Gi Insights

Guest: Miriam Vos, MD, MSPH Host: Mark DeLegge, MD Although it's important to consider the many factors that contribute to childhood obesity when designing a weight loss plan, sugar may be one of the most important components to target. Specifically, how does fructose influence childhood obesity? Dr. Miriam Vos, assistant professor in the department of gastroenterology at Emory University and author of the book The No-Diet Obesity Solution for Kids, published by the AGA Institute Press, offers tips for discussing a healthy lifestyle with parents of overweight children. Dr. Mark DeLegge hosts.

Guest: Mansour Mohamadzadeh, PhD Host: Jay Goldstein, MD Researchers have developed an oral vaccine utilizing probiotics and, in preclinical studies, have found it successful in providing immunity against anthrax. Why are probiotics a good delivery component, and why might this method encourage a greater degree of response than the traditional vaccine injection? Dr. Mansour Mohamadzadeh, associate professor of medicine in the division of gastroenterology at Northwestern University Feinberg School of Medicine, tells host Dr. Jay Goldstein about this new vaccine delivery method. Will oral vaccines soon be ready for clinical trials?

Guest: Elizabeth Montgomery, MD Host: Jay Goldstein, MD Gastroenterologists and pathologists often rely on each other to care for patients. How can clinicians and pathologists best facilitate each other's work for the good of the patient? Dr. Elizabeth Montgomery, professor of pathology and oncology at Johns Hopkins University School of Medicine, explores the interaction between gastroenterologists and pathologists with host Dr. Jay Goldstein. Also, Dr. Montgomery outlines biopsy tips for gastroenterologists.

Host: Jay Goldstein, MD Guest: Linda Lee, MD How does delayed gastric emptying, or gastroparesis, affect patients? What are some of the common comorbid conditions of gastroparesis, and why are women and diabetic patients more susceptible? Dr. Linda Lee, clinical director of the division of gastroenterology and hepatology and director of the Johns Hopkins Integrative Medicine and Digestive Center at the Johns Hopkins University School of Medicine, reviews the best gastroparesis diagnostic tools and management strategies with host Dr. Jay Goldstein.

Guest: William Chey, MD Host: Mark DeLegge, MD Guest: Mark Pimentel, MD Irritable bowel syndrome, or IBS, affects a significant number of patients and can be challenging to treat. How might antibiotic therapy benefit IBS patients, and how is antibiotic therapy a unique option for treating IBS? Should physicians empirically treat IBS patients with antibiotics? Joining us to debate these questions are Dr. William Chey, professor in the department of internal medicine at the University of Michigan Medical School, and Dr. Mark Pimentel, associate professor of medicine at the UCLA Geffen School of Medicine. Dr. Mark DeLegge hosts.

Host: Mark DeLegge, MD Guest: Charles Bernstein, MD Probiotics are becoming increasingly popular, but is there any substantial evidence supporting the efficacy of probiotics for irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD)? Are there any potential risks to IBS and IBD patients using probiotic therapy? Which probiotic strains might be most beneficial, and what dosage is optimal? Dr. Charles Bernstein, director of the University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, explores these and other questions, and suggests physicians might want to be cautious when considering probiotic therapy for their patients. Hosted by Dr. Mark DeLegge.

Guest: Alphonso Brown, MD, MS Host: Mark DeLegge, MD The causes of pancreatitis are often unknown, but we're learning that there are more potential causes than previously believed. Genetic causes are rare, but their detection has improved with new technology. What role might genetic testing play in correctly diagnosing and managing the condition? And what are the ramifications of genetic testing for the patient? Dr. Alphonso Brown, assistant professor of medicine at Harvard Medical School and co-director of the Pancreas Center at Beth Israel Deaconess Medical Center, joins host Dr. Mark DeLegge to discuss the application of genetics for patients with pancreatitis.

Guest: Mark DeLegge, MD Host: Jay Goldstein, MD What unique perspectives can gastroenterologists offer to help manage and treat obesity, and how can gastroenterologists address the needs of their obese or overweight patients? When should a surgical bypass or lap-band procedure be considered? Host Dr. Jay Goldstein welcomes his GI Insights co-host, Dr. Mark DeLegge, to discuss the role of the gastroenterologist in preventing and treating obesity. You can access the AGA’s new materials about nutrition and obesity on the AGA's website, including The Nutrition Toolkit Series, authored by Dr. DeLegge

Host: Jay Goldstein, MD Guest: Deborah Proctor, MD Host Dr. Jay Goldstein welcomes Dr. Deborah Proctor, professor of medicine in the section of digestive diseases and medical director of the Inflammatory Bowel Disease Program at Yale University School of Medicine, to provide an overview of common female gastroenterological disorders. They discuss which gastroenterological disorders present differently in women than in men. How do pelvic surgeries, such as C-sections or hysterectomies, affect colon cancer screening efficacy in women? And what factors increase a woman's chance of developing irritable bowel syndrome or Barrett's esophagus?

Host: Jay Goldstein, MD Guest: Christian Stone, MD, MPH Incidents of Clostridium difficile, or C.diff, are increasing in the US. Are patients with ulcerative colitis or Crohn's disease more at risk for developing C. difficile infection than other patients? Is this due to an increased use of antibiotics in hospitals, or are other factors playing a role? Join host Dr. Jay Goldstein as he welcomes Dr. Christian Stone, associate professor of medicine at Washington University School of Medicine in St. Louis, to discuss the recent trends of C. difficile infections among inflammatory bowel disease patients.

