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Intramural pseudodiverticulosis of the esophagus is a rare benign disease of the eosphageal wall, with dilation of the submucosal glands, and the predominant symptom is dysphagia. This disorder may be associated with gastroesophageal reflux, motility disorders, candidiasis and alcoholism. Inflammation, resulting in periductal fibrosis and compression of the duct orifices, may be a causative factor. Good and long-lasting therapeutic success can be achieved by bouginage of the stenosis with concomitant treatment of the associated esophageal diseases. Esophageal intramural pseudodiverticulosis is a differential diagnosis in cases of dyspagia and/or esophageal strictures if no other causes are found.

We report the case of an autoimmune hepatitis in a 59-year old woman who was referred for a progressive jaundice. The patient had an history of CREST syndrome. The particularity of this case report is the rare association between these two autoimmune diseases.

Lactose intolerance affects millions of people world-wide and should be suspected specially when evaluating gastrointestinal symptoms in ethnic populations in which it is prevalent. Fortunately, once a diagnosis is made, management is fairly straightforward. The authors discuss symptoms and methods of detection and offer their recommendations for helping patients with this common disorder. Coeliac disease is the end result of 3 processes that culminate in intestinal damage: genetic predisposition, environmental factors, and immunological based inflammation. Epidemiological studies based on serologic tests suggest that the prevalence of coeliac disease has been significantly underestimated. The classic sprue syndrome of steatorrhea and malnutrition may be less common than more subtle and often monosymptomatic presentations of the disease. The authors discuss the diagnostic criteria and the clinical utility of serologic tests.

Viral hepatitis are essentially caused by 5 types of viruses which differ in way of transmission and their evolution to chronicity or not. Like the virus causing hepatitis A, the E-virus-discovered en 1983-is a virus with oral-fecal transmission, responsible only for acute hepatitis which may be fulminant, notably in pregnant woman. Responsible for epidemics in Asia and Africa, the E-virus is nearly non-existent in our regions. Just like the B, C and D viruses, the G-virus is a RNA-virus with intravenous transmission. Notwithstanding a high prevalence, its pathogenic role remains hypothetical so that some hesitate to consider it as a virus causing clinical hepatitis. Etiological viral or non-viral agents for the cryptogenic hepatitis which can appear as acute, fulminant, post-transfusional or chronic illness, remain to be discovered.

Treatment of GO reflux and reflux oesophagitis should be based on pathophysiology, natural history, diagnostic assessment and patient expectations. Physiopathologically, GO reflux results from the balance between aggression and defence. The primary importance of motor and sphincters disturbances should make prokinetic drugs the treatment of choice; however, these drugs are unable to influence the inappropriate sphincter relaxation. The severity of symptoms and lesions is related to the duration of exposition of the oesophagus to pH < 4 explaining the superiority of omeprazole over the usual doses of H2RA. Since symptoms and lesions relapse frequently after treatment, long term prophylaxis, either by surgery or by drugs, is necessary. Comparing different therapeutic options is complicated by the absence of a precise definition of abnormal GO reflux or a gold standard; moreover, treatment results depend on the initial oesophagitis grade. Treatment will depend on the desired goal: to treat symptoms of lower grade oesophagitis or to heal lesions and prevent complications of high grade oesophagitis.