Latest Gastroenterology research

Top 10 this week

Week of 1 November 2026

1. 1

   Endoscopic Balloon Dilation Versus Endoscopic Stricturotomy for Short Crohn's Disease Strictures: The BEST-CD Randomized Trial

   Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · Q1 journal · RCT · Evidence level 1 (High) · 28 October 2026

   In a randomized trial of 106 adults, 24.5% treated with endoscopic stricturotomy needed reintervention within a year, compared with 49.1% after balloon dilation; clinical recurrence was also lower, 30.1% versus 54.7%. Adverse events were similar, but surgery rates did not differ significantly. The results favor stricturotomy in expert centers, though multicenter studies are needed to confirm them.

2. 2

   Real-time Voice-Guided Artificial Intelligence Improves Biliopancreatic Endosonography Quality: A Randomized Trial

   Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · Q1 journal · RCT · Evidence level 1 (High) · 28 October 2026

   In a randomized trial of 266 patients, real-time AI voice guidance increased median completeness of recommended biliopancreatic endoscopic ultrasound scanning from 81% to 100%. The procedure took about 2 minutes longer, and no serious procedure-related adverse events occurred; the single-center results still need validation across more centers and equipment.

3. 3

   TASTY AND HEALTHY DIET REDUCES FECAL CALPROTECTIN IN HIGH-RISK FIRST-DEGREE RELATIVES OF PATIENTS WITH CROHN'S DISEASE: PIONIR RANDOMIZED CROSSOVER TRIAL

   Gastroenterology · Q1 journal · RCT · Evidence level 1 (High) · 26 October 2026

   In this 29-person crossover trial, 71% of high-risk relatives had fecal calprotectin fall by at least half after eight weeks on the Tasty&Healthy diet, compared with 27% on their usual diet. The diet also lowered average calprotectin more overall and was acceptable to most participants, but the trial measured inflammation, not whether diet prevents Crohn's disease.

4. 4

   Digital and Coaching Interventions for Uptake of Cancer Genetic Testing: The MiGHT Randomized Clinical Trial

   JAMA network open · Q1 journal · RCT · Evidence level 1 (High) · 1 October 2026

   In a randomized trial, people offered a digital intervention had nearly four times the odds of completing genetic testing by six months compared with usual care; telephone coaching was linked to higher testing odds by 12 months. Still, just 9.6% of participants completed testing during the year, leaving open how to turn improved uptake into broader access.

5. 5

   Meta-Analysis: Potassium-Competitive Acid Blockers Versus Proton Pump Inhibitors for Gastroprotection in Patients Receiving Antiplatelet Therapy

   Alimentary pharmacology & therapeutics · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 28 October 2026

   Across nine studies involving 34,123 patients, potassium-competitive acid blockers and proton pump inhibitors had similar rates of gastrointestinal bleeding. Lower rates of major cardiovascular events and revascularisation with potassium blockers came only from observational studies, which may be confounded; the findings do not establish a cardiovascular benefit or prove the drugs are equivalent, so randomized trials are needed.

6. 6

   Three-week ileostomy closure after colorectal surgery: a multicenter randomized trial of technical and postoperative outcomes

   Techniques in coloproctology · Q1 journal · RCT · Evidence level 1 (High) · 27 October 2026

   In a randomized trial of 224 patients with confirmed healing, closure at 3 weeks took 90 minutes on average, versus 130 minutes with delayed closure, and fewer patients needed extended adhesiolysis. Short-term complications and other postoperative outcomes were similar; 3.6% had a brief delay in chemotherapy. The results support early closure for carefully selected patients, but not without confirming anastomotic healing.

7. 7

   Prognostic associations between patient-reported outcomes and progression-free and overall survival in advanced gastric or gastroesophageal junction adenocarcinoma with PD-L1 TAP score ≥ 5%: results from the RATIONALE-305 trial

   Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · Q1 journal · RCT · Evidence level 1 (High) · 25 October 2026

   In 475 patients with advanced gastric or gastroesophageal junction cancer and a PD-L1 score of at least 5%, tislelizumab plus chemotherapy was linked to 35% to 45% lower risk of progression or death and 27% to 35% lower risk of death across patient-reported domains. Worsening quality of life, pain, and dietary restrictions predicted progression, but the model shows associations, not that symptom changes cause survival differences.

