Media

Clostridia difficile infection (CDI) is epidemic in the United States with more than 300,000 new cases per year and 25,000 deaths per year. Although treatable with antibiotics, recurrent CDI is debilitating, costly and lethal. Recurrent CDI often does not resolve with antibiotic use, prompting unconventional measures such as stool transplantation or fecal microbiota transplantation (FMT). FMT by anecdotal accounts and in small case series is surprisingly effective. There has been an explosion of studies in the past several years investigating FMT for recurrent CDI. In findings reported in the journal Alimentary Pharmacology and Therapeutics an analysis of seven randomized [...]

How do you choose a gastroenterologist for your screening colonoscopy?  Everyone wants “a good doctor” but how do you evaluate your gastroenterologist? If a gastroenterologist is diligent, thorough and spends adequate time during a colonoscopy, polyp detection improves.  Polyp detection is key since the removal of adenomatous (precancerous) polyps has been shown in tightly controlled studies to prevent colon cancer.  It is estimated that in an unscreened population of healthy adults ranging in age from 50 to 60, 30% will have 1 or more polyps.  If a gastroenterologist has a perfect adenoma (polyp) detection rate, this detection rate will [...]

Proton pump inhibitors (PPI) such as Prilosec, Nexium, Prevacid, Dexilant, and Aciphex have recently been associated with cognitive decline or dementia. In a study published this month in Gastroenterology, 10,486 volunteers within the NIH-supported Alzheimer’s Disease Centers who were aged 50 years and older and had either normal cognition or mild cognitive impairment at baseline were followed over a 10 year period. Participants underwent neuropsychological evaluations and self-reported PPI use at two to six annual visits between 2005 and 2015.  The use of PPI’s was not associated with any significant decline in cognitive function. In this large, prospective study [...]

In a retrospective study published in Clinical Gastroenterology and Hepatology researchers report “that in states that legalized marijuana for medical purposes, chronic use of cannabinoid derivatives has led to a significant increase in cannabinoid hyperemesis syndrome, characterized by episodes of severe nausea and cyclical vomiting.”

A recently published study of claims data from a German health plan suggests an association between proton pump inhibitor (PPI) use and dementia in the elderly. Because the claims data used in the current study lack detailed sociodemographic data, such as diet, lifestyle and education, the researchers could not integrate these important factors into the analysis. Researchers identified several confounding factors which were significantly associated with increased dementia risk including depression and stroke. Diabetes and taking five or more prescription drugs other than the PPI (known as “polypharmacy”) were also associated with significantly elevated dementia risk. In the analysis, polypharmacy [...]

Gastroenterology Group of Naples Welcomes New Female Physician NAPLES, FL (Jan. 4, 2016) – Gastroenterology Group of Naples is pleased to announce the addition of Sandra M. Jara, M.D. Dr. Jara is board-certified in gastroenterology and will provide skilled endoscopy, colonoscopy, and small bowel capsule services. She will be accepting new patients starting January 4, 2016. According to Raymond W. Phillips, the group’s founder, Dr. Jara will see patients in its Bonita office, located at 9776 Bonita Beach Road, Suite 202-F, Bonita Springs, FL 34135; and its Naples office, located at 1064 Goodlette Road, Naples, FL 34102. Dr. Jara [...]

FDA Approves New Hepatitis C Drug January 29, 2016The Food and Drug Administration (FDA) has approved Merck & Co.’s Zepatier (elbasvir and grazoprevir), a once-daily, single-tablet combination therapy for hepatitis C. The drug is approved for patients with the most common type of hepatitis C in the US, genotype 1, as well as genotype 4. Zepatier has a list price of $54,000 for a 12-week course of treatment.Commentary:This is great news for patients because the growing number of effective, low risk, short duration, Interferon-free regimens means there will be increased competition between companies and this will lead to further price [...]

