GI Insights

Extraintestinal manifestations (EIMs) that occur in inflammatory bowel disease (IBD) are almost any manifestation that occur outside the gastrointestinal tract. And patients with Crohn’s disease or ulcerative colitis are at an increased risk for developing these manifestations. So to review EIMs in IBD and discuss the importance of a multidisciplinary approach, Dr. Peter Buch is joined by Dr. Katherine Falloon, Gastroenterologist at the Cleveland Clinic.

Due to recent technological advancements, the use of artificial intelligence to detect a variety of gastroenterological conditions like Barrett’s esophagus, gastric cancer, and colon polyps is increasingly being explored. Learn about the application, benefits, and pitfalls of artificial intelligence in gastroenterology with Dr. Peter Buch and Dr. Ali Soroush, Assistant Professor of Gastroenterology at Mount Sinai School of Medicine in New York.

For patients with refractory constipation, it’s important to evaluate the psychological impact of these symptoms. Unfortunately, this disorder can easily affect a patient’s quality of life and keep them from doing their normal routine. So what treatment options can help alleviate some of the burden? Dive in with Dr. Peter Buch as he speaks with Dr. Joy Liu, Instructor of Gastroenterology and Hepatology at the Feinberg School of Medicine at Northwestern.

Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is the most dreaded complication of this procedure. So what are the patient-related, procedure-related, and operator-related risk factors for developing post-ERCP pancreatitis, and how can we work to prevent it? Join Dr. Peter Buch as he speaks with Dr. Prabhleen Chahal, Program Director of the Advanced Endoscopy Fellowship at the Cleveland Clinic.

Affecting over 25 percent of Crohn's disease patients, perianal disease is a persistent and difficult-to-treat condition. Due to its complex management and significant impact on patients' quality of life, a multidisciplinary approach to care is crucial. Here to discuss the management of perianal Crohn’s disease, Dr. Peter Buch is joined by Dr. Benjamin Cohen, Co-Section Head and Clinical Director for Inflammatory Bowel Disease at Cleveland Clinic, and Dr. Stefan Holubar, IBD Surgery Section Chief and Director of Research at Cleveland Clinic.

In patients with chronic live disease, consuming alcohol could contribute to progressive liver damage and a variety of cancers. So alcohol consumption should not be a regular occurrence for those who have underlying chronic liver disease. And approximately four percent of patients with alcohol use disorder are referred at early stages for intervention compared to other liver diseases. To learn more, join Dr. Peter Buch to hear insights from Dr. Paul Kwo, Professor of Medicine and the Director of Hepatology at Stanford University.

Pouchitis is a common inflammatory complication after ileal pouch-anal anastomosis (J-pouch) surgery, but the why behind patients who develop this condition seems to be unclear. So to dive into the updated guidelines for the management of pouchitis and to also hear about some knowledge gaps in preventing pouchitis, join Dr. Peter Buch as he takes a deep dive with Dr. Edward Barnes, Associate Professor of Medicine and Associate Fellowship Program Director at the University of North Carolina School of Medicine and Primary Author of article, titled “AGA Clinical Practice Guideline on the Management of Pouchitis and Inflammatory Pouch Disorders,” which was published in Gastroenterology in 2024.

Symptoms of portal vein thrombosis (PVT) are primarily driven by the extent of the obstruction that the PVT is causing, and some of it’s also driven by how quickly the thrombosis has developed. There’s also some cases where symptoms can be nonspecific. So the role of a multidisciplinary team in helping to address this condition is very important because every case is unique. This collaboration can help provide the best care to our patients case by case. Dive in with Dr. Peter Buch and Dr. Shilpa Junna, Transplant Hepatologist and Assistant Professor at the Cleveland Clinic, to learn more.

C. difficile is a major problem in the United States. On top of that, patients who are diagnosed with this infection have the chance of getting caught in a vicious cycle of recurrence. So how can we provide our patients with the best care and work with them to give them the best treatment option? Learn more with Dr. Peter Buch as he takes a deep dive with Dr. Paul Feuerstadt, Assistant Clinical Professor of Medicine at Yale-New Haven Hospital.

There are a lot of considerations to keep in mind when it comes to liver transplantation in patients with various diseases, like metabolic-associated stereotactic liver diseases, alcoholic liver disease, hepatitis B and C, and more. Joining Dr. Peter Buch to discuss those key considerations surrounding liver transplantation is Dr. Michael Lucey, Professor of Medicine at the University of Wisconsin School of Medicine and Public Health.

It’s become clear that social media is here to stay, and it’s become a way that people get their information and spread information. Dive into this episode to learn about the benefits and challenges of social media in healthcare from a recently published article with Dr. Peter Buch and Dr. Benjamin Schmidt, Gastroenterologist at Esse Health in St. Louis, Missouri. He’s also the author of the article, titled “How a GI Fellow Found a Following: Harnessing the Power of Social Media for Education and Fun,” which was published in Digestive Diseases and Sciences in 2023.

Until recently, surgery was always utilized for appendicitis, but now, antibiotics are an alternative treatment. Find out who the best candidates are for an antibiotic regimen, the efficacy and safety of this approach to treating acute uncomplicated appendicitis, and more with Dr. Peter Buch and Dr. David Talan, Professor of Medicine at UCLA Geffen School of Medicine.

There are a few factors that may predict patients who are more likely to experience postoperative recurrence of Crohn’s disease. So how should we be monitoring our patients for recurrence, and what therapies are available? To learn more, Dr. Peter Buch is joined by Dr. Miguel Regueiro, Chief of Cleveland Clinic’s Digestive Disease Institute.

Intestinal ultrasound has become a useful tool in assessing disease progression and pathophysiology of inflammatory bowel disease (IBD). It’s an approach to visualizing the intestines using a transabdominal ultrasound probe to provide real-time information. But could research from the STARDUST substudy on ustekinumab provide new options for these patients? Tune in with Dr. Peter Buch for an in-depth conversation with Dr. David Rubin, Professor of Medicine at the University of Chicago Pritzker School of Medicine.

Non-invasive biomarkers for metabolic dysfunction-associated steatosis liver disease (MASLD) are used to stratify risk and assess disease severity in our patients. In this episode, Dr. Peter Buch is joined by Dr. Julia Wattacheril, Associate Professor of Medicine at Columbia University Irving Medical Center, to discuss the American Gastroenterological Association’s clinical practice update on the role of noninvasive biomarkers in MASLD.

Unfortunately, there are not a lot of specific pharmacologic agents for incontinent patients; however, using typical antidiarrheal therapies can be helpful for patients who have diarrhea. So what other treatment options should we know about? To learn more, join Dr. Peter Buch as he speaks with Dr. Kyle Staller, Assistant Professor of Medicine at Harvard Medical School and Director of the Gastrointestinal Motility Laboratory at Mass General.

Since the 1990s, clinicians have been seeing a significant increase in colorectal cancer among young patients, who are under the age of 50. A multidisciplinary approach is key as diagnostic and treatment considerations are specific to their age. Dive in with Dr. Peter Buch as he’s joined by Dr. David Liska, Section Chief of Oncology in the Department of Colorectal Surgery at the Cleveland Clinic.

With the increasing incidence and prevalence of cirrhosis in patients, healthcare professionals have to routinely consider giving anticoagulants to these patients. Understanding how we can safely administer these types of medications to cirrhosis patients is important. To learn more, tune in with Dr. Peter Buch as he speaks with Dr. Naga Chalasani, Co-Author of the article, titled “The Safety of Anticoagulants and Antiplatelet Agents in Patients with Cirrhosis,” which was published in Alimentary Pharmacology and Therapeutics in November 2022, and the David W. Crabb Professor of Gastroenterology and Hepatology at Indiana University School of Medicine in Indianapolis.

Liver disease is highly prevalent in patients with type 2 diabetes, and it’s much more likely to be a clinically significant issue in these patients as well. So it’s important to evaluate patients for liver disease during routine check-ups. Dive further into the effects of liver disease in diabetic care with Dr. Peter Buch as he speaks with Dr. Michael Charlton, Professor of Medicine and Co-Director of the Transplant Institute at the University of Chicago.

Non-alcoholic fatty liver disease connoted that there's no alcohol contribution to the fat and didn't accurately convey the interplay between metabolic-driven cytosis, which can come from insulin resistance and all of the other metabolic dysfunction-associated inflammatory patterns, as well as the contributions of alcohol. So what do we know about patients who have metabolic dysfunction-associated steatotic liver disease (MASLD) and also consume alcohol? To learn more, join Dr. Peter Buch as he discusses this with Dr. Paul Kwo, Professor of Medicine and the Director of Hepatology at Stanford University.

Fortunately, there are a lot of studies that have evaluated biosimilars in inflammatory bowel disease (IBD), and those all confirmed that biosimilars are safe, effective, and do not result in worsening patient outcomes. But are we using biosimilars enough in the treatment of IBD? Dive in with Dr. Mary Katherine Cheeley as she speaks with Dr. Shubha Bhat, Clinical Pharmacist in the Digestive Disease Institute at the Cleveland Clinic.

Patients with non-celiac gluten sensitivity can experience the same symptoms of those with celiac disease and IBS, complicating the diagnostic process. Find out how you can accurately identify and distinguish non-celiac gluten sensitivity from other digestive disorders with Dr. Peter Buch and Dr. Marianna Arvanitakis, Associate Clinical Professor in the Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology from the HUB Erasme Hospital in Brussels, Belgium.

Roughly 1 in 10 Americans suffer with some degree of constipation, and many of those patients suffer with ongoing chronic issues around constipation. So for the first time, the American Gastroenterological Association and the American College of Gastroenterology have released joint recommendations for the management of chronic idiopathic constipation (CIC). To dive into these guidelines, Dr. Peter Buch is joined by Dr. William Chey, Marvin Pollard Professor of Gastroenterology and Chief of the Department of Gastroenterology and Hepatology at the University of Michigan.

There are a wide range of therapeutic options when it comes to personalizing your patient’s treatment approach, such as simple lifestyle modifications all the way to a surgical procedure. To learn more, tune in with Dr. Peter Buch as he speaks with Dr. John Pandolfino, Hans Popper Professor and Chief of Gastroenterology and Hepatology in the Department of Medicine at Northwestern Medicine Feinberg School of Medicine in Chicago.

We all face angry and disruptive patients from time to time, making it essential to know how to properly de-escalate and handle the situation. That’s why Dr. Peter Buch speaks with Dr. Douglas Drossman, co-author of an article that was published in the American Journal of Gastroenterology titled “De-escalate, Don’t Escalate: Essential Steps to Effectively Recognize and Manage the Patient Who Is Angry and Disruptive.”

