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Mistakes in metabolic dysfunction associated steatotic liver disease and how to avoid them

Sarah Townsend, Philip Newsome

Summary

AI Generated

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is defined as excess triglyceride storage in the liver with at least one cardiometabolic risk factor and no other discernible cause.

  • Cirrhosis secondary to MASH is the most common cause of liver disease globally and the fastest-growing indication for liver transplantation.
  • MASH-related cirrhosis has a greater than 50% recurrence rate following liver transplantation.
  • MASLD is a subclassification of steatotic liver disease (SLD).
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Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol 2023; 79: 1542–1556. [Link]
2.
Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatol Baltim Md 2016; 64: 73–84. [Link]
3.
Adam R, Karam V, Cailliez V, et al. 2018 Annual Report of the European Liver Transplant Registry (ELTR) - 50-year evolution of liver transplantation. Transpl Int Off J Eur Soc Organ Transplant 2018; 31: 1293–1317. [Link]
4.
Saeed N, Glass L, Sharma P, et al. Incidence and Risks for Nonalcoholic Fatty Liver Disease and Steatohepatitis Post-liver Transplant: Systematic Review and Meta-analysis. Transplantation 2019; 103: e345–e354. [Link]
5.
Younossi ZM, Golabi P, Paik JM, et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatol Baltim Md 2023; 77: 1335–1347. [Link]
6.
Smits MM, Ioannou GN, Boyko EJ, et al. Non-alcoholic fatty liver disease as an independent manifestation of the metabolic syndrome: results of a US national survey in three ethnic groups. J Gastroenterol Hepatol 2013; 28: 664–670. [Link]
7.
Lekakis V, Papatheodoridis GV. Natural history of metabolic dysfunction-associated steatotic liver disease. Eur J Intern Med 2024; 122: 3–10. [Link]
8.
Ma X, Liu S, Zhang J, et al. Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis. BMC Gastroenterol 2020; 20: 10. [Link]
9.
Mofrad P, Contos MJ, Haque M, et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatol Baltim Md 2003; 37: 1286–1292. [Link]
10.
Amarapurkar DN, Patel ND. Clinical spectrum and natural history of non-alcoholic steatohepatitis with normal alanine aminotransferase values. Trop Gastroenterol Off J Dig Dis Found 2004; 25: 130–134. [Link]
11.
Chen Y-T, Chen T-I, Yin S-C, et al. Prevalence, proportions of elevated liver enzyme levels, and long-term cardiometabolic mortality of patients with metabolic dysfunction-associated steatotic liver disease. J Gastroenterol Hepatol; n/a. [Link]
12.
Vogel W, Kathrein H, Dietze O, et al. [Sonography of the liver in Wilson’s disease. Sonographic studies of the liver in Wilson’s disease--significance for assessing prognosis?]. Ultraschall Med Stuttg Ger 1980 1988; 9: 270–273. [Link]
13.
Tacke F, Horn P, Wai-Sun Wong V, et al. EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol 2024; 81: 492–542. [Link]
14.
Eddowes PJ, Sasso M, Allison M, et al. Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2019; 156: 1717–1730. [Link]
15.
Eilenberg M, Munda P, Stift J, et al. Accuracy of non-invasive liver stiffness measurement and steatosis quantification in patients with severe and morbid obesity. Hepatobiliary Surg Nutr 2021; 10: 610–622. [Link]
16.
Ornelas R, Pan D, Chak E. S3264 The Accuracy of Fibroscan: A Real World Study. Off J Am Coll Gastroenterol ACG 2020; 115: S1706. [Link]
17.
Gopalakrishna H, Fashanu OE, Nair GB, et al. Association between body mass index and liver stiffness measurement using transient elastography in patients with non-alcoholic fatty liver disease in a hepatology clinic: a cross sectional study. Transl Gastroenterol Hepatol 2023; 8: 10. [Link]
18.
Harrison Stephen A., Bedossa Pierre, Guy Cynthia D., et al. A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. N Engl J Med 2024; 390: 497–509. [Link]
19.
Francque S, Krag A, Shawcross DL, et al. A turning point in hepatology? EASL reflects on the first approved drug for MASH. Journal of Hepatology 2024; 81: 192–194. [Link]
20.
Newsome PN, Ambery P. Incretins (GLP-1 receptor agonists and dual/triple agonists) and the liver. J Hepatol 2023; 79: 1557–1565. [Link]
21.
Charlton MR, Burns JM, Pedersen RA, et al. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Gastroenterology 2011; 141: 1249–1253. [Link]
22.
Taylor RS, Taylor RJ, Bayliss S, et al. Association Between Fibrosis Stage and Outcomes of Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Gastroenterology 2020; 158: 1611-1625.e12. [Link]
23.
Sanyal AJ, Van Natta ML, Clark J, et al. Prospective Study of Outcomes in Adults with Nonalcoholic Fatty Liver Disease. N Engl J Med 2021; 385: 1559–1569. [Link]
24.
Parker R, Kim S-J, Gao B. Alcohol, adipose tissue and liver disease: mechanistic links and clinical considerations. Nat Rev Gastroenterol Hepatol 2018; 15: 50–59. [Link]
25.
Singh S, Allen AM, Wang Z, et al. Fibrosis Progression in Nonalcoholic Fatty Liver vs Nonalcoholic Steatohepatitis: A Systematic Review and Meta-analysis of Paired-Biopsy Studies. Clin Gastroenterol Hepatol 2015; 13: 643-654.e9. [Link]
26.
Polyzos SA, Kountouras J, Mantzoros CS. Obesity and nonalcoholic fatty liver disease: From pathophysiology to therapeutics. Metabolism 2019; 92: 82–97. [Link]
27.
Romero-Gómez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol 2017; 67: 829–846. [Link]
28.
Noureddin M, Charlton MR, Harrison SA, et al. Expert Panel Recommendations: Practical Clinical Applications for Initiating and Monitoring Resmetirom in Patients with MASH/NASH and Moderate to Noncirrhotic Advanced Fibrosis. Clin Gastroenterol Hepatol. Epub ahead of print 20 July 2024. [Link]
29.
Paklar N, Mijic M, Filipec-Kanizaj T. The Outcomes of Liver Transplantation in Severe Metabolic Dysfunction-Associated Steatotic Liver Disease Patients. Biomedicines 2023; 11: 3096. [Link]
30.
Yong JN, Lim WH, Ng CH, et al. Outcomes of Nonalcoholic Steatohepatitis After Liver Transplantation: An Updated Meta-Analysis and Systematic Review. Clin Gastroenterol Hepatol 2023; 21: 45-54.e6. [Link]
31.
Minich A, Arisar FAQ, Shaikh NS, et al. Predictors of patient survival following liver transplant in non-alcoholic steatohepatitis: A systematic review and meta-analysis. eClinicalMedicine; 50. Epub ahead of print 1 August 2022. [Link]
32.
Haldar D, Kern B, Hodson J, et al. Outcomes of liver transplantation for non-alcoholic steatohepatitis: A European Liver Transplant Registry study. J Hepatol 2019; 71: 313–322. [Link]
33.
VanWagner LB, Bhave M, Te HS, et al. Patients transplanted for nonalcoholic steatohepatitis are at increased risk for postoperative cardiovascular events. Hepatology 2012; 56: 1741–1750. [Link]
34.
Mosko JD, Nguyen GC. Increased perioperative mortality following bariatric surgery among patients with cirrhosis. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2011; 9: 897–901. [Link]
35.
Miñambres I, Rubio M, de Hollanda A, et al. Outcomes of Bariatric Surgery in Patients with Cirrhosis. Obes Surg; 29. Epub ahead of print 1 February 2019. [Link]
36.
Shimizu H, Phuong V, Maia M, et al. Bariatric surgery in patients with liver cirrhosis. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 2013; 9: 1–6. [Link]
37.
Cobb WS, Heniford BT, Burns JM, et al. Cirrhosis is not a contraindication to laparoscopic surgery. Surg Endosc 2005; 19: 418–423. [Link]
38.
Tandon P, Ney M, Irwin I, et al. Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2012; 18: 1209–1216. [Link]
39.
Mantovani A, Csermely A, Petracca G, et al. Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events: an updated systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 903–913. [Link]
40.
Villeret F, Dharancy S, Erard D, et al. Inevitability of disease recurrence after liver transplantation for NAFLD cirrhosis. JHEP Rep; 5. Epub ahead of print 1 March 2023. [Link]
41.
Newsome PN. Recurrence of nonalcoholic fatty liver disease after liver transplantation: it is common, but does it affect outcome? Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2010; 16: 420–422. [Link]
42.
Samji NS, Verma R, Keri KC, et al. Liver Transplantation for Nonalcoholic Steatohepatitis: Pathophysiology of Recurrence and Clinical Challenges. Dig Dis Sci 2019; 64: 3413–3430. [Link]
43.
Shetty A, Giron F, Divatia MK, et al. Nonalcoholic Fatty Liver Disease after Liver Transplant. J Clin Transl Hepatol 2021; 9: 428. [Link]
44.
Heimbach JK, Watt KDS, Poterucha JJ, et al. Combined liver transplantation and gastric sleeve resection for patients with medically complicated obesity and end-stage liver disease. Am J Transplant Off J Am Soc Transplant Am Soc Transpl Surg 2013; 13: 363–368. [Link]
45.
Nair S, Wilding JPH. Sodium glucose cotransporter 2 inhibitors as a new treatment for diabetes mellitus. J Clin Endocrinol Metab 2010; 95: 34–42. [Link]
46.
Ong Lopez AMC, Pajimna JAT. Efficacy of sodium glucose cotransporter 2 inhibitors on hepatic fibrosis and steatosis in non-alcoholic fatty liver disease: an updated systematic review and meta-analysis. Sci Rep 2024; 14: 2122. [Link]
47.
Cheung KS, Ng HY, Hui RWH, et al. Effects of empagliflozin on liver fat in patients with metabolic dysfunction–associated steatotic liver disease without diabetes mellitus: A randomized, double-blind, placebo-controlled trial. Hepatology 2024; 80: 916. [Link]
48.
Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterology 2007; 132: 2131–2157. [Link]
49.
Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2016; 375: 1834–1844. [Link]
50.
Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020; 383: 1413–1424. [Link]
51.
Saad M, Mahmoud AN, Elgendy IY, et al. Cardiovascular outcomes with sodium-glucose cotransporter-2 inhibitors in patients with type II diabetes mellitus: A meta-analysis of placebo-controlled randomized trials. Int J Cardiol 2017; 228: 352–358. [Link]