Eluxadoline (Viberzi, Allergan), a new oral agent with mixed opioid effects, has met fairly stringent criteria for treatment response in men and women with irritable bowel syndrome (IBS) with predominant diarrhea, according to two phase 3 clinical trials published in the January 21 issue of the New England Journal of Medicine (read it here). “Our primary outcome measure required simultaneous improvement in the daily scores for the worst abdominal pain and stool consistency on the same day for at least 50% of the days assessed. Patients who received eluxadoline reported a decrease in stool frequency and in urgency, which are [...]

Resarch published in the Journal of Adolescent and Young Adult Oncology indicates that while “the overall rate of colon cancer has fallen in recent decades…over the last 20 years the disease has been increasing among young and early middle-aged American adults.” Investigators “found that between 1988 and 2009, the biannual colon cancer rates had been rising by 2.7 percent among males 20 to 29 and 40 to 49.” Meanwhile, “among males 30 to 39, the biannual increase was pegged even higher, amounting to 3.5 percent.”

According to the New York Times (1/31, O’Connor, 9.97M), recent studies have found that “people are exceeding the safe limits of nutrient intakes established by the Institute of Medicine” as more foods are being fortified with vitamins and minerals to meet consumer demand for such products. Researchers note that the vitamins that are the most widely used to fortified products, “are already plentiful in the average person’s diet.” Mara Z. Vitolins, a registered dietitian and professor of epidemiology and prevention at Wake Forest Baptist Medical Center stated that for “general population today, there is no scientific justification for a high [...]

A case report published Feb. 4 in the journal Open Forum Infectious Diseases details how a normal-weight female patient suffering from a C. difficile infection “rapidly became obese after receiving a fecal transplant from an overweight relative.” The patient, now cured, has “gained more than 40 pounds since the transplant” and is still putting on weight. The authors of the case report wrote, “This case serves as a note of caution when considering the use of non-ideal donors for fecal microbiota transplant (FMT), and we recommend selecting non-overweight donors,” a conclusion echoed by the authors of an accompanying editorial. [...]

Research published in JAMA Surgery suggests that “organ transplants have saved more than 2 million years of life in the United States over 25 years.” However, researchers found that “less than half of the people who needed a transplant in that time period got one.” The investigators found that “the number of years of life saved by type of organ transplant were: kidney, 1.3 million years; liver, more than 460,000; heart, almost 270,000; lung, close to 65,000; pancreas-kidney, almost 80,000; pancreas, just under 15,000; and intestine, about 4,500.”

University of Adelaide researchers have discovered that the immune system is defective in people suffering from irritable bowel syndrome, which is a major reason why sufferers have ongoing issues with pain. The research — the first of its kind in the world — could also help to explain why some painkillers may not offer satisfactory relief to sufferers. Irritable bowel syndrome (IBS) affects up to 10% of the community. There are different forms of IBS but all of them involve unexplained gut pain, which often has the greatest impact on sufferers’ quality of life. Scientists in the University’s Nerve-Gut Research [...]

Human immunodeficiency virus (HIV) infection is no longer a fatal condition, thanks to newer medications inhibiting the retrovirus, but a puzzling phenomenon has surfaced among these patients — non-AIDS complications. Scientists at Case Western Reserve University School of Medicine have resolved the mystery with their discovery of the leaky gut as the offender. Bacterial products seep out of the colon, trigger inflammation throughout the body and set into motion the processes of cardiovascular, neurodegenerative, chronic kidney and metabolic diseases, and cancer. Their findings appear in an edition this summer of PLOS Pathogens. “Because the space inside the colon (the lumen) [...]

UCLA researchers were part of a team that has discovered the interplay of several genetic factors that may be involved in the development of early-onset ulcerative colitis, a severe type of inflammatory bowel disease. The early research findings in mice suggest possible new targets for prevention and treatment strategies to address the inflammation generated by early-onset ulcerative colitis. The rare disease affects infants and young children and can lead to early development of colon cancer and an increased risk of liver damage. Scientists from the David Geffen School of Medicine at UCLA and Pusan National University in South Korea also [...]

