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Patients sometimes drive hundreds of miles to see their GI physicians for problems that never seem to resolve. Constipation is one of those ailments that can affect quality of life.
The advice is, “Try this diet or laxative. Get a colonoscopy. Often, that’s not getting at the root problem,” said Eric Dinesh Shah, MD, MBA, a gastroenterologist at the University of Michigan, Ann Arbor.
Such methods aren’t equipped to test the pelvic floor, said Dr. Shah, who worked with clinical experts to develop a simple point-of-care device called RED (rectal expulsion device) that makes it easier to diagnose and predict treatment options for constipation.
The device uses a foam-filled balloon to evaluate pelvic floor problems related to constipation, after a digital rectal exam during an office visit. Because the procedure can be performed during a patient’s initial office visit, it can eliminate the need for referrals to far-away specialists for many patients.
In 2019, Dr. Shah received the AGA-Shire Research Scholar Award in Functional GI and Motility Disorders from the AGA Research Foundation for developing RED, and the device was recently cleared by the Food and Drug Administration.
GI doctors don’t always have the answers, he acknowledged in an interview, but this creates the opportunity for new advancements such as RED. utilizing local and regional workshops as well as national conferences to meet like-minded people at similar career stages, and to look for funding opportunities to explore those ideas.
What is the most challenging case you’ve encountered?
Dr. Shah: The most challenging cases to me have been the ones where I wish we could have helped people years ago. It’s not that anyone did anything wrong or was poorly intentioned. It’s quite the opposite: There sometimes is no real avenue to offer testing locally with current technology, even though the local clinical teams completely understand what should be done in a perfect world. That creates challenges where patients go hours out of their way to see specialists, just to find an answer that might have been 1 mile down the road all along.
What has been your solution to help these patients?
Dr. Shah: My work has been about helping patients who drive a hundred miles or routinely go hours out of their way for their care. Usually that’s a sign that things just aren’t working locally. Patients have lost trust in their ability to get care with the teams they have. Or the teams themselves just need help. I think a major part of the job is to reinforce the bond between the patient and their local team by giving them the tools and expertise so that the patients can get that care locally.
There’s been this trend toward this ‘hub and spoke’ model in care where all the patients are filtering into these large hospital-owned mega practices. I wonder about the sustainability of that model because it takes away the ability of patients to see doctors who are invested in their local community. What we need to be doing is trying to flip that.
I’d love to discuss the RED device and how was this device conceived?
Dr. Shah: I partnered with experts, including William Chey, MD, AGAF, at the University of Michigan, who dedicate their entire careers toward creating robust science in large academic medical centers. In understanding the best ways to care for patients today, I could focus my own career on how to translate that level of care for the patients of tomorrow. I would encourage GI trainees to find senior and peer mentors who share perspective on this approach as an anchor to shared success.
For the RED device, the problem in constipation is that patients see their gastroenterologist over and over and over. It’s ‘try this diet, try this laxative, try this drug, try this other treatment,’ and we’re not getting at the root problem. Patients might go through a series of colonoscopies to reassure them but also to reassure their doctor that they’re not missing something. What we haven’t had is a way to test and evaluate the pelvic floor locally because those technologies are high tech and live in these big academic medical centers.
What are plans for its distribution and use in the consumer space?
Dr. Shah: The device is now available in the United States (https://www.red4constipation.com).
As an AGA Research Scholar Award winner, how might AGA play a role in supporting GI doctors?
Dr. Shah: The AGA Research Scholar Award enabled me to learn how RED predicted outcomes for patients seeing general gastroenterologists who then see pelvic floor physical therapy in the community to treat constipation. The availability of pelvic floor physical therapy and the field at large, has exploded in recent years across the country (https://www.pelvicrehab.com), making it easier for patients to get the local care they need.
In looking at what this award did for my own career and those of others in my cohort, I think the AGA Research Scholar Award mechanism serves as an example of what other GI trainees can do across the many areas of GI that are ripe for transformation.
