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Its a vicious cycle: physical discomfort raises stress levels further, and the gut gets stuck in a constant state of tension

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Methods A comprehensive literature search was conducted in Scopus, PubMed, and Web of Science for studies published between 1993 and 2023, using a combination of Medical Subject Headings (MeSH) terms and expert-defined keywords

This review differentiates between low-dose methotrexate used in autoimmune diseases and high-dose methotrexate used in oncology, emphasizing mechanistic differences in hepatotoxicity pathways, integrating MASLD-related risk factors, and summarizing current non-invasive diagnostic strategies