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The gluten-free diet (GFD) has gained increasing popularity in recent years, supported by marketing campaigns, media messages and social networks. Nevertheless, real knowledge of gluten and GF-related implications for health is still poor among the general population. The GFD has also been suggested for non-celiac gluten/wheat sensitivity (NCG/WS), a clinical entity characterized by intestinal and extraintestinal symptoms induced by gluten ingestion in the absence of celiac disease (CD) or wheat allergy (WA). NCG/WS should be regarded as an "umbrella term" including a variety of different conditions where gluten is likely not the only factor responsible for triggering symptoms. Other compounds aside from gluten may be involved in the pathogenesis of NCG/WS. These include fructans, which are part of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), amylase trypsin inhibitors (ATIs), wheat germ agglutinin (WGA) and glyphosate. The GFD might be an appropriate dietary approach for patients with self-reported gluten/wheat-dependent symptoms. A low-FODMAP diet (LFD) should be the first dietary option for patients referring symptoms more related to FODMAPs than gluten/wheat and the second-line treatment for those with self-reported gluten/wheat-related symptoms not responding to the GFD. A personalized approach, regular follow-up and the help of a skilled dietician are mandatory.

The functional gastrointestinal disorders (FGIDs) are common conditions with an overall prevalence burden estimated at approximately one-third of the population. These represent a heterogeneous group of conditions which may include both abnormal symptom perception and functional causes and seems to share similar trigger factors as food, lifestyle and psychological factor. GERD develops when the reflux of gastric contents into the esophagus leads to troublesome symptoms, with or without mucosal involvement. Functional heartburn (FH) represents a subcategory of patients who refers with heartburn but without abnormal esophageal acid exposure, abnormal number of reflux events or any temporal correlation between symptoms and reflux events, on the same hands these patients do not report any symptom relief during antisecretory treatment with proton pump inhibitors. To date, several studies have reported a certain degree of overlap between GERD and FGIDs that it is only partially explained solely by chance. This review evaluated the overlap between GERD but especially FH and different FGIDs as: functional non-cardiac chest pain, irritable bowel syndrome, functional dyspepsia, gastric belching and supragastric belching and pharyngeal globus. A large number of mechanisms have been proposed to elucidate the connection between these numerous conditions. When pathophysiologic tests to subgroup GERD have been performed, FH seems overlap more frequently than GERD with FGIDs. From a therapeutic point of view visceral hypersensitivity, that characterize these functional disorders might be modulated by antidepressant therapy even if there are limited evidences. More studies and especially randomized controlled trials should consider these agents for future agenda researches.

According to the current European Association for the Study of Liver guidelines, transarterial chemoembolization (TACE) is the recommended first-line therapy for patients with intermediate-stage (Barcelona Clinic Liver Cancer-B class) hepatocellular carcinoma (HCC). The efficacy of this therapy is supported by robust evidence; however, there is still a lack of standardization in treatment methodology, and TACE protocols are widely variable. Moreover, TACE can be associated with a number of contraindications. Despite these limitations, research on TACE is still ongoing with the aim of optimizing the use of this methodology in the current management of HCC. In particular, TACE represents a control in comparative studies, and it is currently being investigated in combination schemes, for example, with sorafenib. In this review, we briefly describe the current scenario and the clinical innovations regarding TACE for the treatment of HCC., Competing Interests: Disclosure The authors report no conflicts of interest in this work.