What other AGA workshops are useful to GI doctors?
Dr. Shah: The AGA Tech Summit and Innovation Fellows programs give access to a positive learning environment to network with people across career stages who are seeking to advance the field in this way. These programs are particularly successful because they focus on helping GI trainees find peer success and professional satisfaction in the shared journey, rather than focusing on the accolades. I would strongly encourage GI trainees who have an interest but don’t know where to start to apply for these programs.
What do you think is the biggest misconception about your specialty?
Dr. Shah: That gastroenterologists have all the answers with current technology. There’s a lot we still don’t know. What gives me reassurance is the momentum around new ways of thinking that GI trainees and early-stage gastroenterologists continually bring forward to improve how we care for patients.
Lightning Round
Do you prefer coffee or tea?
Coffee
Are you an early bird or night owl?
Early bird
What’s your go-to comfort food?
Tex Mex
If you could travel anywhere, where would you go?
Antarctica
What’s your favorite TV show?
Below Deck
What’s one hobby you’d like to pick up?
Painting
What’s your favorite way to spend a weekend?
A lazy weekend
If you could have dinner with any historical figure, who would it be?
Winston Churchill
What’s your go-to karaoke song?
Our endoscopy nurses give no choice other than Taylor Swift, Green Day, and the Backstreet Boys
Patients sometimes drive hundreds of miles to see their GI physicians for problems that never seem to resolve. Constipation is one of those ailments that can affect quality of life.
The advice is, “Try this diet or laxative. Get a colonoscopy. Often, that’s not getting at the root problem,” said Eric Dinesh Shah, MD, MBA, a gastroenterologist at the University of Michigan, Ann Arbor.
Such methods aren’t equipped to test the pelvic floor, said Dr. Shah, who worked with clinical experts to develop a simple point-of-care device called RED (rectal expulsion device) that makes it easier to diagnose and predict treatment options for constipation.
The device uses a foam-filled balloon to evaluate pelvic floor problems related to constipation, after a digital rectal exam during an office visit. Because the procedure can be performed during a patient’s initial office visit, it can eliminate the need for referrals to far-away specialists for many patients.
In 2019, Dr. Shah received the AGA-Shire Research Scholar Award in Functional GI and Motility Disorders from the AGA Research Foundation for developing RED, and the device was recently cleared by the Food and Drug Administration.
GI doctors don’t always have the answers, he acknowledged in an interview, but this creates the opportunity for new advancements such as RED. utilizing local and regional workshops as well as national conferences to meet like-minded people at similar career stages, and to look for funding opportunities to explore those ideas.
What is the most challenging case you’ve encountered?
Dr. Shah: The most challenging cases to me have been the ones where I wish we could have helped people years ago. It’s not that anyone did anything wrong or was poorly intentioned. It’s quite the opposite: There sometimes is no real avenue to offer testing locally with current technology, even though the local clinical teams completely understand what should be done in a perfect world. That creates challenges where patients go hours out of their way to see specialists, just to find an answer that might have been 1 mile down the road all along.
What has been your solution to help these patients?
Dr. Shah: My work has been about helping patients who drive a hundred miles or routinely go hours out of their way for their care. Usually that’s a sign that things just aren’t working locally. Patients have lost trust in their ability to get care with the teams they have. Or the teams themselves just need help. I think a major part of the job is to reinforce the bond between the patient and their local team by giving them the tools and expertise so that the patients can get that care locally.
There’s been this trend toward this ‘hub and spoke’ model in care where all the patients are filtering into these large hospital-owned mega practices. I wonder about the sustainability of that model because it takes away the ability of patients to see doctors who are invested in their local community. What we need to be doing is trying to flip that.
I’d love to discuss the RED device and how was this device conceived?
Dr. Shah: I partnered with experts, including William Chey, MD, AGAF, at the University of Michigan, who dedicate their entire careers toward creating robust science in large academic medical centers. In understanding the best ways to care for patients today, I could focus my own career on how to translate that level of care for the patients of tomorrow. I would encourage GI trainees to find senior and peer mentors who share perspective on this approach as an anchor to shared success.
