As of the beginning of August 2021, the United States was on track to perform more than 40,000 organ transplants in one year for the first time, according to the United Network for Organ Sharing. More than 21,000 organs were transplanted in the first 6 months of this year alone. The liver is one of the most common organs transplanted each year, and one of the most common indications for liver transplantation is hepatocellular carcinoma (HCC). This month’s issue of Gastroenterology & Hepatology features an interview with Dr Francis Yao on the use of liver transplantation for the treatment of patients with HCC. In our HCC in Focus column, Dr Yao reviews important issues such as whether patients with HCC are currently over- or underprioritized for liver allocation, survival outcomes, which liver transplant recipients are most likely to experience HCC recurrence, and whether there is an optimal bridging therapy to liver transplantation for HCC.
One of our feature articles highlights the gastrointestinal motility disorder gastroparesis, which is characterized by symptoms such as nausea, vomiting, early satiety, and postprandial fullness. Drs Ting Zheng and Michael Camilleri provide a comprehensive overview of this condition, including its epidemiology, clinical manifestations, diagnosis, and management. The authors examine pharmacologic agents such as prokinetics and antiemetics, investigational agents with different mechanisms, pyloric interventions such as botulinum toxin injection and gastric peroral endoscopic myotomy, gastric electrical stimulation and other experimental devices, alternative therapy, and gastrectomy.
Our other feature article focuses on avoidant/restrictive food intake disorder (ARFID), which is a newly described eating disorder, in patients who have inflammatory bowel disease (IBD). In a single-center cross-sectional pilot study, Drs Kimberly Robelin, Peter Senada, Hassan Ghoz, Leslie Sim, Jocelyn Lebow, Michael Picco, John Cangemi, Francis A. Farraye, and Monia Werlang surveyed 100 patients with IBD to examine the prevalence of ARFID in patients with IBD and evaluate clinician recognition of an eating disorder in these patients. The study findings suggest that patients who have IBD are at risk for ARFID and that clinician recognition of at-risk patients is low.
Our coverage of IBD continues with an Advances in IBD column on the management of fistulas in patients who have Crohn’s disease. Dr Amy L. Lightner discusses which patients with Crohn’s disease are at greatest risk of developing fistulas, the current options for therapy, recent clinical trial data on the use of stem cell therapy, and the risk of fistula recurrence, among other issues.
Minimally invasive treatment of patients with gastroesophageal reflux disease (GERD) is highlighted in our Advances in GERD column, which features an interview with Dr Reginald C. W. Bell. His discussion includes when surgical or endoscopic GERD treatments should be recommended, alternatives to Nissen fundoplication, the efficacy and safety of minimally invasive GERD therapies, and patient satisfaction with these procedures.
Finally, colorectal cancer screening is the focus of our Advances in Endoscopy column. Dr Jason A. Dominitz discusses the main barriers to colorectal cancer screening, strategies such as public service campaigns to increase screening, the impact of the COVID-19 pandemic on screening, the use of colonoscopy and alternatives such as fecal immunochemical tests, and the use of artificial intelligence in screening.
May this issue provide you with helpful information that you can put to good use in your clinical practice.
Sincerely,
Gary R. Lichtenstein, MD, AGAF, FACP, FACG