The goal of this issue of Gastroenterology Clinics is to present GI diseases which affect women uniquely, such as pelvic floor problems and pregnancy related disorders, or which require a more considered approach such as functional bowel disease or autoimmune processes. It will also address the position of women and female gastroenterologists in the health system as a whole. This issue is published at an exciting, transitional time in the future of gastroenterology, as we adjust approaches for the assessment of disease in a large portion of our patient population, and as we address the challenges in practicing medicine based on the uniqueness of specific populations.

This issue details the latest knowledge of early diagnosis, risk factors, limited surgical treatments, and novel therapies for pancreatic diseases. Clinicians will learn the most prognostic scoring systems for acute pancreatitis, review the basics for early management of the disease, and see how current practice guidelines have evolved. Advances in radiological imaging when applied to the pancreas have resulted in enhanced staging and improved selection for surgical intervention. Endoscopy of the pancreas via both ERCP and endoscopic ultrasound has led to unprecedented access and potential for non-operative intervention. Pancreatic surgery now takes advantage of both minimally invasive approaches and techniques learned from organ transplantation. These latest advances are addressed in this issue by key opinion leaders.

In the last three decades, the prevalence of obesity has doubled with over 600 million obese adults worldwide. The gastrointestinal complications of obesity are well publicized; however, the role of the gastrointestinal tract in the development and treatment of obesity is often understated. From the pathophysiologic role of gut hormones and the microbiota, to the purposeful, anatomic derangement of the gastrointestinal tract that is utilized as a treatment for obesity, it is imperative that gastroenterologists understand the full scope of obesity in relation to the gastrointestinal system. Studies suggest that in the U.S. obesity is underrecognized and undertreated by health care providers. Given its complex sociology, pathophysiology, and treatment, obesity, like many other diseases, requires a multidisciplinary approach. Therefore, gastroenterologists must be equipped with the relevant knowledge of obesity that will empower them to properly manage their patients.

Helicobacter pylori (H. pylori) infection is a worldwide disease with a significant morbidity and mortality; it is the leading cause of non-ulcer dyspepsia, peptic ulcers and gastric tumors, including low-grade mucosa-associated lymphoid tissue-lymphoma and adenocarcinoma. In addition, it has also been recognized that the interaction between H. pylori and non-steroidal, anti-inflammatory drugs is damaging to the gastroduodenal mucosa. H. pylori treatment still remains a challenge for physicians, since no current first-line therapy is able to cure the infection in all treated patients. This issue will serve to update gastroenterologists on current therapies, evaluation and management of disease progression, and the future of management of H. pylori infection.

Gastrointestinal (GI) cancers account for nearly 150,000 deaths each year, in the United States alone. Encouragingly, environmental risk factors, premalignant conditions, and high-risk familial kindreds are well described for many GI cancers. In this comprehensive volume on GI Neoplasia, all luminal cancers will be discussed, along with pancreas cancer, gastrointestinal stromal tumors (GISTs), carcinoid tumors, and neuroendocrine tumors. Hepatobiliary cancers are not addressed, as these tumors could form the basis of a separate volume. Articles are organized to address several key topics for each cancer type, such as: public health burden, molecular pathways, risk and protective factors, early detection, clinical evaluation, management, and survivorship.

Dr. Quigley has created a must-have reference on the gut microbiome for the practicing gastroenterologist. A leader in the field of human physiology and digestive disorders, he has laid out the basics on this increasingly important topic, devoting articles to the organization and biology of the human gut microbiome as well as its diagnostic potential. Top international authors have presented articles that discuss the intersection of the gut microbiome and diet and the gut-brain axis. Clinical implications of the gut microbiome are discussed with disease states like IBD, GI cancer, and liver diseases. Finally, the issue ends with the cutting-edge clinical innovation of fecal microbial transplantation. This issue bridges the gap between science and clinical practice and should be an important reference to practicing gastroenterologists.

There are over 180 million people with chronic HCV infection worldwide with between 2.7 and 3.9 million in the United States. Hepatitis C most significantly affects Asia and Africa, with rates up to 15% in countries such as Egypt and up to 30% in certain regions such as Punjab, Pakistan. Hepatitis C places a significant burden on the public health infrastructure, as it remains the leading cause of chronic liver disease, accounting for 50-75% of primary liver cancers and is responsible for 30% of all liver transplantations. It is estimated to have cost the United States $5.5 billion in 1997, comparable to the national cost of asthma, $5.8 billion in 1994.This number is only expected to grow as the current HCV population ages, increasing overall rates of compensated cirrhosis/end-stage liver disease. The evolution of directly acting anti-virals has ushered in a new era for chronic hepatitis C. Ongoing drug development strategy has involved targeting several replication steps of the virus and the hope is to see all oral therapies by late 2014 or early 2015. Thus we are at an exciting cross roads with regard to new information and challenges with HCV: rising disease burden with associated high costs, the challenges globally and in multiple patient populations, and the impending availability of effective and well tolerated treatments. Therefore there is a need to commission an exclusive issue of GCNA for HCV.