Five-year follow-up from the PROFILE randomized trial found that starting anti-TNF therapy immediately after diagnosis was associated with substantially better long-term outcomes than a conventional step-up approach in adults with newly diagnosed, moderate-to-severe Crohn’s disease. Among 386 randomized patients, those assigned to top-down treatment with infliximab plus an immunomodulator had fewer Crohn’s-related abdominal surgeries: 6 patients (3%) vs. 26 (13%) in the step-up group. The adjusted hazard ratio for surgery was 5.23, favoring top-down treatment. Top-down treatment was also associated with lower rates of disease progression to stricturing or penetrating complications (7% vs. 17%) and Crohn’s-related hospitalization (11% vs. 21%).…
Author: Rutali Thakur
Guardant Health’s Shield blood test has already been used by hundreds of thousands of people since its 2025 launch, with the company targeting millions of tests as it works to reach the estimated 54 million Americans who are unscreened or overdue for colorectal cancer screening. The test is increasingly being offered to patients hesitant about colonoscopy, and more than half of those who test positive have gone on to complete a follow-up colonoscopy. But the next challenge is improving what blood-based screening can detect. In the pivotal study, Shield missed 16.9% of colorectal cancers and had just 13.2% sensitivity for…
An AI-powered Red Density (RD) Score that measures colonic mucosal redness at the pixel level predicted long-term clinical outcomes in patients with ulcerative colitis who were in remission. In the prospective PROCEED-UC study of 176 patients across 10 academic centers, those who later experienced clinical failure had significantly higher baseline RD scores than those who remained in remission (52.94 vs. 32.71; P=0.033). A baseline RD score of 63 or higher was associated with clinical failure, with the tool achieving an AUC of 0.82 (P<0.0001). The score also showed moderate correlations with established histologic measures of inflammation, suggesting that AI-based image…
How New Capabilities Enter Mainstream GI By Dr. Charles Accurso and Praveen Suthrum This chapter began with a question from Charley that is deceptively simple: if gastroenterology is changing so quickly, how does a real GI practice turn that change into something it can actually implement? For years, the conversation about the future of GI has focused on what is coming. Scope Forward explored forces that could reorganize the specialty. The Shift went further into artificial intelligence, non-invasive diagnostics, virtual care, robotics, new care models, and companies already building around them. The technologies were no longer theoretical. The future had…
EndoQuest Robotics, Inc., a pioneering leader in endoluminal robotic surgical technology, today announced that enrollment in its pivotal multicenter investigational device exemption (IDE) clinical study, the PARADIGM Trial (Prospective Assessment of a Robotic Assisted Device in Gastrointestinal Medicine), has concluded after the completion of 50 robotic endoscopic submucosal dissection (ESD) procedures across 49 subjects (Clinicaltrials.gov). Preliminary results for the trial were presented at the 2026 Society of Robotic Surgery (SRS) Annual Meeting. The robotic ESD procedures were completed using EndoQuest’s Endoluminal Surgical (ELS) System by 6 different investigators across 5 institutions, including 3 colorectal surgeons and 3 gastroenterologists. Preliminary results…
Why Pathways Need Orchestration Before They Can Scale By Dr. Charles Accurso and Praveen Suthrum Chapter 4 moved from procedures to pathways. That shift matters because procedures are events, while digestive diseases are journeys. Colon cancer screening and surveillance, fatty liver, IBS, GERD, Barrett’s, IBD, celiac disease, motility disorders, chronic constipation, and other digestive conditions do not fit neatly into one visit or one procedure. They require intake, triage, testing, diagnosis, patient communication, scheduling, treatment, follow-up, partner coordination, recall, surveillance, and at times, re-entry into the system years later.That is easy to say.It is much harder to run.A pathway on…
Natera, Inc. (NASDAQ: NTRA), a global leader in cell-free DNA and precision medicine, today announced that Signatera has received regulatory approval from Japan’s Pharmaceuticals and Medical Devices Agency (PMDA). This approval supports the use of Signatera for patients with colorectal cancer (CRC) in the adjuvant setting and makes Signatera the first PMDA-approved MRD test in Japan. Natera expects to commercially launch Signatera for CRC in Japan by the end of 2026, subject to final pricing determination. More than 150,000 people are diagnosed with CRC in Japan each year,1 making it one of the country’s most common cancers. This disease burden is comparable…
How GI Becomes the Coordinator of Digestive Health By Dr. Charles Accurso and Praveen Suthrum At the end of the last chapter, we arrived at a larger question. If a GI practice strengthens access, improves recalls, protects referral relationships, activates existing assets, and builds the leadership capacity to keep its head out of the boat, what comes next? Access to what? More procedures? More office visits? More ancillary revenue? More referrals? Those matter. But if GI stops there, it misses the deeper opportunity. The next stage of gastroenterology will not be defined only by how many procedures a practice performs.…
Why Trust, Access, and Relationships Drive GI Growth By Dr. Charles Accurso and Praveen Suthrum Imagine two GI practices in the same market. Both have good physicians. Both perform high-quality procedures. Both have access to an ambulatory surgery center. Both participate in pathology and anesthesia. Both are clinically competent. From the outside, they may look similar. Ten years later, one is thriving and the other is struggling. The difference is not simply technology. It is not private equity. It is not marketing. It is not even the ASC. The difference is that one practice understood something the other did not:…
Artificial intelligence adoption is accelerating rapidly across healthcare, with a new survey finding that nearly three-quarters of physicians and 70% of nurses now use AI at least once a week at work—up sharply from 38% and 46%, respectively, just one year ago. Clinicians are increasingly using AI for tasks such as summarizing medical literature, analyzing data, and generating clinical documentation through AI scribes. Patients are also embracing the technology, with many using AI to better understand diagnoses, medications, and test results. Yet the survey reveals a growing tension: while AI is helping address workforce pressures and administrative burdens, clinicians worry…