The poor prognosis of patients with pancreatic cancer is well recognized. According to the National Cancer Institute’s Surveillance, Epidemiology, and End Results program, the 5-year overall survival rate is only approximately 8%. However, that number increases for stage IA and IB pancreatic cancer as well as for patients with minute lesions. Thus, early detection may have an impact on disease prognosis. In a feature article in this month’s issue of Gastroenterology & Hepatology, Dr Florencia McAllister, Dr Maria F. Montiel, Dr Guneesh S. Uberoi, Dr Angad S. Uberoi, Dr Anirban Maitra, and Dr Manoop S. Bhutani emphasize the importance of screening patients who have a high risk of pancreatic cancer and examine the methods currently available and in development for early detection and surveillance of pancreatic cancer.
In another feature article, Dr Omar I. Massoud and Dr Nizar N. Zein present results of a study examining the effect of transjugular intrahepatic portosystemic shunt (TIPS) on platelet counts in patients with liver cirrhosis. As the authors note, a common complication of liver cirrhosis is thrombocytopenia, and this condition is thought to be improved in liver cirrhosis patients by methods that reduce portal hypertension, such as TIPS. The authors examine the platelet response of cirrhotic patients to TIPS and evaluate whether other factors are related to this response.
This month’s Advances in IBD column involves the use of combination therapy for the treatment of patients with inflammatory bowel disease. Dr Stephen B. Hanauer outlines the history of this therapeutic approach and highlights findings from a new SONIC analysis. Among other issues, he also discusses the management of patients who are in remission on combination therapy and the short- and long-term safety of this therapeutic approach.
Our Advances in Hepatology column focuses on the recent reports of hepatitis B virus (HBV) reactivation following the use of direct-acting antiviral agents in patients coinfected with HBV and hepatitis C virus (HCV). Dr Robert G. Gish discusses these reports, possible theories for the reactivation of HBV, earlier cases of HBV reactivation with HCV treatment, and adjustments that doctors should make when managing HBV/HCV-coinfected patients, along with other issues.
In our Advances in Endoscopy column, Dr Mouen A. Khashab provides an overview of endoscopic ultrasound–guided gastroenteric anastomosis. He describes the methods for creating an anastomosis, differences between the endoscopic and surgical procedures, the use of stents and balloon dilation, and adverse events, among other issues.
This month’s issue also includes a Clinical Update column on Clostridium difficile infection and the role of adaptive immunity in the microbiome. Among other issues, Dr Monika Fischer discusses the current understanding of the relationship between C difficile infection and the microbiome as well as the adaptive immune response to C difficile and new therapeutic approaches that target this response.
Finally, we are pleased to debut a bimonthly column focusing on irritable bowel syndrome (IBS) with Dr William D. Chey as the Section Editor. In the first installment, Dr Lin Chang examines the Rome IV criteria for IBS. Among the issues discussed are the development of the criteria, how the changes will affect the prevalence of IBS, the role of the criteria in research and clinical practice, and current and future diagnostic tests for IBS.
I hope you find these articles interesting and clinically useful.
Sincerely,
Gary R. Lichtenstein, MD, AGAF, FACP, FACG