Nonalcoholic fatty liver disease (NAFLD) is a growing cause of chronic liver disease worldwide that can manifest as nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH). Compared with NAFL, NASH poses a substantially higher risk of progression to advanced liver disease, cirrhosis and hepatocellular carcinoma (HCC). Given the lack of directed pharmacological therapies and the complex, multifactorial disease aetiology and pathology, NAFLD is expected to become the leading cause of end-stage liver disease in the coming decades.

The introduction and general use of new immunosuppressive agents, including biologic agents and small molecules, has revolutionised the therapeutic management of inflammatory bowel disease (IBD). Such immunosuppression may expose patients to opportunistic infections, which can be challenging to recognise. These infections are crucial due to their association with morbidity or mortality and the challenges regarding effective treatment. New evidence in this field and vaccination strategies for immunosuppressed IBD patients led to updated European Crohn’s and Colitis Organization (ECCO) guidelines in 2021. Here we discuss the errors to avoid when managing the risk of opportunistic infections in IBD patients. The discussion is based on evidence, whenever possible, and our clinical experience.

It is a difficult task and a great responsibility to evaluate and manage patients with acute - and potentially life-threatening - clinical presentations. It is even more complex to achieve high standards of care for cases on call. Indeed, on-call gastroenterologists, hepatologists and endoscopists are faced with a wide and protean range of gastrointestinal, liver and pancreatic emergencies.  The decision-making process for cases on call is mainly based on information received over the phone, on medical knowledge and clinical experience, and on the resources available. As the degree of confidence in any information given on call may vary, it is of tremendous importance to note, and to document, with precise timing, what has been communicated by, proposed to, and eventually decided with, multiple caregivers (i.e. nurses, emergency physicians, intensive care physicians, surgeons, radiologists etc.)

The complexity of managing inflammatory bowel disease (IBD) stems from the heterogeneity of Crohn’s disease and ulcerative colitis. This leads to differences in disease course, complications, and treatment responses among patients. Current treatment strategies rely on a trial-and-error approach, but there's a need for personalized therapy. Efforts have been made to develop reliable prognostic and predictive biomarkers to overcome disease heterogeneity. This article discusses common mistakes in biomarker development, interpretation, and application in IBD, emphasizing evidence-based insights and lessons learned from other fields.

Acute diverticulitis is an inflammatory complication of diverticulosis and can either be uncomplicated or complicated. Making the distinction between uncomplicated and complicated acute diverticulitis is essential because treatment strategies differ between the two. Here, we discuss 10 mistakes frequently made when managing patients with acute diverticulitis. We focus on using the correct terminology, diagnostic preference and several treatment options, such as omitting or administering antibiotics, radiological interventions and various aspects of surgery. Acute diverticulitis is an important topic because its incidence is rising worldwide and it is becoming a considerable burden on healthcare systems. Most of the discussion included here is evidence-based, supplemented with many years’ combined clinical experience where evidence is lacking.

Biological therapy has revolutionised the treatment of moderate to severe inflammatory bowel disease (IBD), namely Crohn’s disease (CD) and ulcerative colitis (UC). However, up to one-third of patients with IBD are primary non-responders, and up to half can lose response over time.These unwanted outcomes can be explained by either pharmacodynamic (mechanistic failure) or pharmacokinetic (PK) issues with or without the development of anti-drug antibodies (ADA), so-called immunogenicity.1 Reactive therapeutic drug monitoring (TDM), defined as the measurement of drug concentrations and anti-drug antibody (ADA) levels in the setting of primary non-response (PNR) or secondary loss of response (SLR), can help to explain better and manage these unwanted outcomes. However, it would make sense to try to prevent PNR and SLR by routinely measuring drug concentrations and ADA to achieve and maintain a targeted therapeutic drug concentration, the so-called proactive TDM. Here we discuss some common mistakes and significant errors to avoid when utilising TDM of biologics in patients with IBD. The discussion is based on evidence, whenever possible, and our clinical experience and perception of the field.