Articles in 2025

Potassium-competitive acid blockers (P-CABs) overcome the limitations of proton pump inhibitors by providing faster, longer and stronger acid suppression without meal timing. Evidence shows that P-CABs are non-inferior for the management of mild erosive oesophagitis and superior for severe erosive oesophagitis, whereas data for non-erosive reflux disease remain conflicting.

Gastric and gastroesophageal junction adenocarcinoma remains a major global health challenge, with a rising incidence among younger individuals worldwide despite advances in biomarker-directed targeted therapies and immunotherapy. Current breakthroughs include perioperative immunotherapy, HER2-directed therapy sequencing and a decisive shift towards biomarker-driven treatment.

Chronic hepatitis B infection remains the dominant aetiology of liver-related complications and hepatocellular carcinoma. In 2025, key evidence emerged supporting the expansion of treatment criteria, confirming the feasibility of an RNA interference-based combination regimen to boost functional cure rate, and identifying low-risk individuals who might not require liver cancer surveillance.

In this Consensus Statement, an international panel of experts present an overview of the latest developments in the field of cholangiocarcinoma. A set of consensus recommendations and research priorities is provided.

In this Review, Altier and colleagues describe the mechanisms of chronic abdominal pain in inflammatory bowel disease (IBD). In addition, they discuss implications for IBD treatment and identify directions for future research.

In summary, 2025 has seen a shift in focus from pure therapeutic management to active disease prevention. The message is unambiguous. The next breakthrough in IBD will not emerge solely from new drugs or biologics, but from reimagining how we live, eat and engage with the microbial ecosystems that define our health.

Individuals living with human immunodeficiency virus infection are experiencing an increase in liver disease burden. This Review summarizes current knowledge on the burden of liver diseases in this population and provides insights into clinical management and future directions.

In this Review, Luedde and colleagues describe the complex role of regulated necrosis pathways, including necroptosis, pyroptosis and ferroptosis, in liver disease and cancer development. Potential therapeutic approaches modulating regulated cell death pathways in liver disease are explored.

Despite more women entering medicine, women in gastroenterology continue to experience disparities in training, research and career opportunities. United European Gastroenterology calls to ensure that everyone has equal access to opportunities, mentoring and supportive workplaces that will benefit both professionals and patients.

Despite the high incidence and mortality rates of hepatopancreatobiliary cancers in the African continent, epidemiological and clinical data are scarce. This Roadmap article describes the efforts of the Africa HepatoPancreatoBiliary Cancer Consortium to establish cancer registries in the region.

This Review examines how advances in tumour biology, immunogenomics and graft preservation are redefining surgical management of hepatocellular carcinoma. Malik et al. describe the shift from anatomical to biology-informed paradigms to individualize surgical decision-making.

A new case report of successful treatment of refractory ulcerative colitis with CD19-directed chimeric antigen receptor T cell therapy sheds light on the role of B lineage cells in disease pathogenesis and the possibility of an ‘immune reset’. This approach could reshape therapeutic strategies, although its long-term efficacy, safety and positioning remain open questions.

Patients with pancreatic exocrine insufficiency are treated with pancreatic enzyme replacement therapy. However, there are several challenges facing the future of this treatment, including infectious agents and the presence of microplastics and nanoplastics.

The liver is a key metabolic organ that influences metabolic homeostasis by communicating with the central nervous system. This Review discusses the role of gut–liver–brain communication in chronic liver disease, highlighting underlying mechanisms and signalling pathways.

In this Review, the authors discuss the role of the main IL-1 family members in gastrointestinal and liver diseases, focusing on preclinical and clinical research. Opportunities for therapeutic interventions are also outlined.