Gastroenterology 'Under Review': What Each Status Means and When to Expect a Decision

Before the paper reaches external reviewers, an AGA associate editor at Gastroenterology evaluates whether the GI significance warrants Gastroenterology's selective editorial slots. Desk rejections often arrive within 1 to 2 weeks per AGA editorial guidance. A desk rejection most often means the associate editor concluded that the work would fit better at a sister AGA title (Clinical Gastroenterology and Hepatology for clinical-practice focus, Cellular and Molecular Gastroenterology and Hepatology for basic-GI mechanism) or that the broad-GI audience appeal is uncertain.

The AGA editorial office confirms files are complete: manuscript with figures embedded, supplementary information separate, reporting checklists where applicable (CONSORT for clinical trials, STROBE for observational GI studies, ARRIVE for animal GI work, MIQE for quantitative PCR, STARD for diagnostic-accuracy studies), cover letter directed to the editor, conflict-of-interest declarations, ethics-statement documentation, IRB approvals for human-subjects research, and statistical analysis plan for clinical-trial submissions. CGH strongly encourages authors to suggest 3 to 4 referees with their email addresses, phone, and fax numbers.

The associate editor reads the paper and evaluates GI significance, methodological rigor, and broad-GI audience fit. Most desk rejections happen here within 1 to 2 weeks.

In parallel with the associate editor's primary read, ambiguous-fit papers are discussed at the AGA editor meeting where peer associate editors at sister AGA titles weigh in on whether the paper would fit better at Gastroenterology, Clinical Gastroenterology and Hepatology, or Cellular and Molecular Gastroenterology and Hepatology. This editorial-team discussion runs alongside the desk-screen and adds 3 to 5 days to the timeline that is invisible to the author in the portal.

AGA associate editors at Gastroenterology typically invite a minimum of 2 to 3 independent reviewers. The recruitment window can take 7 to 14 days because GI reviewers with topic-matched expertise are scarce. The author-suggested reviewer model used at CGH (3 to 4 author suggestions) accelerates recruitment substantially compared to journals where editors find reviewers entirely independently.

Once reviewers agree to review, the duration of the review process varies for each manuscript, typically ranging from 2 to 8 weeks per AGA editorial guidance. This timeline depends on the quality of the submission and the availability of reviewers. Reviewers are asked to evaluate GI significance, methodological rigor, and reproducibility. Reviewer reports for Gastroenterology tend to be thorough; 1500 to 3000 word reports are typical.

After reports return, the associate editor synthesizes them. The 3-week average from submission to editorial decision per AGA guidance reflects the combined desk-decision + reviewer-recruitment + active-review + synthesis cycle for fast-track papers; full-review papers extend to the 2-to-8-week range.

• Rejection within 1 to 5 days: Administrative issue or immediate scope mismatch.

• Rejection within 1 to 2 weeks: Associate editor desk rejection. Most rejections happen here.

• Still Under Review after 3 weeks: Strong signal. Paper passed the steepest AGA filter.

• Still Under Review after 8 weeks: Reviewer-recruitment or reviewer-report delay near the upper end of the 2 to 8 week range. A polite inquiry via the submission portal is appropriate.

• Status changes to "Reports Received": Reports are in; expect a decision within 1 to 2 weeks.

This is the most common anxiety we hear from Gastroenterology authors during the active editorial window. The honest answer: no, 4 weeks at Under Review means your paper passed the associate editor desk screen and is now in active external peer review. Gastroenterology's 2 to 8 week review-process range means 4 weeks puts you mid-cycle. Most reviewer-driven delays come from reviewer-recruitment timing for GI specialists rather than slow reviews.

If the portal still says Under Review at the 6-week mark, the most likely explanation is that one of the assigned reviewers asked for an extension and the associate editor granted it. This is normal practice at AGA.

During the 4-to-6-week window, hold the status inquiry unless the manuscript record shows a technical problem, an ethics disclosure changes, or an urgent funding or conference deadline requires documentation. A useful inquiry names the manuscript ID, current status, submission date, and one concrete reason for the check; it should not ask whether the paper is likely to be accepted.

