News from AGA

The Mayo Clinic Board of Trustees has announced that Gianrico Farrugia, MD, vice president and CEO of Mayo Clinic Florida, will take over as president and CEO of Mayo Clinic at the end of the year. AGA congratulates Dr. Farrugia on this accomplishment.

Here’s three reasons why AGA is excited by this news:

1. Dr. Farrugia is an accomplished GI investigator. Dr. Farrugia runs an NIH-funded translational laboratory focused on disorders of GI motility. The aim of Dr. Farrugia’s work is to understand at a cellular, subcellular and molecular level how the normal functions of the GI tract determine the defects that result in diseases such as diabetic gastroparesis, slow transit constipation, and irritable bowel syndrome (IBS), which will ultimately lead to new strategies to treat these diseases by developing targeted disease-modifying agents.

2. Dr. Farrugia is an alumnus of the AGA Research Foundation Research Scholar Award program. Dr. Farrugia received his Research Scholar Award in 1994 for his project titled “Jejunal Smooth Muscle Ion Channel Regulation in Health and Disease.”

3. Dr. Farrugia has given back to AGA both with his time – serving on the AGA Nominating Committee, AGA Institute Council, and Cellular and Molecular Gastroenterology and Hepatology editorial board – and by contributing, with his wife Geraldine Farrugia, to the AGA Research Foundation at the highest level as an AGA Legacy Society member.

Join AGA members in congratulating Dr. Farrugia in the AGA Community, community.gastro.org.
 

[email protected]

The Mayo Clinic Board of Trustees has announced that Gianrico Farrugia, MD, vice president and CEO of Mayo Clinic Florida, will take over as president and CEO of Mayo Clinic at the end of the year. AGA congratulates Dr. Farrugia on this accomplishment.

Here’s three reasons why AGA is excited by this news:

1. Dr. Farrugia is an accomplished GI investigator. Dr. Farrugia runs an NIH-funded translational laboratory focused on disorders of GI motility. The aim of Dr. Farrugia’s work is to understand at a cellular, subcellular and molecular level how the normal functions of the GI tract determine the defects that result in diseases such as diabetic gastroparesis, slow transit constipation, and irritable bowel syndrome (IBS), which will ultimately lead to new strategies to treat these diseases by developing targeted disease-modifying agents.

2. Dr. Farrugia is an alumnus of the AGA Research Foundation Research Scholar Award program. Dr. Farrugia received his Research Scholar Award in 1994 for his project titled “Jejunal Smooth Muscle Ion Channel Regulation in Health and Disease.”

3. Dr. Farrugia has given back to AGA both with his time – serving on the AGA Nominating Committee, AGA Institute Council, and Cellular and Molecular Gastroenterology and Hepatology editorial board – and by contributing, with his wife Geraldine Farrugia, to the AGA Research Foundation at the highest level as an AGA Legacy Society member.

Join AGA members in congratulating Dr. Farrugia in the AGA Community, community.gastro.org.
 

[email protected]

The Mayo Clinic Board of Trustees has announced that Gianrico Farrugia, MD, vice president and CEO of Mayo Clinic Florida, will take over as president and CEO of Mayo Clinic at the end of the year. AGA congratulates Dr. Farrugia on this accomplishment.

Here’s three reasons why AGA is excited by this news:

1. Dr. Farrugia is an accomplished GI investigator. Dr. Farrugia runs an NIH-funded translational laboratory focused on disorders of GI motility. The aim of Dr. Farrugia’s work is to understand at a cellular, subcellular and molecular level how the normal functions of the GI tract determine the defects that result in diseases such as diabetic gastroparesis, slow transit constipation, and irritable bowel syndrome (IBS), which will ultimately lead to new strategies to treat these diseases by developing targeted disease-modifying agents.

2. Dr. Farrugia is an alumnus of the AGA Research Foundation Research Scholar Award program. Dr. Farrugia received his Research Scholar Award in 1994 for his project titled “Jejunal Smooth Muscle Ion Channel Regulation in Health and Disease.”

3. Dr. Farrugia has given back to AGA both with his time – serving on the AGA Nominating Committee, AGA Institute Council, and Cellular and Molecular Gastroenterology and Hepatology editorial board – and by contributing, with his wife Geraldine Farrugia, to the AGA Research Foundation at the highest level as an AGA Legacy Society member.

Join AGA members in congratulating Dr. Farrugia in the AGA Community, community.gastro.org.
 

[email protected]

We spoke with Dr. Shen, instructor of medicine at the University of Pennsylvania and the recipient of the AGA Research Foundation’s 2016 Microbiome Junior Investigator Award, to learn about his passion for gut microbiome research.

How would you sum up your research in one sentence?

My research examines the metabolic interactions between the gut microbiota and the mammalian host, with a particular emphasis on amino acid metabolism and nitrogen flux via the bacterial enzyme urease.

What impact do you hope your research will have on patients?

My hope is that by better understanding the biological mechanisms by which the gut microbiota impacts host metabolism, we can modulate its effects to treat a variety of conditions and diseases including hepatic encephalopathy, inborn errors of metabolism, obesity, malnutrition, etc.

What inspired you to focus your research career on the gut microbiome?

My clinical experience as a gastroenterologist inspired my interest in metabolic and nutritional research. When I learned of the impact that the gut microbiota has on host metabolism, it created an entirely different perspective for me in terms of thinking about how to treat metabolic and nutritional disorders. There are tremendous opportunities in modifying our gut microbiota in concert with dietary interventions in order to modulate our metabolism.

What recent publication from your lab best represents your work, if anyone wants to learn more?

The following work examined how the use of a defined bacterial consortium without urease activity can reduce colonic ammonia level upon inoculation into the gut and ameliorate morbidity and mortality in a murine model of liver disease: Shen T.D., Albenberg L.A., Bittinger K., et al, Engineering the gut microbiota to treat hyperammonemia. J Clin Invest. 2015 Jul 1;125(7):2841-50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563680/.
 

