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Diet and cancer of the esophagus and stomach
Purpose of review Dietary factors have been linked to cancers. This review focuses on several nutrients, which have strong evidence showing increase in cancer risks in the esophagus and stomach. Recent findings Obesity is an important risk factor in upper gastrointestinal cancers. High sugar content in food and sugary drinks are the main drivers of obesity. Proinflammatory diet is another dietary factor, which is increasingly recognized as being associated with esophageal and gastric cancer. Summary Cancer has been predicted to be the leading cause of death in this century. Cancers of the esophagus and st...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Dietary interventions and irritable bowel syndrome – what really works?
Purpose of review The review examines the latest research on the use of dietary interventions in the management of irritable bowel syndrome (IBS) in order to understand what is the evidence supporting the efficacy of a dietary approach in this disorder. Recent findings A general dietary advice should be offered to all IBS patients. Psyllium supplementation is recommended in IBS with both constipation and diarrhea predominance. There is increasing evidence showing the beneficial effects of a low fermentable oligo-, di-, monosaccharides, and polyols (FODMAP) diet (LFD) on IBS symptoms. FODMAPs that are well tolera...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Macronutrients, microbiome and precision nutrition
Purpose of review Precision nutrition and personalized diets are gaining popularity in nutritional science and medicine. To fully appreciate their potential benefits, a deep understanding of both macronutrients and nutrient–microbe interactions is required. Recent findings Microbiome science has reaffirmed the importance of dietary fiber in microbial and host health. Additional macronutrients, digestible carbohydrate, protein and fat also influence the composition and diversity of the microbiome and, therefore, microbial response to dietary intervention. Attention to macronutrient source, dose, microbial effec...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Nutritional consequences of bariatric surgery – prevention, detection and management
Purpose of review Bariatric surgery is an effective treatment option for severe and complex obesity; however, those who undergo such surgery need access to nutritional monitoring and vitamin and mineral supplementation to avoid the development of nutritional deficiencies. Recent findings The British Obesity and Metabolic Surgery Society and the American Society for Metabolic and Bariatric Surgery have recently updated their recommendations on preoperative and postoperative nutritional monitoring and supplementation. There is a growing interest in the more malabsorptive procedures that are associated with an incr...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Bone loss in patients with inflammatory bowel disease: cause, detection and treatment
Purpose of review Inflammatory bowel disease (IBD) is associated with bone loss leading to osteoporosis and increased fracture risk. Bone loss is the result of changes in the balanced process of bone remodeling. Immune cells and cytokines play an important role in the process of bone remodeling and it is therefore not surprising that cytokines as observed in IBD are involved in bone pathology. This review discusses the role of cytokines in IBD-associated bone loss, including the consequences for treatment. Recent findings Many studies have been conducted that showed the effect of a single cytokine on bone cells ...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Iron deficiency: a modern primer to diagnosis and management
Purpose of review Iron deficiency with anemia (IDA) and without anemia remain a diagnostic and management challenge. Iron deficiency has a broad spectrum of causes, including gastrointestinal malignancy. The purpose of this review is to summarize the value and limitations of current methods to diagnose iron deficiency and underline the relevance of contemporaneous evidence to guide the pretest probability of gastrointestinal disease. Recent findings A number of biomarkers for iron deficiency exist, and all have their caveats. Serum ferritin remains the most pragmatic means of diagnosing iron deficiency. Hepcidin...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Nutrient sensing
Purpose of review Sensing of nutrients is foundational for life and allows for cellular adaption to environmental stress. The aim of this review is to provide a basic background and overview of new data on cellular nutrient sensing. Recent findings We focus on sensing of energy by adenosine monophosphate-activated protein kinase, sensing of amino acids via general amino acid control nonderepresible 2 and regulation of cellular metabolism via mammalian target of rapamycin pathways. Over the last 5 years, new data has elucidated how these pathways are both interconnected and regulated by amino acids. Summary ...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Editorial: Nutrition in health and gastrointestinal disease: from molecule to clinic
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: NUTRITION: Edited by Eamonn M.M. Quigley Source Type: research

Immunotherapy in cholangiocarcinoma
Purpose of review Cholangiocarcinoma is an aggressive heterogeneous group of cancers of the biliary epithelium and most patients are detected with advanced metastatic disease with poor prognosis. The therapeutic options are limited, and the current standard care as systemic therapy is still cytotoxic chemotherapy. With the understanding of the complex immune microenvironment in the liver and these cancers arising in the milieu of chronic inflammation, recent advances in immune oncology have transformed the landscape of cancer management with breakthroughs in the treatment of several solid tumors. Recent findings ...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Primary biliary cholangitis: treatment
Purpose of review To discuss the most recent data regarding treatment of patients with primary biliary cholangitis (PBC) with inadequate response to ursodeoxycholic acid (UDCA). Recent findings Patients with PBC at high-risk of progressive disease are younger, have advanced fibrosis and showed inadequate response to UDCA after 12 months of treatment. These patients need a second-line treatment in addition to UDCA. The goal of therapy should be the normalization of ALP and bilirubin below 0.6 the upper limit of normal. Obeticholic acid (OCA) has proven to be effective in improving surrogate markers of prognosis i...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Primary biliary cholangitis: pathogenic mechanisms
Purpose of review Primary biliary cholangitis (PBC) is characterized by autoimmune damage of intrahepatic bile ducts associated with a loss of tolerance to mitochondrial antigens. PBC etiopathogenesis is intriguing because of different perplexing features, namely: a) although mitochondria are present in all cell types and tissues, the damage is mainly restricted to biliary epithelial cells (BECs); b) despite being an autoimmune disorder, it does not respond to immunosuppressive drugs but rather to ursodeoxycholic acid, a bile salt that induces HCO3− rich choleresis; c) the overwhelming female preponderance of the dis...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Autoimmune hepatitis: from immunopathogenesis to diagnostic and therapeutic innovation
Purpose of review To understand the pathogenesis of autoimmune hepatitis (AIH) and the accuracy of diagnosis and treatment options that have improved lately. We summarize the latest research. Recent findings Concerning pathogenesis of AIH, different groups have identified pieces of the puzzle that fit together well: An altered microbiome in the gut results in a proinflammatory response in the liver. This response is built by type II natural killer cells and CD4 T cells with an inflammatory phenotype and marked tumor necrosis factor production. When looking specifically at autoantigenic CD4 T cells, these have a ...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Mechanisms of autoimmune hepatitis
Purpose of review Autoimmune hepatitis (AIH) is a chronic disease characterized by a lymphocyte infiltrate in the liver. For decades, nonspecific immunosuppression has been used to limit chronic liver inflammation. The high risk of relapse, the treatments side effects, and the significant number of refractory patients are the main clinical issues that require efforts to understand AIH immune mechanisms. Recent findings The balance between regulatory CD4 T cells, known to control autoimmunity, and effector CD4 T cells, that recognize liver self-antigens and mediate the liver inflammation, appears central in AIH i...
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Editorial: Immunity from trigger to therapy in hepatobiliary diseases
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: BILIARY TRACT: Edited by Chantal Housset Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Gastroenterology)
Source: Current Opinion in Gastroenterology - February 18, 2021 Category: Gastroenterology Tags: EDITORIAL INTRODUCTIONS Source Type: research