Clinical issues and challenges in imaging of gastrointestinal diseases:A minireview and our experience

Imaging techniques play a crucial role in the modern era of medicine,particularly in gastroenterology.Nowadays,various non-invasive and invasive imaging modalities are being routinely employed to evaluate different gastrointestinal(GI)diseases.However,many instrumental as well as clinical issues are arising in the area of modern GI imaging.This minireview article aims to briefly overview the clinical issues and challenges encountered in imaging GI diseases while highlighting our experience in the field.We also summarize the advances in clinically available diagnostic methods for evaluating different diseases of the GI tract and demonstrate our experience in the area.In conclusion,almost all imaging techniques used in imaging GI diseases can also raise many challenges that necessitate careful consideration and profound expertise in this field.

Morphological and biochemical characteristics associated with autophagy in gastrointestinal diseases

Autophagy is a cellular catabolic process characterized by the formation of double-membrane autophagosomes.Transmission electron microscopy is the most rigorous method to clearly visualize autophagic engulfment and degradation.A large number of studies have shown that autophagy is closely related to the digestion,secretion,and regeneration of gastrointestinal(GI)cells.However,the role of autophagy in GI diseases remains controversial.This article focuses on the morphological and biochemical characteristics of autophagy in GI diseases,in order to provide new ideas for their diagnosis and treatment.

Fecal calprotectin in pediatric gastrointestinal diseases:Pros and cons

BACKGROUND Fecal calprotectin is a valuable biomarker for assessing intestinal inflammation in pediatric gastrointestinal diseases.However,its role,pros,and cons in various conditions must be comprehensively elucidated.AIM To explore the role of fecal calprotectin in pediatric gastrointestinal diseases,including its advantages and limitations.METHODS A comprehensive search was conducted on PubMed,PubMed Central,Google Scholar,and other scientific research engines until February 24,2024.The review included 88 research articles,56 review articles,six metaanalyses,two systematic reviews,two consensus papers,and two letters to the editors.RESULTS Fecal calprotectin is a non-invasive marker for detecting intestinal inflammation and monitoring disease activity in pediatric conditions such as functional gastrointestinal disorders,inflammatory bowel disease,coeliac disease,coronavirus disease 2019-induced gastrointestinal disorders,gastroenteritis,and cystic fibrosis-associated intestinal pathology.However,its lack of specificity and susceptibility to various confounding factors pose challenges in interpretation.Despite these limitations,fecal calprotectin offers significant advantages in diagnosing,monitoring,and managing pediatric gastrointestinal diseases.CONCLUSION Fecal calprotectin holds promise as a valuable tool in pediatric gastroenterology,offering insights into disease activity,treatment response,and prognosis.Standardized protocols and guidelines are needed to optimize its clinical utility and mitigate interpretation challenges.Further research is warranted to address the identified limitations and enhance our understanding of fecal calprotectin in pediatric gastrointestinal diseases.

Recent Advances for Global Perspectives on Etiology, Pathophysiology, Clinical Presentations, and Management of Moyamoya Disease

Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease.

Gastric IgG4-related disease mimicking a gastrointestinal stromal tumor in a child: A case report

BACKGROUND Gastric IgG4-related disease(IgG4-RD)is rarely encountered in clinical practice,and especially more so among pediatric patients.To our knowledge,this is the first report of IgG4-RD presenting as a calcifying gastric mass in a child.We describe how this entity was difficult to differentiate from a gastrointestinal stromal tumor(GIST)imaging-based approaches.Therefore,this case highlights the importance of considering IgG4-RD in the differential diagnosis of gastric tumor before performing surgical resection,especially to distinguish it from malignancy to avoid unnecessary surgery.CASE SUMMARY The patient suffered from epigastric pain for several days.Panendoscopy and computed tomography scan revealed a submucosal tumor.Differential diagnoses included GIST,leiomyoma,teratoma,and mucinous adenocarcinoma.However,laparoscopic proximal gastrectomy allowed for the definitive diagnosis of IgG4-related stomach disease.CONCLUSION We emphasize the importance of considering IgG4-RD in the differential diagnosis of gastric submucosal tumors before performing surgical resection.

