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Gastroenterology Insights
Special Issues
Chronic Liver Disease and Comorbidities
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Chronic Liver Disease and Comorbidities

A special issue of Gastroenterology Insights (ISSN 2036-7422). This special issue belongs to the section "Liver".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 13187

Special Issue Editor

Dr. Gina Gheorghe

E-Mail Website
Guest Editor
1. Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
2. Department of Gastroenterology, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
Interests: liver diseases; pancreatic cancer; molecular diagnostics; inflammatory bowel diseases; endoscopy

Special Issue Information

Dear colleagues,

Chronic liver diseases are complex, with multiple causes, and affect approximately 1.5 billion individuals worldwide. In recent decades, advances in the diagnostic and therapeutic management of viral hepatitis have led to improvements in the morbidity and mortality rates associated with chronic liver diseases. Thus, the death rate decreased from 21 deaths per 100,000 inhabitants in 1990, to 16.5 cases per 100,000 inhabitants in 2019. Additionally, the proportion of diseases that can evolve into chronic liver disease has changed. Currently, the dominant etiology is represented by nonalcoholic fatty liver disease (NAFLD): 59% of cases.

One clinical challenge is presented by the association of chronic liver disease with other comorbidities and the establishment of optimal therapeutic management. These conditions can have a negative impact on both the quality of life and the life expectancy of these patients. An example is the need for anticoagulant treatment in a patient with chronic liver disease and the impairment of biological markers of coagulation. To ensure optimal therapeutic management of these patients, a multidisciplinary team is necessary.

We invite the submission of articles reporting on this topic. We are particularly interested in reviews or original articles that provide an overview of diagnostic and treatment protocols individualized for patients with chronic liver disease and various comorbidities. Additionally, articles presenting new research directions or future perspectives are welcome.

Dr. Gina Gheorghe
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Gastroenterology Insights is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic liver disease
  • comorbidities
  • NAFLD
  • epidemiology
  • diagnosis
  • treatment

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Published Papers (4 papers)

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Research

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20 pages, 1571 KiB  
Article
A Current Approach to Non-Alcoholic Steatohepatitis in Type 2 Diabetes Mellitus Patients
by Sorina I. Stan, Teodora Biciusca, Viorel Biciusca, Ramona Cioboata, Diana Clenciu, Adina Mitrea, Alice Elena Ghenea and Suzana Danoiu
Gastroenterol. Insights 2023, 14(3), 363-382; https://doi.org/10.3390/gastroent14030027 - 8 Sep 2023
Viewed by 1591
Abstract
(1) Background: The relationship between non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) is bidirectional: NAFLD increases the risk of T2DM, and T2DM promotes the progression of the disease into non-alcoholic steatohepatitis (NASH). (2) Material and methods: We performed a [...] Read more.
(1) Background: The relationship between non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) is bidirectional: NAFLD increases the risk of T2DM, and T2DM promotes the progression of the disease into non-alcoholic steatohepatitis (NASH). (2) Material and methods: We performed a retrospective, open study that included 59 patients with NAFLD and T2DM who were distributed into two groups: 44 (74.57%) patients were diagnosed with hepatic steatosis (HS) and 15 (25.42%) patients were diagnosed with NASH. (3) Results: Among the non-specific inflammatory biomarkers, serum ferritin (SF) and the neutrophil-percentage-to-albumin ratio (NPAR) showed higher and statistically significant mean values (p = 0.003 respectively p = 0.03) in the group of patients with NASH and T2DM. Conclusions: Consequently, it is essential to identify alternative markers for the inflammatory process, particularly in individuals with diabetes, as it is a key characteristic of NASH. This need arises from the desire to avoid the risks associated with liver biopsy procedures (LBP) and to prevent the unpredictable and unfavorable progression of NAFLD in patients with T2DM. Full article
(This article belongs to the Special Issue Chronic Liver Disease and Comorbidities)
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Review

