News and insights in gastroenterology presented at the ACG's 75th Annual Meeting

Many of the world's preeminent gastroenterologists will gather for the American College of Gastroenterology's (ACG) 75th Annual Scientific Meeting at the Henry B. Gonzalez Convention Center in San Antonio, Texas starting Monday October 18, 2010, to review the latest scientific advances in gastrointestinal research, treatment of digestive diseases and clinical practice management. Innovative technologies for the diagnosis and treatment of digestive diseases; insights into digestive health conditions, their causes and how they impact various sectors of the population; and prevention and treatment strategies that address serious GI‐related health issues, like C. difficile, colorectal cancer, obesity, inflammatory bowel disease (IBD) and fructose intolerance in children, are among the highlights of this year's scientific presentations.

Highlights from this year's ACG Scientific Meeting include:

Statin Use Associated with Statistically Significant Reduction in Colorectal Cancer

A comprehensive meta‐analysis by investigators at the University of Michigan at Ann Arbor, which included 22 scientific studies with more than 2.5 million combined participants, found that statins, cholesterol‐lowering drugs used to prevent cardiac problems, are associated with reduced risk of colon and rectal cancers. Importantly, when the analysis was stratified for statin type, the most common category of statins, lipophilic (which includes atorvastatin or Lipitor), showed the greatest effect.

Attack on C. difficile: How We Can Combat This Serious Health Issue

In five different studies, researchers explored the impact of various factors on increasing rates of Clostridium difficile infection (C. difficile), such as the substantial increase in antibiotic use due to new National Hospital Quality Measures; strategies to combat high rates of C. difficile infections; as well as cutting‐edge treatments for this potentially deadly—and quite common—infection.

Fructose Intolerance Common in Children with Chronic Abdominal Pain

Fructose intolerance, or fructose malabsorption, is common in children with recurrent or functional abdominal pain, but the condition can be effectively managed with a low‐fructose diet, according to the results of a new study. Over half of patients who are fructose intolerant are able to maintain a low‐fructose diet and are able to notice an immediate improvement in their symptoms.

Gastric function, as well the activities of the autonomic nervous system that regulates digestion, are impaired in obese individuals in both fasting and fed states, which could lead to over‐eating, according to a study from the University of Texas Medical Branch in Galveston. In a separate study of 35 patients undergoing Roux‐en‐Y gastric bypass surgery at Inova Health System, the rate of weight loss was correlated with only one circulating hormone, obestatin, a peptide produced in the gut which may have a role in appetite suppression.

Vitamin D Deficiency Puts IBD Patients at Greater Risk of Osteoporosis The study found that IBD patients with an abnormal bone density exam had a significantly higher rate of Vitamin D deficiency than those who had normal DEXA scans. Additionally, Crohn's disease patients with Vitamin D deficiency were four times more likely to have a higher rate of abnormal bone density exams compared to patients with ulcerative colitis

Acid Reflux, Functional Dyspepsia Have Significant Impact on Disordered Sleep

The impact of upper GI conditions, like gastroesophageal reflux disease (GERD) and functional dyspepsia, on sleep—and treatments aimed at providing relief to heartburn/acid reflux patients who suffer from disordered sleep—were explored in three new studies. Among the findings, patients with functional dyspepsia were 3.25 times more likely to have disordered sleep compared to healthy controls; the muscle‐relaxant and antispastic drug baclofen significantly improved several measures of sleep in patients with documented GERD and sleep disturbances; and esomeprazole was shown to reverse driving impairment in GERD‐induced sleep disorders.

Notable Racial Disparities in Diagnosis, Treatment and Outcomes of Colorectal Cancer

One study found comparable rates of colorectal cancer between young African American and Hispanic patients and called for a large prospective study to confirm these results before recommending earlier screening in the Hispanic population, as currently advocated for African Americans. Another study suggested that age at colorectal cancer diagnosis, location of tumor within the colon, and survival from colorectal cancer varies significantly among race.

