Great (cultural) expectations
Stephen B. Hanauer
p623 | doi:10.1038/nrgastro.2009.183
Current Issue
November 2009 Vol 6 No 11
Editorial
Research Highlights
Celiac disease: Progress towards noninvasive diagnosis and follow-up | PDF (130 KB)
p625 | doi:10.1038/nrgastro.2009.174
IBS: Soluble fiber benefits patients with IBS | PDF (114 KB)
p626 | doi:10.1038/nrgastro.2009.170
Colorectal cancer: Increased folate intake could reduce risk of colorectal cancer | PDF (107 KB)
p626 | doi:10.1038/nrgastro.2009.173
Liver: Genetic risk factor identified for cystic fibrosis liver disease | PDF (51 KB)
p627 | doi:10.1038/nrgastro.2009.171
GERD: Novel approach to treatment | PDF (47 KB)
p627 | doi:10.1038/nrgastro.2009.172
Mast cell stabilization and POI | PDF (47 KB)
p627 | doi:10.1038/nrgastro.2009.175
In brief
Ulcerative colitis | Endoscopy | Nutrition | Hepatitis | PDF (49 KB)
p628 | doi:10.1038/nrgastro.2009.169
Pancreatic cancer: A new triple combination therapy? | PDF (102 KB)
p628 | doi:10.1038/nrgastro.2009.176
News and Views
Hepatitis: New hope for difficult cases of autoimmune hepatitis
Ugur Halac & Fernando Alvarez
p629 | doi:10.1038/nrgastro.2009.179
Autoimmune hepatitis is an inflammatory liver disease of unknown etiology that predominantly affects females, and requires immunosuppressive treatment. A new study investigates the role of mycophenolate mofetil as a rescue treatment for children with the disease.
GERD: Persistent symptoms on therapy—test on therapy
Radu Tutuian
p630 | doi:10.1038/nrgastro.2009.180
When all state-of-the-art reflux monitoring technologies are available, which should be used for patients who have persistent reflux symptoms despite acid suppressive therapy? A single-center study has investigated this clinical dilemma and provides guidance on the best diagnostic strategy.
Gastrointestinal bleeding: Trends in gastrointestinal bleeding: top down and bottom up!
Venkataraman Subramanian & Krish Ragunath
p632 | doi:10.1038/nrgastro.2009.178
Advances in gastroenterology, including the introduction of PPIs, effective therapies for Helicobacter pylori infection, and endoscopic intervention, have promised to improve the incidence and outcomes of gastrointestinal bleeding and perforation. However, have these improvements been borne out in clinical practice?
Hepatitis C: Thyroid dysfunction in patients with hepatitis C on IFN-
therapy
Alessandro Antonelli, Clodoveo Ferri & Poupak Fallahi
p633 | doi:10.1038/nrgastro.2009.168
IFN-
therapy for hepatitis C is associated with a high prevalence of thyroid dysfunction, which is often irreversible. Two studies have recently investigated the role of HCV, PEG-IFN- and ribavirin in the development of autoimmune thyroid disorders in patients with hepatitis C on antiviral treatment.
Reviews
Diagnosis and management of lower gastrointestinal bleeding
Jürgen Barnert & Helmut Messmann
p637 | doi:10.1038/nrgastro.2009.167
The etiologies of lower gastrointestinal bleeding (LGIB), defined as bleeding from a colonic or anorectal source, are numerous and varied. LGIB can be acute or chronic; for both types, colonoscopy is the diagnostic and therapeutic procedure of choice. Hemostasis, if not occurring spontaneously, can usually be promoted by embolization or modern endoscopy techniques, and surgery is only undertaken as a last resort.
The management of patients awaiting liver transplantation
Ka-Kit Li & James Neuberger
p648 | doi:10.1038/nrgastro.2009.163
Patients with end-stage liver disease often experience disease progression and develop complications while waiting for a liver transplant. Prevention and management of these complications is, therefore, paramount to ensure that the patients can remain on the waiting list and have the greatest chance of a successful outcome following transplantation.
Current understanding of osteoporosis associated with liver disease
Inaam A. Nakchbandi & Schalk W. van der Merwe
p660 | doi:10.1038/nrgastro.2009.166
Osteoporosis is a common complication of chronic liver disease. This Review describes the prevalence and risk factors associated with bone loss in patients with chronic liver disease. New insights into the role of mediators that are involved in orchestrating bone loss in these patients are also discussed.
Endoscopic and pathological aspects of colitis-associated dysplasia
Fiona D. M. van Schaik, G. Johan A. Offerhaus, Marguerite E. I. Schipper, Peter D. Siersema, Frank P. Vleggaar & Bas Oldenburg
p671 | doi:10.1038/nrgastro.2009.162
Identification and classification of dysplasia in patients with ulcerative colitis or Crohn's disease in the large intestine is a challenge. Surveillance programs in these patients aim to detect colitis-associated dysplasia at an early stage, as the risk of these patients developing colorectal cancer is considerable. Good communication and discussion between pathologists and endoscopists is essential to help reach unequivocal diagnoses and to improve the management of colitis-associated dysplasia.
Case Study
Liver transplantation after radioembolization in a patient with unresectable HCC
Laura E. Moreno Luna, Paul Y. Kwo, Lewis R. Roberts, Teresa A. Mettler, Denise N. Gansen, James C. Andrews, Gregory A. Wiseman & Vijay Laxmi Misra
p679 | doi:10.1038/nrgastro.2009.165
This article considers the case of a 58-year-old man with a history of type II diabetes, obesity and hypertension who presented with non-alcoholic steatohepatitis-related liver cirrhosis and hepatocellular carcinoma (HCC), and self-referred for a second opinion. He was diagnosed with unresectable HCC. The patient underwent radioembolization with Yttrium-90 glass microspheres, which substantially decreased the tumor mass. 1 year after initial diagnosis with HCC the patient underwent orthotopic liver transplantation (OLT). He remains negative for recurrence of HCC 2.5 years post-OLT.