[email protected]

We spoke with Dr. Shen, instructor of medicine at the University of Pennsylvania and the recipient of the AGA Research Foundation’s 2016 Microbiome Junior Investigator Award, to learn about his passion for gut microbiome research.

How would you sum up your research in one sentence?

My research examines the metabolic interactions between the gut microbiota and the mammalian host, with a particular emphasis on amino acid metabolism and nitrogen flux via the bacterial enzyme urease.

What impact do you hope your research will have on patients?

My hope is that by better understanding the biological mechanisms by which the gut microbiota impacts host metabolism, we can modulate its effects to treat a variety of conditions and diseases including hepatic encephalopathy, inborn errors of metabolism, obesity, malnutrition, etc.

What inspired you to focus your research career on the gut microbiome?

My clinical experience as a gastroenterologist inspired my interest in metabolic and nutritional research. When I learned of the impact that the gut microbiota has on host metabolism, it created an entirely different perspective for me in terms of thinking about how to treat metabolic and nutritional disorders. There are tremendous opportunities in modifying our gut microbiota in concert with dietary interventions in order to modulate our metabolism.

What recent publication from your lab best represents your work, if anyone wants to learn more?

The following work examined how the use of a defined bacterial consortium without urease activity can reduce colonic ammonia level upon inoculation into the gut and ameliorate morbidity and mortality in a murine model of liver disease: Shen T.D., Albenberg L.A., Bittinger K., et al, Engineering the gut microbiota to treat hyperammonemia. J Clin Invest. 2015 Jul 1;125(7):2841-50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563680/.
 

[email protected]

We spoke with Dr. Shen, instructor of medicine at the University of Pennsylvania and the recipient of the AGA Research Foundation’s 2016 Microbiome Junior Investigator Award, to learn about his passion for gut microbiome research.

How would you sum up your research in one sentence?

My research examines the metabolic interactions between the gut microbiota and the mammalian host, with a particular emphasis on amino acid metabolism and nitrogen flux via the bacterial enzyme urease.

What impact do you hope your research will have on patients?

My hope is that by better understanding the biological mechanisms by which the gut microbiota impacts host metabolism, we can modulate its effects to treat a variety of conditions and diseases including hepatic encephalopathy, inborn errors of metabolism, obesity, malnutrition, etc.

What inspired you to focus your research career on the gut microbiome?

My clinical experience as a gastroenterologist inspired my interest in metabolic and nutritional research. When I learned of the impact that the gut microbiota has on host metabolism, it created an entirely different perspective for me in terms of thinking about how to treat metabolic and nutritional disorders. There are tremendous opportunities in modifying our gut microbiota in concert with dietary interventions in order to modulate our metabolism.

What recent publication from your lab best represents your work, if anyone wants to learn more?

The following work examined how the use of a defined bacterial consortium without urease activity can reduce colonic ammonia level upon inoculation into the gut and ameliorate morbidity and mortality in a murine model of liver disease: Shen T.D., Albenberg L.A., Bittinger K., et al, Engineering the gut microbiota to treat hyperammonemia. J Clin Invest. 2015 Jul 1;125(7):2841-50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563680/.
 

[email protected]

AGA’s new drug affordability principles were put into action in July when AGA Chair Sheila Crowe, MD, AGAF, provided comments on the Department of Health & Human Services (HHS) recent policy statement and Request for Information, “HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs” (Blueprint). Comments were limited to four areas of the Blueprint.

Medicare Part B to Part D drug transition

Over the past decade there has been interest in consolidating Part B and Part D drug coverage and payment. AGA urges physician-administered drugs and biologics to remain under Part B due to the complexities surrounding them.

Since Part D does not allow for supplemental coverage and has higher coinsurance, this action would achieve savings by shifting costs to Medicare beneficiaries. Moving them to Part D would also increase the risk of waste leading to unnecessary Medicare spending. AGA urges the administration to avoid policy solutions that achieve Medicare program savings at the expense of Medicare beneficiaries.

Indication-based payments

The Blueprint seems to imply that off-label uses of prescription drugs are inherently less valuable than on-label uses. If the administration moves towards value-based pricing, off-label indications should not automatically be valued less, or priced lower, than on-label indications. Specifically, AGA urges the administration to ensure all medically accepted indications are appropriately valued for a drug or biologic.

Medicare Part B Competitive Acquisition Program (CAP)

AGA does not oppose the idea of a new, voluntary CAP program as it would allow interested physicians and practices to provide Part B drug administration without the burden of high acquisition costs.

AGA strongly opposes a future Part B CAP that includes vendors or Medicare carriers conducting medical reviews or utilization management. Utilization management undermines shared decision-making between physicians and patients, increases physician burden, and often puts patients at risk by delaying access to necessary care.

Reduce patient out-of-pocket spending

As out-of-pocket costs continue to rise, AGA supports the administration’s plans to increase cost transparency in the Medicare program as it increases the efficiency of the shared decision-making process between patient and physician. Drug and biologic manufacturers, health plans, and pharmacy managers should work together to lower out-of-pocket expenses for Medicare beneficiaries and for all people with digestive diseases.

Although AGA shares the Blueprint’s goal of lowering the cost of prescription drugs, lowering out-of-pocket costs for patients, increasing competition and fostering innovation, we are concerned that the recent proposal by the Trump administration to allow Medicare Advantage (MA) plans to utilize step therapy would threaten the aforementioned goals. Step therapy is a utilization management tool used by insurers that requires patients to fail one or more medications before covering the original therapy that is prescribed by the physician. AGA is concerned that the recent announcement by the Trump administration would not provide patients with the necessary protections, would increase the regulatory burden that physicians already face with step therapy and prior authorization, and could hinder innovation by preferring the lowest cost medication which may not necessarily be the most effective. AGA will continue to push for necessary patient protections to ensure that patients have the ability to appeal step therapy protocols when appropriate and are able to receive the medication that their physician thinks is the most effective to manage their condition.
 

