Summary: Background: Oesophageal disorders and chronic liver disease are common worldwide and significantly impact quality of life. The intricate link between these conditions, including how oesophageal disorders like GERD, Barrett's oesophagus and oesophageal cancer affect and are affected by chronic liver disease, remains poorly understood. Aims: To review the relationship between oesophageal disorders and chronic liver disease, evaluating epidemiology, pathophysiology and therapeutic factors. Methods: We reviewed the literature on the relationship between oesophageal disorders and chronic liver disease, including cirrhosis, using the PubMed database Results: Oesophageal disorders such as gastroesophageal reflux disease, Barrett's oesophagus, oesophageal cancer, oesophageal motor disorders and oesophageal candidiasis are prevalent among individuals with cirrhosis, exacerbating the burden of liver disease. These diseases have a multifaceted symptomatology and pathogenic basis, posing a significant challenge in cirrhotic patients that necessitates careful diagnosis and management. Additionally, therapies frequently used for these diseases, such as proton pump inhibitors, require careful consideration in cirrhotic patients due to potential adverse effects and altered pharmacokinetics. Managing oesophageal disorders in cirrhotic patients requires a cautious approach due to possible interactions with medications and the risk of adverse effects. Furthermore, symptoms associated with these conditions are often exacerbated by common interventions in patients with cirrhosis, such as band ligation for oesophageal varices. Conclusions: Oesophageal disorders are common in cirrhosis and increase the disease burden. These conditions require careful management due to complex symptoms and treatment risks. Proton pump inhibitors and other therapies must be used cautiously, as cirrhosis interventions can worsen symptoms.

Gastric infection by Helicobacter pylori has a variable prevalence worldwide. In Latin America, it can exceed 50% of infected people. It is associated with peptic ulcer, gastric cancer, MALT lymphoma, immune thrombocytopenic purpura, among other pathologies. There is no optimal diagnostic method, and its presence can be detected by both invasive methods that require an upper gastrointestinal endoscopy, and non-invasive methods. Within the invasive, we have the rapid urease test, histology, molecular tests such as polymerase chain reaction and culture. On the other hand, non-invasive tests include the breath test, Helicobacter pylori antigen in stools, polymerase chain reaction in stools and serology. Depending on the clinical scenario, the diagnostic test to be used, its benefits and weaknesses should be known. It is important to consider the age of the patient, their gastric cancer risk factors, the need for endoscopy for this or another reason, the availability of diagnostic tests and the cost, among others.

Neurogastroenterology and motility disorders are complex gastrointestinal conditions that are prevalent worldwide, particularly affecting women and younger individuals. These conditions significantly impact the quality of life of people suffering from them. There is increasing evidence linking these disorders to cirrhosis, with a higher prevalence compared to the general population. However, the link between neurogastroenterology and motility disorders and cirrhosis remains unclear due to undefined mechanisms. In addition, managing these conditions in cirrhosis is often limited by the adverse effects of drugs commonly used for these disorders, presenting a significant clinical challenge in the routine management of patients with cirrhosis. This review delves into this connection, exploring potential pathophysiological links and clinical interventions between neurogastroenterology disorders and cirrhosis. Export

Objectives: Conclusive diagnosis of gastroesophageal reflux disease (GERD) can be challenging. When reflux monitoring is inconclusive, high-resolution esophageal manometry (HRM) may provide additional relevant information. We aimed to identify demographic and manometric parameters associated with GERD and to propose a diagnostic score. Methods: Adult patients with GERD symptoms who underwent reflux monitoring and HRM were considered for inclusion. The gold standard for GERD diagnosis was acid exposure time (AET); patients with AET>6% and AET6%) and 224 did not have GERD (AET<4%). In the multivariate analysis, age, male sex, and the distance between the lower esophageal sphincter and the crural diaphragm (LES-CD) were directly associated with GERD, while esophagogastric junction contractile integral (EGJ-CI) and distal contractile integral (DCI) were inversely associated with GERD (p values: 0.03, <0.01, <0.01, 0.01, and 0.01, respectively). The AUC ROC of a diagnostic score based on these parameters was 0.76 and 0.82 in the generation and validation cohorts, respectively. Conclusions: In this observational study, age, male sex, LES-CD distance, EGJ-CI, and DCI (AGES-D) were independently associated with GERD. A novel score incorporating these parameters could be useful in the assessment of inconclusive cases.