Gastroenterology

AGA Best Practice Advice: managing CDI in patients with IBD

Exclude CDI promptly in IBD patients with new or worsening diarrhea, especially with colonic disease or ileostomy/pouch symptoms. Use multistep toxin testing for diagnosis rather than NAAT alone to avoid overdiagnosis. Prefer fidaxomicin for treatment in IBD patients when feasible, and treat CDI promptly to reduce flare risk. Consider microbiome-based therapies for recurrent CDI in IBD, while noting recommendations lack formal evidence-strength ratings. 1

AI-guided personalized microbiome modulation improved symptoms in oncology survivors

In this single-arm prospective study of 29 female oncology survivors, stool frequency fell from 4.69 to 2.07 episodes/day at three months (p < 0.0001). Self-reported energy rose markedly from 4.00 to 7.24 (p < 0.0001) alongside enrichment of butyrate-producing and barrier-supportive taxa. Change in Bifidobacterium longum correlated independently with stool frequency reduction (β = -0.783, p = 0.0082). The open-label, single-arm design limits causal inference; randomized trials are needed before routine adoption. 2

Scoping review: dietary trials in adult IBS — low FODMAP dominates

This scoping review mapped 71 articles from 57 trials of dietary interventions in adult IBS patients. Low FODMAP diets were the most frequently studied approach (n = 43) and often reduced GI symptoms versus baseline. Trials variably measured quality of life, nutrient intake, adherence, and psychological outcomes rather than consistent metabolic endpoints. When recommending restrictive diets, assess nutrition, anthropometry, and metabolic risks alongside symptom benefit. 3