ACG

Despite warnings and concerns, the evidence points to this bottom line: PPIs are relatively safe over the long term.

Ulcerative colitis is primarily a mucosal disease, and other changes appear to be secondary to this process. By contrast, Crohn disease, or granulomatous colitis, involves the whole thickness of the bowel wall.

Age-based screening recommendations for chronic hepatitis C virus infection targeted to Americans born between 1945 and 1965 were announced by the CDC.

Is the increased risk of IBD due to pollution, a too-clean home, or antibiotics? Or none of the above?

Did you know: The hepatitis B virus is the only human virus that is routinely tested for by measuring a marker, or “footprint,” of the virus in the blood? Here, an explanation for this and 4 more things you need to know about HBV.

Fergus Shanahan, MD, FACG, summarizes his session at ACG 2011, "Probiotics: Are They Ready for Prime Time?"

Christopher Pleyer, MD, from the Mayo Clinic, Rochester, MN, summarizes his part in the plenary session "Observer Bias in the Diagnosis of Gastroesophageal Reflux Disease and Functional Dyspepsia" at ACG 2011. Distinguishing GERD from other upper GI problems is crucial, he explains.

Is obesity really leading to an increase in GERD? Or, has GERD just become a catch-all phrase for all sorts of upper GI distress? Has GERD become the new "dyspepsia"? G. Richard Locke, MD, FACG, from the Mayo Clinic, Rochester, MN, discusses his findings as presented at the ACG 2011 program.

Clostridium difficile infection is a serious, life-threatening nosocomial infection that can follow on the heels of broad-spectrum antibiotic use. It affects over 500,000 Americans annually, with 15,000 deaths. Infection recurs in 15% to 25% of those initially treated successfully; infection subsequently redevelops in 40% to 50% of those an initial recurrence.

If ACG 2011 had a recurrent theme, it was nicely summed up in this lecture: probiotic treatments are coming. Scientific evidence is accumulating for this approach, and patients will likely embrace it as a “natural” remedy. Primary care physicians should carefully follow this emerging trend-it holds promise for some of our most challenging patients with chronic disease.

Like other chronic inflammatory conditions, inflammatory bowel disease (IBD) has been revolutionized by the advent of biologic agents that fundamentally alter the inappropriate inflammatory response. The most potent of these are the biologic agents, infliximab, adalimumab, certolizumab pegol, and natalizumab. They also have the most dangerous side-effect profile.

Following on the heels of the obesity epidemic, a second epidemic has become apparent-sleep-disordered breathing and its effect on esophageal conditions, primarily gastroesophageal reflux disease (GERD). Many, many primary care providers have heard the following complaint: “I gained 10 pounds and now I have heartburn/cough/worsening asthma” (take your pick). What’s going on?

Prevalence for overweight (BMI 24.9 to 29.9) and obesity (BMI > 30) have been steadily rising for the past 30 years-two-thirds of Americans now qualify as overweight or heavier. Hypertension, hyperlipidemia, coronary artery disease, type 2 diabetes, sleep apnea, and GERD prevalence are following this epidemic. Obesity is now the second most common preventable cause of death, exceeded only by smoking.

For better or worse, primary care physicians are encountering increasing numbers of patients who are using complementary and alternative medicines (CAMs) for gastrointestinal syndromes. The use of these agents has exploded over the last decade. Dr. Keshavarzian quoted the 2007 National Health Interview Study from CDC, which revealed that nearly 4 in 10 adults had used a CAM treatment within the past year.

Mention GERD and most of patients probably think of heartburn. But the GERD story does not begin and end with the esophagus. The connection between GERD and laryngeal, pharyngeal, and pulmonary symptoms is the focus of a seminar, “An Eye and Nose Opening Experience-Chronic Complications of GERD,” at the upcoming American College of Gastroenterology Annual Scientific Meeting, October 31 to November 2 in Washington, DC.

When it comes to treating ulcerative colitis, it’s a jungle out there. This is because the gut is the largest and most complex immune environment in the human body. To successfully treat intestinal tract disorders, therapeutic agents must be delivered at the right time, in the right amount, to the right location.

Colorectal cancer is the third leading cause of cancer-related deaths in the United States. However, it is also one of the most manageable. A plenary session on colorectal cancer prevention will be among the highlights of the upcoming American College of Gastroenterology Annual Scientific Meeting, October 31 to November 2 in Washington, DC.

Statins are associated with a slight reduction in the risk of colorectal cancer, according to the results of a recent meta-analysis presented at the 2010 American College of Gastroenterology meeting. Investigators at the University of Michigan at Ann Arbor conducted a systematic review that included 22 studies with a total of more than 2.5 million participants.

Certain patients with inflammatory bowel disease are at heightened risk for the development of colorectal cancer. But researchers have not yet been able to discover markers that can identify these patients.

Turmeric, a spice used in curry, may help prevent Clostridium difficile infection. Rattan Patel, MD, of Cedars Sinai Medical Center in Los Angeles, and his colleagues found that curcumin (the active ingredient in turmeric) inhibited the growth of various strains of C difficile in vitro.

From the perspective of a harried primary care physician, it’s very difficult to sort out arguments and data when two respected specialists diametrically disagree.

Does dye-based chromoendoscopy improve dysplasia detection in patients undergoing surveillance colonoscopy for long-term ulcerative colitis? It does, according to Anna Buchner, MD, PhD, and her coauthors, and this raises the question of whether US guidelines should endorse dye-based chromoendoscopy for dysplasia screening in patients with ulcerative colitis.

Consider fructose intolerance in children with chronic abdominal pain, after you have ruled out more serious GI disorders such as Crohn's disease and ulcerative colitis. A low-fructose diet can be an effective treatment, according to the results of a recent study reported at the ACG 2010 Annual Scientific Meeting.

Obesity is associated with a broad range of GI health risks. An expert panel discussed these risks, which were documented in abstracts presented at the 2010 ACG Scientific Meeting.

Hands-on sessions markedly enhance the CME experience. New to the ACG Scientific Meeting in 2010, the hands-on workshop center proved to be one of the conference’s most popular offerings.

In this engaging session, 5 patients with complex and difficult cases of ulcerative colitis were presented to an expert panel, which consisted of Maria Abreu, MD, Edward Loftus, MD, and David Rubin, MD. The panel moderator was Jean-Paul Achkar, MD.