Alcohol and metabolic dysfunction interaction: MetALD
Introduction In 2023, non-alcoholic fatty liver disease (NAFLD) was redefined as metabolic dysfunction-associated steatotic liver disease (MASLD), and likewise non-alcoholic steatohepatitis (NASH) was redefined as metabolic dysfunction-associated steatohepatitis (MASH). Within this new classification, a new category was proposed, currently termed MetALD (metabolic dysfunction and alcohol-related liver disease), which encompasses patients who meet criteria for MASLD […]
Metabolic hepatic steatosis and hepatocellular carcinoma
Introduction Liver cancer is currently the sixth most common cancer worldwide and the third leading cause of cancer death1. The most recent studies report that metabolic dysfunction-associated steatotic liver disease (MASLD) is the cause of hepatocellular carcinoma (HCC) with the greatest global increase2. MASLD-related HCC (MASLD-HCC) has particular characteristics that distinguish it from HCC of […]
Personalized dietary management in metabolic associated steatotic liver disease
Introduction Diet as a non-pharmacological therapeutic intervention is defined as the structured and personalized modification (based on physical characteristics and nutritional needs according to pathologies) of eating habits with the aim of improving the clinical and metabolic status of patients. Focusing on metabolic-associated steatotic liver disease (MASLD), nutritional intervention is the fundamental pillar of clinical […]
Pharmacological treatment of steatotic liver disease associated with metabolic dysfunction
Introduction Metabolic dysfunction-associated steatotic liver disease (MASLD) ranges from simple steatosis, metabolic dysfunction-associated steatohepatitis (MASH), or cirrhosis to even hepatocellular carcinoma1. Hepatic fibrosis is the main determinant of MASLD progression. Advanced fibrosis (stage ≥ 3) is associated with a higher risk of developing hepatic decompensation (ascites, variceal bleeding, and hepatic encephalopathy), need for liver transplantation, […]
Endoscopic options and bariatric surgery in metabolic dysfunction-associated steatotic liver disease
Introduction First-line treatment for metabolic dysfunction-associated steatotic liver disease (MASLD) consists of intensive lifestyle changes, with the goal of achieving weight loss greater than 7-10% to obtain histological improvement1. However, it has been shown that less than 10% of patients achieve these goals in a sustained manner with conventional dietary and medical therapy, which underscores […]
Gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) is one of the most prevalent digestive disorders worldwide and is a leading reason for medical care in Mexico. With a prevalence ranging from 10% to 20% in the general population of Western countries, and similar figures reported in Mexican studies, GERD not only significantly affects patients’ quality of life but […]
Definition, epidemiology, and risk factors of gastroesophageal reflux disease
Introduction Gastroesophageal reflux disease (GERD) is defined as a condition that develops when reflux of gastroduodenal contents into the esophagus causes troublesome symptoms or complications. The term “troublesome” refers to symptoms that interfere with the patient’s well-being and negatively affect quality of life1. This definition recognizes that GERD is not limited to the presence of […]
Pathophysiology of gastroesophageal reflux disease
Introduction The pathophysiology of gastroesophageal reflux disease (GERD) is complex and multifactorial. Unlike the traditional concept that attributed the disease to acid hypersecretion, it is now recognized that the development of GERD involves a dynamic imbalance between aggressor factors – such as the acidity of gastric contents, the frequency of reflux events, and esophageal sensitivity […]
Gastroesophageal reflux disease classification and subtypes
Introduction Gastroesophageal reflux disease (GERD) is one of the most frequent diseases worldwide. The prevalence rate is estimated to range between 13% and 20% of the general population, although there is considerable regional variability1,2. GERD, as defined by the Montreal consensus, is a condition in which symptoms are recognized as esophageal manifestations (further divided into […]
Clinical suspicion and diagnostic strategies in gastroesophageal reflux disease
Introduction GERD is characterized by the recurrent presence of heartburn and regurgitation, considered bothersome by the patient, as well as by the appearance of specific complications of the disease. When diagnostic studies (endoscopy or pH monitoring) have not been performed to confirm it, it is defined as unproven GERD. In contrast, if there are findings […]