Nature Reviews Gastroenterology & Hepatology Nature Reviews Gastroenterology & Hepatology provides physicians and academics with authoritative and topical discussions of key developments in the field. http://www.nature.com/nrgastro/current_issue/ Nature Publishing Group en © 2009 Nature Publishing Group Nature Reviews Gastroenterology & Hepatology 1759-5045 1759-5053 © 2009 Nature Publishing Group permissions@nature.com Nature Reviews Gastroenterology & Hepatology http://www.nature.com/includes/rj_globnavimages/nrgastro_logo.gif http://www.nature.com/nrgastro/ The burdens of digestive diseases http://dx.doi.org/10.1038/nrgastro.2009.104 Although this journal has an international readership, a recent publication (Everhart, J. E. US Department of Health and Human Services NIDDK National Institute of Diabetes and Digestive and Kidney Diseases [online], [2009]) provides an interesting reference point for the incidence, prevalence and The burdens of digestive diseases

Nature Reviews Gastroenterology & Hepatology 6, 377 (2009). doi:10.1038/nrgastro.2009.104

Author: Stephen B. Hanauer

Although this journal has an international readership, a recent publication (Everhart, J. E. US Department of Health and Human Services NIDDK National Institute of Diabetes and Digestive and Kidney Diseases [online], [2009]) provides an interesting reference point for the incidence, prevalence and

]]> The burdens of digestive diseases Stephen B. Hanauer doi:10.1038/nrgastro.2009.104 Nature Reviews Gastroenterology & Hepatology 6, 377 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.104 http://dx.doi.org/10.1038/nrgastro.2009.104 6 7 Editorial 377 377 Liver: Simvastatin might be an effective therapy for portal hypertension in cirrhosis http://dx.doi.org/10.1038/nrgastro.2009.96 Liver: Simvastatin might be an effective therapy for portal hypertension in cirrhosis

Nature Reviews Gastroenterology & Hepatology 6, 379 (2009). doi:10.1038/nrgastro.2009.96

Author: Rachel Jones

]]> Liver: Simvastatin might be an effective therapy for portal hypertension in cirrhosis Rachel Jones doi:10.1038/nrgastro.2009.96 Nature Reviews Gastroenterology & Hepatology 6, 379 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.96 http://dx.doi.org/10.1038/nrgastro.2009.96 6 7 Research Highlight 379 379 Hepatitis C: Angiotensin blockade—halting liver fibrosis http://dx.doi.org/10.1038/nrgastro.2009.91 Hepatitis C: Angiotensin blockade—halting liver fibrosis

Nature Reviews Gastroenterology & Hepatology 6, 380 (2009). doi:10.1038/nrgastro.2009.91

Author: Susan J. Allison

]]> Hepatitis C: Angiotensin blockade—halting liver fibrosis Susan J. Allison doi:10.1038/nrgastro.2009.91 Nature Reviews Gastroenterology & Hepatology 6, 380 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.91 http://dx.doi.org/10.1038/nrgastro.2009.91 6 7 Research Highlight 380 380 Cirrhosis: PPI use is associated with bacterial peritonitis http://dx.doi.org/10.1038/nrgastro.2009.98 Cirrhosis: PPI use is associated with bacterial peritonitis

Nature Reviews Gastroenterology & Hepatology 6, 380 (2009). doi:10.1038/nrgastro.2009.98

Author: Ezzie Hutchinson

]]> Cirrhosis: PPI use is associated with bacterial peritonitis Ezzie Hutchinson doi:10.1038/nrgastro.2009.98 Nature Reviews Gastroenterology & Hepatology 6, 380 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.98 http://dx.doi.org/10.1038/nrgastro.2009.98 6 7 Research Highlight 380 380 Targeted therapy proves promising http://dx.doi.org/10.1038/nrgastro.2009.76 Targeted therapy proves promising

Nature Reviews Gastroenterology & Hepatology 6, 381 (2009). doi:10.1038/nrgastro.2009.76

