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This Viewpoint makes a plea for more uniform, careful and complete endoscopic diagnosis and grading of Barrett's esophagus in both clinical practice and research. Incorporation of the initiatives proposed into adequately powered, multicenter, prospective studies should provide much needed authoritative guidance on the management of Barrett's esophagus.
In the US, up to 30% of colon cancers exhibit familial clustering and 3–5% are associated with high-risk, inherited colon cancer syndromes. The authors of this Review discuss the clinical presentation and genetics of the major inherited colon cancer syndromes. Particular attention is paid to genetic testing, including when it is indicated, methods used and potential pitfalls. The role of the genetic counselor is also explored.
In this Review, the authors consider the most common severe complication of endoscopic retrograde cholangiopancreatography (ERCP)—post-ERCP pancreatitis—for which there is no definitive means of prevention. The risk factors for post-ERCP pancreatitis and pharmacologic and procedural ways of reducing its incidence are discussed, including proper patient selection, minimally traumatic cannulation techniques and pancreatic duct stenting.
Vitamin D deficiency is common in patients with cirrhosis and is associated with bone density changes. It is generally recommended that patients with cirrhosis and low bone density receive calcium and vitamin D supplementation, despite a lack of evidence for a role of vitamin D in the pathogenesis or treatment of osteoporosis in cirrhotic patients. This Review revisits the controversy surrounding the role of vitamin D in hepatic bone disease and discusses vitamin D therapy in this setting.
