In this crossover podcast, Jeffrey Roberts, Kate Scarlata, Dr. William Chey, and Amanda Lynett discuss advancements in the management of IBS, including the role of nutrition, FODMAPs, and integrative care. Dr. Chey emphasizes evolving IBS treatments, including prebiotics, probiotics, and mast cell stabilizers. Amanda Lynett shares insights on planning conferences like FOOD the Main Course and her passion for GI nutrition. They highlight the importance of pelvic floor therapy and a multidisciplinary approach to IBS care, offering hope to patients and guidance for healthcare providers.
Author: Abhay Panchal
The gastroenterology industry faces challenges like declining reimbursement rates and staffing shortages, even as demand for GI procedures increases due to a lowering of the recommended age for colonoscopies and rising obesity rates. Cuts proposed for 2025 by CMS could exacerbate these issues, particularly for private practice, which makes up a large part of the specialty. This may lead to more consolidation in the industry as independent practices struggle to compete with larger hospitals offering higher salaries to new graduates.
A study conducted by Dr. Rafael Bandeira Lages and colleagues in Brazil explored a less invasive alternative to traditional impedance-pH monitoring for diagnosing GERD. By measuring esophageal mucosal impedance during endoscopy, the research found high diagnostic accuracy, particularly at 2 cm above the esophagogastric junction. This method, which is more comfortable for patients, holds promise as a diagnostic tool but requires further validation and refinement before it can be used widely in clinical practice.
A recent study suggests that combining fecal immunochemical testing (FIT) with colonoscopy could improve colorectal cancer surveillance for individuals with a family history of the disease. The optimal strategy involves 10-yearly colonoscopy with 2-yearly FIT screenings, providing a balance of cost-effectiveness and clinical outcomes. The study highlights the growing interest in less-invasive screening options and emphasizes the importance of maintaining quality assurance in both colonoscopy and FIT procedures. While FIT alone has limitations, the combined approach could potentially offer better cancer prevention and detection rates.
Exact Sciences presented data from a study on its blood-based colorectal cancer test at the European Society for Medical Oncology Congress. The test showed 88.3% sensitivity for detecting colorectal cancer and 31.2% for advanced precancerous lesions, with a specificity of 90.1%. This development brings the test closer to providing a non-invasive screening option. Analysts reacted positively but expressed concern over potential performance degradation, with final results from the BLUE-C study expected by the first half of 2025.
In 2021, colonoscopy screenings in the U.S. cost $23.7 billion, with rising colorectal cancer (CRC) rates contributing to increasing demand. Colonoscopy costs vary by setting, averaging $925 in Ambulatory Surgery Centers (ASCs) and $1,224 in hospitals. Despite this, reimbursements for gastroenterologists have declined, with a 38% drop in colonoscopy-related payments between 2007 and 2022.
A 35-year-old patient at the University of Chicago Medicine became the first person globally to receive Tremfya (guselkumab) after its FDA approval for treating moderate to severe ulcerative colitis. The drug, previously used for psoriasis and psoriatic arthritis, was shown to be effective for ulcerative colitis in a study led by Dr. David T. Rubin at UChicago Medicine.
Experts outline five key strategies to improve colonoscopy performance: enhancing bowel prep with tailored approaches, boosting adenoma detection rates through AI and new tools, adhering to appropriate polyp surveillance intervals, reducing the environmental footprint of GI practices, and incorporating AI to increase efficiency and quality. Dr. Brian Jacobson emphasizes better prep processes, while Dr. Tonya Kaltenbach and others highlight AI’s potential in colonoscopy. These methods aim to improve patient care, efficiency, and sustainability in GI practices.
The rise in private equity (PE) acquisitions of medical practices, particularly in dermatology and gastroenterology, offers financial security and operational efficiency for doctors but comes with risks like loss of autonomy and a focus on short-term profits. While PE firms can modernize practices and provide capital, they may also impose changes that could affect patient care and staff morale. Physicians considering a sale should thoroughly research PE firms and consult advisors to ensure alignment with their long-term goals and maintain high standards of care.
The article from The Medical Futurist outlines seven essential tools for the modern doctor of the 21st century, focusing on how technological advancements are reshaping medical practice. These include portable diagnostic devices, telemedicine capabilities, artificial intelligence for diagnostics, wearable health tech, personalized medicine, digital health literacy, and the ability to integrate big data into clinical decisions. These tools not only improve patient outcomes but also enhance the efficiency and precision of healthcare delivery.