Abstract

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a subclassification of steatotic liver disease (SLD), defined as the presence of excess triglyceride storage in the liver in conjunction with at least one cardiometabolic risk factor and no other discernible cause.1 Cirrhosis secondary to MASH is the most common cause of liver disease in the world and is the fastest-growing indication for liver transplantation, but it also has a >50% recurrence rate post-transplantation.

Topics

Hepatobiliary

Citation

Townsend SA and Newsome PN. Mistakes in nonalcoholic fatty liver disease and how to avoid them. UEG Education 2017; 17: 39–41.

Published

2024

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UEG Mistakes In Articles
Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Log in to continue.

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Log In Create a free account

Not sure what you can access? Learn more about account types.

Mistakes in the management of unexplained diarrhoea and how to avoid them

Magnus Simrén, Hans Törnblom

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol 2023; 79: 1542–1556. [Link]
2.
Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatol Baltim Md 2016; 64: 73–84. [Link]
3.
Adam R, Karam V, Cailliez V, et al. 2018 Annual Report of the European Liver Transplant Registry (ELTR) - 50-year evolution of liver transplantation. Transpl Int Off J Eur Soc Organ Transplant 2018; 31: 1293–1317. [Link]
4.
Saeed N, Glass L, Sharma P, et al. Incidence and Risks for Nonalcoholic Fatty Liver Disease and Steatohepatitis Post-liver Transplant: Systematic Review and Meta-analysis. Transplantation 2019; 103: e345–e354. [Link]
5.
Younossi ZM, Golabi P, Paik JM, et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatol Baltim Md 2023; 77: 1335–1347. [Link]
6.
Smits MM, Ioannou GN, Boyko EJ, et al. Non-alcoholic fatty liver disease as an independent manifestation of the metabolic syndrome: results of a US national survey in three ethnic groups. J Gastroenterol Hepatol 2013; 28: 664–670. [Link]
7.
Lekakis V, Papatheodoridis GV. Natural history of metabolic dysfunction-associated steatotic liver disease. Eur J Intern Med 2024; 122: 3–10. [Link]
8.
Ma X, Liu S, Zhang J, et al. Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis. BMC Gastroenterol 2020; 20: 10. [Link]
9.
Mofrad P, Contos MJ, Haque M, et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatol Baltim Md 2003; 37: 1286–1292. [Link]
10.
Amarapurkar DN, Patel ND. Clinical spectrum and natural history of non-alcoholic steatohepatitis with normal alanine aminotransferase values. Trop Gastroenterol Off J Dig Dis Found 2004; 25: 130–134. [Link]
11.
Chen Y-T, Chen T-I, Yin S-C, et al. Prevalence, proportions of elevated liver enzyme levels, and long-term cardiometabolic mortality of patients with metabolic dysfunction-associated steatotic liver disease. J Gastroenterol Hepatol; n/a. [Link]
12.
Vogel W, Kathrein H, Dietze O, et al. [Sonography of the liver in Wilson’s disease. Sonographic studies of the liver in Wilson’s disease--significance for assessing prognosis?]. Ultraschall Med Stuttg Ger 1980 1988; 9: 270–273. [Link]
13.
Tacke F, Horn P, Wai-Sun Wong V, et al. EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol 2024; 81: 492–542. [Link]
14.
Eddowes PJ, Sasso M, Allison M, et al. Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2019; 156: 1717–1730. [Link]
15.
Eilenberg M, Munda P, Stift J, et al. Accuracy of non-invasive liver stiffness measurement and steatosis quantification in patients with severe and morbid obesity. Hepatobiliary Surg Nutr 2021; 10: 610–622. [Link]
16.
Ornelas R, Pan D, Chak E. S3264 The Accuracy of Fibroscan: A Real World Study. Off J Am Coll Gastroenterol ACG 2020; 115: S1706. [Link]
17.
Gopalakrishna H, Fashanu OE, Nair GB, et al. Association between body mass index and liver stiffness measurement using transient elastography in patients with non-alcoholic fatty liver disease in a hepatology clinic: a cross sectional study. Transl Gastroenterol Hepatol 2023; 8: 10. [Link]
18.
Harrison Stephen A., Bedossa Pierre, Guy Cynthia D., et al. A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. N Engl J Med 2024; 390: 497–509. [Link]
19.
Francque S, Krag A, Shawcross DL, et al. A turning point in hepatology? EASL reflects on the first approved drug for MASH. Journal of Hepatology 2024; 81: 192–194. [Link]
20.
Newsome PN, Ambery P. Incretins (GLP-1 receptor agonists and dual/triple agonists) and the liver. J Hepatol 2023; 79: 1557–1565. [Link]
21.
Charlton MR, Burns JM, Pedersen RA, et al. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Gastroenterology 2011; 141: 1249–1253. [Link]
22.
Taylor RS, Taylor RJ, Bayliss S, et al. Association Between Fibrosis Stage and Outcomes of Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Gastroenterology 2020; 158: 1611-1625.e12. [Link]
23.
Sanyal AJ, Van Natta ML, Clark J, et al. Prospective Study of Outcomes in Adults with Nonalcoholic Fatty Liver Disease. N Engl J Med 2021; 385: 1559–1569. [Link]
24.
Parker R, Kim S-J, Gao B. Alcohol, adipose tissue and liver disease: mechanistic links and clinical considerations. Nat Rev Gastroenterol Hepatol 2018; 15: 50–59. [Link]
25.
Singh S, Allen AM, Wang Z, et al. Fibrosis Progression in Nonalcoholic Fatty Liver vs Nonalcoholic Steatohepatitis: A Systematic Review and Meta-analysis of Paired-Biopsy Studies. Clin Gastroenterol Hepatol 2015; 13: 643-654.e9. [Link]
26.
Polyzos SA, Kountouras J, Mantzoros CS. Obesity and nonalcoholic fatty liver disease: From pathophysiology to therapeutics. Metabolism 2019; 92: 82–97. [Link]
27.
Romero-Gómez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol 2017; 67: 829–846. [Link]
28.
Noureddin M, Charlton MR, Harrison SA, et al. Expert Panel Recommendations: Practical Clinical Applications for Initiating and Monitoring Resmetirom in Patients with MASH/NASH and Moderate to Noncirrhotic Advanced Fibrosis. Clin Gastroenterol Hepatol. Epub ahead of print 20 July 2024. [Link]
29.
Paklar N, Mijic M, Filipec-Kanizaj T. The Outcomes of Liver Transplantation in Severe Metabolic Dysfunction-Associated Steatotic Liver Disease Patients. Biomedicines 2023; 11: 3096. [Link]
30.
Yong JN, Lim WH, Ng CH, et al. Outcomes of Nonalcoholic Steatohepatitis After Liver Transplantation: An Updated Meta-Analysis and Systematic Review. Clin Gastroenterol Hepatol 2023; 21: 45-54.e6. [Link]
31.
Minich A, Arisar FAQ, Shaikh NS, et al. Predictors of patient survival following liver transplant in non-alcoholic steatohepatitis: A systematic review and meta-analysis. eClinicalMedicine; 50. Epub ahead of print 1 August 2022. [Link]
32.
Haldar D, Kern B, Hodson J, et al. Outcomes of liver transplantation for non-alcoholic steatohepatitis: A European Liver Transplant Registry study. J Hepatol 2019; 71: 313–322. [Link]
33.
VanWagner LB, Bhave M, Te HS, et al. Patients transplanted for nonalcoholic steatohepatitis are at increased risk for postoperative cardiovascular events. Hepatology 2012; 56: 1741–1750. [Link]
34.
Mosko JD, Nguyen GC. Increased perioperative mortality following bariatric surgery among patients with cirrhosis. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2011; 9: 897–901. [Link]
35.
Miñambres I, Rubio M, de Hollanda A, et al. Outcomes of Bariatric Surgery in Patients with Cirrhosis. Obes Surg; 29. Epub ahead of print 1 February 2019. [Link]
36.
Shimizu H, Phuong V, Maia M, et al. Bariatric surgery in patients with liver cirrhosis. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 2013; 9: 1–6. [Link]
37.
Cobb WS, Heniford BT, Burns JM, et al. Cirrhosis is not a contraindication to laparoscopic surgery. Surg Endosc 2005; 19: 418–423. [Link]
38.
Tandon P, Ney M, Irwin I, et al. Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2012; 18: 1209–1216. [Link]
39.
Mantovani A, Csermely A, Petracca G, et al. Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events: an updated systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 903–913. [Link]
40.
Villeret F, Dharancy S, Erard D, et al. Inevitability of disease recurrence after liver transplantation for NAFLD cirrhosis. JHEP Rep; 5. Epub ahead of print 1 March 2023. [Link]
41.
Newsome PN. Recurrence of nonalcoholic fatty liver disease after liver transplantation: it is common, but does it affect outcome? Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2010; 16: 420–422. [Link]
42.
Samji NS, Verma R, Keri KC, et al. Liver Transplantation for Nonalcoholic Steatohepatitis: Pathophysiology of Recurrence and Clinical Challenges. Dig Dis Sci 2019; 64: 3413–3430. [Link]
43.
Shetty A, Giron F, Divatia MK, et al. Nonalcoholic Fatty Liver Disease after Liver Transplant. J Clin Transl Hepatol 2021; 9: 428. [Link]
44.
Heimbach JK, Watt KDS, Poterucha JJ, et al. Combined liver transplantation and gastric sleeve resection for patients with medically complicated obesity and end-stage liver disease. Am J Transplant Off J Am Soc Transplant Am Soc Transpl Surg 2013; 13: 363–368. [Link]
45.
Nair S, Wilding JPH. Sodium glucose cotransporter 2 inhibitors as a new treatment for diabetes mellitus. J Clin Endocrinol Metab 2010; 95: 34–42. [Link]
46.
Ong Lopez AMC, Pajimna JAT. Efficacy of sodium glucose cotransporter 2 inhibitors on hepatic fibrosis and steatosis in non-alcoholic fatty liver disease: an updated systematic review and meta-analysis. Sci Rep 2024; 14: 2122. [Link]
47.
Cheung KS, Ng HY, Hui RWH, et al. Effects of empagliflozin on liver fat in patients with metabolic dysfunction–associated steatotic liver disease without diabetes mellitus: A randomized, double-blind, placebo-controlled trial. Hepatology 2024; 80: 916. [Link]
48.
Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterology 2007; 132: 2131–2157. [Link]
49.
Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2016; 375: 1834–1844. [Link]
50.
Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020; 383: 1413–1424. [Link]
51.
Saad M, Mahmoud AN, Elgendy IY, et al. Cardiovascular outcomes with sodium-glucose cotransporter-2 inhibitors in patients with type II diabetes mellitus: A meta-analysis of placebo-controlled randomized trials. Int J Cardiol 2017; 228: 352–358. [Link]

