Volume 11 Issue 5, May 2014

Quality of life and disability have been compared in patients with ulcerative colitis who were undergoing one of the two current major treatments of choice, proctocolectomy or anti-TNF therapy. The only significant differences between the two groups were increased use of antidiarrhoeal medication and stool frequency in those who underwent surgery.

Are some patients with hepatocellular carcinoma just too old to be treated? More specifically, should the age of a patient influence the way sorafenib is prescribed? A new study has tried to address these questions, providing helpful information to guide clinicians making these decisions.

Designing clinical trials for the treatment of NASH is challenging. The pathogenesis of this disease is poorly understood and is probably multifactorial. A trial of a phosphodiesterase-4 inhibitor produced negative results, despite promising preclinical data. Examining why this trial failed might help us design better trials of treatments for NASH in the future.

Primary sclerosing cholangitis (PSC) is understood to be associated with an increased risk of malignancy in the bile ducts, gallbladder and colon. The risk of hepatocellular carcinoma in the setting of PSC, however, is not well defined. Zenouzi et al. provide an analysis of their experience in a recent article

With the ongoing shortage of livers available for transplantation, attention has turned to cell-based approaches to support liver function and enable liver regeneration. However, hepatocyte transplantation is beset with problems and a clinically adoptable strategy is lacking. How can a plentiful supply of hepatocyte-like cells with long-term proliferation be generated?

This Review presents the emerging surgical therapies available to treat patients with faecal incontinence. These techniques include neuromodulation, neosphincter creation (muscle or artificial) and injection therapy. The need for further research and development—not only in terms of the devices and procedures, but also to identify which patients are likely to benefit most from such interventions—is also 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.

This Review outlines the nomenclature of addiction to alcohol and details how patients who drink to excess should be assessed for liver transplantation. Michael Lucey also explores the controversies about predicting future drinking behaviour and offering liver transplantation to patients with severe alcoholic hepatitis.

Thrombosis of the portal venous system is a frequent and potentially life-threatening condition. Here, the authors discuss how imaging can provide assistance to physicians involved in this decision-making process in different clinical settings including liver cirrhosis and hepatocellular carcinoma.

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.