Volume 6 Issue 3, March 2009

The optimal duration for stent placement in patients with refractory, benign esophageal strictures (RBES) is not clear. This Viewpoint article discusses the types of stent available for RBES, their benefits and limitations, and the factors that influence stenting duration. The authors provide their opinion regarding optimal stent choice and duration on the basis of available evidence and their own experience.

IBS is a major drain on health-care resources, partly because the pharmacological management of this condition is currently unsatisfactory. Cognitive behavioral therapy, psychotherapy and hypnotherapy can help by providing a global therapeutic approach for IBS. This Viewpoint article discusses the available evidence for these behavioral therapies and highlights the benefits and the difficulties of using such approaches.

Portal hypertensive gastropathy (PHG) is often seen in patients with portal hypertension, and can lead to transfusion-dependent anemia as well as acute, life-threatening bleeding episodes. This Review article discusses the available knowledge regarding the mechanisms underlying the pathogenesis of PHG that provide reasonable grounds for the treatment of this condition, ultimately translating basic research into clinical practice.

The prevalence of hepatocellular carcinoma (HCC) is increasing worldwide. Despite the use of aggressive treatments, the survival of patients with HCC is affected by tumor recurrence and the development of extrahepatic metastases. This Review discusses the available evidence for specific multimodal approaches in the treatment of HCC. Future directions of combinatory treatment approaches are also discussed.

The development of multimodality and targeted treatment strategies has improved the prognosis of patients with gastrointestinal cancers. Not all patients, however, benefit equally from these treatment approaches, and the ability to predict who will respond positively to a treatment type is of particular importance. This Review discusses the role of biomarkers and metabolic imaging approaches in the prediction of response to therapy early on in treatment.

This article considers the case of a 73-year-old white man who presented with synchronous gastric carcinomas and a 20-year history of mixed polyposis. Genetic-testing and molecular-pathology analyses confirmed a diagnosis of Cowden's syndrome. The case explores the diagnostic challenges of differentiating between hamartomatous and adenomatous polyposis syndromes in patients with mixed polyposis, and emphasizes the need to characterize the risk of gastrointestinal cancer in patients with this syndrome.