Abdominal distension and bloating are among the most frequently misunderstood complaints in gastroenterology. They are often used as interchangeable terms, a conceptual mistake that continues to drive diagnostic errors and ineffective treatment. According to Rome IV, bloating and distension may represent either a primary disorder of gut–brain interaction (DGBI) or occur as symptoms with other DGBIs, such as irritable bowel syndrome (IBS), functional dyspepsia (FD) or functional constipation (FC).

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.

Children and adolescents with chronic diseases requiring lifelong care face unique challenges that affect their daily lives and those of their families. Initially, these patients receive specialized care in pediatric facilities, where parents play a key role in treatment decisions. However, transitioning to adult healthcare facilities is inevitable, and this process, recognized as crucial years ago, involves moving adolescents with chronic conditions from child-centered to adult-oriented care. This transition can be complicated by varying age limits for pediatric care and the scarcity of adult care centers with specific expertise. The transition often requires cooperation between different centers or even countries due to patient mobility. The transition phase is critical, as it can lead to loss of follow-up, treatment suspension, and increased risks of complications or disease relapse. Beyond medical management, various factors influence the long-term prognosis of chronic conditions, making a well-organized transition program essential. While many hospitals have implemented transition models with mixed results in satisfaction, disease control, and follow-up adherence, there are frequent shortcomings in the process. This Mistakes In article will outline eight common mistakes made during the transition from pediatric to adult care, supported by literature and professional experience.

The term ‘gastroparesis’ was first coined by Kassander in 1958 to describe the fact that barium did not leave the stomach of patients with diabetes for over 24 hours — so-called ‘gastroparesis diabeticorum’. Nowadays it refers to a delay in gastric emptying that is associated with symptoms primarily of nausea and vomiting as well as the absence of mechanical obstruction. In 1958, 21 cases were described, but in 2019, 5 million US individuals were diagnosed as having gastroparesis. This rapid increase in prevalence is likely to have occurred because it has become much easier to measure gastric emptying and to attribute symptoms to this without necessarily thinking through differentials. The incidence of hospital admissions for patients labelled as having gastroparesis is rapidly rising, increasing at a much faster rate than admissions for patients with nausea and vomiting, gastro-oesophageal reflux disease, gastritis or gastric ulcers, which are all remaining relatively static. Gastroparesis therefore represents a major healthcare burden. Gastroparesis can be idiopathic or is most frequently caused by diabetes (type 1 more than type 2) or surgical procedures that can disrupt the vagus nerve (e.g. Billroth gastrectomy, oesophagectomy, gastric bypass surgery and fundoplication). In this article, I describe the mistakes most frequently made in patients who have a suspected diagnosis of gastroparesis. I base my discussion on the available evidence as well as clinical experience in the field. 

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.