Abstract

Diarrhoea, acute or chronic, is a common gastrointestinal symptom in healthcare. In most cases, acute diarrhoea in healthy individuals requires limited diagnostic and therapeutic efforts, except for the replacement of fluid electrolytes, and stool culture in severe occurrences. Acute diarrhoea is often self-limiting due to short-lived reactions to food intake and bacterial or viral infections. However, diarrhoea can persist and fulfil definitions of chronicity when a month or more has passed since the onset. Here we discuss some basic mistakes that should be avoided when managing unexplained non-bloody diarrhoea that persists beyond the acute setting. In this context, the term 'unexplained' refers to a patient without apparent alarm features and where initial consultations have failed at making a diagnosis. We used an evidence-based approach and included aspects predominantly based on clinical experience when appropriate.


Topics

Neurogastroenterology & Motility

Citation

Törnblom H and Simrén M. Mistakes in the management of unexplained diarrhoea and how to avoid them. UEG Education 2022; 22: 16–19.

Published

2022

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Carolina Malagelada Carolina Malagelada

Mistakes in faecal incontinence management and how to avoid them

Mistakes in faecal incontinence management and how to avoid them

Kestutis Adamonis Kestutis Adamonis, Stéphanie O Breukink, Sadé L Assmann

UEG Mistakes In Articles
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Mistakes in rumination syndrome and how to avoid them

