Volume 9 Issue 2, February 2012

Chronic HCV infection is a leading cause of liver-related morbidity and mortality. In 2011, treatment options for patients infected with HCV genotype 1 changed dramatically with the approval of two nonstructural protein 3 protease inhibitors—boceprevir and telaprevir—by the FDA and the European Medicines Agency.

Despite enthusiastic efforts using the latest advanced molecular technologies, no specific universal genetic alteration has been found in hepatocellular carcinoma (HCC). The application of whole-genome sequencing using next-generation sequencing technologies is starting to clarify the intraindividual and intratumoral diversity in genomic alterations in HCC. A new sequencing era in HCC has begun.

Important advances have been made in the management of IBD in 2011. Research has focused on optimizing the currently available therapies and taking a more tailored approach to each individual patient.

Interest in the gut microbiota has escalated with growing appreciation of the role of indigenous microbes in the health of the host and in the pathogenesis of several intestinal and extraintestinal disorders. The microbiota has become a plausible target for drug and dietary therapy and a repository from which bioactive agents or new drugs can be mined.

Neurogastroenterology encompasses intrinsic and extrinsic neural processes that regulate gut functions, sensation and related behaviors such as ingestion. In 2011, key advances were made in understanding gut–brain interactions, visceral sensation, serotonin signaling, neurogenesis and neuromuscular transmission.

Treating pancreatic cancer can be challenging, as patients often have a poor prognosis and chemoresistance is common. As pancreatic cancer is fundamentally a genetic disease, the authors of this Review emphasize the complex mutational heterogeneity of pancreatic ductal adenocarcinomas and the importance of moving towards a model of tailoring therapies to the specific genetic characteristics of individual tumors.

The gut microbiota is now widely recognized to have a central role in human health and disease, and can be manipulated to improve an individual's health. Fecal microbiota transplantation (FMT), as outlined in this Review, is one such approach to resolve dysbiosis of the gut microbiota and has therapeutic potential in a range of gastrointestinal diseases. The authors provide a broad overview of FMT and a timely update on the latest advances.

Nonvariceal upper gastrointestinal bleeding (UGIB) is a major cause of morbidity and mortality worldwide, and despite improvements in the management of patients with this condition, there have only been moderate improvements in mortality rates. This Review discusses the diagnosis of UGIB and describes the optimal management of patients with this condition, in accordance with the current consensus recommendations and contemporary literature. The authors examine endoscopy, management of bleeding and pharmacological therapy for patients with UGIB.

Cholangiocarcinoma is the second most common tumor of the liver worldwide. Endoscopy could have a useful role in the work-up of patients with hilar cholangiocarcinoma who are unsuitable for surgery. In this Review, the authors present an overview of the diagnostic and therapeutic role of endoscopic procedures in the management of hilar cholangiocarcinoma.

Pelvic floor dysfunction encompasses a range of symptoms that are presented to specialists across multiple disciplines. In this Perspectives Hans Peter Dietz provides an interdisciplinary overview of imaging pelvic floor dysfunction. Modern pelvic floor imaging techniques, including MRI, defecation proctography and ultrasound are discussed as well as their potential application to improving management of pelvic floor disorders.