Volume 11 Issue 10, October 2014

Although clinicians instinctively recognise acute-on-chronic liver failure (ACLF), heretofore we have had no way of accurately studying the syndrome, as no definition of this entity existed. A consortium of European centres has finally offered a definition of ACLF and proposed a prognostic index based upon easily obtained features of patients with decompensated cirrhosis.

An international consensus on the classification, diagnosis and multidisciplinary treatment of perianal fistulising Crohn's disease has recently been published. The statement is an important starting point to address the many problems we still have with the clinical classification and treatment of fistulising Crohn's disease.

Measurement of faecal calprotectin concentration is increasingly used to assess disease activity in patients with IBD. Lasson et al. have now demonstrated that calprotectin concentrations in faeces of patients with mild or moderate left-sided or extensive ulcerative colitis vary considerably and have questioned the long-term stability of calprotectin when stored at room temperature.

Improved methods are needed to dynamically image gut behaviour to assess whether neuromuscular degenerative disease is present. So-called nanonaps (soluble nanoformulated naphthalocyanines) have been developed for oral administration to pass through the intestines and provide high contrast for visualizing bowel motion on photoacoustic imaging. Moreover, radiotracer labelling of these nanoparticles facilitates multimodal detection using PET.

Colorectal cancer (CRC) screening, the decade's most promising cancer-related public health development, is evolving. Faecal immunochemical tests (FIT) will be the primary population-based CRC screening biomarker for the next 10–15 years. Will the international community exploit the full potential of FIT and other CRC risk indicators to enable a revolution in the effectiveness of screening?

Glycan research holds great promise in the development of biomarkers, and might highlight targets for novel therapeutics in IBD. This Review introduces the main characteristics of glycosylation, and the roles of glycans in health and disease are also briefly presented. The authors subsequently describe in detail the current body of glycobiology literature in relation to IBD and conclude with proposed strategies for further glycan research.

Growth retardation and delayed puberty are unique features of IBD in children and are caused by both undernutrition and inflammation. The substantial effect of impaired growth and delayed puberty on quality of life creates particular difficulties for disease management. This Review focuses on the pathogenesis of disrupted growth and puberty in children with IBD and the emerging therapies for resolving inflammation and restoring growth.

Neuronal processing along the gut–brain axis is crucial for the function and modulation of key gastrointestinal processes, and evidence suggests that this processing can be altered by gut inflammation or infection. This Review discusses the current body of evidence for neuroplasticity (the structural, synaptic or intrinsic changes that alter neuronal function) affecting gastrointestinal function.

The discovery ofHelicobacter pylori redirected our understanding of certain gastroduodenal diseases. Many of these diseases (such as ulcer disease and mucosal associated lymphoid tissue lymphoma) have become curable, and others (gastric cancer) might be preventable with the application of H. pylori eradication therapy. This Timeline gives an overview of the success of clinical research on H. pylorito date and highlights some future trends in this area.