Two in five adults meet criteria for a gut-brain disorder, and the number has not moved

The edition in brief

Four findings for the gastroenterology and hepatology desk. The Rome V global epidemiology survey questioned 28,771 adults in 15 countries. At least one disorder of gut-brain interaction was present in 40.9%, against 40.5% under Rome IV, with the same pattern of higher prevalence in women and falling prevalence with age. Functional dyspepsia was the commonest gastroduodenal disorder at 8.1%, unclassified bowel disorder the commonest bowel disorder at 9.6%, then chronic constipation at 8.9% and irritable bowel syndrome at 8.5%. Two new entities were measured: abdominal migraine at 5.1% and inability to belch syndrome at 1.4%. MYR301 followed 150 patients with chronic hepatitis D through 144 weeks of bulevirtide and 96 weeks off treatment. Virologic response at the end of treatment was 73% to 92% depending on group, but fell to around 30% two years after stopping. Only 23 of 64 patients with undetectable HDV RNA at the end of treatment stayed undetectable, and the length of continuous undetectability was the best predictor of who did. A network meta-analysis of 13 randomised trials and 4,156 patients found that computer-aided colonoscopy improves detection of polyps 5 mm or smaller (standardised mean difference 0.21, 95% CI 0.07 to 0.35) but has almost no effect at 6-9 mm or 10 mm and above. Heterogeneity was high and GRADE certainty very low to low. A randomised comparison of two-dose against three-dose infant hepatitis B schedules found seroprotection of 90.9% to 94.2% across schedules and similar anamnestic responses three years later; the three-dose comparison group was not randomised. A 35-expert Delphi panel reached consensus that MASLD raises colorectal cancer risk and argued for earlier, risk-adapted screening.