Falk Gastro Info 12/2025

Nørgård BM et al, Am J Gastroenterol. 2025;120(11):2632-2643

Alarmingly high proportion of chronic opioid users in inflammatory bowel disease (IBD): Opioid use in IBD is associated with a poor prognosis. Results of a nationwide cohort study from Denmark report that 27% of patients with Crohn's disease and 22% of patients with ulcerative colitis became chronic opioid users. Risk factors include previous surgery, the use of hypnotics/sedatives and an age ≥ 50 years.

Budzyń K et al, Lancet Gastroenterol Hepatol. 2025;10(10):896-903

Risk of endoscopists losing skills after the use of artificial intelligence (AI) in screening colonoscopy: A retrospective multicenter evaluation from Poland suggests that continuous AI exposure during colonoscopy reduces the adenoma detection rate in standard, non-AI-assisted screening colonoscopies.

Rhee H et al, Gastroenterology. 2025;168(6):1170-1177.e12

HCC surveillance in liver cirrhosis: Is non-contrast MRI superior to ultrasound?

In a randomized study from South Korea which enrolled patients with compensated liver cirrhosis, non-contrast MRI surveillance identified very early HCC (BCLC 0) more frequently and resulted in fewer false-positive findings compared to ultrasound. However, the overall detection rate of early-stage tumors (BCLC 0 or A) was not significantly different. These findings suggest that non-contrast MRI may offer advantages in high-risk populations, although cost, availability, and practical feasibility must be taken into account before wider implementation.

Alvarado-Tapias E et al, Hepatology. 2025;82(1):140-154

Improved portal pressure reduction with combined carvedilol and simvastatin: In a Spanish study, patients with cirrhosis and significant portal hypertension were first treated with carvedilol and then randomized to receive either additional simvastatin or placebo. The combination of carvedilol + simvastatin resulted in a significantly greater reduction in the hepatic venous pressure gradient compared to carvedilol alone. This suggests that the combination therapy may provide a meaningful additional benefit in patients with severe portal hypertension.

Old O et al, Gastroenterology. 2025;169(6):1233-1243.e12

Endoscopic surveillance of Barrett's esophagus put into question: In a randomized trial in the United Kingdom (BOSS), 3453 patients with Barrett's esophagus were randomized to either biennial surveillance endoscopy or at-need endoscopy in case of symptoms when symptoms occurred. There were no differences in overall survival or cancer-specific survival after more than 12 years of follow-up.

Shin J et al, Gut. 2025;74(11):1821-1827

Hemostatic powder after primary hemostasis in non-variceal upper gastrointestinal bleeding (NVUGIB): The application of hemostatic powder following endoscopic hemostasis significantly reduced early (3 days) and late (30 days) rebleeding rates in a randomized trial involving 341 patients.