Gi Insights

Guest: Prateek Sharma, MD Host: Mark DeLegge, MD Esophageal cancer survival rates greatly decline when the cancer has reached its late stages, so detecting neoplasia in a Barrett's esophagus patient early is a crucial tool in cancer management. What are some emerging endoscopic techniques that can be used for a Barrett's esophageal patient? Dr. Prateek Sharma, professor of medicine in the division of gastroenterology and hepatology at the University of Kansas School of Medicine, discusses the best ways to manage esophageal cancer and Barrett's esophagus patients with host Dr. Mark DeLegge.

Guest: Brennan Spiegel, MD, MSHS Host: Jay Goldstein, MD In its 1948 charter constitution, the World Health Organization defined health as "a state of complete physical, mental and social well-being." Today, to measure this totality of well-being, we measure quality of life. Host Dr. Jay Goldstein discusses how quality of life measurements can be incorporated into everyday practice, with Dr. Brennan Spiegel, assistant professor of medicine in the division of digestive diseases at the David Geffen School of Medicine at UCLA. How is health-related quality of life measured objectively in clinical trials? To what degree do quality of life endpoints trump physiological endpoints?

Guest: Carla Ginsburg, MD, MPH Host: Jay Goldstein, MD Physicians continue to face payment cuts from Medicare, largely due to a flawed payment formula. What is on the horizon for 2009 and beyond? President-elect Obama has identified sweeping health care reform as a goal of his presidency. How could the new administration's health care overhaul affect physician reimbursement? Dr. Carla Ginsburg, professor of medicine at Harvard Medical School and private practice counselor on the governing board of the AGA, dissects the complexities of Medicare with host Dr. Jay Goldstein.    

Guest: David Peura, MD Host: Jay Goldstein, MD Helicobacter pylori, often known as H. pylori, was discovered in the 1980s and is found worldwide in the stomachs of billions of people. H. pylori can cause gastritis and ulcers, but often presents no symptoms or problems for years. How concerned should we be about the stomach bacterium? Host Dr. Jay Goldstein discusses with Dr. David Peura, professor of medicine at the University of Virginia School of Medicine, the extent to which H. pylori is still a health problem in the United States.

Host: Jay Goldstein, MD Guest: Richard Fedorak, MD Steroids used to be the standard treatment for inflammatory bowel disease. But now biologic and immunosuppresive therapies are often used. How can we increase the efficacy of these medications? What combinations work best? Dr. Richard Fedorak, professor of medicine in the division of gastroenterology at the University of Alberta in Canada, discusses IBD treatments with host Dr. Jay Goldstein.

Guest: Richard Fedorak, MD Host: Jay Goldstein, MD What are probiotics, and how do strains differ? How can they be used most effectively? Dr. Richard Fedorak, professor of medicine in the division of gastroenterology at the University of Alberta in Canada, probes the potential of probiotics with host Dr. Jay Goldstein. Can they be used to replace medications for certain patients with gastrointestinal disorders? Find out what you should you tell your patients about probiotics.

Guest: Michael Vaezi, MD, PhD Host: Mark DeLegge, MD Gastroesophageal reflux disease (GERD) is the most common GI diagnosis. But many aspects of diagnosing and treating GERD and related syndromes vary considerably. Now, the AGA has issued new evidence-based guidelines on this widespread disorder. Some of the recommendations may surprise you. Dr. Michael Vaezi, co-author of the guidelines, discusses the best GERD management strategies with host Dr. Mark DeLegge. To view the AGA's GERD Guidelines, please click here.  

Guest: Lawrence Kim, MD Host: Mark DeLegge, MD Endoscopy is extremely safe when performed by a qualified gastroenterologist. What role does accreditation play in ensuring patient safety? What's the difference between the associations that accredit ambulatory surgery centers? Host Dr. Mark DeLegge discusses what GIs need to know about accreditation with Dr. Lawrence Kim, a practicing gastroenterologist at South Denver Gastroenterology in Colorado.

Guest: Mary Igo, MBA, RN Host: Mark DeLegge, MD The Physician Quality Reporting Initiative (PQRI) is a CMS-based program designed to help medical professionals measure performance outcomes in their practice. How does the PQRI define quality, and how can it provide more concrete measurements of quality? What do GI practices need to know when becoming involved in the PQRI? Mary Igo, MBA, CEO of Minnesota Gastroenterology, a GI practice based in St. Paul, and an expert in medical group management, assesses the pros and cons of implementing the PQRI system with host Dr. Mark DeLegge.

Guest: Peter Cotton, MD Host: Mark DeLegge, MD The outcomes for endoscopy can vary greatly, depending on the training and technique of the endoscopist. Dr. Peter Cotton, professor of medicine at the Digestive Disease Center at the Medical University of South Carolina, discusses the risks of endoscopy, and quality-control measures, from the establishment of benchmarks to voluntary report cards to ensure quality outcomes. Dr. Mark DeLegge hosts.

Guest: Thomas D. Wang, MD, PhD Host: Mark DeLegge, MD Microscopic imaging of the digestive tract moves beyond examination of tissue at subcellular levels, helping us identify molecular regions in which to probe for dysplasia. Dr. Thomas Wang, assistant professor of medicine and biomedical engineering at the University of Michigan Medical School, details this 'biopsy inside the body' with host Dr. Mark DeLegge. How could this technology shape the future of GI practice? How does this differ from chromoendoscopy, autofluorescence, and other current technologies?

Guest: William Chey, MD Host: Mark DeLegge, MD Guest: Nicholas Shaheen, MD, MPH Gastrointestinal (GI) disease is a major source of morbidity and mortality, yet physicians and patients often regard it as a basic nuisance. What contributes to this perception, and how can we change it? Host Dr. Mark DeLegge welcomes two chairmen of the upcoming AGA Clinical Congress, Dr. William Chey, professor of internal medicine at the University of Michigan Medical School, and Dr. Nicholas Shaheen, associate professor of medicine at the University of North Carolina School of Medicine, to discuss strategies to help us and our patients keep current on GI disease.

Host: Jay Goldstein, MD Guest: Douglas Rex, MD Gastroenterology-directed propofol is controversial among many practitioners, even though evidence suggests it is very safe. What barriers are there to gastroenterologists administering propofol, without an anesthesiologist on site? Guest Dr. Douglas Rex, Chancellor's Professor and professor of medicine at Indiana University School of Medicine, and host Dr. Jay Goldstein examine the reasons for the slow growth of gastroenterologist-directed propofol, and what the future of anesthesiology might be for gastroenterologists.

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

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

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

Guest: Lawrence Cohen, MD Host: Mark DeLegge, MD Propofol is used for deep sedation, and is often preferred by patients undergoing an endoscopy, since it's a short-acting agent. Can it be administered safely and effectively by trained gastroenterologists, or should an anesthesiologist be present to monitor the procedure? Dr. Larry Cohen, associate clinical professor at Mount Sinai School of Medicine, joins host Dr. Mark DeLegge to discuss the benefits, costs and risks of using propofol during endoscopy. From a medical-legal perspective, are gastroenterologists at more risk if they administer propofol during endoscopy than they would be if an anesthesiologist had been present?

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

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

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