Alberto Ezquerra-Durán, Elizabeth Barba Orozco

Summary

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Summary is not available for this content yet.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol 2023; 79: 1542–1556. [Link]
2.
Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatol Baltim Md 2016; 64: 73–84. [Link]
3.
Adam R, Karam V, Cailliez V, et al. 2018 Annual Report of the European Liver Transplant Registry (ELTR) - 50-year evolution of liver transplantation. Transpl Int Off J Eur Soc Organ Transplant 2018; 31: 1293–1317. [Link]
4.
Saeed N, Glass L, Sharma P, et al. Incidence and Risks for Nonalcoholic Fatty Liver Disease and Steatohepatitis Post-liver Transplant: Systematic Review and Meta-analysis. Transplantation 2019; 103: e345–e354. [Link]
5.
Younossi ZM, Golabi P, Paik JM, et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatol Baltim Md 2023; 77: 1335–1347. [Link]
6.
Smits MM, Ioannou GN, Boyko EJ, et al. Non-alcoholic fatty liver disease as an independent manifestation of the metabolic syndrome: results of a US national survey in three ethnic groups. J Gastroenterol Hepatol 2013; 28: 664–670. [Link]
7.
Lekakis V, Papatheodoridis GV. Natural history of metabolic dysfunction-associated steatotic liver disease. Eur J Intern Med 2024; 122: 3–10. [Link]
8.
Ma X, Liu S, Zhang J, et al. Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis. BMC Gastroenterol 2020; 20: 10. [Link]
9.
Mofrad P, Contos MJ, Haque M, et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatol Baltim Md 2003; 37: 1286–1292. [Link]
10.
Amarapurkar DN, Patel ND. Clinical spectrum and natural history of non-alcoholic steatohepatitis with normal alanine aminotransferase values. Trop Gastroenterol Off J Dig Dis Found 2004; 25: 130–134. [Link]
11.
Chen Y-T, Chen T-I, Yin S-C, et al. Prevalence, proportions of elevated liver enzyme levels, and long-term cardiometabolic mortality of patients with metabolic dysfunction-associated steatotic liver disease. J Gastroenterol Hepatol; n/a. [Link]
12.
Vogel W, Kathrein H, Dietze O, et al. [Sonography of the liver in Wilson’s disease. Sonographic studies of the liver in Wilson’s disease--significance for assessing prognosis?]. Ultraschall Med Stuttg Ger 1980 1988; 9: 270–273. [Link]
13.
Tacke F, Horn P, Wai-Sun Wong V, et al. EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol 2024; 81: 492–542. [Link]
14.
Eddowes PJ, Sasso M, Allison M, et al. Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2019; 156: 1717–1730. [Link]
15.
Eilenberg M, Munda P, Stift J, et al. Accuracy of non-invasive liver stiffness measurement and steatosis quantification in patients with severe and morbid obesity. Hepatobiliary Surg Nutr 2021; 10: 610–622. [Link]
16.
Ornelas R, Pan D, Chak E. S3264 The Accuracy of Fibroscan: A Real World Study. Off J Am Coll Gastroenterol ACG 2020; 115: S1706. [Link]
17.
Gopalakrishna H, Fashanu OE, Nair GB, et al. Association between body mass index and liver stiffness measurement using transient elastography in patients with non-alcoholic fatty liver disease in a hepatology clinic: a cross sectional study. Transl Gastroenterol Hepatol 2023; 8: 10. [Link]
18.
Harrison Stephen A., Bedossa Pierre, Guy Cynthia D., et al. A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. N Engl J Med 2024; 390: 497–509. [Link]
19.
Francque S, Krag A, Shawcross DL, et al. A turning point in hepatology? EASL reflects on the first approved drug for MASH. Journal of Hepatology 2024; 81: 192–194. [Link]
20.
Newsome PN, Ambery P. Incretins (GLP-1 receptor agonists and dual/triple agonists) and the liver. J Hepatol 2023; 79: 1557–1565. [Link]
21.
Charlton MR, Burns JM, Pedersen RA, et al. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Gastroenterology 2011; 141: 1249–1253. [Link]
22.
Taylor RS, Taylor RJ, Bayliss S, et al. Association Between Fibrosis Stage and Outcomes of Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Gastroenterology 2020; 158: 1611-1625.e12. [Link]
23.
Sanyal AJ, Van Natta ML, Clark J, et al. Prospective Study of Outcomes in Adults with Nonalcoholic Fatty Liver Disease. N Engl J Med 2021; 385: 1559–1569. [Link]
24.
Parker R, Kim S-J, Gao B. Alcohol, adipose tissue and liver disease: mechanistic links and clinical considerations. Nat Rev Gastroenterol Hepatol 2018; 15: 50–59. [Link]
25.
Singh S, Allen AM, Wang Z, et al. Fibrosis Progression in Nonalcoholic Fatty Liver vs Nonalcoholic Steatohepatitis: A Systematic Review and Meta-analysis of Paired-Biopsy Studies. Clin Gastroenterol Hepatol 2015; 13: 643-654.e9. [Link]
26.
Polyzos SA, Kountouras J, Mantzoros CS. Obesity and nonalcoholic fatty liver disease: From pathophysiology to therapeutics. Metabolism 2019; 92: 82–97. [Link]
27.
Romero-Gómez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol 2017; 67: 829–846. [Link]
28.
Noureddin M, Charlton MR, Harrison SA, et al. Expert Panel Recommendations: Practical Clinical Applications for Initiating and Monitoring Resmetirom in Patients with MASH/NASH and Moderate to Noncirrhotic Advanced Fibrosis. Clin Gastroenterol Hepatol. Epub ahead of print 20 July 2024. [Link]
29.
Paklar N, Mijic M, Filipec-Kanizaj T. The Outcomes of Liver Transplantation in Severe Metabolic Dysfunction-Associated Steatotic Liver Disease Patients. Biomedicines 2023; 11: 3096. [Link]
30.
Yong JN, Lim WH, Ng CH, et al. Outcomes of Nonalcoholic Steatohepatitis After Liver Transplantation: An Updated Meta-Analysis and Systematic Review. Clin Gastroenterol Hepatol 2023; 21: 45-54.e6. [Link]
31.
Minich A, Arisar FAQ, Shaikh NS, et al. Predictors of patient survival following liver transplant in non-alcoholic steatohepatitis: A systematic review and meta-analysis. eClinicalMedicine; 50. Epub ahead of print 1 August 2022. [Link]
32.
Haldar D, Kern B, Hodson J, et al. Outcomes of liver transplantation for non-alcoholic steatohepatitis: A European Liver Transplant Registry study. J Hepatol 2019; 71: 313–322. [Link]
33.
VanWagner LB, Bhave M, Te HS, et al. Patients transplanted for nonalcoholic steatohepatitis are at increased risk for postoperative cardiovascular events. Hepatology 2012; 56: 1741–1750. [Link]
34.
Mosko JD, Nguyen GC. Increased perioperative mortality following bariatric surgery among patients with cirrhosis. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2011; 9: 897–901. [Link]
35.
Miñambres I, Rubio M, de Hollanda A, et al. Outcomes of Bariatric Surgery in Patients with Cirrhosis. Obes Surg; 29. Epub ahead of print 1 February 2019. [Link]
36.
Shimizu H, Phuong V, Maia M, et al. Bariatric surgery in patients with liver cirrhosis. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 2013; 9: 1–6. [Link]
37.
Cobb WS, Heniford BT, Burns JM, et al. Cirrhosis is not a contraindication to laparoscopic surgery. Surg Endosc 2005; 19: 418–423. [Link]
38.
Tandon P, Ney M, Irwin I, et al. Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2012; 18: 1209–1216. [Link]
39.
Mantovani A, Csermely A, Petracca G, et al. Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events: an updated systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 903–913. [Link]
40.
Villeret F, Dharancy S, Erard D, et al. Inevitability of disease recurrence after liver transplantation for NAFLD cirrhosis. JHEP Rep; 5. Epub ahead of print 1 March 2023. [Link]
41.
Newsome PN. Recurrence of nonalcoholic fatty liver disease after liver transplantation: it is common, but does it affect outcome? Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2010; 16: 420–422. [Link]
42.
Samji NS, Verma R, Keri KC, et al. Liver Transplantation for Nonalcoholic Steatohepatitis: Pathophysiology of Recurrence and Clinical Challenges. Dig Dis Sci 2019; 64: 3413–3430. [Link]
43.
Shetty A, Giron F, Divatia MK, et al. Nonalcoholic Fatty Liver Disease after Liver Transplant. J Clin Transl Hepatol 2021; 9: 428. [Link]
44.
Heimbach JK, Watt KDS, Poterucha JJ, et al. Combined liver transplantation and gastric sleeve resection for patients with medically complicated obesity and end-stage liver disease. Am J Transplant Off J Am Soc Transplant Am Soc Transpl Surg 2013; 13: 363–368. [Link]
45.
Nair S, Wilding JPH. Sodium glucose cotransporter 2 inhibitors as a new treatment for diabetes mellitus. J Clin Endocrinol Metab 2010; 95: 34–42. [Link]
46.
Ong Lopez AMC, Pajimna JAT. Efficacy of sodium glucose cotransporter 2 inhibitors on hepatic fibrosis and steatosis in non-alcoholic fatty liver disease: an updated systematic review and meta-analysis. Sci Rep 2024; 14: 2122. [Link]
47.
Cheung KS, Ng HY, Hui RWH, et al. Effects of empagliflozin on liver fat in patients with metabolic dysfunction–associated steatotic liver disease without diabetes mellitus: A randomized, double-blind, placebo-controlled trial. Hepatology 2024; 80: 916. [Link]
48.
Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterology 2007; 132: 2131–2157. [Link]
49.
Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2016; 375: 1834–1844. [Link]
50.
Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020; 383: 1413–1424. [Link]
51.
Saad M, Mahmoud AN, Elgendy IY, et al. Cardiovascular outcomes with sodium-glucose cotransporter-2 inhibitors in patients with type II diabetes mellitus: A meta-analysis of placebo-controlled randomized trials. Int J Cardiol 2017; 228: 352–358. [Link]

Abstract

Topics

Neurogastroenterology & Motility

Citation

Ezquerra-Durán A and Barba-Orozco E. Mistakes in rumination syndrome and how to avoid them. UEG Education 2025; 25: 10-13.

Published

2025

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Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Log in to continue.

