Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
The leading clinical investigators from the European community, the so-called “Mallorca group”, have recently published revised guidelines for the clinical management of Lynch syndrome. Their paper provides an important update on the identification, education and management of Lynch syndrome, but further investigation is still warranted.
The risk of severe complications during colonoscopy is very low. This risk should be kept low when changing strategies to reduce discomfort during the examination. The increased use of deep sedation from <10% in 2000 to 35% in 2009 might have its downsides in years to come if the trend continues.
Emerging evidence indicates that the intestinal microbiota influence brain chemistry, development and behaviour in animals. Tillisch and colleagues now show that ingestion of selected probiotics changes brain connectivity and responses to emotional challenge in healthy humans, paving the way for therapeutic exploitation of the microbiome–brain axis for functional gastrointestinal and primary behavioural disorders.
Liver transplantation is a risky business and donated organs are second-hand. Grafts carry risk and the surgeon must match the graft with the recipient. Macrosteatosis >30% is associated with poor outcomes, but assessment is not straightforward; for once, a study has shown that clinical assessment might be just as reliable as more sophisticated and objective measures.
NAFLD is becoming much more common, and will soon be the major underlying aetiology for liver transplantation. This article discusses the evidence that NAFLD is a multisystem disease and outlines the factors that determine interindividual variation in the development and progression of NAFLD.
Therapy for Crohn's disease has traditionally been based on a step-up approach, with treatment with the powerful TNF antagonists reserved as a last resort before surgery. In this Review, the authors discuss the use of anti-TNF agents as first-line therapy to achieve disease modification and the challenges in selecting appropriate patients for this approach.
Gastrointestinal mucus is the first line of defence against bac-teria; the organization of this protective system varies markedly along the digestive tract. In this Review, the authors provide an overview of the mucus system and discuss the role of mucus in health and disease.
The acinar cell of the exocrine pancreas produces, stores and secretes enzymes necessary for the digestion and absorption of food. Here, Logsdon and Ji describe two major stressors of the acinar cell, endoplasmic reticulum and digestive enzyme stress, which are major drivers of pancreatic pathology, as well as outlining the coping mechanisms that have evolved to compensate for these two key stressors.
This Review presents current knowledge on the complex popu-lation usually included under the umbrella term of nonerosive reflux disease. The authors outline the need to clearly separate the subsets of patients with real reflux disease from the sub-group with functional heartburn, which does not pertain to GERD.
