Gastroenterology and HepatologyPathophysiology, presentation, diagnosis and management

Gastroenterology, in its widest definition, encompasses a tremendous breadth of human disease including within its compass, not only disorders of the luminal digestive tract, but also disorders of related organs; the liver and the pancreas. Such disorders, from diarrhoea to colon cancer and from the irritable bowel to hepatitis are... read moreamong the most common disorders world wide. Thus, digestive cancers (colon, stomach, liver, oesophagus and pancreas, as well as rarer tumours) collectively represent the most common cancers world wide and, therefore, pose major public health, not to mind clinical, challenges for the community, the individual practitioner and the patient.

Recent years have witnessed impressive advances in the diagnosis of gastrointestinal and liver diseases: the ability of endoscopic techniques to visualise and sample every part of the gastrointestinal tract, the development and widespread utilisation of more detailed and accurate imaging methods and the application of molecular techniques to such diseases as hepatitis and enteric infections, to name but a few.

Therapeutic progress has also been in evidence: the impact of Helicobacter pylori eradication on peptic ulcer disease, the ever expanding therapeutic possibilities of endoscopy and allied techniques, the widespread use of laparoscopic and robotic surgical approaches and the application of molecular principles and methods to drug discovery with the resultant development, for example, of highly effective acid suppressive agents and anti-viral therapies; progress which has also contribute hugely to the success of solid organ transplantation. For some of the most common complaints, however, such as irritable bowel syndrome, progress has been less dramatic and much remains to be learned of the cause(s) of such prevalent and, sometimes, troublesome conditions which continue to pose a significant therapeutic challenge.

The main emphasis in this series will be on the major clinical issues in Gastroenterology and Hepatology in the adult population: what has been the progress in our understanding of each area and how has such progress advanced the detection, diagnosis, prevention and management? An emphasis will be placed, not only in defining what we know, but also in clearly identifying the unanswered questions.