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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Mistakes in transitional care for children and young adults and how to avoid them

Patrizia Burra, Hans Törnblom, Jorge Amil Dias, Moriam Mustapha

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol 2023; 79: 1542–1556. [Link]
2.
Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatol Baltim Md 2016; 64: 73–84. [Link]
3.
Adam R, Karam V, Cailliez V, et al. 2018 Annual Report of the European Liver Transplant Registry (ELTR) - 50-year evolution of liver transplantation. Transpl Int Off J Eur Soc Organ Transplant 2018; 31: 1293–1317. [Link]
4.
Saeed N, Glass L, Sharma P, et al. Incidence and Risks for Nonalcoholic Fatty Liver Disease and Steatohepatitis Post-liver Transplant: Systematic Review and Meta-analysis. Transplantation 2019; 103: e345–e354. [Link]
5.
Younossi ZM, Golabi P, Paik JM, et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatol Baltim Md 2023; 77: 1335–1347. [Link]
6.
Smits MM, Ioannou GN, Boyko EJ, et al. Non-alcoholic fatty liver disease as an independent manifestation of the metabolic syndrome: results of a US national survey in three ethnic groups. J Gastroenterol Hepatol 2013; 28: 664–670. [Link]
7.
Lekakis V, Papatheodoridis GV. Natural history of metabolic dysfunction-associated steatotic liver disease. Eur J Intern Med 2024; 122: 3–10. [Link]
8.
Ma X, Liu S, Zhang J, et al. Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis. BMC Gastroenterol 2020; 20: 10. [Link]
9.
Mofrad P, Contos MJ, Haque M, et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatol Baltim Md 2003; 37: 1286–1292. [Link]
10.
Amarapurkar DN, Patel ND. Clinical spectrum and natural history of non-alcoholic steatohepatitis with normal alanine aminotransferase values. Trop Gastroenterol Off J Dig Dis Found 2004; 25: 130–134. [Link]
11.
Chen Y-T, Chen T-I, Yin S-C, et al. Prevalence, proportions of elevated liver enzyme levels, and long-term cardiometabolic mortality of patients with metabolic dysfunction-associated steatotic liver disease. J Gastroenterol Hepatol; n/a. [Link]
12.
Vogel W, Kathrein H, Dietze O, et al. [Sonography of the liver in Wilson’s disease. Sonographic studies of the liver in Wilson’s disease--significance for assessing prognosis?]. Ultraschall Med Stuttg Ger 1980 1988; 9: 270–273. [Link]
13.
Tacke F, Horn P, Wai-Sun Wong V, et al. EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol 2024; 81: 492–542. [Link]
14.
Eddowes PJ, Sasso M, Allison M, et al. Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2019; 156: 1717–1730. [Link]
15.
Eilenberg M, Munda P, Stift J, et al. Accuracy of non-invasive liver stiffness measurement and steatosis quantification in patients with severe and morbid obesity. Hepatobiliary Surg Nutr 2021; 10: 610–622. [Link]
16.
Ornelas R, Pan D, Chak E. S3264 The Accuracy of Fibroscan: A Real World Study. Off J Am Coll Gastroenterol ACG 2020; 115: S1706. [Link]
17.
Gopalakrishna H, Fashanu OE, Nair GB, et al. Association between body mass index and liver stiffness measurement using transient elastography in patients with non-alcoholic fatty liver disease in a hepatology clinic: a cross sectional study. Transl Gastroenterol Hepatol 2023; 8: 10. [Link]
18.
Harrison Stephen A., Bedossa Pierre, Guy Cynthia D., et al. A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. N Engl J Med 2024; 390: 497–509. [Link]
19.
Francque S, Krag A, Shawcross DL, et al. A turning point in hepatology? EASL reflects on the first approved drug for MASH. Journal of Hepatology 2024; 81: 192–194. [Link]
20.
Newsome PN, Ambery P. Incretins (GLP-1 receptor agonists and dual/triple agonists) and the liver. J Hepatol 2023; 79: 1557–1565. [Link]
21.
Charlton MR, Burns JM, Pedersen RA, et al. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Gastroenterology 2011; 141: 1249–1253. [Link]
22.
Taylor RS, Taylor RJ, Bayliss S, et al. Association Between Fibrosis Stage and Outcomes of Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Gastroenterology 2020; 158: 1611-1625.e12. [Link]
23.
Sanyal AJ, Van Natta ML, Clark J, et al. Prospective Study of Outcomes in Adults with Nonalcoholic Fatty Liver Disease. N Engl J Med 2021; 385: 1559–1569. [Link]
24.
Parker R, Kim S-J, Gao B. Alcohol, adipose tissue and liver disease: mechanistic links and clinical considerations. Nat Rev Gastroenterol Hepatol 2018; 15: 50–59. [Link]
25.
Singh S, Allen AM, Wang Z, et al. Fibrosis Progression in Nonalcoholic Fatty Liver vs Nonalcoholic Steatohepatitis: A Systematic Review and Meta-analysis of Paired-Biopsy Studies. Clin Gastroenterol Hepatol 2015; 13: 643-654.e9. [Link]
26.
Polyzos SA, Kountouras J, Mantzoros CS. Obesity and nonalcoholic fatty liver disease: From pathophysiology to therapeutics. Metabolism 2019; 92: 82–97. [Link]
27.
Romero-Gómez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol 2017; 67: 829–846. [Link]
28.
Noureddin M, Charlton MR, Harrison SA, et al. Expert Panel Recommendations: Practical Clinical Applications for Initiating and Monitoring Resmetirom in Patients with MASH/NASH and Moderate to Noncirrhotic Advanced Fibrosis. Clin Gastroenterol Hepatol. Epub ahead of print 20 July 2024. [Link]
29.
Paklar N, Mijic M, Filipec-Kanizaj T. The Outcomes of Liver Transplantation in Severe Metabolic Dysfunction-Associated Steatotic Liver Disease Patients. Biomedicines 2023; 11: 3096. [Link]
30.
Yong JN, Lim WH, Ng CH, et al. Outcomes of Nonalcoholic Steatohepatitis After Liver Transplantation: An Updated Meta-Analysis and Systematic Review. Clin Gastroenterol Hepatol 2023; 21: 45-54.e6. [Link]
31.
Minich A, Arisar FAQ, Shaikh NS, et al. Predictors of patient survival following liver transplant in non-alcoholic steatohepatitis: A systematic review and meta-analysis. eClinicalMedicine; 50. Epub ahead of print 1 August 2022. [Link]
32.
Haldar D, Kern B, Hodson J, et al. Outcomes of liver transplantation for non-alcoholic steatohepatitis: A European Liver Transplant Registry study. J Hepatol 2019; 71: 313–322. [Link]
33.
VanWagner LB, Bhave M, Te HS, et al. Patients transplanted for nonalcoholic steatohepatitis are at increased risk for postoperative cardiovascular events. Hepatology 2012; 56: 1741–1750. [Link]
34.
Mosko JD, Nguyen GC. Increased perioperative mortality following bariatric surgery among patients with cirrhosis. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2011; 9: 897–901. [Link]
35.
Miñambres I, Rubio M, de Hollanda A, et al. Outcomes of Bariatric Surgery in Patients with Cirrhosis. Obes Surg; 29. Epub ahead of print 1 February 2019. [Link]
36.
Shimizu H, Phuong V, Maia M, et al. Bariatric surgery in patients with liver cirrhosis. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 2013; 9: 1–6. [Link]
37.
Cobb WS, Heniford BT, Burns JM, et al. Cirrhosis is not a contraindication to laparoscopic surgery. Surg Endosc 2005; 19: 418–423. [Link]
38.
Tandon P, Ney M, Irwin I, et al. Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2012; 18: 1209–1216. [Link]
39.
Mantovani A, Csermely A, Petracca G, et al. Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events: an updated systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 903–913. [Link]
40.
Villeret F, Dharancy S, Erard D, et al. Inevitability of disease recurrence after liver transplantation for NAFLD cirrhosis. JHEP Rep; 5. Epub ahead of print 1 March 2023. [Link]
41.
Newsome PN. Recurrence of nonalcoholic fatty liver disease after liver transplantation: it is common, but does it affect outcome? Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2010; 16: 420–422. [Link]
42.
Samji NS, Verma R, Keri KC, et al. Liver Transplantation for Nonalcoholic Steatohepatitis: Pathophysiology of Recurrence and Clinical Challenges. Dig Dis Sci 2019; 64: 3413–3430. [Link]
43.
Shetty A, Giron F, Divatia MK, et al. Nonalcoholic Fatty Liver Disease after Liver Transplant. J Clin Transl Hepatol 2021; 9: 428. [Link]
44.
Heimbach JK, Watt KDS, Poterucha JJ, et al. Combined liver transplantation and gastric sleeve resection for patients with medically complicated obesity and end-stage liver disease. Am J Transplant Off J Am Soc Transplant Am Soc Transpl Surg 2013; 13: 363–368. [Link]
45.
Nair S, Wilding JPH. Sodium glucose cotransporter 2 inhibitors as a new treatment for diabetes mellitus. J Clin Endocrinol Metab 2010; 95: 34–42. [Link]
46.
Ong Lopez AMC, Pajimna JAT. Efficacy of sodium glucose cotransporter 2 inhibitors on hepatic fibrosis and steatosis in non-alcoholic fatty liver disease: an updated systematic review and meta-analysis. Sci Rep 2024; 14: 2122. [Link]
47.
Cheung KS, Ng HY, Hui RWH, et al. Effects of empagliflozin on liver fat in patients with metabolic dysfunction–associated steatotic liver disease without diabetes mellitus: A randomized, double-blind, placebo-controlled trial. Hepatology 2024; 80: 916. [Link]
48.
Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterology 2007; 132: 2131–2157. [Link]
49.
Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2016; 375: 1834–1844. [Link]
50.
Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020; 383: 1413–1424. [Link]
51.
Saad M, Mahmoud AN, Elgendy IY, et al. Cardiovascular outcomes with sodium-glucose cotransporter-2 inhibitors in patients with type II diabetes mellitus: A meta-analysis of placebo-controlled randomized trials. Int J Cardiol 2017; 228: 352–358. [Link]

