By the Numbers

10 Gastroenterology Highlights from 2017: Nutrition, PPIs, Guidelines

Numerous advances were made in the field of gastroenterology this year. The role of dietary therapy in treating a range of GI conditions was a notable trending topic on Healio.com/GI in 2017, as were important new guidelines released by the leading gastroenterological societies, and our exclusive interviews with experts and cover stories on hot topics like the risks of proton pump inhibitors and medical cannabis.

To recap the year’s top news in gastroenterology, the editors of Healio Gastroenterology and Liver Disease compiled 10 of the most popular GI-related news articles from 2017.

1. Specific carbohydrate diet shows promise in pediatric IBD

Children with Crohn’s disease and ulcerative colitis achieved clinical remission after specific carbohydrate diet therapy, according to the results of a small prospective study. Read more

More recently, we interviewed study investigator David L. Suskind, MD, professor of pediatrics and director of clinical gastroenterology at Seattle Children’s Hospital, about the role of diet in stabilizing the microbiome in IBD. Read the interview here

2. AGA issues 10 best practice recommendations for long-term PPI use

In April, the American Gastroenterological Association released a clinical practice update on long-term use of proton pump inhibitors, in which experts recommended that health care providers should weigh the risks and benefits of these medications before prescribing them to patients. They emphasized that the benefits likely outweigh the risks when PPIs are prescribed appropriately. Read more

On a related note, the cover story in the December issue of Healio Gastroenterology and Liver Disease includes expert perspective on the evidence for PPI risks, and recommendations to prevent overprescribing. Read the cover story here

3. Cannabis in Gastroenterology: Physicians Lack Answers as Patient Interest Peaks

The cover story in the September issue of Healio Gastroenterology and Liver Disease addressed the current evidence supporting the role of medical cannabis in GI conditions. Experts also provided recommendations for how to best communicate with patients about the potential risks and benefits of this emerging therapeutic alternative. Read more

4. False positive Cologuard test not linked to higher rates of death, cancer

Patients who have a false positive Cologuard test result followed by a negative colonoscopy did not have higher rates of subsequent cancer or death compared with true negative patients, according to results from the LONG-HAUL cohort study.

These findings led investigators to conclude that false positive patients do not require aggressive follow-up evaluation. Read more

5. Individualized IBS diets reduce symptoms better than placebo

Individualized elimination diets guided by leukocyte activation tests reduced symptoms of irritable bowel syndrome better than a sham diet in a randomized controlled trial.

Researchers concluded that this dietary strategy may enable patients with IBS to alleviate their symptoms with less food restrictions than those required by the low FODMAP diet, which could improve long-term adherence. Read more

6. GI nutrition conference highlights latest in diet therapies, microbiome, telemedicine

In September, dieticians, gastroenterologists, and other health care providers from across the world gathered in Ann Arbor, Michigan, for a 3-day program focused on the role of nutrition and lifestyle interventions in the management of patients with digestive and liver diseases.

We spoke with the course director, William D. Chey, MD, Nostrant Professor of Gastroenterology & Nutrition Sciences at Michigan Medicine, Ann Arbor, about the highlights from the conference, and the importance of multidisciplinary collaboration between gastroenterologists and dieticians. Read the interview

7. 'Normal' bowel habits differ between men, women

For the first time, researchers characterized normal bowel habits for adults in the United States.

For normal bowel frequency, they confirmed the commonly accepted “3 and 3” metric — a range of three bowel movements per day to three bowel movements per week — and for normal bowel consistency, they found that men and women showed different criteria. Further, they identified key demographic risk factors for abnormal bowel habits, which notably included Hispanic ethnicity. Read more

8. Oats appear safe for patients with celiac disease

Adding oats to increase the nutritional value of a gluten-free diet does not appear to affect symptoms, histology, immunity or serologic features of patients with celiac disease, according to research published in Gastroenterology earlier this year.

These results are “reassuring, and suggest that non-contaminated oats are tolerated by the great majority of patients,” Peter H. R. Green, MD, professor of medicine at Columbia University Medical Center, and director of the Celiac Disease Center at Columbia University, and colleagues wrote. However, they noted that their “confidence is limited by the low quality and limited geographic distribution of the data.” Read more

9. ACG guideline expands indications for H. pylori testing, treatment

Early this year, the American College of Gastroenterology released new, updated guideline recommendations on the treatment of Helicobacter pylori infection in North America, based on the latest international data and expert consensus. Read more

10. AGA President: 7 new developments in celiac disease, wheat sensitivity

At the American Gastroenterological Association Presidential Plenary at Digestive Disease Week in May, newly appointed AGA President Sheila Crowe, MD, from University of California, San Diego, highlighted the latest developments in celiac disease and wheat sensitivity disorders. Read more

Numerous advances were made in the field of gastroenterology this year. The role of dietary therapy in treating a range of GI conditions was a notable trending topic on Healio.com/GI in 2017, as were important new guidelines released by the leading gastroenterological societies, and our exclusive interviews with experts and cover stories on hot topics like the risks of proton pump inhibitors and medical cannabis.