For the RED device, the problem in constipation is that patients see their gastroenterologist over and over and over. It’s ‘try this diet, try this laxative, try this drug, try this other treatment,’ and we’re not getting at the root problem. Patients might go through a series of colonoscopies to reassure them but also to reassure their doctor that they’re not missing something. What we haven’t had is a way to test and evaluate the pelvic floor locally because those technologies are high tech and live in these big academic medical centers.
What are plans for its distribution and use in the consumer space?
Dr. Shah: The device is now available in the United States (https://www.red4constipation.com).
As an AGA Research Scholar Award winner, how might AGA play a role in supporting GI doctors?
Dr. Shah: The AGA Research Scholar Award enabled me to learn how RED predicted outcomes for patients seeing general gastroenterologists who then see pelvic floor physical therapy in the community to treat constipation. The availability of pelvic floor physical therapy and the field at large, has exploded in recent years across the country (https://www.pelvicrehab.com), making it easier for patients to get the local care they need.
In looking at what this award did for my own career and those of others in my cohort, I think the AGA Research Scholar Award mechanism serves as an example of what other GI trainees can do across the many areas of GI that are ripe for transformation.
What other AGA workshops are useful to GI doctors?
Dr. Shah: The AGA Tech Summit and Innovation Fellows programs give access to a positive learning environment to network with people across career stages who are seeking to advance the field in this way. These programs are particularly successful because they focus on helping GI trainees find peer success and professional satisfaction in the shared journey, rather than focusing on the accolades. I would strongly encourage GI trainees who have an interest but don’t know where to start to apply for these programs.
What do you think is the biggest misconception about your specialty?
Dr. Shah: That gastroenterologists have all the answers with current technology. There’s a lot we still don’t know. What gives me reassurance is the momentum around new ways of thinking that GI trainees and early-stage gastroenterologists continually bring forward to improve how we care for patients.
Lightning Round
Do you prefer coffee or tea?
Coffee
Are you an early bird or night owl?
Early bird
What’s your go-to comfort food?
Tex Mex
If you could travel anywhere, where would you go?
Antarctica
What’s your favorite TV show?
Below Deck
What’s one hobby you’d like to pick up?
Painting
What’s your favorite way to spend a weekend?
A lazy weekend
If you could have dinner with any historical figure, who would it be?
Winston Churchill
What’s your go-to karaoke song?
Our endoscopy nurses give no choice other than Taylor Swift, Green Day, and the Backstreet Boys
Patients sometimes drive hundreds of miles to see their GI physicians for problems that never seem to resolve. Constipation is one of those ailments that can affect quality of life.
The advice is, “Try this diet or laxative. Get a colonoscopy. Often, that’s not getting at the root problem,” said Eric Dinesh Shah, MD, MBA, a gastroenterologist at the University of Michigan, Ann Arbor.
Such methods aren’t equipped to test the pelvic floor, said Dr. Shah, who worked with clinical experts to develop a simple point-of-care device called RED (rectal expulsion device) that makes it easier to diagnose and predict treatment options for constipation.
The device uses a foam-filled balloon to evaluate pelvic floor problems related to constipation, after a digital rectal exam during an office visit. Because the procedure can be performed during a patient’s initial office visit, it can eliminate the need for referrals to far-away specialists for many patients.
In 2019, Dr. Shah received the AGA-Shire Research Scholar Award in Functional GI and Motility Disorders from the AGA Research Foundation for developing RED, and the device was recently cleared by the Food and Drug Administration.
GI doctors don’t always have the answers, he acknowledged in an interview, but this creates the opportunity for new advancements such as RED. utilizing local and regional workshops as well as national conferences to meet like-minded people at similar career stages, and to look for funding opportunities to explore those ideas.
What is the most challenging case you’ve encountered?
