Risk factors articles within Nature Reviews Gastroenterology & Hepatology

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  • News & Views |

    A new study by Díaz and colleagues links strong alcohol policy with improved health and societal outcomes. The evidence for what works to reduce the enormous burden from alcohol is clear. The question is why are governments still not acting?

    • William Gilmore
    •  & Ian Gilmore

  • Comment |

    A new report from the World Health Organization has evaluated the risks of dietary exposure to nanoplastic and microplastic particles (NMPs) to human health. Although challenges in the detection of NMPs in food and beverages remain, it is clear that humans are being exposed. Presently, no convincing evidence of adverse health effects are found, but major knowledge gaps remain.

    • Luc J. W. van der Laan
    • , Thijs Bosker
    •  & Willie J. G. M. Peijnenburg

  • Review Article |

    Cancer development is a dynamic evolutionary process. This Review explores the mechanisms underlying clonal expansion and contraction as well as the evolutionary dynamics in Barrett oesophagus and its progression to dysplasia and oesophageal adenocarcinoma. The implications for patient management (including surveillance, risk stratification and therapy) are also explored.

    • Melissa Schmidt
    • , Richard J. Hackett
    •  & Trevor A. Graham

  • Review Article |

    This Review describes the evidence of an association and causal link between nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM), discusses their pathophysiological mechanisms and summarizes the pharmacological treatments that might benefit or adversely affect the risk of T2DM or NAFLD progression.

    • Giovanni Targher
    • , Kathleen E. Corey
    •  & Michael Roden

  • Perspective |

    Population screening and endoscopic surveillance are widely used for colorectal cancer (CRC) prevention and early diagnosis. This Perspective explores the rationale for and approach to risk stratification for CRC prevention and diagnosis, including the limitations, advantages and future challenges for this approach.

    • Mark A. Hull
    • , Colin J. Rees
    •  & Sara Koo

  • Review Article |

    Inflammatory bowel disease (IBD) has different manifestations and associated risk factors between the sexes. This Review explores the sex-based differences in presentation and management of IBD, as well as insights into sex-based differences in pathogenesis and underlying mechanisms inferred from basic research.

    • Wendy A. Goodman
    • , Ian P. Erkkila
    •  & Theresa T. Pizarro

  • News & Views |

    Obesity is a known risk factor for pancreatic cancer. Now, a new study reports that obesity accelerates early pancreatic cancer development and growth in mice through local perturbations in the pancreatic microenvironment and implicates pancreatic islet-derived cholecystokinin as a driving factor.

    • Guido Eibl

  • Review Article |

    The incidence of early-onset colorectal cancer (in patients <50 years old) is increasing at an alarming rate. This Review highlights potential risk factors and putative mechanisms that drive this disease, and suggests likely areas for fruitful research, including diet, stress and antibiotics.

    • Lorne J. Hofseth
    • , James R. Hebert
    •  & Franklin G. Berger

  • Review Article |

    Liver diseases exert a substantial disease burden across the Asia–Pacific region. In this Review, the authors explore the epidemiological trends in the most common liver diseases in the region, including HBV infection, HCV infection and nonalcoholic fatty liver disease, and discuss implications for preventive measures.

    • Martin C. S. Wong
    • , Jason L. W. Huang
    •  & Siew C. Ng

  • Comment |

    Alcohol use and 'social' drinking are increasing among the young and particularly in women. However, gender equity does not extend to the risk of alcohol-associated liver disease and alcoholic hepatitis, which are increased and often caused by as little as half as much cumulative alcohol consumption in women compared with men.

    • Gyongyi Szabo

  • Review Article |

    NAFLD is growing in prevalence worldwide, and has emerged as a leading cause of end-stage liver disease in many countries. In this Review, the authors describe the global epidemiology of NAFLD, discuss associated risk factors and outline challenges for screening and management.

    • Zobair Younossi
    • , Quentin M. Anstee
    •  & Elisabetta Bugianesi

  • Review Article |

    Incidence of food allergy has increased considerably in the past two decades, especially in developed countries. Here, Nowak-Wegrzyn and colleagues discuss the epidemiology, pathophysiology, diagnosis and gastrointestinal manifestations of food allergy, and examine current and future treatment approaches.

    • Anna Nowak-Wegrzyn
    • , Hania Szajewska
    •  & Gideon Lack

  • News & Views |

    In a new study, Younossi et al. poignantly depict the daunting and enormous prevalence of NAFLD and its associated clinical and economic burden in the USA and four countries in Europe. The astronomical health-care costs will increase as the prevalence of NAFLD increases. All stakeholders are called to action.

    • Manal F. Abdelmalek

  • Review Article |

    Necrotizing enterocolitis is the most frequent and lethal gastrointestinal disease in premature infants. This Review outlines current approaches for the treatment and diagnosis of necrotizing enterocolitis and examines the progress made in our understanding of the molecular mechanisms of this disease as well as potential avenues for future treatment development.

    • Diego F. Niño
    • , Chhinder P. Sodhi
    •  & David J. Hackam

  • News & Views |

    A recent study reports that being overweight in late adolescence is associated with an increased risk of liver-related morbidity and mortality later in life. These findings give further strength to the concerns for the deleterious effects of childhood obesity on liver health. Early prevention by screening and lifestyle modification should be advised by health policies.

