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The use of antibiotics in patients with active, uncomplicated IBD is controversial. Clinical studies in patients with Crohn's disease have been small and yielded uncertain results, which have discouraged clinicians from including antibiotics in the therapeutic armamentarium for this disease. The author of this Viewpoint article discusses the available evidence for the use of antibiotics in IBD, and outlines possible mechanisms of action.
Dietary treatment for obesity can lead to reasonable weight loss, resulting in associated health benefits. The author of this Review discusses the various types of diet available for the treatment of obesity, their relative efficacies, and associated adverse effects. The author also considers alternative treatment options when dietary strategies fail and discusses the challenges associated with long-term weight maintenance.
Gastrointestinal complications are a common occurrence in patients receiving oncologic therapy. These complications can be severe or even life-threatening and, therefore, require prompt diagnosis and treatment. This Review discusses some of the most common gastrointestinal complications associated with oncologic therapy, including esophagitis, diarrhea, radiation proctitis and drug hepatotoxicity. The diagnosis and symptoms of the complications are discussed, together with current concepts relating to their treatment.
Celiac disease is a common condition and is associated with considerable morbidity and mortality. The incidence of celiac disease is increasing, and a substantial proportion of new diagnoses are in elderly individuals. This Review highlights age-related differences in the clinical presentation, investigation and management of elderly patients suspected of having celiac disease, and emphasizes the need for a greater awareness of this condition in the elderly population.
This article considers the case of a 72-year-old male who presented with epigastric pain, anorexia and progressive jaundice. Liver function tests revealed enzyme abnormalities consistent with cholestasis, while radiographic and endoscopic findings were suggestive of autoimmune pancreatitis with biliary involvement. Examinations for the presence of malignant cells were negative. A diagnosis of autoimmune pancreatitis with IgG4-associated cholangitis was made and the patient was treated with corticosteroids.
