Volume 3 Issue 6, June 2006

Colorectal cancer claims more than 50,000 lives annually in the US. Screening for colorectal cancer, with the removal of any identified polyps, significantly impacts the death rate from this largely preventable cancer. This Viewpoint discusses the relative merits and pitfalls of colonoscopy and CT colonography as screening modalities in the setting of colorectal cancer.

Ursodeoxycholic acid has been administered as a remedy for liver diseases since the time of the Tang dynasty. Today, it is used to treat cholestatic liver diseases, such as primary biliary cirrhosis, primary sclerosing cholangitis and intrahepatic cholestasis of pregnancy. This Review considers what is currently known about the potential mechanisms and sites of action underlying the anticholestatic effect of ursodeoxycholic acid.

A constellation of cardiac abnormalities, including blunted contractile responses to stress and repolarization abnormalities, can be found in patients with cirrhosis. So-called cirrhotic cardiomyopathy is now recognized as a significant contributor to morbidity and mortality. In this Review, the authors discuss the clinical features of cirrhotic cardiomyopathy, pathogenic mechanisms underlying the condition, and general diagnostic criteria and treatment measures for cirrhotic cardiomyopathy.

Hepatorenal syndrome, which is characterized by functional renal failure secondary to renal vasoconstriction in the absence of underlying kidney pathology, is a feared complication of cirrhosis. This Review focuses on the pathogenesis, clinical features, and diagnosis of hepatorenal syndrome. The authors also consider current management options, which include liver transplantation, pharmacologic therapies, transjugular intrahepatic portosystemic shunt placement and albumin dialysis.