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It has been suggested that genetic factors are likely to have a major role in the manifestation of functional gastrointestinal disorders. In this Review, the authors consider the evidence available for such a role. They discuss the results of family and twin studies and studies of individual genes thought to be involved in the manifestation of functional gastrointestinal disorders.
Severe ulcerative colitis is considered a medical emergency, the management of which requires close collaboration between gastroenterologists and surgeons. The authors of this Review discuss the identification of prognostic factors and intensive medical treatment for both uncomplicated and complicated ulcerative colitis, as well as the timing of surgery.
The efficacy of biologic therapies is proven and their use is growing worldwide; however, there is concern about their long-term safety, including the risk of developing cancer. In this Review, data available on the association of anti-tumor necrosis factor therapies and the anti-α4 integrin monoclonal antibody natalizumab with cancer in patients with IBD are discussed.
Although alcohol consumption and tobacco use are the major risk factors for esophageal cancer in developed countries, nutrition and diet are also important. This Viewpoint discusses evidence for a link between diet and esophageal cancer and the influence it might have with regard to the prevention of esophageal cancer.
Dyspepsia is remarkably common. Of those individuals with dyspepsia who present for care, perhaps 10% are referred because their symptoms remain refractory and troublesome. Many gastroenterologists seem to feel somewhat at a loss in this situation; however, there are sensible management options to consider. This Review considers the testing and treatment alternatives, and discusses what can be done for the difficult-to treat dyspeptic patient.
Chronic consumption of alcohol can cause a spectrum of liver abnormalities, ranging from simple steatosis to steatohepatitis, cirrhosis and hepatocellular carcinoma. Alcoholic liver disease is still the most common cause of liver cirrhosis in the Western world. This Review focuses on the current management of patients with alcoholic liver disease, with emphasis on alcoholic steatohepatitis and cirrhosis.
The main physiologic function of albumin is to maintain colloid osmotic pressure. The recognition of many other physiologic functions, however, means that the clinical application of albumin has expanded. This Review discusses the physiologic actions of albumin, the clinical settings in which albumin has been used in patients with cirrhosis, and the potential benefits and pitfalls associated with the use of albumin.
