Biliary gastritis is an under-recognized inflammatory condition associated with duodenogastric bile reflux and nonspecific gastrointestinal symptoms, often leading to diagnostic challenges. Epidemiological data from the Kurdistan Region of Iraq are limited. This study aimed to estimate the prevalence of biliary gastritis among adults with available diagnostic data and to examine its associations with demographic, lifestyle, dietary, and clinical factors.

Early gastric carcinogenesis progresses from gastritis through intestinal metaplasia to early gastric cancer, yet the spatial origin of malignant transformation and subtype divergence remains unclear. Here we show, using spatial transcriptomics across human gastric tissues spanning disease progression, that an OLFM4-positive transitional subset emerges at the interface between gastric isthmus/glands and proliferative intestinal metaplasia crypts, consistent with an early step in intestinalization. From these crypts, transcriptional trajectories diverge toward distinct intestinal differentiation programs. Notably, proliferative crypt regions display the closest transcriptional similarity to early gastric cancer and are enriched for proliferation and DNA-repair pathways, supporting their role as a premalignant niche. We further identify increased activity of USF2-associated regulatory networks shared between crypt and cancer regions. Further stratification by Lauren subtype reveals that intestinal-type gastric cancer is characterized by a CDX2-dominated program, whereas diffuse-type gastric cancer exhibits developmental and stemness-related networks with SPP1 and CD44 co-occurring. Together, these findings highlight the intestinal metaplasia crypt as a premalignant niche and provide spatially resolved candidate markers for early detection and mechanistic investigation.

Collagenous gastritis is a rare pediatric disease characterized by chronic gastritis with superficial, irregular mucosal involvement, focal atrophy of the gastric glands, an inflammatory infiltrate predominantly composed of lymphocytes and plasma cells, and areas of epithelial erosion. Focal collagen deposition in the subepithelial region of the lamina propria is a hallmark feature. Gastric epithelial erosions can cause hematemesis and, more generally, occult gastrointestinal bleeding, leading to chronic iron-deficiency anemia. Currently, there are no established management guidelines, and data on long-term follow-up are lacking. We report a clinical case of collagenous gastritis, emphasizing its features and therapeutic approach.

PurposeThis study aimed to characterize FAERS reports of immune-mediated upper gastrointestinal (GI) toxicities associated with immune checkpoint inhibitors and to explore disproportional reporting patterns across ICI classes and treatment regimens.MethodsInput data were downloaded from the public release of the FDA database including time period between January 1 2016, and December 31, 2024. 132 patients with upper-GI toxicity were included. Categorical variables were compared using either the chi-square test or Fisher's exact test. To evaluate the potential association between ICIs and specific upper-GI toxicity events of interest, a disproportionality analysis was conducted using the Reporting Odds Ratio (ROR) method. A signal was considered statistically significant when the lower bound of the 95% confidence interval for the ROR exceeded 1.0.ResultsAnti-PD-1 agents showed higher disproportional reporting of upper-GI toxicities compared to anti-PD-L1 (p = 0.001, ROR = 3.83 95% CI: 1.53-15.23). A higher proportion of hospitalization among reported cases were observed in patients treated with concurrent chemotherapy, compared to those did not receive chemotherapy (ROR = 2.5; 95% CI: 1.05-5.921; p = 0.045).ConclusionAnti-PD-1 therapy showed a stronger reporting signal for upper-GI toxicity than anti-PD-L1 therapy in FAERS, although the number of anti-PD-L1 cases was small. Concurrent chemotherapy was associated with a higher proportion of hospitalization among reported cases. These findings are exploratory and hypothesis-generating.

Collagenous gastritis (CG) is an extremely rare chronic inflammatory gastropathy with non-specific symptoms and high misdiagnosis rate. We report a 21-year-old female with 6-month postprandial epigastric discomfort, anorexia, dizziness, fatigue, and severe iron deficiency anemia. Endoscopy showed diffuse erythema, erosions, and typical nodular elevation-depression lesions in the gastric corpus. Histopathology and Masson's trichrome staining verified subepithelial collagen band thickening (>10 μm), confirming CG. After 8-week oral iron and proton pump inhibitor treatment, clinical symptoms resolved and hematological parameters improved markedly, but histological changes persisted. This case indicates that CG should be considered in young adults with unexplained iron deficiency anemia and atypical endoscopic features, and nodule-depression pattern serves as a key diagnostic clue.