Abstract

Children and adolescents with chronic diseases requiring lifelong care face unique challenges that affect their daily lives and those of their families. Initially, these patients receive specialized care in pediatric facilities, where parents play a key role in treatment decisions. However, transitioning to adult healthcare facilities is inevitable, and this process, recognized as crucial years ago, involves moving adolescents with chronic conditions from child-centered to adult-oriented care. This transition can be complicated by varying age limits for pediatric care and the scarcity of adult care centers with specific expertise. The transition often requires cooperation between different centers or even countries due to patient mobility. The transition phase is critical, as it can lead to loss of follow-up, treatment suspension, and increased risks of complications or disease relapse. Beyond medical management, various factors influence the long-term prognosis of chronic conditions, making a well-organized transition program essential. While many hospitals have implemented transition models with mixed results in satisfaction, disease control, and follow-up adherence, there are frequent shortcomings in the process. This Mistakes In article will outline eight common mistakes made during the transition from pediatric to adult care, supported by literature and professional experience.

Topics

Primary Care

Citation

Jorge Amil-Dias, Hans Törnblom, Moriam Mustapha and Patrizia Burra. Mistakes in transitional care for children and young adults and how to avoid them. UEG Education 2023; 23: 22-25.

Published

2023

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Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Log in to continue.

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Mistakes in hepatitis C and how to avoid them

Ana Catarina Garcia, Gonçalo Alexandrino

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References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol 2023; 79: 1542–1556. [Link]
2.
Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatol Baltim Md 2016; 64: 73–84. [Link]
3.
Adam R, Karam V, Cailliez V, et al. 2018 Annual Report of the European Liver Transplant Registry (ELTR) - 50-year evolution of liver transplantation. Transpl Int Off J Eur Soc Organ Transplant 2018; 31: 1293–1317. [Link]
4.
Saeed N, Glass L, Sharma P, et al. Incidence and Risks for Nonalcoholic Fatty Liver Disease and Steatohepatitis Post-liver Transplant: Systematic Review and Meta-analysis. Transplantation 2019; 103: e345–e354. [Link]
5.
Younossi ZM, Golabi P, Paik JM, et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatol Baltim Md 2023; 77: 1335–1347. [Link]
6.
Smits MM, Ioannou GN, Boyko EJ, et al. Non-alcoholic fatty liver disease as an independent manifestation of the metabolic syndrome: results of a US national survey in three ethnic groups. J Gastroenterol Hepatol 2013; 28: 664–670. [Link]
7.
Lekakis V, Papatheodoridis GV. Natural history of metabolic dysfunction-associated steatotic liver disease. Eur J Intern Med 2024; 122: 3–10. [Link]
8.
Ma X, Liu S, Zhang J, et al. Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis. BMC Gastroenterol 2020; 20: 10. [Link]
9.
Mofrad P, Contos MJ, Haque M, et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatol Baltim Md 2003; 37: 1286–1292. [Link]
10.
Amarapurkar DN, Patel ND. Clinical spectrum and natural history of non-alcoholic steatohepatitis with normal alanine aminotransferase values. Trop Gastroenterol Off J Dig Dis Found 2004; 25: 130–134. [Link]
11.
Chen Y-T, Chen T-I, Yin S-C, et al. Prevalence, proportions of elevated liver enzyme levels, and long-term cardiometabolic mortality of patients with metabolic dysfunction-associated steatotic liver disease. J Gastroenterol Hepatol; n/a. [Link]
12.
Vogel W, Kathrein H, Dietze O, et al. [Sonography of the liver in Wilson’s disease. Sonographic studies of the liver in Wilson’s disease--significance for assessing prognosis?]. Ultraschall Med Stuttg Ger 1980 1988; 9: 270–273. [Link]
13.
Tacke F, Horn P, Wai-Sun Wong V, et al. EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol 2024; 81: 492–542. [Link]
14.
Eddowes PJ, Sasso M, Allison M, et al. Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2019; 156: 1717–1730. [Link]
15.
Eilenberg M, Munda P, Stift J, et al. Accuracy of non-invasive liver stiffness measurement and steatosis quantification in patients with severe and morbid obesity. Hepatobiliary Surg Nutr 2021; 10: 610–622. [Link]
16.
Ornelas R, Pan D, Chak E. S3264 The Accuracy of Fibroscan: A Real World Study. Off J Am Coll Gastroenterol ACG 2020; 115: S1706. [Link]
17.
Gopalakrishna H, Fashanu OE, Nair GB, et al. Association between body mass index and liver stiffness measurement using transient elastography in patients with non-alcoholic fatty liver disease in a hepatology clinic: a cross sectional study. Transl Gastroenterol Hepatol 2023; 8: 10. [Link]
18.
Harrison Stephen A., Bedossa Pierre, Guy Cynthia D., et al. A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. N Engl J Med 2024; 390: 497–509. [Link]
19.
Francque S, Krag A, Shawcross DL, et al. A turning point in hepatology? EASL reflects on the first approved drug for MASH. Journal of Hepatology 2024; 81: 192–194. [Link]
20.
Newsome PN, Ambery P. Incretins (GLP-1 receptor agonists and dual/triple agonists) and the liver. J Hepatol 2023; 79: 1557–1565. [Link]
21.
Charlton MR, Burns JM, Pedersen RA, et al. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Gastroenterology 2011; 141: 1249–1253. [Link]
22.
Taylor RS, Taylor RJ, Bayliss S, et al. Association Between Fibrosis Stage and Outcomes of Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Gastroenterology 2020; 158: 1611-1625.e12. [Link]
23.
Sanyal AJ, Van Natta ML, Clark J, et al. Prospective Study of Outcomes in Adults with Nonalcoholic Fatty Liver Disease. N Engl J Med 2021; 385: 1559–1569. [Link]
24.
Parker R, Kim S-J, Gao B. Alcohol, adipose tissue and liver disease: mechanistic links and clinical considerations. Nat Rev Gastroenterol Hepatol 2018; 15: 50–59. [Link]
25.
Singh S, Allen AM, Wang Z, et al. Fibrosis Progression in Nonalcoholic Fatty Liver vs Nonalcoholic Steatohepatitis: A Systematic Review and Meta-analysis of Paired-Biopsy Studies. Clin Gastroenterol Hepatol 2015; 13: 643-654.e9. [Link]
26.
Polyzos SA, Kountouras J, Mantzoros CS. Obesity and nonalcoholic fatty liver disease: From pathophysiology to therapeutics. Metabolism 2019; 92: 82–97. [Link]
27.
Romero-Gómez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol 2017; 67: 829–846. [Link]
28.
Noureddin M, Charlton MR, Harrison SA, et al. Expert Panel Recommendations: Practical Clinical Applications for Initiating and Monitoring Resmetirom in Patients with MASH/NASH and Moderate to Noncirrhotic Advanced Fibrosis. Clin Gastroenterol Hepatol. Epub ahead of print 20 July 2024. [Link]
29.
Paklar N, Mijic M, Filipec-Kanizaj T. The Outcomes of Liver Transplantation in Severe Metabolic Dysfunction-Associated Steatotic Liver Disease Patients. Biomedicines 2023; 11: 3096. [Link]
30.
Yong JN, Lim WH, Ng CH, et al. Outcomes of Nonalcoholic Steatohepatitis After Liver Transplantation: An Updated Meta-Analysis and Systematic Review. Clin Gastroenterol Hepatol 2023; 21: 45-54.e6. [Link]
31.
Minich A, Arisar FAQ, Shaikh NS, et al. Predictors of patient survival following liver transplant in non-alcoholic steatohepatitis: A systematic review and meta-analysis. eClinicalMedicine; 50. Epub ahead of print 1 August 2022. [Link]
32.
Haldar D, Kern B, Hodson J, et al. Outcomes of liver transplantation for non-alcoholic steatohepatitis: A European Liver Transplant Registry study. J Hepatol 2019; 71: 313–322. [Link]
33.
VanWagner LB, Bhave M, Te HS, et al. Patients transplanted for nonalcoholic steatohepatitis are at increased risk for postoperative cardiovascular events. Hepatology 2012; 56: 1741–1750. [Link]
34.
Mosko JD, Nguyen GC. Increased perioperative mortality following bariatric surgery among patients with cirrhosis. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2011; 9: 897–901. [Link]
35.
Miñambres I, Rubio M, de Hollanda A, et al. Outcomes of Bariatric Surgery in Patients with Cirrhosis. Obes Surg; 29. Epub ahead of print 1 February 2019. [Link]
36.
Shimizu H, Phuong V, Maia M, et al. Bariatric surgery in patients with liver cirrhosis. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 2013; 9: 1–6. [Link]
37.
Cobb WS, Heniford BT, Burns JM, et al. Cirrhosis is not a contraindication to laparoscopic surgery. Surg Endosc 2005; 19: 418–423. [Link]
38.
Tandon P, Ney M, Irwin I, et al. Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2012; 18: 1209–1216. [Link]
39.
Mantovani A, Csermely A, Petracca G, et al. Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events: an updated systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 903–913. [Link]
40.
Villeret F, Dharancy S, Erard D, et al. Inevitability of disease recurrence after liver transplantation for NAFLD cirrhosis. JHEP Rep; 5. Epub ahead of print 1 March 2023. [Link]
41.
Newsome PN. Recurrence of nonalcoholic fatty liver disease after liver transplantation: it is common, but does it affect outcome? Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2010; 16: 420–422. [Link]
42.
Samji NS, Verma R, Keri KC, et al. Liver Transplantation for Nonalcoholic Steatohepatitis: Pathophysiology of Recurrence and Clinical Challenges. Dig Dis Sci 2019; 64: 3413–3430. [Link]
43.
Shetty A, Giron F, Divatia MK, et al. Nonalcoholic Fatty Liver Disease after Liver Transplant. J Clin Transl Hepatol 2021; 9: 428. [Link]
44.
Heimbach JK, Watt KDS, Poterucha JJ, et al. Combined liver transplantation and gastric sleeve resection for patients with medically complicated obesity and end-stage liver disease. Am J Transplant Off J Am Soc Transplant Am Soc Transpl Surg 2013; 13: 363–368. [Link]
45.
Nair S, Wilding JPH. Sodium glucose cotransporter 2 inhibitors as a new treatment for diabetes mellitus. J Clin Endocrinol Metab 2010; 95: 34–42. [Link]
46.
Ong Lopez AMC, Pajimna JAT. Efficacy of sodium glucose cotransporter 2 inhibitors on hepatic fibrosis and steatosis in non-alcoholic fatty liver disease: an updated systematic review and meta-analysis. Sci Rep 2024; 14: 2122. [Link]
47.
Cheung KS, Ng HY, Hui RWH, et al. Effects of empagliflozin on liver fat in patients with metabolic dysfunction–associated steatotic liver disease without diabetes mellitus: A randomized, double-blind, placebo-controlled trial. Hepatology 2024; 80: 916. [Link]
48.
Baggio LL, Drucker DJ. Biology of incretins: GLP-1 and GIP. Gastroenterology 2007; 132: 2131–2157. [Link]
49.
Marso SP, Bain SC, Consoli A, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2016; 375: 1834–1844. [Link]
50.
Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020; 383: 1413–1424. [Link]
51.
Saad M, Mahmoud AN, Elgendy IY, et al. Cardiovascular outcomes with sodium-glucose cotransporter-2 inhibitors in patients with type II diabetes mellitus: A meta-analysis of placebo-controlled randomized trials. Int J Cardiol 2017; 228: 352–358. [Link]

