Volume 13 Issue 5, May 2016

Chronic kidney disease has joined the growing list (pneumonia, myocardial infarction, hip fracture, Clostridium difficile infections, acute interstitial nephritis, hypomagnesaemia) of putative risks associated with chronic PPI use based on results from an observational epidemiological study. However, the low hazard ratio (<1.5) makes it doubtful that this association is a causal relationship.

Hepatocellular carcinoma is associated with HCV infection but the underlying interplay between virus and tumour remains to be elucidated. Now, Harouaka et al. report that in patients with HCV-related cirrhosis, HCV replication is restricted within liver tissue originating from hepatocellular carcinoma, with an associated increase in the diversity and complexity of the HCV quasispecies.

A recent paper indicates that intraoperative and postoperative complications associated with complete mesocolic excision are increased when compared with conventional surgery. Variability in complication rates between studies highlights the need for standardization in colorectal surgery. This process should start by addressing factors that have hampered standardization to date.

In the past few years, the mechanisms leading to an acquired resistance to anti-EGFR monoclonal antibodies became an important topic in metastatic colorectal cancer research. In this commentary, we briefly summarize the latest update to this field by Arena and colleagues, and discuss promising new drugs and treatment strategies that might lead to overcoming secondary resistance.

Cholangiocarcinomas are a heterogeneous group of bile duct cancers and the second most common primary liver tumour worldwide. In this Consensus statement, the newly formed European Network for the Study of Cholangiocarcinoma (ENS-CCA) detail the classification, pathophysiology and underlying mechanisms, and current therapies for cholangiocarcinoma, as well as future perspectives.

Up to 30% of patients with typical GERD symptoms are refractory to standard acid-suppressive treatment. In this Review, the authors discuss the clinical features and current management of patients with refractory GERD, and the roles of surgical interventions and pharmaceutical agents. Finally, the authors provide up-to-date algorithms for the optimal management of patients with refractory GERD.

Constipation is common, affecting quality of life and causing a burden on health-care resources. Here, the authors provide an overview of the diagnosis and management of chronic constipation in adults, highlighting the pathophysiology of the condition and the available treatment options.

Acute pancreatitis is a common cause of acute hospitalization, and infected (extra)pancreatic necrosis is a potentially lethal complication. In this Perspectives, the authors discuss challenges in the management of infected necrotizing pancreatitis, particularly in relation to the timing of catheter drainage.