Falk Gastro Info 4/2025

Lesmana E et al, Clin Gastroenterol Hepatol. 2025;23(1):69-78

Clinical presentation and outcomes of Alpha-Gal syndrome (AGS): The alpha-gal syndrome is an IgE-mediated allergic reaction to galactose-α-1,3 galactose linked to Lone Star tick bites in the United States that presents with urticaria, gastrointestinal symptoms and delayed anaphylaxis following red meat consumption. It has been proposed that European ticks might cause similar complaints. This American cohort study of AGS patients suggests that a diagnosis of AGS should be considered in patients with a history of tick bites and allergic or gastrointestinal manifestations. Most patients responded to a diet avoiding red meat.

Aspirin after completion of standard adjuvant therapy for colorectal cancer: In patients with colorectal cancer, aspirin 200 mg daily for 3 years after completion of standard adjuvant therapy was well tolerated but did not significantly improve disease-free survival in a phase 3 trial involving > 1500 patients.

Dajti E et al, J Hepatol. 2025;82(3):490-498

Role of endoscopy in the diagnosis of clinically significant portal hypertension: Non-invasive tests (NITs) cannot reliably identify the presence of clinically significant portal hypertension (CSPH) in all patients with cirrhosis. A new algorithm combining NITs and endoscopy improves diagnosis and risk stratification, particularly in cases within a grey zone. However, the addition of spleen stiffness measurements may potentially eliminate the need for endoscopy in these cases.

Córdoba KM et al, Gut. 2025;74(2):270-283

A novel animal model for the development of therapies for acute intermittent porphyria (AIP): This study demonstrated that knockdown of the gene encoding hepatic porphobilinogen deaminase (PBGD) in non-human primates can induce the clinical picture of AIP. In addition, administration of human PBGD mRNA subsequently corrected this phenotype. This model therefore appears suitable for further research into novel therapies for hepatic porphyrias.

Miyoshi J et al, Gut. 2025;74(2):169-181

Liquid biopsy to identify Barrett’s esophagus: The authors developed and validated a novel blood test based on expression patterns of 6 miRNAs that performed well in the tested cohorts including patients with reflux disease and might complement screening options for Barrett’s esophagus and esophageal adenocarcinoma.

Mark-Christensen A et al, Inflamm Bowel Dis. 2025;31(1):123-130

Prior appendectomy and clinical disease course of Crohn’s disease: Several studies suggest that prior appendectomy is associated with favorable disease outcomes in patients with ulcerative colitis. This nationwide population-based study from Denmark revealed that prior appendectomy was also associated with a milder disease course of Crohn’s disease.