Abstract

Hepatitis C virus (HCV) infection remains an important global health concern. It is estimated that there are approximately 50 million people infected with HCV globally, with around 1 million new infections each year and about 242,000 deaths annually attributed to HCV-related complications. Most acute HCV infections (55–85%) become chronic due to the virus’s effective evasion strategies, with spontaneous clearance being rare once chronicity is established. This condition often progresses silently, with many individuals unaware of their infection until advanced liver damage has occurred. If left untreated, HCV can lead to severe complications, including liver cirrhosis and hepatocellular carcinoma (HCC). HCV transmission occurs mainly through percutaneous exposure to infected blood. HCV can also spread from mother to infant (vertical transmission) and, less frequently, via sexual contact.1,2 In recent years, the introduction of oral direct-acting antivirals (DAAs), with remarkable safety and effectiveness profiles, has led to a sustained virological response (SVR) in virtually all (>97%) HCV-infected patients, regardless of HCV genotype or disease stage. However, significant barriers remain, such as issues with diagnosis, access to treatment and awareness of the disease.

Here, we discuss some of the misconceptions in HCV management and provide a practical management approach grounded in evidence and clinical experience.

Topics

Hepatobiliary

Citation

Garcia A.C and Alexandrino G. Mistakes in hepatits C and how to avoid them. UEG Education 2025; 25: 14-17.

Published

2025

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UEG Standards and Guidelines
Consensus
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European Guideline on Chronic Nausea and Vomiting—A UEG and ESNM Consensus for Clinical Management

Carolina Malagelada

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Guideline

ABSTRACT

Introduction

Chronic nausea and vomiting are symptoms of a wide range of gastrointestinal and non-gastrointestinal conditions. Diagnosis can be challenging and requires a systematic and well-structured approach. If the initial investigation for structural, toxic and metabolic disorders is negative, digestive motility and gut-brain interaction disorders should be assessed. United European Gastroenterology (UEG) and the European Society for Neurogastroenterology and Motility (ESNM) identified the need for an updated, evidence-based clinical guideline for the management of chronic nausea and vomiting.

Methods

A multidisciplinary team of experts in the field, including European specialists and national societies, participated in the development of the guideline. Relevant questions were addressed through a literature review and statements were developed and voted on according to a Delphi process.

Results

Ninety-eight statements were identified and voted following the Delphi process. Overall agreement was high, although the grade of scientific evidence was low in many areas. Disagreement was more evident for some pharmacological treatment options. A diagnostic algorithm was developed, focussing on the differentiating features between gastrointestinal motility and gut-brain interaction disorders with predominant nausea and vomiting.

Conclusion

These guidelines provide an evidence-based framework for the evaluation and treatment of patients with chronic nausea and vomiting.

Publisher

European Society of Neurogastroenterology and Motility logo
European Society of Neurogastroenterology and Motility

Guideline

Consensus

Topics

Neurogastroenterology & Motility Paediatrics Primary Care Stomach & H. Pylori

Citation

United European Gastroenterol J.

Published

2025

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Mistakes in faecal incontinence management and how to avoid them

