GI Insights

Host: Mark DeLegge, MD Guest: Michael Camilleri, 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 ba...

Host: Mark DeLegge, MD Guest: Timothy Rubin, 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...

Host: Jay Goldstein, MD Guest: Emmet Keeffe, 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.

Host: Jay Goldstein, MD Guest: John Inadomi, 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 Ina...

Host: Mark DeLegge, MD Guest: David Peura, 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...

Host: Mark DeLegge, MD Guest: Rowen Zetterman, 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...

Host: Mark DeLegge, MD Guest: Mark Donowitz, 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 Gastroe...

Host: Mark DeLegge, MD Guest: Donald Castell, 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 DeLegg...

Host: Jay Goldstein, MD Guest: Glenn Eisen, MD, MPH 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...

Host: Jay Goldstein, MD Guest: Scott Cotler, 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...

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...

Host: Mark DeLegge, MD Guest: Prateek Sharma, 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...

Host: Jay Goldstein, MD Guest: Brennan Spiegel, MD, MSHS 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. Brenn...

Host: Jay Goldstein, MD Guest: Carla Ginsburg, MD, MPH 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, pr...

Host: Jay Goldstein, MD Guest: David Peura, 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...

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, discuss...

Host: Jay Goldstein, MD Guest: Richard Fedorak, 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 gastrointesti...

Host: Mark DeLegge, MD Guest: Michael Vaezi, MD, PhD 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, discusse...

Host: Mark DeLegge, MD Guest: Lawrence Kim, 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 gastroenterolo...

Host: Mark DeLegge, MD Guest: Mary Igo, MBA, RN 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 Minn...

Host: Mark DeLegge, MD Guest: Peter Cotton, 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 e...

Host: Mark DeLegge, MD Guest: Thomas D. Wang, MD, PhD 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....

Host: Mark DeLegge, MD Guest: William Chey, 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 in...

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 ho...

Host: Jay Goldstein, MD Guest: Ronald Fogel, MD It's the third most commonly diagnosed cancer, with more than 150,000 new cases projected in 2008, and the second leading cancer killer at more than 50,000 deaths this year alone, yet questions remain about screening strategies for colorectal cancer. Given that many health insurance plans don't cover screenings, how can we find other avenues to addre...