Foreword
Riccardo Lencioni is Director of the Division of Diagnostic Imaging and Intervention in the Department of Hepatology and Liver Transplantation at Pisa University Hospital in Italy. Professor Lencioni takes an active role in numerous academic and scientific organisations. He is Chairman of the Membership Committee of the Cardiovascular and Interventional Radiological Society of Europe, Chairman of the European Conference on Interventional Oncology and a member of the Governing Board of the International Liver Cancer Association. Professor Lencioni also serves as an editorial board member for several scientific titles. He has authored 140 articles in peer-reviewed international journals and has written numerous book chapters in textbooks of radiology, surgery, gastroenterology and hepatology. In addition, he has been the editor of seven books. Professor Lencioni has been an invited or honorary lecturer at more than 450 international meetings or conferences.
I
n this issue of European Gastroenterology & Hepatology Review, many topics relevant to gastroenterological practice are discussed. Despite the fact that irritable bowel syndrome (IBS) has a prevalence of 10–20% in the general population, many IBS patients express concern that their complaints are not taken seriously by healthcare professionals and they feel they are not well informed enough. Education and reassurance seem to be two of the most important components in the management of IBS patients. Størsrud et al. review various education strategies for IBS used in recent years.
Remaining on the topic of quality of life, Farmer and Aziz discuss the interaction between opiates and the gastrointestinal tract, including the pathophysiology of narcotic bowel syndrome that occurs in approximately 4–6% of chronic opiate users. Although there is no consensus on the management of narcotic bowel syndrome, the authors review some therapeutic strategies and future directions for research in this field.
Another common disease is colorectal cancer, representing the third most common cancer in the UK. Kent and Greenfield propose a new approach to the diagnostic management of colorectal cancer patients, choosing total colonoscopy or flexible sigmoidoscopy on the basis of different symptoms between right- or left-sided tumours. In this article, the authors describe how to decrease the risk of patients with right-sided tumours undergoing flexible sigmoidoscopy and propose an interesting flow chart.
Muhammed and Gupte highlight recent advances in intestinal transplantation as well as the outcome of new treatments in children with intestinal failure. The goal of a multidisciplinary team should be to ensure long-term growth, promote intestinal adaptation and minimise parenteral nutrition-related complications. In this article, the authors describe different medical and surgical strategies that can be adopted.
Three interesting articles focus on relevant topics for the upper part of the gastrointestinal tract. Barrett’s adenocarcinoma is increasing in incidence, and it has a high mortality unless detected early. Manner and Pech review current techniques for the treatment of Barrett’s oesophagus, highlighting the role of endoscopic resection and ablation of the remaining Barrett’s epithelium after successful resection. The authors elegantly describe the technical aspects, clinical results available and the role of these therapeutic options in terms of surgery. Recent studies documented that up to 70% of reflux patients have typical reflux symptoms in the absence of endoscopically visible oesophageal mucosal injuries making non-erosive reflux disease (NERD) the most common form of gastroesophageal reflux disease. Savarino et al. review pathophysiology, history, new diagnostic tools and future therapeutic strategies for patients without oesophageal mucosal ulcers and/or erosions.
Last but not least, the emerging and challenging topic of the use of probiotics in the therapy of Helicobacter pylori. Francavilla et al. review the principal aspects of this alternative therapy with a focus on currently available in vitro and in vivo results.
Liver biopsy is considered the worldwide gold standard method to assess fibrosis, although it is associated with the risk of complications. Fernandez-Varo and Jiménez review non-invasive markers, including transient elastography and serum markers, for evaluation of hepatic fibrosis and for the assessment of antiviral treatment.
I trust that you will find the content of this issue of great interest and relevance to your practice. n
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© TOUCH BRIEFINGS 2011
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