8. 8

   KangDuo surgical robot KD-SR-01 versus da Vinci Xi in robot-assisted colorectal cancer resection: oncologic outcomes at three years in a multicenter randomized trial

   Journal of robotic surgery · Q1 journal · RCT · Evidence level 1 (High) · 1 September 2026

   In a multicenter randomized trial of 100 patients, the KD-SR-01 robot achieved a 3-year disease-free survival of 85.3%, virtually the same as the 85.5% seen with the da Vinci Xi, and overall survival was 100% versus 94% respectively, with no statistically significant differences. These results suggest the newer Chinese system offers oncologic outcomes comparable to the established da Vinci platform, though longer follow-up is needed.

9. 9

   Benefit-risk profiling of advanced therapies in moderate-to-severe ulcerative colitis: a clustered network meta-analysis

   Frontiers in pharmacology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 14 October 2026

   Across 32 randomized trials, indirect comparisons ranked upadacitinib highest for efficacy among evaluated therapies in patients previously treated with biologics. Other results favored upadacitinib for induction and maintenance efficacy, while IL-23 drugs showed favorable maintenance tolerability; because few therapies were compared head to head, these rankings are estimates, not proof of superiority.

10. 10

    Thymus serpyllum Extract Improves Gastrointestinal Symptoms and Modulates Fecal Gut Microbiome Composition in a Multicenter, Randomized, Placebo-Controlled Clinical Trial

    Medical sciences (Basel, Switzerland) · Q1 journal · RCT · Evidence level 1 (High) · 28 September 2026

    In a placebo-controlled trial, adults taking wild thyme extract reported a greater reduction in gastrointestinal symptom burden and improved quality of life after 8 weeks; week-8 data were available for 131 of 178 participants. Overall microbiome diversity did not differ between groups, and the significance of specific microbial shifts remains unclear.

Paper of the day, last two weeks

• Colonoscopy surveillance after colorectal cancer surgery: meta-analysis

  BJS open · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 3 November 2026

  In five trials involving 2,337 patients, colonoscopy surveillance detected more recurrences before symptoms and led to more curative-intent reoperations, but did not improve survival. About 159 colonoscopies were needed to find one recurrence; the trials were mostly decades old and included other surveillance methods, leaving colonoscopy's added value in modern care uncertain.

• Efficacy and safety profile of advanced therapies in Crohn's disease: a systematic review and network meta-analysis

  Pharmacological reports : PR · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 4 November 2026

  In a network analysis of 27 trials, guselkumab ranked highest for clinical response and remission during both initial and maintenance treatment. But most comparisons were indirect, and maintenance differences from several other therapies were not statistically significant; the rankings do not establish that guselkumab is superior, and safety comparisons remain uncertain.

• High-flow versus standard nasal cannula oxygenation during prone-position ERCP under nurse-administered propofol sedation: a randomized controlled trial

  Surgical endoscopy · Q1 journal · RCT · Evidence level 1 (High) · 2 November 2026

  In a randomized trial of 300 adults undergoing prone endoscopic bile-duct procedures with propofol sedation, high-flow oxygen reduced low-oxygen events and the need for airway maneuvers compared with standard nasal oxygen. Hypotension was more common but did not require treatment or stop procedures; the two-center findings need confirmation in broader practice.

• Pharmacological and procedural strategies to prevent post-ERCP pancreatitis: an umbrella review of meta-analyses of randomized controlled trials

  BMC medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 6 August 2026

  An umbrella review of 47 meta-analyses covering 137,391 participants found pancreatic stents had the strongest evidence for preventing post-ERCP pancreatitis; indomethacin and other preventive measures also showed benefit. However, no intervention had stronger than suggestive evidence for preventing moderate to severe cases, so whether these strategies prevent the most serious outcomes remains unclear.

• Efficacy of Endoscopic Hand Suturing for Prevention of Adverse Events After Gastric Endoscopic Submucosal Dissection: A Multicenter Propensity Score-Matched Study

  Endoscopy · Q1 journal · Cohort · Evidence level 3 (Low) · 2 November 2026

  In this multicenter, propensity-matched study, adverse events after gastric endoscopic submucosal dissection occurred in 1.6% of patients whose ulcers were sutured, compared with 8.9% without suturing; delayed bleeding was also less frequent. Closure took a median 52.5 minutes, and the retrospective findings need confirmation, though success improved with operator experience.

