In consultation with Consulting Editor, Dr. Alan Buchman, Dr. Stanley J. Naides has put together a state-of the-art issue of the Gastroenterology Clinics of North America devoted to Laboratory Monitoring of Gastrointestinal and Hepatobiliary Disease. Clinical review articles from expert authors are specifically devoted to the following: Inborn Errors of Metabolism and the GI track; Primary Immunodeficiency and the gut; Liver fibrosis determination; IBD; Autoimmune liver disease diagnosis and classification; Laboratory Diagnosis of Viral hepatitis; IgG4-RD with Emphasis on its GI Manifestation; Bowel Microbiome in Health and Disease; AAV System; and Celiac Disease. Readers will come away with the latest information they need to diagnose and monitor patients with gastrointestinal and hepatobiliary disease.

Dr. Alan Buchman, Consulting Editor, selected world renown experts on celiac disease, Dr. Green and Dr. Lebwohl, to update the topic for gastroenterology readers. They have secured expert authors from top institutions to contribute articles with high clinical utility on the diagnosis, treatment, and management of celiac disease. These clinical reviews are devoted to the following topics: Clinical features and diagnosis of celiac disease; The gluten-free diet; Histopathology of celiac disease; Epidemiology and risk factors for celiac disease; Enteroscopy and capsule endoscopy in celiac disease; Measuring symptoms and other outcomes in celiac disease; Celiac disease in Asia; The microbiome and celiac disease; Follow-up of celiac disease; Refractory celiac disease; Non-dietary therapies for celiac disease; and Non-Celiac gluten or wheat sensitivity. Readers will come away with the most current clinical information they need to inform clinical decisions to improve patient outcomes.

This issue of Medical Clinics, Guest Edited by Dr. Kerry B. Dunbar, is devoted to Gastroenterology. Articles in this issue include: Proton Pump Inhibitors: What the Internist Needs to Know; Management of Refractory GERD; Colonoscopy, Polypectomy, and the Risk of Bleeding; Pancreatic Cysts: Sinister Findings or ‘Incidentalomas’?; The Future of Non-Alcoholic Fatty Liver Disease Treatment; Effective Treatments for Irritable Bowel Syndrome; The Revolution in Treatment of Hepatitis C; Diet and the Role of Food in GI Symptoms; Eosinophilic Esophagitis; Colorectal Cancer Screening: Is Colonoscopy the Best Option?; Celiac Disease and Gluten Sensitivity; Management of Chronic Pancreatitis; and Helping Patients with Gastroparesis.

The Guest Editor, Dr. Robert J. Shulman, and Consulting Editor, Dr. Alan Buchman, have created a thorough review of the current clinical updates on treating children with gastrointestinal disorders and diseases. Expert authors have submitted review articles on the following topics: Update on Diet Management of Functional GI Disorders; Brain-Gut Axis: Clinical Implications; Pancreatitis: Molecular Mechanisms and Management; Inflammatory Bowel Disease: What Very Early Onset Disease Teaches Us; GI Development: Implications for Management of the Preterm and Term Infant; Infectious Diarrhea: New and Emerging Issues; New Insights into the Pathogenesis and Treatment of Malnutrition; Infantile Colic: New Insights into an Old Problem; Constipation: Beyond the Old Paradigms; Integration of Biomedical and Psychosocial Treatments in Functional GI Disorders; GI Neuropathies: New Insights and Emerging Therapies; Food Sensitivities: Fact versus Fiction; IBD in Children: A Focus on Quality Improvement and Pediatric Focused Care; Molecular Advances in the Understanding of Pediatric Cholestasis; Assessment and Treatment of Nonadherence in Transplant Recipients; and Update on Fatty Liver Disease in Children. Readers will come away with the current updates they need to diagnose and treat pediatric patients and improve outcomes.

