[Gastroenterology: recent advances and perspectives]

Among the significant current topics in gastroenterology, the endoscopic capsule, virtual colonography, and ischaemic colitis deserve special considerations. Main indications of the endoscopic capsule are the diagnosis of small intestinal (bleeding) angiodysplasias, Crohn's lesions and tumours. The main drawbacks are gastrointestinal blockage of the capsule due to stenosis and flat batteries before the capsule reaches the distal small intestine. Future advantages may stem from a wider pre-use of an auto-digestible capsule capable of pre-cautionary excluding stenotic gastrointestinal segments ant the pill-cam for the evaluation of the oesophagus. Virtual colonography is a promising and attractive non-invasive alternative for the detection of tumoral colonic lesions (polyps and cancers). Its specific role as a screening procedure or investigation of symptomatic patients has to be better established. In a near future development of patients-friendly bowel preparation, high standard level of the evaluators and advances in computed software should likely allow a better definition of its overall potential. Ischaemic colitis is still a very difficult proposition for gastroenterologists and surgeons from any point of view. Its prompt recognition is a very significant advantage for the therapy. In addition to the advances in diagnostics and therapy, recent data have been reported as far as the pathogenesis of ischaemic colitis is concerned. Useful information has paradoxically come from the side effects of the 5-HT3 antagonists and 5-HT4 agonists used in treatment of irritable bowel syndrome patients.