[email protected]

AGA’s new drug affordability principles were put into action in July when AGA Chair Sheila Crowe, MD, AGAF, provided comments on the Department of Health & Human Services (HHS) recent policy statement and Request for Information, “HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs” (Blueprint). Comments were limited to four areas of the Blueprint.

Medicare Part B to Part D drug transition

Over the past decade there has been interest in consolidating Part B and Part D drug coverage and payment. AGA urges physician-administered drugs and biologics to remain under Part B due to the complexities surrounding them.

Since Part D does not allow for supplemental coverage and has higher coinsurance, this action would achieve savings by shifting costs to Medicare beneficiaries. Moving them to Part D would also increase the risk of waste leading to unnecessary Medicare spending. AGA urges the administration to avoid policy solutions that achieve Medicare program savings at the expense of Medicare beneficiaries.

Indication-based payments

The Blueprint seems to imply that off-label uses of prescription drugs are inherently less valuable than on-label uses. If the administration moves towards value-based pricing, off-label indications should not automatically be valued less, or priced lower, than on-label indications. Specifically, AGA urges the administration to ensure all medically accepted indications are appropriately valued for a drug or biologic.

Medicare Part B Competitive Acquisition Program (CAP)

AGA does not oppose the idea of a new, voluntary CAP program as it would allow interested physicians and practices to provide Part B drug administration without the burden of high acquisition costs.

AGA strongly opposes a future Part B CAP that includes vendors or Medicare carriers conducting medical reviews or utilization management. Utilization management undermines shared decision-making between physicians and patients, increases physician burden, and often puts patients at risk by delaying access to necessary care.

Reduce patient out-of-pocket spending

As out-of-pocket costs continue to rise, AGA supports the administration’s plans to increase cost transparency in the Medicare program as it increases the efficiency of the shared decision-making process between patient and physician. Drug and biologic manufacturers, health plans, and pharmacy managers should work together to lower out-of-pocket expenses for Medicare beneficiaries and for all people with digestive diseases.

Although AGA shares the Blueprint’s goal of lowering the cost of prescription drugs, lowering out-of-pocket costs for patients, increasing competition and fostering innovation, we are concerned that the recent proposal by the Trump administration to allow Medicare Advantage (MA) plans to utilize step therapy would threaten the aforementioned goals. Step therapy is a utilization management tool used by insurers that requires patients to fail one or more medications before covering the original therapy that is prescribed by the physician. AGA is concerned that the recent announcement by the Trump administration would not provide patients with the necessary protections, would increase the regulatory burden that physicians already face with step therapy and prior authorization, and could hinder innovation by preferring the lowest cost medication which may not necessarily be the most effective. AGA will continue to push for necessary patient protections to ensure that patients have the ability to appeal step therapy protocols when appropriate and are able to receive the medication that their physician thinks is the most effective to manage their condition.
 

[email protected]

AGA’s new drug affordability principles were put into action in July when AGA Chair Sheila Crowe, MD, AGAF, provided comments on the Department of Health & Human Services (HHS) recent policy statement and Request for Information, “HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs” (Blueprint). Comments were limited to four areas of the Blueprint.

Medicare Part B to Part D drug transition

Over the past decade there has been interest in consolidating Part B and Part D drug coverage and payment. AGA urges physician-administered drugs and biologics to remain under Part B due to the complexities surrounding them.

Since Part D does not allow for supplemental coverage and has higher coinsurance, this action would achieve savings by shifting costs to Medicare beneficiaries. Moving them to Part D would also increase the risk of waste leading to unnecessary Medicare spending. AGA urges the administration to avoid policy solutions that achieve Medicare program savings at the expense of Medicare beneficiaries.

Indication-based payments

The Blueprint seems to imply that off-label uses of prescription drugs are inherently less valuable than on-label uses. If the administration moves towards value-based pricing, off-label indications should not automatically be valued less, or priced lower, than on-label indications. Specifically, AGA urges the administration to ensure all medically accepted indications are appropriately valued for a drug or biologic.

Medicare Part B Competitive Acquisition Program (CAP)

AGA does not oppose the idea of a new, voluntary CAP program as it would allow interested physicians and practices to provide Part B drug administration without the burden of high acquisition costs.

AGA strongly opposes a future Part B CAP that includes vendors or Medicare carriers conducting medical reviews or utilization management. Utilization management undermines shared decision-making between physicians and patients, increases physician burden, and often puts patients at risk by delaying access to necessary care.

Reduce patient out-of-pocket spending

As out-of-pocket costs continue to rise, AGA supports the administration’s plans to increase cost transparency in the Medicare program as it increases the efficiency of the shared decision-making process between patient and physician. Drug and biologic manufacturers, health plans, and pharmacy managers should work together to lower out-of-pocket expenses for Medicare beneficiaries and for all people with digestive diseases.

Although AGA shares the Blueprint’s goal of lowering the cost of prescription drugs, lowering out-of-pocket costs for patients, increasing competition and fostering innovation, we are concerned that the recent proposal by the Trump administration to allow Medicare Advantage (MA) plans to utilize step therapy would threaten the aforementioned goals. Step therapy is a utilization management tool used by insurers that requires patients to fail one or more medications before covering the original therapy that is prescribed by the physician. AGA is concerned that the recent announcement by the Trump administration would not provide patients with the necessary protections, would increase the regulatory burden that physicians already face with step therapy and prior authorization, and could hinder innovation by preferring the lowest cost medication which may not necessarily be the most effective. AGA will continue to push for necessary patient protections to ensure that patients have the ability to appeal step therapy protocols when appropriate and are able to receive the medication that their physician thinks is the most effective to manage their condition.
 

