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Top AGA Community patient cases
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Possible congestive heart failure, tuberculosis (http://ow.ly/QdmG30pZqqo) – Join the GI community in discussing the echocardiogram results of a Holocaust survivor with a history of diabetes, hypothyroidism, benign prostate hyperplasia and hypercholesterolemia, and whose daughter was recently found to be QuantiFERON Gold positive.
2. Recurrent diarrhea in Behcet’s disease patient (http://ow.ly/YX6L30pZqws) – A 42-year-old patient diagnosed with Behcet’s disease at age 13 presented with recurrent diarrhea; a colonoscopy revealed terminal ileal and cecal ulcerations.
3. Gastroparesis patient unable to take anti-emetics (http://ow.ly/E5jD30pZqw4) – Help your colleague address a tricky patient with prolonged QT and gastroparesis.
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Possible congestive heart failure, tuberculosis (http://ow.ly/QdmG30pZqqo) – Join the GI community in discussing the echocardiogram results of a Holocaust survivor with a history of diabetes, hypothyroidism, benign prostate hyperplasia and hypercholesterolemia, and whose daughter was recently found to be QuantiFERON Gold positive.
2. Recurrent diarrhea in Behcet’s disease patient (http://ow.ly/YX6L30pZqws) – A 42-year-old patient diagnosed with Behcet’s disease at age 13 presented with recurrent diarrhea; a colonoscopy revealed terminal ileal and cecal ulcerations.
3. Gastroparesis patient unable to take anti-emetics (http://ow.ly/E5jD30pZqw4) – Help your colleague address a tricky patient with prolonged QT and gastroparesis.
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Possible congestive heart failure, tuberculosis (http://ow.ly/QdmG30pZqqo) – Join the GI community in discussing the echocardiogram results of a Holocaust survivor with a history of diabetes, hypothyroidism, benign prostate hyperplasia and hypercholesterolemia, and whose daughter was recently found to be QuantiFERON Gold positive.
2. Recurrent diarrhea in Behcet’s disease patient (http://ow.ly/YX6L30pZqws) – A 42-year-old patient diagnosed with Behcet’s disease at age 13 presented with recurrent diarrhea; a colonoscopy revealed terminal ileal and cecal ulcerations.
3. Gastroparesis patient unable to take anti-emetics (http://ow.ly/E5jD30pZqw4) – Help your colleague address a tricky patient with prolonged QT and gastroparesis.
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Simple ways to create your legacy
Creating a legacy of giving is easier than you think. As the new year begins, take some time to start creating your legacy while supporting the AGA Research Foundation. Gifts to charitable organizations, such as the AGA Research Foundation, in your future plans ensure your support for our mission continues even after your lifetime.
Here are two ideas to help you get started.
Name the AGA Research Foundation as a beneficiary. This arrangement is one of the most tax-smart ways to support the AGA Research Foundation after your lifetime. When you leave retirement plan assets to us, we bypass any taxes and receive the full amount.
Include the AGA Research Foundation in your will or living trust. This gift can be made by including as little as one sentence in your will or living trust. Plus, your gift can be modified throughout your lifetime as circumstances change.
Want to learn more about including a gift to the AGA Research Foundation in your future plans? Visit our website at https://gastro.planmylegacy.org or contact Harmony Excellent at 301-272-1602 or [email protected].
Creating a legacy of giving is easier than you think. As the new year begins, take some time to start creating your legacy while supporting the AGA Research Foundation. Gifts to charitable organizations, such as the AGA Research Foundation, in your future plans ensure your support for our mission continues even after your lifetime.
Here are two ideas to help you get started.
Name the AGA Research Foundation as a beneficiary. This arrangement is one of the most tax-smart ways to support the AGA Research Foundation after your lifetime. When you leave retirement plan assets to us, we bypass any taxes and receive the full amount.
Include the AGA Research Foundation in your will or living trust. This gift can be made by including as little as one sentence in your will or living trust. Plus, your gift can be modified throughout your lifetime as circumstances change.
Want to learn more about including a gift to the AGA Research Foundation in your future plans? Visit our website at https://gastro.planmylegacy.org or contact Harmony Excellent at 301-272-1602 or [email protected].
Creating a legacy of giving is easier than you think. As the new year begins, take some time to start creating your legacy while supporting the AGA Research Foundation. Gifts to charitable organizations, such as the AGA Research Foundation, in your future plans ensure your support for our mission continues even after your lifetime.
Here are two ideas to help you get started.
Name the AGA Research Foundation as a beneficiary. This arrangement is one of the most tax-smart ways to support the AGA Research Foundation after your lifetime. When you leave retirement plan assets to us, we bypass any taxes and receive the full amount.
Include the AGA Research Foundation in your will or living trust. This gift can be made by including as little as one sentence in your will or living trust. Plus, your gift can be modified throughout your lifetime as circumstances change.
Want to learn more about including a gift to the AGA Research Foundation in your future plans? Visit our website at https://gastro.planmylegacy.org or contact Harmony Excellent at 301-272-1602 or [email protected].
Talk to your patients about the current state of prebiotics
Bridgette Wilson, PhD, RD, postdoctoral research associate in nutritional sciences, and Kevin Whelan, PhD, RD, professor of dietetics, King’s College London, England, share talking points to help your patients understand what is currently known about the use of prebiotics for GI disorders.
Explaining prebiotics for GI disorders
Different prebiotic supplements have different effects on gut symptoms. For example, lower doses of noninulin type fructans (e.g., beta-galacto-oligosaccharides [GOS], pectin, partially hydrolyzed guar gum) are likely to be better tolerated in patients with functional gut symptoms, including irritable bowel syndrome (IBS).