How can we use biomarkers to treat patients with ulcerative colitis? That’s the exact question the latest guideline from the American Gastroenterological Association (AGA) sought to address. Learn about this guideline and other best practices with Dr. Peter Buch and Dr. Siddharth Singh, Assistant Professor of Medicine at the University of California-San Diego and co-author of an article published in Gastroenterology in March 2023 titled “AGA Clinical Practice Guideline on the Role of Biomarkers for the Management of Ulcerative Colitis.”

According to the United Network for Organ Sharing (UNOS), more than 95 percent of patients are alive and doing well after a liver transplant. So what else can we learn from UNOS? Join Dr. Peter Buch as he speaks with Dr. Alan Bonder, Assistant Professor of Medicine at Harvard Medical School.

The American Gastroenterological Association (AGA) recently published updated clinical guidelines for the use of endoscopic ultrasound (EUS). Are there caveats involved with these recommendations? Join Dr. Peter Buch as he speaks with Dr. Kunal Jajoo, Assistant Professor of Medicine at Harvard Medical School, about the best utilization of EUS in clinical practice.

If an elevation of delta aminolevulinic or porphobilinogen occurs in the urine more than three times what is normal, that is presumptive acute hepatic porphyria (AHP. Join the conversation as Dr. Peter Buch speaks with Dr. Herbert Bonkovsky, Professor of Medicine and Molecular Medicine and Translational Science at Wake Forest University, about his article published in Gastroenterology.

Even though nonalcoholic fatty liver disease is the most common form of chronic liver disease in the United States, there are unfortunately no FDA-approved medications for this condition. That’s why Dr. Peter Buch speaks with Dr. Sidney Barritt about even more treatment strategies for nonalcoholic fatty liver disease in the second and final part of this two-episode series. Dr. Barritt is an Associate Professor of Medicine and the Director of Hepatology at the UNC Liver Center at the University of North Carolina.

Even though nonalcoholic fatty liver disease is the most common form of chronic liver disease in the United States, there are unfortunately no FDA-approved medications for this condition. That’s why Dr. Peter Buch speaks with Dr. Sidney Barritt about top treatment strategies for nonalcoholic fatty liver disease in part one of this two-episode series. Dr. Barritt is an Associate Professor of Medicine and the Director of Hepatology at the UNC Liver Center at the University of North Carolina.

Consuming ultra-processed foods can pose many risks to your health that go beyond the GI system. Explore the risks associated with ultra-processed foods with Dr. Peter Buch and Dr. Marianna Arvanitakis, Associate Clinical Professor in the Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology from the HUB Erasme Hospital in Brussels, Belgium.

When a person has a low IgA level, the tissue transglutaminase immunoglobulin A antibody is no longer a useful screening test for celiac disease. So how should we be assessing patients with an IgA deficiency? To discuss these new recommendations, Dr. Peter Buch is joined by Dr. Claire Jansson-Knodell, Gastroenterologist at the Cleveland Clinic’s Digestive Disease Institute.

Metoclopramide is the only FDA-approved medication for the treatment of gastroparesis; however, it comes with a black box warning. To discuss the challenges in diagnosing and treating gastroparesis, Dr. Peter Buch is joined by Dr. Michael Camilleri, Professor of Medicine, Pharmacology, and Physiology at the Mayo Clinic in Rochester, Minnesota.

Assessing eosinophilic esophagitis (EOE) patients’ sensitivity to specific foods is key to creating a personalized diet to help treat this disease. So what role does the six-food elimination diet have in EOE patients? Dive in with Dr. Peter Buch as he speaks with Dr. Brooks Cash, Chief of the Division of Gastroenterology, Hepatology, and Nutrition at the University of Texas Health Sciences Center at Houston.

According to this clinician, the most important thing for primary biliary cholangitis (PBC) patients is the diagnosis, and anyone with abnormal liver tests should be sent an antimitochondrial antibody (AMA). Dive into this interview with host Dr. Peter Buch and Dr. Alan Bonder, Assistant Professor of Medicine and the Medical Director of Liver Transplantation at Beth Israel Medical Center in Boston.

Clinicians should be assessing their patients immediately and trying to understand how quickly they need to provide endoscopy and endoscopic therapy. So in patients with a high risk for thromboembolism, how soon after GI bleeding may anticoagulation be considered? Take a deep dive with Dr. Peter Buch as he speaks with Dr. Kunal Jajoo, Assistant Professor of Medicine at the Brigham and Women’s Hospital of Harvard Medical School.

Patients with underlying autoimmune diseases could be at a higher risk of developing autoimmune hepatitis (AIH). So what challenges might occur when diagnosing patients with AIH? Learn more with Dr. Peter Buch as he discusses this with Dr. Alan Bonder, Director of Liver Transplantation at Beth Israel Deaconess Hospital and an Assistant Professor of Medicine at Harvard Medical School.

Lower GI bleeding is one of the most common reasons that patients are hospitalized due to a digestive disorder in the U.S.; however, there is little data available to help clinicians manage this condition in their patients. So how can we provide better care for these patients? Tune in with Dr. Peter Buch as he speaks with Dr. Neil Sengupta, Associate Professor of Medicine at the University of Chicago.

There may be benefit in testing all hepatitis B patients for hepatitis D, such as reducing the risk of disease progression and liver disease complications. So when should we be concerned about potential hepatitis D infection in our patients? Join Dr. Peter Buch as he discusses this with Dr. Robert Wong, Clinical Associate Professor at Stanford University.

A new treatment option may help relieve chronic constipation in patients who might not respond well to traditional therapies. To learn more about a novel FDA-approved vibrating capsule, join Dr. Peter Buch as he speaks with Dr. Eamonn Quigley, the David M. Underwood Chair of Medicine in Digestive Disorders and a Professor of Medicine at Houston Methodist.

Hepatocellular carcinoma (HCC) is the most common type of liver cancer and most often occurs in people with chronic liver disease. So should we be utilizing modalities other than standard ultrasound for routine early detection of HCC in cirrhotic patients? Listen to this discussion led by Dr. Peter Buch as he speaks with Dr. Amit Singal, Professor of Medicine and the Chief of Hepatology at the University of Texas Southwestern Medical Center.

Gastroesophageal reflux disease (GERD) is an important risk factor for Barrett’s esophagus and esophageal adenocarcinoma (EAC), but there are other important risk factors, such as gender and race. So is it time to look at alternative approaches to increase appropriate screenings? Join Dr. Peter Buch as he is joined by Dr. Joel Rubenstein, Research Scientist at the Kettles VA in Ann Arbor, Michigan and a Professor of Internal Medicine in the Department of Gastroenterology and Hepatology at the University of Michigan School of Medicine.

Clostridioides difficile, or C. difficile for short, is a bacteria that continues to plague our patients. What are the latest treatment updates that you need to be aware of? Dr. Neil Nandi is joined by Dr. Monika Fischer from Indiana University to dive into treatment options and discuss the latest updates.

Acute colonic pseudo-obstruction, also known as Ogilvie’s syndrome, is a rare form of colonic dilatation that can be serious and life-threatening. To learn more about this disorder, Dr. Peter Buch and Dr. Brooks Cash take a look at risk factors, testing strategies, and treatment options for Ogilvie’s syndrome.

In an age where there’s an app for everything, are smartphone apps and other technology-enable solutions revolutionizing mental health treatment in patients with GI challenges? Dr. Neil Nandi speaks with Dr. Megan Riehl from the University of Michigan to explore the capabilities of these technologies and their role in treatment.

Patients with cirrhosis of the liver are typically more susceptible to portal vein thrombosis (PVT). So how can we provide the best care to our PVT patients? To find out, Dr. Peter Buch is joined by Dr. Maurizio Bonacini, CEO of Mission Gastroenterology and Hepatology and Associate Clinical Professor of Medicine at the University of California, San Francisco.

What do the guideline updates recommend for the endoscopic treatment of Crohn’s disease strictures? Dr. Neil Nandi speaks with one of the guideline authors, Dr. Gursimran Kochhar from the Allegheny Health Network in Pittsburgh, Pennsylvania, to better understand how to manage these strictures.

What facts should we keep in mind when considering liver transplantation? And how do we determine which of our patients are the right candidates? Dr. Peter Buch explores important considerations for liver transplantation with Dr. Koji Hashimoto, the Director of Liver Transplantation at the Cleveland Clinic.

From bird beaking to functional lumen imaging probes (FLIP), what do we need to know about the presentation and treatment of achalasia? Dr. Peter Buch speaks with Dr. John Pandolfino from the Feinberg School of Medicine at Northwestern University about the various treatment options available for achalasia.

The pathogenesis of irritable bowel syndrome (IBS) remains unclear, but according to one professor, gravity may play a bigger role in this condition than we think. Dr. Peter Buch sits down with Dr. Brennen Spiegel from the Cedars Sinai Center for Outcomes Research and Education to dive into his research on gravitational management systems and IBS.

Chronic abdominal pain can be caused by many things—including hereditary angioedema (HAE). Are there any barriers to diagnosing patients with HAE? Dr. Peter Buch speaks with Dr. Kyle Staller from the Gastrointestinal Motility Laboratory at Mass General to explore the differential diagnosis for HAE and share what clinicians should be on the lookout for.

Drug-induced liver injury (DILI) is a common problem for patients who take prescription medicine or herbal and dietary supplements. So what resources are available to help reduce this injury? Join Dr. Peter Buch as he speaks with Dr. Jawad Ahmad, Professor of Medicine at Icahn School of Medicine at Mount Sinai, to discuss his study and research on drug-induced liver injury.

Between 2.4 and 4.7 million people have hepatitis C in the United States, but not all have access to proper treatments. So how can clinicians reach more people in the community with this virus? Dr. Peter Buch will give us further insight with Dr. Paul Kwo, Professor of Medicine and the Director of Hepatology at Stanford University.

The pregnancy inflammatory bowel disease and neonatal outcomes (PIANO) registry is the largest US-based study that examines pregnant women who have inflammatory bowel disease (IBD). So how can clinicians use the takeaways from this study in their practice? Join Dr. Peter Buch as he discusses IBD in pregnant women with Dr. Eugenia Shmidt, Assistant Professor in the Division of Gastroenterology, Hepatology, and Nutrition at the University of Minnesota.

The horizon for patients with Crohn’s disease is looking promising as new treatments are expected to come out in the next few years. So what are the best practices for treating fistulizing Crohn’s disease? Explore the treatment landscape with Dr. Peter Buch and Dr. Miguel Regueiro, Chair of the Digestive Disease and Surgery Institute at Cleveland Clinic.

