The coordination of smooth muscle and nerve function in the gastrointestinal tract is crucial for digestion and waste disposal. Disorders in this process can lead to chronic intestinal pseudo-obstruction (CIPO), a severe condition where the intestines fail to propel contents. Managing CIPO involves improving intestinal motility, maintaining nutrition, treating complications, managing exacerbations, and carefully considering invasive procedures. This article focuses on common mistakes in CIPO diagnosis and management, offering evidence-based insights and clinical experience.

Ostomy management refers to the care and maintenance of an ostomy and involves various aspects to ensure the individual’s health, comfort, and quality of life. This should involve the patient, a close support system (family and/or friends), and a healthcare team, including ostomy nurses and healthcare professionals specialising in ostomy care.

Coeliac disease is an autoimmune disorder triggered by gluten, which activates an immune reaction against the autoantigen tissue transglutaminase (TG2) in genetically predisposed subjects. Genetic susceptibility to coeliac disease has been proven by its close linkage with major histocompatibility complex (MHC) class II human leukocyte antigen (HLA) DQ2 and DQ8 haplotypes. The identification of biomarkers for coeliac disease (e.g. endomysial antibodies [EmA] and antibodies to TG2 [anti-TG2]) has changed the epidemiology of coeliac disease from being a rare to a frequent condition, with an expected prevalence of 1% in the worldwide population. Coeliac disease can be difficult to diagnose because symptoms vary from patient to patient, and the majority of patients who have coeliac disease remain undiagnosed. Small intestinal biopsy remains the gold standard for coeliac disease diagnosis, and a delayed diagnosis in the elderly can be considered a risk factor for complications. Complicated coeliac disease is not so frequent, but for those who have it, the prognosis is very poor, with a low rate of survival after 5 years.

Short bowel is a condition that occurs after single or multiple intestinal resections. The incidence of short bowel in Europe is 2 per million of the population and it carries with it lifelong morbidity and mortality. The initial recognition and management of short bowel in the adult population tends to occur in the postoperative period and in the secondary care setting, where specialist input from clinicians experienced in short bowel is often lacking.