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Cannabis (or marijuana) has been used in traditional medicine to treat intestinal inflammation. A survey by Ravikoff Allegretti et al. at a specialized IBD clinic shows that, in the USA, marijuana is used by a substantial number of patients with IBD to alleviate their symptoms.
In 2013, several new IBD drugs, including golimumab and vedolizumab, have been approved or completed successful programmes, showing efficacy in both Crohn's disease and ulcerative colitis. In addition, classic IBD drugs have been formulated for colonic delivery, such as budesonide MMX®, which was recently approved for mild-to-moderate ulcerative colitis.
Factors associated with ageing, such as comorbidities, polypharmacy and diminished physical reserve, can affect the natural history of IBD. This Review highlights how these age-associated variables can affect older patients with IBD and also illustrates the multiple gaps in our current knowledge of IBD in the elderly.
Helicobacter pyloriinfection has been associated with multiple diseases, including cardiovascular disease and hepatobiliary diseases, localized outside of the stomach, especially those characterized by a persistent and low-grade systemic inflammation. Here, the authors describe the most important studies published so far about a possible role ofH. pyloriin non-gastrointestinal diseases.
IBD is a chronic disorder with disease onset ranging from early childhood to beyond the sixth decade of life. This Review provides an overview of the differences in epidemiology, clinical characteristics, and natural history of paediatric, adult, and elderly-onset IBD. In addition, potential differences in host–gene–microbial interactions according to age are highlighted.
We are moving towards an era of disease categorization beyond Crohn's disease and ulcerative colitis to a more robust definition of a spectrum of IBD subtypes. This Review outlines some of the genetic, clinical, biochemical, serological, and microbiome data that could be used for risk stratification and treatment selection in clinically meaningful subgroups of patients.
Advances are being made in understanding the pathogenesis, treatment outcomes and surveillance of Barrett oesophagus. Central obesity and age at onset of gastro-oesophageal reflux are being recognized as risk factors that have implications for screening. The persistent finding of nondysplastic Barrett oesophagus during surveillance is associated with low risk of malignant progression, whereas dysplastic Barrett oesophagus requires continued surveillance.
Coeliac disease comprises intolerance against dietary wheat, rye and barley gluten and is one of the most common food-related life-long disorders in Western countries. In 2013, new knowledge of the clinical diversity of coeliac disease and further details about the autoimmune aspects of this disorder have emerged.
Targeting angiogenesis has not been successful as a treatment for pancreatic cancer. Studies using monoclonal antibodies or small molecule inhibitors of the VEGFR pathway have failed to demonstrate benefit. Now, a phase II study has shown that sorafenib does not improve the efficacy of gemcitabine plus cisplatin chemotherapy in patients with locally advanced or metastatic pancreatic adenocarcinoma.
This Perspectives article evaluates the progress that has been made in the field of neural stem cells for enteric nervous system disorders and outlines the challenges that remain before such treatments can be established in the clinical arena.