Gi Insights

Guest: David Peura, MD Host: Mark DeLegge, MD Constipation is a common symptom that presents more often in women and as patients get older. What are the primary and secondary causes of chronic constipation? What are some of the differentiating factors between chronic constipation and IBS-C? Dr. David Peura, professor of medicine at the University of Virginia School of Medicine, joins host Dr. Mark DeLegge to discuss algorithms for diagnosing chronic constipation. When are lifestyle changes not enough for treating chronic constipation, and what are the most effective alternatives?

Guest: Rowen Zetterman, MD Host: Mark DeLegge, MD Acetaminophen, vitamin supplements and antibiotics are just a few of the medications that can cause liver injury. What are the signs of drug-induced liver injury? Are the effects immediate, or do the effects become noticeable after an extended period of time? Dr. Rowen Zetterman, professor of internal medicine at the University of Nebraska Medical Center, provides an overview of factors that might lead to drug-induced liver injury. Dr. Mark DeLegge hosts.

Guest: Mark Donowitz, MD Host: Mark DeLegge, MD Are there fewer physician-scientists today than there were a few decades ago? What does the future landscape look like for medical research? Dr. Mark Donowitz, LeBoff Professor of Medicine and director of the Center for Epithelial Disorders at the Johns Hopkins University School of Medicine, as well as immediate past-president of the American Gastroenterological Association, discusses some of the barriers and challenges physician-scientists face, and how we can ensure a sound future for research. Dr. Mark DeLegge hosts.    

Guest: Donald Castell, MD Host: Mark DeLegge, MD How common is Barrett's esophagus in patients with chronic gastroesophageal reflux disease (GERD) or asymptomatic reflux? What risk factors might predict a diagnosis of Barrett's esophagus? Dr. Donald Castell, professor of medicine and director of the esophageal disorder program at the Medical University of South Carolina, joins host Dr. Mark DeLegge to discuss this potentially pre-cancerous condition.

Guest: Glenn Eisen, MD, MPH Host: Jay Goldstein, MD What does outcomes research measure, and how does it differ from clinical trials? Is evidence-based medicine related to outcomes research? Host Dr. Jay Goldstein evaluates outcomes research with Dr. Glenn Eisen, professor in the department of medicine and the division of gastroenterology at Oregon Health and Science University. How will outcomes research impact clinical practices?

Guest: Scott Cotler, MD Host: Jay Goldstein, MD Untreated hepatitis B can lead to cirrhosis and liver cancer. What methods are available for physicians to treat hepatitis B patients? Host Dr. Jay Goldstein reviews available treatments for reducing liver damage from hepatitis B with Dr. Scott Cotler, chief of hepatology at the University of Illinois at Chicago. How can the virus be suppressed while reducing the progression of liver disease?

Host: Mark DeLegge, MD Guest: William J. Sandborn, MD The current treatment paradigm for Crohn's disease is a pyramid approach, where patients are given the safest medications before pursuing more aggressive strategies. New evidence suggests that Crohn's disease should be treated with the most effective medications first, such as anti-TNF therapies. But is a top-down strategy safe enough for most patients? Dr. William Sandborn, professor of medicine and gastrointestinal research at Mayo Clinic College of Medicine, describes the results of new Crohn's disease trials and research. Is using steroids to treat Crohn's disease an idea of the past, or are steroids still effective for certain patients? Dr. Mark DeLegge hosts.

Guest: Prateek Sharma, MD Host: Mark DeLegge, MD Esophageal cancer survival rates greatly decline when the cancer has reached its late stages, so detecting neoplasia in a Barrett's esophagus patient early is a crucial tool in cancer management. What are some emerging endoscopic techniques that can be used for a Barrett's esophageal patient? Dr. Prateek Sharma, professor of medicine in the division of gastroenterology and hepatology at the University of Kansas School of Medicine, discusses the best ways to manage esophageal cancer and Barrett's esophagus patients with host Dr. Mark DeLegge.

Guest: Brennan Spiegel, MD, MSHS Host: Jay Goldstein, MD In its 1948 charter constitution, the World Health Organization defined health as "a state of complete physical, mental and social well-being." Today, to measure this totality of well-being, we measure quality of life. Host Dr. Jay Goldstein discusses how quality of life measurements can be incorporated into everyday practice, with Dr. Brennan Spiegel, assistant professor of medicine in the division of digestive diseases at the David Geffen School of Medicine at UCLA. How is health-related quality of life measured objectively in clinical trials? To what degree do quality of life endpoints trump physiological endpoints?

Guest: Carla Ginsburg, MD, MPH Host: Jay Goldstein, MD Physicians continue to face payment cuts from Medicare, largely due to a flawed payment formula. What is on the horizon for 2009 and beyond? President-elect Obama has identified sweeping health care reform as a goal of his presidency. How could the new administration's health care overhaul affect physician reimbursement? Dr. Carla Ginsburg, professor of medicine at Harvard Medical School and private practice counselor on the governing board of the AGA, dissects the complexities of Medicare with host Dr. Jay Goldstein.    

