Inflammatory bowel disease (IBD) affects approximately 0.5% to 1% of the population, a prevalence that challenges healthcare systems where it is too rare for primary care but common enough for general gastroenterologists. While some patients experience mild symptoms, others suffer from severe, disabling symptoms and unpredictable disease progression, necessitating a coordinated, multidisciplinary approach to management. Recent advances in understanding IBD pathogenesis, diagnostics, therapies, and surgical techniques have significantly changed IBD management. This Mistakes In article explores common pitfalls in treating IBD, highlighting the complexities and challenges faced by clinicians, and draws on evidence and clinical experience to suggest improvements in patient outcomes.

Hepatitis C virus (HCV) infection remains an important global health concern. It is estimated that there are approximately 50 million people infected with HCV globally, with around 1 million new infections each year and about 242,000 deaths annually attributed to HCV-related complications. Most acute HCV infections (55–85%) become chronic due to the virus’s effective evasion strategies, with spontaneous clearance being rare once chronicity is established. This condition often progresses silently, with many individuals unaware of their infection until advanced liver damage has occurred. If left untreated, HCV can lead to severe complications, including liver cirrhosis and hepatocellular carcinoma (HCC). HCV transmission occurs mainly through percutaneous exposure to infected blood. HCV can also spread from mother to infant (vertical transmission) and, less frequently, via sexual contact.1,2 In recent years, the introduction of oral direct-acting antivirals (DAAs), with remarkable safety and effectiveness profiles, has led to a sustained virological response (SVR) in virtually all (>97%) HCV-infected patients, regardless of HCV genotype or disease stage. However, significant barriers remain, such as issues with diagnosis, access to treatment and awareness of the disease.

Here, we discuss some of the misconceptions in HCV management and provide a practical management approach grounded in evidence and clinical experience.

Alcohol consumption is the most prevalent aetiology for liver cirrhosis in Europe and the third leading risk factor for overall mortality.1,2 In fact, alcoholic liver cirrhosis accounts for almost half a million deaths a year worldwide, corresponding to 50% of all cases of cirrhosis, according to the World Health Organization (WHO).3 Alcoholic liver disease (ALD) is multifaceted, with several cofactors influencing its progression. Patients abusing alcohol can simultaneously have viral hepatitis B or C, or a genetic disease, such as alpha-1 antitrypsin deficiency or haemochromatosis.

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.)

Tissue sampling during endoscopic procedures is a fundamental aspect of investigating digestive diseases, with histological examination playing a crucial role in almost every case. Given its prevalence, the potential for mistakes is significant. Therefore, understanding the appropriate indications, techniques, and consequences of tissue sampling is essential for gastroenterologists. Key questions to consider before taking a biopsy or acquiring tissue include: Why? What for? How? How many?

This manuscript addresses these critical questions by detailing the eight most frequent and correctable mistakes in tissue acquisition during endoscopy. The recommendations provided are largely supported by existing guidelines and evidence, with some insights drawn from the authors' professional experience.

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.