Volume 2 Issue 11, November 2005

Acute fatty liver of pregnancy is a devastating disorder that can significantly affect the morbidity and mortality of both mother and fetus. This Viewpoint discusses the prevalence and implications of this disorder and examines the role of genetic screening in helping to identify patients at risk for this disease.

In this era of critical organ shortage, how should physicians and patients decide whether to accept or decline the offer of a specific deceased-donor liver? The author of this Viewpoint article considers recent data evaluating the impact of donor characteristics and severity of recipient disease on the decision-making process.

Fecal incontinence is a common symptom that is generally caused by conditions associated with anorectal sensorimotor dysfunction or diarrhea. Clinical assessment and diagnostic testing should be tailored to the patient's age and symptom severity. Management options, including modulation of disordered bowel habits, biofeedback and surgery, must be tailored to the clinical manifestations, and include treatment of underlying diseases.

The demonstration that endoscopic band ligation has a greater efficacy and fewer side effects than endoscopic injection sclerotherapy has renewed interest in endoscopic treatments for esophageal varices in patients with cirrhosis. This Review focuses on the role of endoscopic band ligation in the primary and secondary prevention of variceal bleeding as well as in the treatment of acute bleeding episodes.

Smoking can have a detrimental and beneficial effect on gastrointestinal disease—it has such a 'polarizing effect' in patients with Crohn's disease and ulcerative colitis. Studies in tobacco smokers have made it difficult to identify which agents are responsible for these effects, but work on the action of nicotine alone might help to explain some of the positive and negative links between smoking and gastrointestinal disease.