Though prebiotic-containing foods are thought to benefit gut health in general, some prebiotics are FODMAPs that have been associated with symptoms in IBS patients. Individual patients on restrictive diets should systematically introduce prebiotic foods to identify the type and quantity they can tolerate.
Prebiotic supplementation of more than 10 g/d may soften stools and increase bowel movements in patients with defecation difficulty or constipation.
Prebiotic supplementation may worsen symptoms in Crohn’s disease but is well tolerated in ulcerative colitis, although there is no effect on disease activity.
These tips are from “The current state of prebiotics,” the third article of a four-part CME series on prebiotics. This activity is supported by an educational grant from GlaxoSmithKline. Part one, “Prebiotics 101,” and part two, “Diet vs. Prebiotics,” are available through AGA University (agau.gastro.org).
AGA also has educational materials for patients on probiotics, which can be accessed at www.gastro.org/probiotics in English and Spanish.
Bridgette Wilson, PhD, RD, postdoctoral research associate in nutritional sciences, and Kevin Whelan, PhD, RD, professor of dietetics, King’s College London, England, share talking points to help your patients understand what is currently known about the use of prebiotics for GI disorders.
Explaining prebiotics for GI disorders
Different prebiotic supplements have different effects on gut symptoms. For example, lower doses of noninulin type fructans (e.g., beta-galacto-oligosaccharides [GOS], pectin, partially hydrolyzed guar gum) are likely to be better tolerated in patients with functional gut symptoms, including irritable bowel syndrome (IBS).
Though prebiotic-containing foods are thought to benefit gut health in general, some prebiotics are FODMAPs that have been associated with symptoms in IBS patients. Individual patients on restrictive diets should systematically introduce prebiotic foods to identify the type and quantity they can tolerate.
Prebiotic supplementation of more than 10 g/d may soften stools and increase bowel movements in patients with defecation difficulty or constipation.
Prebiotic supplementation may worsen symptoms in Crohn’s disease but is well tolerated in ulcerative colitis, although there is no effect on disease activity.
These tips are from “The current state of prebiotics,” the third article of a four-part CME series on prebiotics. This activity is supported by an educational grant from GlaxoSmithKline. Part one, “Prebiotics 101,” and part two, “Diet vs. Prebiotics,” are available through AGA University (agau.gastro.org).
AGA also has educational materials for patients on probiotics, which can be accessed at www.gastro.org/probiotics in English and Spanish.
Bridgette Wilson, PhD, RD, postdoctoral research associate in nutritional sciences, and Kevin Whelan, PhD, RD, professor of dietetics, King’s College London, England, share talking points to help your patients understand what is currently known about the use of prebiotics for GI disorders.
Explaining prebiotics for GI disorders
Different prebiotic supplements have different effects on gut symptoms. For example, lower doses of noninulin type fructans (e.g., beta-galacto-oligosaccharides [GOS], pectin, partially hydrolyzed guar gum) are likely to be better tolerated in patients with functional gut symptoms, including irritable bowel syndrome (IBS).
Though prebiotic-containing foods are thought to benefit gut health in general, some prebiotics are FODMAPs that have been associated with symptoms in IBS patients. Individual patients on restrictive diets should systematically introduce prebiotic foods to identify the type and quantity they can tolerate.
Prebiotic supplementation of more than 10 g/d may soften stools and increase bowel movements in patients with defecation difficulty or constipation.
Prebiotic supplementation may worsen symptoms in Crohn’s disease but is well tolerated in ulcerative colitis, although there is no effect on disease activity.
These tips are from “The current state of prebiotics,” the third article of a four-part CME series on prebiotics. This activity is supported by an educational grant from GlaxoSmithKline. Part one, “Prebiotics 101,” and part two, “Diet vs. Prebiotics,” are available through AGA University (agau.gastro.org).
AGA also has educational materials for patients on probiotics, which can be accessed at www.gastro.org/probiotics in English and Spanish.
Step Therapy National Day of Advocacy
AGA and 17 other specialty physician and patient advocacy organizations partnered with the Digestive Disease National Coalition (DDNC) on an advocacy day focused on the need for step therapy reform.
We met with congressional offices to seek support for patient protection guardrails in step therapy and to encourage co-sponsorship of the Safe Step Act. This bipartisan legislation would create a clear process for a patient or physician to request an exception to a step therapy protocol. It also would require insurers to grant exemptions to step therapy in the following situations:
- Patient already tried and failed on a required treatment
- Delayed treatment will cause irreversible damage
- Required treatment will cause harm to the patient
- Required treatment will prevent a patient from working or fulling daily activities
- Patient is stable on their current treatment
AGA representatives and patient advocates met with the congressional offices of these legislators who serve on key committees that have jurisdiction over this issue.
Sen. Chris Van Hollen, D-Md
Sen. Tim Scott, R-S.C.
Sen. Thom Tillis, R-N.C.
Sen. Lamar Alexander, R-N.C.
Rep. Alma Adams, D-N.C.
Rep. Mark Walker, R-N.C.
Rep. Tim Walberg, R-Mich
A special thanks to AGA members who contacted your legislators online. A combination of 344 tweets and emails were sent urging federal legislators to support the Safe Step Act.
Sharing is caring
Legislators and their staff are always asking us for real-life examples from constituents about step therapy burdens to humanize the issue. Contact AGA staff at [email protected] to share your story.
AGA and 17 other specialty physician and patient advocacy organizations partnered with the Digestive Disease National Coalition (DDNC) on an advocacy day focused on the need for step therapy reform.
We met with congressional offices to seek support for patient protection guardrails in step therapy and to encourage co-sponsorship of the Safe Step Act. This bipartisan legislation would create a clear process for a patient or physician to request an exception to a step therapy protocol. It also would require insurers to grant exemptions to step therapy in the following situations:
- Patient already tried and failed on a required treatment
- Delayed treatment will cause irreversible damage
- Required treatment will cause harm to the patient
- Required treatment will prevent a patient from working or fulling daily activities
- Patient is stable on their current treatment
AGA representatives and patient advocates met with the congressional offices of these legislators who serve on key committees that have jurisdiction over this issue.
