The fall conference season is upon us, with the World Congress of Gastroenterology at ACG2017 being held October 13 to 18 in Orlando, Florida, and The Liver Meeting 2017 being held October 20 to 24 in Washington, DC. These conferences offer wonderful opportunities for us to present and discuss the latest research and catch up with colleagues. As you travel to and attend these conferences, or follow the proceedings from afar, I hope you find the content in this issue of Gastroenterology & Hepatology to be valuable.
One of our feature articles this month focuses on noninvasive methods that can be used to evaluate the regression of fibrosis in patients with hepatitis C virus (HCV) infection who have achieved sustained virologic response. Dr Hirsh D. Trivedi, Dr Steven C. Lin, and Dr Daryl T. Y. Lau examine the use of noninvasive serologic tests for fibrosis as well as nonserologic tests. The authors also discuss the noninvasive prediction of fibrosis and portal hypertension as well as the regression of these conditions, and propose an algorithm for managing patients who have had successful HCV therapy.
In our other feature article, Ms Carol Rees Parrish and Dr John K. DiBaise provide a thorough overview of the management of short bowel syndrome in adults. Patients with this disorder are unable to maintain nutritional, electrolyte, and/or fluid homeostasis despite having a healthy diet after bowel resection. The authors examine the physiologic alterations and clinical complications of short bowel syndrome; the importance of a multidisciplinary treatment approach involving dietary, fluid, and phar-macologic therapies; and the role of surgery.
Our Advances in IBD column offers an introduction to the use of biosimilars for the treatment of inflammatory bowel disease (IBD). In this column, the first of a 3-part series on biosimilars in IBD, I define important terms (such as biosimilar, biobetter, and generic) and concepts (such as extrapolation of indication, inter-changeability, and nonmedical switching). I also discuss other key issues such as the rationale for using biosimilars in this setting and the regulatory review process for production of these agents.
In our Advances in Hepa-tology column, Dr Guadalupe Garcia-Tsao discusses the management of portal hypertension with nonselective beta blockers. Among other issues, she examines the stages, causes, and consequences of portal hypertension; studies that have been conducted on nonselective beta blockers in this setting; the risks and contraindications of these agents; alternate therapeutic options; and promising alternate treatments under development.
Our Advances in GERD column focuses on the use of hybrid argon plasma coagulation for the management of Barrett esophagus. Dr Oliver Pech explains how this procedure was developed, its efficacy and safety, its advantages and disadvantages compared to alternate techniques, and its learning curve, among other issues.
In our Advances in Endoscopy column, Dr Richard A. Kozarek examines the evolution of endoscopic retro-grade cholangiopancreatography (ERCP). Among other issues, he discusses the current indications of this pro-cedure, factors affecting the utilization of ERCP, and changes in ERCP training that have occurred and that may occur in the future.
Finally, our bimonthly HCC in Focus column returns with an interview with Dr Hashem B. El-Serag on the current use of sorafenib in patients with hepatocellular carcinoma. He discusses the current indications for this drug; the latest research involving effectiveness, quality of life, and cost-effectiveness; observations from real-world experiences and registries; and remaining research needs.
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