. What used to be considered the standard of care 10 years ago has evolved. While covering all topics in this regard would be beyond the scope of this Special Issue, we hope to improve clinical outcomes and add to the knowledge of providers in the clinical practice of gastrointestinal medicine in this vulnerable, immunocompromised patient population.

Dr. Anusha Shirwaikar Thomas
Dr. Yinghong Wang
Guest Editors

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 250 words) can be sent to the Editorial Office for assessment.

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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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

  • GI bleed
  • nutrition
  • obstructive jaundice
  • drug-induced liver injury
  • GI motility
  • clostridium difficile infection
  • large bowel obstruction
  • colon cancer prevention and surveillance

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Published Papers (3 papers)

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Research

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10 pages, 967 KB  
Article
Predictive Value of FDG Uptake on PET for Future Immune Checkpoint Inhibitor-Mediated Colitis: A Case Series
by Malek Shatila, Kei Takigawa, Yang Lu, Andres Caleb Urias Rivera, Nitish Mittal, Abdullah Sagar Aleem, Sean Ngo, Eric Lu, Deanna Wu, Gabriel Sperling, Sidra Naz, Bryan Schneider, Anusha Shirwaikar Thomas and Yinghong Wang
J. Clin. Med. 2025, 14(1), 256; https://doi.org/10.3390/jcm14010256 - 4 Jan 2025
Cited by 1 | Viewed by 2783
Abstract
Objectives: Immune-mediated colitis (IMC) is a common immune-related adverse event during immune checkpoint inhibitor (ICI) therapy. This case series and review aimed to highlight atypical cases of IMC and explore the potential of PET/CT to predict imminent ICI colitis. Methods: Through [...] Read more.
Objectives: Immune-mediated colitis (IMC) is a common immune-related adverse event during immune checkpoint inhibitor (ICI) therapy. This case series and review aimed to highlight atypical cases of IMC and explore the potential of PET/CT to predict imminent ICI colitis. Methods: Through a descriptive, retrospective study at a tertiary cancer center, we identified adult patients receiving ICIs for any cancer between 2010 and 2022 who also underwent PET/CT for routine cancer surveillance during this time. We included patients who had signs and symptoms of colitis and reviewed their surveillance PET/CT scans obtained 2 to 6 weeks before and up to 3 months after diagnosis. Results: For the 33 included patients, surveillance scans were reviewed in collaboration with a nuclear radiologist. A total of 17 patients (51.5%) received combination therapy, while 14 (42.4%) received anti–PD-1/PD-L1 monotherapy. While ICI therapy has a median duration of 6.5 months, most patients (72.7%) had negative surveillance PET/CT for colitis. Diarrhea and colitis severity were similar among those with positive and negative findings for colitis on surveillance PET/CT. The outcomes of colitis were similar, with an 81.8% resolution in patients with negative PET/CT and 71.4% in patients with positive PET/CT. Conclusions: PET/CT imaging did not appear to assist in predicting IMC. This may be due to the long interval between clinical IMC and surveillance PET/CT imaging. The continued use of clinical criteria combined with laboratory markers, e.g., lactoferrin and calprotectin, and endoscopy/histology will enable more accurate detection and timely treatment of IMC. Full article
(This article belongs to the Special Issue Gastrointestinal Diseases: Clinical Challenges and Management)
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Review