Yale University researchers have identified a handful of bacterial culprits that may drive inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis, using patients’ own intestinal immune responses as a guide. The findings are published Aug. 28 in the journal Cell. Trillions of bacteria exist within the human intestinal microbiota, which plays a critical role in the development and progression of IBD. Yet it’s thought that only a small number of bacterial species affect a person’s susceptibility to IBD and its potential severity. “A handful of bad bacteria are able to attain access to the immune system and [...]

One of the most severe complications of hepatitis B is the development of liver cancer, which is responsible for approximately 745,000 deaths worldwide each year. Two new studies appearing in the June issue of Gastroenterology provide strong evidence that antiviral therapy can reduce the risk of liver cancer in patients with chronic hepatitis B infection. Gastroenterology is the official journal of the American Gastroenterological Association. In the first paper,1 researchers from National Yang-Ming University in Taiwan showed that the licensed oral antiviral agent nucleos(t)ide (NUC) resulted in a reduced long-term risk for liver cancer in a large, nationwide cohort of [...]

A team of representatives from five gastroenterology and hepatology societies have created a toolbox designed to help gastroenterology training directors meet the Accreditation Council for Graduate Medical Education (ACGME) Internal Medicine Subspecialty Reporting Milestones requirements while training fellows to independently care for patients. Thirteen core tasks, known as “entrustable professional activities,” or EPAs, have been identified that define the work of gastroenterologists and hepatologists. A toolbox for each task includes, among other things, specific behavioral objectives related to knowledge, skills and attitudes; identification of the key reporting milestones needed to achieve mastery; and suggested assessments to gauge progress. This toolbox [...]

Immunosuppressive drugs called thiopurines have been found to increase the risk of myeloid disorders, such as acute myeloid leukemia and myelodysplastic syndrome, a rare bone marrow disorder, seven-fold among inflammatory bowel disease (IBD) patients. These data were reported in a new study published in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association (AGA). Thiopurines are an established treatment for IBD patients, used to reduce inflammation and provide symptom relief. “In order to make appropriate, informed decisions about thiopurines, patients and providers need to be well-educated about the risks and benefits of this treatment,” said [...]

Adding quinoa to the gluten-free diet of patients with celiac disease is well-tolerated, and does not exacerbate the condition, according to new research published in The American Journal of Gastroenterology. Dr. Victor F. Zevallos, from the Department of Gastroenterology, King’s College London, United Kingdom, evaluated the in-vivo effects of consuming quinoa in adult celiac patients. Quinoa, a highly nutritious grain, is traditionally recommended as part of a gluten-free diet. However, in-vitro data suggests that quinoa storage proteins can stimulate innate and adaptive immune responses in celiac patients. Celiac disease is an immune-based reaction to dietary gluten (storage protein for wheat, [...]

Probiotics are effective in preventing hepatic encephalopathy in patients with cirrhosis of the liver, according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association. Hepatic encephalopathy is a deterioration of brain function that is a serious complication of liver disease. “This rigorous new research finds that probiotics modify the gut microbiota to prevent hepatic encephalopathy in patients with cirrhosis of the liver,” said David W. Victor III, MD, who contributed an editorial in Clinical Gastroenterology and Hepatology on this research. “These results offer a safe, well-tolerated and perhaps cheaper alternative [...]

Carbonation, an essential component of popular soft drinks, alters the brain’s perception of sweetness and makes it difficult for the brain to determine the difference between sugar and artificial sweeteners, according to a new article in Gastroenterology, the official journal of the American Gastroenterological Association. “This study proves that the right combination of carbonation and artificial sweeteners can leave the sweet taste of diet drinks indistinguishable from normal drinks,” said study author, Rosario Cuomo, associate professor, gastroenterology, department of clinical medicine and surgery, “Federico II” University, Naples, Italy. “Tricking the brain about the type of sweet could be advantageous to [...]

Individuals with celiac disease often experience ‘brain fog’ in addition to intestinal problems, but a new study shows that adhering to a gluten-free diet can lead to improvements in cognition that correlate with the extent of intestinal healing. The Alimentary Pharmacology & Therapeutics findings indicate that ridding the diet of gluten may help address problems that celiac disease patients can experience related to attention, memory, and other mental tasks.“The study outcomes highlight the importance for individuals with celiac disease of maintaining a gluten-free diet not just for physical well-being but also for mental well-being,” said senior author Dr. Greg Yelland.Story [...]

