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Medicina
Special Issues
Management of Gastrointestinal Disorders Related to Infectious Diseases and Medications
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Management of Gastrointestinal Disorders Related to Infectious Diseases and Medications

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (15 February 2026) | Viewed by 5052

Special Issue Editors

Dr. Amir Mari

E-Mail Website
Guest Editor
1. Gastroenterology Unit, Nazareth EMMS Hospital, Nazareth, Israel
2. The Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel
Interests: esophageal disease; neurogastroenterology; esophageal diagnostics; gastrointestinal conditions; infectious diseases
Special Issues, Collections and Topics in MDPI journals
Dr. Fadi Abu Baker

E-Mail Website
Guest Editor Assistant
1. Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Hadera, Israel
2. The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
Interests: endoscopic evaluation of GI disorders; diagnostic and therapeutic endoscopy; hepatology, particularly viral hepatitis and MASLD
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Gastrointestinal (GI) symptoms and conditions, including nausea, vomiting, diarrhea, abdominal pain, bleeding and changes in bowel habits, are prevalent manifestations in patients with infectious diseases and those undergoing various pharmacological treatments. These symptoms significantly impact patient quality of life and present frequent challenges in primary care, internal medicine, and gastroenterology settings. Despite their common occurrence, the management of GI symptoms related to infections and medications remains underexplored in the medical literature. This Special Issue aims to address this gap, seeking original research and comprehensive reviews that explore the pathophysiology, diagnostic approaches, and therapeutic strategies for GI symptoms associated with infectious agents and pharmacological interventions. We encourage submissions that investigate the prevalence and burden of these symptoms in various populations, assess the efficacy of current management protocols, and identify areas requiring further inquiry. By deepening the understanding of these multifaceted interactions, this issue aspires to inform clinical practices and advance patient care strategies to effective manage GI symptoms linked to infections and medications.

Dr. Amir Mari
Guest Editor

Dr. Fadi Abu Baker
Guest Editor Assistant

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • gastrointestinal symptoms
  • drug-related gastrointestinal disorders
  • gastrointestinal infections
  • diarrhea
  • infectious
  • intestinal microbiota
  • foodborne diseases
  • patient-centered outcomes

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Published Papers (4 papers)

