In the era of artificial intelligence, machines are demonstrating an unprecedented capacity to learn from massive amounts of real-world data to perform human-like cognitive processes, enabling them to recognize environments, objects, and conditions and make critical decisions more accurately than ever. In the medical field, the potential to generate realistic, privacy-preserving, unbiased synthetic data can be the key to unlocking the potential of artificial intelligence in medicine and overcoming the current barriers such as data privacy concerns and high data curation costs. Advanced data-driven solutions could lead towards more robust clinical decision support systems and enhanced clinical training. This Perspective critically examines current and emerging advances in synthetic data generation, and highlights its anticipated transformational effect for early and efficient prevention, diagnosis and treatment of gastrointestinal diseases. Research challenges and directions are identified for leveraging the benefits of synthetic data as well as translating and adopting them in clinical workflows.

Irritable bowel syndrome (IBS) is a common medical condition characterized by different phenotypes. Diarrhea is usually prevalent in IBS patients, but constipation and meteorism are also common. Pharmacological therapies do not modify the IBS natural history. Thus, food supplements are used in clinical practice. The present Italian educational activity investigated the characteristics of IBS patients and compared the attitudes of gastroenterologists (GEs) and general practitioners (GPs). Fifty-three gastroenterologists and 42 GPs enrolled 2442 IBS patients. This initiative consisted of two distance learning sessions and a field training session. Demographic and clinical parameters, tests, and treatments (including past/ongoing and current) were collected. Mean age (46 years), female gender, and IBS with diarrhea were prevalent and consistent with literature data. Roma IV criteria were scarcely adopted by GPs. Patients managed by GEs were more complex than patients followed by GPs. GEs prescribed more appropriate diagnostic tests than GPs. Food supplements were commonly used both alone or combined with drugs, mainly by GPs. Symbiotic use was associated with less cramping pain, tension pain, and meteorism than other food supplements. An impressive increase in symbiotic prescriptions occurred during the field training. This real-world experience described the main characteristics of IBS patients, highlighted the differences between GEs and GPs, and reinforced the importance of educational programs in updating the medical class.

Despite national and international guidelines on Helicobacter pylori management, limited evidence exists on how these recommendations are applied in routine clinical practice. This nationwide survey, conducted by the Italian Association of Hospital Gastroenterologists and Endoscopists and the Italian Federation of General Practitioners (FIMMG), aimed to identify the empirical first- and second-line treatments most commonly recommended in Italy. Members of societies were invited via email to anonymously complete an original 20-item questionnaire. Ten therapeutic regimens were proposed, with treatment durations classified as 7, 10, or 14 days. Respondents reported the type of proton-pump inhibitor (PPI) used, total daily dose (mg/day), and whether probiotics and/or lactoferrin were recommended. PPI doses were standardized according to acid inhibition potency and categorized as low, standard, or high. Among the 1262 respondents [358 gastroenterologists (GEs) and 904 general practitioners (GPs)], the first-line regimen most frequently prescribed was the triple therapy with PPI, clarithromycin and amoxicillin (35.2%; 12% of GEs vs. 44.4% of GPs; P < 0.0001), followed by bismuth quadruple therapy - three-in-one capsule (BQT-TSC: 31.2%; 51.4 vs. 23.3%, P < 0.001), and sequential therapy (21.7%; 26.8 vs. 19.7%, P < 0.001). For second-line, BQT-TSC was the most prescribed regimen (53.1%; GEs versus GSs: not statistically significant). 10-day courses and low-dose PPIs predominated, and approximately 1/3 of respondents recommended probiotics. Empirical regimen selection, PPI dosing, and probiotic use frequently diverged from guideline recommendations. These findings highlight the need to align clinical practice with evidence-based standards to improve eradication rates, optimize cost-effectiveness, and preserve healthcare resources.