Author: Susan J. Allison

]]> Targeted therapy proves promising Susan J. Allison doi:10.1038/nrgastro.2009.76 Nature Reviews Gastroenterology & Hepatology 6, 381 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.76 http://dx.doi.org/10.1038/nrgastro.2009.76 6 7 Research Highlight 381 381 Celiac disease: Increased celiac disease in IBS http://dx.doi.org/10.1038/nrgastro.2009.93 Celiac disease: Increased celiac disease in IBS

Nature Reviews Gastroenterology & Hepatology 6, 381 (2009). doi:10.1038/nrgastro.2009.93

Author: Ezzie Hutchinson

]]> Celiac disease: Increased celiac disease in IBS Ezzie Hutchinson doi:10.1038/nrgastro.2009.93 Nature Reviews Gastroenterology & Hepatology 6, 381 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.93 http://dx.doi.org/10.1038/nrgastro.2009.93 6 7 Research Highlight 381 381 Surgery: Acute appendicitis—antibiotics versus appendicectomy http://dx.doi.org/10.1038/nrgastro.2009.95 Surgery: Acute appendicitis—antibiotics versus appendicectomy

Nature Reviews Gastroenterology & Hepatology 6, 381 (2009). doi:10.1038/nrgastro.2009.95

Author: Lisa Richards

]]> Surgery: Acute appendicitis—antibiotics versus appendicectomy Lisa Richards doi:10.1038/nrgastro.2009.95 Nature Reviews Gastroenterology & Hepatology 6, 381 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.95 http://dx.doi.org/10.1038/nrgastro.2009.95 6 7 Research Highlight 381 381 Large intestine: Exercise decreases risk of diverticular complications http://dx.doi.org/10.1038/nrgastro.2009.94 Large intestine: Exercise decreases risk of diverticular complications

Nature Reviews Gastroenterology & Hepatology 6, 382 (2009). doi:10.1038/nrgastro.2009.94

Author: Rachel Jones

]]> Large intestine: Exercise decreases risk of diverticular complications Rachel Jones doi:10.1038/nrgastro.2009.94 Nature Reviews Gastroenterology & Hepatology 6, 382 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.94 http://dx.doi.org/10.1038/nrgastro.2009.94 6 7 Research Highlight 382 382 Pancreas: EUS-guided celiac plexus block for pain management http://dx.doi.org/10.1038/nrgastro.2009.97 Pancreas: EUS-guided celiac plexus block for pain management

Nature Reviews Gastroenterology & Hepatology 6, 382 (2009). doi:10.1038/nrgastro.2009.97

Author: Susan J. Allison

]]> Pancreas: EUS-guided celiac plexus block for pain management Susan J. Allison doi:10.1038/nrgastro.2009.97 Nature Reviews Gastroenterology & Hepatology 6, 382 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.97 http://dx.doi.org/10.1038/nrgastro.2009.97 6 7 Research Highlight 382 382 Hepatitis: HCV variability, the immune system and resistance to antiviral drugs http://dx.doi.org/10.1038/nrgastro.2009.102 Several novel antiviral treatments for HCV are in preclinical or clinical development, and most target viral enzymes and their functions. These new drugs all potentially select for resistant viral variants, both in vitro and in vivo; viral resistance is, therefore, likely to become an important issue in clinical practice. Hepatitis: HCV variability, the immune system and resistance to antiviral drugs

Nature Reviews Gastroenterology & Hepatology 6, 383 (2009). doi:10.1038/nrgastro.2009.102

Author: Jean-Michel Pawlotsky

Several novel antiviral treatments for HCV are in preclinical or clinical development, and most target viral enzymes and their functions. These new drugs all potentially select for resistant viral variants, both in vitro and in vivo; viral resistance is, therefore, likely to become an important issue in clinical practice.

