How can we best approach the nutritional management of adult Crohn’s disease patients? This month’s issue of Gastroenterology & Hepatology features an Advances in IBD column that explores this question. In a comprehensive discussion focusing on the nutritional management of this patient population, Dr Stephen A. McClave reviews topics such as the impact of malnutrition, potential effects of a typical Western diet, the appropriateness of restrictive diets, and the role of exclusive enteral nutrition or partial enteral nutrition in patients who have Crohn’s disease. Additionally, he discusses the value of dietary fiber and whether supplements and probiotics should be used in the management of adult Crohn’s disease patients as well as future directions in research.
Our feature article this month highlights hepatitis C virus infection in pregnancy. Ms Jacqueline Slobin, Dr Lital Aliasi-Sinai, and Dr Tatyana Kushner point out that this virus affects nearly 60 million people across the world and is increasing in prevalence among reproductive-age women. The authors examine recent data on the epidemiology of hepatitis C virus and the maternal and pediatric implications of being infected with this virus during pregnancy. In addition, the authors discuss screening guidelines from different international and national societies as well as considerations to keep in mind when determining hepatitis C virus treatment of pregnant patients, including recent research on the use of direct-acting antiviral agents in these patients.
Our Advances in Hepatology column centers on cirrhosis and glucagon-like peptide-1 receptor agonists. Dr Sujit Janardhan discusses the impact of glucagon-like peptide-1 receptor agonists on the risk of patients progressing to cirrhosis or decompensation, whether these agents can reverse fibrosis in the cirrhotic setting, and their impact on all-cause mortality. Among other issues, he also covers whether there are any safety concerns with the use of glucagon-like peptide-1 receptor agonists in patients who have compensated cirrhosis or decompensated cirrhosis and provides guidance for the management of cirrhotic patients receiving such therapy.
Meditative movement practices are the focus of our Advances in IBS column. Dr Elyse R. Thakur discusses which practices have demonstrated safety and efficacy in patients with irritable bowel syndrome, the benefits of such practices, and when they should be considered for this patient population. Other topics of discussion include how to approach potential candidates for these types of interventions, whether there are any disadvantages or contraindications to these practices, and how these approaches can be incorporated into an irritable bowel syndrome management plan.
Finally, our Advances in Upper GI Disorders column, which is authored by Professor Carmelo Scarpignato, highlights recent research on potassium-competitive acid blockers (P-CABs) and hypergastrinemia. He discusses the effects of P-CABs on gastrin levels, why these levels increase when patients take a P-CAB or a proton pump inhibitor, and when gastrin levels should be monitored. Additionally, he discusses the potential complications of hypergastrinemia, whether this condition can be predicted, whether P-CAB treatment should be re-evaluated, and how P-CAB–associated hypergastrinemia can be best managed.
May this issue provide you with helpful information that you can put to good use in your clinical practice.
Sincerely,
Gary R. Lichtenstein, MD, FACG, AGAF, FCCF, FACP