People with irritable bowel syndrome (IBS) experience chronic intermittent symptoms, such as abdominal pain, bloating and/or altered bowel movements. These symptoms may negatively impact their daily life, prohibiting participation in social activities or leading to work absenteeism, and they are associated with increased healthcare utilisation.More than 85% of people with IBS indicate that food is one of the triggers for their gastrointestinal symptoms. Many of them have also tried diets, eliminated certain foods, taken supplements or used over-the-counter remedies before consulting a doctor or dietitian.4 Somewhat contradictorily, according to surveys of patients’ expectations in primary care, patients with IBS expect their general practitioner to provide reassurance or drug treatments, but less than 10% value dietary intervention. This is despite the fact that almost 95% of general practitioners report that they start the treatment of IBS by giving nutritional advice.5 Dietary interventions are also given a prominent place in the guidelines as both first- and second-line treatments for IBS.

Carbohydrates not absorbed in the small intestine are fermented by colonic bacteria to organic acids and gases(e.g. carbon dioxide, hydrogen and methane), part of which is absorbed in the colon, the other part remaining in the lumen. Large interindividual differences have been demonstrated for the production of such acids and gas. Carbohydrate malabsorption can be diagnosed by using the hydrogen breath test, because the gases produced after administration of a provocative dose of carbohydrate are unique products of bacterial carbohydrate fermentation.

Conducting primary research and creating new knowledge is how we push the boundaries of science, how we assess new and/or alternative treatments, and ultimately what underpins decisions on who to treat, when, and how to treat them. It is fundamental to the concept of evidence-based medicine (EBM).  Many people working within the field of gastroenterology will be directly involved in conducting epidemiological research. In this article, we discuss some of the common pitfalls that may render such research less useful than hoped.  This is, of course, a brief overview and if we were able to stress one thing from our experience of conducting research it would be to ensure that you have the right mix of people and skills in place from the outset of your project. Collaborative research allows people with different backgrounds and knowledge bases to address a single problem from different angles, and ultimately makes for better, and more enjoyable, research. 

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a subclassification of steatotic liver disease (SLD), defined as the presence of excess triglyceride storage in the liver in conjunction with at least one cardiometabolic risk factor and no other discernible cause.1 Cirrhosis secondary to MASH is the most common cause of liver disease in the world and is the fastest-growing indication for liver transplantation, but it also has a >50% recurrence rate post-transplantation.

Familial Mediterranean fever (FMF), also called periodic disease, Armenian disease, etc., is a prototypical autoinflammatory disorder where the underlying mechanism is the dysfunction of innate immunity, resulting in unprovoked episodes of inflammation.¹ Although considered rare worldwide, it is prevalent in people of Mediterranean origin; however, one can expect to encounter patients in all parts of the modern world. FMF is a monogenic disease with autosomal recessive inheritance.² Unlike other monogenic disorders, the diagnosis remains largely clinical, and it is important to understand the limitations of genetic testing. Another distinguishing feature is the well-established effectiveness of lifelong monotherapy with colchicine in preventing attacks and complications.³