Lynch syndrome is the most common cause of inherited colon cancer and is often underdiagnosed. How can we improve detection of these patients? To find out more, Dr. Peter Buch joins Dr. Bryson Katona from the Hospital of the University of Pennsylvania to explore some key detection strategies.

The most common liver disease caused by pregnancy is intrahepatic cholestasis of pregnancy (ICP). So what do clinicians need to know to best treat their patients? Explore the impact of liver disease on pregnancy as Dr. Peter Buch is joined by Dr. Nancy S. Reau, Professor in the Department of Internal Medicine at Rush Medical College.

The American Gastroenterological Association released updated guidelines for patients with irritable bowel syndrome with constipation (IBS-C). To find out more about the latest updates in treatment, Dr. Peter Buch dives into these guideline recommendations with Dr. Arnold Wald, a Professor of Medicine at the University of Wisconsin.

In the United States, about 80 percent of tests used to diagnose C. difficile are PCR assays. So what are the best options to diagnose and treat patients with this infection? To discuss the evolving treatment and evaluation landscape for C. difficile, Dr. Peter Buch is joined by Dr. Paul Feuerstadt, Assistant Clinical Professor at Yale New Haven Hospital.

A kay cofounder in managing postoperative Crohn’s disease, bile acid diarrhea can be challenging to diagnose. What tests are currently available? To discuss this cofounder and how to diagnose it, Dr. Peter Buch sits down with Dr. Robert Battat, the Director of the Center for Clinical and Translational Research for Inflammatory Bowel Disease at the University of Montreal.

What confounders do we face when managing postoperative Crohn’s disease, and what tools do we have available to us? Dr. Peter Buch dives into this topic with Dr. Robert Battat, the Director of the Center for Clinical and Translational Research for Inflammatory Bowel Disease at the University of Montreal.

Acute pancreatitis can be tricky to diagnose and treat. To help us understand how to better manage this condition, Dr. Peter Buch is joined by Dr. Daniel Strand, the Director of Pancreatobiliary Endoscopy at UVA Health in Charlottesville and an Associate Professor of GI Hepatology to share management updates for patients with recurrent acute and chronic pancreatitis.

Irritable bowel disease (IBD) often requires a personalized approach to treatment. So what does the current therapeutic drug monitoring landscape look like? Dr. Neil Nandi speaks with Dr. Andres Yarur, Associate Professor of Medicine at Cedars-Sinai in Los Angeles, about therapeutic drug monitoring for IBD.

The procedure of transjugular intrahepatic portosystemic shunt (TIPS) is a crucial therapeutic option when treating patients with complications of portal hypertension. So what do we need to know about this procedure? To further delve into TIPS, Dr. Peter Buch is joined by Dr. Justin Boike, Assistant Professor of Medicine at the Northwestern University Feinberg School of Medicine.

Given what medications are currently available, inflammatory bowel disease (IBD) can be difficult to manage. What do we need to know about them, and how do we know which of our patients are the right candidates for them? To answer this question, Dr. Peter Buch speaks with Dr. Aline Charabaty from the Sibley Memorial Hospital.

What do the guidelines recommend for hepatitis B vaccination? Dr. Peter Buch joins Dr. Ira Jacobson, Director of Hepatology and Professor of Medicine at NYU Langone Health and NYU Grossman School of Medicine, to explore challenges and guidelines for hepatitis B vaccination.

Adenoma detection rate (ADR) may help us better detect our patients’ risk of developing colorectal cancer. To explore what we need to know about this quality indicator, Dr. Peter Buch joins Dr. Aasma Shaukat from the New York University Grossman School of Medicine to talk about ADR.

Ulcerative colitis (UC) has an evolving treatment landscape, which has made it difficult for clinicians to position treatment options for their patients. What’s currently available? Dr. Peter Buch dives into this rapidly changing treatment landscape with Dr. Sara Horst, an Associate Professor at Vanderbilt University.

New recommendations about the pharmacological management of irritable bowel syndrome (IBS) with diarrhea by the American Gastroenterological Association (AGA) was published in Gastroenterology 2022. So what do we need to know about these updates, and which medications should we be using? To provide insight, Dr. Peter Buch is joined by Dr. Eamonn Quigley, the David M Underwood Chair of Medicine in Digestive Disorders and Professor of Medicine at the Academic Institute.

Proton pump inhibitors (PPIs) are among the most commonly prescribed class of medication for acid-related disorders. But what are the long-term consequences of PPIs? And how have they changed the prescribing pattern among gastroenterologists? To help us better understand this topic, Dr. David Leiman, Assistant Professor of Medicine at Duke University School of Medicine, joins Dr. Peter Buch to discuss how we should be utilizing PPIs with our patients.

New data suggests that the use of anti-TNF therapy early in the treatment course can be effective for patients with inflammatory bowel disease (IBD). However, some of them may still require surgery. But is anti-TNF therapy safe in the perioperative period? To answer this question, Dr. Peter Buch is joined by Drs. Benjamin Cohen and Stefan Holubar from the Cleveland Clinic to discuss the findings from the PUCCINI study.

Endoscopic sleeve gastroplasty may be an effective option for weight loss. But which of our patients are the right candidates—and what do they need to know about before and after the procedure? Dr. Peter Buch dives into this procedure with Dr. Victoria Gomez, an Associate Professor of Medicine at the Mayo Clinic in Florida.

Endoscopic ultrasound-guided gallbladder drainage (ESU) is used to treat patients with cholecystitis and infection of the gallbladder. So when should we be utilizing ESU, and what are some common challenges associated with this procedure? Joining Dr. Peter Buch to explore this topic is Dr. Michel Kahaleh, Chief of Endoscopy, Director of the Pancreas Program, and Medical Director of the Advanced Endoscopy Research Program at Robert Wood Johnson Medical School.

Gastroparesis is a complex disease that has limited treatment options. What do we need to know about it? Dr. Mandu Grover, an Associate Professor of Medicine at the Mayo Clinic, joins Dr. Peter Buch to discuss gastroparesis.

Gastroparesis can be a complex disease to understand—and treat. What therapeutics are currently available? Dr. Peter Buch is joined by Dr. Mandu Grover, an Associate Professor of Medicine at the Mayo Clinic, to take a look at current treatment options.

What factors affect the microbiome? And who should we be prescribing probiotics to? Find out the answers to those and other key questions with Dr. Peter Buch and returning guest Dr. Eamonn Quigley, Professor of Medicine and Chief of the Division of Gastroenterology and Hepatology at Weill Cornell Medical College at Houston Methodist Hospital.

Alpha-gal allergy is a recently identified food allergy to red meat and other products made by mammals. So what more do we need to know about this new allergy, and which of our patients are at risk for anaphylaxis? To dive into this topic, Dr. Peter Buch is joined by Dr. Sarah McGill, Associate Professor of Medicine at the University of North Carolina, to discuss her recent research on alpha-gal allergy.

The role of diet and nutrition in irritable bowel syndrome (IBS) has long been established, but clinical updates are always evolving. That’s why Dr. Peter Buch welcomes Dr. William Chey, Professor of Medicine and Chief of Gastroenterology at the University of Michigan, to talk about the latest clinical updates from the American Gastroenterological Association.

Gastric emptying tests may be used for patients with gastroparesis and functional dyspepsia. But when it comes to assessing patients with symptoms, is it time to discard these tests? Find out with Dr. Peter Buch as he speaks with Dr. Reena Chokshi, Assistant Professor at Baylor College of Medicine and author of an editorial on this topic, titled Is It Time to Abandon Gastric Emptying in Patients With Symptoms of Gastroparesis and Functional Dyspepsia?, which was published in the Clinical Gastroenterology and Hepatology journal in May 2021.

What non-invasive techniques are available to assess liver fibrosis? Joining Dr. Peter Buch to give us insight on this key question, along with how we can incorporate these treatments into our patient care, is Dr. Maurizio Bonacini. Dr. Bonacini is an Associate Professor of Clinical Medicine at the University of California, San Francisco and CEO of Mission Gastroenterology and Hepatology.

What are our treatment options for hepatitis B, and do they have any limitations? Here to walk us through the challenges treatment landscape for hepatitis B is Dr. Robert Wong, who is a Clinical Associate Professor at Stanford University.

Hydrogen breath tests can help clinicians determine if a patient has conditions that can affect their digestive health, and they’re especially important for the diagnosis of carbohydrate maldigestion and small intestinal bacterial overgrowth. That’s why Dr. Peter Buch takes an in-depth look at breath testing with Dr. Mark Pimentel, Professor of Medicine at the David Geffen School of Medicine at UCLA and Associate Professor at Cedars-Sinai Medical Center.

In contrast to traditional monoclonal antibodies or small molecules, hyperbaric oxygen therapy involves a different type of treatment. But is this therapeutic option effective for our ulcerative colitis patients? To better understand this, Dr. Neil Nandi speaks with Dr. Parambir Dulai from Northwestern University to share his research on hyperbaric oxygen therapy.

Have you ever wondered what the practice of gastroenterology will look like in 10 years? If so, you’re not alone. And to help clear up that crystal ball, Dr. Peter Buch speaks with Dr. Eamonn Quigley about what’s to come in gastroenterology.

The treatment landscapes for alcoholic hepatitis and acute kidney injury in cirrhosis are evolving. So how are we now defining acute kidney injury with cirrhosis, and how should we treat these two conditions based on the latest therapeutic updates? To find out, Dr. Peter Buch speaks with Dr. Paul Kwo, Professor of Medicine and Director of Hepatology at Stanford University.

What do we need to know about esophageal perforations? Dr. Todd H. Baron from the University of North Carolina School of Medicine shares how he treats patients with esophageal perforations.

Diverticular disease is a common condition for which clinical therapies continue to evolve. So what has changed in the treatment paradigm? Joining Dr. Peter Buch to discuss everything from the role of colonoscopy, diverticular bleeding, long-term complications, and more is Dr. Brennan Spiegel, Director of Health Services Research at Cedars-Sinai and Professor of Medicine at UCLA.

For patients with Barrett’s esophagus with dysplasia, endoscopic surveillance is recommended to monitor the progression of the condition. But with the release of an updated guideline from the ACG, which of our patients are the right candidates for endoscopic treatment, and when should we be stopping surveillance? To discuss these and other key questions stemming from the updated guideline, Dr. Peter Buch is joined by Dr. Nicholas Shaheen, Professor of Medicine and Epidemiology and Chief of the Division of Gastroenterology and Hepatology at the University of North Carolina School of Medicine.

Treating benign esophageal strictures can be challenging. How can we avoid mistakes and improve care? Dr. Peter Buch joins Dr. Todd Baron, Professor of Medicine and Director of Advanced Therapeutic Endoscopy at the Division of Gastroenterology and Hepatology at the University of North Carolina School of Medicine to share common therapeutic mistakes and discuss how to treat esophageal strictures.

