Volume 11 Issue 4, April 2014

Epidemiology studies have shown an ∼1% prevalence of coeliac disease in Europe, North America, the Middle East and South America, but the prevalence in the Asia–Pacific region remains relatively unknown. Now, Makharia et al. have proposed much needed recommendations to help tackle the problem of coeliac disease in this region.

NAFLD is regarded unquestionably as one of the components of the metabolic syndrome. Hence, metabolic perturbations occurring in the fatty liver become a systemic metabolic derangement. The phenotypic switching from fatty liver to NASH entails a reprogramming of liver metabolism to fit a stressful metabolic environment.

Functional dyspepsia has been defined in various ways, but the diagnostic yield of these definitions has not been well validated. Ford et al. have now reported the diagnostic yield of the Rome III criteria, which was not superior to previous definitions. The study also indicates the difficulty of excluding organic diseases using these criteria.

Patients chronically infected with HBV are at risk of HBV reactivation if immunosuppressive therapies are initiated. In this Review, Hwang and Lok describe the clinical manifestations, incidence and risk factors associated with HBV reactivation during immunosuppression. Practical insights into the management of patients with HBV who require immunosuppressive therapy are also provided.

Here, Nathalie Rommel, Jan Tack and colleagues provide an overview of the extensive literature concerning globus and discuss the quality of the evidence to date. They also put forward a potential theoretical model to support management and future research in globus.

Helicobacter pyloriinfection has been associated with multiple diseases, including cardiovascular disease and hepatobiliary diseases, localized outside of the stomach, especially those characterized by a persistent and low-grade systemic inflammation. Here, the authors describe the most important studies published so far about a possible role ofH. pyloriin non-gastrointestinal diseases.

Despite the proven and often clinically marked efficacy of anti-TNF drugs for IBD, these biologic agents are not immune to treatment failures. Tailoring anti-TNF treatment in IBD mandates considerations of the different clinical scenarios in which therapy failure might occur while bearing in mind an opposite group of patients in whom intensive therapy might be unnecessary.

IBS is a debilitating chronic condition that substantially affects quality of life. Dietary management of IBS has garnered much interest, with dietary restriction of fermentable carbohydrates (the so-called low FODMAP diet) being explored as an approach to manage gastrointestinal symptoms in IBS. Here, the authors introduce the concept of fermentable carbohydrate restriction, providing an overview of the underlying mechanisms, efficacy and clinical application of this approach.