To recap the year’s top news in gastroenterology, the editors of Healio Gastroenterology and Liver Disease compiled 10 of the most popular GI-related news articles from 2017.

1. Specific carbohydrate diet shows promise in pediatric IBD

Children with Crohn’s disease and ulcerative colitis achieved clinical remission after specific carbohydrate diet therapy, according to the results of a small prospective study. Read more

More recently, we interviewed study investigator David L. Suskind, MD, professor of pediatrics and director of clinical gastroenterology at Seattle Children’s Hospital, about the role of diet in stabilizing the microbiome in IBD. Read the interview here

2. AGA issues 10 best practice recommendations for long-term PPI use

In April, the American Gastroenterological Association released a clinical practice update on long-term use of proton pump inhibitors, in which experts recommended that health care providers should weigh the risks and benefits of these medications before prescribing them to patients. They emphasized that the benefits likely outweigh the risks when PPIs are prescribed appropriately. Read more

On a related note, the cover story in the December issue of Healio Gastroenterology and Liver Disease includes expert perspective on the evidence for PPI risks, and recommendations to prevent overprescribing. Read the cover story here

3. Cannabis in Gastroenterology: Physicians Lack Answers as Patient Interest Peaks

The cover story in the September issue of Healio Gastroenterology and Liver Disease addressed the current evidence supporting the role of medical cannabis in GI conditions. Experts also provided recommendations for how to best communicate with patients about the potential risks and benefits of this emerging therapeutic alternative. Read more

4. False positive Cologuard test not linked to higher rates of death, cancer

Patients who have a false positive Cologuard test result followed by a negative colonoscopy did not have higher rates of subsequent cancer or death compared with true negative patients, according to results from the LONG-HAUL cohort study.

These findings led investigators to conclude that false positive patients do not require aggressive follow-up evaluation. Read more

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5. Individualized IBS diets reduce symptoms better than placebo

Individualized elimination diets guided by leukocyte activation tests reduced symptoms of irritable bowel syndrome better than a sham diet in a randomized controlled trial.

Researchers concluded that this dietary strategy may enable patients with IBS to alleviate their symptoms with less food restrictions than those required by the low FODMAP diet, which could improve long-term adherence. Read more

6. GI nutrition conference highlights latest in diet therapies, microbiome, telemedicine

In September, dieticians, gastroenterologists, and other health care providers from across the world gathered in Ann Arbor, Michigan, for a 3-day program focused on the role of nutrition and lifestyle interventions in the management of patients with digestive and liver diseases.

We spoke with the course director, William D. Chey, MD, Nostrant Professor of Gastroenterology & Nutrition Sciences at Michigan Medicine, Ann Arbor, about the highlights from the conference, and the importance of multidisciplinary collaboration between gastroenterologists and dieticians. Read the interview

7. 'Normal' bowel habits differ between men, women

For the first time, researchers characterized normal bowel habits for adults in the United States.

For normal bowel frequency, they confirmed the commonly accepted “3 and 3” metric — a range of three bowel movements per day to three bowel movements per week — and for normal bowel consistency, they found that men and women showed different criteria. Further, they identified key demographic risk factors for abnormal bowel habits, which notably included Hispanic ethnicity. Read more

8. Oats appear safe for patients with celiac disease

Adding oats to increase the nutritional value of a gluten-free diet does not appear to affect symptoms, histology, immunity or serologic features of patients with celiac disease, according to research published in Gastroenterology earlier this year.

These results are “reassuring, and suggest that non-contaminated oats are tolerated by the great majority of patients,” Peter H. R. Green, MD, professor of medicine at Columbia University Medical Center, and director of the Celiac Disease Center at Columbia University, and colleagues wrote. However, they noted that their “confidence is limited by the low quality and limited geographic distribution of the data.” Read more

9. ACG guideline expands indications for H. pylori testing, treatment

Early this year, the American College of Gastroenterology released new, updated guideline recommendations on the treatment of Helicobacter pylori infection in North America, based on the latest international data and expert consensus. Read more

10. AGA President: 7 new developments in celiac disease, wheat sensitivity

At the American Gastroenterological Association Presidential Plenary at Digestive Disease Week in May, newly appointed AGA President Sheila Crowe, MD, from University of California, San Diego, highlighted the latest developments in celiac disease and wheat sensitivity disorders. Read more

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