Dr. Shah: The most challenging cases to me have been the ones where I wish we could have helped people years ago. It’s not that anyone did anything wrong or was poorly intentioned. It’s quite the opposite: There sometimes is no real avenue to offer testing locally with current technology, even though the local clinical teams completely understand what should be done in a perfect world. That creates challenges where patients go hours out of their way to see specialists, just to find an answer that might have been 1 mile down the road all along.
What has been your solution to help these patients?
Dr. Shah: My work has been about helping patients who drive a hundred miles or routinely go hours out of their way for their care. Usually that’s a sign that things just aren’t working locally. Patients have lost trust in their ability to get care with the teams they have. Or the teams themselves just need help. I think a major part of the job is to reinforce the bond between the patient and their local team by giving them the tools and expertise so that the patients can get that care locally.
There’s been this trend toward this ‘hub and spoke’ model in care where all the patients are filtering into these large hospital-owned mega practices. I wonder about the sustainability of that model because it takes away the ability of patients to see doctors who are invested in their local community. What we need to be doing is trying to flip that.
I’d love to discuss the RED device and how was this device conceived?
Dr. Shah: I partnered with experts, including William Chey, MD, AGAF, at the University of Michigan, who dedicate their entire careers toward creating robust science in large academic medical centers. In understanding the best ways to care for patients today, I could focus my own career on how to translate that level of care for the patients of tomorrow. I would encourage GI trainees to find senior and peer mentors who share perspective on this approach as an anchor to shared success.
For the RED device, the problem in constipation is that patients see their gastroenterologist over and over and over. It’s ‘try this diet, try this laxative, try this drug, try this other treatment,’ and we’re not getting at the root problem. Patients might go through a series of colonoscopies to reassure them but also to reassure their doctor that they’re not missing something. What we haven’t had is a way to test and evaluate the pelvic floor locally because those technologies are high tech and live in these big academic medical centers.
What are plans for its distribution and use in the consumer space?
Dr. Shah: The device is now available in the United States (https://www.red4constipation.com).
As an AGA Research Scholar Award winner, how might AGA play a role in supporting GI doctors?
Dr. Shah: The AGA Research Scholar Award enabled me to learn how RED predicted outcomes for patients seeing general gastroenterologists who then see pelvic floor physical therapy in the community to treat constipation. The availability of pelvic floor physical therapy and the field at large, has exploded in recent years across the country (https://www.pelvicrehab.com), making it easier for patients to get the local care they need.
In looking at what this award did for my own career and those of others in my cohort, I think the AGA Research Scholar Award mechanism serves as an example of what other GI trainees can do across the many areas of GI that are ripe for transformation.
What other AGA workshops are useful to GI doctors?
Dr. Shah: The AGA Tech Summit and Innovation Fellows programs give access to a positive learning environment to network with people across career stages who are seeking to advance the field in this way. These programs are particularly successful because they focus on helping GI trainees find peer success and professional satisfaction in the shared journey, rather than focusing on the accolades. I would strongly encourage GI trainees who have an interest but don’t know where to start to apply for these programs.
What do you think is the biggest misconception about your specialty?
Dr. Shah: That gastroenterologists have all the answers with current technology. There’s a lot we still don’t know. What gives me reassurance is the momentum around new ways of thinking that GI trainees and early-stage gastroenterologists continually bring forward to improve how we care for patients.
Lightning Round
Do you prefer coffee or tea?
Coffee
Are you an early bird or night owl?
Early bird
What’s your go-to comfort food?
Tex Mex
If you could travel anywhere, where would you go?
Antarctica
What’s your favorite TV show?
Below Deck
What’s one hobby you’d like to pick up?
Painting
What’s your favorite way to spend a weekend?
A lazy weekend
If you could have dinner with any historical figure, who would it be?
Winston Churchill
What’s your go-to karaoke song?
Our endoscopy nurses give no choice other than Taylor Swift, Green Day, and the Backstreet Boys