Sen. Chris Van Hollen, D-Md
Sen. Tim Scott, R-S.C.
Sen. Thom Tillis, R-N.C.
Sen. Lamar Alexander, R-N.C.
Rep. Alma Adams, D-N.C.
Rep. Mark Walker, R-N.C.
Rep. Tim Walberg, R-Mich
A special thanks to AGA members who contacted your legislators online. A combination of 344 tweets and emails were sent urging federal legislators to support the Safe Step Act.
Sharing is caring
Legislators and their staff are always asking us for real-life examples from constituents about step therapy burdens to humanize the issue. Contact AGA staff at [email protected] to share your story.
AGA and 17 other specialty physician and patient advocacy organizations partnered with the Digestive Disease National Coalition (DDNC) on an advocacy day focused on the need for step therapy reform.
We met with congressional offices to seek support for patient protection guardrails in step therapy and to encourage co-sponsorship of the Safe Step Act. This bipartisan legislation would create a clear process for a patient or physician to request an exception to a step therapy protocol. It also would require insurers to grant exemptions to step therapy in the following situations:
- Patient already tried and failed on a required treatment
- Delayed treatment will cause irreversible damage
- Required treatment will cause harm to the patient
- Required treatment will prevent a patient from working or fulling daily activities
- Patient is stable on their current treatment
AGA representatives and patient advocates met with the congressional offices of these legislators who serve on key committees that have jurisdiction over this issue.
Sen. Chris Van Hollen, D-Md
Sen. Tim Scott, R-S.C.
Sen. Thom Tillis, R-N.C.
Sen. Lamar Alexander, R-N.C.
Rep. Alma Adams, D-N.C.
Rep. Mark Walker, R-N.C.
Rep. Tim Walberg, R-Mich
A special thanks to AGA members who contacted your legislators online. A combination of 344 tweets and emails were sent urging federal legislators to support the Safe Step Act.
Sharing is caring
Legislators and their staff are always asking us for real-life examples from constituents about step therapy burdens to humanize the issue. Contact AGA staff at [email protected] to share your story.
GI societies advise FDA on duodenoscope reprocessing
AGA, ACG, ASGE and SAGES were represented by three physicians who made oral remarks to the panel: Michael Kochman, MD, AGAF, Wilmott Professor of Medicine and Surgery at the University of Pennsylvania; Bret Petersen, MD, FASGE, professor of medicine and advanced endoscopist at the Mayo Clinic in Rochester, Minn. and Danielle Walsh, MD, associate professor of surgery at East Carolina University.
The GI societies over-arching goal is to ensure patient safety and ready access to clinically indicated procedures employing duodenoscopes and other elevator-channel endoscopes.
The panel discussed the adequacy/margin of safety for high-level disinfection, as well as the challenges and benefits of sterilization for routine for duodenoscope reprocessing. The panel’s consensus was that cleaning is the most important step in duodenoscope reprocessing. The panel noted that in properly cleaned duodenoscopes, high-level disinfection is appropriate; however, panel members acknowledged that reports indicate that duodenoscopes are not properly cleaned. The panel also discussed the challenges of implementing sterilization of duodenoscopes, such as potential decreased patient access to endoscopic retrograde cholangiopancreatography (ERCP) and increased costs.
On behalf of the GI societies, Dr. Kochman and Dr. Petersen proposed several overarching principles for the future evolution of our clinical practices focusing on patient safety and outcomes:
We encourage embracing multiple solutions, using a measured step-wise approach to the transition with both iterative and novel devices and processes.
We encourage data-based solutions addressing real-world efficacy while incorporating ongoing surveillance of processes and performance to ensure that early trouble signals are detected.
We believe that device or reprocessing transitions can be incorporated over the lifecycle of current instrumentation, to eliminate the potential for gaps in accessibility of care and to ensure that there is adequate efficacy and safety data to support the adoption of new technology.
We accept minimizing extensive premarket studies, while expecting vigilant post-market surveillance, for technologies or device changes made exclusively with intent to convert to conceptually more safe designs without significant changes in mechanism or function.
We support the addition of durability testing for devices undergoing both standard reprocessing and, in particular, those undergoing sterilization.
Our societies are prepared to support and participate in continued discussion regarding:
Mandatory servicing and inspections.
Mandatory device retirement for reusable devices.
Assessment of the role and standards for third-party inspection and repair.
Our societies strongly support the importance and oversight of succinct, practical, reproducible, user-friendly guidance in manufacturers’ instructions for use (IFUs), which should incorporate post-market validation studies and updates.
We recommend that devices that incorporate programmable features (AERs, washers, sterilizers) should have lock-down mechanisms in place to prevent both user and manufacturer from deviating from the FDA-cleared IFU parameters for the device.
Our societies, as well as numerous guidelines, include high-level disinfection as a currently acceptable option for endoscope reprocessing, assuming use of enhanced washing and drying standards of practice.
Finally, we support the FDA in its efforts to convey to companies the necessary endpoints and goals for performance and expectations relative to post-market review and development of new data to ensure efficacy in the community.
Our societies appreciated this opportunity to comment on the complex and critical topic at hand. Our over-arching goal as physicians remains that of ensuring patient safety and ready access to clinically indicated procedures employing duodenoscopes and other elevator-channel endoscopes.
AGA, ACG, ASGE and SAGES were represented by three physicians who made oral remarks to the panel: Michael Kochman, MD, AGAF, Wilmott Professor of Medicine and Surgery at the University of Pennsylvania; Bret Petersen, MD, FASGE, professor of medicine and advanced endoscopist at the Mayo Clinic in Rochester, Minn. and Danielle Walsh, MD, associate professor of surgery at East Carolina University.