    • Milena Marietti
    •  & Elisabetta Bugianesi

  • News & Views |

    Obesity is a risk factor for several noncommunicable diseases, but some individuals with obesity remain metabolically healthy throughout life; whether these individuals are at risk of developing NAFLD is uncertain. In a new study, Chang et al. showed a statistically significant, graded relationship between BMI and NAFLD in metabolically healthy individuals.

    • Giovanni Targher
    •  & Christopher D. Byrne

  • News & Views |

    The recently released UK Chief Medical Officers Alcohol Guidelines Review set up new restricted limitations in alcohol consumption—14 units, the same amount for both men and women. In parallel, the popular Dry January campaign was launched again, aimed at promoting prolonged abstinence. Are these campaigns enough to give up boozing?

    • Joaquin Cabezas
    •  & Ramon Bataller

  • Review Article |

    NAFLD is a leading cause of chronic liver disease worldwide. This Review discusses the diagnosis and stratification of patients with NAFLD by disease stage, and provides a stage-based approach to treatment. Pharmaceuticals in advanced development and potential future therapeutics are also addressed.

    • Mary E. Rinella
    •  & Arun J. Sanyal

  • News & Views |

    Spondyloarthritis (SpA) is the most common extraintestinal manifestation of IBD. SpA symptoms are not always recognized in patients with IBD. Subsequently, patients with symptoms of SpA can be underdiagnosed, with effective treatment delayed. Cooperation between gastroenterologists and rheumatologists is necessary and, ideally, an integrated management of these patients should be adopted.

    • Paolo Gionchetti
    •  & Fernando Rizzello

  • News & Views |

    Rationing of livers for transplantation is a difficult problem especially when creation of national policies is needed. Italy recently convened a national consensus conference to decide who should be first in line.

    • John P. Roberts

  • News & Views |

    Restrictive transfusion strategy saves blood and is safe in most clinical settings, including gastrointestinal bleeding. However, generalizability of a restrictive transfusion approach in acute gastrointestinal bleeding remains controversial as it often affects elderly patients with major cardiovascular comorbidity who have been excluded from existing trials.

    • Càndid Villanueva

  • Review Article |

    The incidence and prevalence of IBD is changing, in both established and emerging populations. Here, the epidemiological trends of IBD are described, as are the risk factors (such as genetics, microbiota and lifestyle) that might contribute to disease development. How these risk factors, particularly the environmental ones, can be modified as a means of intervention for disease management are also discussed.

    • Ashwin N. Ananthakrishnan

  • News & Views |

    A report has demonstrated that in patients with atrial fibrillation the novel oral anticoagulant, dabigatran, increases the risk of gastrointestinal bleeding by nearly twofold compared with warfarin. Here, the risk of gastrointestinal bleeding associated with anticoagulants and antiplatelet agents is placed into clinical context and key management principles are emphasized.

    • Don C. Rockey

  • Review Article |

    Patients with IBD might be at increased risk of cardiovascular disease and stroke. This Review discusses the epidemiology, pathophysiology, risk factors (in particular, the role of IBD activity and IBD-related medications) and management of cardiovascular disease in patients with IBD. The potential effects of cardiovascular medications on IBD are also discussed.

    • Siddharth Singh
    • , Iftikhar J. Kullo
    •  & Edward V. Loftus Jr

  • News & Views |

    IBD has emerged as a global disease. Ng and colleagues have identified that some environmental risk factors are shared across the world, whereas others are distinctly unique to individuals living in Asia. This work adds a new clue to the mystery of the environmental determinates of IBD.

    • Gilaad G. Kaplan

  • News & Views |

    A new study suggests that co-prescription of low-dose aspirin and PPIs increases the incidence of small-bowel mucosal breaks. Should we be concerned about the potential negative interactions of these drugs? Or is the balance of evidence still substantially tipped towards the need for PPIs to protect against aspirin-induced upper gastrointestinal damage?

    • Angel Lanas
    •  & Carlos Sostres

  • News & Views |

    Predicting outcomes in upper gastrointestinal bleeding (UGIB) is important for identifying patients at high risk of morbidity and mortality who would benefit from early intervention. Various scoring systems have been developed to this end, but could clinical judgment replace or complement these risk stratification scores?

    • Philip W. Y. Chiu
    •  & Francis K. L. Chan

  • Review Article |

    PPIs are one of the most commonly prescribed drugs worldwide. However, it has been suggested that PPIs are associated with an increased risk of pneumonia, bone fractures and enteric infections, and that they interact with clopidogrel. In this Review, Paul Moayyedi and Grigorios Leontiadis detail how the evidence supporting these associations is limited, but suggest that PPIs are only given to patients for whom these drugs have been proven beneficial.

    • Paul Moayyedi
    •  & Grigorios I. Leontiadis

  • News & Views |

    Smoking is known to be a risk factor for chronic pancreatitis. However, to date, few studies have investigated the association between smoking and the risk of acute pancreatitis. A recent prospective, population-based study provides strong evidence that smoking should be considered a risk factor for acute pancreatitis.

    • Albert B. Lowenfels
    •  & Patrick Maisonneuve

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