[email protected]

Four leading experts in microbiome research have recently been appointed to the scientific advisory board of the AGA Center for Gut Microbiome Research and Education.

Robert A. Britton, PhD

Baylor College of Medicine, Houston, Texas

Dr. Britton studies the role of microbes in health and diseases, with a focus on identifying microbes with therapeutic properties for a variety of disorders.



Suzanne Devkota, PhD

Cedars-Sinai Medical Center, Los Angeles, California

Dr. Devkota investigates the role of diet in shaping the community of bacteria that live in our intestines (the “gut microbiome”).
 

Lita M. Proctor, PhD

National Human Genome Research Institute, Rockville, Maryland

Dr. Proctor is responsible for coordination of the Human Microbiome Project (HMP), an eight-year NIH Common Fund initiative to create a toolbox of resources for the emerging field of microbiome research.
 

Liping Zhao, PhD

Rutgers University, New Brunswick, New Jersey

Dr. Zhao studies the interactions between diet and gut microbiota in the onset and progression of chronic diseases such as obesity and diabetes.



AGA recognizes the outgoing members of the scientific advisory board who have made valuable contributions to the center’s work over their terms: Lee M. Kaplan, MD, PhD, AGAF, Zain Kassam, MD, MPH, and Ece Mutlu, MD, MBA, AGAF.
 

[email protected]

Four leading experts in microbiome research have recently been appointed to the scientific advisory board of the AGA Center for Gut Microbiome Research and Education.

Robert A. Britton, PhD

Baylor College of Medicine, Houston, Texas

Dr. Britton studies the role of microbes in health and diseases, with a focus on identifying microbes with therapeutic properties for a variety of disorders.



Suzanne Devkota, PhD

Cedars-Sinai Medical Center, Los Angeles, California

Dr. Devkota investigates the role of diet in shaping the community of bacteria that live in our intestines (the “gut microbiome”).
 

Lita M. Proctor, PhD

National Human Genome Research Institute, Rockville, Maryland

Dr. Proctor is responsible for coordination of the Human Microbiome Project (HMP), an eight-year NIH Common Fund initiative to create a toolbox of resources for the emerging field of microbiome research.
 

Liping Zhao, PhD

Rutgers University, New Brunswick, New Jersey

Dr. Zhao studies the interactions between diet and gut microbiota in the onset and progression of chronic diseases such as obesity and diabetes.



AGA recognizes the outgoing members of the scientific advisory board who have made valuable contributions to the center’s work over their terms: Lee M. Kaplan, MD, PhD, AGAF, Zain Kassam, MD, MPH, and Ece Mutlu, MD, MBA, AGAF.
 

[email protected]

Four leading experts in microbiome research have recently been appointed to the scientific advisory board of the AGA Center for Gut Microbiome Research and Education.

Robert A. Britton, PhD

Baylor College of Medicine, Houston, Texas

Dr. Britton studies the role of microbes in health and diseases, with a focus on identifying microbes with therapeutic properties for a variety of disorders.



Suzanne Devkota, PhD

Cedars-Sinai Medical Center, Los Angeles, California

Dr. Devkota investigates the role of diet in shaping the community of bacteria that live in our intestines (the “gut microbiome”).
 

Lita M. Proctor, PhD

National Human Genome Research Institute, Rockville, Maryland

Dr. Proctor is responsible for coordination of the Human Microbiome Project (HMP), an eight-year NIH Common Fund initiative to create a toolbox of resources for the emerging field of microbiome research.
 

Liping Zhao, PhD

Rutgers University, New Brunswick, New Jersey

Dr. Zhao studies the interactions between diet and gut microbiota in the onset and progression of chronic diseases such as obesity and diabetes.



AGA recognizes the outgoing members of the scientific advisory board who have made valuable contributions to the center’s work over their terms: Lee M. Kaplan, MD, PhD, AGAF, Zain Kassam, MD, MPH, and Ece Mutlu, MD, MBA, AGAF.
 

[email protected]

AGA applauds Congress for recognizing the need to sustain the momentum for NIH funding and to ensure that it has the purchasing power it needs to attract the best and brightest scientists to pursue careers in research.

The Senate approved the fiscal year (FY) 2019 Labor-HHS-Education Appropriations bill that included a $2 billion increase in funding for the National Institutes of Health (NIH). This increase represents a 5.5% increase in NIH funding, on top of the 8.8% increase that NIH received as part of the Omnibus Appropriations bill for FY 2018. The funding also represents the largest increase in funding since the doubling period (FY 1999-FY 2003), and enabled NIH to support 1,149 additional research grants.

The $2 billion increase included in the Senate bill reflects the necessary funding that NIH needs to keep pace with medical research inflation. This increase will enable NIH to continue to fund innovative research, improve the quality of care for millions of Americans, and maintain U.S. global leadership in medical research. The House has recommended a $1.1 billion increase in NIH funding, but AGA will be pushing for the $2 billion increase. House and Senate leaders will be working to negotiate an agreement on funding.
 

[email protected]

AGA applauds Congress for recognizing the need to sustain the momentum for NIH funding and to ensure that it has the purchasing power it needs to attract the best and brightest scientists to pursue careers in research.

The Senate approved the fiscal year (FY) 2019 Labor-HHS-Education Appropriations bill that included a $2 billion increase in funding for the National Institutes of Health (NIH). This increase represents a 5.5% increase in NIH funding, on top of the 8.8% increase that NIH received as part of the Omnibus Appropriations bill for FY 2018. The funding also represents the largest increase in funding since the doubling period (FY 1999-FY 2003), and enabled NIH to support 1,149 additional research grants.