The GI societies over-arching goal is to ensure patient safety and ready access to clinically indicated procedures employing duodenoscopes and other elevator-channel endoscopes.
The panel discussed the adequacy/margin of safety for high-level disinfection, as well as the challenges and benefits of sterilization for routine for duodenoscope reprocessing. The panel’s consensus was that cleaning is the most important step in duodenoscope reprocessing. The panel noted that in properly cleaned duodenoscopes, high-level disinfection is appropriate; however, panel members acknowledged that reports indicate that duodenoscopes are not properly cleaned. The panel also discussed the challenges of implementing sterilization of duodenoscopes, such as potential decreased patient access to endoscopic retrograde cholangiopancreatography (ERCP) and increased costs.
On behalf of the GI societies, Dr. Kochman and Dr. Petersen proposed several overarching principles for the future evolution of our clinical practices focusing on patient safety and outcomes:
We encourage embracing multiple solutions, using a measured step-wise approach to the transition with both iterative and novel devices and processes.
We encourage data-based solutions addressing real-world efficacy while incorporating ongoing surveillance of processes and performance to ensure that early trouble signals are detected.
We believe that device or reprocessing transitions can be incorporated over the lifecycle of current instrumentation, to eliminate the potential for gaps in accessibility of care and to ensure that there is adequate efficacy and safety data to support the adoption of new technology.
We accept minimizing extensive premarket studies, while expecting vigilant post-market surveillance, for technologies or device changes made exclusively with intent to convert to conceptually more safe designs without significant changes in mechanism or function.
We support the addition of durability testing for devices undergoing both standard reprocessing and, in particular, those undergoing sterilization.
Our societies are prepared to support and participate in continued discussion regarding:
Mandatory servicing and inspections.
Mandatory device retirement for reusable devices.
Assessment of the role and standards for third-party inspection and repair.
Our societies strongly support the importance and oversight of succinct, practical, reproducible, user-friendly guidance in manufacturers’ instructions for use (IFUs), which should incorporate post-market validation studies and updates.
We recommend that devices that incorporate programmable features (AERs, washers, sterilizers) should have lock-down mechanisms in place to prevent both user and manufacturer from deviating from the FDA-cleared IFU parameters for the device.
Our societies, as well as numerous guidelines, include high-level disinfection as a currently acceptable option for endoscope reprocessing, assuming use of enhanced washing and drying standards of practice.
Finally, we support the FDA in its efforts to convey to companies the necessary endpoints and goals for performance and expectations relative to post-market review and development of new data to ensure efficacy in the community.
Our societies appreciated this opportunity to comment on the complex and critical topic at hand. Our over-arching goal as physicians remains that of ensuring patient safety and ready access to clinically indicated procedures employing duodenoscopes and other elevator-channel endoscopes.
AGA, ACG, ASGE and SAGES were represented by three physicians who made oral remarks to the panel: Michael Kochman, MD, AGAF, Wilmott Professor of Medicine and Surgery at the University of Pennsylvania; Bret Petersen, MD, FASGE, professor of medicine and advanced endoscopist at the Mayo Clinic in Rochester, Minn. and Danielle Walsh, MD, associate professor of surgery at East Carolina University.
The GI societies over-arching goal is to ensure patient safety and ready access to clinically indicated procedures employing duodenoscopes and other elevator-channel endoscopes.
The panel discussed the adequacy/margin of safety for high-level disinfection, as well as the challenges and benefits of sterilization for routine for duodenoscope reprocessing. The panel’s consensus was that cleaning is the most important step in duodenoscope reprocessing. The panel noted that in properly cleaned duodenoscopes, high-level disinfection is appropriate; however, panel members acknowledged that reports indicate that duodenoscopes are not properly cleaned. The panel also discussed the challenges of implementing sterilization of duodenoscopes, such as potential decreased patient access to endoscopic retrograde cholangiopancreatography (ERCP) and increased costs.
On behalf of the GI societies, Dr. Kochman and Dr. Petersen proposed several overarching principles for the future evolution of our clinical practices focusing on patient safety and outcomes:
We encourage embracing multiple solutions, using a measured step-wise approach to the transition with both iterative and novel devices and processes.
We encourage data-based solutions addressing real-world efficacy while incorporating ongoing surveillance of processes and performance to ensure that early trouble signals are detected.
We believe that device or reprocessing transitions can be incorporated over the lifecycle of current instrumentation, to eliminate the potential for gaps in accessibility of care and to ensure that there is adequate efficacy and safety data to support the adoption of new technology.
We accept minimizing extensive premarket studies, while expecting vigilant post-market surveillance, for technologies or device changes made exclusively with intent to convert to conceptually more safe designs without significant changes in mechanism or function.
We support the addition of durability testing for devices undergoing both standard reprocessing and, in particular, those undergoing sterilization.
Our societies are prepared to support and participate in continued discussion regarding:
Mandatory servicing and inspections.
Mandatory device retirement for reusable devices.
Assessment of the role and standards for third-party inspection and repair.
Our societies strongly support the importance and oversight of succinct, practical, reproducible, user-friendly guidance in manufacturers’ instructions for use (IFUs), which should incorporate post-market validation studies and updates.
We recommend that devices that incorporate programmable features (AERs, washers, sterilizers) should have lock-down mechanisms in place to prevent both user and manufacturer from deviating from the FDA-cleared IFU parameters for the device.
Our societies, as well as numerous guidelines, include high-level disinfection as a currently acceptable option for endoscope reprocessing, assuming use of enhanced washing and drying standards of practice.
