Non-Hodgkin lymphoma is one of the most common types of lymphoma affecting the gastrointestinal tract. This malignancy can originate from either B-lymphocytes or T-lymphocytes. Intestinal perforation due to non-Hodgkin lymphoma is a relatively rare occurrence, and when it does happen, it typically arises after the initiation of chemotherapy. In the reported case, the perforation happened prior to the chemotherapy, making the case unusual. We aim to highlight the importance of maintaining a high index of suspicion and the critical role of timely, multidisciplinary management in improving patient outcomes. A 27-year-old male farmer from a rural area in North West Gondar, Ethiopia, was referred to our hospital for further evaluation and management. He initially presented to the referring facility with a 1-week history of abdominal pain. The pain began as a periumbilical discomfort during the first 5 days and later progressed to become diffuse, involving all regions of the abdomen. He also reported three episodes of vomiting and a high-grade fever that had persisted for the last 2 days. Due to lack of timely histopathologic evaluation, confirmatory diagnosis was done after 1 month of surgical intervention. Intestinal perforation caused by lymphoma is a rare occurrence in clinical practice, especially before the initiation of chemotherapy. When such perforation does occur, it is often misdiagnosed or diagnosed late due to its atypical clinical presentation. In many cases, the diagnosis is only established postoperatively following histopathological examination.

Background: The Chinese dwarf cherry (CDC) has been valued for over 2000 years for its medicinal and nutritional properties, particularly its kernels. Despite its recognition as a rich source of oil, the potential health benefits of CDC kernel oil remain unclear. Method: Initially, we evaluated the preventive effectiveness of CDC in a mouse model of constipation induced by loperamide. Results: The findings indicated that CDC kernel oil alleviated constipation by reducing the first black fecal defecation time and increasing the fecal number, wet weight, water content and gastrointestinal transit rate in model mice. Additionally, CDC kernel oil reduced inhibitory neurotransmitters and increased excitability neurotransmitters, two anti-oxidases’ activity and fecal short-chain fatty acid (SCFA) content. Histological analysis revealed an improved mucus cell morphology in the intestinal tract. Furthermore, CDC kernel oil increased the abundance of some beneficial bacteria. It was identified that the gut microbiota was associated with neurotransmitters, mediators of inflammation and SCFAs. Conclusion: The findings offer a scientific foundation for considering CDC kernel oil as a potential functional food for the alleviation of constipation.

Inflammatory bowel disease (IBD), a chronic relapsing inflammatory disorder of the gastrointestinal tract, significantly increases the risk of progression to colorectal cancer (CRC). Emerging studies highlight the critical roles of gut microbial dysbiosis and sustained intestinal inflammation in driving this pathological transformation. Probiotics and prebiotics, as modulators of gut microbial ecology, have attracted considerable attention as potential interventions to restore microbial balance, regulate immune responses, and mitigate carcinogenic processes. In this review, we integrate the interplay mechanisms among inflammation, microbiota, and immunity in IBD-associated colorectal carcinogenesis (IBD-CRC), with a focus on the roles of probiotics and prebiotics in microbial remodeling, enhancement of epithelial barrier integrity, inhibition of inflammatory signaling, and activation of antitumor immunity. Furthermore, we discuss preclinical and clinical evidence supporting their efficacy in delaying or preventing IBD-CRC. The review also provides perspectives on future customized synbiotic strategies in microbiota-targeted therapy and cancer prevention.

Multiple myeloma is a malignant plasma cell disorder primarily involving the bone marrow and skeleton, leading to anemia, renal dysfunction, and lytic bone lesions. Extramedullary disease, seen in about 9% of cases, reflects aggressive disease biology with poor prognosis. Common sites include the pleura, liver, and gastrointestinal tract, while pericardial involvement is exceedingly rare and often detected postmortem. Fewer than 25 cases of pericardial effusion or cardiac tamponade due to multiple myeloma have been reported, usually in advanced disease. The mechanism likely involves hematogenous spread or direct extension from adjacent lesions, often associated with high-risk cytogenetic abnormalities. This case presents an unusual first manifestation of multiple myeloma as pericardial effusion with tamponade physiology, emphasizing the need to consider hematologic malignancy in unexplained pericardial effusion, especially in resource-limited settings. A 60-year-old Ethiopian man presented with a 6-month history of progressive dry cough, dull chest pain, and worsening shortness of breath. He had been repeatedly treated for pneumonia and pulmonary tuberculosis without improvement. Chest computed tomography revealed a large pericardial effusion with features of cardiac tamponade. Echocardiography confirmed pericardial fluid causing right atrial and ventricular collapse. Pericardiocentesis drained 800mL of hemorrhagic fluid, and cytology showed atypical plasma cells. Further evaluation, including serum protein electrophoresis and bone marrow biopsy, confirmed multiple myeloma. The patient was managed with Pericardiocentesis and systemic chemotherapy, showing clinical and radiologic improvement, highlighting the rarity of pericardial involvement as an initial presentation of multiple myeloma. Pericardial involvement in multiple myeloma is an extremely rare and serious manifestation, usually signifying advanced or aggressive disease. While malignant pericardial effusions are commonly due to solid tumors, multiple myeloma should also be considered when no other cause is identified. Early echocardiography-guided pericardiocentesis is lifesaving, and definitive procedures such as a pericardial window may prevent recurrence. This case highlights the importance of suspecting hematologic malignancy in patients with unexplained pericardial effusion or cardiac tamponade. Early recognition and prompt initiation of systemic therapy can improve survival, particularly in resource-limited settings where diagnostic challenges are common.

