September 2009 Volume 6 Number 9
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=========================== ADVERTISEMENT ===========================
New ACG Guidelines Issued for the Management of IBS
The American College of Gastroenterology (ACG) has updated its 2002
Evidence-Based Position Statement on the Management of Irritable Bowel
Syndrome - complete with new treatments, new graded recommendations and
new recommendations on diagnostic testing.
Irritable Bowel Syndrome is one of the most common disorders managed by
gastroenterologists and primary care physicians, and in light of the
changes in the clinical landscape relating to IBS therapy in recent
years the ACG has decided to update its position statement.
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EDITORIAL
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Addicted to acid suppression
Stephen B. Hanauer
p497 | doi:10.1038/nrgastro.2009.146
http://links.ealert.nature.com/ctt?kn=44&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
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RESEARCH HIGHLIGHTS
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Pancreas: Pancreatic cancer-effects of BMI on risk, age of onset, and
survival
p499 | doi:10.1038/nrgastro.2009.136
http://links.ealert.nature.com/ctt?kn=54&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Pancreas: Prognostic indicator in acute pancreatitis
p500 | doi:10.1038/nrgastro.2009.130
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Nutrition: Dietary nutrient composition affects progression of liver
disease
p500 | doi:10.1038/nrgastro.2009.135
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Celiac disease: Undiagnosed cases-rising prevalence, increased mortality
p501 | doi:10.1038/nrgastro.2009.131
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Nutrition: Carbohydrate malabsorption in chronic intestinal disorders
p501 | doi:10.1038/nrgastro.2009.132
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Physical activity improves NAFLD
p501 | doi:10.1038/nrgastro.2009.134
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Genetics: Genetic variants associated with primary biliary cirrhosis
p502 | doi:10.1038/nrgastro.2009.133
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Colorectal cancer: CT colonography for colorectal cancer screening
p502 | doi:10.1038/nrgastro.2009.137
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NEWS AND VIEWS
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Hepatitis C: Should antiviral therapy be offered to elderly patients?
Annarosa Floreani
p503 | doi:10.1038/nrgastro.2009.138
Relatively little information exists on the prognosis for elderly patients
with chronic hepatitis C (CHC). Moreover, the majority of randomized,
clinical trials of hepatitis C treatment exclude elderly patients.
Findings from a 2009 clinical study address risk of hepatocellular
carcinoma, life expectancy and the influence of antiviral therapy in
elderly patients with CHC.
http://links.ealert.nature.com/ctt?kn=6&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Nonalcoholic fatty liver disease: Disease and comorbidity-effects on
quality of life
Giulio Marchesini and Giampaolo Bianchi
p504 | doi:10.1038/nrgastro.2009.142
Nonalcoholic fatty liver disease has long been neglected by health-care
professionals unless affected patients develop cirrhosis; however, new
research shows this disease impairs health-related quality of life. The
association of nonalcoholic fatty liver disease with chronic metabolic
diseases and cardiovascular complications restricts our ability to
define a specific role for liver damage in the poor perceived health
status of these patients.
http://links.ealert.nature.com/ctt?kn=42&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Large intestine: Remission of lymphocytic colitis with budesonide
Curt Tysk
p506 | doi:10.1038/nrgastro.2009.139
Few randomized, controlled trials have investigated the efficacy of
pharmacological treatment for lymphocytic colitis. Data from a new
randomized, placebo-controlled trial have demonstrated the efficacy
of budesonide in inducing remission of this disease; this study is an
important contribution to this field.
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Colorectal cancer: Irinotecan therapy-following a trail of breadcrumbs?