Finally, we support the FDA in its efforts to convey to companies the necessary endpoints and goals for performance and expectations relative to post-market review and development of new data to ensure efficacy in the community.
Our societies appreciated this opportunity to comment on the complex and critical topic at hand. Our over-arching goal as physicians remains that of ensuring patient safety and ready access to clinically indicated procedures employing duodenoscopes and other elevator-channel endoscopes.
Inside Dr. Swathi Eluri’s journey to physician-scientist
Inspired by her father, who was diagnosed with inflammatory bowel disease (IBD), Swathi Eluri, MD, spent time during her college days at the University of North Carolina (UNC), Chapel Hill, in a GI basic science lab hoping to better understand this condition.
After a stint at John Hopkins Hospital in Baltimore for her medical degree and residency, Dr. Eluri returned to UNC Chapel Hill for her GI fellowship, where she remains today as an assistant professor of medicine in the division of gastroenterology and hepatology. Dr. Eluri’s research is focused on increasing early detection of esophageal cancer, to allow for earlier and more effective treatment. The AGA Research Foundation was proud to support Dr. Eluri’s work with a 2018 AGA Research Scholar Award.
Learn more about Dr. Swathi Eluri’s inspiring career by visiting: https://www.gastro.org/news/inside-dr-swathi-eluris-journey-to-physician-scientist.
Help AGA build a community of investigators through the AGA Research Foundation
Your donation to the AGA Research Foundation can fund future success stories by keeping young scientists working to advance our understanding of digestive diseases. Make your year-end donation today at www.gastro.org/donateonline.
Inspired by her father, who was diagnosed with inflammatory bowel disease (IBD), Swathi Eluri, MD, spent time during her college days at the University of North Carolina (UNC), Chapel Hill, in a GI basic science lab hoping to better understand this condition.
After a stint at John Hopkins Hospital in Baltimore for her medical degree and residency, Dr. Eluri returned to UNC Chapel Hill for her GI fellowship, where she remains today as an assistant professor of medicine in the division of gastroenterology and hepatology. Dr. Eluri’s research is focused on increasing early detection of esophageal cancer, to allow for earlier and more effective treatment. The AGA Research Foundation was proud to support Dr. Eluri’s work with a 2018 AGA Research Scholar Award.
Learn more about Dr. Swathi Eluri’s inspiring career by visiting: https://www.gastro.org/news/inside-dr-swathi-eluris-journey-to-physician-scientist.
Help AGA build a community of investigators through the AGA Research Foundation
Your donation to the AGA Research Foundation can fund future success stories by keeping young scientists working to advance our understanding of digestive diseases. Make your year-end donation today at www.gastro.org/donateonline.
Inspired by her father, who was diagnosed with inflammatory bowel disease (IBD), Swathi Eluri, MD, spent time during her college days at the University of North Carolina (UNC), Chapel Hill, in a GI basic science lab hoping to better understand this condition.
After a stint at John Hopkins Hospital in Baltimore for her medical degree and residency, Dr. Eluri returned to UNC Chapel Hill for her GI fellowship, where she remains today as an assistant professor of medicine in the division of gastroenterology and hepatology. Dr. Eluri’s research is focused on increasing early detection of esophageal cancer, to allow for earlier and more effective treatment. The AGA Research Foundation was proud to support Dr. Eluri’s work with a 2018 AGA Research Scholar Award.
Learn more about Dr. Swathi Eluri’s inspiring career by visiting: https://www.gastro.org/news/inside-dr-swathi-eluris-journey-to-physician-scientist.
Help AGA build a community of investigators through the AGA Research Foundation
Your donation to the AGA Research Foundation can fund future success stories by keeping young scientists working to advance our understanding of digestive diseases. Make your year-end donation today at www.gastro.org/donateonline.
A GI society update on MOC reform
Our work was suspended when ABIM announced the creation of a new longitudinal assessment option for maintenance of certification across all specialties.
GI society leaders are in touch with ABIM. Here’s an update on what we know:
- • The ABIM Board of Directors committed to evolve its program to provide a longitudinal assessment option for Maintenance of Certification (MOC), offering a self-paced pathway for physicians to acquire and demonstrate ongoing knowledge. The traditional, long-form assessment will also remain an option, as some physicians have expressed a preference for a point-in-time exam taken less frequently.
Our next steps include seeking clarity from ABIM including:
1. The milestones in the process to create the new pathway.
2. When the new pathway will be available to diplomates.
3. Consideration and integration of the GI societies’ principles in the development of the new pathway for recertification, including:
a. MOC needs to be simpler, less intrusive and less expensive.
b. We continue to support alternatives to the high-stakes, every-10-year recertification exam.
c. We do not support single source or time-limited assessments, as they do not represent the current realities of medicine in the digital age.
d. We support the concept that, for the many diplomates who specialize within certain areas of gastroenterology and hepatology, MOC should not include high-stakes assessments of areas in which the diplomate may not practice.
e. We support the principles of lifelong learning, as evidenced by ongoing CME activities, rather than lifelong testing.
4. The role the GI societies, as representatives for thousands of U.S. members who are ABIM diplomates, play in the creation and implementation of the new pathway.
AASLD, ACG, AGA and ASGE want to be fully informed and fully respected partners in an endeavor that touches upon one of the toughest challenges facing our members and the single issue we hear about most often requesting our help.
We will continue to update our members as we learn the answers to these questions from ABIM.
Together, our first priority on the MOC issue remains ensuring that GI diplomates have a pathway for recertification that meets your needs.
Our work was suspended when ABIM announced the creation of a new longitudinal assessment option for maintenance of certification across all specialties.
