Volume 12 Issue 2, February 2015

In 2014, NAFLD was confirmed as the fastest growing aetiology for hepatocellular cancer in the USA. However, 2014 also saw progress in our understanding of the heritability and pathogenesis of NAFLD, and an important clinical trial targeting the farnesoid X receptor pathway has illustrated advances in developing a pharmacological therapy.

Several key studies published in 2014 have shed light on the pathogenesis of IBD by investigating the molecular mechanisms controlling mucosal homeostasis and intestinal barrier function. These studies revealed that alterations of intestinal homeostasis drive chronic intestinal inflammation. Here, we describe these findings and discuss future directions for translational research in IBD.

In 2014, pancreatic fibrosis has increasingly been recognized as a key determinant of the pathogenesis, therapy response and disease progression of chronic pancreatitis and pancreatic cancer. In addition, secretin-stimulated magnetic resonance cholangiopancreatography has gained increasing importance, especially in visualizing pancreatic duct abnormalities. However, the true imaging capacity has not been fully analysed.

Since the discovery of HBV in the 1960s, its life cycle and the natural history of infection have been delineated by many studies. In 2014, new findings concerning the host–virus interaction and new studies of HBV reactivation from occult HBV infection are of considerable interest.

IBS affects up to 15% of the population and continues to provide the medical profession with diagnostic and therapeutic challenges. The pathophysiology is complex and until it is better understood management strategies will necessarily remain rather empirical.

Oesophageal cancer is characterized by poor prognosis, and curatively intended treatment is extensive and demanding. In 2014, well-designed clinical studies have advanced our knowledge of how to improve the treatment of oesophageal cancer at various tumour stages.

The association that the mycobiome has with gastrointestinal health and disease is gradually being revealed using state-of-the-art sequencing technologies. This Review presents the latest research on the interaction between fungi, bacteria and the host in relation to gastrointestinal disease, in particular IBD and graft-versus-host disease. The authors point out that further research is needed in this developing area of science and highlight areas of future endeavour.

For patients to take part in detection programmes and therefore reduce premature mortality due to cancer, it is vital for hereditary colorectal cancer syndromes to be identified early. Implementation of high-throughput techniques and genetic profiling of all new cases of colorectal cancer has improved early identification of affected families. As cancer risk and surveillance recommendations vary depending on gene defect, this Review argues that it is advantageous to include the gene defect in disease terminology to help facilitate the appropriate clinical management.

Stress-related mucosal bleeding (SRMD) is an important issue owing to its severity, and its management in critically ill patients is especially difficult. In this Review, the latest information on the epidemiology, risk factors and management of SRMD are outlined to help guide clinicians of the most appropriate treatment strategies for patients in intensive care units.

This Review provides an in-depth and up-to-date overview of the major achievements in the evolving field of gut rehabilitation, with special emphasis on visceral transplantation. New insights into current challenges are highlighted, including future strategies to optimize the management of gut failure and enhance the long-term therapeutic efficacy of transplantation.