Volume 13 Issue 1, January 2016

For many patients with Hirschsprung disease, the underlying pathogenic mechanisms are unknown. A new study using a novel line of transgenic mice and tissue from patients with Hirschsprung disease suggests that overproduction of collagen VI could contribute to pathogenesis and the increased incidence of Hirschsprung disease in patients with Down syndrome.

Spondyloarthritis (SpA) is the most common extraintestinal manifestation of IBD. SpA symptoms are not always recognized in patients with IBD. Subsequently, patients with symptoms of SpA can be underdiagnosed, with effective treatment delayed. Cooperation between gastroenterologists and rheumatologists is necessary and, ideally, an integrated management of these patients should be adopted.

The interval colorectal cancer rate is a robust indicator of the quality and effectiveness of a screening programme, enabling the identification of unmet requirements and development of specific strategies to resolve them. A recent study demonstrated the use of interval cancer as an indicator to target quality improvement of colonoscopy in a screening programme.

IBD is a chronic inflammatory disorder of the gut and major progress has been made in understanding the underlying mechanisms that mediate the disease. Here, the authors provide a comprehensive overview of the immunopathogenesis of IBD, discussing known and emerging pathogenic factors that include immune and nonimmune events.

Pre-operative diagnosis of biliary strictures often presents as a challenge to clinicians. Strictures have a range of benign causes, but can also be a result of cancer and so an ability to diagnose them accurately is very important. In this Review the authors discuss the existing modalities of assessing strictures and argue that a multimodal and multidisciplinary approach is likely to be best. New biomarkers and emerging techniques are hoped to improve diagnostic capabilities in future.

The gastrointestinal hormones ghrelin and motilin are released during hunger to stimulate appetite and interdigestive movement of the stomach, respectively. Ghrelin and motilin receptor agonists also increase gastric emptying of meals and emerging data shows previously unknown effects on nausea and constipation. In this Review, Sanger and Furness describe the complex interactions of ghrelin and motilin with their receptors and the pathways influencing gastrointestinal functions. Finally, they describe the potential of receptor agonists to treat various gastrointestinal disorders.

Oropharyngeal dysphagia is a common swallowing disorder. In this Review, Rommel and Hamdy describe the most frequent manifestations of oropharyngeal dysphagia, including potential causes and complications. They also provide a comprehensive overview of the techniques available to diagnose this condition.