As we begin 2014, we can’t help but look back at 2013 and all the incredible discoveries that were made by gastroenterology and hepatology researchers. Based on the year’s most-downloaded original research articles from Gastroenterology and CGH, exciting things are happening in research on inflammatory bowel diseases, gluten sensitivity, and other digestive disorders.
The most-downloaded article from Gastroenterology in 2013 came from Maria I. Vazquez–Roque et al. who reported that a gluten-free diet reduces the number of bowel movements/day and intestinal permeability, compared with a gluten-containing diet, in patients with diarrhea-predominant irritable bowel syndrome (IBS-D). The authors concluded that gluten alters bowel barrier functions in patients with IBS-D—particularly in those that are HLA-DQ2/8-positive.
However, gluten is not the culprit in all GI disorders. Jessica R. Biesiekierski et al. showed that rapidly fermented poorly absorbed short-chain carbohydrates (FODMAPs), rather than gluten or other wheat proteins, cause symptoms in people who do not have celiac disease but feel better on gluten-free diets.
In the third-most downloaded Gastroenterology article of 2013, Jacques Cosnes et al. reported that administration of azathioprine within 6 months of diagnosis of Crohn’s disease was no more effective than conventional management (giving azathioprine only to patients with corticosteroid dependency, chronic active disease with frequent flares, poor responses to corticosteroids, or those who developed severe perianal disease) in increasing time of clinical remission.
Although early administration of azathioprine does not appear to benefit patients with Crohn’s disease, cannabis does. In the most-downloaded CGH article of 2013, Timna Naftali et al. presented results from the first placebo-controlled study of cannabis for this disease. Their trial showed that 8 weeks of smoking THC-rich cannabis cigarettes significantly reduced disease activity scores and led to clinical responses in 90% of patients.
Almost as many readers downloaded the validation of the ulcerative colitis index of severity by Sunil Samuel et al., which correlated the index measurements of disease activity. Equally popular was a retrospective cohort study from Maryam Derogar et al. reporting that in patients with cardiovascular disease, discontinuation of low-dose aspirin therapy after peptic ulcer bleeding increases risk of death and acute cardiovascular events almost 7-fold.
Going into 2014, we anticipate more exciting insights into these disorders and others. As always, the AGA Journals Blog will keep you updated on the latest GI and hepatology research discoveries.