As rates of eosinophilic esophagitis continue to rise, how should we adjust our approach to management? To answer that question, Dr. Peter Buch is joined by Dr. Kathryn Peterson, an Associate Chief of the Division of Gastroenterology at the University of Utah Health.

Irritable bowel syndrome (IBS) varies by geography, culture, and environment. So to learn more about IBS in the Asian population, Dr. Peter Buch welcomes Dr. Andrew Ong, who discusses the differences between IBS in the Asian population compared to North America and the importance of considering cultural differences when confronting IBS.

Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease in the United States and affects about one-quarter of the population. So what are the risk factors for developing NAFLD, and how can we monitor its progression and manage our patients? Joining Dr. Peter Buch to answer these and other key questions is Dr. Naim Alkhouri, Chief of Transplant Hepatology and the Director of the Fatty Liver Program at Arizona Liver Health.

Although the rate of females in gastroenterology has increased, gender disparities such as equal pay and leadership positions still persist. That’s why Drs. Aline Charabaty and Anita Afzali co-founded Scrubs & Heels, a leadership organization working to foster professional growth for women in gastroenterology. And now, they join Dr. Neil Nandi to discuss Scrubs & Heels’ mission and how we can close gender disparities and promote women in the field of gastroenterology.

Per-oral endoscopic myotomy (POEM) is a specialized endoscopic procedure to treat motility disorders of the esophagus. But what’s the procedure’s specific use in treating achalasia and other esophageal dysmotilities? To help answer that key question, Dr. Peter Buch is joined by Dr. Michel Kahaleh, Professor of Medicine and Director of the Pancreas Program in the Department of Medicine at Robert Wood Johnson Medical School, to discuss which patients to consider for POEM and key limitations of the procedure that clinicians should be aware of.

Join Dr. Peter Buch as he explores the management of acute gastrointestinal bleeding and the periendoscopic period with anticoagulants and with Dr. Neena Abraham, Associate Medical Director at the Mayo Clinic Center for the Science of Health Care Delivery in Arizona and lead author of the joint “American College of Gastroenterology-Canadian Association of Gastroenterology Clinical Practice Guideline.”

Over the last two decades, up to 20 percent of the population in industrialized nations have reported an abnormal physical response to food ingestion, also known as an adverse reaction to food. So what key information do we need to know about food allergies and intolerances amid this recent rise around the world? To find out, Dr. Peter Buch is joined by Dr. Frances Onyimba, Assistant Professor of Medicine at the University of Maryland School of Medicine. Together, they’ll discuss how we can better identify and diagnose food allergies and intolerances.

Proton pump inhibitors (PPIs) are among the 10 most widely prescribed medications, but PPI overuse has been associated with adverse events. So what is the best advice for de-prescribing PPIs, and which of our patients should remain on PPIs? Find out the answers to these and other key questions with Dr. Peter Buch and Dr. Laura Targownik, who’s the lead author of the American Gastroenterological Association’s Clinical Practice Update on De-Prescribing of Proton Pump Inhibitors.

H. pylori testing is accessible now more than ever before. Why is this development so important? To help us understand why, Dr. David Graham, a Professor of Medicine and Gastroenterology at the Baylor College of Medicine, joins Dr. Peter Buch to discuss this availability and dive into “Antimicrobial Susceptibility Testing for Helicobacter pylori Is Now Widely Available: When, How, Why."

In patients with cirrhosis and chronic liver disease, acute-on-chronic liver failure is emerging as a major cause of mortality. That’s why an update on precipitating factors and essential management strategies is the basis of Dr. Peter Buch’s discussion with Dr. Jasmohan Bajaj, Professor of Medicine at the Richmond VA Medical Center and lead author of the article “Acute-on-Chronic Liver Failure Clinical Guidelines,” which was published in the American Journal of Gastroenterology in February 2022.

What are some ways we can strike the perfect balance when it comes to treating our patients with GERD? To help us answer this question, Dr. Harish Gagneja from the Dell Medical School at the University of Texas joins Dr. Peter Buch to explore balanced treatment options for these patients.

Let’s escape our busy day for a moment to imagine the future of gastroenterology and to ask ourselves: How can technology make us better clinicians? Explore that very question with Drs. Peter Buch and Brennan Spiegel as they discuss the latest advances in artificial intelligence and virtual reality that are aiding both clinical practice and research efforts.

Small intestinal bacterial overgrowth (SIBO) has been recognized for years, yet the optimal method of diagnosis remains controversial. So to help clear up the controversy, Dr. Peter Buch welcomes back returning guest Dr. Alexander Perelman to talk about diagnosing and treating SIBO.

Therapeutic drug monitoring has emerged as an important tool to optimize therapy for patients with inflammatory bowel disease (IBD). To help us learn more about this tool, Dr. Peter Buch is joined by Dr. Adam Cheifetz of Beth Israel Deaconess Medical Center and Professor of Medicine at Harvard Medical School.

Over the last few years, we've only started to gain an understanding of how gender affects our approach to GI illnesses. And since a greater awareness of these differences will help us become better clinicians, Dr. Peter Buch speaks with Dr. Asma Khapra about how we can optimize our approach to managing common GI illnesses in our female patients.

What's on the horizon for the management of inflammatory bowel disease? To share some of the latest clinical trial updates, Dr. Neil Nandi is joined by Dr. Peter Higgins from the University of Michigan to explore some of the latest developments in early detection tools and treatment strategies for patients with IBD.

Immune checkpoint inhibitors have evolved the treatment landscape for cancer, but we need to consider the GI side effects. To do so, Dr. Peter Buch is joined by Dr. Rashid N. Lui to assess the GI impacts of ICIs and how to manage them.

As clinicians, providing the best quality of care is paramount. But when it comes to procedure-intensive specialties, medical malpractice is a notable concern. So what do we need to know about the common malpractice claims in the GI field, and how can we mitigate the risk of those claims? To find out, Dr. Peter Buch is joined by Dr. Michael Weinstein, President and CEO of Capital Digestive Care.

Proton pump inhibitors (PPIs) are among the most frequently prescribed medications in the world, but in many instances, they may be unnecessary. So how might this impact our patients’ health, and how can we identify those patients who should be prescribed PPIs? Dr. Peter Buch is joined by Dr. Alexander Perelman to talk about the overuse of PPIs.

Primary biliary cholangitis, which was formerly known as primary biliary cirrhosis, is a chronic disease that progresses over time. Fortunately, much progress has been made in that many patients are being diagnosed and treated much earlier than before. But what exactly has changed when it comes to our detection and treatment of this disease? Dr. Peter Buch is joined by Dr. Hetal Karsan, Adjunct Professor of Medicine in the Division of Digestive Diseases at Emory University School of Medicine, to discuss key updates in primary biliary cholangitis care.

As clinicians, we know that adherence to treatment regimens is associated with improved outcomes in our patients with inflammatory bowel disease (IBD). However, many factors can contribute to a patient's nonadherence, and understanding what those factors are, especially in underserved patient populations, is an important category of care that we need to keep in mind. Tune in to hear Dr. Peter Buch speak with Dr. Lea Ann Chen about how we can manage IBD in underserved patient populations.

Since only 70 percent of initial eradication attempts of Helicobacter pylori are successful, it’s important for us to understand the factors that might be contributing to this startling statistic. That’s why Dr. Peter Buch speaks with Dr. Erick Argueta about why Helicobacter pylori can be difficult to eradicate and how we can best treat this infection.

Inflammatory bowel disease (IBD) among the elderly is common, and when compared to IBD in younger patients, it’s characterized by a different disease course and has an increased risk of mortality. So how can we achieve better outcomes for our elderly patients? Dr. Peter Buch is joined by Dr. Benjamin Cohen, Co-Section Head and Clinical Director for Inflammatory Bowel Disease at the Cleveland Clinic, to discuss evaluation and treatment strategies for our elderly patients with IBD.

It's estimated that 50 percent of patients with IBD experience arthralgia, with the most common form being peripheral arthritis. What screening strategies are available to help us identify those patients with peripheral discomforts? Tune in to hear multidisciplinary perspectives on peripheral arthritis in IBD from gastroenterologist Dr. Neil Nandi and rheumatologist Dr. Monica Schwartzman.

From new guideline recommendations to a concert featuring the American College of Gastroenterology’s official band, a lot is being done to help raise awareness of the importance of screening for colorectal cancer. So how can you help increase screening rates in your own community? Get inspired with these creative initiatives shared by Dr. Neil Nandi and Dr. Samir Shah, President of the American College of Gastroenterology.

Over the past two decades, there has been an increasing need for GI hospitalists to help provide rapid access to care. Since then, GI hospitalists have become an important part to many healthcare systems and their approach to patient care. Joining Dr. Peter Buch to discuss the benefits and challenges that come along with the GI hospitalist role is Dr. Michelle Hughes, Assistant Professor of Medicine and Medical Chief of Quality and Safety for Digestive Health at Yale New Haven Health.

Gastroparesis affects approximately five million people in the United States alone, and there are more than 50 recognized causes. In recent years, however, it's been shown that simply accelerating gastric emptying may not improve symptoms, and the overlap of functional dyspepsia and gastroparesis has further clouded our understanding of this condition. So to help clear up some of that confusion, Dr. Peter Buch speaks with Dr. Amir Masoud about treatment strategies for gastroparesis.

While hepatologists can help gastroenterologists manage the pulmonary manifestations that may occur in our patients with chronic liver disease, it’s still important for gastroenterologists to know what they should be on the lookout for so that patients can receive timely and appropriate treatment. Additionally, gastroenterologists need to consider the potential impacts of those pulmonary manifestations on transplant outcomes. Joining Dr. Neil Nandi to discuss those and other key considerations gastroenterologists need to know is Dr. Karen Krok from Penn State Health Milton S. Hershey Medical Center.

The symptoms of early satiety, chronic nausea, and even vomiting can be physically and emotionally challenging for the gastroparesis patient. Adding to the challenge is the fact that the journey from diagnosis to treatment is often daunting and frustrating. So to help us combat these challenges, Dr. Neil Nandi speaks with Dr. Nitin Ahuja, who walks us through the ins and outs of diagnosing and managing gastroparesis.

How do we determine which of our patients with Barrett's esophagus with dysplasia are good candidates for ablation therapy, and what’s the role of the gastroenterologist in serving patients who've already received post-ablative therapy? Joining Dr. Neil Nandi to answer those and other key questions is Dr. Nicholas Shaheen, who was the primary investigator of one of the largest multicenter studies of radiofrequency ablation.

