Review Articles in 2013

Gastrointestinal motility disorders are common in clinical practice. In this Review, the authors present an overview of the currently available gastrointestinal motility and function tests that are used to establish a diagnosis of functional disorders.

Postoperative recurrence (POR) frequently occurs in patients with Crohn's disease, but current medications have proven of little benefit for this indication. In this Review, Dario Sorrentino outlines the definition, the main modalities of diagnosis and the risk factors for POR. The various medications and approaches used to prevent POR are also discussed and an algorithm for prevention of POR is proposed.

Nys et al. discuss the emerging role of autophagy as a regula-tor of immune and/or inflammatory responses and as a stress adaptive mechanism, and analyze its value as a diagnostic and/or therapeutic target in Crohn's disease. Moreover, they highlight how several drugs used in the treatment of Crohn's disease have already been shown to affect autophagy induction as part of their mode of action.

Compelling evidence indicates that liver regeneration after portal vein occlusion and liver resection promotes tumour progression in patients with colorectal liver metastases. Here, the authors present clinical and experimental data from animal models of colorectal liver metastases pertaining to whether liver regeneration causes proliferation of tumour cells.

Variceal bleeding is a life-threatening condition. Here the au-thors summarize recent clinical findings and present the most updated advances on the management of gastro-oesophageal varices and variceal bleeding.

The authors present the emerging evidence that pancreatic cancer causes diabetes and associated weight loss. The emerging concepts in the pathogenesis of these metabolic changes are also discussed as well as the potential for the discovery of biomarkers for the early diagnosis of pancreatic cancer.

This Review presents current knowledge on the complex popu-lation usually included under the umbrella term of nonerosive reflux disease. The authors outline the need to clearly separate the subsets of patients with real reflux disease from the sub-group with functional heartburn, which does not pertain to GERD.

NAFLD is becoming much more common, and will soon be the major underlying aetiology for liver transplantation. This article discusses the evidence that NAFLD is a multisystem disease and outlines the factors that determine interindividual variation in the development and progression of NAFLD.

The acinar cell of the exocrine pancreas produces, stores and secretes enzymes necessary for the digestion and absorption of food. Here, Logsdon and Ji describe two major stressors of the acinar cell, endoplasmic reticulum and digestive enzyme stress, which are major drivers of pancreatic pathology, as well as outlining the coping mechanisms that have evolved to compensate for these two key stressors.

Gastrointestinal mucus is the first line of defence against bac-teria; the organization of this protective system varies markedly along the digestive tract. In this Review, the authors provide an overview of the mucus system and discuss the role of mucus in health and disease.

Therapy for Crohn's disease has traditionally been based on a step-up approach, with treatment with the powerful TNF antagonists reserved as a last resort before surgery. In this Review, the authors discuss the use of anti-TNF agents as first-line therapy to achieve disease modification and the challenges in selecting appropriate patients for this approach.

NAFLD prevalence in most regions of Asia is increasing. This Review presents emerging data on genetic polymorphisms that predispose Asian people to NAFLD, NASH and cirrhosis, and discusses the clinical and pathological outcomes of these diseases.

The gut is innervated by many types of extrinsic sensory neurons, and little consensus exists about the different classes that these afferents might belong to. In this Review, Simon Brookes and colleagues suggest that five different morphological types of endings can be distinguished by their structure, and that this scheme is compatible with physiologically based classifications.

Shigellainfection continues to have a high disease burden worldwide, especially in young children in developing countries. Here, the latest progress inShigella vaccine research is reviewed—including the identification of new vaccine antigens and technological advances in vaccine design and manufacture—as well as the barriers that impede the development of a successful Shigellavaccine.

Surgery is a key feature of IBD management. Here, the authors present an overview of IBD surgical management, focusing on the potential benefits and drawbacks of laparoscopy compared with open surgery.

Patients with IBD are at risk of the same vaccine-preventable illnesses as the general population. However, the characteristics of IBD and the immunosuppressive agents prescribed to treat it can lead to low response rates to vaccinations in these patients. Gisbert and Chaparro provide practical advice on vaccination strategies for clinicians who diagnose and treat patients with IBD.

Worldwide, ∼170 million people are thought to be chronically infected with HCV. These patients can develop serious long-term complications. Therapy for hepatitis C has progressed rapidly in the past few years; here, Donald Jensen and Noura Dabbouseh discuss the latest advances.

The Rome III consensus has divided functional dyspepsia into two subgroups; postprandial distress syndrome, characterized by postprandial fullness and early satiation, and epigastric pain syndrome, characterized by epigastric pain or burning. This Review describes the symptoms of functional dyspepsia and discusses the evidence to support the two subgroups.

Functional gastrointestinal disorders span a wide spectrum of clinical phenotypes. This Review discusses advances in the diagnosis and management of achalasia, gastroparesis, intestinal pseudo-obstruction and chronic constipation that result from enteric neuropathies, including both primary (idiopathic) and secondary forms.

Functional dyspepsia treatment remains unsatisfactory for too many patients. Here, the authors provide an overview of current management strategies, covering both lifestyle modifications for patients with mild or intermittent symptoms and drug therapy for patients with severe symptoms or non-responders.