The $2 billion increase included in the Senate bill reflects the necessary funding that NIH needs to keep pace with medical research inflation. This increase will enable NIH to continue to fund innovative research, improve the quality of care for millions of Americans, and maintain U.S. global leadership in medical research. The House has recommended a $1.1 billion increase in NIH funding, but AGA will be pushing for the $2 billion increase. House and Senate leaders will be working to negotiate an agreement on funding.
 

[email protected]

AGA applauds Congress for recognizing the need to sustain the momentum for NIH funding and to ensure that it has the purchasing power it needs to attract the best and brightest scientists to pursue careers in research.

The Senate approved the fiscal year (FY) 2019 Labor-HHS-Education Appropriations bill that included a $2 billion increase in funding for the National Institutes of Health (NIH). This increase represents a 5.5% increase in NIH funding, on top of the 8.8% increase that NIH received as part of the Omnibus Appropriations bill for FY 2018. The funding also represents the largest increase in funding since the doubling period (FY 1999-FY 2003), and enabled NIH to support 1,149 additional research grants.

The $2 billion increase included in the Senate bill reflects the necessary funding that NIH needs to keep pace with medical research inflation. This increase will enable NIH to continue to fund innovative research, improve the quality of care for millions of Americans, and maintain U.S. global leadership in medical research. The House has recommended a $1.1 billion increase in NIH funding, but AGA will be pushing for the $2 billion increase. House and Senate leaders will be working to negotiate an agreement on funding.
 

[email protected]

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from fellow GIs on therapy and disease management options, best practices, and diagnoses.

In case you missed it, here are the most popular clinical cases shared in the forum recently:
 

1. Eosinophilic esophagitis and stricture

A tight stricture in the mid-esophagus of a 25-year-old patient prevented the physician from passing the scope on multiple occasions within 5 weeks.

2. Behcet’s

A 41-year-old patient with Behcet’s disease and celiac disease originally reported joint pain and diarrhea, which subsided after treatment with prednisone and sulfasalazine. Despite a limited diet and therapeutic levels of Humira, her symptoms resurfaced 6 months later with loose stools and urgency.

3. Ectopic varices with portal vein thrombosis

This case involves a 49-year-old male who developed necrotizing pancreatitis due to microlithiasis in 2008, followed by pyrexia with three pyogenic liver abscesses this past May. The attending physician solicited advice from the GI community on management of this patient’s portal hypertension.

4. Firefighters at higher CRC risk?

Join this informative discussion about a reported “1.21 times greater risk” for colorectal cancer in firefighters, and increased screening for this demographic.

More clinical cases and discussions are at https://community.gastro.org/discussions.
 

[email protected]

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from fellow GIs on therapy and disease management options, best practices, and diagnoses.

In case you missed it, here are the most popular clinical cases shared in the forum recently:
 

1. Eosinophilic esophagitis and stricture

A tight stricture in the mid-esophagus of a 25-year-old patient prevented the physician from passing the scope on multiple occasions within 5 weeks.

2. Behcet’s

A 41-year-old patient with Behcet’s disease and celiac disease originally reported joint pain and diarrhea, which subsided after treatment with prednisone and sulfasalazine. Despite a limited diet and therapeutic levels of Humira, her symptoms resurfaced 6 months later with loose stools and urgency.

3. Ectopic varices with portal vein thrombosis

This case involves a 49-year-old male who developed necrotizing pancreatitis due to microlithiasis in 2008, followed by pyrexia with three pyogenic liver abscesses this past May. The attending physician solicited advice from the GI community on management of this patient’s portal hypertension.

4. Firefighters at higher CRC risk?

Join this informative discussion about a reported “1.21 times greater risk” for colorectal cancer in firefighters, and increased screening for this demographic.

More clinical cases and discussions are at https://community.gastro.org/discussions.
 

[email protected]

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from fellow GIs on therapy and disease management options, best practices, and diagnoses.

In case you missed it, here are the most popular clinical cases shared in the forum recently:
 

1. Eosinophilic esophagitis and stricture

A tight stricture in the mid-esophagus of a 25-year-old patient prevented the physician from passing the scope on multiple occasions within 5 weeks.

2. Behcet’s

A 41-year-old patient with Behcet’s disease and celiac disease originally reported joint pain and diarrhea, which subsided after treatment with prednisone and sulfasalazine. Despite a limited diet and therapeutic levels of Humira, her symptoms resurfaced 6 months later with loose stools and urgency.

3. Ectopic varices with portal vein thrombosis

This case involves a 49-year-old male who developed necrotizing pancreatitis due to microlithiasis in 2008, followed by pyrexia with three pyogenic liver abscesses this past May. The attending physician solicited advice from the GI community on management of this patient’s portal hypertension.

4. Firefighters at higher CRC risk?

Join this informative discussion about a reported “1.21 times greater risk” for colorectal cancer in firefighters, and increased screening for this demographic.

More clinical cases and discussions are at https://community.gastro.org/discussions.
 

[email protected]

A simple, flexible and versatile way to ensure the AGA Research Foundation can continue to help spark the scientific breakthroughs of today so clinicians will have the tools to improve care tomorrow is through a gift in your will or living trust, known as a charitable bequest.

To make a charitable bequest, you need a current will or living trust. Your gift can be made as a percentage of your estate. Or you can make a specific bequest by giving a certain amount of cash, securities or property. After your lifetime, the Foundation receives your gift.

Including the AGA Research Foundation in your will is a popular gift to give because it is:

• Affordable. The actual giving of your gift occurs after your lifetime, so your current income is not affected.

• Flexible. Until your will goes into effect, you are free to alter your plans or change your mind.

• Versatile. You can give a specific item, a set amount of money or a percentage of your estate. You can also make your gift contingent upon certain events.