]]> Hepatitis: HCV variability, the immune system and resistance to antiviral drugs Jean-Michel Pawlotsky doi:10.1038/nrgastro.2009.102 Nature Reviews Gastroenterology & Hepatology 6, 383 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.102 http://dx.doi.org/10.1038/nrgastro.2009.102 6 7 News and Views 383 385 Stomach: Quadruple therapy for Helicobacter pylori eradication http://dx.doi.org/10.1038/nrgastro.2009.101 The low success rates of standard triple-therapy regimens for eradication of Helicobacter pylori infection have led to development of alternative approaches. Findings from a new meta-analysis that compared the efficacy of concomitant quadruple therapy with that of standard triple therapy revealed the concomitant approach to be superior for eradication of H. pylori. Stomach: Quadruple therapy for Helicobacter pylori eradication

Nature Reviews Gastroenterology & Hepatology 6, 385 (2009). doi:10.1038/nrgastro.2009.101

Author: Javier P. Gisbert

The low success rates of standard triple-therapy regimens for eradication of Helicobacter pylori infection have led to development of alternative approaches. Findings from a new meta-analysis that compared the efficacy of concomitant quadruple therapy with that of standard triple therapy revealed the concomitant approach to be superior for eradication of H. pylori.

]]> Stomach: Quadruple therapy for Helicobacter pylori eradication Javier P. Gisbert doi:10.1038/nrgastro.2009.101 Nature Reviews Gastroenterology & Hepatology 6, 385 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.101 http://dx.doi.org/10.1038/nrgastro.2009.101 6 7 News and Views 385 386 Ulcerative colitis: Natural history—an optimistic message from Norway http://dx.doi.org/10.1038/nrgastro.2009.100 Selection of an optimum treatment regimen for patients with ulcerative colitis depends on several factors, including the natural history of the disease. A new study indicates that prognosis for patients with newly diagnosed ulcerative colitis might not be as bad as typically thought—an important finding that should be taken into account when the risks and benefits of future treatment strategies are discussed. Ulcerative colitis: Natural history—an optimistic message from Norway

Nature Reviews Gastroenterology & Hepatology 6, 387 (2009). doi:10.1038/nrgastro.2009.100

Authors: Laurent Peyrin-Biroulet & Jean-Frederic Colombel

Selection of an optimum treatment regimen for patients with ulcerative colitis depends on several factors, including the natural history of the disease. A new study indicates that prognosis for patients with newly diagnosed ulcerative colitis might not be as bad as typically thought—an important finding that should be taken into account when the risks and benefits of future treatment strategies are discussed.

]]> Ulcerative colitis: Natural history—an optimistic message from Norway Laurent Peyrin-Biroulet Jean-Frederic Colombel doi:10.1038/nrgastro.2009.100 Nature Reviews Gastroenterology & Hepatology 6, 387 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.100 http://dx.doi.org/10.1038/nrgastro.2009.100 6 7 News and Views 387 388 Surgery: New indications for laparoscopic sigmoidectomy http://dx.doi.org/10.1038/nrgastro.2009.99 Current recommendations for the performance of laparoscopic sigmoidectomy in patients with diverticulitis reserve this procedure for individuals who have complications of the disease or have had numerous, severe disease episodes. Findings from a 2009 study challenge this dogma and suggest that patients' quality of life should also be considered. Surgery: New indications for laparoscopic sigmoidectomy

Nature Reviews Gastroenterology & Hepatology 6, 388 (2009). doi:10.1038/nrgastro.2009.99

Authors: Badma Bashankaev & Steven D. Wexner

Current recommendations for the performance of laparoscopic sigmoidectomy in patients with diverticulitis reserve this procedure for individuals who have complications of the disease or have had numerous, severe disease episodes. Findings from a 2009 study challenge this dogma and suggest that patients' quality of life should also be considered.

