High-resolution anorectal manometry (HRAM) has improved anorectal physiological assessment but remains limited by conventional pressure-based metrics that incompletely reflect the complex spatiotemporal physiology of continence and defecation. This review summarizes recent advances in artificial intelligence (AI) and machine learning and their potential to enhance HRAM interpretation and clinical decision-making.

Small intestinal bacterial overgrowth (SIBO) remains a significant diagnostic and therapeutic challenge in pediatric gastroenterology. This review summarizes the epidemiology, pathophysiology, diagnosis, and management of SIBO in children, with emphasis on recent advances in microbiome science, evolving diagnostic paradigms, and pediatric-specific clinical considerations.

Patient-initiated elimination diets are widely adopted by those with inflammatory bowel disease (IBD), yet the evidence supporting their long-term use remains limited and their risks are increasingly recognized. Some common elimination diets utilized by patients include the specific carbohydrate diet (SCD), low-FODMAP diet, and gluten-free and dairy-free diets. This narrative review critically examines the role of self-initiated restrictive dietary strategies in IBD management, evaluating the evidence for and against common elimination-based approaches, and contrasts these with emerging data supporting more inclusive dietary patterns.

Eosinophilic esophagitis is a chronic, type 2 inflammatory disease of the esophagus. Diet elimination trials suggest that EoE is triggered by food antigens, however, incomplete response rates present gaps in our understanding. This review aims to synthesize current evidence surrounding the diet-microbiome-immune axis in EoE and propose a conceptual framework for how dietary interventions may influence disease beyond antigen elimination.

This review investigates how advances in breath testing (BT), small bowel (SB) culture, metagenomics, metatranscriptomics, transcriptomics and proteomics are reshaping the definition and diagnosis of small intestinal bacterial overgrowth (SIBO). It also discusses whether SIBO should be redefined as part of a larger group of microbial overgrowth syndromes.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver condition in older adults, yet its management in the geriatric context remains poorly characterized. This review examines the unique pathophysiology, diagnostic challenges, and tailored therapeutic strategies for MASLD in the aging population.

Surgery for inflammatory bowel disease (IBD) often results in alterations in gut function beyond the anatomical changes. While some patients develop short bowel syndrome (SBS), a significant proportion of IBD patients benefit from pharmacologic and dietary interventions for SBS even in the absence of true SBS or IF.

Gastrointestinal symptoms are common and often severe in patients with hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorders (hEDS/HSD), postural orthostatic tachycardia syndrome (POTS), and mast cell activation syndrome (MCAS). This review provides a structured, practical framework for evaluation of gastrointestinal symptoms and appropriate use of nutrition support in this population, where clinical practice remains variable and escalation to non-oral nutrition support may occur prematurely.

Irritable bowel syndrome is a common disorder of gut-brain interaction characterized by chronic abdominal pain and altered bowel habits in the absence of structural pathology. Its pathophysiology reflects a complex interplay between the central nervous system, enteric nervous system, microbiota, immune signaling, epithelial barrier dysfunction etc. Despite advances in the understanding of the mechanisms causing IBS, the diagnosis of IBS remains primarily symptom-based, necessitating the use of objective tools to improve diagnostic precision and personalized management. This review synthesizes highlights existing literature on IBS biomarkers, including inflammatory markers (cytokines, C-reactive protein), microbial signatures (gut microbiota composition, anti-CdtB and anti-vinculin antibodies), metabolic indicators (bile acids, short-chain fatty acids), and markers of intestinal permeability (zonulin) to assess their applications in the diagnosis and management of IBS. We also examined emerging multi-omics technologies that identify the complex patterns linking the gut, the brain and the microbiota. Early research focusing on single biomarkers demonstrated limited diagnostic utility due to the heterogeneous and multifactorial nature of IBS. Recent advances support the development of composite, mechanism-based biomarker panels that integrate multiple biological domains, offering improved representation of underlying pathophysiological processes. These developments mark a shift from a single-marker approach toward multidimensional biomarker strategies. This narrative review synthesizes current evidence and proposes a framework for integrating biomarkers into clinical practice. Biomarkers are best utilized following a positive symptom-based diagnosis and exclusion of alarm features, to stratify patients into biologically relevant subtypes and guide targeted therapy. This supports a transition from exclusion-based diagnosis of IBS towards a positive and more precise one.

High-resolution manometry (HRM), the gold standard for diagnosing esophageal motility disorders, remains constrained by inter-rater variability, limited access to expert esophagologists, and inadequate training infrastructure. Many gastroenterology fellowship programs provide insufficient motility training, and dedicated expert centers remain geographically concentrated. Emerging Artificial intelligence (AI) tools have the potential to automate diagnosis, and augment clinician interpretive capacity and democratizing expert-level motility assessment.

Chronic gastroduodenal symptoms affect > 7% of adults, yet current diagnostic frameworks are challenged by limited mechanistic specificity, weak symptom correlation, and variable reproducibility. This review evaluates how body surface gastric mapping (BSGM), a non-invasive technology combining high-resolution gastric myoelectrical recording with validated symptom profiling, may improve the diagnosis and management of gastric motility disorders.

Malnutrition and sarcopenia are increasingly recognized as clinically meaningful but underappreciated components of gastrointestinal (GI) motility disorders. This review examines the prevalence, pathophysiology, assessment, and clinical care of malnutrition in the context of patients with GI motility disease.

This review evaluates the evolving management strategies for common bile duct stones (CBDSs), focusing on standard endoscopic techniques, advanced intraductal interventions for refractory stones, and contemporary minimally invasive surgical options.

Solitary rectal ulcer syndrome (SRUS) is a gastrointestinal disorder with a varied range of clinical, endoscopic and histological features. It is often misdiagnosed as inflammatory bowel disease or rectal malignancy. This review aims to outline a practical approach to diagnosing and managing SRUS.

The microbiome in the esophagus has been an area of early active investigation. In the past 5 years, advancements in next-generation sequencing and computational analysis have provided a more detailed picture of the esophageal microbiome. This review will examine the most recent advances in the past 5 years on the study of microbiome changes in healthy and diseased esophagus to better understand the link between microbiome and esophageal diseases, potentially leading to new prevention or treatment strategies.