If your Gastroenterology paper is rejected after review, the natural cascade depends on what the reviewers and associate editor cited:

Clinical Gastroenterology and Hepatology (CGH) is the most natural AGA cascade for papers with clinical-practice focus rather than broad-GI significance. AGA supports manuscript-transfer within the AGA family with reviewer reports preserved. The transfer process takes 5 to 10 days.

Cellular and Molecular Gastroenterology and Hepatology (CMGH) is the AGA cascade for basic-GI mechanism papers where the molecular mechanism is stronger than the clinical relevance.

Gut is the BMJ cascade option for European-GI-focused work. BMJ operates independently from AGA; reports do not transfer.

Hepatology is the AASLD cascade option for hepatology-specific papers where the AASLD focus is more appropriate than broad-GI.

AGA asks reviewers at Gastroenterology to evaluate four things specifically. The table below maps each to actionable preparation.

In our pre-submission work with Gastroenterology manuscripts, three patterns generate the most consistent reviewer concerns we see at Gastroenterology. The recurring issue is not usually a missing portal step. It is that the manuscript asks AGA reviewers to infer the broad-GI consequence from specialist detail instead of making the cross-field reader's reason to care explicit.

Narrow GI subfield framing flagged for broad-audience fit. When the introduction frames the work too narrowly around one GI subfield without broader-GI generalization, AGA reviewers consistently flag broad-audience concerns. The strongest manuscripts frame around broader GI principles.

Check your broad-GI framing →

CONSORT/ARRIVE-compliance gaps surface as reviewer requests for clarification. When reporting-checklist items are incomplete or animal-study documentation is thin, AGA reviewers consistently flag for revision. The 2-week minimum reviewer turnaround means initial reports often request quick compliance fixes.

Check your reporting and methods package →

AGA venue mismatch flagged by associate editor. When the associate editor concludes the work is sound but the broad-GI audience appeal is uncertain, transfer offers to Clinical Gastroenterology and Hepatology or Cellular and Molecular Gastroenterology and Hepatology are common. AGA editors take these transfers seriously.

Check your Gastroenterology versus AGA sister-title route →

We have reviewed 50+ manuscripts targeting Gastroenterology, Gut, Hepatology, and Clinical Gastroenterology and Hepatology. Full Manusights reviews include a 60-day money-back guarantee, and we do not train models on your manuscript.

In the 100-manuscript Manusights sample across GI and liver targets, Manusights internal analysis identifies five recurring preventable risks before peer review: a narrow disease-niche claim, incomplete checklist traceability, under-described animal or diagnostic methods, weak data-transparency language, and a mismatch between AGA flagship scope and a stronger sister-journal route. Source limitation: official guidance explains submission rules and peer-review policy, but it cannot diagnose whether your abstract, first figure or table, methods appendix, reporting package, and cover letter satisfy Gastroenterology's broad-GI bar.

This page was created from AGA's public author guidance at Elsevier author instructions, AGA editorial documentation including the 3-week average decision target, 2 minimum reviewer policy, and 2-to-8-week review-process range, and Manusights pre-submission review experience with Gastroenterology-targeted manuscripts.

For the AGA GI landscape beyond Gastroenterology, see Clinical Gastroenterology and Hepatology (clinical-practice focus), Cellular and Molecular Gastroenterology and Hepatology (basic-GI mechanism), and sister GI titles (Gut, Hepatology, Inflammatory Bowel Diseases). The choice across these titles depends on whether the central contribution is broad-GI-significance (Gastroenterology), clinical-practice (CGH), basic-mechanism (CMGH), European-GI (Gut), or hepatology-specific (Hepatology).

Reviewers at Gastroenterology typically draw from one clinical gastroenterologist and one basic-GI or methodologist specialist. Preparing a response template that addresses both perspectives accelerates revision rounds substantially.

For a pre-upload check of your manuscript against the Gastroenterology GI-significance-plus-methodological-rigor bar before submission, our Gastroenterology pre-submission diagnostic flags the framing weaknesses and reporting-checklist gaps most likely to surface in reviewer reports.