We hope you’ll consider including a gift to the AGA Research Foundation in your will or liv-ing trust. It’s simple – just a few sentences in your will or trust are all that is needed. The official bequest language for the AGA Research Foundation is: “I, [name], of [city, state, ZIP], give, devise and bequeath to the AGA Research Foundation [written amount or per-centage of the estate or description of property] for its unrestricted use and purpose.”

By including a gift to the AGA Research Foundation in your will, you can help fill the funding gap and protect the next generation of investigators.

For more information, visit http://gastro.planmylegacy.org/ or contact us at [email protected].
 

A simple, flexible and versatile way to ensure the AGA Research Foundation can continue to help spark the scientific breakthroughs of today so clinicians will have the tools to improve care tomorrow is through a gift in your will or living trust, known as a charitable bequest.

To make a charitable bequest, you need a current will or living trust. Your gift can be made as a percentage of your estate. Or you can make a specific bequest by giving a certain amount of cash, securities or property. After your lifetime, the Foundation receives your gift.

Including the AGA Research Foundation in your will is a popular gift to give because it is:

• Affordable. The actual giving of your gift occurs after your lifetime, so your current income is not affected.

• Flexible. Until your will goes into effect, you are free to alter your plans or change your mind.

• Versatile. You can give a specific item, a set amount of money or a percentage of your estate. You can also make your gift contingent upon certain events.

We hope you’ll consider including a gift to the AGA Research Foundation in your will or liv-ing trust. It’s simple – just a few sentences in your will or trust are all that is needed. The official bequest language for the AGA Research Foundation is: “I, [name], of [city, state, ZIP], give, devise and bequeath to the AGA Research Foundation [written amount or per-centage of the estate or description of property] for its unrestricted use and purpose.”

By including a gift to the AGA Research Foundation in your will, you can help fill the funding gap and protect the next generation of investigators.

For more information, visit http://gastro.planmylegacy.org/ or contact us at [email protected].
 

A simple, flexible and versatile way to ensure the AGA Research Foundation can continue to help spark the scientific breakthroughs of today so clinicians will have the tools to improve care tomorrow is through a gift in your will or living trust, known as a charitable bequest.

To make a charitable bequest, you need a current will or living trust. Your gift can be made as a percentage of your estate. Or you can make a specific bequest by giving a certain amount of cash, securities or property. After your lifetime, the Foundation receives your gift.

Including the AGA Research Foundation in your will is a popular gift to give because it is:

• Affordable. The actual giving of your gift occurs after your lifetime, so your current income is not affected.

• Flexible. Until your will goes into effect, you are free to alter your plans or change your mind.

• Versatile. You can give a specific item, a set amount of money or a percentage of your estate. You can also make your gift contingent upon certain events.

We hope you’ll consider including a gift to the AGA Research Foundation in your will or liv-ing trust. It’s simple – just a few sentences in your will or trust are all that is needed. The official bequest language for the AGA Research Foundation is: “I, [name], of [city, state, ZIP], give, devise and bequeath to the AGA Research Foundation [written amount or per-centage of the estate or description of property] for its unrestricted use and purpose.”

By including a gift to the AGA Research Foundation in your will, you can help fill the funding gap and protect the next generation of investigators.

For more information, visit http://gastro.planmylegacy.org/ or contact us at [email protected].
 

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community forum to seek advice from fellow GIs on therapy and disease management options, best practices and diagnoses.

In case you missed it, here are the most popular clinical cases shared in the forum recently:

1. Ulcerative colitis
A 24-year-old male with severe pancolitis is in remission and currently functioning well, but the attending GI is fearful that a relapse is impending based on a fecal calprotectin of 1258 in a “clinically stable patient on long term maximal therapy.”



2. Esophageal varices on Warfarin
A 64-year-old patient with Child-Turcotte-Pugh (CTP) class A cirrhosis had an upper endoscopy that showed large esophageal varices with no prior history of bleeding. View Dr. Miguel Malespin’s take on this popular case in the August issue of AGA Perspectives.



3. Does he have IBS or what?
A 37-year-old male with psoriatic arthritis and abdominal pain experiences rectal bleeding and abnormal findings during colonoscopy.



4. Chronic pancolitis
Quite a few GI experts commented on next steps for this 77-year-old pancolitis patient who has refused biologics based on cost.



5. Pouchitis
This 40-year-old patient developed diarrhea, fever, abdominal pain and other symptoms, with observed ulceration and inflammation in the pouch and proximally.

More clinical cases and discussions are at https://community.gastro.org/discussions.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community forum to seek advice from fellow GIs on therapy and disease management options, best practices and diagnoses.

In case you missed it, here are the most popular clinical cases shared in the forum recently:

1. Ulcerative colitis
A 24-year-old male with severe pancolitis is in remission and currently functioning well, but the attending GI is fearful that a relapse is impending based on a fecal calprotectin of 1258 in a “clinically stable patient on long term maximal therapy.”



2. Esophageal varices on Warfarin
A 64-year-old patient with Child-Turcotte-Pugh (CTP) class A cirrhosis had an upper endoscopy that showed large esophageal varices with no prior history of bleeding. View Dr. Miguel Malespin’s take on this popular case in the August issue of AGA Perspectives.



3. Does he have IBS or what?
A 37-year-old male with psoriatic arthritis and abdominal pain experiences rectal bleeding and abnormal findings during colonoscopy.



4. Chronic pancolitis
Quite a few GI experts commented on next steps for this 77-year-old pancolitis patient who has refused biologics based on cost.



5. Pouchitis
This 40-year-old patient developed diarrhea, fever, abdominal pain and other symptoms, with observed ulceration and inflammation in the pouch and proximally.

More clinical cases and discussions are at https://community.gastro.org/discussions.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community forum to seek advice from fellow GIs on therapy and disease management options, best practices and diagnoses.