Microscopic colitis can have a variety of symptoms ranging from very mild to debilitating. Fortunately, there are several treatment options and strategies available that can help you alleviate your patient’s symptoms. Joining Dr. Peter Buch to share those options and strategies is Dr. Donna Cipolla.

It's currently estimated that 50 percent of IBD patients experience some form of joint stiffness, otherwise known as arthralgia. With so many patients being affected, how can you determine if it’s inflammatory or noninflammatory arthralgia and treat it appropriately? To find out, Dr. Neil Nandi speaks with Dr. Monica Schwartzman, assistant attending physician at the Hospital for Special Surgery and Clinical Instructor of Medicine at Weill Cornell Medical College. Together, they’ll discuss the screening tools gastroenterologists can use to differentiate the types of arthralgia in their patients as well as key management approaches.

If you suspect your patient might have small bowel bleeding despite a massive workup, what evaluation tools are at your disposal to help you find out for sure? Tune in to hear Dr. Peter Buch explore the available tools—and their inherent challenges to be aware of—with Dr. Jonathan Leighton, one of the nation’s leading experts on small bowel bleeding.

Drug-induced liver injury (DILI) continues to be one of the leading causes of acute liver failure, and its prevalence is only increasing. That’s why Dr. Peter Buch speaks with leading expert Dr. Naga Chalasani, who talks about everything we need to know about DILI—from its phenotypes to common symptoms to look for in patients.

Inflammatory bowel disease (IBD) has long been associated with the development of arthritis, which can be detected in up to 30 percent of IBD patients. So how can gastroenterologists and rheumatologists work together to detect and manage IBD-associated arthritis? To find out, Dr. Neil Nandi speaks with rheumatologist Dr. Sergio Schwartzman about IBD-associated arthritis.

Many IBD clinicians and patients talk about diet, but not many conversations happen about fitness. Based on the latest research, exercise may be one therapeutic tool in our kit that remains unexploited. That’s why IBD specialist Dr. Susan Kais joins Dr. Neil Nandi to walk us through key findings and how we can prescribe fitness for our IBD patients.

Screening for colorectal cancer is unique because there are several screening options available. So how can we balance the latest ACG Clinical Guidelines with patient preferences, cultural context, and insurance coverage to find the best screening option for our patients? Joining Dr. Peter Buch to discuss the updated recommendations is Dr. Aasma Shaukat, lead author of the 2021 ACG Clinical Guidelines for colorectal cancer screening.

Since patients with chronic GERD may develop Barrett’s esophagus, screening and prevention are both critical. But who should we screen, and how do we screen? Joining Dr. Neil Nandi to answer those and other questions to help us better screen chronic GERD patients for Barrett’s esophagus is Dr. Gary Falk, Director of the Esophagology and Swallowing Center at the University of Pennsylvania.

Once we’ve diagnosed a patient with Barrett’s esophagus, strict surveillance is necessary to help prevent the development esophageal cancer. But what do surveillance strategies look like according to the latest guidelines? Joining Dr. Neil Nandi to share how we can best maximize surveillance guidelines for Barrett's esophagus and apply some of the evolving technologies that are helping us do just that is Dr. Gary Falk, Director of the Esophagology and Swallowing Center at the University of Pennsylvania.

How can we make the differentiation between pouchitis and cuffitis to provide the best possible care? And once we accurately identify and treat pouchitis, how can we manage surgical complications that may arise? Tune in to hear Dr. Jason Schairer from the Henry Ford Health System in the Division of Gastroenterology and Hepatology discuss these FAQs with Dr. Neil Nandi.

For a significant portion of our patients, pouchitis can be a frustrating and trying condition plagued with urgent diarrhea, incontinence, and even complications of fistula and stricture. Fortunately, a group of clinicians have gathered together to develop consensus guidelines on the endoscopic evaluation and clinical management of pouchitis and its potential complications. And who better to give us an in-depth review of the new guidelines than Dr. Jason Schairer, one of the authors of the guidelines.

An ongoing question for clinicians and patients alike is how diet can impact IBD treatment and management. Here to discuss this topic with Dr. Neil Nandi is Dr. James Lewis of the University of Pennsylvania IBD Center. Dr. Lewis recently conducted a clinical randomized trial that compared the impact of two diets on patients with mild-to-moderate Crohn’s disease symptoms, and now, Drs. Nandi and Lewis are diving into this study, the reasoning behind it, and its outcomes.

Many IBD patients and clinicians shy away from the topic of sexual health—and understandably so. Talking about sex in the clinic sadly remains a taboo, and there’s not many research studies exploring IBD and sexual health to use for guidance. But sexuality and intimacy are vital matters to discuss with our patients, which is why Dr. Jordan Axelrad joins Dr. Neil Nandi to share how we can facilitate an open and honest conversation with patients about their sexual health.

Many patients undergo surgery to help manage their inflammatory bowel disease (IBD), but many questions still surround the surgical management of IBD. When should a patient receive surgery? How do we know which procedure is best? And what do we need to keep in mind before, during, and after a patient's surgery? Joining Dr. Peter Buch to help address those and other questions is colorectal surgeon Dr. Amanda Ayers.

Predicting which patients with IBD will develop complications allows for much better medication choices. But how do we go about predicting that risk? Joining Dr. Peter Buch to tackle this topic is Dr. Corey Siegel, Section Chief of Gastroenterology and Hepatology at Dartmouth-Hitchcock Medical Center.

The approach to managing pancreatic necrosis has evolved over the past several years. To learn more, Dr. Peter Buch speaks with Dr. Christopher J. DiMaio, who’s one of the lead authors of the clinical practice update from the American Gastroenterological Association focusing on the management of pancreatic necrosis.

Despite significant advances in Crohn’s disease therapy, sometimes patients have no other option but surgery. So to learn more about surgery for Crohn’s disease, Dr. Peter Buch speaks with Dr. Randolph Steinhagen, Chief of the Division of Colorectal Surgery and the Director for the Colon and Rectal Fellowship Program at Mount Sinai.

Many of our patients suffer from bile acid diarrhea. In fact, it’s estimated that about a third of the patients with functional diarrhea or irritable bowel syndrome with diarrhea actually have bile acid malabsorption or bile acid diarrhea, and one in every five adolescents with chronic diarrhea have evidence of bile acid diarrhea based on very simple blood tests. But despite its prevalence, bile acid diarrhea is often difficult to diagnose, which is why Dr. Peter Buch and Dr. Michael Camilleri from the Mayo Clinic come together to discuss key diagnostic and treatment strategies for bile acid diarrhea.

There are many questions and considerations that arise when managing patients with eosinophilic esophagitis, which is exactly what the 2020 AGA guidelines seek to address. Joining Dr. Neil Nandi to walk us through those guidelines and how we can apply them to the care of our patients with eosinophilic esophagitis is Dr. Kristle Lynch, Associate Professor Clinical Medicine Division of Gastroenterology and Hepatology at the Perelman School of Medicine at the University of Pennsylvania.

Many studies focus on the impact of Crohn’s disease and ulcerative colitis in adult patients, but what about our youngest patients? To learn more about how we can treat our pediatric patients with Crohn’s disease and ulcerative colitis, Dr. Peter Buch speaks with Dr. Jeffrey Hyams, one of the world’s leading experts in pediatric inflammatory bowel disease.

Gastric cancer is rare, but not as rare as we think. This makes screening and surveilling patients at high risk extremely important, but with no current guidelines available on how to do so, what steps can we take to make a difference in gastric cancer outcomes? To find out, Dr. Peter Buch speaks with Dr. Joo Ha Hwang, a Professor of Medicine at the Stanford University Medical Center who shares his insights on the early detection of gastrointestinal malignancies.

Over the years, there has been an immense focus on defining what really constitutes a high-quality endoscopy, but many questions still remain regarding what that actually looks like in practice and how we can ensure quality in endoscopy units. That’s why Director of Ambulatory Services and Digestive Disease at Yale School of Medicine Dr. Hamita Sachar joins Dr. Peter Buch to help address some of those questions.

Are patients with inflammatory bowel disease (IBD) at increased risk for COVID-19 infection? And what should we recommend for an IBD patient in remission who tests positive for COVID-19 versus a patient with active disease? These are just some of the questions that have arisen since the onset of the COVID-19 pandemic, and the questions Dr. Peter Buch explores with Dr. Russell Cohen, Director of Inflammatory Bowel Disease Center and Co-Director of the Advanced IBD Fellowship Program at the University of Chicago School of Medicine.

Small intestinal bacterial overgrowth (SIBO) can be a challenging condition to navigate due to the several controversies surrounding its testing and treatment. Joining Dr. Peter Buch to discuss these complex issues and controversies is Dr. Mark Pimentel, Director of the Medically Associated Science and Technology Program at Cedars Sinai in Los Angeles and author of the “ACG Clinical Guideline Small Intestinal Bacterial Overgrowth” article published in the American Journal of Gastroenterology in 2020.

The evaluation and treatment of Barrett’s esophagus has been evolving over the last several years, but there are still many controversies and unanswered questions surrounding it. So to help answer some of these questions, Dr. Peter Buch speaks with Dr. Prateek Sharma, author of the “AGA Clinical Practice Update on Endoscopic Treatment of Barrett’s Esophagus with Dysplasia and/or Early Cancer Expert Review,” which was published in the Gastroenterology journal in 2020.

Bezlotoxumab is an IV antitoxin infusion treatment option for Clostridium difficile (C. diff) that’s been shown to reduce recurrence in IBD patients…so why isn’t it being used as much as it should be? Here to share the latest data and insights on bezlotoxumab as a treatment option for IBD patients with C. diff is Dr. Jessica Allegretti, Associate Director of the Crohn's and Colitis Center and Director of the Fecal Microbiota Transplant Program at the Brigham and Women's Hospital in Boston, Massachusetts.

Also known as C. diff for short, Clostridium difficile is an extremely difficult intestinal disease to manage…but not an impossible one. Joining Dr. Neil Nandi to share her insights on how to best mange C. diff in IBD patients is Dr. Jessica Allegretti, the Associate Director of the Crohn's and Colitis Center and the Director of the Fecal Microbiota Transplant Program at the Brigham and Women's Hospital in Boston, Massachusetts.

Since the onset of the COVID-19 pandemic, many questions have arisen regarding the care of our patients with IBD. Are they at increased risk of COVID-19? How should we treat a patient with IBD who has active COVID-19? Should they get vaccinated, and if so, when? These are all questions Dr. Peter Buch addresses with Dr. Asher Kornbluth, Clinical Professor of Medicine and Gastroenterology at Mount Sinai School of Medicine in New York, to help us optimize our approach to care amid the COVID-19 pandemic.