Gastrointestinal Diseases Classification Using Deep Transfer Learning and Features Optimization

Gastrointestinal diseases like ulcers, polyps’, and bleeding areincreasing rapidly in the world over the last decade. On average 0.7 millioncases are reported worldwide every year. The main cause of gastrointestinaldiseases is a Helicobacter Pylori (H. Pylori) bacterium that presents in morethan 50% of people around the globe. Many researchers have proposeddifferent methods for gastrointestinal disease using computer vision techniques.Few of them focused on the detection process and the rest of themperformed classification. The major challenges that they faced are the similarityof infected and healthy regions that misleads the correct classificationaccuracy. In this work, we proposed a technique based on Mask Recurrent-Convolutional Neural Network (R-CNN) and fine-tuned pre-trainedResNet-50 and ResNet-152 networks for feature extraction. Initially, the region ofinterest is detected using Mask R-CNN which is later utilized for the trainingof fine-tuned models through transfer learning. Features are extracted fromfine-tuned models that are later fused using a serial approach. Moreover, anImproved Ant Colony Optimization (ACO) algorithm has also opted for thebest feature selection from the fused feature vector. The best-selected featuresare finally classified using machine learning techniques. The experimentalprocess was conducted on the publicly available dataset and obtained animproved accuracy of 96.43%. In comparison with state-of-the-art techniques,it is observed that the proposed accuracy is improved.

Dynamic contrast enhanced ultrasound in gastrointestinal diseases:A current trend or an indispensable tool?

Contrast enhanced ultrasound(CEUS)has been widely implemented in clinical practice because of the enormous quantity of information it provides,along with its low cost,reproducibility,minimal invasiveness,and safety of the secondgeneration ultrasound contrast agents.To overcome the limitation of CEUS given by the subjective evaluation of the contrast enhancement behaviour,quantitative analysis of contrast kinetics with generation of time-intensity curves has been introduced in recent years.The quantification of perfusion parameters[named as dynamic-CEUS(D-CEUS)]has several applications in gastrointestinal neoplastic and inflammatory disorders.However,the limited availability of large studies and the heterogeneity of the technologies employed have precluded the standardisation of D-CEUS,which potentially represents a valuable tool for clinical practice in management of gastrointestinal diseases.In this article,we reviewed the evidence exploring the application of D-CEUS in gastrointestinal diseases,with a special focus on liver,pancreas,and inflammatory bowel diseases.

Research progress of TCM regulation of Cajal interstitial cells in the treatment of functional Gastrointestinal diseases

Interstitial cells of Cajal are a different class of cells with unique ultrastructure,molecular phenotype and function,and their main function is to generate slow waves,thereby triggering gastrointestinal pacing and regulating gastrointestinal motility.They play an extremely important physiological role in coordinating the normal activities of the digestive system,and their number,shape and function abnormalities often have a certain impact on gastrointestinal motility.Functional gastrointestinal disease is a type of digestive system disease closely related to gastrointestinal motility.Relevant studies have shown that the pathogenesis of functional gastrointestinal disease is closely related to the abnormal number,morphology and function of Cajal interstitial cells.Regulating the shape and number of interstitial cells of Cajal,maintaining the normal operation of gastrointestinal electrophysiology,inhibiting excessive autophagy and activating related signaling pathways,etc.,can improve gastrointestinal motility,thereby treating functional gastrointestinal diseases.This article will discuss the treatment of functional gastrointestinal diseases from traditional Chinese medicine compound,traditional Chinese medicine monomer,and external treatment of traditional Chinese medicine by regulating Cajal interstitial cells.

Prevention and Treatment of Gastrointestinal Diseases in College Students

Objective:This paper aims to discuss the prevention and treatment strategies of gastrointestinal diseases in college students.Methods:A sample of 60 college students suffering from gastrointestinal diseases,from August 2021 to August 2022,was used to discuss the symptoms,causes,prevention strategies,and treatment strategies of gastrointestinal diseases based on questionnaire survey.Results:The high-incidence types of gastrointestinal diseases in college students mainly included chronic gastritis,acute gastritis,duodenal ulcer,and dyspepsia,which were closely related to mental state,diet,and living habits.Conclusion:There are many causes of gastrointestinal diseases in college students.During the period of active symptomatic treatment,it is necessary to focus on the prevention of gastrointestinal diseases in colleges and universities,correct the unhealthy lifestyle of students,and reduce the risk of gastrointestinal diseases.

Gastrointestinal disease in children with autism spectrum disorders:Etiology or consequence?

Chronic gastrointestinal(GI)symptoms and disorders are common in children with autism spectrum disorder and have been shown to be significantly correlated with the degree of behavioral and cognitive impairment.In this unique population,GI symptoms often arise very early in development,during infancy or toddlerhood,and may be misdiagnosed-or not diagnosed at all–due in part to the challenges associated with recognition of symptoms in a minimally or noncommunicative child.Evidence demonstrating that the gut-brain-axis can communicate gut dysbiosis and systemic immune dysregulation in a bidirectional manner raises the question as to whether an untreated gastrointestinal disorder can directly impact neurodevelopment or,conversely,whether having a neurodevelopmental disorder predisposes a child to chronic GI issues.From the data presented in this mini review,we conclude that the preponderance of available evidence would suggest the former scenario is more strongly supported.

