Functional dyspepsia (FD), a widespread and debilitating digestive disease, is thought to originate from disrupted gut-brain communication. The cause of FD is not completely understood, but recent evidence suggests it could be due to multiple factors and can vary among different patient groups. Factors like gut motility changes, increased sensitivity to pain in the gut, ongoing low-level inflammation, and increased gut permeability have all been linked to the development of FD. Additionally, changes in the gut microbiome have been suggested to play a significant role in the disease. The gut microbiota in the duodenum could either be a cause or a result of the immune and nervous system issues seen in FD, but the ways in which the gut flora in the small intestine affects gut function, digestive metabolites and symptoms are not yet clear, more studies being needed in order to completely assess the relationship between gastrointestinal microbiota and development and progression of FD.This review summarizes the available research on the relationship between FD and the microbiota and examines the various treatments, including probiotics, that have been shown to relieve symptoms. Finally, suggestions for improving diagnosis and treatment for those with FD are presented.

Background: Gastric cancer is still an important public health problem. Efforts have been made to lower its prevalence globally. The Operative Link on Gastritis Assessment (OLGA) and operating link for gastric intestinal metaplasia (OLGIM) histological grading systems have been proposed to identify individuals with types of gastritis that have the potential to become malignant.Aim of the study: Our study was conducted to assess the value of OLGA and OLGIM systems in the diagnosis of gastric precancerous lesions, in the Moldovan population.Methods: In a prospective study, 142 consecutive patients with chronic atrophic gastritis (CAG) from a larger group of patients referred to upper gastrointestinal endoscopy for dyspeptic symptoms or gastric cancer screening was investigated. The sample was divided into three groups: (a) CAG without intestinal metaplasia and gastric dysplasia; (b) CAG with intestinal metaplasia; (c) CAG with gastric dysplasia according to the morphological type of the lesion. GastroPanel biomarkers were correlated with OLGA and OLGIM stages.Results: There was a direct, moderate and statistically significant correlation between types of CAG and OLGA stages (p < 0.001), a direct, weak and statistically significant correlation between forms of chronic atrophic gastritis and OLGIM stages (p < 0.001). A statistically significant reduction in Pepsinogen I and the Pepsinogen-I/Pepsinogen-II ratio was observed alongside an increase in the stages of the OLGA and OLGIM systems.Conclusion: OLGA and OLGIM systems are useful tools in diagnosing CAG. This is the first study assessing the use of this systems in the Moldovan population.

Background and Objectives: The threshold for ineffective esophageal motility (IEM) diagnosis was changed in Chicago v4.0. Our aim was to determine IEM prevalence using the new criteria and the differences between patients with definite IEM versus “inconclusive diagnosis”. Materials and Methods: We retrospectively selected IEM and fragmented peristalsis (FP) patients from the high-resolution esophageal manometries (HREMs) database. Clinical, demographic data and manometric parameters were recorded. Results: Of 348 HREMs analyzed using Chicago v3.0, 12.3% of patients had IEM and 0.86% had FP. Using Chicago v4.0, 8.9% of patients had IEM (IEM-4 group). We compared them with the remaining 16 with an inconclusive diagnosis of IEM (borderline group). Dysphagia (77% vs. 44%, Z-test = 2.3, p = 0.02) and weight loss were more commonly observed in IEM-4 compared to the borderline group. The reflux symptoms were more prevalent in the borderline group (87.5% vs. 70.9%, p = 0.2). Type 2 or 3 esophagogastric junction morphology was more prevalent in the borderline group (81.2%) vs. 64.5% in IEM-4 (p = 0.23). Distal contractile integral (DCI) was lower in IEM-4 vs. the borderline group, and resting lower esophageal sphincter (LES) pressure and mean integrated relaxation pressure (IRP) were similar. The number of ineffective swallows and failed swallows was higher in IEM-4 compared to the borderline group. Conclusions: Using Chicago v4.0, less than 10% of patients had a definite diagnosis of IEM. The dominant symptom was dysphagia. Only DCI and the number of failed and inefficient swallows were different between definite IEM patients and borderline cases.

Background and aims. Most colorectal cancers (CRC) originate from precancerous adenomatous and serrated lesions. Accepted risk determinants for conventional adenomas and CRC include age, male gender and familial history. The aim of our study was to outline the characteristics of colorectal polyps in our center, as well as to uncover associations between them and certain clinical presentations. Methods. We retrospectively collected the data available in a tertiary center of the patients that underwent colonoscopy for various indications (e.g.: rectorrhagia, abdominal pain, screening, anemia etc.) between the 1st of January 2022 and the 1st of August 2023. We analyzed the age, gender and symptoms of the patients. We analyzed the colorectal polyps detected. We classified the polyps based on location, size, shape, architecture and dysplasia grade. Statistical analysis was conducted to evaluate potential associations between their characteristics. Results. 248 subjects were identified and included in the study. There were 584 polyps uncovered during the colonoscopies in 248 subjects. 498 polyps were excised and retrieved; 44.5% were right-sided and 55.5% were left-sided. Most of the polyps were < 1 cm (78.2%). There were significantly more adenomatous polyps (68.8%) than non-adenomatous (31.2%). Most of the polyps had a low grade of dysplasia (59.8%). There were significant associations between the polyp size and dysplasia grade, number and location on the transverse colon. Polyps under 1 cm were more likely to be tubular (p=0.008). The age of the patients >50 years was associated with a greater number of polyps (p=0.002). There was a moderate statistically significant association (p=0.0297) between the male gender and the number of adenomatous polyps. Conclusions. Male gender, age greater than 50 years, history of colorectal polyps are risk factors for the development of colorectal polyps in the studied population. A history of more than 2 polyps and a size greater of 1 cm can be associated with higher rates of dysplasia.