Many patients tailor their diets to their gastrointestinal disorders, such as IBS, and adopt a low FODMAP regimen. What skills do we need to help screen patients for FODMAP sensitivities and identify foods they should avoid? Dr. Neil Nandi will be discussing these skills with Kate Scarlata, a registered dietitian, and a New York Times best-selling author.

While diagnosing irritable bowel syndrome and inflammatory bowel disease is critical to care, treating these illnesses and improving quality of life is just as important. Joining Dr. Peter Buch to share strategies to help counsel and care for our patients beyond diagnosis is Dr. Laurie Keefer, Professor of Medicine, Gastroenterology, and Psychiatry at Mount Sinai School of Medicine.

Many of us use social media to stay connected with family and friends. But have you ever considered using social media to communicate with other clinicians and even earn CME credit? Clinical Director of Gastroenterology and Director of the Inflammatory Bowel Disease Center at Sibley Memorial Hospital Dr. Aline Charabaty saw that opportunity and used it to create Monday Night IBD, and now Dr. Charabaty is here to talk about that program and the benefits of social media for clinicians with Dr. Neil Nandi.

Decreased resistance to antibiotics has adversely impacted our ability to fight H. pylori. How can we help our patients overcome this threat? Dr. Peter Buch is here today to discuss this issue with Dr. Cynthia Sears, professor of medicine at the Johns Hopkins University School of Medicine to help improve health outcomes for our patients.

Gender bias and trauma are prevalent issues that have far-reaching impacts on our GI patients’ health and even our diagnostic and treatment approaches. To learn more about how gender bias and trauma impact patients and clinicians alike, Dr. Peter Buch is joined by Dr. Douglas Drossman and patient advocate Ms. Johanna Ruddy from the Rome Foundation.

The field of endoscopic bariatric weight loss has developed over the years, but there’s a lot we still don’t know. Dr. Neil Nandi is here today with Dr. Austin Chiang, Director of the Endoscopic Bariatric Program at Thomas Jefferson University Hospital, to provide some insight on advanced endoscopy for bariatric weight loss.

Thanks to recent research and advancements, our understanding and treatment of gastroesophageal reflux disease (GERD) has greatly evolved over the years. So what do we now know about diagnosing and treating this common GI disorder? Find out with Dr. Peter Buch and Dr. Arlene Wright, President of the Florida Nurse Practitioner Network and Executive Vice President of the Nurse Practitioners of Lee County, Florida.

Many IBD patients have received their COVID-19 vaccine, but many others still have reservations due to the abundance of myths and misconceptions surrounding the COVID-19 vaccines. That’s why Dr. Neil Nandi welcomes Dr. Freddy Caldera to discuss these common fears and challenges as well as some of the very best answers to address the concerns of our immunosuppressed IBD patients.

How has the COVID-19 pandemic impacted patients with IBD? Dr. Neil Nandi is here to answer our COVID-19 questions for our IBD patients with Dr. David Rubin, Professor of Medicine at the University of Chicago Pritzker School of Medicine.

Pancreatic cysts may be detected in up to 50 percent of patients undergoing intraabdominal MR imaging. But not all of them are malignant, so how can we determine which patients need further testing, monitoring, and perhaps even surgery? Joining Dr. Peter Buch to answer that and other questions is gastroenterologist Dr. Rajeev Attam.

With more data emerging on COVID-19 vaccines every day, what do our patients with inflammatory bowel disease need to know about the vaccine currently available? Dr. Neil Nandi will be discussing these updates and how we can keep our patients safe with Dr. David Rubin, Professor of Medicine at the University of Chicago Pritzker School of Medicine.

Should sobriety and drug abstinence be required for hepatitis C therapy? Dr. Peter Buch dives into this dilemma with Dr. Colin Swales, Assistant Medical Director of Transplant Services at Harvard Hospital, as he walks us through both sides of this controversial issue.

From cirrhosis to liver cancer, there are many dangers associated with non-alcoholic fatty liver disease. So what are some best practices for managing this condition? Dr. Peter Buch sits down with Dr. Colin Swales, Assistant Medical Director of Transplant Services at Harvard Hospital, to discuss the management of non-alcoholic fatty liver disease.

How can we help the two to four million Americans who are living with hepatitis C? Joining Dr. Peter Buch to answer this question and share treatment strategies for various case scenarios is hepatologist Dr. Colin Swales, Assistant Medical Director of Transplant Services at Harvard Hospital.

Millions of patients are treated with anticoagulants, and many more are treated with antiplatelet therapy. But when those therapies overlap with GI bleeding, what do you need to know so that your patients don’t experience any problematic health outcomes? Dr. Peter Buch is discussing this topic with physician assistant Mr. Adam Olsen, who’s the Department Chair and Program Director for the Master of Physician Assistant Studies Program at Sacred Heart University in Stamford, Connecticut.

Patients suffering from disorders of the gut-brain interaction are often subjected to stigma. But what can we do to help challenge these stigmas? Here today is Dr. Peter Buch who will be joined by Dr. Douglas Drossman, President of the Rome Foundation, and Ms. Johanna Ruddy, Executive Director of the Rome Foundation, to talk about the impact of stigma in DGBI.

Strong communication is a critical component in improving health outcomes for patients with IBS. What do we need to know to help our patients feel heard and valued? Dr. Peter Buch is joined by Dr. Douglas Drossman, President of the Rome Foundation, and Ms. Johanna Ruddy, Executive Director of the Rome Foundation, to discuss how to effectively communicate with our patients.

The COVID-19 pandemic has demonstrated the effectiveness of telemedicine, but will this approach still be utilized after the pandemic ends? Dr. Peter Buch is joined by Dr. Andres Nieto, Assistant Professor at Frank H. Netter MD School of Medicine, to discuss the role of telemedicine and its future

Dyspepsia affects a large number of Americans. But what exactly is dyspepsia? And how can we distinguish dyspepsia from other diseases? Joining Dr. Peter Buch to answer those and other questions is Dr. Scott Gabbard, who’s the section head of the Neurogastroenterology and Motility Center at the Cleveland Clinic.

The world of healthcare continues to drastically change over the years. But what do you need to know about the variety of employment models available for gastroenterologists today? Dr. Peter Buch is joined by Dr. John Allen, Clinical Professor of Medicine at the University of Michigan School of Medicine, to discuss recent changes in practice models.

Millions of colonoscopies are performed each year in the United States, but which indicators should we be using to measure the quality of these procedures? Dr. Peter Buch is joined by Dr. Douglas Rex, Distinguished Professor Emeritus of Medicine at Indiana University School of Medicine, to discuss the importance of these indicators.

Racial and ethnic bias prevent patients with colorectal cancer from receiving the highest quality of care. Dr. Neil Nandi is joined by Dr. Fola May, Assistant Professor of Medicine at UCLA, to discuss racial inequalities in access to care and screening for patients with colorectal cancer.

The management of motility disorders like achalasia and gastroparesis can be very complex for both patients and clinicians alike. Fortunately, there have been several advancements in the evaluation and treatment of these disorders. Joining Dr. Peter Buch to walk us through what those developments are and how they can help improve our patients’ quality of life is Dr. Nicole Hanley-Williams, who specializes in motility and functional disorders at Beth Israel Lahey Health.

Tofacitinib is a common treatment option for patients with ulcerative colitis. But it’s not without its risks. Here to share what we need to consider before we start our patients on tofacitinib is Dr. Philip Ginsburg, Medical Director of Research and the Director of the Inflammatory Bowel Disease Center of Connecticut.

With so many treatment options currently available for moderate to severe Crohn’s disease and ulcerative colitis, how do you know which one will work best for your patients? Joining Dr. Peter Buch to help answer that and other questions is Dr. Philip Ginsburg, Medical Director of Research and the Director of the Inflammatory Bowel Disease Center of Connecticut.

Now that we have therapies like vedolizumab and ustekinumab, many are wondering if there’s still a role for anti-TNFs in the treatment of IBD. Here to share his perspective and how he uses the multitude of available treatment options to his advantage is Dr. Jeffrey Basile, a gastroenterologist from Charleston GI.

The treatment and evaluation of inflammatory bowel disease, or IBD, is continuously changing to provide the best quality of care for patients. Dr. Peter Buch is joined by Dr. Jeffrey Basile, a gastroenterologist from Charleston GI, to shed some light on the latest treatment options for IBD patients.

Clostridium difficile impacts many patients around the United States. How can we better diagnose and treat this infection? Dr. Peter Buch is joined by Dr. Paul Feuerstadt, Assistant Clinical Professor of Medicine at Yale New Haven Hospital the discuss the importance of managing Clostridium difficile.

What do we need to know about choosing the right medication for our patients with IBS? Stay tuned as Dr. Neil Nandi talks with Dr. Brain Lacy, a gastroenterologist at the Mayo Clinic, Jacksonville, and the co-editor-in-chief of the American Journal of Gastroenterology, on these pharmacologic therapies.

Irritable bowel syndrome can be difficult to manage for both physicians and patients. What can we do to help better diagnose and manage IBS? Here today is Dr. Neil Nandi who is discussing the IBS Guidelines highlights with Dr. Brain Lacy, a gastroenterologist at the Mayo Clinic, Jacksonville, Florida, and the co-editor-in-chief of the American Journal of Gastroenterology.

Non-cardiac chest pain, NCCP, is chest pain in patients who do not have heart disease. How do we identify and diagnose NCCP? Stay tuned as Dr. Peter Buch talks with Dr. Ronnie Fass, Chief of the Division of Gastroenterology and Hepatology, on the important aspects of non-cardiac chest pain.

Avoidant Restrictive Food Intake Disorder, AFRID, is a newly introduced eating disorder at the forefront of GI care. Stay tuned to hear Dr. Neil Nandi discuss the impact of ARFID on GI health with Dr. Tiffany Taft, the Director of Psychogastroenterology Research in the Division of Gastroenterology and Hepatology at Northwestern University.

Patients with an inflammatory bowel disorder, or IBD, often suffer from post-traumatic stress disorder, or PTSD. But how do the psychological impacts of PTSD impact our IBD patients? Dr. Neil Nandi is joined by Dr. Tiffany Taft, the Director of Psychogastroenterology Research in the Division of Gastroenterology and Hepatology at Northwestern University, to discuss IBD’s relationship with PTSD.

Environmental factors can affect many different aspects of a patient’s heath, but how do these factors play a role in developing inflammatory bowel disorders, or IBD? Tune in to hear Dr. Neil Nandi and Dr. Maria Abreu, the director of the Crohn’s and Colitis Center at the University of Miami, discuss the role of environmental factors in patients at risk of developing IBD.