GI society leaders are in touch with ABIM. Here’s an update on what we know:
- • The ABIM Board of Directors committed to evolve its program to provide a longitudinal assessment option for Maintenance of Certification (MOC), offering a self-paced pathway for physicians to acquire and demonstrate ongoing knowledge. The traditional, long-form assessment will also remain an option, as some physicians have expressed a preference for a point-in-time exam taken less frequently.
Our next steps include seeking clarity from ABIM including:
1. The milestones in the process to create the new pathway.
2. When the new pathway will be available to diplomates.
3. Consideration and integration of the GI societies’ principles in the development of the new pathway for recertification, including:
a. MOC needs to be simpler, less intrusive and less expensive.
b. We continue to support alternatives to the high-stakes, every-10-year recertification exam.
c. We do not support single source or time-limited assessments, as they do not represent the current realities of medicine in the digital age.
d. We support the concept that, for the many diplomates who specialize within certain areas of gastroenterology and hepatology, MOC should not include high-stakes assessments of areas in which the diplomate may not practice.
e. We support the principles of lifelong learning, as evidenced by ongoing CME activities, rather than lifelong testing.
4. The role the GI societies, as representatives for thousands of U.S. members who are ABIM diplomates, play in the creation and implementation of the new pathway.
AASLD, ACG, AGA and ASGE want to be fully informed and fully respected partners in an endeavor that touches upon one of the toughest challenges facing our members and the single issue we hear about most often requesting our help.
We will continue to update our members as we learn the answers to these questions from ABIM.
Together, our first priority on the MOC issue remains ensuring that GI diplomates have a pathway for recertification that meets your needs.
Our work was suspended when ABIM announced the creation of a new longitudinal assessment option for maintenance of certification across all specialties.
GI society leaders are in touch with ABIM. Here’s an update on what we know:
- • The ABIM Board of Directors committed to evolve its program to provide a longitudinal assessment option for Maintenance of Certification (MOC), offering a self-paced pathway for physicians to acquire and demonstrate ongoing knowledge. The traditional, long-form assessment will also remain an option, as some physicians have expressed a preference for a point-in-time exam taken less frequently.
Our next steps include seeking clarity from ABIM including:
1. The milestones in the process to create the new pathway.
2. When the new pathway will be available to diplomates.
3. Consideration and integration of the GI societies’ principles in the development of the new pathway for recertification, including:
a. MOC needs to be simpler, less intrusive and less expensive.
b. We continue to support alternatives to the high-stakes, every-10-year recertification exam.
c. We do not support single source or time-limited assessments, as they do not represent the current realities of medicine in the digital age.
d. We support the concept that, for the many diplomates who specialize within certain areas of gastroenterology and hepatology, MOC should not include high-stakes assessments of areas in which the diplomate may not practice.
e. We support the principles of lifelong learning, as evidenced by ongoing CME activities, rather than lifelong testing.
4. The role the GI societies, as representatives for thousands of U.S. members who are ABIM diplomates, play in the creation and implementation of the new pathway.
AASLD, ACG, AGA and ASGE want to be fully informed and fully respected partners in an endeavor that touches upon one of the toughest challenges facing our members and the single issue we hear about most often requesting our help.
We will continue to update our members as we learn the answers to these questions from ABIM.
Together, our first priority on the MOC issue remains ensuring that GI diplomates have a pathway for recertification that meets your needs.
Dr. Anil Rustgi and Dr. Raymond DuBois elected to National Academy of Medicine
Anil Rustgi, MD, AGAF, and Raymond DuBois, MD, PhD, AGAF, were elected to the National Academy of Medicine, considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.
Share your congratulations with both Dr. Rustgi and Dr. DuBois on the AGA Community.
Dr. Rustgi is recognized for illuminating the importance of GI cancers, genomics, and genetics and demonstrating that p120-catenin, part of the adherens junctions, is a tumor suppressor gene in cancers and the first to link p120-catenin to mesenchymal-epithelial transition (MET) in tumor metastasis, advancing therapeutic opportunities.
Dr. Rustgi is Irving Professor of Medicine and director of the Herbert Irving Comprehensive Cancer Center, and associate dean of oncology, department of medicine, Vagelos College of Physicians and Surgeons at Columbia University, New York.
Dr. DuBois is recognized for discovering the critical and mechanistic role of prostaglandins (PGs)/cyclooxygenase in colon cancer and its malignant progression, elucidating the role of PGs in the tumor microenvironment, and spearheading the now common use of drugs for human cancer prevention that target the PG pathway, like aspirin and other NSAIDs.
Dr. DuBois is dean of the College of Medicine, and professor of biochemistry and medicine at The Medical University of South Carolina, Charleston.
Anil Rustgi, MD, AGAF, and Raymond DuBois, MD, PhD, AGAF, were elected to the National Academy of Medicine, considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.
Share your congratulations with both Dr. Rustgi and Dr. DuBois on the AGA Community.
Dr. Rustgi is recognized for illuminating the importance of GI cancers, genomics, and genetics and demonstrating that p120-catenin, part of the adherens junctions, is a tumor suppressor gene in cancers and the first to link p120-catenin to mesenchymal-epithelial transition (MET) in tumor metastasis, advancing therapeutic opportunities.
Dr. Rustgi is Irving Professor of Medicine and director of the Herbert Irving Comprehensive Cancer Center, and associate dean of oncology, department of medicine, Vagelos College of Physicians and Surgeons at Columbia University, New York.
Dr. DuBois is recognized for discovering the critical and mechanistic role of prostaglandins (PGs)/cyclooxygenase in colon cancer and its malignant progression, elucidating the role of PGs in the tumor microenvironment, and spearheading the now common use of drugs for human cancer prevention that target the PG pathway, like aspirin and other NSAIDs.
Dr. DuBois is dean of the College of Medicine, and professor of biochemistry and medicine at The Medical University of South Carolina, Charleston.
