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The selective, chloride channel 2 activator, lubiprostone, facilitates intestinal-fluid secretion and stimulates gastrointestinal motility. These effects increase stool frequency and improve abdominal discomfort for patients with constipation-predominant IBS, which makes lubiprostone the newest addition to the treatment armamentarium for these patients. Findings from a new, pivotal, phase III study by Drossman and colleagues support the use of lubiprostone in such patients.
Children and adolescents with untreated celiac disease display disease-related, histological alterations in the duodenal bulb, according to a new study. In 16 of the 665 patients enrolled in the study, lesions were confined to the duodenal bulb.
In a study carried out in India, antioxidant therapy for chronic pancreatitis offered short-term benefits and was associated with few adverse events. Although the etiology and characteristics of this condition vary between countries, antioxidant therapy could be implemented as an adjunct treatment in the early inflammatory phase of chronic pancreatitis.
Extensive research has addressed the effectiveness of various endoscopic treatments for bleeding peptic ulcers. These studies are often heterogeneous in their methodology, definitions, end points and combinations of modalities used. Evidence-based recommendations that address clinically relevant questions are now available, and will be a valuable resource for practicing endoscopists.
Eosinophilic esophagitis is a chronic esophageal inflammatory disease of undetermined pathophysiology resulting in dense mucosal eosinophilia and esophageal dysfunction. This Review discusses the disease in terms of its clinical presentation in children and adults, pathogenesis, diagnosis and treatment.
Effective cleansing of the colon is pivotal to achieve an accurate colonoscopy evaluation and affords many benefits, including improved visualization, reduced procedure times and reduced complication rates. This Review discusses the colonoscopy preparations available, with an emphasis on the efficacy, tolerability and safety of each method. Knowledge of the different approaches will enable physicians to choose the best preparation for their patients.
Secondary sclerosing cholangitis is a chronic cholestatic biliary disease, which unlike primary sclerosing cholangitis, is thought to develop as a consequence of known injuries. The presence of sclerosing cholangitis in critically ill patients is a new entity that is increasingly recognized. This Review discusses the features, diagnosis, pathogenesis and treatment options for secondary sclerosing cholangitis and sclerosing cholangitis in critically ill patients.
Increased risk of colorectal cancer in patients with IBD may be due to genomic instability caused by chronic colonic inflammation. This Review evaluates the alterations to gene expression and the genetic mutations associated with colitis-associated colorectal cancer and the clinical conditions that precede it. Feagins et al. identify potential molecular targets for colorectal cancer therapy that deserve further investigation.
In this article, Rhee and colleagues review the ample preclinical evidence suggesting that the commensal bacterial flora physiologically present in the gut modulates and influences bidirectional communication between the host's gut and central nervous system. The authors propose possible mechanisms by which these three-way mutual interactions may occur and may affect the host's healthy and diseased states.