Current international practice guidelines recommend videofluoroscopic swallow studies (VFSSs) include oesophageal screening. However, the clinical application of oesophageal screening is not well established. A multidisciplinary dysphagia team at one hospital refined their oesophageal screening protocol and clinical pathway over five years, exploring clinical and operational impacts. Retrospective chart audits were conducted for 100 consecutive 2024 VFSS patients (refined protocol group). VFSS reports, gastroenterologist (GE) consultations and clinical pathway adherence were compared to previously published VFSS cohorts at the research site (pre-protocol group, 2019-20, n = 100; protocol group, 2020-21, n = 160). There were no differences between the three groups for age (p > .05) or oropharyngeal dysphagia severity (p > .05). Rates of oesophageal screening significantly increased (p < .001) following protocol introduction. In the refined protocol group, there was a significant increase (83% versus 6%, p < .001) in speech-language pathologists (SLPs) providing oesophageal strategy advice and no difference in patient VFSS radiation dose (p > .05) compared to the protocol group when oesophageal screening was conducted. There was no difference between the three groups for new GE consultation rates (p > .05). Post-audit, SLP + GE case discussions were added to the clinical pathway to allow for more individualised management of complex patients. The refined oesophageal screening protocol and clinical pathway expanded clinician understanding of patients' dysphagia by marrying reported symptoms with VFSS findings and led to targeted intervention without adverse impacts. Ongoing work is required to further optimise multidisciplinary dysphagia team collaboration and patient outcomes.

Abstract Background ABP-654 (WEZLANA®), a biosimilar to ustekinumab (UST), was approved by Health Canada in December 2023 for several immune diseases, including Crohn’s disease (CD) and ulcerative colitis (UC). Real-world data on its use remains limited. Aims To provide initial findings on the real-world use and effectiveness of ABP-654 as the first UST biosimilar approved for use in patients with inflammatory bowel disease (IBD) across Canada Methods Data were drawn from the Adelphi IBD Disease Specific Programmen TM, a cross-sectional survey with retrospective data collection from physicians conducted in Canada from May-October 2025. Gastroenterologists (GIs) provided data on their patients with IBD receiving ABP-654, who had received &amp;gt;2 subcutaneous doses, including demographics, clinical characteristics, treatment utilization, and satisfaction. Analyses were descriptive. Results Seven GIs reported data on 32 patients (15 CD, 17 UC). Mean [standard deviation; SD] age was 46.3 [15.7] years and 59% of patients were male. Mean [SD] time since initiating ABP-654 therapy at the time of consultation was 8.4 [2.5] months; 29 initiated ABP-654 as first UST therapy and 3 previously received UST. At initiation of ABP-654, 94% (30/32) of patients had moderate to severe disease severity and 84% (27/32) of patients’ disease progression was deteriorating, as reported by their GI. Following ABP-654 therapy at the time of consultation, 22% (7/32) of patients had moderate to severe disease severity, and 3% (1/32) of patients’ disease progression was deteriorating (Figure 1A; Table 1). Additionally, 84% (27/32), 69% (22/32), and 84% (27/32) of patients had achieved clinical, endoscopic, and biochemical remission, respectively (Figure 1B). GIs reported they were satisfied and believed this was the best control that could be achieved for 88% (28/32) of patients (Table 1). Conclusions After ∼ 8 months of follow-up, findings from this analysis indicate that most patients receiving ABP-654, improved to mild disease, achieved remission outcomes, and GIs reported high satisfaction. Funding Agencies Amgen Inc

Sexual health counseling (SHC) is a critical aspect of inflammatory bowel disease (IBD) care. Less is known about sexual health counseling in patients who identify as members of a sexual or gender minority (SGM) group. This study aims to characterize patient-reported sexual health counseling in SGM vs. non-SGM patients with IBD. We conducted an anonymous, cross-sectional survey of patients over 18years old with IBD, currently receiving care at a large, tertiary care IBD center. Data collection included demographics, IBD history, and patient recall of SHC. Patients who self-identified as SGM were compared to non-SGM patients, with subgroup analyses by sex assigned at birth. Means were compared using t tests and percentages compared using chi-square analysis. A total of 162 patients (41 SGM and 121 non-SGM) completed the survey. Both groups reported IBD impacted their sexual practices (ranging from 44% non-SGM men to 64% SGM women). SGM patients were more likely to report that their gastroenterologist asked about sexual health compared to non-SGM patients (p < .005). Importantly, 31% of respondents reported seeking SHC from their gastroenterologist (GI), placing GIs among the top sources of information regarding sexual health in this cohort. Most study participants reported that IBD has impacted their sexual practices. SHC rates were low in all study groups despite GI providers being a primary source of information. Clearer recommendations on aspects of SHC could improve quality of care for both SGM and non-SGM patients with IBD.