Diet is a common concern for many patients with inflammatory bowel disorders. How can we best guide our patients on the influence of diet? Dr. Neil Nandi is joined by Dr. Maria Abreu, the director of the Crohn’s and Colitis Center at the University of Miami, to discuss the impact of diet on ulcerative colitis.

Colon cancer rates for patients younger than 50 have increased at an alarming rate. How can we help screen our younger individuals for colon cancer? Tune in to hear Dr. Peter Buch speak with Dr. Joseph Anderson, Associate Professor of Medicine at Dartmouth, to discuss the transitions occurring in colon cancer screening.

While many know that COVID-19 can affect the respiratory system, but how can this disease also influence the gastrointestinal tract? Tune in to hear Dr. Peter Buch discuss with Dr. Myron Brand, a Clinical Professor of Medicine, Yale University School of Medicine, the impact of COVID-19 on the GI system and GI disorders.

A strong doctor-physician partnership is a critical component of patient care. Here today is Dr. Peter Buch who will be joined by Dr. Douglas Drossman, President of the Rome Foundation, and Ms. Johanna Ruddy, Executive Director of the Rome Foundation, to discuss how to build this foundation and maintain the relationship.

While diverticulitis is a common disease, what can be done to help better understand this infection? Here today is our GI Insights host, Dr. Peter Buch, to discuss complications and approaches to managing and treating diverticulitis.

Obesity is a worldwide phenomenon and linked to morbidity and mortality. How can we help our obese patients along their weight loss journey to ensure long-term success? Dr. Peter Buch is joined by Dr. Devika Umashanker, Obesity Medicine Director of the Department of Bariatric Surgery at Hartford HealthCare Medical Group, to assess strategies for helping your patients see positive long-term weight loss outcomes.

The COVID-19 pandemic has presented a unique set of challenges for healthcare professionals. What are some of the biggest threats to our GI patients, and how should we help them stay safe? Here today is our GI Insights host, Dr. Neil Nandi, to shed some light on his experiences while caring for patients during the pandemic.

Facing winter during the COVID-19 pandemic has been challenging for many patients. What are some ways gastroenterologists can protect the health of their patients this season? Tune in to hear our GI Insights hosts Dr. Neil Nandi and Dr. Peter Buch share some tips on how you keep your patients safe throughout the wintertime.

Non-invasive assessments of liver fibrosis can be subcategorized into many different tests. What do we need to know about these increasingly popular assessments? Dr. Peter Buch is joined by Dr. Richard Sterling, professor of medicine at Virginia Commonwealth University to discuss when it is appropriate to use each of these assessments for patients with liver fibrosis.

Misconceptions around chronic idiopathic constipation can make it challenging to diagnose and treat. What do we need to know to help our patients manage this condition? Dr. Peter Buch is joined by Dr. Kyle Staller, assistant professor of medicine at the Harvard Medical School to discuss these myths and misconceptions about constipation.

Irritable bowel syndrome, or IBS, is a common disorder that can be challenging to treat. What is the best therapeutic approach to treating this condition? Dr. Peter Buch is joined by Wendy Wright, an adult and family nurse practitioner from New Hampshire, to discuss how to test and treat patients with IBS from a primary care perspective.

Virtual reality has shown the ability to decrease pain, reduce opioid dependence, and boost mental health. How is this digital therapeutic changing the treatment landscape for gastroenterology? Dr. Neil Nandi is joined by Dr. Brennan Spiegel, Director of the Cedars-Sinai CORE program, on his innovative research about the positive impact of virtual reality in gastroenterology.

Gastrointestinal bleeding, or GI bleeding, is a serious but common condition, and upper GI bleeding requires an individualized approach. How can we better detect and manage this condition? Dr. Peter Buch will be discussing the importance of managing upper GI bleeding with Dr. John Saltzman, Director of Endoscopy at the Brigham and Women’s Hospital.

Effective communication is essential to improving the patient-provider relationship. What is the best approach a physician can take when speaking to patients with IBS? Dr. Peter Buch will discuss valuable communication strategies with Dr. Douglas Drossman, president of the Rome Foundation.

Developed to treat psychiatric disorders, emerging evidence suggests that neuromodulators play a vital role in treating functional GI disorders. Here today is Dr. Peter Buch who will be discussing the role of neuromodulators in functional GI disorders with Dr. Douglas Drossman.

Patients with chronic diarrhea are often misdiagnosed with irritable bowel syndrome with diarrhea, or IBS-D. How can we better assess these patients to prevent misdiagnosis? Joining Dr. Peter Buch to discuss diagnostic tools and testing strategies is Dr. Lawrence Schiller, Program Director of the Gastroenterology Fellowship at Baylor University Medical Center.

Physician Quality Reporting Systems, or PQRS, are here to stay in clinical medicine. Within the field of gastroenterology, understanding the metrics of PQRS can make a substantial difference in the success of a practice. Joining host Dr. Barry Mennen to detail the ins and outs of PQRS in gastroenterology is Dr. Ziad Gellad, Assistant Professor of Medicine, Director of Quality in the Division of Gastroenterology, and Director of Clinical Improvement in the Department of Medicine at Duke University Medical Center.

Host Dr. Barry Mennen welcomes Dr. Ashwin Ananthakrishnan, Assistant Professor of Medicine at Harvard Medical School and medical co-director at the MGH Crohn’s and Colitis center. Dr. Ananthakrishnan is involved in several large cohort studies that are attempting to examine established and novel environmental factors, including diet, that influence the risk of development of inflammatory bowel diseases. His recent study focusing on the potential role of dietary zinc in preventing bowel inflammation becomes the focus of this discussion.

Dr. Carol Burke, Director of the Center for Colon Polyp and Cancer Prevention at the Cleveland Clinic, unveils ongoing but underrecognized gender disparities in the practice of gastroenterology, such as differences in academic vs private practice opportunities, average salaries and hours worked, rates of promotion and partnerships, and male-modeled endoscopic equipment designs. Dr. Burke then explores gender disparities in GI care for patients with colorectal cancer, including differences in efficacy of colorectal cancer screening, male vs female morbidity and mortality rates, and even the underlying biologies of cancers themselves.

Irritable bowel syndrome is becoming increasingly recognized as a complex interplay of pathologies, from changes in gut microflora to nutrient absorption abnormalities to psychosocial stressors. The ways in which these factors contribute and interact create different profiles of disease, requiring personalized therapeutic plans for IBS patiets. Joining Dr. Barry Mennen to discuss a multimodal model for approaching the root causes of IBS is Dr. Neelesh A. Tipnis, the Paul H. Parker Professor and Chair of Pediatric Gastroenterology and Director of the GI Motility and Functional Bowel Disorders Program at the University of Mississippi Medical Center.

Live from the floor of Digestive Disease Week in Washington DC, GI Insights presents two interviews focusing on screening, surveillance, and therapeutic updates for colorectal and liver cancers, hosted by Dr. Barry Mennen. Guests on this program include:

• Dr. Linda Rabeneck, Vice President of Prevention and Cancer Control at Cancer Care Ontario (CCO), Professor of Medicine at the University of Toronto, and Senior Scientist at the Institute for Clinical Evaluative Sciences (ICES) in Toronto. Dr. Rabeneck speaks on global initiatives to increase awareness about colorectal cancer screening and surveillance.

• Dr. Kris Kowdley, Director of the Liver Care Network and Research Director of the Organ Care Program at Swedish Medical Center in Seattle, WA. Dr. Kowdley summarizes key takeaways on recognition of liver cancer and other related diseases of the liver in American populations today.

Live from the floor of Digestive Disease Week in Washington DC, GI Insights presents two interviews focusing on innovative approaches to inflammatory bowel disease, hosted by Dr. Barry Mennen. Guests on this program include:

• Dr. Jonathan Braun, Professor and Chair of Pathology and Lab Medicine at the David Geffen School of Medicine at UCLA. His research centers on the biology of mucosal interaction of host immunity with the local microbial community, and its impact on chronic mucosal inflammatory disease and cancer.

• Michael Hurst, author of Poop Power: How a Man Used a Fecal Transplant at Home to Permanently Cure Himself of Ulcerative Colitis. Mr. Hurst is a known advocate and volunteer for the Fecal Transplant Foundation, whose story of self-designing an unorthodox treatment regimen for ulcerative colitis has since offered new insights on best clinical management practices for IBD.

Host Dr. Barry Mennen welcomes Dr. Ryan Stidham, Assistant Professor of Internal Medicine at the Inflammatory Bowel Diseases Center of the University of Michigan Health System, to discuss the current therapeutic landscape for IBD based on recent comparative clinical trials.

Host Dr. Jay Goldstein discusses the latest in IBS & Functional GI Disorders (FGIDs) with guest expert Dr. Douglas Drossman of the Drossman Center for the Education and Practice of Integrated Care. Dr. Drossman is Professor Emeritus in the departments of Gastroenterology and Psychiatry at the Center for Functional GI and Motility, University of North Carolina at Chapel Hill.

Host Dr. Jay Goldstein welcomes Dr. Sunanda V. Kane, Professor of Medicine in the Department of Gastroenterology & Hepatology at Mayo Clinic, to dicuss the latest in Crohn's disease diagnosis and management. Dr. Kane is author of IBD Self-Management: The AGA Guide to Crohn's Disease and Ulcerative Colitis, now in its second edition.

What types of small bowel abnormalities are most common among pediatric patients? How can physicians investigate suspected small bowel disease or gastrointestinal (GI) bleeding in our younger patients? Dr. Stanley Cohen, gastroenterologist at the Combined Center for Inflammatory Bowel Disease and Children's Center for Digestive Health Care at Children's Healthcare of Atlanta, and adjunct clinical professor of pediatrics, Emory University School of Medicine, in Atlanta, Georgia, discusses the roles of CT scans, MRIs and small bowel capsule endoscopy in evaluating pediatric patients with suspected small bowel disease. Dr. Jay Goldstein hosts.

Obscure gastrointesinal bleeding can pose investigational challenges. What are the potential causes of obscure GI bleeding? After initial negative upper endoscopy and colonoscopy tests are performed, what new technologies can help physicians more effectively detect small bowel abnormalities? Dr. Jonathan Leighton, professor of medicine and chair of the division of gastroenterology at the Mayo Clinic in Arizona, and Dr. Moshe Rubin, director of gastroenterology and program director of the GI fellowship training program at New York Hospital Queens Medical Center and the Weill-Cornell Medical College in New York, discuss the roles of small bowel capsule endoscopy, balloon-assisted enteroscopy, spiral enteroscopy, and CT enterography in evaluating patients with obscure GI bleeding. Dr. Jay Goldstein hosts.