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17 pages, 994 KiB  
Review
Clinical Significance and Management of Hyponatremia in Liver Cirrhosis
by Martin Janičko, Sylvia Dražilová, Jakub Gazda, Martin Tomáš, Martin Kučera, Želmíra Šuchová and Peter Jarčuška
Gastroenterol. Insights 2023, 14(4), 446-462; https://doi.org/10.3390/gastroent14040033 - 8 Oct 2023
Viewed by 5195
Abstract
The overall prevalence of hyponatremia in cirrhotics is around 50%. Hypovolemic hyponatremia is a result of excessive fluid loss caused mostly by diuretic treatment or diarrhea. More common is hypervolemic hyponatremia, which results from excessive activation of water and sodium-retaining mechanisms caused by [...] Read more.
The overall prevalence of hyponatremia in cirrhotics is around 50%. Hypovolemic hyponatremia is a result of excessive fluid loss caused mostly by diuretic treatment or diarrhea. More common is hypervolemic hyponatremia, which results from excessive activation of water and sodium-retaining mechanisms caused by effective arterial hypovolemia. This review focuses on the associations of hyponatremia with clinical outcomes and reviews the available data on its management. Hyponatremia is a strong predictor of mortality and is also associated with an increased probability of hepatorenal syndrome, disturbance of consciousness, infections, and unfavorable post-transplant outcomes. In the management of hyponatremia, it is crucial to distinguish between hypovolemic and hypervolemic hyponatremia. The treatment of hypervolemic hyponatremia should be started only in symptomatic patients. The cessation of the treatment with traditional diuretics and fluid restriction may prevent further decrease in natremia. Pharmacological treatment is directed towards cirrhosis itself, precipitating factor, or hyponatremia directly. Currently, only albumin infusions can be recommended routinely. Other possibilities, such as vaptans, splanchnic vasoconstrictors, niravoline, or osmotic diuretics, are restricted to specific use cases (e.g., imminent liver transplantation) or need more research to determine their efficacy. We tried to summarize the management of hyponatremia into a concise flowchart. Full article
(This article belongs to the Special Issue Chronic Liver Disease and Comorbidities)
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14 pages, 371 KiB  
Review
Hepatobiliary Impairments in Patients with Inflammatory Bowel Diseases: The Current Approach
by Vlad Alexandru Ionescu, Gina Gheorghe, Valentin Nicolae Varlas, Ana Maria Alexandra Stanescu and Camelia Cristina Diaconu
Gastroenterol. Insights 2023, 14(1), 13-26; https://doi.org/10.3390/gastroent14010002 - 27 Dec 2022
Cited by 2 | Viewed by 2951
Abstract
Inflammatory bowel disease (IBD) refers to chronic conditions with a low mortality but high disability. The multisystemic nature of these diseases can explain the appearance of some extraintestinal manifestations, including liver damage. Abnormal liver biochemical tests can be identified in approximately one third [...] Read more.
Inflammatory bowel disease (IBD) refers to chronic conditions with a low mortality but high disability. The multisystemic nature of these diseases can explain the appearance of some extraintestinal manifestations, including liver damage. Abnormal liver biochemical tests can be identified in approximately one third of patients with IBD and chronic liver disease in 5% of them. Among the liver diseases associated with IBD are primary sclerosing cholangitis, cholelithiasis, fatty liver disease, hepatic amyloidosis, granulomatous hepatitis, drug-induced liver injury, venous thromboembolism, primary biliary cholangitis, IgG4-related cholangiopathy, autoimmune hepatitis, liver abscesses or the reactivation of viral hepatitis. The most common disease is primary sclerosing cholangitis, a condition diagnosed especially in patients with ulcerative colitis. The progress registered in recent years in the therapeutic management of IBD has not eliminated the risk of drug-induced liver disease. Additionally, the immunosuppression encountered in these patients increases the risk of opportunistic infections, including the reactivation of viral hepatitis. Currently, one of the concerns consists of establishing an efficiency and safety profile of the use of direct-acting antiviral agents (DAA) among patients with hepatitis C and IBD. Early diagnosis and optimal treatment of liver complications can improve the prognoses of these patients. Full article
(This article belongs to the Special Issue Chronic Liver Disease and Comorbidities)

Other

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8 pages, 599 KiB  
Opinion
Non-Invasive Methods for the Prediction of Spontaneous Bacterial Peritonitis in Patients with Cirrhosis
by Ngoc Huynh Cao, Phat Tan Ho, Hoang Huu Bui and Thong Duy Vo
Gastroenterol. Insights 2023, 14(2), 170-177; https://doi.org/10.3390/gastroent14020013 - 3 Apr 2023
Cited by 1 | Viewed by 2606
Abstract
Spontaneous bacterial peritonitis (SBP) is a potentially fatal complication in patients with liver cirrhosis. Early diagnosis and prompt treatment of SBP are vital to shorten hospital stays and reduce mortality. According to society guidelines, patients with cirrhosis and ascites who are admitted to [...] Read more.
Spontaneous bacterial peritonitis (SBP) is a potentially fatal complication in patients with liver cirrhosis. Early diagnosis and prompt treatment of SBP are vital to shorten hospital stays and reduce mortality. According to society guidelines, patients with cirrhosis and ascites who are admitted to the hospital should have diagnostic paracentesis. However, for various reasons, paracentesis may be delayed or not performed. Therefore, recent research has focused on identifying non-invasive parameters useful in SBP prediction which require urgent antibiotic therapy if rapid and secure paracentesis is not possible or there is insufficient experience with this method. In this review, we discuss the non-invasive methods available to predict SBP. Full article
(This article belongs to the Special Issue Chronic Liver Disease and Comorbidities)
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