Gastroenterology/Hepatology: What You May Have Missed in 2025.

PubMed14 Apr 2026·Annals of internal medicine● 4/10i

Gastroenterology/Hepatology: What You May Have Missed in 2025.

AlAwadhi HK, Chang NH, Jogendran M, Bretthauer M

Nine gastroenterology and hepatology studies from 2025 showed treatment advances including new drug options for metabolic dysfunction-associated steatohepatitis and evidence that fecal microbiota transplantation matches vancomycin efficacy for first-episode C. difficile infection. Annual review of selected studies from major journals, details on study designs not specified in this overview. This compilation highlights emerging therapeutic options across multiple GI conditions that non-specialist clinicians commonly manage. Limited detail provided as this is a summary of multiple separate studies rather than primary research.

Strategic signal

The MASH treatment pipeline expansion validates the massive investment by Madrigal, Intercept, and others in this $35 billion market opportunity. FMT non-inferiority to vancomycin for C. diff creates competitive pressure on Ferring's Rebyota and could accelerate FDA approval pathways for additional FMT products. Aspirin's emergence in PI3K-positive colorectal cancer represents potential label expansion opportunity, though impact depends on biomarker prevalence and integration with existing oncology standards.

Liver/NASHOther

Original Abstract

During 2025, gastroenterology and hepatology experienced advances in treatment and surveillance of common diseases. Technological innovations have been reported that may positively affect patients worldwide. New drug options for treatment of metabolic dysfunction-associated steatohepatitis are emerging, and old drugs have new indications and patterns of use for common gastroenterologic diseases. The 9 articles featured here were selected because they represent important information for clinicians who are not gastroenterologists but who often diagnose, treat, and follow patients with gastroenterologic conditions. Two randomized trials address potential overtreatment of patients with Barrett esophagus without high-grade dysplasia and patients with severe alcohol-associated hepatitis. For clinicians who care for patients with malignant gastric outlet obstruction, 2 new randomized trials now provide evidence that a new endoscopic approach is a good alternative to traditional surgical gastroenterostomy or duodenal stenting. Aspirin is emerging as promising adjuvant therapy for patients with colorectal cancer that is positive for PI3K pathway alterations, and fecal microbiota transplantation has been shown to be noninferior to standard vancomycin for patients with a first episode of Clostridioides difficile infection. Finally, a randomized trial showed that structured exercise and training for patients with colon cancer after surgery and adjuvant oncologic treatment reduce recurrence and increase survival.

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