]]> Surgery: New indications for laparoscopic sigmoidectomy Badma Bashankaev Steven D. Wexner doi:10.1038/nrgastro.2009.99 Nature Reviews Gastroenterology & Hepatology 6, 388 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.99 http://dx.doi.org/10.1038/nrgastro.2009.99 6 7 News and Views 388 390 Surgery: Laparoscopy for suspected appendicitis http://dx.doi.org/10.1038/nrgastro.2009.85 The routine use of diagnostic laparoscopy for young women who present with right iliac fossa pain reduces the rate of negative appendectomy, according to a new study. However, the implementation of laparoscopy as a routine approach for the diagnosis of suspected acute appendicitis would probably increase morbidity and mortality for these patients. Surgery: Laparoscopy for suspected appendicitis

Nature Reviews Gastroenterology & Hepatology 6, 390 (2009). doi:10.1038/nrgastro.2009.85

Author: Roland E. Andersson

The routine use of diagnostic laparoscopy for young women who present with right iliac fossa pain reduces the rate of negative appendectomy, according to a new study. However, the implementation of laparoscopy as a routine approach for the diagnosis of suspected acute appendicitis would probably increase morbidity and mortality for these patients.

]]> Surgery: Laparoscopy for suspected appendicitis Roland E. Andersson doi:10.1038/nrgastro.2009.85 Nature Reviews Gastroenterology & Hepatology 6, 390 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.85 http://dx.doi.org/10.1038/nrgastro.2009.85 6 7 News and Views 390 391 Mucosal ablation of Barrett esophagus http://dx.doi.org/10.1038/nrgastro.2009.90 The management of Barrett esophagus is evolving with the emergence of new endoscopic technologies. Traditionally, patients with high-grade dysplasia or cancer were referred for esophagectomy. However, with the advent of endoscopic ablative therapies for Barrett esophagus, the treatment paradigm has shifted. Patients with high-grade dysplasia Mucosal ablation of Barrett esophagus

Nature Reviews Gastroenterology & Hepatology 6, 393 (2009). doi:10.1038/nrgastro.2009.90

Authors: Irving Waxman & Vani J. A. Konda

The management of Barrett esophagus is evolving with the emergence of new endoscopic technologies. Traditionally, patients with high-grade dysplasia or cancer were referred for esophagectomy. However, with the advent of endoscopic ablative therapies for Barrett esophagus, the treatment paradigm has shifted. Patients with high-grade dysplasia

]]> Mucosal ablation of Barrett esophagus Irving Waxman Vani J. A. Konda doi:10.1038/nrgastro.2009.90 Nature Reviews Gastroenterology & Hepatology 6, 393 (2009) 2009-06-02 Nature Reviews Gastroenterology & Hepatology 2009-06-02 10.1038/nrgastro.2009.90 http://dx.doi.org/10.1038/nrgastro.2009.90 6 7 Review 393 401 New and experimental therapies for HCV http://dx.doi.org/10.1038/nrgastro.2009.92 Despite improvements to treatments for HCV infection, almost half of patients cannot be cured with standard combination therapy (pegylated interferon α and ribavirin). The HCV life cycle offers a number of potential targets for molecular therapy, and several specifically targeted antiviral therapies for HCV (STAT-Cs) New and experimental therapies for HCV

Nature Reviews Gastroenterology & Hepatology 6, 403 (2009). doi:10.1038/nrgastro.2009.92

Authors: Arema A. Pereira & Ira M. Jacobson

Despite improvements to treatments for HCV infection, almost half of patients cannot be cured with standard combination therapy (pegylated interferon α and ribavirin). The HCV life cycle offers a number of potential targets for molecular therapy, and several specifically targeted antiviral therapies for HCV (STAT-Cs)

]]> New and experimental therapies for HCV Arema A. Pereira Ira M. Jacobson doi:10.1038/nrgastro.2009.92 Nature Reviews Gastroenterology & Hepatology 6, 403 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.92 http://dx.doi.org/10.1038/nrgastro.2009.92 6 7 Review 403 411 Pancreatic cancer: molecular pathogenesis and new therapeutic targets http://dx.doi.org/10.1038/nrgastro.2009.89 Patients with pancreatic cancer normally present with advanced disease that is lethal and notoriously difficult to treat. Survival has not improved dramatically despite routine use of chemotherapy and radiotherapy; this situation signifies an urgent need for novel therapeutic approaches. Over the past decade, a large Pancreatic cancer: molecular pathogenesis and new therapeutic targets