Infections of the liver and biliary system are not uncommon, while most of the infections are viral in nature. Globally, viral hepatitis is a major public health problem and parallels infections such as HIV and tuberculosis and is associated with significant morbidity and mortality. Rapid advances have been made with HCV therapy at a time when the community focus has shifted to global elimination. This issue highlights some of the areas of considerable advances and challenges in viral hepatitis B and C. In addition, Hepatitis E is resurfacing as an infection of significance, particularly in the Western World where there is a prevalence of chronic infections. Gastroenterologists and hepatologists often think of viral hepatitis as the sole cause of hepatic infections, but there are other infections caused to bacteria, fungi and parasites; this issue highlights these infections as well. Articles are devoted to the following topics: Global epidemiology of viral hepatitis; Update on diagnostics in viral hapatitis; Heptatitis B: Immunization and impact on natural history and cancer incidence; Heptatitis B: Current status of therapy and future therapies; Hepatitis Delta: Prevalence, natural history, and treatment options; Hepatitis C: How good is real-life data and do generics work: Hepatitis C: Does successful treatment alter the natural history and quality of life; Hepatitis E: Epidemiology,clinical course, prevention, and treatment; CMV and EBV infections of the liver; Extrahepatic manifestations of viral hepatitis; Pyogenic and amebic infections of the liver; and Fungal and parasitic infections of the liver.

In consultation with Consulting Editor, Dr. Alan Buchman, Dr. Rocheyllys Diaz Heijtz has put together a state-of the-art issue of the Gastroenterology Clinics of North America devoted to The Microbiome: Interactions with Organ Systems, Diet, and Genetics. Clinical review articles from expert authors are specifically devoted to the following: The Role of the Microbiome of o the Female Reproductive Tract on Health and Pregnancy; Eating Disorders and the Gut Microbiota; Maturation of the Infant Microbiome Community Structure and Function; Microbe-Host Interactions in Allergic Diseases; Emerging Role of the Gut Microbiota in Neurodevelopmental Disorders; Brain-Gut-Microbiota Axis and Mood Disorders; Brain-Gut-Microbiota and ADHD; The Microbiota-Gut-Brain Axis and Postpartum Depression; and The Microbiota and Pancreatic Cancer. Readers will come away with the latest information on the microbiome and how to incorporate the information into gut health for patients.

This issue of Gastroenterology Clinics of North America is all about acute upper GI bleeding and is divided into two distinct sections: section I is devoted to nonvariceal upper GI bleeding and section II is devoted to variceal upper GI bleeding. Acute nonvariceal upper GI bleeding may originate from the esophagus, stomach, or duodenum, essentially anywhere proximal to the Ligament of Treitz. In Section I, Dr Gianluca Rotondano, Hospital Maresca, Torre del Greco, Italy, begins with a review of the epidemiology and diagnosis of acute nonvariceal upper GI bleeding. We then turn to patient presentation, risk stratification, and how to initially medically manage these bleeding patients. I am pleased to have one of our emergency medicine colleagues, Dr Andrew Meltzer, Department of Emergency Medicine, George Washington University, contribute this important article and provide a unique viewpoint from the emergency department where most of these patients initially present. As we all know, endoscopic hemostasis is the accepted standard of care for patients with acute nonvariceal upper GI bleeding. Moreover, peptic ulcer bleeding is the most common nonvariceal cause of acute upper GI bleeding; thus, Drs Yidan Lu, Yen-I Chen, and Alan Barkun from McGill University, Montreal, Canada, provide an in-depth review of the endoscopic management of peptic ulcer bleeding. Drs Eric Tjwa, I. Lisanne Holster, and Ernst Kuipers from the Erasmus Medical Center University Hospital, Rotterdam, The Netherlands, review the endoscopic management of all other causes of acute nonvariceal upper GI bleeding, and in addition, Drs Louis Wong Kee Song and Michael Levy from the Mayo Clinic, Rochester, Minnesota discuss emerging endoscopic hemostasis treatments, such as topical sprays and over-the-scope clipping devices. Although endoscopic hemostasis is very highly effective, there are unfortunately cases where bleeding is unable to be controlled or when significant rebleeding occurs that is not amenable to endoscopic therapy. Therefore, I have included two articles that provide insight into the question...what if endoscopic hemostasis fails? The first article, written by Drs Philip Wai Yan Chiu and James Yun Wong Lau, from Prince of Wales Hospital, The Chinese University of Hong Kong, focuses on tried and true surgical treatment options. The second article, by Dr Sujal Nanavati, University of California at San Francisco, Department of Radiology and Biomedical Imaging, addresses the alternative treatment strategy of angiographic embolization, which has now emerged as the often preferred salvage treatment strategy.