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15 pages, 2422 KB  
Article
Multicenter Real-World Observational Study of Pargeverine/Lysine Clonixinate in Acute Visceral Colicky Pain
by Gerardo E. Espinosa-Estrada, Samuel Sevilla-Fuentes, Brandon Bautista-Becerril, Ramcés Falfán-Valencia, Luis Ángel Mendoza-Vargas, José Francisco Araiza-Rodríguez and Pedro Moreno-Chavez
Medicina 2026, 62(4), 706; https://doi.org/10.3390/medicina62040706 - 7 Apr 2026
Viewed by 736
Abstract
Background and objectives: Acute colicky abdominal pain, involving visceral spasms and inflammatory mechanisms, is a common complaint in everyday medical practice. Despite its widespread use, clinical evidence on the fixed-dose combination of pargeverine 10 mg plus lysine clonixinate 125 mg remains limited. The [...] Read more.
Background and objectives: Acute colicky abdominal pain, involving visceral spasms and inflammatory mechanisms, is a common complaint in everyday medical practice. Despite its widespread use, clinical evidence on the fixed-dose combination of pargeverine 10 mg plus lysine clonixinate 125 mg remains limited. The objective of this study was to describe real-world clinical outcomes, safety, and patient-reported experience associated with this combination in routine practice. Materials and methods: This multicenter, observational, non-comparative, real-world study included adult patients with acute colicky abdominal pain of gastrointestinal, urological, or gynecological origin. Pain intensity was assessed using a visual analog scale (VAS) at baseline and at 5 ± 3 days. Secondary outcomes included time to pain relief, satisfaction with treatment, and safety. Associations between pain reduction and patient-reported outcomes were explored. Results: A total of 202 patients were analyzed. Significant pain reduction was observed across all etiologies (p < 0.001), with median VAS reductions ranging from 6 to 9 points (approximately 70% to 90% from baseline). More than 95% of patients reported early improvement, and sustained relief was maintained in more than 96% throughout the study period, regardless of the pain’s origin. Adverse events were infrequent (3%), mild in intensity (primarily transient gastrointestinal symptoms), and did not lead to treatment discontinuation. Conclusions: In real-world clinical practice, the fixed-dose combination of pargeverine and lysine clonixinate was associated with early and sustained, clinically meaningful pain reduction across multiple forms of acute visceral colicky pain, with a favorable safety and tolerability profile, supporting its relevance as a short-term therapeutic option in mild to severe acute pain. Full article
(This article belongs to the Special Issue Management of Gastrointestinal Disorders Related to Infectious Diseases and Medications)
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16 pages, 789 KB  
Article
Performance of Serum-Based Non-Invasive Fibrosis Scores Compared with Liver Biopsy in Patients with Chronic Hepatitis B
by Umut Devrim Binay, Faruk Karakeçili, Orçun Barkay and Betül Kuru
Medicina 2026, 62(4), 646; https://doi.org/10.3390/medicina62040646 - 28 Mar 2026
Viewed by 480
Abstract
Background and Objectives: Accurate assessment of liver fibrosis is essential for treatment decisions in patients with chronic hepatitis B (CHB). Although liver biopsy is considered the reference standard, its invasive nature limits routine use. Serum-based non-invasive fibrosis scores have been proposed as [...] Read more.
Background and Objectives: Accurate assessment of liver fibrosis is essential for treatment decisions in patients with chronic hepatitis B (CHB). Although liver biopsy is considered the reference standard, its invasive nature limits routine use. Serum-based non-invasive fibrosis scores have been proposed as alternatives; however, their diagnostic performance in CHB remains variable. This study aimed to compare multiple serum-based non-invasive fibrosis scores with liver biopsy findings and to evaluate their association with histological activity. Materials and Methods: This retrospective cross-sectional study included 219 adult patients with CHB who underwent liver biopsy with simultaneous laboratory evaluation. Patients with viral co-infections (HIV, HCV, or HDV), metabolic syndrome, diabetes mellitus, hepatic steatosis, or incomplete data were excluded. Non-invasive fibrosis scores—including APRI, FIB-4, AST/ALT ratio (AAR), age–platelet index (API), GGT-to-platelet ratio (GPR), Lok index, modified Forns index, Albumin–Bilirubin (ALBI) score, and red cell distribution width (RDW)-based indices—were calculated using routine laboratory parameters. Histopathological fibrosis staging served as the reference standard. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis, and areas under the curve (AUC) were compared using the DeLong test. Associations with histological activity index (HAI) were assessed using Spearman correlation. Results: For the prediction of significant fibrosis (≥F2), FIB-4 demonstrated the highest AUC, followed by ALBI and APRI. For advanced fibrosis (≥F3), FIB-4 again showed the highest AUC, followed by APRI and GPR. For significant fibrosis (≥F2), DeLong analysis revealed no statistically significant differences between FIB-4 and the other serum-based scores (p > 0.05). APRI (r = 0.556, p < 0.001) and FIB-4 (r = 0.463, p < 0.001) showed the strongest correlations with HAI. In ROC analysis for moderate-to-severe histological activity (HAI ≥ 4), APRI demonstrated the highest diagnostic accuracy (AUC = 0.677). Conclusions: Serum-based non-invasive fibrosis scores demonstrate comparable but overall modest diagnostic performance for biopsy-confirmed fibrosis in patients with chronic hepatitis B. Indices such as FIB-4 and APRI demonstrated relatively better discrimination and may be considered as screening or rule-out tools in selected clinical contexts. APRI and FIB-4 also show associations with histological activity; however, their clinical application should be interpreted with caution, given their moderate discriminatory capacity. Full article
