New research from IRB Barcelona and CNAG uncovers how colorectal tumors build a powerful two-layer defense that shields them from the immune system. Through the hormone TGF-β, tumors block immune cells (T lymphocytes) from entering and expanding within the tumor—effectively turning the cancer “invisible” to treatment. The study, published in Nature Genetics, shows that when TGF-β is inhibited, immune cells can flood the tumor and reignite their attack. The team also identified osteopontin, a macrophage-derived protein, as a secondary suppressor, offering a new drug target that could complement immunotherapy. While direct TGF-β inhibitors carry toxicity risks, the researchers propose alternative…
Author: Abhay Panchal
A new national analysis has revealed just how common—and costly—unnecessary endoscopies for heartburn still are in the U.S. According to Motive Medical Intelligence, which analyzed over 100 million insurance claims from mid-2022 through mid-2024, nearly 11% of GERD visits led to upper endoscopy despite long-standing guidelines advising against it for uncomplicated reflux. The result: millions of avoidable procedures and hundreds of billions in wasted spending annually. Geographic disparities are striking — states like Maine and New Hampshire showed the lowest overuse, while Wyoming, Iowa, and Alaska ranked among the highest. Experts note that this reflects not only variations in practice…
Obesity is a chronic, relapsing disease with significant health and economic impacts. As obesity rates and new medication options rise, national societies have developed guidelines for high-quality pharmacologic care. AGA has introduced new quality indicators to define and benchmark best practices for the use of obesity medications. These indicators are supported by strong evidence, address care gaps, and may be submitted for inclusion in national quality payment programs.
CapsoVision has filed for FDA Breakthrough Device Designation for its CapsoCam UGI capsule endoscopy system — a swallowable camera designed to detect pancreatic ductal adenocarcinoma at earlier, treatable stages. Unlike traditional imaging or invasive endoscopy, the device offers a completely non-invasive, panoramic view of the duodenal papilla, where subtle structural changes may reveal pancreatic disease. If granted, the designation would fast-track collaboration with the FDA and accelerate clinical validation. With pancreatic cancer’s 5-year survival rate lingering near 10% and most diagnoses made too late for surgery, a screening capsule could mark a turning point in detection. CapsoVision’s platform already powers…
Gastroenterologists practicing in ASCs face significant financial pressure starting in 2026, due to a new Medicare payment model that cuts physician payments for procedures performed in both hospital outpatient and ASC settings, and boosts payments for the office setting.While converting to office-based endoscopy isn’t feasible for every practice, now is the time to understand what it would take and if it’s right for your situation. Neil Gupta, MD, MPH, FASGE, successfully transitioned to office-based endoscopy and offers key considerations to evaluate whether it could be a viable part of your long-term strategy under the new payment system.
Fresh from ACG 2025, Dr. David Johnson spotlights four studies poised to reshape GI practice — from colonoscopy quality to breakthroughs in liver and pelvic floor disorders. One standout analysis linked higher sessile serrated lesion detection rates (SSLDR) to up to 80% lower post-colonoscopy cancer risk, pushing benchmarks beyond the current 6% target. Yet, another nationwide registry revealed major noncompliance with bowel prep guidelines, with over half of patients never returning after inadequate preparation — a “9-1-1 call” for improving colonoscopy follow-up. Beyond colon cancer, translumbosacral neuromodulation therapy showed dramatic reductions in fecal incontinence episodes, hinting at nerve regeneration potential.…
Obesity now intersects with nearly every GI condition—from MAFLD-driven cirrhosis and increased cancer risk to tougher IBD surgeries and lower screening uptake. Dr. Kelly lays out a practical, stigma-free framework for making weight care core to GI practice: start with a thoughtful weight history (sleep, meds, disordered eating, OSA risk), use patient-first language, and assess adiposity beyond BMI (with lower cutoffs for Asian patients).
Exact Sciences just took a major step toward expanding its leadership in colorectal cancer screening. The company announced that the Hart-Scott-Rodino (HSR) antitrust waiting period has expired for its exclusive U.S. licensing deal with Freenome, giving it the rights to Freenome’s blood-based colorectal cancer (CRC) screening tests. The exclusivity, however, hinges on FDA first-line approval of Freenome’s test. This partnership strengthens Exact Sciences’ multi-modality approach — complementing Cologuard®’s stool-based test with a blood-based option aimed at improving patient uptake and screening accessibility. Following the deal’s completion, Exact updated its 2025 guidance to reflect a $75 million initial cash payment, reducing…
AI is quietly reshaping medicine — from clinic rooms to hospital boardrooms — but not all doctors are on board. In Business Insider’s deep dive, physicians across the US shared how they’re experimenting with tools like ChatGPT, from generating referral letters to testing AI-powered note-taking. Some, like Harvard’s Dr. Adam Rodman, even use ChatGPT in live patient conversations, while others—like Mayo Clinic’s Dr. Francisco Lopez-Jimenez—see cardiology leading the AI charge. Yet trust remains split. Nearly half of clinicians now use AI, but skepticism runs deep amid concerns over accuracy, ethics, and “shiny object syndrome.”
Even among top-tier gastroenterologists, how to best manage Barrett esophagus remains unsettled. A new Mayo Clinic–led survey of BE experts revealed striking inconsistencies — nearly half (47%) never offer ablation for nondysplastic Barrett’s, while 44% question biopsy diagnoses made by community gastroenterologists. Despite updated guidelines, opinions diverged on everything from when to use radiofrequency ablation to how aggressively to surveil or treat reflux after surgery. While most agreed on ablation for low-grade dysplasia, many differed on diagnostic tools like WATS-3D and long-term proton pump inhibitor use. The findings highlight a widening gap between evidence-based recommendations and real-world practice — even…