• Comparing real-world continuous clinical remission rates of anti-tumor necrosis factor, vedolizumab, ustekinumab, tofacitinib, and upadacitinib in ulcerative colitis

  Inflammatory bowel diseases · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 29 October 2026

  In a 1,406-patient observational study, ustekinumab had the highest one-year continuous remission in patients new to advanced therapy, while upadacitinib performed best among those previously treated with biologics. Ustekinumab had the fewest adverse events; upadacitinib had the most, though few patients stopped it. Treatment choice still needs confirmation in comparative trials.

• Comparing real-world continuous clinical remission rates of anti-tumor necrosis factor, vedolizumab, ustekinumab, tofacitinib, and upadacitinib in ulcerative colitis

  Inflammatory bowel diseases · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 29 October 2026

  In a 1,406-patient observational study, ustekinumab had the highest one-year continuous remission in patients new to advanced therapy, while upadacitinib performed best among those previously treated with biologics. Ustekinumab had the fewest adverse events; upadacitinib had the most, though few patients stopped it. Treatment choice still needs confirmation in comparative trials.

• Comparing real-world continuous clinical remission rates of anti-tumor necrosis factor, vedolizumab, ustekinumab, tofacitinib, and upadacitinib in ulcerative colitis

  Inflammatory bowel diseases · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 29 October 2026

  In a 1,406-patient observational study, ustekinumab had the highest one-year continuous remission in patients new to advanced therapy, while upadacitinib performed best among those previously treated with biologics. Ustekinumab had the fewest adverse events; upadacitinib had the most, though few patients stopped it. Treatment choice still needs confirmation in comparative trials.

• Optimising Expert Pathology Referral in Barrett's Oesophagus Dysplasia Through p53-Guided Triage: A Nationwide Real-World Cohort Study

  United European gastroenterology journal · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 1 October 2026

  In a nationwide cohort of 1,146 patients, expert review changed 46.9% of referring diagnoses, and reclassified 73.4% of cases called indefinite for dysplasia. Abnormal p53 staining helped identify diagnoses likely to stand: 91.7% of low- or high-grade dysplasia biopsies with this pattern were confirmed, supporting triage of limited expert review capacity, though prospective validation is needed.

• Dual therapy with tofacitinib and steroids for acute severe ulcerative colitis: a randomized double-blind placebo-controlled trial

  Journal of Crohn's & colitis · Q1 journal · RCT · Evidence level 1 (High) · 9 October 2026

  In a 58-patient trial stopped early for slow recruitment, day 6 treatment failure was lower with tofacitinib only after adjustment for baseline differences; the unadjusted result was not significant. Rescue therapy was less frequent over 90 days, but colectomy rates were nearly identical. Larger trials are needed to confirm whether the treatment improves outcomes.

• Safety and sustainability of potable tap water irrigation in endoscopy in Canada: an interrupted time series study

  Lancet regional health. Americas · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 14 October 2026

  In 29,522 procedures at one Canadian hospital, emergency visits, unplanned admissions or deaths within seven days occurred after 1.6% of procedures in both the sterile-water and tap-water periods. The study also found no increase in infections, supporting tap water as an alternative, but its results come from a single health system and need broader confirmation.

• Dual therapy with tofacitinib and steroids for acute severe ulcerative colitis: a randomized double-blind placebo-controlled trial

  Journal of Crohn's & colitis · Q1 journal · RCT · Evidence level 1 (High) · 9 October 2026

  In a 58-patient trial stopped early for slow recruitment, day 6 treatment failure was lower with tofacitinib only after adjustment for baseline differences; the unadjusted result was not significant. Rescue therapy was less frequent over 90 days, but colectomy rates were nearly identical. Larger trials are needed to confirm whether the treatment improves outcomes.

Evidence summaries in Gastroenterology

• Hepatocellular Carcinoma
• Gastroesophageal Reflux Disease
• Acute Cholangitis
• Hepatitis C
• Peptic Ulcer Disease
• Celiac Disease
• Achalasia
• Ulcerative Colitis
• Spontaneous Bacterial Peritonitis
• Endoscopy
• Diverticulitis
• Crohn Disease
• Inflammatory Bowel Disease
• Gastrointestinal Amyloidosis
• Acute Upper Gastrointestinal Bleeding