Gastroenterology & Hepatology

June 2018 - Volume 14, Issue 6

Letter From the Editor: Traveling With Inflammatory Bowel Disease 

Gary R. Lichtenstein, MD, AGAF, FACP, FACG

As summer nears, many people are planning their vacations. For patients with inflammatory bowel disease (IBD), traveling can pose certain risks. In the Advances in IBD column in this month’s issue of Gastroenterology & Hepatology, Dr Gerhard Rogler discusses why IBD patients have an increased risk for infection (including opportunistic infection), some of the infections commonly encountered in this patient population, which vaccines and other preventive measures (including insect repellents) are recommended before and while traveling, how to manage traveler’s diarrhea, and whether high-altitude travels and long-distance flights may trigger IBD flares, among other issues.

One of our feature articles this month focuses on current and future therapeutic approaches for chronic hepatitis D. Dr Patrizia Farci and Dr Grazia Anna Niro highlight the unconventional nature of hepatitis D virus, current management with standard or pegylated interferon-α, and how new insights from the life cycle of this virus have resulted in the emergence of novel drug classes presently being investigated (ie, sodium taurocholate cotransporting polypeptide receptor inhibitors, farnesyltransferase inhibitors, and nucleic acid polymers). 

Another feature article outlines the evolution of the diagnostic framework for eosinophilic esophagitis (EoE), a disease that was first reported in the literature over 40 years ago. Dr Hannah P. Kim and Dr Evan S. Dellon describe the initial clinical guidelines for EoE, how and why the guidelines have changed over time, how the disease should currently be diagnosed, and future directions for diagnosis. They also provide a helpful visual representation of EoE’s evolving international diagnostic approach over time.

Our third feature article this month examines the role of abdominal ultrasound in the diagnosis of cirrhosis in patients without portal hypertension who were referred for sonographic liver assessment. Dr Erin M. M. Kelly, Dr Vickie A. Feldstein, Ms Monica Parks, Ms Rebecca Hudock, Mr Dustin Etheridge, and Dr Marion G. Peters discuss the materials, methods, and results of their single-center, retrospective study on this issue.

In our Advances in Hepatology column, Dr Stephen A. Harrison outlines current and emerging approaches to the management of patients with nonalcoholic steatohepatitis (NASH). Among other issues, he discusses the role that diet and exercise play in the treatment of NASH patients, whether vitamin D or E supplementation has a role in these patients, and pharmacologic approaches presently being investigated in phase 2A, 2B, and 3 trials.

Peroral endoscopic myotomy (POEM) in the setting of achalasia is the focus of our Advances in GERD column. Along with related issues, Dr Mouen A. Khashab discusses both short- and long-term data on the safety and efficacy of this procedure, how POEM compares to other treatment options for achalasia, its benefits and limitations, possible adverse events, contraindications, required follow-up, and learning curve.

In our bimonthly HCC in Focus column, Dr Alessio Aghemo provides an update on the management of hepatocellular carcinoma (HCC), focusing on the guidelines recently released by the European Association for the Study of the Liver (EASL). He examines the current status of HCC management and recent changes reflected in the EASL guidelines involving surveillance, diagnosis, liver allocation, liver transplantation, systemic treatment, and other therapeutic options, among other issues.

I hope that you enjoy these articles and find them interesting and clinically useful.


Gary R. Lichtenstein, MD, AGAF, FACP, FACG

Millennium Medical Publishing, Inc