Medical care in the gastrointestinal (GI) tract is a major global issue. Soft actuators are expected to solve associated issues such as poor accessibility and difficult operability within the GI tract. The actuators will be inserted into the body through the mouth or anus with a small diameter, perform various tasks in the GI tract with a large diameter, and finally be removed again. Therefore, deployability and retractivity are common requirements. Variable stiffness is also required to adjust or maintain forces on weak tissues. We proposed the new deployable and stiffness-variable miniature actuator consisting of a shape memory polymer bar and flexible channel part with water circulation, which is useful for medical applications in the GI tract. We established the design method of the actuator based on derived physical models and the fabrication method of prototypes. We evaluated the performances of thermal response, retractive deformation, and variable stiffness and confirmed the validity of the concept through the demonstration of continuous actuation, including deploying, retracting, and stiffness-varying. Furthermore, as a case study, we verified the feasibility of endoscopic submucosal dissection traction using prototypes and artificial materials. In the future, the actuator mechanism and design method may also contribute to the development of other medical tools interacting with delicate tissues in the GI tract.

Exosomes, which are molecular cargo-containing, nanosized extracellular vesicles formed through double invagination of the plasma membrane, have emerged as important mediators of intercellular communication within the gastrointestinal tract. In addition to its established function in digestion and nutrient uptake, the gastrointestinal tract is central to immune regulation and maintenance of epithelial barrier integrity. Exosomes derived from intestinal epithelial cells, the gut microbiota and gut resident immune cells are key in sustaining intestinal homeostasis and regulating host-microbiota interactions. Dysregulation of these vesicles is increasingly linked to gastrointestinal disease pathogenesis, including inflammatory bowel disease. Currently, exosomes are being explored for use as diagnostic biomarkers and therapeutic agents in gastrointestinal ailments. In this review, we examine the roles of exosomes in gastrointestinal health and disease, highlighting their contributions in the regulation of epithelial barrier function, modulation of immune responses and communication with the gut microbiota. We further discuss the dysregulation of exosome-mediated signaling pathways in IBD and assess their potential as next-generation therapies for gastrointestinal disorders.

ABSTRACT: Bioactive compounds are secondary metabolites secreted by plants and plant derived products which are essential for human health. Because bioactive chemicals have the potential to maximize therapeutic efficacy and minimize side effects, there has been a lot of attention focused on developing effective delivery systems for these compounds in recent years. One method that has shown promise for overcoming the difficulties in delivering bioactive substances is nanoencapsulation. The state-of-the-art in bioactive compound delivery systems using nanoencapsulation is thoroughly reviewed in this paper. Present review deals with the brief study of bioactive delivery and their improvement for better biostability via nanoencapsulation. Nanotechnology holds potential perspectives for food processing, including superior antimicrobial effects, improved sensory quality and safety, enhanced nutrient bioavailability in food preparations, and targeted delivery and controlled release of bioactive ingredient along the gastrointestinal tract. The review commences with an explanation of the principles of nanoencapsulation, covering different methods for encapsulating bioactive substances in nano-sized carriers, including coacervation, emulsification, and nanoprecipitation. The benefits of nanoencapsulation are also emphasized, including enhanced solubility, stability, bioavailability, and targeted distribution. Keywords: Nanoencapsulation, bioactive compounds