The Path to Diagnosis: Best Practices in Gastrointestinal Histopathology Collection and Examination.

Abstract Background Family physicians (FP), comprising general practitioners and pediatricians, may be considered as key pillars of the gateway to the healthcare system. In the context of inflammatory bowel disease (IBD), patients most commonly consult them when they experience first symptoms of IBD, then later for e.g., age-related health conditions. It is therefore interesting to investigate the role FP may play in the health trajectory of IBD patients, as well as how the collaboration with gastroenterologists (GE) stands. Objectives of the study were to understand how comfortable FD are with managing clinical situations typical of IBD patients and how they collaborate with GE, in a multicultural country with a fragmented decentralized healthcare system. Methods We conducted a survey based on case vignettes to assess clinical attitudes of GPs. Vignettes were proposed to the Sentinella network, comprising FD initially involved in sentinel surveillance of communicable diseases in Switzerland. The study duration was 8 weeks, from July to August 2025. We performed a descriptive analysis of vignette-case answers, with group comparisons where appropriate. Results Sixty-eight FDs completed a total of 332 vignettes (60% men, 34% females (6% mix-gender group practices)), 73% had their practice in urban area and 27% in peri-urban / rural area. The median (IQR)number of IBD patients followed by GPs was 5 (3.5-10) and ranges between 1 to &amp;gt; 150, depending on regions and proximity of university hospitals / specialized practices for IBD. 65% of men answered they were mostly comfortable with IBD care, as compared to 43% for females, 13% were not; 23% reported a currently complete (75% partial) delegation of IBD care to GE, but an ideal delegation in favor of less delegation. Ranked on a 10-point scale, median (IQR) responsibility for vaccination of IBD patients was ranked 8 (7-10), knowledge on vaccination 7 (5-8), IBD treatment 5.5 (5-7), CRC screening in IBD 5 (4-7), responsibility in CRC screening 8 (6-10), Fig1. 66% of FD reported receiving mostly no recommendations on vaccination from GE, and 41% no recommendations on therapy surveillance. Conclusion First results show regional variations in number of patients followed by FD, indicating IBD patients may choose to consult primarily GE for their health issues. FD responsibility and confidence on IBD care is rated high to moderate for vaccination, treatment or CRC screening. Ratings show higher self-rated responsibility but lower knowledge on the matter, with gender differences. Conflict of interest: Dr. Pittet, Valérie: No conflict of interest Mottet, Christian: No conflict of interest Mueller, Yolanda: No conflict of interest

