Purpose This narrative review evaluates the clinical value of key globally marketed potassium-competitive acid blockers (P-CABs) for acid-related diseases (ARDs) based on current evidence-based medical research to inform clinical practice. Methods We compare P-CABs and proton pump inhibitors (PPIs) in terms of their mechanisms of acid suppression, speed of onset, metabolic pathways, and long-term safety. We present a detailed comparison of the clinical efficacy of individual P-CABs and PPIs for gastroesophageal reflux disease (GERD), peptic ulcers, and Helicobacter pylori (H. pylori) eradication, synthesizing findings from recent clinical trials and meta-analyses. Results This highlights the advantages of P-CABs, such as rapid acid control and the achievement of maximal efficacy with the first dose, as well as their reduced susceptibility to CYP2C19 polymorphisms. Evidence suggests that P-CABs have potential advantages in the initial and maintenance treatment of erosive esophagitis (EE). P-CABs demonstrate non-inferiority to PPIs in ulcer healing. For H. pylori eradication, P-CABs are comparable to PPIs in standard regimens; however, P-CAB-based dual therapy (e.g., P-CAB + high-dose amoxicillin) is emerging as a promising first-line treatment option. Conclusion This review emphasizes the evolving role of P-CABs in optimizing management strategies for ARDs.

Background To explore the effect of 580 μg linaclotide combined with 2 L polyethylene glycol (PEG) in bowel preparation for overweight individuals and compare it with the 3 L PEG split-dose regimen. Methods Patients aged 18–70 years who were overweight were randomly assigned to two groups: 2 L PEG + 580 μg linaclotide (2 L PEG + 2 L) and 3 L PEG split-dose. The primary outcome was adequate bowel preparation, as assessed by the Boston Bowel Preparation Scale (BBPS). Secondary outcomes included cecal intubation rate, terminal ileum intubation rate, adverse events (AEs), willingness to repeat the preparation next time, and patient satisfaction score. Results A total of 240 patients were included in the analysis: 121 in the 2 L PEG + 2 L group and 119 in the 3 L PEG group. Adequate bowel preparation did not differ significantly between the two groups (p > 0.05). The incidence of nausea, vomiting, and abdominal discomfort was significantly lower in the 2 L PEG + 2 L group than in the 3 L PEG group (p < 0.05). The patient satisfaction score was significantly higher in the 2 L PEG + 2 L group than in the 3 L PEG group (p < 0.05). The 2 L PEG +2 L group had a significantly higher willingness to repeat bowel preparation than the 3 L PEG group (p < 0.05). Binary logistic regression revealed a significant increase in inadequate bowel preparation with increased BMI. Conclusions Among overweight individuals, the 2 L PEG + 2 L regimen provides equally effective bowel cleansing quality compared with the 3 L PEG regimen, while offering superior tolerability and patient satisfaction. It represents a preferable modified bowel preparation strategy for this population.

Purpose The purpose of this study was to review the clinical application of cold resection for colorectal polyps and determine its efficacy and safety for polyps of different sizes. Methods A narrative review was conducted to analyze and compare key indicators, including complete resection rate (CRR), bleeding rate, perforation rate, and recurrence rate, for polyps of different sizes undergoing cold versus hot resection. Results The CRR of cold snare polypectomy (CSP) for resecting colorectal polyps measuring ≤ 10 mm is comparable to that of hot resection. However, the risk of delayed bleeding and perforation is significantly lower with CSP. With nonpedunculated colorectal polyps measuring 10–19 mm, particularly sessile serrated lesions (SSLs), cold resection (e.g., piecemeal cold snare polypectomy (pCSP)) is a safe and feasible option. For colorectal adenomas, however, the risk of recurrence with cold resection may be slightly higher than with hot resection. For large (≥ 20 mm) sessile serrated lesions (L-SSLs), cold resection offers significant safety advantages; however, the risk of recurrence is higher than with hot resection. Due to the higher risk of recurrence, cold resection is not recommended for removing large (≥ 20 mm) nonpedunculated adenomatous polyps (LNPCPs). Cold resection is particularly suitable for patients taking anticoagulants and those in poor health who cannot tolerate complications. Conclusions Cold resection has become the standard treatment for small polyps due to its excellent safety profile. It is now also used for some larger polyps, particularly SSLs. However, strict adherence to histology guidance is crucial for larger polyps and adenomatous lesions because of the higher rate of postoperative recurrence.