Review Articles in 2014

The pathophysiology of IBS is complex with a number of different factors involved. Here, the authors highlight crosstalk between the gut microbiota, enteroendocrine system, immune system (including neuroimmune interactions) and intestinal permeability in the development of IBS. Insights into how these entities might interact are discussed.

Patients with IBD might be at increased risk of cardiovascular disease and stroke. This Review discusses the epidemiology, pathophysiology, risk factors (in particular, the role of IBD activity and IBD-related medications) and management of cardiovascular disease in patients with IBD. The potential effects of cardiovascular medications on IBD are also discussed.

Oesophageal dysphagia is considered to be an 'alarm symptom' related to diseases such as oesophageal carcinoma and more commonly, functional disorders. Frank Zerbib and Taher Omari discuss the different aetiologies and clinical presentation of oesophageal dysphagia. In addition, they outline the use of endoscopy, biopsy and high resolution manometry for diagnosis.

The association that the mycobiome has with gastrointestinal health and disease is gradually being revealed using state-of-the-art sequencing technologies. This Review presents the latest research on the interaction between fungi, bacteria and the host in relation to gastrointestinal disease, in particular IBD and graft-versus-host disease. The authors point out that further research is needed in this developing area of science and highlight areas of future endeavour.

Polycystic liver diseases are inherited in a dominant or recessive form and result in progressive bile duct dilatation and/or cyst development. Current therapeutic strategies are limited and the only curative option is liver transplantation. This Review discusses the molecular mechanisms that cause polycystic liver diseases and preclinical and clinical studies into new therapeutic targets. The authors also highlight future avenues of research.

Coeliac disease is a common gastrointestinal disease that can present at any age. Previous diagnosis relied on duodenal biopsy however contemporary techniques of antibody detection and determination of genetic susceptibility using HLA genotyping have improved diagnostic accuracy and reduced the our reliance on biopsy samples. This Review discusses the diagnostic process in children, adolescents and adults in light of the progress that has been made in developing accurate coeliac disease diagnostic tools.

Infant nutrition is a key determinant of the early gut microbiota structure. This Review discusses the effect of diet on host–microbial interactions in early life and highlights the key aspects of nutritional programming during the postnatal period that influence the lifelong function of the immune system in health and disease.

As the incidental discovery of benign liver lesions increases with more widespread use of medical imaging, a better understanding of the natural history of these lesions is required to inform medical management. This Review discusses improved imaging techniques in diagnosing and managing patients with benign liver lesions. The changing attitudes to performing biopsies and surgery for diagnosis and treatment are also addressed.

This Review highlights different imaging techniques that are used to assess IBD activity and to survey patients with IBD. Moreover, technical improvements and new tools that aim to measure intestinal fibrosis, postoperative recurrence, activity indices and endoscopic features are analysed. All of these imaging techniques are aimed at changing the paradigm from symptom-driven to lesion-driven treatment of IBD.

Gastric cancer accounts for a notable proportion of cancer mortality around the world. Over the past few decades, advances in technology and high-throughput analysis have improved understanding of the molecular aspects of the pathogenesis of gastric cancer. This Review discusses these genetic aspects of the pathogenesis of gastric cancer.

IBS is a prevalent condition worldwide that incurs substantial health-care costs. The condition can be difficult to diagnose owing to is multifactorial aetiology. Here, the authors provide an overview of the current approaches available to diagnose IBS, including symptoms, symptom-based criteria, biomarkers and psychological markers. Future directions for the field are also discussed.

HCV recurrence occurs in many patients after a liver transplantation, which is associated with considerable morbidity and mortality. Here, Deepak Joshi and colleagues discuss the important risk factors that influence HCV recurrence after liver transplantation, assessment of fibrosis and new antiviral therapies.

The balance of procoagulants and antihaemostatic factors, which usually results in haemostasis is more fragile in patients with liver disease. Owing to this added complexity, treating coagulopathy in patients with liver disease can be difficult. As the pathophysiology of coagulopathy is a rapidly progressing field, this Review aims to provide a therapeutic framework by setting out a clinical rationale for the use of available procoagulants.

Neuronal processing along the gut–brain axis is crucial for the function and modulation of key gastrointestinal processes, and evidence suggests that this processing can be altered by gut inflammation or infection. This Review discusses the current body of evidence for neuroplasticity (the structural, synaptic or intrinsic changes that alter neuronal function) affecting gastrointestinal function.

Growth retardation and delayed puberty are unique features of IBD in children and are caused by both undernutrition and inflammation. The substantial effect of impaired growth and delayed puberty on quality of life creates particular difficulties for disease management. This Review focuses on the pathogenesis of disrupted growth and puberty in children with IBD and the emerging therapies for resolving inflammation and restoring growth.

Functional brain imaging has become an established field in gastroenterology in the quest to further understand the gut–brain axis. This Review provides a broad overview of the use of functional brain imaging in gastrointestinal health and disease, highlighting information gleaned from such studies, current issues in the field and future directions for improvements.

The goals of treatment of chronic pancreatitis can roughly be divided into three categories: pain management, prevention and management of complications of pancreatitis, and correction of pancreatic insufficiency. In this Review, the authors discuss the merits and drawbacks of various treatment modalities for chronic pancreatitis, with a focus on management of pain.

Glycan research holds great promise in the development of biomarkers, and might highlight targets for novel therapeutics in IBD. This Review introduces the main characteristics of glycosylation, and the roles of glycans in health and disease are also briefly presented. The authors subsequently describe in detail the current body of glycobiology literature in relation to IBD and conclude with proposed strategies for further glycan research.

Infants can experience congenital and developmental pharyngeal and/or gastrointestinal motility disorders. This Review highlights the prenatal development of upper gastrointestinal motility and describes the most common motility disorders that occur in early infancy.

Since its introduction in 1974, endoscopic extraction of common bile stones has been continually evolving. Techniques such as endoscopic papillary large-balloon dilation after sphincterotomy have improved safety, and the introduction of cholangioscopically guided electrohydraulic and laser lithotripsy has expanded patient eligibility. This Review focuses on advances in endoscopic management of common bile duct stones, in particular the removal of 'difficult' stones.