Nature Reviews Gastroenterology & Hepatology 6, 412 (2009). doi:10.1038/nrgastro.2009.89

Authors: Han H. Wong & Nicholas R. Lemoine

Patients with pancreatic cancer normally present with advanced disease that is lethal and notoriously difficult to treat. Survival has not improved dramatically despite routine use of chemotherapy and radiotherapy; this situation signifies an urgent need for novel therapeutic approaches. Over the past decade, a large

]]> Pancreatic cancer: molecular pathogenesis and new therapeutic targets Han H. Wong Nicholas R. Lemoine doi:10.1038/nrgastro.2009.89 Nature Reviews Gastroenterology & Hepatology 6, 412 (2009) 2009-06-09 Nature Reviews Gastroenterology & Hepatology 2009-06-09 10.1038/nrgastro.2009.89 http://dx.doi.org/10.1038/nrgastro.2009.89 6 7 Review 412 422 Targeted therapy for hepatocellular carcinoma http://dx.doi.org/10.1038/nrgastro.2009.86 Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. The major etiologies and risk factors for development of HCC are well defined and some steps of hepatocellular carcinogenesis have been elucidated. Despite these scientific advances and the implementation of measures for early Targeted therapy for hepatocellular carcinoma

Nature Reviews Gastroenterology & Hepatology 6, 423 (2009). doi:10.1038/nrgastro.2009.86

Authors: Hans Christian Spangenberg, Robert Thimme & Hubert E. Blum

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. The major etiologies and risk factors for development of HCC are well defined and some steps of hepatocellular carcinogenesis have been elucidated. Despite these scientific advances and the implementation of measures for early

]]> Targeted therapy for hepatocellular carcinoma Hans Christian Spangenberg Robert Thimme Hubert E. Blum doi:10.1038/nrgastro.2009.86 Nature Reviews Gastroenterology & Hepatology 6, 423 (2009) 2009-06-02 Nature Reviews Gastroenterology & Hepatology 2009-06-02 10.1038/nrgastro.2009.86 http://dx.doi.org/10.1038/nrgastro.2009.86 6 7 Review 423 432 Hepatosplenic T-cell lymphoma in a patient with Crohn's disease http://dx.doi.org/10.1038/nrgastro.2009.87 Background. A 58-year-old man who had a 35-year history of Crohn's disease presented to our IBD center with a disease flare, pararectal fistulas and abscess formation. The patient had previously undergone ileocolic resection for a stenosis and his abscesses had been treated by surgical Hepatosplenic T-cell lymphoma in a patient with Crohn's disease

Nature Reviews Gastroenterology & Hepatology 6, 433 (2009). doi:10.1038/nrgastro.2009.87

Authors: Florian Beigel, Matthias Jürgens, Cornelia Tillack, Marion Subklewe, Doris Mayr, Burkhard Göke, Stephan Brand & Thomas Ochsenkühn

Background. A 58-year-old man who had a 35-year history of Crohn's disease presented to our IBD center with a disease flare, pararectal fistulas and abscess formation. The patient had previously undergone ileocolic resection for a stenosis and his abscesses had been treated by surgical

]]> Hepatosplenic T-cell lymphoma in a patient with Crohn's disease Florian Beigel Matthias Jürgens Cornelia Tillack Marion Subklewe Doris Mayr Burkhard Göke Stephan Brand Thomas Ochsenkühn doi:10.1038/nrgastro.2009.87 Nature Reviews Gastroenterology & Hepatology 6, 433 (2009) Nature Reviews Gastroenterology & Hepatology 10.1038/nrgastro.2009.87 http://dx.doi.org/10.1038/nrgastro.2009.87 6 7 Case Study 433 436