In case you missed it, here are the most popular clinical cases shared in the forum recently:

1. Ulcerative colitis
A 24-year-old male with severe pancolitis is in remission and currently functioning well, but the attending GI is fearful that a relapse is impending based on a fecal calprotectin of 1258 in a “clinically stable patient on long term maximal therapy.”



2. Esophageal varices on Warfarin
A 64-year-old patient with Child-Turcotte-Pugh (CTP) class A cirrhosis had an upper endoscopy that showed large esophageal varices with no prior history of bleeding. View Dr. Miguel Malespin’s take on this popular case in the August issue of AGA Perspectives.



3. Does he have IBS or what?
A 37-year-old male with psoriatic arthritis and abdominal pain experiences rectal bleeding and abnormal findings during colonoscopy.



4. Chronic pancolitis
Quite a few GI experts commented on next steps for this 77-year-old pancolitis patient who has refused biologics based on cost.



5. Pouchitis
This 40-year-old patient developed diarrhea, fever, abdominal pain and other symptoms, with observed ulceration and inflammation in the pouch and proximally.

More clinical cases and discussions are at https://community.gastro.org/discussions.

Congrats to AGA Research Foundation grantee Amir Zarrinpar, MD, PhD, from UC San Diego whose new microbiome research has been published in Nature Communications. Dr. Zarrinpar — a former AGA Microbiome Junior Investigator Research Award recipient — used his AGA funding to study cyclical fluctuations in the gut microbiome and its effects on host metabolism. This new study in Nature Communications is an unexpected finding resulting from Dr. Zarrinpar’s AGA research project with his collaborator Satchin Panda, PhD, and their colleagues in the Salk Institute.

The study, Antibiotic-induced microbiome depletion alters metabolic homeostasis by affecting gut signaling and colonic metabolism, finds that mice that have their microbiomes depleted with antibiotics have decreased levels of glucose in their blood and better insulin sensitivity. The research has implications for understanding the role of the microbiome in diabetes. It also could lead to better insight into the side effects seen in people who are being treated with high levels of antibiotics.

The next steps for Dr. Zarrinpar and his team are to better understand what bacterial metabolites can affect insulin sensitivity and to functionally manipulate the microbiome to alter gut signaling to treat diabetes and other metabolic diseases. We look forward to seeing additional research on this topic that can eventually translate into improvements in patient care.
 

[email protected]

Congrats to AGA Research Foundation grantee Amir Zarrinpar, MD, PhD, from UC San Diego whose new microbiome research has been published in Nature Communications. Dr. Zarrinpar — a former AGA Microbiome Junior Investigator Research Award recipient — used his AGA funding to study cyclical fluctuations in the gut microbiome and its effects on host metabolism. This new study in Nature Communications is an unexpected finding resulting from Dr. Zarrinpar’s AGA research project with his collaborator Satchin Panda, PhD, and their colleagues in the Salk Institute.

The study, Antibiotic-induced microbiome depletion alters metabolic homeostasis by affecting gut signaling and colonic metabolism, finds that mice that have their microbiomes depleted with antibiotics have decreased levels of glucose in their blood and better insulin sensitivity. The research has implications for understanding the role of the microbiome in diabetes. It also could lead to better insight into the side effects seen in people who are being treated with high levels of antibiotics.

The next steps for Dr. Zarrinpar and his team are to better understand what bacterial metabolites can affect insulin sensitivity and to functionally manipulate the microbiome to alter gut signaling to treat diabetes and other metabolic diseases. We look forward to seeing additional research on this topic that can eventually translate into improvements in patient care.
 

[email protected]

Congrats to AGA Research Foundation grantee Amir Zarrinpar, MD, PhD, from UC San Diego whose new microbiome research has been published in Nature Communications. Dr. Zarrinpar — a former AGA Microbiome Junior Investigator Research Award recipient — used his AGA funding to study cyclical fluctuations in the gut microbiome and its effects on host metabolism. This new study in Nature Communications is an unexpected finding resulting from Dr. Zarrinpar’s AGA research project with his collaborator Satchin Panda, PhD, and their colleagues in the Salk Institute.

The study, Antibiotic-induced microbiome depletion alters metabolic homeostasis by affecting gut signaling and colonic metabolism, finds that mice that have their microbiomes depleted with antibiotics have decreased levels of glucose in their blood and better insulin sensitivity. The research has implications for understanding the role of the microbiome in diabetes. It also could lead to better insight into the side effects seen in people who are being treated with high levels of antibiotics.

The next steps for Dr. Zarrinpar and his team are to better understand what bacterial metabolites can affect insulin sensitivity and to functionally manipulate the microbiome to alter gut signaling to treat diabetes and other metabolic diseases. We look forward to seeing additional research on this topic that can eventually translate into improvements in patient care.
 

[email protected]

The AGA Research Foundation Research Awards Program includes two grants dedicated to digestive cancer research: the AGA–Caroline Craig Augustyn & Damian Augustyn Award in Digestive Cancer and the AGA–R. Robert & Sally Funderburg Research Award in Gastric Cancer.

Continue reading to learn about the novel research projects being conducted by our 2018 digestive cancer grant recipients.

AGA–Caroline Craig Augustyn & Damian Augustyn Award in Digestive Cancer

Ravikanth Maddipati, MD

University of Pennsylvania Hospital System, Philadelphia

Dr. Maddipati’s research focuses on understanding and treating metastatic disease in pancreatic cancer. With this grant, Dr. Maddipati will use advanced lineage-traced mouse models and innovative bioengineering approaches to identify the molecular pathways involved in tumor cell cooperation and define the role of circulating tumor cell-clusters in pancreatic cancer progression. This work will lead to a noninvasive method for monitoring disease progression and response to treatment in pancreatic cancer patients.

