The journal Gastroenterology & Hepatology marks the beginning of its twentieth year of publication with a wide variety of informative and clinically relevant articles. Among the featured content in this month’s issue is an Advances in IBD column on the use of dietary therapy for patients who have Crohn’s disease. Dr James D. Lewis reviews the recent literature on numerous dietary therapies, including the Mediterranean-style diet, Specific Carbohydrate Diet, Autoimmune Protocol Diet, and Crohn’s Disease Exclusion Diet. Along with related topics, he also discusses the challenges of using a dietary approach and shares his own dietary recommendations for patients with Crohn’s disease.
This month’s issue also features a review article on the intestinal microbiome and depression that was written by Dr Ann F. Kopera, Dr Yii Chun Khiew, Dr Mohd Amer Alsamman, Dr Mark C. Mattar, Dr Raena S. Olsen, and Dr David B. Doman. Their article examines a number of hypotheses that suggest that depression may be affected by the gut microbiome via several pathways. The authors also review the research on emerging therapies that target gut microbiota and depression outcomes. Also covered are the next steps needed in this area, including the performance of large randomized controlled trials and gut microbiome sequencing.
Our other review article highlights the evaluation of liver fibrosis and steatosis via noninvasive modalities. As Dr Iqra Nadeem Kazi, Dr Lily Kuo, and Dr Eugenia Tsai note, liver biopsy is the gold standard for assessing steatosis, necroinflammation, and fibrosis, but this procedure is associated with a number of disadvantages, including invasiveness, procedure risk, and sampling error. The authors outline the growth of noninvasive assessment that has occurred over the past 10 years. The noninvasive tests discussed in this article include the Fibrosis-4 index, Enhanced Liver Fibrosis test, transient elastography, and other ultrasound- and magnetic resonance–based imaging modalities. The authors also cover the use of sequential algorithms and the future of noninvasive assessment.
Endoscopic bypass procedures are the focus of this month’s Advances in Endoscopy column. Dr Christopher C. Thompson discusses recent developments in these procedures and compares their outcomes and risks. His discussion also includes what training should be involved to perform these procedures, device improvements that are needed, challenges to overcome, and how these procedures can be optimized.
Our Advances in Hepatology column reviews the recent guidelines from the American College of Gastroenterology (ACG) on acute liver failure. Dr Alexandra Shingina discusses the definition of acute liver failure and how it can be differentiated from other liver diseases such as acute-on-chronic liver failure. She also summarizes key ACG recommendations for diagnosis, liver biopsy, liver transplant, and other management considerations for patients who have acute liver failure.
Finally, Dr Evan S. Dellon compares gastroesophageal reflux disease (GERD) and eosinophilic esophagitis in our Advances in GERD column. His discussion covers why it is important to distinguish these diseases from each other, their differing diagnostic features, how each disease may be misdiagnosed as the other, and when further testing is needed for differentiation, among other topics.
I hope these articles provide useful information and valuable clinical insight for the coming year, and I wish you and your patients a happy and healthy new year.
Sincerely,
Gary R. Lichtenstein, MD, AGAF, FACP, FACG