From macroautophagy to mitophagy:Unveiling the hidden role of mitophagy in gastrointestinal disorders

In this editorial,we comment on an article titled“Morphological and biochemical characteristics associated with autophagy in gastrointestinal diseases”,which was published in a recent issue of the World Journal of Gastroenterology.We focused on the statement that“autophagy is closely related to the digestion,secretion,and regeneration of gastrointestinal cells”.With advancing research,autophagy,and particularly the pivotal role of the macroautophagy in maintaining cellular equilibrium and stress response in the gastrointestinal system,has garnered extensive study.However,the significance of mitophagy,a unique selective autophagy pathway with ubiquitin-dependent and independent variants,should not be overlooked.In recent decades,mitophagy has been shown to be closely related to the occurrence and development of gastrointestinal diseases,especially inflammatory bowel disease,gastric cancer,and colorectal cancer.The interplay between mitophagy and mitochondrial quality control is crucial for elucidating disease mechanisms,as well as for the development of novel treatment strategies.Exploring the pathogenesis behind gastrointestinal diseases and providing individualized and efficient treatment for patients are subjects we have been exploring.This article reviews the potential mechanism of mitophagy in gastrointestinal diseases with the hope of providing new ideas for diagnosis and treatment.

Changes in the etiology of liver cirrhosis and the corresponding management strategies

We read with interest the article by Xing Wang,which was published in the recent issue of the World Journal of Hepatology 2023;15:1294-1306.This article focuses particularly on the prevalence and trends in the etiology of liver cirrhosis(LC),prognosis for patients suffering from cirrhosis-related complications and hepatocellular carcinoma(HCC),and management strategies.The etiology of cirrhosis varies according to geographical,economic,and population factors.Viral hepatitis is the dominant cause in China.Vaccination and effective treatment have reduced the number of people with viral hepatitis,but the overall number is still large.Patients with viral hepatitis who progress over time to LC and HCC remain an important population to manage.The increased incidence of metabolic syndrome and alcohol consumption is likely to lead to a potential exponential increase in metabolic dysfunction-associated steatotic liver disease(MASLD)-associated LC and alcoholic liver disease in the future.Investigating the evolution of the etiology of LC is important for guiding the direction of future research and policy development.These changing trends indicate a need for greater emphasis on tackling obesity and diabetes,and implementing more effective measures to regulate alcohol consumption in order to reduce the occurrence of MASLD.In an effort to help cope with these changing trends,the authors further proposed countermeasures for healthcare authorities doctors,and patients.

Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis

BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality rate.AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record system.Data pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and analyzed.RESULTS Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among males.Notably,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial symptom.Upon admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding.Urgent routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding episode.Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite trend.Additionally,diet-related bleeding was more common among the young age group compared to the middle-aged group.Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB(73.3%),followed by gastrointestinal malignancies(10.9%),acute gastric mucous lesions(9.8%),and androgenic upper gastrointestinal bleeding(1.5%)among inpatients with ANVUGIB.Of the 532 patients with gastrointestinal bleeding,68 underwent endoscopic hemostasis,resulting in an endoscopic treatment rate of 12.8%,with a high immediate hemostasis success rate of 94.1%.

Trends in gastrointestinal disease hospitalizations and outcomes during the first year of the coronavirus pandemic

BACKGROUND The impact of the coronavirus on hospitalizations for gastrointestinal(GI)disease,particularly at a population level is understudied.AIM To investigate trends in hospitalizations,inpatient endoscopy resource utilization,and outcomes during the first year of the coronavirus pandemic and subsequent lockdowns.METHODS Using the California State Inpatient Database for 2018-2020,we explored year-toyear and 2020 month-to-month trends in hospitalizations,length of stay,and inpatient mortality(all-cause&viral pneumonia-specific)for common inpatient GI diagnoses including acute pancreatitis,diverticulitis,cholelithiasis,noninfectious gastroenteritis,upper and lower GI bleeding(LGIB),Clostridium difficile,viral gastroenteritis,inflammatory bowel disease,and acute cholangitis.RESULTS Disease-specific hospitalizations decreased for all included conditions except nonvariceal upper GI bleeding(NVUGIB),LGIB,and ulcerative colitis(UC)(ptrend<0.0001).Allcause inpatient mortality was higher in 2020 vs 2019,for acute pancreatitis(P=0.029),diverticulitis(P=0.04),NVUGIB(P=0.003),and Crohn’s disease(P=0.004).In 2020,hospitalization rates were lowest in April,November,and December.There was no significant corresponding increase in inpatient mortality except in UC(ptrend=0.048).Viral pneumonia and viral pneumonia complicated by respiratory failure increased(P<0.001)among GI hospitalizations.Endoscopy utilization within 24 h of admission was unchanged for GI emergencies except NVUGIB(P<0.001).CONCLUSION Our findings suggest that hospitalization rates for common GI conditions significantly declined in California during the COVID pandemic,particularly in April,November and December 2020.Allcause mortality was significantly higher among acute pancreatitis,diverticulitis,NVUGIB,and Crohn’s disease hospitalizations.Emergency endoscopy rates were mostly comparable between 2020 and 2019.

