The edition · Gastroenterology & Hepatology
A blood test triples early liver-cancer detection, and why to keep IBD biologics going
A blood test caught three times as many early liver cancers as ultrasound, though with more false positives; keeping biologics through COVID protects against IBD flares; opioid-sparing analgesia cut post-gastrectomy ileus; and the global liver-disease burden keeps climbing.
The edition in brief
Today's gastroenterology and hepatology edition leads with the ALTUS study, where a multi-target blood test for hepatocellular carcinoma caught early-stage cancer far more often than ultrasound (66.7% vs 22.2% sensitivity) but with lower specificity (81.8% vs 98.6%), meaning more false positives. A randomised trial found opioid-sparing analgesia after laparoscopic gastrectomy roughly a third of the ileus of conventional opioids. A global liver-disease update puts chronic liver disease at over 1.5 billion people, with rising MASLD and alcohol-related disease and the heaviest burden in lower-income regions. A pearl reinforces prophylactic antibiotics in cirrhotic gastrointestinal bleeding. The edition closes on a meta-analysis showing COVID-19 did not worsen IBD, but stopping biologics around infection drove flares, so the practice signal is to maintain treatment in patients without high-risk features.
A blood test caught more early liver cancers than ultrasound
A multi-target blood test finds far more early liver cancers than ultrasound but with more false positives; view it as a promising adjunct, not yet a guideline substitute.
Opioid-sparing analgesia cut ileus after gastrectomy
Favour multimodal opioid-sparing analgesia after gastrointestinal surgery to reduce ileus and speed bowel recovery.
The global liver-disease burden keeps climbing, unevenly
Target liver-disease effort where it pays: viral hepatitis case-finding, MASLD and alcohol prevention, especially in resource-limited settings.
Give prophylactic antibiotics in cirrhotic GI bleeding
In cirrhosis with acute GI bleeding, give prophylactic antibiotics at presentation alongside vasoactive therapy and early endoscopy.
Keep IBD biologics going through COVID
Maintain biologic therapy in IBD patients who get COVID-19 unless they have high-risk features; stopping it, not the virus, drives flares.
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