This month in Scandinavian Journal of Gastroenterology

In this issue of the Scandinavian Journal of Gastroenterology Becher & El-Serag present a systematic review on non-malignant complications in gastroesophageal reflux disease (GERD) [1]. Although death due to GERD and its non-malignant complications is rarely encountered, it is interesting that mortality from this disease seems to be increasing over time. Using dual-channel 24-h pH-metry, Ghoshal et al. [2] have studied the relationship of gastric acid exposure with severity of GERD, esophageal acidification and symptoms during nocturnal acid breakthrough (NAB). They found no relation between GERD and gastric acid exposure and no difference in either esophageal acid exposure or nocturnal symptoms in those with or without NAB. Despite some limitations, in particular regarding the representativeness of a relatively small patient sample, the study by van Vliet et al. [3] does not suggest an increased risk for an underlying severe disorder in patients buying over-the-counter acid inhibitors or antacids. It is still too early to state that there is a causative link between Epstein Barr virus (EBV) and gastric carcinomas. The study by Saxena et al. [4] demonstrates a significant association between the presence of EBV DNA with or without concomitant Helicobacter pylori infection and both gastric cancer and peptic ulcer disease. In a relatively large population of patients with panic disorders, Sugaya et al. [5] found a high prevalence of irritable bowel disorders (IBS); the study also suggests that there might be an association between diarrhea-predominant IBS and a more severe form of agoraphobia. Dickey et al. have evaluated homocysteine and B-vitamin status in a population of celiac patients both newly diagnosed patients and those on a glutenfree diet [6]. They found that gluten exclusion improves folate status and homocysteine levels. Diagnosis and treatment of celiac disease might thus reduce the risk of patients developing homocysteine-related disorders. In a murine colitis model, Kudo et al. [7] demonstrate that recombinant human granulocytestimulating factor (rhG-CSF) attenuates the colitis and reduces colonic epithelial cell apoptosis. It is too early to draw any conclusions on a possible therapeutic role of rhG-CSF in patients with inflammatory bowel disease, but the study at least gives an indication of a possible effect. Traditionally, it has been regarded as impossible to detect dysplastic lesions in routine colonoscopy and that random biopsies are needed. In the retrospective study by Blonski et al. [8] the investigators found that the majority of dysplastic lesions were macroscopically visible during endoscopy. By studying biopsies from 80 patients with ulcerative colitis and backwash ileitis in Ussing chambers, Kroesen et al. [9] have demonstrated that such patients have impaired barrier function of the ileoanal pouch, indicating a long-term impact of backwash ileitis on the epithelial barrier function. The observations by Tedde et al. [10] of an association of a functional relevant polymorphism in the promoter region of the IL10 gene (-1082 G/A) with ulcerative colitis and the fact that significant differences were only seen between female patients with ulcerative colitis and controls after gender stratification are interesting and could elucidate the potential role of the IL10 gene in the genetic predisposition for ulcerative colitis. In an in vitro study, Nylund et al. demonstrate that high-frequency ultrasound allows identification of