[Gastroenterology. I: General gastroenterology]

Area of Science:

• Gastroenterology
• Internal Medicine

Context:

• Over the past two decades, substantial progress has been made in managing complex gastrointestinal conditions.
• Key areas include motility disorders, chronic inflammatory bowel diseases, and esophageal variceal bleeding.

Purpose:

• To review recent therapeutic advancements in motility-associated disorders, inflammatory bowel diseases, and esophageal variceal bleeding.
• To highlight the impact of evidence-based treatments on patient outcomes.

Summary:

• Motility disorders such as achalasia, functional dyspepsia, irritable bowel syndrome, and intestinal pseudoobstruction are now better managed with pro- or anti-motility drugs.
• Controlled studies have clarified the roles of specific medications (e.g., 5-ASA, azathioprine) in treating ulcerative colitis and Crohn's disease.
• Esophageal variceal bleeding is effectively managed using combined mechanical treatments (sclerotherapy, banding) and pharmacologic approaches (octreotide, vasoactive agents) to reduce portal pressure.
• Prophylaxis of variceal bleeding has been established using non-selective beta-blockers based on clinical trial data.

Impact:

• Improved treatment strategies offer better patient outcomes for motility disorders and inflammatory bowel diseases.
• Current therapeutic protocols enhance the management and prophylaxis of bleeding from esophageal varices.
• Evidence-based medicine guides clinical practice, leading to more effective gastrointestinal care.