Richard M. Goldberg and Bert H. O'Neil
p507 | doi:10.1038/nrgastro.2009.140
The optimal therapy for patients with metastatic and treatment-refractory
colorectal cancer is controversial. Questions with regard to both the
sequence and combinations of different drugs need to be answered by
well-designed and adequately powered studies before the most appropriate
option for second-line treatment for these patients can be defined.
http://links.ealert.nature.com/ctt?kn=36&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Hepatitis C: The role of new interferons in the era of STAT-C
Rami Moucari and Patrick Marcellin
p509 | doi:10.1038/nrgastro.2009.141
More than 50% of patients infected with HCV genotype 1 fail respond to
standard treatment with peginterferon plus ribavirin. Potent treatment
strategies are urgently needed to improve outcomes for such patients.
Novel interferons and specifically targeted antiviral therapy for HCV
(STAT-C) represent promising strategies.
http://links.ealert.nature.com/ctt?kn=34&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Crohn's disease: How modern is the management of fistulizing disease?
Alessandro Fichera
p511 | doi:10.1038/nrgastro.2009.109
Considerable advances in tools for the diagnosis and management of Crohn's
disease have been made. Despite technological progress, a new study
reports that more than one-third of patients with Crohn's disease are
still diagnosed with fistulizing disease intraoperatively and that the
surgical management of these patients is not well characterized.
http://links.ealert.nature.com/ctt?kn=26&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
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REVIEWS
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Mechanisms of growth impairment in pediatric Crohn's disease
Thomas D. Walters and Anne M. Griffiths
p513 | doi:10.1038/nrgastro.2009.124
Restoration of normal growth is a marker of success of therapy in
pediatric Crohn's disease. This Review highlights current understanding
of the complex pathophysiologic mechanisms that contribute to growth
impairment, which clearly stems from more than simply injudicious chronic
corticosteroid use and inadequate nutrition.
Abstract: http://links.ealert.nature.com/ctt?kn=85&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=56&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Insights into the future of gastric acid suppression
Kenneth R. DeVault and Nicholas J. Talley
p524 | doi:10.1038/nrgastro.2009.125
The development of effective acid-suppression therapy has revolutionized
the treatment of acid-related diseases. This Review provides an update
on the status of acid-suppression therapy and includes discussion of
the efficacy and safety of available agents, novel agents in development,
risks of acid suppression, and directions for future research.
Abstract: http://links.ealert.nature.com/ctt?kn=43&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=62&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Diagnosis and management of acute cholangitis
John G. Lee
Published online: 04 August 2009
p533 | doi:10.1038/nrgastro.2009.126
Acute cholangitis is a bacterial infection of the biliary tract that
occurs in an obstructed system and is characterized by fever, abdominal
pain and jaundice. No universally accepted consensus for the diagnosis
of acute cholangitis exists. This Review describes current recommendations
for the diagnosis and management of this disease and discusses the merits
and drawbacks of the most comprehensive guidelines available.
Abstract: http://links.ealert.nature.com/ctt?kn=84&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=64&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Management of acute liver failure
R. Todd Stravitz and David J. Kramer
Published online: 04 August 2009
p542 | doi:10.1038/nrgastro.2009.127
Acute liver failure is the abrupt loss of hepatocellular function in a
patient with a previously normal liver. In this Review, Stravitz and
Kramer discuss the intensive care management of patients with acute liver
failure, the treatment of complications to prevent multi-organ-system
failure, and the role of orthotopic liver transplantation in this setting.
Abstract: http://links.ealert.nature.com/ctt?kn=82&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=86&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
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PERSPECTIVES
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OPINION
Does PPI therapy predispose to Clostridium difficile infection?
Chaitanya Pant, Phillip Madonia and Anil Minocha
p555 | doi:10.1038/nrgastro.2009.128
The incidence of Clostridium difficile infection has dramatically risen,
in concert with the increasing use of PPIs for gastric acid suppression.
This Perspective focuses on the role that PPI use may have in C. difficile
infection, and weighs up the pros and cons of PPI therapy.
Abstract: http://links.ealert.nature.com/ctt?kn=81&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=77&m=33941485&r=MTc2OTYyOTQ2MwS2&b=2&j=NTczMjM1NDIS1&mt=1&rt=0
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