(This article belongs to the Special Issue Management of Gastrointestinal Disorders Related to Infectious Diseases and Medications)
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11 pages, 427 KB  
Article
Predictive Factors Associated with Inappropriate Intravenous Proton Pump Inhibitors Use in Hospitalized Patients: A Case-Control Study
by Niveen Khoury, David Stepensky, Naim Abu Freha, Mahmud Mahamid, Tawfik Khoury and Amir Mari
Medicina 2025, 61(1), 10; https://doi.org/10.3390/medicina61010010 - 25 Dec 2024
Viewed by 2406
Abstract
Background and Objectives: Proton Pump Inhibitors (PPIs) are the most effective agents for treating acid-related gastrointestinal disorders. The prescription of an intravenous (IV) formulation of PPIs has increased dramatically. The aims of this study were to assess the appropriateness of IV PPI [...] Read more.
Background and Objectives: Proton Pump Inhibitors (PPIs) are the most effective agents for treating acid-related gastrointestinal disorders. The prescription of an intravenous (IV) formulation of PPIs has increased dramatically. The aims of this study were to assess the appropriateness of IV PPI use and to define the risk factors and outcomes associated with its inappropriate use. Materials and Methods: A case-control retrospective study included all the hospitalized patients who received IV PPIs was conducted. Patient health records were reviewed, data were collected covering the period of the individual patients’ admission to the hospital until discharge or death, and over the 3-month post-discharge period. The appropriateness of the IV PPI use and the resulting clinical outcomes were analyzed. Results: Overall, 540 patients were analyzed. Among them, 130/540 (24%) had inappropriate PPI use in terms of indication, dosage, and duration of treatment vs. 410 patients who had appropriate indications. Two parameters were associated with inappropriate use: congestive heart failure (OR 1.77; p = 0.02) and prescription of IV PPIs by surgeons vs. internists (OR 1.53; p = 0.05). Conclusions: Inappropriate IV PPI use is still common in daily clinical practice. Significant predictors of inappropriate use were the presence of congestive heart failure, elderly age, current use of anticoagulants and antithromotics, and the cases managed by surgeons, naturally due to suspected upper gastrointestinal bleedings. Full article
(This article belongs to the Special Issue Management of Gastrointestinal Disorders Related to Infectious Diseases and Medications)
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25 pages, 1139 KB  
Systematic Review
Recent Developments and Applicability of In Vitro Gut Microbiota Models in Biomedical Research and Digestive Diseases—A Systematic Review
by Ioana-Miruna Balmus, Gabriel Dascalescu, Viorica Rarinca, Alin Ciobica, Elena Toader, Georgiana-Emmanuela Gilca-Blanariu, Simona Stefania Juncu, Carol Stanciu and Anca Trifan
Medicina 2026, 62(3), 554; https://doi.org/10.3390/medicina62030554 - 16 Mar 2026
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Abstract
Background and Objectives: Current research approaches focusing on the human gut microbiota require complex in vitro systems that could provide sufficient viability and similarity with the conditions provided by the human intestine. As critical physiological functions, such as metabolic and inflammatory modulation, [...] Read more.
Background and Objectives: Current research approaches focusing on the human gut microbiota require complex in vitro systems that could provide sufficient viability and similarity with the conditions provided by the human intestine. As critical physiological functions, such as metabolic and inflammatory modulation, are associated with gut microbiota activity, complex host–microbiota interactions represent a pivotal new direction for therapeutic and nutritional interventions. However, there are several limitations to the current development of advanced in vitro models. Materials and Methods: A systematic review was performed according to the PRISMA guidelines for data collection and interpretation. Results: This manuscript summarizes the most advanced in vitro approaches for studying the gut microbiota, including batch fermentation models, dynamic fermentation models, and state-of-the-art technologies, such as organoids and gut-on-a-chip platforms. Each model offers beneficial study backgrounds, advantages, limitations, and the capacity to replicate the physiological complexity of the intestinal environment. However, due to the increased heterogeneity of the reported models, there is an urgent need for standardization. In this way, coherent regulatory frameworks are needed to guide the development and application of in vitro models. Conclusions: By consolidating knowledge and critically addressing current challenges, this study contributes to gut microbiota research by providing a direction for ethical, precise, and high-impact scientific studies. Full article
(This article belongs to the Special Issue Management of Gastrointestinal Disorders Related to Infectious Diseases and Medications)
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