Intestinal dysmotility represents a significant health burden, often leading to severe and life-threatening complications. Current therapies are limited, highlighting the need for smart treatment strategies. We propose a novel, minimally invasive approach involving the oral delivery of mucoadhesive magneto-responsive nanoparticles, which can be actuated by external magnets. As a proof of concept, Fe 3 O 4 nanoparticles were coated with chitosan to optimise their interaction and adhesion to the intestinal epithelium and to enhance cytocompatibility. To protect the chitosan-coated particles from the acidic conditions of the stomach and enable their targeted release further along the gastrointestinal tract, they were encapsulated in pH responsive alginate beads. Using an advanced 3D multi-layered in vitro model of the intestinal wall, we confirmed the absence of nanoparticle translocation across the barrier. Moreover, epithelial para- and transcellular transport pathways were unaltered in the presence of the chitosan-coated particles, suggesting that nutrient passage is conserved. Finally, a hydrogel simulating the intestinal submucosal layer was loaded with the nanoparticles and then actuated with external magnets to verify their capacity to generate physiological strains. These findings demonstrate the feasibility of magnetically actuated mucoadhesive nanoparticles as a foundation for new therapeutic strategies to restore intestinal motility, paving the way for externally controlled, minimally invasive interventions in gastrointestinal disorders.

Bilirubin is a breakdown product of erythrocytes and plays a crucial role in elimination of heme-containing proteins. After its synthesis in the reticuloendothelial system, unconjugated bilirubin is released into plasma and taken up into the liver. In hepatocytes, bilirubin is conjugated and excreted into the gastrointestinal tract via bile, where it is further converted to urobilinoids. There are various genetic factors causing abnormal bilirubin levels in plasma, such as Gilbert syndrome, Crigler-Najjar syndrome, Dubin-Johnson syndrome, and Rotor syndrome. To better understand bilirubin metabolism and its disorders, this study develops a physiologically based computational model incorporating published literature as well as real-world clinical data from the Explorys database. The model simulates bilirubin levels in both healthy individuals and patients with disorders of bilirubin metabolism. Population simulations show that Gilbert syndrome requires a substantial reduction in UDP-glucuronosyltransferase 1A1 activity, while Crigler-Najjar syndrome requires near-complete loss of its function. In contrast, Dubin-Johnson syndrome is characterized by a significant impairment of multidrug resistance-associated protein 2 activity. To also illustrate model behavior under targeted perturbations, we simulated administration of atazanavir in healthy individuals and patients with Gilbert syndrome to investigate its effect on bilirubin levels. Relative to baseline, unconjugated bilirubin maximum concentration (Cmax) increased by 34% in healthy individuals but by 67% in Gilbert syndrome. Overall, this study provides a conceptual and mechanistically informed framework for studying bilirubin homeostasis and the functional consequences of drug administration in health and disease.

The term Artificial intelligence (AI) is revolutionizing gastrointestinal (GI) endoscopy by enhancing advanced imaging techniques such as Narrow Band Imaging (NBI), Linked Color Imaging (LCI), iSCAN, and Confocal Laser Endomicroscopy (CLE). AI-driven deep learning algorithms, particularly convolutional neural networks (CNNs) and transformer-based models, have demonstrated high accuracy in the real-time detection, classification, and risk stratification of premalignant and malignant lesions, thereby reducing unnecessary biopsies and improving diagnostic efficiency. In the upper GI tract, AI has shown superior performance in detecting dysplasia in Barrett’s esophagus, distinguishing early gastric cancer from benign alterations, and predicting submucosal invasion depth. This capability enhances decision-making regarding endoscopic resection, such as endoscopic submucosal dissection (ESD). In the lower GI tract, AI is increasingly applied for real-time identification of adenomas, serrated lesions, and neoplastic changes in ulcerative colitis. Studies have confirmed that AI-assisted colonoscopy significantly increases adenoma detection rates, thereby reducing the incidence of interval colorectal cancer. Furthermore, AI-powered advanced endoscopy allows for a more objective assessment of mucosal and histological healing in IBD, helping predict outcomes and advancing precision medicine in its management. This narrative review comprehensively analyzes AI’s role in advanced endoscopic imaging, highlighting its impact on optical diagnosis in both upper and lower GI pathologies. It explores the integration of multimodal AI approaches, which combine imaging data with clinical and molecular biomarkers, to enhance diagnostic precision. Additionally, it discusses current challenges, including the need for multicenter validation, standardization of AI algorithms, and ethical considerations for clinical implementation. Future perspectives emphasize the necessity for high-quality prospective studies to validate AI’s real-world applicability and long-term benefits in endoscopic practice.

Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a multifaceted systemic condition, with the mechanisms linking intrahepatic lesions to systemic complications remaining a significant enigma in the field. This review posits that extracellular vesicles (EVs) serve as pivotal mediators facilitating communication between the liver and the entire organism. Within the hepatic environment, lipotoxic hepatocyte-derived EVs modulate macrophage populations and stellate cells, thereby promoting inflammatory and fibrotic processes. Systemically, the liver engages in bidirectional communication with adipose tissue, the intestinal tract, the cardiovascular system, and the pancreas via EVs, thus orchestrating metabolic homeostasis. Furthermore, we critically evaluate non-invasive diagnostic strategies and emerging therapies, including both natural and engineered EVs, based on EV-based interventions. We highlight the substantial potential and current challenges associated with achieving precision medicine in MASLD through targeted modulation of this specific communication network.

Fecal microbiota transplantation (FMT) is a pioneering medical technique designed to re-establish a balanced gut microbiome by transferring processed stool from a rigorously screened donor into the gastrointestinal tract of a recipient. Initially conceived as a last-resort therapy for recurrent Clostridioides difficile (C. difficile ) infections - a challenging condition frequently resistant to conventional antibiotics - FMT has achieved impressive clinical response rates, often surpassing 80% in resolving recurrent C. difficile infections. This remarkable success has generated significant enthusiasm for its potential use in addressing a broader spectrum of disorders linked to disrupted gut microbial populations, including inflammatory bowel disease, irritable bowel syndrome, metabolic syndrome, and various autoimmune and neurological conditions. However, the wider clinical integration of FMT is accompanied by several notable challenges. These include the need for optimal donor selection, comprehensive long-term follow-up of recipients, standardization of stool processing and delivery methods, and thorough economic evaluation to establish cost-effectiveness. Safety remains a top priority, with particular attention paid to minimizing the risk of infectious disease transmission and preventing unwanted immune responses. Regulatory standards for FMT vary internationally, with some nations categorizing it as a biologic therapy or experimental treatment, while others have established more formalized approval processes. This article offers a comprehensive examination of FMT, covering its historical evolution, underlying mechanisms, current clinical applications, safety protocols, and regulatory landscape. By consolidating the latest research and clinical guidelines, it aims to educate clinicians, researchers, and policymakers on the expanding role of FMT in modern healthcare.

IntroductionAlthough the reported incidence of congenital vascular malformations is ~1.5% of the general population, the true incidence of these lesions is difficult to assess due to the heterogeneity of vascular anomalies and the variability in terminology used in reporting. These vascular anomalies can involve capillaries, lymphatics, venous, and/or arterial structures and can occur anywhere in the body. Rarely does a vascular malformation originate from the gastrointestinal (GI) mesentery and present as a bowel obstruction.Case ReportThis report describes an adolescent patient with an unusual presentation of a vascular malformation involving the GI mesentery, manifesting as midgut volvulus. Emergent laparotomy revealed a large intra‐abdominal cystic structure that volvulized resulting in a small bowel obstruction. The lesion and involved segment of small bowel were resected and found to be a mesenteric venous malformation on pathology.ConclusionVascular anomalies of the GI tract are uncommon but should be included in the broad differential for patients presenting with abdominal pain, symptoms consistent with a small bowel obstruction, and/or a cystic intra‐abdominal mass. In addition, utilization of accurate and standardized terminology when reporting these lesions is important to facilitate prompt and accurate diagnosis and treatment of patients and to establish a reliable foundation of continued research on vascular anomalies.

Drug delivery system based on the novel acidic self-assembling peptide hydrogels: Insights into N-terminal modulation, assembly mechanism, and applications.

Efficacy and Safety of Activated Charcoal in Primary Gout: A Double-Blind, Double-Dummy, Randomized Controlled Trial.

Background: Lower Gastrointestinal Bleeding is characterized refers to bleeding that originates from the lower part of the gastrointestinal tract, including the colon, rectum, and anus. It can present with various symptoms and can range from mild to severe. Patients and methods: Across sectional study of 93 patients complaining of Lower Gastrointestinal Tract Bleeding (LGITB) were examined by Emergency Department (ED) doctors from 1st of February 2023 to 1st of October 2023 in ED of Al-Yarmouk teaching hospital. All Patients present with acute infectious bloody diarrhoea, Upper Gastrointestinal Tract Bleeding (UGITB) and age less than 16 years excluded from the study. General information taken from the patients by a questioner all parameters include (age, sex, Presentation to ED, past medical and surgical history, Clinical finding, laboratory investigation, Treatment, Time spent in ED). Diagnosis was aided by proctoscope, sigmoidoscopy, and colonoscopy, and the role of ED in management were assessed. Results: A total 93 patients (62 males and 31 female) with mean age 51.5 years were treated. The most frequent diagnosis was haemorrhoid (40.9%) followed by polyp (11.8%) and diverticulosis (10. 8%).All patient stay in ED less than 24 hours with mean time stay was 11.6 hours. Most common presentation was fresh blood per rectum (60.2%), haematochezia (24.7%) and melena (15.1%). Conclusion: Proctoscopy done in ED gives a fast diagnosis and treated patient in ED and discharge home (reduce admission rate). Over all ED have an important role of management of patients with LGITB if good protocol were applied.