Influence of non-alcoholic fatty liver disease on non-variceal upper gastrointestinal bleeding:A nationwide analysis

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the leading cause of liver disease globally with an estimated prevalence of 25%,with the clinical and economic burden expected to continue to increase.In the United States,non-variceal upper gastrointestinal bleeding(NVUGIB)has an estimated incidence of 61-78 cases per 100000 people with a mortality rate of 2%-15%based on co-morbidity burden.AIM To identify the outcomes of NVUGIB in NAFLD hospitalizations in the United States.METHODS We utilized the National Inpatient Sample from 2016-2019 to identify all NVUGIB hospitalizations in the United States.This population was divided based on the presence and absence of NAFLD.Hospitalization characteristics,outcomes and complications were compared.RESULTS The total number of hospitalizations for NVUGIB was 799785,of which 6%were found to have NAFLD.NAFLD and GIB was,on average,more common in younger patients,females,and Hispanics than GIB without NAFLD.Interestingly,GIB was less common amongst blacks with NAFLD.Multivariate logistic regression analysis was conducted,controlling for the multiple covariates.The primary outcome of interest,mortality,was found to be significantly higher in patients with NAFLD and GIB[adjusted odds ratio(aOR)=1.018(1.013-1.022)].Secondary outcomes of interest,shock[aOR=1.015(1.008-1.022)],acute respiratory failure[aOR=1.01(1.005-1.015)]and acute liver failure[aOR=1.016(1.013-1.019)]were all more likely to occur in this cohort.Patients with NAFLD were also more likely to incur higher total hospital charges(THC)[$2148($1677-$2618)];however,were less likely to have a longer length of stay[0.27 d(0.17-0.38)].Interestingly,in our study,the patients with NAFLD were less likely to suffer from acute myocardial infarction[aOR=0.992(0.989-0.995)].Patients with NAFLD were not more likely to suffer acute kidney injury,sepsis,blood transfusion,intubation,or dialysis.CONCLUSION NVUGIB in NAFLD hospitalizations had higher inpatient mortality,THC,and complications such as shock,acute respiratory failure,and acute liver failure compared to those without NAFLD.

Upper gastrointestinal bleeding as an unusual manifestation of localized Ménétrier’s disease with an underlying lipoma:A case report

BACKGROUND Ménétrier’s disease is a rare condition characterized by enlarged gastric folds,usually located in the whole body and fundus of the stomach.This report presents an unusual case of localized Ménétrier’s disease elevated by a submucosal lipoma and thus looking like a polypoid mass and causing an episode of upper gastrointestinal bleeding.The mass was successfully removed with endoscopic submucosal dissection.CASE SUMMARY Esophagogastroduodenoscopy was performed on a 76-year-old male patient after an episode of upper gastrointestinal bleeding,manifesting as fatigue and melena.A large polypoid mass(4 cm×1 cm)with enlarged mucosal folds was found in the body of the stomach,between the lesser curvature and posterior wall.A small ulcer at the distal end of the mass was identified as the source of the bleeding.Biopsy was negative for neoplasia.Computed tomography showed a submucosal lesion beneath the affected mucosa,most likely a lipoma.The mass was removed en bloc with tunneling endoscopic submucosal dissection.Final pathology determined that the mass included Ménétrier’s disease and a submucosal lipoma.The patient was scheduled for follow-up esophagogastroduodenoscopy.CONCLUSION Localized Ménétrier’s disease can coexist with a submucosal lipoma creating a polypoid mass with risk of bleeding.

