The proximal small intestine is key for nutrition, metabolism and immune responses, and can be affected by a wide range of disorders. This Review describes the cellular and molecular bases of diseases of the proximal small intestine (including rare monogenic disorders), proposing a mechanism-based taxonomy.

Many aspects of the biology and pathogenesis of hepatitis E virus (HEV) infection remain underexplored. In this Review, Steinmann and colleagues summarize the role of the innate and adaptive immune systems in HEV infection.

This Perspective discusses the nomenclature change from nonalcoholic fatty liver disease to metabolic dysfunction-associated steatotic liver disease (MASLD) and proposes steps necessary to improve care and end the public health threat posed by MASLD and metabolic dysfunction-associated steatohepatitis.

Management of anticoagulation in cirrhosis is challenging because of the concomitant risk of both thromboembolism and bleeding complications. Randomized controlled studies are lacking. Direct oral anticoagulants seem to be the most manageable option. However, for patients with Child C cirrhosis, the only safer anticoagulant strategy, currently, is low-molecular-weight heparin.

Digital twins provide a framework to advance the field of personalized medicine by generating clinically actionable strategies that leverage individualized data as well as current and emerging research. Strong interdisciplinary teamwork, specific funding mechanisms and integration of key biological details such as somatic evolution are necessary for the effective adoption of digital twins in medicine.

Nature Reviews Gastroenterology & Hepatology is launching a new Series on justice, equity, diversity and inclusion in an effort to increase awareness and advance equitable health.

Therapeutic advances in inflammatory bowel disease (IBD) have been universally directed towards patients with established disease to control inflammation, ameliorate symptoms and hinder disease progression, but preventing IBD development or delaying its onset are highly attractive. This Comment discusses the emerging approaches and future promises of interventional disease prevention trials in IBD.