**1. Inflammatory Bowel Disease (IBD): Crohn’s & Ulcerative Colitis**
* **New biologics approved:**
In **Q1 2025**, the FDA approved **mirikizumab (Omvoh)** and **guselkumab (Tremfya)** for **moderately to severely active Crohn’s disease**, expanding the IL‑23 inhibitor class for both Crohn’s and ulcerative colitis ([HCP Live][1], [HCP Live][2]).
* **Icotrokinra (JNJ‑2113):**
A phase 2b trial (ANTHEM‑UC) reported significant clinical and endoscopic remission in UC patients by week 12, offering a novel inflammatory pathway target ([HCP Live][2]).
* **Microbiome-based and gut‑restorative therapies:**
Microba’s **MetaPanel** diagnostic identifies pathogens in \~21% of IBD flares, enabling more precise treatment decisions ([News.com.au][3]).
Additionally, their therapeutic candidate **MAP 315** is progressing to Phase 2 as a live‑biotherapeutic to restore gut health rather than merely suppress inflammation ([News.com.au][3]).
* **Vagus‑nerve stimulation (VNS):**
A recent clinical trial demonstrated that non‑invasive VNS reduced inflammation and symptoms in ulcerative colitis, suggesting it may become a useful adjunctive therapy ([TIME][4]).
---
## **2. Clostridioides difficile Infection (CDI)**
* **Fecal Microbiota Transplantation (FMT):**
Emerging data support FMT as a **first-line therapy** in hospitalized or recurrent CDI cases, showing superiority to vancomycin in some settings ([HCP Live][1]).
U.S. approvals include **Rebyota** (live fecal microbiota) in Nov 2022 and **Vowst** (spore‑based, oral formulation) in April 2023, improving accessibility ([Wikipedia][5]).
---
## **3. Gastrointestinal Bleeding**
* **AI‑assisted capsule endoscopy:**
A comprehensive review of machine learning applications in video capsule endoscopy demonstrated enhanced accuracy and speed in detecting bleeding sources—potentially reducing diagnostic delay and hospitalization duration ([arXiv][6]).
---
## **4. Imaging and Diagnostics**
* **Multi‑contrast laser endoscopy (MLE):**
Introduced in 2025, MLE enhances polyp and lesion detection during colonoscopy—tripling contrast and increasing color differentiation compared to standard white light or narrow-band imaging ([arXiv][7]).
* **Novel biomarkers for early detection:**
University of Birmingham research identified microbiome and metabolite signatures predictive of IBD, gastric and colorectal cancer. These biomarkers promise earlier, non-invasive diagnosis and personalized risk stratification ([News-Medical][8]).
---
## **5. Short Bowel Syndrome & Other GI Conditions**
* **Apraglutide (GLP‑2 analog):**
The Phase 3 STARS trial showed apraglutide reduced parenteral support requirements and improved fluid/weight management in short bowel syndrome. It may become available as early as 2026 via fast-track FDA evaluation ([Medscape][9]).
* \*\*Microbiome therapeutics for IBS-C & EoE:\*\*
Microbiome product **EBX‑102‑02** showed early signals of efficacy in constipation-dominant IBS.
Meanwhile, **barzolvolimab** (Phase 2) demonstrated mast cell depletion in eosinophilic esophagitis, offering targeted immunomodulation ([GastroScholar][10]).
---
## **6. Upper GI Cancers & Premalignant Lesions**
* **Enhanced endoscopic tools & AI:**
Recent cancer-focused imaging tools—magnification endoscopy, narrow-band imaging, confocal laser endomicroscopy, AI lesion detection—are significantly improving early detection and patient outcomes ([Verywell Health][11]).
* **Minimally invasive surgery and neoadjuvant protocols:**
Combining immunotherapy (e.g. durvalumab) with chemotherapy before surgery shows promise in reducing tumor size and recurrence risk; minimally invasive resection techniques further optimize recovery ([Verywell Health][11]).
---
## **Relevance to Dr. Rawat’s Practice**
Given Dr. Rawat’s focus on advanced endoscopy, capsule endoscopy, therapeutic endoscopy and GI bleeding management ([agraheartcentre.com][12]):
* **MLE and AI capsule technologies** align closely with his endoscopic expertise and can enhance lesion detection in upper/lower GI bleeding or early cancer screening.
* **Microbiome diagnostics and therapeutics** (MetaPanel, EBX‑102‑02, MAP 315, FMT) complement his IBD, IBS, CDI and gastroenteropathy patient population.
* **New biologics** like mirikizumab, guselkumab and icotrokinra complement his IBD surgical and medical management portfolio.
* **AI‑clinician systems for H. pylori personalization** (from recent research) may assist treatment decisions in refractory cases and reduce hospitalization for peptic ulcer complications ([News.com.au][3], [HCP Live][1], [arXiv][13]).
---
## **Conclusion & Clinical Outlook**
The landscape of hospitalized gastrointestinal care is rapidly evolving:
* **Precise diagnostics**—microbiome biomarkers, AI-guided imaging—are enabling earlier intervention.
* **Novel therapies**, from microbiome-based treatments to neural modulation and targeted biologics, are expanding beyond immunosuppression to restoration and modulation of gut health.
* **Technological advances** in imaging and capsules reduce invasive procedures and improve detection rates.
For Dr. Rawat, integrating these developments offers an opportunity to enhance patient outcomes across the spectrum—from acute C. difficile hospitalizations to complex IBD hospital management and early GI cancer detection.
If you’d like deeper detail on any specific treatment or trial, or practical steps for clinical incorporation, feel free to ask!
* [News.com.au](click here
* [Verywell Health](click here
* [TIME](click here
[1]: click here "Gastroenterology First Half Recap: 2025"
[2]: click here "Q1 2025 Recap: Gastroenterology News and Updates"
[3]: click here "Urgent health crisis to plague Australia"
[4]: click here "What to Know About Vagus Nerve Stimulation for IBD"
[5]: click here "Clostridioides difficile infection"
[6]: click here "Artificial Intelligence in Gastrointestinal Bleeding Analysis for Video Capsule Endoscopy: Insights, Innovations, and Prospects (2008-2023)"
[7]: click here "Multi-contrast laser endoscopy for in vivo gastrointestinal imaging"
[8]: click here "New biomarkers could help improve detection and treatment of gastrointestinal diseases"
[9]: click here "Promising New Drug Data for Several Common GI Conditions"
[10]: click here "Gastroenterology News Briefing: June 10-16, 2025 - GastroScholar"
[11]: click here "Advances in Upper Gastrointestinal Cancer Treatment"
[12]: click here "Dr. Karan R Rawat: The Most Acclaimed Gastroenterologist and Hepatologist » Agra Heart Centre"
[13]: click here "The Helicobacter p
ylori AI-Clinician: Harnessing Artificial Intelligence to Personalize H. pylori Treatment Recommendations"
