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Although it is well-known that Barrett's esophagus is a major risk factor for the development of esophageal adenocarcinoma, our understanding of the pathogenesis, causes of progression and optimal clinical management is limited. This viewpoint considers the problems of managing Barrett's esophagus, which include defining the condition and determining the value of surveillance and interventional strategies.
Helminth parasites mostly have been eliminated in industrialized parts of the world, where the incidence of inflammatory bowel disease (IBD) is the highest. The authors propose that helminths protect the bowel by downregulating inflammatory responses. Evidence for the immune regulatory effect of helminths in animal models of colitis and in human IBD is discussed.
The choice of therapy for patients with irritable bowel syndrome (IBS) has been based on the predominant bowel symptom; however, it has proven difficult to identify any optimal single pharmacological therapeutic targets. This Review summarizes current and future therapeutic strategies for the treatment of IBS on the basis of putative pathophysiological models.
Several mechanisms that control food intake have been described. As a result, effective appetite suppressants have been developed, and others are being evaluated. Monoamines, amino acids, and peptides all contribute to the control of feeding, and each of the pathways they are part of could contribute to the development of clinically useful drugs for the treatment of obesity.
Distinguishing patients with inflammatory bowel disease (IBD) from those with irritable bowel syndrome can be difficult, and a simple and reliable test that detects intestinal inflammation would be very useful in the clinic. This Review discusses the formation, measurement and intended clinical use of three novel markers of IBD—fecal calprotectin, fecal lactoferrin and luminal nitric oxide.
The total adipose tissue mass is now defined as a real endocrine organ, thanks to the discovery of adipocytokines. Adipocytokines are involved in many processes, including immune function and regulating energy homeostasis. This Review discusses the role of visceral adipose tissue and adipocytokines in intestinal and mesenteric diseases, with special focus on 'creeping fat' in Crohn's disease and mesenteric panniculitis.