Guest: David Peura, MD Host: Jay Goldstein, MD Helicobacter pylori, often known as H. pylori, was discovered in the 1980s and is found worldwide in the stomachs of billions of people. H. pylori can cause gastritis and ulcers, but often presents no symptoms or problems for years. How concerned should we be about the stomach bacterium? Host Dr. Jay Goldstein discusses with Dr. David Peura, professor of medicine at the University of Virginia School of Medicine, the extent to which H. pylori is still a health problem in the United States.

Host: Jay Goldstein, MD Guest: Richard Fedorak, MD Steroids used to be the standard treatment for inflammatory bowel disease. But now biologic and immunosuppresive therapies are often used. How can we increase the efficacy of these medications? What combinations work best? Dr. Richard Fedorak, professor of medicine in the division of gastroenterology at the University of Alberta in Canada, discusses IBD treatments with host Dr. Jay Goldstein.

Guest: Richard Fedorak, MD Host: Jay Goldstein, MD What are probiotics, and how do strains differ? How can they be used most effectively? Dr. Richard Fedorak, professor of medicine in the division of gastroenterology at the University of Alberta in Canada, probes the potential of probiotics with host Dr. Jay Goldstein. Can they be used to replace medications for certain patients with gastrointestinal disorders? Find out what you should you tell your patients about probiotics.

Guest: Michael Vaezi, MD, PhD Host: Mark DeLegge, MD Gastroesophageal reflux disease (GERD) is the most common GI diagnosis. But many aspects of diagnosing and treating GERD and related syndromes vary considerably. Now, the AGA has issued new evidence-based guidelines on this widespread disorder. Some of the recommendations may surprise you. Dr. Michael Vaezi, co-author of the guidelines, discusses the best GERD management strategies with host Dr. Mark DeLegge. To view the AGA's GERD Guidelines, please click here.  

Guest: Lawrence Kim, MD Host: Mark DeLegge, MD Endoscopy is extremely safe when performed by a qualified gastroenterologist. What role does accreditation play in ensuring patient safety? What's the difference between the associations that accredit ambulatory surgery centers? Host Dr. Mark DeLegge discusses what GIs need to know about accreditation with Dr. Lawrence Kim, a practicing gastroenterologist at South Denver Gastroenterology in Colorado.

Guest: Mary Igo, MBA, RN Host: Mark DeLegge, MD The Physician Quality Reporting Initiative (PQRI) is a CMS-based program designed to help medical professionals measure performance outcomes in their practice. How does the PQRI define quality, and how can it provide more concrete measurements of quality? What do GI practices need to know when becoming involved in the PQRI? Mary Igo, MBA, CEO of Minnesota Gastroenterology, a GI practice based in St. Paul, and an expert in medical group management, assesses the pros and cons of implementing the PQRI system with host Dr. Mark DeLegge.

Guest: Peter Cotton, MD Host: Mark DeLegge, MD The outcomes for endoscopy can vary greatly, depending on the training and technique of the endoscopist. Dr. Peter Cotton, professor of medicine at the Digestive Disease Center at the Medical University of South Carolina, discusses the risks of endoscopy, and quality-control measures, from the establishment of benchmarks to voluntary report cards to ensure quality outcomes. Dr. Mark DeLegge hosts.

Guest: Thomas D. Wang, MD, PhD Host: Mark DeLegge, MD Microscopic imaging of the digestive tract moves beyond examination of tissue at subcellular levels, helping us identify molecular regions in which to probe for dysplasia. Dr. Thomas Wang, assistant professor of medicine and biomedical engineering at the University of Michigan Medical School, details this 'biopsy inside the body' with host Dr. Mark DeLegge. How could this technology shape the future of GI practice? How does this differ from chromoendoscopy, autofluorescence, and other current technologies?

Guest: William Chey, MD Host: Mark DeLegge, MD Guest: Nicholas Shaheen, MD, MPH Gastrointestinal (GI) disease is a major source of morbidity and mortality, yet physicians and patients often regard it as a basic nuisance. What contributes to this perception, and how can we change it? Host Dr. Mark DeLegge welcomes two chairmen of the upcoming AGA Clinical Congress, Dr. William Chey, professor of internal medicine at the University of Michigan Medical School, and Dr. Nicholas Shaheen, associate professor of medicine at the University of North Carolina School of Medicine, to discuss strategies to help us and our patients keep current on GI disease.

Host: Jay Goldstein, MD Guest: Douglas Rex, MD Gastroenterology-directed propofol is controversial among many practitioners, even though evidence suggests it is very safe. What barriers are there to gastroenterologists administering propofol, without an anesthesiologist on site? Guest Dr. Douglas Rex, Chancellor's Professor and professor of medicine at Indiana University School of Medicine, and host Dr. Jay Goldstein examine the reasons for the slow growth of gastroenterologist-directed propofol, and what the future of anesthesiology might be for gastroenterologists.