A microRNA cluster believed to be important for suppressing colon cancer has been found to play a critical role in wound healing in the intestine, UT Southwestern cancer researchers have found. The findings, first discovered in mice and later reproduced in human cells, could provide a fresh avenue for investigating chronic digestive diseases and for potentially repairing damage in these and other disease or injury settings. “We identified a novel role for microRNAs in regulating wound healing in the intestine. This finding has important implications for diseases such as ulcerative colitis and Crohn’s disease and may be relevant to wound [...]

Rather than the typical series of oxidative steps that take place in the citric acid cycle, cancer cells metabolize sugar via the glycolytic pathway irrespective of whether oxygen is present or not. InThe EMBO Journal, researchers in the United States report that the reason for this difference in colon cancer is changes in the Wnt signaling pathway, an essential communication pathway operating in these tumors. More than 60 years ago Otto Warburg recognized that cancer cells differ from normal cells in the metabolic pathway they use for the oxidation of sugar. Rather than the typical series [...]

University of Adelaide research has provided new hope for the early detection of stomach cancer with the identification of four new biomarkers in the blood of human cancer patients. Stomach or gastric cancer is the fourth most common cancer in the world and the second leading cause of death due to cancer. “Stomach cancer is typically without symptoms in the early stages so most cancers are not diagnosed until the later stages, and the survival rates are therefore low,” says Associate Professor Peter Hoffmann, project leader and Director of the University’s Adelaide Proteomics Centre. “Endoscopic investigations are invasive and expensive [...]

Got heartburn? More than 60 million adults in the U.S. have acid reflux, or heartburn, and approximately 10 percent are at risk for developing esophageal cancer, due in part to complications from Barrett’s esophagus. But researchers at Rhode Island Hospital discovered a pathway they believe links Barrett’s esophagus to the development of esophageal cancer. Their data suggest that blocking this pathway, such as with a proton pump inhibitor (e.g. omeprazole), may prevent the development of esophageal cancer. The study is published online in advance of print in the journal American Journal of Cell Physiology. The common ailment goes by many [...]

Over 3.5 million people in Europe and the US suffer from Crohn’s disease or ulcerative colitis — the two most common forms of IBD. Chronic bowel inflammation is caused by an overreaction of the immune system to the bacteria which naturally occur in the gut. “This overreaction can come about if, for example, the anti-stress mechanism in the cells of the intestinal mucosa does not function correctly,” explains Prof. Dirk Haller of the TUM Chair of Nutrition and Immunology. What Prof. Haller is referring to is the unfolded protein response (UPR) — a sequential chain of signals in the cell, [...]

New research conducted at Aarhus University has revealed that people who have grown up on a farm with livestock are only half as likely as their urban counterparts to develop the most common inflammatory bowel diseases: ulcerative colitis and Crohn’s disease. The study findings have recently been published in the European Journal of Epidemiology. “It is extremely exciting that we can now see that not only allergic diseases, but also more classic inflammatory diseases appear to depend on the environment we are exposed to early in our lives,” relates Vivi Schlünssen, Associate Professor in Public Health at Aarhus University. Greater [...]

Being sick due to an infection can make us feel lousy. But what must the ecosystem of bacteria, or microbiota, colonizing our guts be going through when hit with infection? A study from Brigham and Women’s Hospital (BWH) has utilized unique computational models to show how infection can affect bacteria that naturally live in our intestines. The findings may ultimately help clinicians to better treat and prevent gastrointestinal infection and inflammation through a better understanding of the major alterations that occur when foreign bacteria disrupt the gut microbiota. “Our gut contains ten-times more bacterial cells than there are human cells [...]