Abstract Background Upadacitinib (UPA), a Janus kinase inhibitor, was approved for adults with moderate-to-severe ulcerative colitis (UC) in 2022. However, real-world data comparing its effectiveness to other advanced therapies (ATs) is limited. This study compared the time to achieve remission for UPA vs other ATs in patients with moderate-to-severe UC. Methods Data were drawn from the Adelphi Real World UC Disease Specific Programme™, a cross-sectional survey with retrospective data collection, of gastroenterologists (GIs) in France, Germany, Italy, Spain, UK and US from February 2023 – October 2024. Patients with a known treatment duration, clinical remission status (GI reported; defined as an absence or reduction in symptoms) and clinical remission achievement date were included in the analysis. GIs reported data on their patients with moderate to severe UC including demographics, treatment utilisation, and remission status. Data were collected in real-life practice, based on the most recent scheduled GI consultation. Time to remission (defined as time from AT initiation to real-world clinical remission) for UPA vs other ATs, including anti–tumour necrosis factor inhibitors (TNFis), vedolizumab, ustekinumab and tofacitinib, was analysed using unadjusted Kaplan-Meier curves and significance was assessed using log-rank tests. Cox-proportional hazard models were used to control for covariates, reporting hazard ratios (HRs). Patients who had not yet reached clinical remission were censored at data capture. Subgroup comparisons were made for UPA vs TNFis and other ATs excluding TNFis. Results GIs reported data on 281 patients with UC treated with UPA and 1061 patients with UC treated with other ATs (Table 1). Patients treated with UPA had significantly faster time to remission compared to other ATs (P = 0.0001), with median (95% confidence interval [CI]) time to remission for UPA of 4.4 (3.5, 5.8) months compared to 6.9 (6.0, 7.8) months for other ATs (Figure 1). This remained significant after adjusting for covariates (adjusted HR [aHR]: 1.58, P = 0.0002). Subgroup analysis showed that UPA also had significantly faster median time to remission compared to anti-TNFis alone (6.9 [CI 5.9, 8.9], P &amp;lt; 0.0001), as well as all other ATs except anti-TNFis (6.7 [CI 5.7, 7.9], P = 0.0015). These remained significant after adjusting for covariates (aHR 1.66, P = 0.0003 and aHR 1.46, P = 0.0025). Conclusion In a global, real-world setting, patients receiving UPA achieved clinical remission approximately 3 months faster compared to those receiving other ATs, highlighting the effectiveness of UPA treatment for moderate-to-severe UC. Faster remission may contribute to improved quality of life and reduced corticosteroid use or resource burden. Conflict of interest: Seidelin, Jakob Benedict: JS has received research grants from Takeda and Janssen, and is a national coordinator of studies from AbbVie, Arena Pharmaceuticals, Ely Lilly, and Boehringer Ingelheim. Marín-Jiménez, Ignacio: IMJ has served as a speaker, a consultant and advisory member for or has received research funding from AbbVie, Amgen, Chiesi, Dr. Falk Pharma, Faes Farma, Ferring, Fresenius, Galapagos, Gebro Pharma, Janssen, Kern Pharma, Lilly, MSD, Otsuka Pharmaceutical, Pfizer, Sandoz, Shire Pharmaceuticals, Takeda, Tillotts Pharma, and Vifor Pharma. Dawod, Fatima: Full time employee of Adelphi Real World and has received consulting fees and research support from AbbVie. Barlow, Sophie: Full time employee of Adelphi Real World and has received consulting fees and research support from AbbVie. Lukanova, Rina: Full time employee of Adelphi Real World and has received consulting fees and research support from AbbVie. Jones, William: Full time employee of Adelphi Real World and has received consulting fees and research support from AbbVie. Sharma, Dolly: Employee of AbbVie and may own stock or options. Morisset, Pierre: Employee of AbbVie and may own stock or options. Kim, Jae: Employee of AbbVie and may own stock or options. Siegel, Corey: Consultant/Advisory Board: Abbvie, Boomerang, Celltrion, Johnson and Johnson, Lilly, Napo Pharmaceuticals, Path Healthcare, Pfizer, Prometheus Labs, Sanofi, Takeda, Trellus Health Speaker for CME activities: Abbvie, Johnson &amp; Johnson, Pfizer, Takeda Grant support: Abbvie, Celltrion, Johnson &amp; Johnson, Lilly, Pfizer Intellectual property: MiTest Health, LLC (software company) has a patent for a “System and Method of Communicating Predicted Medical Outcomes.” Equity Interest: Dr. Corey Siegel and Dr. Lori Siegel are co-founders of MiTest Health, LLC (software company). Technology developed by MiTest Health, LLC has been licensed to Takeda. Dr. Corey Siegel has an equity interest in Path Healthcare. Dr. Corey Siegel has an equity interest in Trellus Health

Spanish multidisciplinary Consensus on the diagnosis and management of laryngopharyngeal reflux (ReFaL Consensus).

