What if the future of GI isn’t just about scopes and procedures—but about rewiring the gut-brain connection itself? Dr. Brennan Spiegel, a physician, researcher, and author at the forefront of digital therapeutics, is challenging everything we know about gastroenterology. From virtual reality (VR) reshaping IBS treatment to AI rewriting the role of physicians, he sees the gut not just as an organ—but as an entire unexplored universe. In this conversation, he unpacks what the gut-brain axis is, why GIs are falling behind in microbiome research, and how gravity itself could be influencing gut health in ways we’ve never considered. He also dives into AI—how it’s extending human capabilities while simultaneously shrinking cognitive…
Author: Abhay Panchal
On its 15th anniversary, the Affordable Care Act (ACA) has largely fulfilled its original goals of expanding coverage and controlling costs, achieving record-high health insurance rates and moderating healthcare spending. While not all policies worked as intended, the law exceeded expectations in some areas—such as the effectiveness of premium tax credits and the realization that near-universal coverage is possible without the individual mandate. Key lessons include prioritizing improvements to existing programs, extending enhanced subsidies, and simplifying policy design.
Cigna has officially sold its Medicare Advantage, prescription drug, and Medigap businesses — along with its CareAllies provider enablement unit — to Health Care Service Corporation (HCSC) for $3.7 billion. This expands HCSC’s reach to 26.5 million members and significantly increases its Medicare Advantage footprint. The deal enables Cigna to exit the financially pressured Medicare market and refocus on employer-sponsored insurance and health services through Evernorth. Despite criticism over the sale’s valuation, Cigna sees the divestiture as a strategic move toward leaner operations and improved earnings in 2025.
The ASCOLT trial, a landmark international Phase 3 study led by clinician-scientists in Singapore, investigated aspirin’s role in preventing colorectal cancer recurrence after surgery and chemotherapy. While the trial did not find a statistically significant improvement in disease-free survival across all patients, it revealed a consistent trend toward improved survival, especially in certain subgroups.
Johnson & Johnson announced FDA approval for TREMFYA® (guselkumab) as a treatment for adults with moderately to severely active Crohn’s disease (CD), making it the first IL-23 inhibitor to offer both intravenous (IV) and subcutaneous (SC) induction options. Backed by robust Phase 3 data from GRAVITI and GALAXI studies, TREMFYA® demonstrated significant clinical and endoscopic remission rates, outperforming STELARA® across pooled endoscopic endpoints. This milestone marks TREMFYA®’s fourth U.S. indication and brings greater flexibility to patients with chronic immune-mediated diseases.
Atul Gupta, Wharton assistant professor of health care management, discusses the growing involvement of private equity in the health care sector, its benefits and risks, and the regulatory challenges surrounding transparency and ownership structures.
The updated guidance from the US Multi-Society Task Force on Colorectal Cancer marks a significant shift toward more personalized, patient-centered bowel preparation for colonoscopy. The new recommendations emphasize improved patient education, allow for lower-volume and same-day prep regimens in select patients, and offer more flexible dietary restrictions based on individual risk. Critically, the task force now recommends tracking bowel prep adequacy at both provider and unit levels, raising the benchmark from 85% to 90%. Experts say these timely updates could improve patient adherence, satisfaction, and ultimately, colorectal cancer prevention outcomes.
In his insightful article, Spencer Dorn, MD, explores how nurse practitioners (NPs) and physician associates (PAs) are reshaping American healthcare amid a persistent physician shortage. While training differences remain stark, research shows that NPs and PAs often provide comparable care in structured clinical scenarios. Dorn argues it’s time to move beyond the “who’s better” debate and focus instead on how to best deploy all clinicians to meet rising care demands. With AI on the horizon and a sicker, aging population, the future of medicine will require teamwork, adaptability, and a rethinking of roles across the board.
The article discusses the growing movement to deprescribe GLP-1 therapy for obesity due to cost concerns — but warns this is a shortsighted approach. Backed by robust clinical evidence, it argues that obesity is a chronic, relapsing condition and that discontinuing GLP-1s often leads to weight regain and worsened health outcomes. The real question, it concludes, isn’t whether we can afford to continue treatment — it’s whether we can afford not to.
The American Gastroenterological Association (AGA) issued no formal recommendation on the use of AI-assisted colonoscopy (CADe) in adults, citing very low certainty of evidence regarding critical long-term outcomes such as colorectal cancer (CRC) incidence, mortality, and post-colonoscopy CRC. The guideline highlights the need for future research in diverse populations and settings, particularly regarding detection of clinically significant polyps, cost-effectiveness, patient preferences, and real-world outcomes, with plans to update the recommendation as evidence evolves.