The American Gastroenterological Association has issued new clinical guidance on gastroparesis, emphasizing a personalized, patient-centered approach over rigid treatment pathways. The guideline includes 12 conditional recommendations shaped by both clinical evidence and patient input. Key updates include the preference for a four-hour gastric emptying scintigraphy study (over shorter ≤2-hour protocols) for accurate diagnosis, and metoclopramide or erythromycin as first-line pharmacologic options. Beyond medication, the guidance urges shared decision-making, highlights unmet needs, and calls for innovation to expand treatment options for this challenging condition.
Author: Abhay Panchal
Infants delivered by C-section are known to carry a distinct gut microbiome that increases their risk of allergies, asthma, and other immune-related conditions later in life. In a new randomized controlled trial, researchers tested a personalized microbiome-based program that combined stool microbiome reports, tailored recommendations, education, and coaching for parents. Within six months, C-section infants in the intervention arm showed a dramatic rise in beneficial Bifidobacterium (especially B. infantis), improved capacity to digest human milk oligosaccharides, and a “C-section index” resembling that of vaginally delivered infants.
The gut-skin axis (GSA) is emerging as a key player in linking gastrointestinal health to dermatological diseases through immune, metabolic, and microbial pathways. This narrative review highlights how dysbiosis, leaky gut, and systemic inflammation can manifest as skin disorders like acne, psoriasis, atopic dermatitis, and hidradenitis suppurativa — often serving as early warning signs of underlying GI disease. For gastroenterologists, the GSA offers both a diagnostic lens and a therapeutic opportunity. Microbiome-targeted interventions — probiotics, prebiotics, dietary strategies, and even fecal microbiota transplantation — show promise in reshaping systemic inflammation and improving outcomes in both gut and skin conditions.
This Medscape Gastroenterology commentary by Grace E. Kim, MD highlights why mentorship should be a priority for new GI fellows, even amid the pressures of scoping skills and consults. The right mentor, she argues, can shape not only fellowship success but also long-term career trajectories — especially for those aiming for subspecialties like IBD or interventional GI. Dr. Kim offers practical guidance: identify your true passions rather than chasing reputations, research mentors’ recent work and real-world commitments, and remain patient if the right fit isn’t immediate. Program directors can often help, and fellows should consider building a “team” of mentors…
A first-of-its-kind real-world study reports that an AI-enhanced digital collaborative care model (Ayble Health) delivered big, durable gains for people with IBS—without requiring a brick-and-mortar “IBS clinic.” In a prospective single-arm cohort of 202 adults with active symptoms, participants chose among three pathways—personalized elimination diet, brain–gut behavioral therapy (GDH/CBT/ACT), and a care team with coach support—while AI mined multimodal data to flag patterns and suggest next steps. Average symptom burden (IBS-SSS) fell by 140 points, and 86% achieved a clinically meaningful ≥50-point drop, with improvements emerging by week 4 and persisting out to 42 weeks; benefits were seen across IBS…
A new study in JAMA Health Forum raises pressing questions about the rise of private equity (PE) in gastroenterology. Analyzing more than 1.1 million patients, researchers found that PE-backed GI practices drove up colonoscopy prices and physician spending—but without improving quality measures such as polyp detection or complication rates. With 13% of U.S. gastroenterologists now working in PE-owned groups, the specialty leads medicine in private equity penetration. Proponents argue acquisitions boost efficiency and expand access, while critics warn of physician autonomy loss and profit-driven overutilization. As consolidation accelerates, this study spotlights a central tension: are patients and payors really getting…
Guardant Health and Quest Diagnostics have struck a multi-year deal to make Shield™, the first FDA-approved blood test for colorectal cancer screening, widely available across Quest’s massive network. Starting in early 2026, physicians will be able to order Shield directly through Quest’s EHR system, with patients accessing it at 2,000 service centers and 6,000 in-office phlebotomy sites. By replacing invasive prep with a simple blood draw, the partnership could unlock screening for the 50+ million U.S. adults who currently skip recommended testing — a potential game-changer for early CRC detection and outcomes.
Type 1 diabetes treatment is undergoing its most dramatic transformation in a century. For the first time, disease-modifying therapies like teplizumab are delaying clinical onset by targeting the autoimmune process itself, while stem-cell–derived β-cell replacement therapies are showing proof-of-concept for restoring natural insulin production. At the same time, next-generation insulins—ultrarapid, once-weekly, and even glucose-responsive—are converging with automated insulin delivery systems to bring care closer to physiological glucose control than ever before.
GLP-1 receptor agonists like Ozempic and Trulicity, now staples in diabetes and obesity care, are presenting new challenges in colonoscopy and endoscopy prep. By slowing gastric emptying and bowel motility, these drugs can leave patients with retained contents and incomplete bowel clearance, raising concerns about inadequate visualization and anesthesia risks. CU Anschutz experts advise personalized strategies—from holding daily or weekly doses, to extending prep regimens or shifting to clear liquids—to balance safety with procedure quality. For GI leaders, the message is clear: as GLP-1 use accelerates, endoscopy teams must rethink prep protocols and collaborate closely with anesthesia to avoid missed…
A new single-operator study in Cureus throws a curveball at the AI-in-endoscopy hype: when a high-volume, expert endoscopist turned on real-time polyp-detection (GI Genius™), adenoma and polyp detection rates didn’t budge (ADR 35% pre-AI vs 31% with AI; NS). Yet the AI era shaved over a full minute off average withdrawal time (9.34 vs 10.44 minutes), hinting at a quiet efficiency dividend without sacrificing core quality metrics. Translation: for seasoned colonoscopists already performing at a high ADR, AI looks less like a magic booster and more like a workflow accelerator. The intriguing play may be targeted deployment—use AI to lift…