Upper gastrointestinal microbiota and digestive diseases

Metagenomics which combines the power of genomics,bioinformatics,and systems biology,provide new access to the microbial world.Metagenomics permit the genetic analysis of complex microbial populations without requiring prior cultivation.Through the conceptual innovations in metagenomics and the improvements in DNA high-throughput sequencing and bioinformatics analysis technology,gastrointestinal microbiology has entered the metagenomics era and become a hot topic worldwide.Human microbiome research is underway,however,most studies in this area have focused on the composition and function of the intestinal microbiota and the relationship between intestinal microbiota and metabolic diseases(obesity,diabetes,metabolic syndrome,etc.) and intestinal disorders [inflammatory bowel disease,colorectal cancer,irritable bowel syndrome(IBS),etc.].Few investigations on microbiota have been conducted within the upper gastrointestinal tract(esophagus,stomach and duodenum).The upper gastrointestinal microbiota is essential for several gastrointestinal illnesses,including esophagitis,Barrett's esophagus,and esophageal carcinoma,gastritis and gastric cancer,small intestinal bacterial overgrowth,IBS and celiac disease.However,the constitution and diversity of the microbiota in different sections of the upper gastrointestinal tract under health and various disease states,as well as the function of microbiota in the pathogenesis of various digestive diseases are still undefined.The current article provides an overview of the recent findings regarding the relationship between upper gastrointestinal microbiota and gastrointestinal diseases;and discusses the study limitations and future directions of upper gastrointestinal microbiota research.

Gastrointestinal motility disorders in inflammatory bowel diseases

The relationship between motility and inflammatory gastrointestinal disorders is at the same time complex and intriguing since these conditions might share some genetic,environmental,immunological and microbial predisposing factors.In addition,significant symptom overlapping may occur,muddling the waters within the clinical context.Although on one hand this represents a challenge for the clinician for a potential under-or over-treatment and diagnostic delay,on the other hand it possibly represents an opportunity for the researcher to better disclose the intimate relationship between chronic(often low-grade)inflammation,motor disorders and deranged sensory function.The best example is probably represented by Crohn’s disease and ulcerative colitis.In fact,a number of gastrointestinal motor disorders have been described in association with these diseases,disorders which span from the esophagus to the anorectum,and which will be extensively covered in this review.It is conceivable that at least part of this derangement is strictly related to inflammatory cytokine trafficking and neuromuscular changes;however,given the high prevalence of functional gastrointestinal disorders in the general population,this overlap might also be serendipitous.However,it is worth noting that literature data on this topic are relatively scarce,sometimes quite outdated,and mostly focused on the interplay between irritable bowel syndrome and inflammatory bowel disease.Nevertheless,both researchers and clinicians must be aware that symptoms related to gastrointestinal motility disorders may be highly prevalent in both active and inactive inflammatory bowel disease,correlate with greater psychological comorbidity and poorer quality of life,and may negatively influence the therapeutic approaches.

Circadian rhythms in the pathogenesis of gastrointestinal diseases

The etiology of digestive pathologies such as irritable bowel syndrome(IBS), inflammatory bowel diseases(IBD) and cancer is not yet fully understood. In recent years, several studies have evidenced circadian variations in mechanisms involved in digestive health. In situations of disturbed circadian rhythms(chronodisruption) where the central clock and the peripheral clocks receive incoherent signals, the synchronicity is lost producing implications for health. This lack of coordination could alter the tissue function and cause long term damage to the organs. Life habits such as sleep, physical exercise, social interaction, and feeding times are determinants for stability and integrity of circadian rhythms. In recent years, experimental and clinical studies have consistently evidenced that the alteration of circadian rhythms is associated with the development of digestive pathologies mainly linked to dismotility or changes in microbiota composition. Likewise, it seems reasonable to deep into the importance of chronodisruption as a factor that may participate in the development of pathologies such as IBS, IBD and digestive cancers. Moreover, life habits respecting circadian rhythms should be promoted for the prevention of these diseases. Further studies will allow us a better understanding of the mechanisms acting at molecular level, and the development of new therapeutic targets.

Therapeutic potential of curcumin in gastrointestinal diseases

Curcumin,also known as diferuloylmethane,is derived from the plant Curcuma longa and is the active ingredient of the spice turmeric.The therapeutic activities of curcumin for a wide variety of diseases such as diabetes,allergies,arthritis and other chronic and inflammatory diseases have been known for a long time.More recently,curcumin's therapeutic potential for preventing and treating various cancers is being recognized.As curcumin's therapeutic promise is being explored more systematically in various diseases,it has become clear that,due to its increased bioavailability in the gastrointestinal tract,curcumin may be particularly suited to be developed to treat gastrointestinal diseases.This review summarizes some of the current literature of curcumin's anti-inflammatory,anti-oxidant and anti-cancer potential in inflammatory bowel diseases,hepaticfibrosis and gastrointestinal cancers.