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. 

Around 11% of the worldwide population experience irritable bowel syndrome (IBS), making it one of the most frequent gastroenterological diagnoses.1 The symptoms of IBS include abdominal pain associated with unpredictable bowel habits and variable changes in the form and frequency of stool.2 While all patients with IBS suffer from recurrent bouts of abdominal pain, their bowel habits are varied: around one-third suffer predominantly with diarrhoea (IBS-D), one-fifth experience predominantly constipation (IBS-C) and half have an erratic mixed pattern of both diarrhoea and constipation (IBS-M).3 This very heterogeneous condition undoubtedly has multiple causes and an individualized approach to management and treatment is required. Here I discuss the mistakes most frequently made when diagnosing and managing IBS. The mistakes and discussion that follow are based, where possible, on published data and failing that on many years of my own clinical experience.

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.

Diarrhoea, acute or chronic, is a common gastrointestinal symptom in healthcare. In most cases, acute diarrhoea in healthy individuals requires limited diagnostic and therapeutic efforts, except for the replacement of fluid electrolytes, and stool culture in severe occurrences. Acute diarrhoea is often self-limiting due to short-lived reactions to food intake and bacterial or viral infections. However, diarrhoea can persist and fulfil definitions of chronicity when a month or more has passed since the onset. Here we discuss some basic mistakes that should be avoided when managing unexplained non-bloody diarrhoea that persists beyond the acute setting. In this context, the term 'unexplained' refers to a patient without apparent alarm features and where initial consultations have failed at making a diagnosis. We used an evidence-based approach and included aspects predominantly based on clinical experience when appropriate.

People with faecal incontinence (FI) suffer from chronic involuntary loss of bowel content. Patients often experience embarrassment, shame, low self-esteem, and depression, affecting their quality of life. Treatment approaches vary, and less invasive options should be tried before considering more invasive treatments. It's important to consider contributing factors, physician and patient preferences, and available procedures. This article discusses common mistakes in treating faecal incontinence and how to avoid them, based on evidence and clinical experience.

Proton pump inhibitors (PPIs), first introduced with omeprazole in 1988, revolutionized the treatment of gastric acid-related conditions like gastro-oesophageal reflux disease, gastroduodenal ulcers, and Helicobacter pylori infections. Despite their effectiveness, PPIs are often prescribed for conditions without a proven link to gastric acid, such as dyspepsia and upper abdominal discomfort. Long-term use of PPIs has raised safety concerns, including risks of vitamin and mineral malabsorption, pneumonia, gastrointestinal infections, and dementia. This Mistakes In article addresses nine common mistakes in PPI use and aims to clarify misconceptions about their use.