Kestutis Adamonis, Sadé L Assmann, Stéphanie O Breukink

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes
References
Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10
1.
Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol 2023; 79: 1542–1556. [Link]
2.
Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatol Baltim Md 2016; 64: 73–84. [Link]
3.
Adam R, Karam V, Cailliez V, et al. 2018 Annual Report of the European Liver Transplant Registry (ELTR) - 50-year evolution of liver transplantation. Transpl Int Off J Eur Soc Organ Transplant 2018; 31: 1293–1317. [Link]
4.
Saeed N, Glass L, Sharma P, et al. Incidence and Risks for Nonalcoholic Fatty Liver Disease and Steatohepatitis Post-liver Transplant: Systematic Review and Meta-analysis. Transplantation 2019; 103: e345–e354. [Link]
5.
Younossi ZM, Golabi P, Paik JM, et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatol Baltim Md 2023; 77: 1335–1347. [Link]
6.
Smits MM, Ioannou GN, Boyko EJ, et al. Non-alcoholic fatty liver disease as an independent manifestation of the metabolic syndrome: results of a US national survey in three ethnic groups. J Gastroenterol Hepatol 2013; 28: 664–670. [Link]
7.
Lekakis V, Papatheodoridis GV. Natural history of metabolic dysfunction-associated steatotic liver disease. Eur J Intern Med 2024; 122: 3–10. [Link]
8.
Ma X, Liu S, Zhang J, et al. Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis. BMC Gastroenterol 2020; 20: 10. [Link]
9.
Mofrad P, Contos MJ, Haque M, et al. Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatol Baltim Md 2003; 37: 1286–1292. [Link]
10.
Amarapurkar DN, Patel ND. Clinical spectrum and natural history of non-alcoholic steatohepatitis with normal alanine aminotransferase values. Trop Gastroenterol Off J Dig Dis Found 2004; 25: 130–134. [Link]
11.
Chen Y-T, Chen T-I, Yin S-C, et al. Prevalence, proportions of elevated liver enzyme levels, and long-term cardiometabolic mortality of patients with metabolic dysfunction-associated steatotic liver disease. J Gastroenterol Hepatol; n/a. [Link]
12.
Vogel W, Kathrein H, Dietze O, et al. [Sonography of the liver in Wilson’s disease. Sonographic studies of the liver in Wilson’s disease--significance for assessing prognosis?]. Ultraschall Med Stuttg Ger 1980 1988; 9: 270–273. [Link]
13.
Tacke F, Horn P, Wai-Sun Wong V, et al. EASL–EASD–EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol 2024; 81: 492–542. [Link]
14.
Eddowes PJ, Sasso M, Allison M, et al. Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2019; 156: 1717–1730. [Link]
15.
Eilenberg M, Munda P, Stift J, et al. Accuracy of non-invasive liver stiffness measurement and steatosis quantification in patients with severe and morbid obesity. Hepatobiliary Surg Nutr 2021; 10: 610–622. [Link]
16.
Ornelas R, Pan D, Chak E. S3264 The Accuracy of Fibroscan: A Real World Study. Off J Am Coll Gastroenterol ACG 2020; 115: S1706. [Link]
17.
Gopalakrishna H, Fashanu OE, Nair GB, et al. Association between body mass index and liver stiffness measurement using transient elastography in patients with non-alcoholic fatty liver disease in a hepatology clinic: a cross sectional study. Transl Gastroenterol Hepatol 2023; 8: 10. [Link]
18.
Harrison Stephen A., Bedossa Pierre, Guy Cynthia D., et al. A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. N Engl J Med 2024; 390: 497–509. [Link]
19.
Francque S, Krag A, Shawcross DL, et al. A turning point in hepatology? EASL reflects on the first approved drug for MASH. Journal of Hepatology 2024; 81: 192–194. [Link]
20.
Newsome PN, Ambery P. Incretins (GLP-1 receptor agonists and dual/triple agonists) and the liver. J Hepatol 2023; 79: 1557–1565. [Link]
21.
Charlton MR, Burns JM, Pedersen RA, et al. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Gastroenterology 2011; 141: 1249–1253. [Link]
22.
Taylor RS, Taylor RJ, Bayliss S, et al. Association Between Fibrosis Stage and Outcomes of Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Gastroenterology 2020; 158: 1611-1625.e12. [Link]
23.
Sanyal AJ, Van Natta ML, Clark J, et al. Prospective Study of Outcomes in Adults with Nonalcoholic Fatty Liver Disease. N Engl J Med 2021; 385: 1559–1569. [Link]
24.
Parker R, Kim S-J, Gao B. Alcohol, adipose tissue and liver disease: mechanistic links and clinical considerations. Nat Rev Gastroenterol Hepatol 2018; 15: 50–59. [Link]
25.
Singh S, Allen AM, Wang Z, et al. Fibrosis Progression in Nonalcoholic Fatty Liver vs Nonalcoholic Steatohepatitis: A Systematic Review and Meta-analysis of Paired-Biopsy Studies. Clin Gastroenterol Hepatol 2015; 13: 643-654.e9. [Link]
26.
Polyzos SA, Kountouras J, Mantzoros CS. Obesity and nonalcoholic fatty liver disease: From pathophysiology to therapeutics. Metabolism 2019; 92: 82–97. [Link]
27.
Romero-Gómez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol 2017; 67: 829–846. [Link]
28.
Noureddin M, Charlton MR, Harrison SA, et al. Expert Panel Recommendations: Practical Clinical Applications for Initiating and Monitoring Resmetirom in Patients with MASH/NASH and Moderate to Noncirrhotic Advanced Fibrosis. Clin Gastroenterol Hepatol. Epub ahead of print 20 July 2024. [Link]
29.
Paklar N, Mijic M, Filipec-Kanizaj T. The Outcomes of Liver Transplantation in Severe Metabolic Dysfunction-Associated Steatotic Liver Disease Patients. Biomedicines 2023; 11: 3096. [Link]
30.
Yong JN, Lim WH, Ng CH, et al. Outcomes of Nonalcoholic Steatohepatitis After Liver Transplantation: An Updated Meta-Analysis and Systematic Review. Clin Gastroenterol Hepatol 2023; 21: 45-54.e6. [Link]
31.
Minich A, Arisar FAQ, Shaikh NS, et al. Predictors of patient survival following liver transplant in non-alcoholic steatohepatitis: A systematic review and meta-analysis. eClinicalMedicine; 50. Epub ahead of print 1 August 2022. [Link]
32.
Haldar D, Kern B, Hodson J, et al. Outcomes of liver transplantation for non-alcoholic steatohepatitis: A European Liver Transplant Registry study. J Hepatol 2019; 71: 313–322. [Link]
33.
VanWagner LB, Bhave M, Te HS, et al. Patients transplanted for nonalcoholic steatohepatitis are at increased risk for postoperative cardiovascular events. Hepatology 2012; 56: 1741–1750. [Link]
34.
Mosko JD, Nguyen GC. Increased perioperative mortality following bariatric surgery among patients with cirrhosis. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2011; 9: 897–901. [Link]
35.
Miñambres I, Rubio M, de Hollanda A, et al. Outcomes of Bariatric Surgery in Patients with Cirrhosis. Obes Surg; 29. Epub ahead of print 1 February 2019. [Link]
36.
Shimizu H, Phuong V, Maia M, et al. Bariatric surgery in patients with liver cirrhosis. Surg Obes Relat Dis Off J Am Soc Bariatr Surg 2013; 9: 1–6. [Link]
37.
Cobb WS, Heniford BT, Burns JM, et al. Cirrhosis is not a contraindication to laparoscopic surgery. Surg Endosc 2005; 19: 418–423. [Link]
38.
Tandon P, Ney M, Irwin I, et al. Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value. Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2012; 18: 1209–1216. [Link]
39.
Mantovani A, Csermely A, Petracca G, et al. Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events: an updated systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021; 6: 903–913. [Link]
40.
Villeret F, Dharancy S, Erard D, et al. Inevitability of disease recurrence after liver transplantation for NAFLD cirrhosis. JHEP Rep; 5. Epub ahead of print 1 March 2023. [Link]
41.
Newsome PN. Recurrence of nonalcoholic fatty liver disease after liver transplantation: it is common, but does it affect outcome? Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2010; 16: 420–422. [Link]
42.
Samji NS, Verma R, Keri KC, et al. Liver Transplantation for Nonalcoholic Steatohepatitis: Pathophysiology of Recurrence and Clinical Challenges. Dig Dis Sci 2019; 64: 3413–3430. [Link]
43.
Shetty A, Giron F, Divatia MK, et al. Nonalcoholic Fatty Liver Disease after Liver Transplant. J Clin Transl Hepatol 2021; 9: 428. [Link]
44.
Heimbach JK, Watt KDS, Poterucha JJ, et al. Combined liver transplantation and gastric sleeve resection for patients with medically complicated obesity and end-stage liver disease. Am J Transplant Off J Am Soc Transplant Am Soc Transpl Surg 2013; 13: 363–368. [Link]
45.
Nair S, Wilding JPH. Sodium glucose cotransporter 2 inhibitors as a new treatment for diabetes mellitus. J Clin Endocrinol Metab 2010; 95: 34–42. [Link]
46.
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Abstract

People with faecal incontinence (FI) suffer from chronic involuntary loss of bowel content. Patients often experience embarrassment, shame, low self-esteem, and depression, affecting their quality of life. Treatment approaches vary, and less invasive options should be tried before considering more invasive treatments. It's important to consider contributing factors, physician and patient preferences, and available procedures. This article discusses common mistakes in treating faecal incontinence and how to avoid them, based on evidence and clinical experience.

Topics

Neurogastroenterology & Motility

Citation

Assmann S L, Breukink S O and Keszthelyi D. Mistakes in faecal incontinence management and how to avoid them. UEG Education 2023; 23: 1-3.

Published

2023

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