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24 pages, 391 KB  
Review
Gastric Motility Disorders Post Organ Transplantation—A Comprehensive Review
by Hareesha Rishab Bharadwaj, Thai Hau Koo, Dushyant Singh Dahiya, Priyal Dalal, Muhtasim Fuad, Sammy Arab, Karanjot Chhatwal, Taha Bhatti, Maham Malik, Simardeep Singh, Fariha Hasan, Christina Tofani and Anthony Infantolino
J. Clin. Med. 2025, 14(21), 7581; https://doi.org/10.3390/jcm14217581 - 25 Oct 2025
Cited by 2 | Viewed by 2349
Abstract
Motility disorders, particularly gastroparesis, are prevalent complications following solid organ transplantation, significantly impacting quality of life, nutritional status, graft survival, and mortality. This comprehensive review synthesises evidence from PubMed, Scopus, and Embase databases on pathophysiology, clinical manifestations, diagnosis, management, and prognostic factors across [...] Read more.
Motility disorders, particularly gastroparesis, are prevalent complications following solid organ transplantation, significantly impacting quality of life, nutritional status, graft survival, and mortality. This comprehensive review synthesises evidence from PubMed, Scopus, and Embase databases on pathophysiology, clinical manifestations, diagnosis, management, and prognostic factors across transplant types. Mechanisms include vagal nerve injury (highest in lung transplants, prevalence 40–91%), immunosuppressive effects (e.g., tacrolimus accelerates motility; mycophenolate impairs it), surgical trauma, microbiome dysbiosis (reduced Firmicutes/Bacteroidetes ratio), and metabolic factors like post-transplant diabetes (OR 5.17 in kidney recipients). Pediatric and thoracic recipients face the highest risks, with lung transplant gastroparesis conferring a 2.7-fold increased mortality/retransplantation hazard (p < 0.05). Diagnosis relies on gastric emptying scintigraphy (gold standard, sensitivity 85–95%) and wireless motility capsules (100% sensitivity for delay), while management encompasses prokinetics (60–80% response), endoscopic G-POEM (85% success), gastric electrical stimulation (100% quality-of-life improvement in series), and nutritional support. Prognostic factors include younger age (better intervention response), aetiology (anatomical worse than metabolic), and early therapy success. Outcomes vary: lung recipients experience severe impacts on chronic allograft dysfunction (83% oesophageal motility abnormalities correlate with 66–67% rejection). Future directions emphasise microbiome therapies, AI predictive models (AUC 0.85), and wearables for continuous monitoring. Multidisciplinary approaches are essential to balance immunosuppression with GI management, addressing ethical dilemmas like drug interactions and access disparities. Ultimately, early screening and personalised interventions can mitigate complications, enhancing long-term transplant success. Full article
(This article belongs to the Special Issue Gastrointestinal Diseases: Clinical Challenges and Management)
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17 pages, 1756 KB  
Review
Ferroptosis in Gastrointestinal Diseases: A New Frontier in Pathogenesis and Therapy
by Adam Wawrzeńczyk, Katarzyna Napiórkowska-Baran, Ewa Alska, Alicja Gruszka-Koselska, Ewa Szynkiewicz, Józef Sławatycki, Paula Klemenska and Zbigniew Bartuzi
J. Clin. Med. 2025, 14(12), 4035; https://doi.org/10.3390/jcm14124035 - 7 Jun 2025
Cited by 7 | Viewed by 3033
Abstract
Ferroptosis, a form of regulated cell death driven by iron-dependent lipid peroxidation, has emerged as a key player in the pathogenesis of gastrointestinal (GI) diseases. Unlike apoptosis or necrosis, ferroptosis is characterized by distinctive metabolic and molecular pathways, including dysregulated iron metabolism, oxidative [...] Read more.
Ferroptosis, a form of regulated cell death driven by iron-dependent lipid peroxidation, has emerged as a key player in the pathogenesis of gastrointestinal (GI) diseases. Unlike apoptosis or necrosis, ferroptosis is characterized by distinctive metabolic and molecular pathways, including dysregulated iron metabolism, oxidative stress, and impaired antioxidant defenses. This review explores the complex role of ferroptosis in conditions such as inflammatory bowel disease (IBD), non-alcoholic steatohepatitis (NASH), and gastrointestinal cancers. Special attention is given to the molecular mechanisms underlying ferroptosis, including the Xc−/GSH/GPX4 axis, ferritinophagy, ACSL4/LPCAT3-mediated lipid remodeling, and the influence of the gut microbiota. Therapeutic strategies targeting ferroptosis—including pharmacological inhibitors, iron chelators, and microbiota-based interventions—are evaluated for their translational potential, underscoring ferroptosis as a promising target for precision therapies in gastroenterology and highlighting the need for further clinical studies to validate its diagnostic and therapeutic implications. Full article
(This article belongs to the Special Issue Gastrointestinal Diseases: Clinical Challenges and Management)
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