Keep your cool: burn calories
Stephen B. Hanauer
p315 | doi:10.1038/nrgastro.2009.88
Table of contents
June 2009 Vol 6 No 6
Editorial
Research Highlights
Ulcerative colitis: Appendicitis, but not appendectomy, reduces risk of ulcerative colitis | PDF (101 KB)
p317 | doi:10.1038/nrgastro.2009.78
IBD: Diagnosis by proteasome pattern | PDF (140 KB)
p318 | doi:10.1038/nrgastro.2009.74
Esophageal cancer: Hot tea raises risk of cancer | PDF (94 KB)
p318 | doi:10.1038/nrgastro.2009.79
Prediction of recurrent C. difficile infection | PDF (158 KB)
p319 | doi:10.1038/nrgastro.2009.73
Liver: Dietary links to NAFLD in nonobese patients | PDF (70 KB)
p320 | doi:10.1038/nrgastro.2009.75
Gastrointestinal stromal tumor: Adjuvant imatinib mesylate therapy improves recurrence-free survival | PDF (115 KB)
p320 | doi:10.1038/nrgastro.2009.80
News and Views
Pancreas: Alcoholic pancreatitis—it's the alcohol, stupid
Minoti V. Apte, Romano C. Pirola & Jeremy S. Wilson
p321 | doi:10.1038/nrgastro.2009.84
The management of alcoholic pancreatitis is mostly reactive; little is done to prevent disease progression. It is time for physicians to pay attention to the root cause of the condition—that is, alcohol—rather than just responding to its effects. This article discusses an important paper that describes the first prospective, randomized, controlled, clinical trial to investigate the effect of brief interventions for alcohol abuse on the progression of alcoholic pancreatitis.
Rectal cancer: The evolution of laparoscopy—what's next?
Heidi Nelson
p322 | doi:10.1038/nrgastro.2009.82
Despite advances in laparoscopic surgery for colorectal cancer, the role of laparoscopic approaches for rectal cancer remains controversial. A large, single-center study has now demonstrated the safety and feasibility of laparoscopy for rectal cancer, which provides new incentives for prospective clinical trials to rigorously test this surgical approach.
Motility: Prucalopride for chronic constipation
Gabrio Bassotti & Vincenzo Villanacci
p324 | doi:10.1038/nrgastro.2009.81
Many patients with chronic constipation have a poor quality of life and are dissatisfied with laxative treatment. Findings from a multicenter, randomized, placebo-controlled, phase III study have demonstrated the beneficial effects of the 5-hydroxytryptamine 4 receptor agonist, prucalopride, for chronic constipation and associated symptoms. This drug represents the newest addition to the medical armamentarium for this disorder.
Hepatitis C: New therapeutic strategies needed for advanced disease
Wolf P. Hofmann & Stefan Zeuzem
p325 | doi:10.1038/nrgastro.2009.63
Approximately 50% of patients with chronic hepatitis C fail to achieve a sustained virological response to standard therapy with pegylated interferon and ribavirin. Progression to advanced liver disease (which may lead to hepatic decompensation, hepatocellular carcinoma, and death) is common in these patients, but can low-dose pegylated interferon maintenance therapy improve outcomes?
Surgery: Neoadjuvant chemoradiation and sphincter preservation
Vincenzo Valentini & Francesco Cellini
p327 | doi:10.1038/nrgastro.2009.83
The benefit of preoperative combined chemotherapy and radiotherapy to perform sphincter-preserving surgery for patients with locally advanced distal rectal cancer is not supported by findings from randomized, controlled trials. These findings have, however, now been questioned by a study that supports the prospect of a tailored surgical approach to rectal-cancer treatment on the basis of tumor behavior after neoadjuvant treatment.
Reviews
Management of gastric polyps: a pathology-based guide for gastroenterologists
Susanne W. Carmack, Robert M. Genta, David Y. Graham & Gregory Y. Lauwers
p331 | doi:10.1038/nrgastro.2009.70
Appropriate clinical and pathological evaluation is crucial for the diagnosis and management of gastric polyps and polypoid lesions. This Review discusses the endoscopic characteristics, histopathology, pathogenesis and management of polyps and common polypoid lesions in the stomach, and provides a practical guide for gastroenterologists.
Actions and therapeutic pathways of ghrelin for gastrointestinal disorders
Michael Camilleri, Athanasios Papathanasopoulos & Suwebatu T. Odunsi
p343 | doi:10.1038/nrgastro.2009.72
Ghrelin is an orexigenic hormone that acts to increase food intake and fat deposition, and at high doses, can modulate gastric motility. This Review addresses the actions of ghrelin in gastrointestinal systems. Studies that have investigated the role of ghrelin receptor agonists and antagonists for the treatment of gastrointestinal motility disorders and obesity are also discussed.
Capsule endoscopy: progress update and challenges ahead
Andrea Moglia, Arianna Menciassi, Paolo Dario & Alfred Cuschieri
p353 | doi:10.1038/nrgastro.2009.69
Advances in complementary metal oxide semiconductor technology have enabled the development of capsule endoscopy, a diagnostic technique that involves ingestion of a pill-sized camera that collects and relays still images of the tissues lining the gastrointestinal tract. Moglia and colleagues review the literature on the use of different capsule endoscopy devices for the inspection of the small bowel, esophagus and colon, and discuss the potential future applications and developments of this technology.
A guide for the diagnosis and management of gastrointestinal stromal cell tumors
Paul S. Sepe & William R. Brugge
p363 | doi:10.1038/nrgastro.2009.43
Gastrointestinal stromal cell tumors (GISTs) always have a degree of malignant potential, and, increasingly, they are diagnosed only on routine endoscopy. Sepe and Brugge provide a gastroenterologist's guide for GIST diagnosis and assessment of malignant potential. The authors of this Review also propose an algorithm for the treatment of localized GISTs that is especially useful for the management of incidentally diagnosed tumors.
Case Study
Treatment of chronic hepatitis C in a slow responder: a case for extended therapy
Paul J. Gaglio
p372 | doi:10.1038/nrgastro.2009.65
This article considers the case of a 49-year-old man who presented with fatigue and poor concentration. He was diagnosed with HCV genotype 1 infection and started on a 48-week course of pegylated interferon 
2b plus ribavirin. Despite initial reductions in his serum HCV-RNA levels, HCV-RNA remained detectable at week 12; however, it was undetectable by week 24. The patient was classified as a slow responder and therapy was extended to 72 weeks.