Promising New Avenues for Treating Liver Disease in Overweight Americans

A progressive form of non‐alcoholic fatty liver disease (NAFLD) known as non‐alcoholic steatohepatitis (NASH) can lead to cirrhosis and all its complications. Two studies investigated the effectiveness of potential treatments for NASH, one assessing pentoxifyline, a commonly used TNFα antagonist, as well as a separate analysis of pioglitazone, an insulin sensitizer, compared to vitamin E.

Investment in Colorectal Cancer Screening Programs Targeting Pre‐Medicare Population Could Reduce Treatment Costs in the Medicare Population

Investment in screening programs that target the pre‐Medicare population, individuals aged between 50 and 64, could reduce the costs of colorectal cancer in the Medicare program, according to a study. According to the findings, the up‐front investment in screening individuals aged 50 to 64 was recouped only after they transition to Medicare at age 65.

Obesity's Impact on GI Health

Researchers found that patients with non‐cirrhotic liver cancer had a high prevalence of diabetes and elevated body mass indexes (BMI) despite a lack of steatosis. In other findings, BMI was also linked with adenoma recurrence in the short‐and long‐term; the prevalence of angiographically‐proven coronary disease in the non‐alcoholic fatty liver disease (NAFLD) cohort was 61 percent compared to 26 percent in the non‐NAFLD controls; and that inflammatory bowel disease is likely an independent risk factor for coronary artery disease.

Colonoscopy Technique Increases Polyp Detection in Far Reaches of Right Colon

An endoscopic technique known as retroflexion, when used in the right side of the colon, may increase the diagnostic yield of polyps, including large adenomas (larger than 10 millimeters) and serrated lesions, particularly in men, older patients and those with polyps found on forward examination according to researchers at Indiana University Medical Center in Indianapolis. Importantly, 41 percent of the patients who had polyps identified on retroflexion had negative exams on forward examination.

Diagnostic Techniques Help IBD Patients Avoid Ionizing Radiation Exposure

Several studies of the effectiveness of non‐X‐ray techniques to evaluate Crohn's disease revealed that diagnostic strategies such as capsule endoscopy (CE) and magnetic resonance enteroscopy (MRE) are useful in managing patients with inflammatory bowel disease (IBD) and avoiding ionizing radiation.

Unusual Polyps Advance to CRC Slower than Other Adenomas

Precancerous growths in the colon know as sessile serrated adenomas (SSA) are found in approximately 1 percent of colonoscopy exams. A sessile serrated adenoma is a pre‐malignant flat lesion in the colon thought to lead to colorectal cancer through the serrated pathway. Researchers observed that these polyps appear to advance at a slower rate than conventional adenomas.

Lunchtime media briefings are being planned on the following topics:

Monday, October 18, 2010, 1:15 pm CDT

Attack on C. difficile: A GI Perspective – How Can We Combat This Serious Health Issue

Panelists
Lawrence J. Brandt, M.D., MACG, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
Mark H. Mellow, M.D., FACG, Center for Digestive Health, Oklahoma City, OK
C. Brock Miller, M.D., University of North Carolina at Chapel Hill

Media may access the C. difficile Press Briefing remotely on Monday:

Teleconference Access Dial‐In U.S. Only
Toll‐Free 866‐434‐5269
Participant Code 9149365

Tuesday, October 19, 2009, 12:45 pm CDT

Obesity – GI Risks and Clinical Implications: Researchers Explore Obesity's Impact on GI Health and the Efficacy of treatments for Overweight and Obese GI Patients

Panelists
Amy E. Foxx‐Orenstein, D.O., FACG, Mayo Clinic, Scottsdale, Ariz.
David A. Johnson, M.D., FACG, Eastern Virginia Medical School, Norfolk, Va.

Media may access the Obesity Press Briefing remotely on Tuesday:

Teleconference Access Dial‐In U.S. Only
Toll‐Free 866‐434‐5269
Participant Code 9149365

Source: American College of Gastroenterology