Volume 11 Issue 9, September 2014

The presence of ductal abnormalities after an unexplained acute attack of acute pancreatitis or in patients with recurrent acute pancreatitis might lead to a misdiagnosis of chronic pancreatitis or complications of acute pancreatitis. A new study suggests secretin administered during magnetic resonance cholangiopancreatography (MRCP) leads to a better diagnostic yield than MRCP alone.

There is increasing interest in the role that diabetes has in liver-related outcomes in patients with chronic HCV. Elkrief and colleagues have furthered this discussion by indicating that diabetes may be considered a prognostic factor for major liver-related outcomes in patients with chronic HCV infection, including death and transplantation.

Treatment of patients with steroid-refractory ulcerative colitis is still a challenge for physicians. A recent study has evaluated the effectiveness and safety of sequential rescue therapies in this subgroup of patients.

NSAIDs provide improved pain control and reduce the use of opioids—both important components of enhanced recovery programs after colorectal surgery. However, the possible association between NSAID use and anastomotic leaks is greatly debated. Anastomotic leak remains an important concern due to the substantial associated morbidity.

Barrett oesophagus is an important precursor lesion for the development of oesophageal adenocarcinoma. Here, the authors describe the role of endoscopic and histological findings in the prediction of neoplastic progression of Barrett oesophagus to dysplasia. Risk-prediction models that include endoscopic and histological parameters are also discussed.

Since its introduction in 1974, endoscopic extraction of common bile stones has been continually evolving. Techniques such as endoscopic papillary large-balloon dilation after sphincterotomy have improved safety, and the introduction of cholangioscopically guided electrohydraulic and laser lithotripsy has expanded patient eligibility. This Review focuses on advances in endoscopic management of common bile duct stones, in particular the removal of 'difficult' stones.

Infants can experience congenital and developmental pharyngeal and/or gastrointestinal motility disorders. This Review highlights the prenatal development of upper gastrointestinal motility and describes the most common motility disorders that occur in early infancy.

The goals of treatment of chronic pancreatitis can roughly be divided into three categories: pain management, prevention and management of complications of pancreatitis, and correction of pancreatic insufficiency. In this Review, the authors discuss the merits and drawbacks of various treatment modalities for chronic pancreatitis, with a focus on management of pain.

Functional brain imaging has become an established field in gastroenterology in the quest to further understand the gut–brain axis. This Review provides a broad overview of the use of functional brain imaging in gastrointestinal health and disease, highlighting information gleaned from such studies, current issues in the field and future directions for improvements.