AGA’s take: Pancreatic cancer, namely pancreatic ductal adenocarcinoma, is one of the deadliest cancers in the U.S. The AGA Research Foundation is pleased to fund Dr. Maddipati’s research. As a physician-scientist, he is in a unique position to translate findings from basic research, using preclinical models, to develop improved approaches to treating patients with pancreatic cancer.
 

AGA–R. Robert & Sally Funderburg Research Award in Gastric Cancer

Jingwu Xie, PhD

Indiana University, Indianapolis

Dr. Xie’s research focuses on drug resistance in gastric cancer. His team recently had a monumental discovery — activated hedgehog signaling, via GLI1 and GLI2 gene up-regulation, is responsible for drug resistance in gastric cancer. Dr. Xie’s AGA-funded research will work to identify novel ways to sensitize gastric cancer cells to drug treatment by suppressing GLI1 and GLI2 activity.

AGA’s take: Gastric cancer is a very underfunded area of research in the U.S., and with limited treatment options for patients, there is a great need for novel research projects. The AGA Research Foundation is proud to fund Dr. Xie’s research, which we believe has the potential to translate into a new treatment that will improve outcomes for gastric cancer patients.
 

To see the full class of 2018 AGA Research Foundation awardees, visit the Meet Our Awardees section of our website, www.gastro.org/foundation-awardees.

[email protected]

The AGA Research Foundation Research Awards Program includes two grants dedicated to digestive cancer research: the AGA–Caroline Craig Augustyn & Damian Augustyn Award in Digestive Cancer and the AGA–R. Robert & Sally Funderburg Research Award in Gastric Cancer.

Continue reading to learn about the novel research projects being conducted by our 2018 digestive cancer grant recipients.

AGA–Caroline Craig Augustyn & Damian Augustyn Award in Digestive Cancer

Ravikanth Maddipati, MD

University of Pennsylvania Hospital System, Philadelphia

Dr. Maddipati’s research focuses on understanding and treating metastatic disease in pancreatic cancer. With this grant, Dr. Maddipati will use advanced lineage-traced mouse models and innovative bioengineering approaches to identify the molecular pathways involved in tumor cell cooperation and define the role of circulating tumor cell-clusters in pancreatic cancer progression. This work will lead to a noninvasive method for monitoring disease progression and response to treatment in pancreatic cancer patients.

AGA’s take: Pancreatic cancer, namely pancreatic ductal adenocarcinoma, is one of the deadliest cancers in the U.S. The AGA Research Foundation is pleased to fund Dr. Maddipati’s research. As a physician-scientist, he is in a unique position to translate findings from basic research, using preclinical models, to develop improved approaches to treating patients with pancreatic cancer.
 

AGA–R. Robert & Sally Funderburg Research Award in Gastric Cancer

Jingwu Xie, PhD

Indiana University, Indianapolis

Dr. Xie’s research focuses on drug resistance in gastric cancer. His team recently had a monumental discovery — activated hedgehog signaling, via GLI1 and GLI2 gene up-regulation, is responsible for drug resistance in gastric cancer. Dr. Xie’s AGA-funded research will work to identify novel ways to sensitize gastric cancer cells to drug treatment by suppressing GLI1 and GLI2 activity.

AGA’s take: Gastric cancer is a very underfunded area of research in the U.S., and with limited treatment options for patients, there is a great need for novel research projects. The AGA Research Foundation is proud to fund Dr. Xie’s research, which we believe has the potential to translate into a new treatment that will improve outcomes for gastric cancer patients.
 

To see the full class of 2018 AGA Research Foundation awardees, visit the Meet Our Awardees section of our website, www.gastro.org/foundation-awardees.

[email protected]

The AGA Research Foundation Research Awards Program includes two grants dedicated to digestive cancer research: the AGA–Caroline Craig Augustyn & Damian Augustyn Award in Digestive Cancer and the AGA–R. Robert & Sally Funderburg Research Award in Gastric Cancer.

Continue reading to learn about the novel research projects being conducted by our 2018 digestive cancer grant recipients.

AGA–Caroline Craig Augustyn & Damian Augustyn Award in Digestive Cancer

Ravikanth Maddipati, MD

University of Pennsylvania Hospital System, Philadelphia

Dr. Maddipati’s research focuses on understanding and treating metastatic disease in pancreatic cancer. With this grant, Dr. Maddipati will use advanced lineage-traced mouse models and innovative bioengineering approaches to identify the molecular pathways involved in tumor cell cooperation and define the role of circulating tumor cell-clusters in pancreatic cancer progression. This work will lead to a noninvasive method for monitoring disease progression and response to treatment in pancreatic cancer patients.

AGA’s take: Pancreatic cancer, namely pancreatic ductal adenocarcinoma, is one of the deadliest cancers in the U.S. The AGA Research Foundation is pleased to fund Dr. Maddipati’s research. As a physician-scientist, he is in a unique position to translate findings from basic research, using preclinical models, to develop improved approaches to treating patients with pancreatic cancer.
 

AGA–R. Robert & Sally Funderburg Research Award in Gastric Cancer

Jingwu Xie, PhD

Indiana University, Indianapolis

Dr. Xie’s research focuses on drug resistance in gastric cancer. His team recently had a monumental discovery — activated hedgehog signaling, via GLI1 and GLI2 gene up-regulation, is responsible for drug resistance in gastric cancer. Dr. Xie’s AGA-funded research will work to identify novel ways to sensitize gastric cancer cells to drug treatment by suppressing GLI1 and GLI2 activity.

AGA’s take: Gastric cancer is a very underfunded area of research in the U.S., and with limited treatment options for patients, there is a great need for novel research projects. The AGA Research Foundation is proud to fund Dr. Xie’s research, which we believe has the potential to translate into a new treatment that will improve outcomes for gastric cancer patients.
 

To see the full class of 2018 AGA Research Foundation awardees, visit the Meet Our Awardees section of our website, www.gastro.org/foundation-awardees.

[email protected]