Constipation affects about 25% of the general population, with higher prevalence in elderly people. Many of the products used for the treatment of constipation, laxatives and drugs with this indication have undesirable effects such as dehydration, electrolyte disturbances and diarrhea or side effects that, in frail patients with comorbidities, such as the elderly, can have clinically significant consequences. For these reasons, the treatment of chronic constipation constitutes, especially in the elderly patient, a partial unmet medical need.

Endoscopic retrograde appendicitis therapy (ERAT) and its visually enhanced technique (Endoscopic direct appendicitis therapy, EDAT) represent a novel minimally invasive approach, offering advantages such as high-definition real-time visualization and precise intervention. This article reports a case of a 49-year-old male with acute appendicitis accompanied by an early abscess. CT findings suggested appendicitis with abscess formation, while EDAT exploration confirmed perforation at the appendiceal tip along with adjacent fecalith impaction, further verified by contrast imaging. During the procedure, the fecalith was extracted via EDAT, followed by irrigation of the purulent cavity and placement of a modified 7 Fr × 7 cm pancreatic stent for drainage. The patient experienced immediate symptom relief postoperatively, with serial follow-up CT scans on the procedure day, 3rd, and 7th postoperative days demonstrating gradual abscess resolution and normalized inflammatory markers, leading to discharge on day 3. A subsequent 3-month telephone follow-up revealed no recurrence of abdominal pain. This case illustrates that EDAT/ERAT can provide integrated diagnosis and definitive management for complicated appendicitis, avoiding the trauma associated with surgical intervention and offering valuable clinical insights.

The American Gastroenterological Association gathered a group of interdisciplinary experts to develop an updated Clinical Care Pathway on how to best screen for, diagnose, and treat metabolic dysfunction-associated steatotic liver disease. The complementary clinical application was also updated to reflect the changes in the clinical guidance: MASLD/MASH Clinical Care Pathway mobile application at gastro.org/MASLD.

Cirrhosis is associated with significant risk of comorbidity and early mortality. Low physical function is common in patients with cirrhosis and could predict prognosis. Cardiorespiratory fitness (CRF), determined by maximal exercise with gas exchange measurement, has proven to predict the risk of mortality and disability in other chronic diseases. In patients with cirrhosis, it could help to inform prognostic stratification to improve care and management in clinical practice. This systematic review aims to determine the association between CRF (VO2Peak, percentage of predicted VO2Peak, Anaerobic Threshold (AT)) and mortality prediction, as well as morbidity prediction in cirrhosis.