Anil Rustgi, MD, AGAF, and Raymond DuBois, MD, PhD, AGAF, were elected to the National Academy of Medicine, considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.
Share your congratulations with both Dr. Rustgi and Dr. DuBois on the AGA Community.
Dr. Rustgi is recognized for illuminating the importance of GI cancers, genomics, and genetics and demonstrating that p120-catenin, part of the adherens junctions, is a tumor suppressor gene in cancers and the first to link p120-catenin to mesenchymal-epithelial transition (MET) in tumor metastasis, advancing therapeutic opportunities.
Dr. Rustgi is Irving Professor of Medicine and director of the Herbert Irving Comprehensive Cancer Center, and associate dean of oncology, department of medicine, Vagelos College of Physicians and Surgeons at Columbia University, New York.
Dr. DuBois is recognized for discovering the critical and mechanistic role of prostaglandins (PGs)/cyclooxygenase in colon cancer and its malignant progression, elucidating the role of PGs in the tumor microenvironment, and spearheading the now common use of drugs for human cancer prevention that target the PG pathway, like aspirin and other NSAIDs.
Dr. DuBois is dean of the College of Medicine, and professor of biochemistry and medicine at The Medical University of South Carolina, Charleston.
Top AGA Community patient cases
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Severe lower GI bleed (http://ow.ly/iTrS30pOKaP) – A 15-year-old male patient was sent to the ER with severe lower GI bleed after a general physical exam revealed he was experiencing hypotension and tachycardia. The GI community discusses diagnostic possibilities for severe lower GI bleed at such young age and management options.
2. Refractory nausea and vomiting in a transgender patient (http://ow.ly/Di9C30pOKbq) – In this case of a 45-year-old transgender male-to-female patient, the community deliberates on several clinical issues, including a non-binary gender option on patient identification forms, treatment options for the patient and if hormonal therapy is contributing to GI symptoms.
3. Multidisciplinary guidelines (http://ow.ly/BtUK30pOKC8) – Are multidisciplinary guidelines with related specialty societies “the need of the hour” or too rare and short-lived for the effort?
Also in the forum: The AGA Clinical Practice Updates Committee is soliciting topics for future clinical expert review and commentaries commissioned by AGA. Share your ideas with the GI community (http://ow.ly/siV930pOJS1).
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Severe lower GI bleed (http://ow.ly/iTrS30pOKaP) – A 15-year-old male patient was sent to the ER with severe lower GI bleed after a general physical exam revealed he was experiencing hypotension and tachycardia. The GI community discusses diagnostic possibilities for severe lower GI bleed at such young age and management options.
2. Refractory nausea and vomiting in a transgender patient (http://ow.ly/Di9C30pOKbq) – In this case of a 45-year-old transgender male-to-female patient, the community deliberates on several clinical issues, including a non-binary gender option on patient identification forms, treatment options for the patient and if hormonal therapy is contributing to GI symptoms.
3. Multidisciplinary guidelines (http://ow.ly/BtUK30pOKC8) – Are multidisciplinary guidelines with related specialty societies “the need of the hour” or too rare and short-lived for the effort?
Also in the forum: The AGA Clinical Practice Updates Committee is soliciting topics for future clinical expert review and commentaries commissioned by AGA. Share your ideas with the GI community (http://ow.ly/siV930pOJS1).
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Physicians with difficult patient scenarios regularly bring their questions to the AGA Community (https://community.gastro.org) to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses. In case you missed it, here are the most popular clinical discussions shared in the forum recently:
1. Severe lower GI bleed (http://ow.ly/iTrS30pOKaP) – A 15-year-old male patient was sent to the ER with severe lower GI bleed after a general physical exam revealed he was experiencing hypotension and tachycardia. The GI community discusses diagnostic possibilities for severe lower GI bleed at such young age and management options.
2. Refractory nausea and vomiting in a transgender patient (http://ow.ly/Di9C30pOKbq) – In this case of a 45-year-old transgender male-to-female patient, the community deliberates on several clinical issues, including a non-binary gender option on patient identification forms, treatment options for the patient and if hormonal therapy is contributing to GI symptoms.
3. Multidisciplinary guidelines (http://ow.ly/BtUK30pOKC8) – Are multidisciplinary guidelines with related specialty societies “the need of the hour” or too rare and short-lived for the effort?
Also in the forum: The AGA Clinical Practice Updates Committee is soliciting topics for future clinical expert review and commentaries commissioned by AGA. Share your ideas with the GI community (http://ow.ly/siV930pOJS1).
Access these clinical cases and more discussions at https://community.gastro.org/discussions.
Meet Donald Payne, Jr. – A staunch advocate for increasing access to colorectal cancer screening
Rep. Donald Payne Jr., D-N.J., has been representing the 10th congressional district of New Jersey which includes the Newark area and the thriving life-sciences community in the region since 2012. Rep. Payne Jr. ran to serve in the seat that his father, the late Rep.
Donald M. Payne, D-N.J., held for eleven terms until his untimely death in March 2012. The elder Payne succumbed to colon cancer 1 month after his initial diagnosis, and Rep. Payne Jr. has made it his personal mission since assuming his father’s seat to increase awareness of colorectal cancer screenings. In fact, shortly after entering office, Rep. Payne Jr. wrote an op-ed with AGA member Carla Ginsburg, MD, MPH, AGAF, on the importance of screening, relaying in deeply personal terms the cost of not getting screened.
Rep. Payne Jr. also made it a top priority to push national awareness of colon cancer screening beyond the halls of Congress. To that end, Rep. Payne Jr. successfully lobbied the Obama administration in 2014 to designate March as National Colorectal Cancer Awareness Month – the first colorectal cancer presidential proclamation in over than a decade. The presidential proclamation was subsequently reissued in both 2015 and 2016 by the Obama administration and in 2018 and 2019 by the Trump administration. Additionally, Rep. Payne Jr. introduces a resolution in the House of Representatives every year to designate March as National Colorectal Cancer Awareness Month in an effort to further promote awareness and educational activities of colorectal cancer screening in the chamber.
