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Controversy exists as to whether ursodeoxycholic acid improves survival in patients with primary biliary cirrhosis. This is mainly because the disease is uncommon and slowly progressive, which has meant that many clinical trials lack hard endpoints such as mortality. This Viewpoint article discusses the importance of the appropriate design of clinical trials in this field.
Although there are many similarities among pediatric and adult Crohn's disease patients, some unique features of the pediatric population influence the therapeutic approach adopted; pediatric Crohn's disease can have a significant impact on the patient's quality of life, growth, bone health, and development. This Review focuses on the latest advances in the treatment of complicated pediatric Crohn's disease, including the use of biologic therapies such as infliximab.
This Review discusses the use of C-reactive protein as an inflammatory marker in gastrointestinal diseases. Inflammation does not produce a good C-reactive protein response in all diseases, however, and until there are more data, the use of C-reactive protein and other biomarkers should be seen only as an aid to clinical observation and physical examination and not as a replacement.
Pyoderma gangrenosum is a rare condition of unknown etiology that was described as an extraintestinal manifestation of inflammatory bowel disease in 1930. At present, there are few well-designed published studies that help determine the optimal therapeutic strategy to use for the management of pyoderma gangrenosum. This article reviews the published treatment strategies in current use and aims to guide effective management.
Gastroesophageal reflux disease is associated with laryngopharyngeal reflux, but the cause and effect relationship between these two clinical entities is far from established. This Review considers studies of the pathogenesis of laryngopharyngeal reflux, the value of diagnostic testing either on or off therapy, and treatment options and duration, that have increased our our understanding of this field.
