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Endoscopy is an established tool for the diagnosis and treatment of patients with upper gastrointestinal bleeding. The timing of endoscopy is, however, a matter of controversy. This Viewpoint article argues that endoscopy has the greatest potential for therapeutic benefit and reductions in costs and resource use when it is performed urgently, before a patient is admitted to hospital.
Few celiac disease patients now present with the classic symptoms and signs of overt malabsorption. As upper gastrointestinal symptoms are common in celiac disease patients, esophagogastroduodenoscopy might be part of their initial workup, often without celiac disease being considered within the differential diagnosis. This Review describes the endoscopic markers associated with celiac disease and their role in its diagnosis.
Basic research has provided evidence for a role for statins in cancer treatment and prevention; however, clinical research has both supported and refuted the role of statins in this setting. In this Review, the authors critically evaluate the current body of literature on the role of statins in the treatment and prevention of gastrointestinal cancers, with a particular focus on clinical and observational studies.
The author of this Review considers who is at risk of developing NSAID-related gastrointestinal complications, what treatment options are available for patients with a high gastrointestinal risk, the cardiovascular risk of COX-2 inhibitors, and how to assess the risk. Recommendations for prescribing NSAIDs according to both gastrointestinal and cardiovascular risk are provided.
Over the past decade, inflammation-induced alterations at the hepatocellular, bile ductular and ductal level have been linked to different clinical presentations of cholestasis in sepsis. In this Review, the authors give a comprehensive overview of the molecular and cellular mechanisms that underlie sepsis-associated cholestasis and the potential clinical and therapeutic implications that these mechanisms have for critically ill patients.