An innovative laparoscopic procedure that implants a ring of magnetic beads to help prevent acid reflux in patients who suffer from Gastroesophageal Reflux Disease (GERD) is the latest tool surgeons at Stony Brook University Hospital (SBUH) have to treat the disease. More than 30 million American’s suffer from acid reflux each month, and the risk for developing GERD increases after age 40. The symptoms of GERD include heartburn, regurgitation, sore throat, cough, and chest pain. When left untreated, reflux disease can lead to serious complications, such as esophagitis, stricture, Barrett’s esophagus and esophageal cancer. Using a small, flexible band of [...]

While the causes of Crohn’s disease are not well understood, recent research indicates an important role for an abnormal immune response to the microbes that live in the gut. In the largest study of its kind, researchers have now identified specific bacteria that are abnormally increased or decreased when Crohn’s disease develops. The findings, which appear in the March 12 issue of the Cell Press journal Cell Host & Microbe, suggest which microbial metabolites could be targeted to treat patients with this chronic and currently incurable inflammatory bowel disease. Twenty-eight gastroenterology centers across North America have been working together to [...]

Inflammatory Bowel Disease (IBD), a group of chronic inflammatory disorders of the intestine that result in painful and debilitating complications, affects over 1.4 million people in the U.S., and while there are treatments to reduce inflammation for patients, there is no cure. Now, Cincinnati Cancer Center and University of Cincinnati (UC) Cancer Institute researcher Susan Waltz, PhD, and scientists in her lab have done what is believed to be the first direct genetic study to document the important function for the Ron receptor, a cell surface protein often found in certain cancers, and its genetic growth factor, responsible for stimulating [...]

Age-Related Colon Condition Not Cause for Alarm, Study Says Chances of diverticulosis developing into serious disorder are slimmer than thought THURSDAY, Dec. 5, 2013 (HealthDay News) — Diverticulosis — a medical problem characterized by pouches in the lining of the colon — is much less risky than previously believed, a new study contends. Previous research concluded that up to one-quarter of people with diverticulosis will develop a painful and sometimes serious infection called diverticulitis. But this new 15-year study shows that the risk is actually only about 1 percent over seven years. “These colon pouches are commonly detected during colonoscopy, [...]

Johnson & Johnson (JNJ) and Medivir AB (MVIRB) won U.S. approval for their pill to treat chronic hepatitis C, the first drug allowed for sale in a competition to bring new treatments for the virus to market. The Food and Drug Administration cleared simeprevir, to be called Olysio, in combination with other medicines for the viral disease that damages the liver, the agency said in a statement. The drug can shorten current treatment by half, limiting interferon injections that may cause flu-like symptoms. J&J, Medivir, Gilead Sciences Inc. (GILD) and Bristol-Myers Squibb Co. (BMY) are among companies developing new pills [...]

ROBOTS LET DOCTORS ‘BEAM’ INTO REMOTE HOSPITALS BY TERENCE CHEA ASSOCIATED PRESS AP Photo/Rich Pedroncelli TECHNOLOGY VIDEO BUY AP PHOTO REPRINTS CARMICHAEL, Calif. (AP) — The doctor isn’t in, but he can still see you now. Remote presence robots are allowing physicians to “beam” themselves into hospitals to diagnose patients and offer medical advice during emergencies. A growing number of hospitals in California and other states are using telepresence robots to expand access to medical specialists, especially in rural areas where there’s a shortage of doctors. These mobile video-conferencing machines move on wheels and typically stand about 5 feet, with [...]

By Kathleen Doheny HealthDay Reporter SUNDAY, Oct. 27 (HealthDay News) — Powerful “super-magnets” found in adult desk toys and other novelty items still trigger many emergency-room visits after children swallow them, according to a new report, even though some products with these magnets have been recalled. “These ingestions have increased over the past three to five years,” said study researcher Dr. Daniel Rosenfield, a pediatric resident at the University of Toronto and the Hospital for Sick Children, in Canada. At the hospital, Rosenfield’s team looked back at the records involving about 2,700 ingestion incidents from 2001 through 2012. They found [...]