Guest: Andrew Chan, MD, MPH Host: Mark DeLegge, MD Guest: David Lieberman, MD It's currently recommended that patients at average risk for colorectal cancer repeat a colonoscopy every 10 years. Is the 10-year interval appropriate for average-risk patients, or would patients benefit from more frequent colonoscopies? What evidence do we have to support the idea that more frequent colonoscopies would provide more accurate screening? Or, would a shorter intervals between colonoscopies unnecessarily increase cost and inconvenience, without much added benefit? Dr. Mark DeLegge hosts a point-counterpoint discussion. Dr. David Lieberman, professor of medicine at Oregon Health and Science University, supports the standard interval, while Dr. Andrew Chan, assistant professor of medicine at Harvard Medical School, challenges the idea that a screening every 10 years is appropriate for most average-risk patients.

Guest: T. Karl Byrne, MD Host: Mark DeLegge, MD What are the advantages to each of the two main types of obesity surgeries— gastric bypass and lap band surgery? How do the recovery times, efficacy and potential complications compare? Host Dr. Mark DeLegge welcomes Dr. T. Karl Byrne, professor of surgery and medical director of the Bariatric Surgery Center at the Medical University of South Carolina, to discuss the role of the gastric bypass and lap band procedures in treating obesity. Are some patients clear candidates for one procedure over the other? And how is a third procedure — the sleeve gastrectomy — becoming another attractive option for treating obesity?

Guest: Douglas Rex, MD Host: Mark DeLegge, MD Fecal immunochemical testing (or FIT testing) replaces the older stool guaiac test in the recent colorectal cancer screening guidelines. What's the advantage to FIT testing? Is there a place for fecal DNA testing in the realm of colorectal cancer screening methods right now, or does this procedure need further revision? Host Dr. Mark DeLegge discusses the newest developments in colorectal cancer screening technologies with Dr. Douglas Rex, distinguished professor of medicine at Indiana University School of Medicine. Is CT colonography also a viable screening option?

Guest: Lisa Boardman, MD Host: Mark DeLegge, MD Early detection through screening for colorectal cancer (CRC) can make a huge impact in preventing the development or progression of CRC. What screening methods are most recommended? Dr. Lisa Boardman, assistant professor of medicine at the Mayo Clinic, reviews details of the CRC screening guidelines from both the Joint Effort Panel, as well as the United States Preventive Services Task Force. Will these guidelines be dramatically revised in the near future, and if so, will we shift towards widespread use of the newer CRC screening technologies? Dr. Mark DeLegge hosts.

Guest: Robert Bresalier, MD Host: Jay Goldstein, MD What are some common gastrointestinal complications from oncologic therapies? How can physicians differentiate a side effect from a condition that requires further evaluation? Host Dr. Jay Goldstein welcomes Dr. Robert Bresalier, professor of medicine in the department of gastrointestinal medicine and nutrition at the M.D. Anderson Cancer Center, to discuss the role of the gastroenterologist in treating cancer and complications from oncologic therapies. Is there a way to prevent gastroenterologic complications?

Guest: J. Randolph Hecht, MD Host: Jay Goldstein, MD How have treatments for colorectal and pancreatic cancers advanced in recent years, and are novel treatments reducing the mortality rate of patients with these cancers? Dr. J. Randolph Hecht, director of the GI Oncology Program at the UCLA Health System and clinical professor of medicine in the hematology-oncology division at the UCLA David Geffen School of Medicine, looks at some of the newer pharmacological agents and methods being used to treat these gastrointestinal cancers. Dr. Jay Goldstein hosts.

Guest: Michael Camilleri, MD Host: Mark DeLegge, MD What are some of the newer bariatric endoscopic procedures, and when are these procedures preferred over traditional gastric bypass surgery? Dr. Michael Camilleri, professor of medicine and physiology at the Mayo Clinic Medical School in Rochester, Minnesota, reviews the most common gastric bypass procedures, such as the Roux-en-Y, laproscopic banding and duodenal switch procedures, and explains the advantages to some of the newer surgeries, including the sleeve gastrectomy and transoral gastroplasty. Dr. Mark DeLegge hosts.  

Guest: Timothy Rubin, MD Host: Mark DeLegge, MD The micro-organism Clostridium difficile, or C. diff, can cause serious infection and is often resistant to antibiotic therapy. A less traditional approach to treatment — the stool transplant — has emerged as a very successful therapy for patients suffering from C. diff. What does the procedure involve, and which patients might be candidates? Host Dr. Mark DeLegge explores this unconventional therapy with Dr. Timothy Rubin, gastroenterologist at Saint Mary's Duluth Clinic Health System in Minnesota.  

Guest: Emmet Keeffe, MD Host: Jay Goldstein, MD What do recent measures recommend to primary care physicians and gastroenterologists who care for patients with hepatitis C? Dr. Emmet Keeffe, professor of medicine emeritus at Stanford University Medical Center, joins host Dr. Jay Goldstein to outline the 10 measures for diagnosing and treating patients with hepatitis C.

Guest: John Inadomi, MD Host: Jay Goldstein, MD Non-cardiac chest pain and chronic cough are just two of the extraesophageal manifestations of gastroesophageal reflux disease, or GERD. What other symptoms should we look for? If a patient displays characteristics of GERD, such as esophogeal regurgitation, is that patient also likely to experience extraesophogeal manifestations of GERD? Dr. John Inadomi, the Dean M. Craig Endowed Chair in Gastrointestinal Medicine at the University of California, San Francisco, explains what distinguishes extraesophogeal manifestations of GERD from GERD symptoms. Do proton pump inhibitors treat both GERD and its extraesophogeal symptoms? Dr. Jay Goldstein hosts.