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Obesity can be present in patients with celiac disease. Great concern exists that after diagnosis patients might gain weight and, instead of improving their health with the management of their condition, will substitute the problems of celiac disease for the increased health risks associated with weight gain and obesity.
The allocation and distribution of deceased donor livers for transplant remains intensely scrutinized because demand far exceeds supply. In the USA, distribution of organs is organized according to a local, regional and national sharing plan. Ongoing assessment of the characteristics and success of these arrangements is necessary to ensure the system is as equitable as possible.
Narrow-band imaging (NBI) might improve the detection of Barrett esophagus and its associated neoplasia. A randomized controlled trial suggests that NBI with targeted biopsies can yield the same detection rate for Barrett esophagus with fewer biopsies compared with standard high-definition white light endoscopy with random biopsies.
New research has shown encouraging results with the use of probiotic-enriched artichokes as a treatment for constipation. However, the findings call into question the use of functional foods as a prescribed treatment, and how best to advise our patients asking for information on such products.
Intraductal papillary mucinous neoplasms of the pancreas (IPMNs) are being increasingly diagnosed, and are the most frequent cystic neoplasms of the pancreas. In this Review, Werner and colleagues describe the key features of IPMNs (including epidemiology and pathology) and focus on the currently available surgical options for the different types of IPMNs.
Nutrigenomics utilizes high-throughput genomics technologies to reveal changes in gene and protein expression that are modulated by the patient's nutrition. In this Review, Lynnette Ferguson describes how these methods have been successfully applied to animal models of Crohn's disease, and suggests that the time is right to move them to human studies.
The migrating motor complex (MMC) is a cyclic, recurring motility pattern that occurs in the stomach and small bowel during fasting. The physiological role of the MMC is incompletely understood, and the regulation of the MMC is complex, involving different gut hor-mones and activation of the parasympathetic and enteric nervous system. In this Review, the authors summarize current knowledge of the MMC, especially its role in health and disease.
Neurogastroenterology encompasses control of digestion through the enteric nervous system, the central nervous system and integrative centers in sympathetic ganglia. In this Review, John Furness provides a broad overview of the rapidly developing field of neurogastroenterology, with a focus on the roles of the enteric nervous system in the control of the musculature of the gastrointestinal tract and transmucosal fluid movement.
Gluten sensitivity is an emerging entity that is becoming increasingly common; however, little is known about its pathogenesis. Here, Umberto Volta and Roberto De Giorgio discuss the current knowledge of gluten sensitivity and define its pathogenetic, clinical and diagnostic criteria. They aim to provide a practical appraisal of gluten sensitivity that is useful for doctors and researchers in the diagnosis and appropriate management of patients with gluten sensitivity.