Gastroenterology & Hepatology

March 2019 - Volume 17, Issue 3

Letter from the Editor: Diet and Inflammatory Bowel Disease

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


Over our 15 years of publication, Gastroenterology & Hepatology has covered a number of dietary inventions for the management of different diseases in various feature articles and columns. This month’s issue adds to our growing collection with a feature article on diet and inflammatory bowel disease (IBD) contributed by Mr Nicolaus Nazarenkov, Dr Kristina Seeger, Ms Lori Beeken, Dr Ashwin N. Ananthakrishnan, Dr Hamed Khalili, Dr James D. Lewis, and Dr Gauree Gupta Konijeti. This comprehensive article examines dietary risk factors for IBD, patients’ dietary perceptions, malnutrition, and macro- and micronutrient deficiencies, as well as evaluates various dietary therapies for active IBD, including the Specific Carbohydrate Diet; the autoimmune protocol diet; the low–fermentable oligosaccharide, disaccharide, monosaccharide, and polyol diet; and the IBD–anti-inflammatory diet. The article also offers recommendations for IBD patients interested in modifying their diet. 

Our other feature article this month focuses on primary biliary cholangitis, formerly known as primary biliary cirrhosis. Dr Fernanda Q. Onofrio, Dr Gideon M. Hirschfield, and Dr Aliya F. Gulamhusein provide a thorough review of this disease, including its epidemiology, risk factors and pathogenesis, clinical presentation and diagnosis, risk stratification, and first- and second-line treatment options, as well as therapeutic approaches for managing symptoms.

Our hepatology coverage continues with our Advances in Hepatology column on the management of thrombocytopenia in patients with chronic liver disease. In his discussion, Dr Robert S. Brown Jr examines when prophylactic measures should be used in patients with both of these conditions who are planning an elective procedure with a bleeding risk, and provides an overview of the current management options, including the newly approved thrombopoietin analogues avatrombopag and lusutrombopag. 

Extraintestinal manifestations of IBD are the focus of our Advances in IBD column. Dr Millie D. Long discusses the different types of extraintestinal
manifestations that may develop as well as issues such as whether these manifestations are more common with Crohn’s disease or ulcerative colitis, when they typically occur, how the presence of IBD influences their management, collaboration with specialists, and recent research and trends.

Our Advances in Endoscopy column highlights the use of fiducial markers via endoscopic ultrasound for the management of gastrointestinal malignancies. In their discussion, Dr Manoop S. Bhutani and Dr Joseph M. Herman describe different types of fiducial markers and delivery systems, where the markers should be placed, and important research findings, as well as adverse events and the long-term effectiveness of this technique.

Finally, the treatment of irritable bowel syndrome (IBS) using microbiome-based strategies is the focus of our Advances in IBS column. Dr William D. Chey starts by discussing the relationship between IBS and the microbiome, and then examines different therapeutic approaches, including probiotics, antibiotics, dietary therapies, and fecal microbiota transplantation. The role of biomarker-based strategies is also discussed. 

*       *       *

On a sad note, I would like to acknowledge the recent passing of Dr John Baillie, who faithfully served as our section editor of endoscopy for 13 years, starting from our very first issue. He was passionate about highlighting clinically relevant, “hot” topics in our monthly Advances in Endoscopy column and always made time for his editorial duties. We greatly appreciate all of his contributions to the journal and will miss his enthusiasm and expertise.


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

Millennium Medical Publishing, Inc