ACG

Like other chronic inflammatory conditions, inflammatory bowel disease (IBD) has been revolutionized by the advent of biologic agents that fundamentally alter the inappropriate inflammatory response. The most potent of these are the biologic agents, infliximab, adalimumab, certolizumab pegol, and natalizumab. They also have the most dangerous side-effect profile.

Following on the heels of the obesity epidemic, a second epidemic has become apparent-sleep-disordered breathing and its effect on esophageal conditions, primarily gastroesophageal reflux disease (GERD). Many, many primary care providers have heard the following complaint: “I gained 10 pounds and now I have heartburn/cough/worsening asthma” (take your pick). What’s going on?

Prevalence for overweight (BMI 24.9 to 29.9) and obesity (BMI > 30) have been steadily rising for the past 30 years-two-thirds of Americans now qualify as overweight or heavier. Hypertension, hyperlipidemia, coronary artery disease, type 2 diabetes, sleep apnea, and GERD prevalence are following this epidemic. Obesity is now the second most common preventable cause of death, exceeded only by smoking.

For better or worse, primary care physicians are encountering increasing numbers of patients who are using complementary and alternative medicines (CAMs) for gastrointestinal syndromes. The use of these agents has exploded over the last decade. Dr. Keshavarzian quoted the 2007 National Health Interview Study from CDC, which revealed that nearly 4 in 10 adults had used a CAM treatment within the past year.

Mention GERD and most of patients probably think of heartburn. But the GERD story does not begin and end with the esophagus. The connection between GERD and laryngeal, pharyngeal, and pulmonary symptoms is the focus of a seminar, “An Eye and Nose Opening Experience-Chronic Complications of GERD,” at the upcoming American College of Gastroenterology Annual Scientific Meeting, October 31 to November 2 in Washington, DC.

When it comes to treating ulcerative colitis, it’s a jungle out there. This is because the gut is the largest and most complex immune environment in the human body. To successfully treat intestinal tract disorders, therapeutic agents must be delivered at the right time, in the right amount, to the right location.

Colorectal cancer is the third leading cause of cancer-related deaths in the United States. However, it is also one of the most manageable. A plenary session on colorectal cancer prevention will be among the highlights of the upcoming American College of Gastroenterology Annual Scientific Meeting, October 31 to November 2 in Washington, DC.

Statins are associated with a slight reduction in the risk of colorectal cancer, according to the results of a recent meta-analysis presented at the 2010 American College of Gastroenterology meeting. Investigators at the University of Michigan at Ann Arbor conducted a systematic review that included 22 studies with a total of more than 2.5 million participants.

Certain patients with inflammatory bowel disease are at heightened risk for the development of colorectal cancer. But researchers have not yet been able to discover markers that can identify these patients.

Turmeric, a spice used in curry, may help prevent Clostridium difficile infection. Rattan Patel, MD, of Cedars Sinai Medical Center in Los Angeles, and his colleagues found that curcumin (the active ingredient in turmeric) inhibited the growth of various strains of C difficile in vitro.