Gastroenterology

Pages we plan to refresh

• MELD / MELD-Na: this is one of our highest-priority updates. The current transplant-allocation MELD formula changed in July 2023. We plan to rebuild the GlobalRPh calculator around the current variables and clearly identify older MELD and MELD-Na formulas as historical.
• Rome III / Rome IV: we plan to make Rome IV the primary IBS diagnostic page, retain Rome III as a historical/research reference, and improve the explanation of disorders of gut-brain interaction and red-flag features that require evaluation outside a symptom-based framework.
• IBS Treatment Options: the existing page contains useful material but an older reference base. We plan to incorporate current dietary therapy, soluble fiber, secretagogues, rifaximin, neuromodulators, digital CBT, pelvic-floor considerations and evidence around microbiome-directed approaches.
• IBD Drug Table / TNF Inhibitors: we plan to expand this beyond older TNF-centered treatment pathways to reflect current biologics, small molecules, treatment sequencing, treat-to-target concepts, preventive care, infection screening and the 2025 Crohn’s and ulcerative-colitis guidelines.
• Crohn’s and ulcerative-colitis scores: we plan to preserve CDAI, Harvey-Bradshaw and Mayo scoring while making it clearer how symptom scores relate to biomarkers, endoscopy, imaging and modern treatment targets.
• H. pylori Drug Table: we plan to rebuild the regimen table around the 2024 ACG guideline, antibiotic resistance, optimized bismuth quadruple therapy, susceptibility-guided therapy, rifabutin/vonoprazan options where appropriate and confirmation of eradication.
• PPI / H2 / antacid tables: we plan to update currently marketed products, comparative acid suppression, indications, interaction concerns, long-term-use considerations and the evolving role of potassium-competitive acid blockers.
• Upper GI bleeding scores: we plan to retain Glasgow-Blatchford, Rockall and Forrest classification while updating their clinical context, pre-endoscopic triage, transfusion strategy, PPI use, timing of endoscopy and anticoagulant-management links.
• Ranson’s Criteria: we plan to preserve this historically important pancreatitis score while adding contemporary acute-pancreatitis context, including risk assessment, fluid strategy, early feeding, biliary disease evaluation and when higher-acuity monitoring is warranted.
• Laxatives / constipation therapy: we plan to update the older drug table around current chronic idiopathic constipation pharmacotherapy, secretagogues, prokinetic therapy, opioid-induced constipation and appropriate evaluation of secondary causes.
• Antidiarrheals / antispasmodics / anticholinergics / antiemetics: we plan to re-check current product availability, contraindications, geriatric considerations, QT risk, drug interactions and syndrome-specific use.
• Alcohol-associated hepatitis scores: we plan to retain ABIC, AHHS, GAHS, Lille and Maddrey while updating terminology, treatment context, current guideline links and the distinction between prognostic scoring and treatment eligibility.
• MASLD / MASH tools: we plan to add a stronger noninvasive fibrosis-assessment pathway and connect future tools with current AASLD guidance, metabolic-risk assessment and newer pharmacotherapy.
• Endoscopy content: we plan to continue expanding the portal around modern surveillance intervals, bowel-preparation quality, advanced endoscopic resection, AI-assisted detection and post-polypectomy follow-up.