Resistance to proton pump inhibitors, or PPIs, is not uncommon among patients with gastroesophogeal reflux disease, or GERD. How should physicians initially approach managing patients with suspected GERD, and at what point should physicians classify a patient as a PPI non-responder? Our guest, Dr. Brian Lacy, associate professor of medicine at Dartmouth Medical School, and director of the GI Motility Laboratory at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, suggests tests that physicians might use in evaluating patients with refractory GERD, including upper endoscopy and various types of pH monitoring. What therapeutic strategies can physicians use to manage these patients? Hosted by Dr. Freedman.

How do we categorize and define value-based purchasing, and how can it help us avoid unnecessary costs and foster better quality of care? What are some examples, and how do guidelines work in conjunction with value-based purchasing? Dr. Joel Brill, assistant clinical professor of medicine at the University of Arizona School of Medicine and chief medical officer of Predictive Health, LLC, talks about how we can best characterize and measure the still-nebulous ideals of quality and value. Hosted by Dr. Jay Goldstein.

Dr. Maria Abreu, professor of medicine and chief of the division of gastroenterology at the University of Miami Miller School of Medicine, joins host Dr. Jay Goldstein to discuss inflammatory bowel disease, or IBD, and women's reproductive health. Does inflammatory bowel disease, or IBD, affect female fertility? What influence does IBD have on the course of pregnancy, and how does pregnancy, in turn, affect the natural history of IBD? Which medicines used to treat IBD are safe to use during pregnancy, and for new mothers who are nursing? Tune in to hear a discussion of these questions and more.

The cost of malpractice insurance and the cost of resolving malpractice claims continues to climb. What are the trends in premiums for gastroenterologists around the country? And what are some of the most common risks and most commonly alleged errors? What’s the likelihood of a gastroenterologist being sued during his career? Rebecca West, CEO of Piedmont Liability Trust, a non-profit serving the University of Virginia School of Medicine, joins host Dr. Mark DeLegge to discuss strategies for avoiding malpractice claims. Ms. West also provides an update on national efforts at tort reform and how malpractice insurance premiums might be affected.

What is the underlying mechanism of propulsion in the digestive system, and how is motility stimulated? How are some newer pharmacotherapies looking to target serotonin to treat conditions such as IBS and constipation? Dr. Jack Grider, professor in the department of medicine, division of gastroenterology at the Virginia Commonwealth University School of Medicine, talks about future pharmacotherapy directions that either suppress or encourage motility in the digestive system. Hosted by Dr. Mark DeLegge.

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.

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?

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.

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.

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.

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.

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.

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 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?

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.

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.

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?

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?

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?

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.

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.

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.

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.

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.

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?

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.

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.

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.

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?

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?

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.

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.

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?

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.

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.

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.

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.

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.

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.

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.

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?

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.

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.

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 address this dilemma? Dr. Ronald Fogel, chair of the Public Policy and Advocacy Committee of the AGA, probes vital issues with host Dr. Jay Goldstein.

Is Natural Orifice Transluminal Endoscopic Surgery (NOTES) the wave of the future, or just a wrinkle in the endoscopy movement? According to Dr. Pankaj Jay Pasricha, professor of medicine and chief of gastroenterology and hepatology at the Stanford University School of Medicine, the direction taken by NOTES may impact the core of gastroenterology. Dr. Pasricha shares his perspective, in the context of other emerging technologies that will shape the future of GI practice and endoscopy. Dr. Jay Goldstein hosts.

Food allergies are becoming increasingly common. Such allergies are often not easy to diagnose, and can present differently in adults and children. What is the difference between a food allergy and a specific food intolerance? What causes food allergies, and are there effective treatments beyond avoidance? Host Dr. Jay Goldstein probes the truth about food allergies with Dr. Sheila Crowe, professor of medicine in the division of gastroenterology and hepatology at the University of Virginia.

We've heard quite a bit about electronic medical record (EMR) systems. Many of us have also counted the reasons why we're hesitant to make the switch. But are the benefits of EMRs too real and too many to pass up? Dr. Lawrence Kosinski, a member of the AGA's Practice Management and Economics Committee, counts simplified compliance, and valuable feedback from clinical performance improvement studies, as a few of the many advantages of EMRs in his group practice. Find out more with host Dr. Mark DeLegge.

Physicians were previously obligated to provide nutrition and hydration to all patients during end of life care. Now, the courts have placed the responsibility with the patient. How can you best counsel patients and their families in making difficult decisions on feeding for the terminally ill? Dr. Stephen McClave, professor of medicine and director of clinical nutrition at the University of Louisville School of Medicine, takes a closer look at the ethical, legal and practical ramifications related to end-of-life nutrition with host Dr. Mark DeLegge.

Because there are no early stage symptoms for pancreatic cancer, diagnosis is often delayed until after the cancer has metastasized. The search for a clue to the onset of this disease is a priority. Dr. David C. Whitcomb, professor of medicine, chief of gastroenterology and medical director of the Comprehensive Pancreas Program at the University of Pittsburgh School of Medicine discusses the latest biomarkers for cancer on the pancreas with host Dr. Mark DeLegge.

A squeeze on federal funding is forcing researchers to explore different avenues for financing. What paths are most effective for finding support? Dr. Philip Toskes, professor of medicine in the division of gastroenterology, hepatology, and nutrition at the University of Florida College of Medicine, and former president of the AGA, speaks with host Dr. Jay Goldstein about NIH paylines, and the potential for small business innovation research grants, as well as the landscape for career building in academia.

There is expanding evidence that colonic health is based on diet and the microenvironment of the colon and its contents. Dr. Stephen O'Keefe, professor of medicine in the division of gastroenterology at the University of Pittsburgh School of Medicine, joins host Dr. Jay Goldstein to discuss the microbiota of the colonic tract. How do these bacteria, many of which are linked to patients' diet and lifestyle, generate byproducts that lead to the health or disease processes of the colon?

Advances in minimally invasive devices are fostering new endoscopic strategies in gastroenterology, including Natural Orifice Translumenal Endoscopic Surgery (NOTES). Dr. Christopher Thompson, assistant professor of medicine at Harvard Medical School and director of developmental endoscopy at Brigham and Women's Hospital in Boston, details the near-term impact of NOTES for liver biopsy, as well as long-range goals in bariatrics. Dr. Jay Goldstein hosts.

Our healthcare system is methodically assimilating the age of electronic information, despite several barriers to widespread adoption for physicians. One key aspect of this trend centers on e-prescribing. In terms of safety, ease of use, and savings of time and cost, is e-prescribing a viable option? Host Dr. Jay Goldstein examines the issue and its effect on the GI practice with Dr. Peter Kaufman, a partner in the Metropolitan GI Group based in greater Washington, DC, and chief medical officer of DrFirst, a company specializing in electronic prescribing.

Recertification for internal medicine (and subspecialties, including gastroenterology) continues to evolve, with new requirements for certification designed to improve practice quality and management. Dr. John Kuemmerle, professor of medicine and physiology, and associate chair of GI research at the Medical College of Virginia, details these requirements with host Dr. Jay Goldstein. How are these requisites impacting clinical practice?

In these suffocating times of decreased reimbursement and intensified regulation, will electronic medical records (EMR) provide an opportunity to increase your service output and improve functionality? Dr. James Leavitt, assistant clinical professor of gastroenterology at the University of Miami Miller School of Medicine, weighs the immediate impact of EMRs on your practice and offers tips for approaching the choice of EMR adoption with host Dr. Jay Goldstein.

Successfully navigating the tenure process in academic gastroenterology requires strategy, fortitude, and a firm understanding of its implications. What are the unwritten rules of the academic ladder? What can you do to make sure that you receive the promotion for which you strive? Host Dr. Jay Goldstein aims to remove the mystery behind tenure with Kim Barrett, PhD, professor of medicine and dean of graduate studies at the University of California, San Diego School of Medicine.

Dr. Helen Shields, associate professor of medicine at Harvard Medical School, reviews key preparatory factors for a successful screening colonoscopy with host Dr. Jay Goldstein. Have we resolved recent controversies surrounding sodium phosphate preps? Beyond sodium phosphate, what alternatives can we rely on to cleanse the colon prior to colonoscopy? Dr. Shields addresses split-dosing considerations and provides dietary advice for your patients.

Though sodium phosphate preparations for colonoscopy have been around for many years, we've recently encountered an influx of kidney problems related to this procedure. Which patient populations face the greatest risk of nephrotoxicity? How severe are these maladies, and what are possible alternatives for our patients? Host Dr. Jay Goldstein discusses the quality of current colonoscopy preps with Dr. Helen Shields, associate professor of medicine at Harvard Medical School.

CT colonography has been touted as a less invasive and lower-risk alternative to traditional screening colonoscopy. When considering accuracy and test functionality, do the realities match the acclaim? Host Dr. Jay Goldstein speaks with Dr. Don Rockey, professor of internal medicine and chief of digestive and liver diseases at the University of Texas Southwestern Medical School, about the practicalities of CT colonography and its potential role in colorectal cancer screening.

The emphasis on transparency in healthcare is beginning to impact the practice of gastroenterology. Host Dr. Jay Goldstein analyzes upcoming quality measures and accountability standards for GI medicine with Dr. Joel Brill, a prominent GI practice management expert and chair of the AGA Institute’s Clinical Practice and Economics Committee. Dr. Brill also elucidates trends in a new gastroenterology battleground: sedation administration.

We are developing increasingly effective therapies for patients with chronic hepatitis C, yet many physicians who treat a high volume of these patients are struggling to maintain economically viable strategies for providing care. Is treatment of hepatitis C becoming a money-losing proposition? Can a few simple adjustments revitalize your clinic's financial outlook? Dr. Imtiaz Alam, founding medical director of the Austin Hepatitis Center in Austin, Tex., joins host Dr. David Rubin.

The number of new cases of hepatitis C has declined significantly since its peak in the late 1980s. But now, two decades later, we’re seeing the manifestation of long-term complications from this chronic disease. Dr. Imtiaz Alam, founding medical director of the Austin Hepatitis Center in Austin, Tex., examines the clinical obstacles that often occur when treating a large volume of patients with complex cases of hepatitis C. Looking to the future, how can screening and other prevention mechanisms aid in fighting the pervasive impact of this disease? Find out more with host Dr. David Rubin.

Annually, Medicare payments to physicians are modified using the sustainable growth rate formula, or “SGR”. Recently, the formula mandated cuts to physicians in recent years; and only through quick congressional fixes were these cuts avoided. With payments expected to drop more than 40 percent in the next eight years, can the SGR truly be part of an effective solution to our healthcare crisis? What is the formula, and what impact will it continually have on patient care? Gastroenterologist, and Assistant Clinical Professor of Medicine at Harvard Medical School speaks with your host, Dr. David Rubin.