Too Much Sitting Could Raise Colorectal Cancer Risks For Men Oct 28, 2013 For men, too much time sitting could raise the likelihood of experiencing colorectal adenomas — known precursors for colorectal cancer — again, according to a new study. Researchers from the Columbia University Mailman School of Public Health found an association between time spent being sedentary and risk of recurrence of colorectal adenomas, which are also known as colorectal adenomatous polyps. Colorectal adenomas usually give way to colorectal cancer; the adenomas, once detected, are typically removed during a colonoscopy. “Given the substantial increase in risk of colorectal [...]

By Andrew M. Seaman NEW YORK | Mon Sep 30, 2013 5:14pm EDT NEW YORK (Reuters Health) – Older Americans who visit their doctors regularly are less likely to develop or die from colon and rectal cancers, according to a new study. Researchers credit screening that catches precancerous growths and early cancers for the differences seen in rates of both cancers and deaths among people on Medicare. “The main takeaway here is that we need to improve access to primary care and encourage elderly people to use primary care,” Dr. Jeanne Ferrante, the study’s lead author from the Robert [...]

Study unclear whether this helps or hinders people trying to lose weight FRIDAY, Sept. 20 (HealthDay News) — Did they get your diet soda order right at the drive-thru? It may not be so easy to tell. According to a new study, carbonation in soft drinks alters the brain’s perception of sweetness and makes it difficult to distinguish between sugar and artificial sweeteners. So the combination of carbonation and sugar may lead to increased sugar and food consumption since the brain perceives less sugar intake, the researchers said. This may explain why eating disorders, metabolic diseases and obesity are [...]

By Eryn Brown September 18, 2013, 2:58 p.m. Getting a colonoscopy is not something most people look forward to — but a new analysis suggests that it’s worth it to follow screening recommendations and have the test done every 10 years (or every five for those at high risk.) Writing in the New England Journal of Medicine on Wednesday, Harvard researcher Reiko Nishihara and co-authors assessed colonoscopy use, colorectal cancer cases and colorectal cancer deaths among participants in the multidecade Nurses’ Health Study and Health Professionals Follow-up Study. Following 88,902 subjects over 22 years, they found that people who [...]

In 2009 almost 150,000 cases of colon cancer occurred with nearly 50,000 deaths. Colon cancer is the second leading cause of cancer mortality in the United States and is an equal gender offender – both genders are affected to the same degree. Over the past 20 years these numbers have not improved dramatically despite advances in both surgical and medical therapy. For years medical testing had relied on symptoms in hopes that the prompt evaluation based on timely reporting of these symptoms by patients to their physicians would lead to early detection of cancer and favorably impact survival – [...]

“You are what you eat”, a statement emphasizing healthy eating was derived from a phrase in 1826 “Tell me what you eat and I will tell you what you are”. Research on the digestion and absorption of food has clarified the relationship between content, volume and timing of meals vis a vis our sense of well being. Certain foods have a direct effect on the GI tract. Mints, chocolate and alcohol relax the lower esophageal sphincter (LES, a sphincter which separates the esophagus from the stomach); relaxation of this sphincter promotes reflux of stomach contents into the esophagus. It [...]

If you are 50 or older and have not yet been screened for colon cancer, you are taking a significant but unnecessary risk. Colon cancer develops from a benign lesion called a polyp (adenoma-carcinoma hypothesis). The National Polyp study in 1991 demonstrated that by detecting and removing polyps, colon cancer could be prevented from developing. Subsequent studies have suggested that up to 90% of colon cancer can be prevented by widespread screening beginning at age 50. People with a family history are at increased risk for developing colon cancer and should be screened even earlier. If you are 50 [...]

Gastroesophageal reflux (GER) is the term for reflux of stomach contents (acid, food, air, bile and pancreatic enzymes) into the esophagus. GER is prevented by the lower esophageal sphincter (LES) which separates the esophagus from the stomach. Upon swallowing, food is propelled through the esophagus, the LES relaxes and food enters the stomach whereupon the LES closes. Certain events, such as distension of the stomach due to accumulation of swallowed air can stimulate the LES to relax and allow this accumulated air to escape in the form of a belch – always great entertainment for children and teenagers. Certain [...]