Despite the well-documented benefits of a healthy lifestyle for many patients, discussing lifestyle is currently not a structural part of routine clinical practice in hospital care. The aim of this study was to gain insight in the attitudes of healthcare professionals (HCPs) towards discussing lifestyle in their routine clinical practice, and explore differences between various types of HCPs. Semi-structured interviews were conducted with healthcare professionals (i.e. doctors, nurses, and allied health professionals (AHP)) from different departments (i.e. cardiology, gastrointestinal medicine, gynaecology, hepato-pancreato-biliary surgery, internal medicine, neurology, orthopaedics) in two university medical centers in the Netherlands. Interviews were audio-recorded and analyzed using a hybrid inductive-deductive analysis with Atlas.ti and MaxQDA. An existing framework by Van Aalderen et al. was utilized to explore attitudes, focusing on cognitive beliefs, affective states, and perceived control. The domain of cognitive beliefs had four distinguishing beliefs regarding perceived relevance (i.e. beliefs about: 1) relevance; 2) responsibility; 3) consequences; and 4) referral options), three sub-themes regarding perceived patient beliefs (i.e. patient motivation; patient capability; and patient opportunities) and one sub-theme regarding perceived difficulty. For the domain affective states the two themes were: enjoyment and anxiety. The domain of perceived control had two themes: self-efficacy and context dependency, which had three sub-themes (i.e. time, financial reimbursement and institutional policy). Overall, doctors seem more ambivalent in their attitudes than nurses and allied health professionals. A relatively large and diverse sample of healthcare professionals provided insight into health care professional's attitudes towards discussing lifestyle with patients during routine consultations. Research is needed to improve health promotion training for HCPs, patient-professional dynamics, and for implementation in routine clinical practice. HCPs need greater self-efficacy, support, and clear policies to integrate lifestyle discussions into routine care, requiring collaboration between educators, managers, and organizations.

Purpose: Physical inactivity is widely recognized as a global public health concern that requires a collective action, and there is a significant relationship between gastrointestinal diseases and physical activity (PA) levels.The study aims to evaluate the beliefs, attitudes, and knowledge of gastroenterologists (GE) concerning PA and exercise.Methods: To facilitate interpretation and test structural validity, the researchers developed a survey and applied Exploratory Factor Analysis.Latent Class Analysis was used to identify both favorable and unfavorable perceptions among GEs.Results: Of the 143 GEs, 30% were assistants, 29% were clinicians, and 41% were academics.Initially, 78% of GEs reported sufficient knowledge about PA and exercise; this increased to 93% after providing a brief informational text.76% of GEs found it difficult to prescribe exercise to patients with comorbidities, 46% believed PA and exercise were effective, and 24% thought exercise was unnecessary or harmful.81% of GEs consulted physiotherapists or dietitians, and 88% were successful in implementing lifestyle changes like diet or exercise.The difference in referral rates to physiotherapists vs. dietitians was statistically significant (36% vs. 76%, respectively; p<0.001). Conclusion:This study shows that GEs are aware of their knowledge gaps regarding lifestyle changes and are willing to consult physiotherapists for patients with comorbidities while collaborating more frequently with dietitians.Training seminars on the effectiveness of PA and exercise could enhance multidisciplinary collaboration and improve the overall quality of healthcare.

Nepal has experienced a rising number of pharmaceutical recalls due to quality failures, regulatory non-compliance, and the circulation of substandard and falsified medicines, highlighting critical weaknesses in post-market drug surveillance. Evidence from national recall data shows a persistent increase in recalled products over the past decade, with antimicrobials, analgesics, gastrointestinal medicines, and supplements most frequently affected. However, recall notices alone underestimate the true burden of poor-quality medicines, as delayed detection, limited laboratory capacity, and reactive regulatory processes allow many products to be consumed before corrective action. National surveys and field reports further indicate that quality failures extend across both public and private supply chains. Drawing on Nepal-specific evidence and global literature, this perspective argues that strengthening post-market surveillance requires a shift from recall-driven responses to proactive, risk-based systems. Key pathways forward include expanding routine sampling, enhancing laboratory capacity, improving transparency, adopting traceability tools, fostering regional collaboration, and supporting continuous national medicine-quality research to better protect public health.