An enterovesical fistula (EVF) is an abnormal connection between the intestinal tract and urinary bladder, typically developing with symptoms of pneumaturia and fecaluria. We herein present the case of an 81-year-old man with 10-day watery diarrhea. After ineffective empiric antidiarrheal treatment, computed tomography and cystography revealed EVF and gas in the bladder lumen and within its wall. His diarrhea improved after urethral catheter placement. EVF can occasionally cause diarrhea in a delicate pressure balance between the bladder and intestine. Clinicians should be aware of this unusual condition and include "urinary diarrhea" in the differential diagnosis of diarrhea.

Layer-by-layer stimuli-responsive self-assembled nanocarriers for green-extracted polyphenols sequential delivery: Investigation of stability, bioactivity, and bioaccessibility during simulated gastrointestinal digestion.

Introduction Piperine (PIP), the active alkaloid found in black pepper ( Piper nigrum ), has gained attention for its potential therapeutic role in managing non-alcoholic fatty liver disease (NAFLD) due to its anti-inflammatory, lipid-lowering, antioxidant, and insulin-sensitising properties. Nevertheless, PIP’s poor solubility limits its absorption in the gastrointestinal tract, thereby, compromising its systemic bioavailability. Consequently, the objective of this research has been to formulate piperine-loaded solid lipid nanoparticles (PIP- SLNs) so as to increase its oral bioavailability and prolong its hepatic circulation time. Methods Herein, PIP-SLNs were prepared by the hot homogenization method. The fabricated PIP-SLNs were characterized for size, zeta potential, surface morphology, entrapment efficiency and in vitro release performance. The impact of the optimized formula (F6) on key parameters associated with NAFLD, such as oral glucose tolerance (OGTT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC), triglyceride (TG) levels, and liver weight, was evaluated using a hyperlipidaemic Swiss albino mice model. Additionally, liver histopathology was examined pre- and post-treatment to assess the efficacy of PIP-SLNs in mitigating hyperlipidaemia. Results and discussion Particle size, zeta potential, and drug entrapment efficiency of the optimized formula (F6) was found to be 191.2 ± 27.9 nm, - 20 ± 1.3 mV, 72.3% ± 2.8, respectively. Morphologically, the PIP-SLNs were found to be spherical. The optimized formulation (F6) exhibited sustained release up to 70% at 48 h, fitting the Higuchi model (R 2 = 0.976) indicative of diffusion-driven release, with a Korsmeyer‐Peppas exponent (n = 0.63), further confirming anomalous diffusion-relaxation transport. Most importantly, the NAFLD study demonstrated a significant (p < 0.05) drop in blood glucose levels, serum markers (AST and ALT, p < 0.001), total cholesterol and triglycerides (p < 0.05), and also liver weight (p < 0.028), which was far superior to those elicited by plain PIP suspension. These findings reiterate the potential of solid lipid nanoparticles in increasing the bioavailability and thereby its hepatic circulation of PIP, which in turn, significantly enhanced its hepatoprotective effect in NAFLD.

Magnetic soft robots are emerging as biomedical tools for minimally invasive interventions. They synergize remote magnetic actuation with the compliance of soft materials to ensure safe navigation and therapy within delicate anatomical structures, such as the gastrointestinal tract, blood vessels, and urinary system. This review analyzes material-tissue toxicity and mechanical interactions and summarizes material innovations in magnetic hydrogels, elastomers, ferrofluids, and responsive composites. Organ-specific material and structural designs for clinical applications are discussed, showcasing advances of soft medical robots in targeted drug delivery, thrombus extraction, tissue sampling, thermal therapy, and in situ sensing. Furthermore, we focus on key translational challenges, including long-term biostability of materials, adaptive closed-loop control, and multifunctional system integration, which must be addressed to reach the full potential of magnetic soft robots for clinical applications.