Volume 13 Issue 9, September 2016

Symptom-based diagnostic criteria have been criticized for being overly complex and performing modestly in differentiating organic from functional gastrointestinal diseases. The new Rome IV criteria now supersede Rome III. In general, these minor amendments are unlikely to lead to substantial improvement in accuracy and use in routine clinical care. Is a different approach required in future?

Maternal obesity has been linked to neurodevelopmental disorders in offspring but the underlying mechanisms are unclear. Buffington and colleagues now provide causal evidence linking maternal diet, gut microbiota and the central nervous system, highlighting key components of gut–brain signalling and indicating that a probiotic might relieve behavioural abnormalities.

Since the recognition of reflux oesophagitis as a disease entity, scientists and clinicians have commonly assumed that the first step in its pathogenesis was a loss of superficial epithelial cells, brought about by caustic acid injury. However, new data suggests that it is time to reconsider this concept.

A recent study reports that being overweight in late adolescence is associated with an increased risk of liver-related morbidity and mortality later in life. These findings give further strength to the concerns for the deleterious effects of childhood obesity on liver health. Early prevention by screening and lifestyle modification should be advised by health policies.

Faecal microbiota transplantation (FMT) has emerged as a successful treatment forClostridium difficileinfection (CDI). Here, the authors describe the latest information on the mechanisms of action of FMT in the context of CDI and how it might restore the gut microbial community and structure. They also explore future applications of FMT beyond CDI.

The enteric nervous system is vital for life, and its dysfunction participates not only in digestive disorders, but also in diseases of the central nervous system (CNS). Here, Rao and Gershon discuss the gastrointestinal consequences of neurological disorders, the acquisition of CNS disease in the gut and the spread of pathology along the gut–brain axis.

Correct diagnosis and detailed assessments in patients with GERD are needed to correctly characterize the condition in adults and children and to avoid overtreatment. In this Review, the authors outline currently available diagnostic tests and discuss approaches to limit any unnecessary medical or surgical interventions.

Resection of the diseased gastrointestinal tract can lead to surgical complications and low quality of life. In this Review, Bitar summarizes advances in gastrointestinal tissue engineering and regenerative medicine that aim to overcome these complications and restore tissue function.