ABSTRACTBackgroundHistopathological interpretation is crucial for diagnosing inflammatory bowel disease (IBD), distinguishing between Crohn's Disease (CD), Ulcerative Colitis (UC), IBD‐Unclassified (IBD‐U), and Non‐IBD colitis (NIBDC). However, interobserver variability and limited expertise can reduce diagnostic accuracy. Large Language Models (LLMs) such as GPT‐5 may offer clinical support in interpreting histology reports.MethodsWe analyzed 100 real‐life histological reports from ileo‐colonoscopies, equally representing CD, UC, IBD‐U, and NIBDC, collected across five Italian healthcare centers, including both IBD‐specialized and non‐specialized hospitals. A reference standard was established by an expert pathologist. Independent classifications were generated by GPT‐5, five gastrointestinal pathologists, five IBD‐expert gastroenterologists (GIs), and five non‐expert GIs. Diagnostic performance (accuracy, recall, precision, F1‐score), agreement with the reference standard (Cohen's κ), and inter‐rater reliability (Fleiss' κ) were assessed.ResultsGPT‐5 achieved the highest agreement with the reference standard with the highest accuracy (76.0%), compared to pathologists (68.6%), IBD‐experts (69.2%), and non‐experts (63.2%). Agreement with the reference standard was substantial for GPT‐5 (κ = 0.671) and moderate for human groups (κ = 0.508–0.588). GPT‐5 showed perfect recall for CD and UC, high recall for NIBDC (96.0%), but poor performance for IBD‐U (recall 8.0%, F1‐score 14.3%). Fleiss' κ indicated moderate agreement among pathologists and IBD‐experts, and fair agreement among non‐experts.ConclusionGPT‐5 demonstrated reliable performance in interpreting IBD histological reports, exhibiting high accuracy and strong agreement with the reference standard. While unreliable for IBD‐U, GPT‐5 may serve as a supportive tool in histopathological interpretation of IBD, particularly in centers with limited access to expert pathologists or IBD‐specialists.

The accumulation of unused and expired medicines in households poses significant economic, health, and environmental challenges. This study aimed to estimate the economic value of unused medicines and identify factors contributing to their accumulation among households in the Cibarusah District, Bekasi Regency, Indonesia. A cross-sectional survey was conducted from May to June 2025 involving 354 households selected using a convenience sampling approach. Data were collected through structured, face-to-face interviews with validated questionnaires and analyzed descriptively using Microsoft Excel 2021 and SPSS version 29. Results showed that 71.5% of households stored unused medicines, representing an estimated total economic value of IDR 25,271,179, or an average loss of IDR 99,886 per household. Expired medicines accounted for 28.5% of all stored items, with a mean value of IDR 114,897 per household. Analgesics, antipyretics, nonsteroidal anti-inflammatory drugs (NSAIDs), and antigout agents were the most frequently stored drug classes (20.1%), followed by gastrointestinal medicines (15.2%). The primary reasons for medicine accumulation were recovery from illness (70.9%), drug ineffectiveness (15.8%), and expiration (28.5%). Most respondents were female (67.2%), aged 36–55 years, and had completed secondary education. When extrapolated to all 32,515 households in Cibarusah District, the potential economic loss due to unused medicines reached approximately IDR 1.18 billion. This study highlights the substantial economic burden associated with household medicine storage and the need for improved public awareness of rational medicine use. Strengthening educational programs, involving community pharmacists in household medicine management, and establishing structured medicine take-back systems are essential to reduce pharmaceutical waste and its economic impact. These findings contribute valuable local evidence to support national strategies for promoting sustainable and responsible medicine use in Indonesia.