Most importantly, Rep. Payne Jr. is the lead champion of legislative efforts in the House to increase access to colorectal cancer screenings. Specifically, Rep. Payne Jr. is the lead sponsor of H.R. 1570, the Removing Barriers to Colorectal Cancer Screening Act, legislation that has been one of AGA’s top policy priorities. The legislation, which enjoys broad bipartisan support with over 300 cosponsors in the House, would correct the Medicare beneficiary coinsurance issue when a screening colonoscopy becomes therapeutic. He also is a strong supporter of biomedical research funding, noting in an op-ed with former Rep. Charlie Dent, R-Pa., that “scientists need stable, consistent, and robust funding to ensure that we can continue ... breakthroughs for the colorectal cancer community and beyond.”
AGA looks forward to continuing to work with Rep. Payne Jr. and his office in the 116th Congress on these critical issues and on policies affecting our patients and the field of gastroenterology.
Rep. Donald Payne Jr., D-N.J., has been representing the 10th congressional district of New Jersey which includes the Newark area and the thriving life-sciences community in the region since 2012. Rep. Payne Jr. ran to serve in the seat that his father, the late Rep.
Donald M. Payne, D-N.J., held for eleven terms until his untimely death in March 2012. The elder Payne succumbed to colon cancer 1 month after his initial diagnosis, and Rep. Payne Jr. has made it his personal mission since assuming his father’s seat to increase awareness of colorectal cancer screenings. In fact, shortly after entering office, Rep. Payne Jr. wrote an op-ed with AGA member Carla Ginsburg, MD, MPH, AGAF, on the importance of screening, relaying in deeply personal terms the cost of not getting screened.
Rep. Payne Jr. also made it a top priority to push national awareness of colon cancer screening beyond the halls of Congress. To that end, Rep. Payne Jr. successfully lobbied the Obama administration in 2014 to designate March as National Colorectal Cancer Awareness Month – the first colorectal cancer presidential proclamation in over than a decade. The presidential proclamation was subsequently reissued in both 2015 and 2016 by the Obama administration and in 2018 and 2019 by the Trump administration. Additionally, Rep. Payne Jr. introduces a resolution in the House of Representatives every year to designate March as National Colorectal Cancer Awareness Month in an effort to further promote awareness and educational activities of colorectal cancer screening in the chamber.
Most importantly, Rep. Payne Jr. is the lead champion of legislative efforts in the House to increase access to colorectal cancer screenings. Specifically, Rep. Payne Jr. is the lead sponsor of H.R. 1570, the Removing Barriers to Colorectal Cancer Screening Act, legislation that has been one of AGA’s top policy priorities. The legislation, which enjoys broad bipartisan support with over 300 cosponsors in the House, would correct the Medicare beneficiary coinsurance issue when a screening colonoscopy becomes therapeutic. He also is a strong supporter of biomedical research funding, noting in an op-ed with former Rep. Charlie Dent, R-Pa., that “scientists need stable, consistent, and robust funding to ensure that we can continue ... breakthroughs for the colorectal cancer community and beyond.”
AGA looks forward to continuing to work with Rep. Payne Jr. and his office in the 116th Congress on these critical issues and on policies affecting our patients and the field of gastroenterology.
Rep. Donald Payne Jr., D-N.J., has been representing the 10th congressional district of New Jersey which includes the Newark area and the thriving life-sciences community in the region since 2012. Rep. Payne Jr. ran to serve in the seat that his father, the late Rep.
Donald M. Payne, D-N.J., held for eleven terms until his untimely death in March 2012. The elder Payne succumbed to colon cancer 1 month after his initial diagnosis, and Rep. Payne Jr. has made it his personal mission since assuming his father’s seat to increase awareness of colorectal cancer screenings. In fact, shortly after entering office, Rep. Payne Jr. wrote an op-ed with AGA member Carla Ginsburg, MD, MPH, AGAF, on the importance of screening, relaying in deeply personal terms the cost of not getting screened.
Rep. Payne Jr. also made it a top priority to push national awareness of colon cancer screening beyond the halls of Congress. To that end, Rep. Payne Jr. successfully lobbied the Obama administration in 2014 to designate March as National Colorectal Cancer Awareness Month – the first colorectal cancer presidential proclamation in over than a decade. The presidential proclamation was subsequently reissued in both 2015 and 2016 by the Obama administration and in 2018 and 2019 by the Trump administration. Additionally, Rep. Payne Jr. introduces a resolution in the House of Representatives every year to designate March as National Colorectal Cancer Awareness Month in an effort to further promote awareness and educational activities of colorectal cancer screening in the chamber.
Most importantly, Rep. Payne Jr. is the lead champion of legislative efforts in the House to increase access to colorectal cancer screenings. Specifically, Rep. Payne Jr. is the lead sponsor of H.R. 1570, the Removing Barriers to Colorectal Cancer Screening Act, legislation that has been one of AGA’s top policy priorities. The legislation, which enjoys broad bipartisan support with over 300 cosponsors in the House, would correct the Medicare beneficiary coinsurance issue when a screening colonoscopy becomes therapeutic. He also is a strong supporter of biomedical research funding, noting in an op-ed with former Rep. Charlie Dent, R-Pa., that “scientists need stable, consistent, and robust funding to ensure that we can continue ... breakthroughs for the colorectal cancer community and beyond.”
AGA looks forward to continuing to work with Rep. Payne Jr. and his office in the 116th Congress on these critical issues and on policies affecting our patients and the field of gastroenterology.