Innovations 2022 in hepato-gastroenterology

Géraldine Dahlqvist 1, Bénédicte Delire 1, Olivier Dewit 1, Nicolas Lanthier 1,2, Hubert Piessevaux 1 Published in the journal : February 2023 Category : Hépato-Gastro-Entérologie

The year 2022 was rich in lessons and saw the issuance of many recommendations in hepatology. Indeed, animal and human studies have shown that hepatic steatosis is closely linked to insulin resistance, justifying not only to search for diabetes in patients suffering from hepatic steatosis but also to evaluate the severity of the possible hepatic impairment in diabetic patients. In addition, new recommendations (Baveno VII) were published in 2022 and propose threshold values for hepatic elastometry for the screening of clinically significant portal hypertension in compensated advanced chronic liver disease and its treatment with non-cardioselective beta blockers to prevent the first episode of cirrhotic decompensation. In January 2022, the American Association for the Study of Liver Diseases also published guidelines for the palliative management of patients with decompensated cirrhosis in whom liver transplantation is not indicated. In the area of inflammatory bowel diseases, two new drugs have been added to the therapeutic arsenal for ulcerative colitis in Belgium in 2022: filgotinib and ozanimod. In addition, the first randomized controlled study of comBIOtherapy was carried out: the “VEGA” study. This is the first randomized study to focus on the combination of biologicals in the field of digestive inflammatory diseases. On the other hand, the “SPARE” study investigated a treatment tapering strategy, particularly in patients with Crohn’s disease. Finally, a group of Belgian experts met several times during the years 2021 and 2022 to establish Belgian recommendations for the management of irritable bowel syndrome. The product of this comprehensive work was published in April 2022.

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Hepatology, endoscopy, and proctology: several outstanding events in 2021

Nicolas Lanthier, Bénédicte Delire, Géraldine Dahlqvist, Marie Armelle Denis, Tom Moreels Published in the journal : February 2022 Category : Hépato-Gastro-Entérologie

The year 2021 saw several developments and advances in hepato-gastroenterology, particularly in regard to the general practitioner. In 2021, several simple non-invasive methods were made available and validated by the European scientific society for the study of the liver in order to assess liver fibrosis in at-risk individuals, including patients with metabolic syndrome or excessive alcohol consumption. Moreover, the criteria for reimbursement of certain medications against hepatitis B virus were reviewed. Indeed, these criteria no longer require a systematic liver biopsy while targeting even more patients at risk. Concerning the metabolic dysfunction-associated fatty liver disease, scientific studies with different types of diets were demonstrated to induce disease regression, with their potential advantages and disadvantages described. As a result, these diets can now be proposed by general practitioners. A lesser-known field of endoscopy has also been presented using motorized spiral enteroscopy, which is currently being employed at the Cliniques universitaires Saint-Luc. This technique is likely to improve both exploration and management of small bowel disease. Lastly, for practitioners often confronted with hemorrhoidal disease, recommendations for its management were drawn up and published by a group of Belgian proctologists.

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