Introduction.While post-operative appendectomy complications have been reported as high as 25%, there is little research on association between appendectomy follow-up patterns and complication rates.This study examined follow-up patterns of appendectomy patients, modifiable factors impacting follow-up, and their relationship with post-operative complications.Methods.This retrospective study included patients who underwent appendectomy July 2022-December 2023.Patients treated non-operatively with antibiotics were excluded.Patient followup status was defined as either in-person with Emergency General Surgery (EGS) Department or no-follow-up.Modifiable factors included having a social work consult, primary care provider (PCP) or gastroenterologist (GI) specialist involvement, and follow-up with another provider if EGS follow-up was missed.Demographic factors included insurance status and zip code.AAST Grade and Charleston Comorbidity Index Score were analyzed for their association with complications and follow-up pattern.Results.Of the 158 patients, insurance status was significantly associated with follow-up rates (p = 0.047), but AAST appendicitis grade was not (p = 0.888).Complications were not significantly associated with poverty rate (p = 0.799) or insurance status (p = 0.243).There was a higher mean poverty rate for those that did not follow-up (14.8) compared to those that did (12.6).Factors not significantly associated with complications or follow-up status included having a PCP, GI, or other provider (all p >0.05).Conclusions.Lack of follow-up does not appear to be associated with post-operative complications.Insurance status was significantly associated with follow-up.Most patients who did not follow-up had shorter hospital stays and would be expected to follow-up less.

GutGPT: A multidimensional knowledge-enhanced large language model for gastrointestinal medicine.

Background: Third-space endoscopy (TSE) is a rapidly emerging field in gastrointestinal (GI) medicine that employs techniques such as endoscopic submucosal dissection (ESD), peroral endoscopic myotomy (POEM), and submucosal tunneling endoscopic resection. Despite TSE’s expanding clinical applications and minimally invasive advantages of TSE, the global research landscape and collaborative networks that drive its evolution remain poorly defined. Methods: A comprehensive search of the Web of Science Core Collection (WoSCC) was conducted for publications between 2015 and 2025 using predefined TSE-related keywords. Bibliometric indicators, including publication volume, citation analysis, geographic distribution, institutional and author productivity, and keyword co-occurrence networks, were assessed using VOSviewer and Microsoft Excel. Results: Of the initial 47,569 records, 6347 met our inclusion criteria. The number of publications per year has increased steadily from 2015 to 2025, indicating an intensification of academic and clinical interest in the TSE. Japan, the United States, and China were identified as the most prolific contributors, with leading institutions such as the Japan National Cancer Center and the Mayo Clinic. Europe has not been able to demonstrate a dominant scientific position in this field, and has lagged behind. “Surgical Endoscopy and Other Interventional Techniques” emerged as the journal with the highest number of articles published in the field of TSE. ESD and peroral endoscopic myotomy (POEM) are dominant research themes. Conclusion: This bibliometric and visual analysis highlights the expanding role of TSE in modern gastrointestinal endoscopy. This underlines the clinical impact and research momentum. The predominance of Japanese and American institutions points to both geographical clustering of expertise and potential opportunities for wider international participation. Future perspectives should emphasize comparative clinical studies and rigorous long-term outcome studies to confirm the position of TSE as a cornerstone of minimally invasive GI treatment.

Nanomedicine has emerged as a prominent field with significant potential to transform the future of medicine, thereby attracting considerable attention from researchers worldwide. In various studies, nanoparticles with high potential as delivery systems have been used in combination with probiotics, microorganisms that have beneficial health effects when consumed in sufficient doses, in treating inflammatory bowel disease, including ulcerative colitis and Crohn's disease. Nanoparticles are synthesized by various methods, including biological, physical, and chemical, and depending on their size and structure, they produce different effects on the digestive system when combined with probiotics. The study demonstrates that combining various nanoparticles with specific probiotics can effectively modulate intestinal microbiota, reduce inflammation, enhance mucosal barrier function, and boost antioxidant activity, thereby aiding in the treatment of inflammatory digestive diseases. So, future research should further investigate the long-term safety, optimal dosing, and mechanisms of action of these nanoparticle-probiotic combinations in clinical settings to maximize therapeutic benefits.

Multi-disciplinary teams for Crohn's disease: Who should be presented?