Edward V. Loftus Jr., MD

Currently, gastroenterologists and other physicians have quite a few options to treat overweight and obesity, but at times that is overwhelming.

Almost all gastroenterologists, no matter their expertise, have become quasi-experts in treating patients with Clostridioides difficile infection (CDI) because it is such a common malady, especially in individuals with inflammatory bowel disease (IBD).

During this year’s American College of Gastroenterology Annual Meeting, I had the honor of hosting the inaugural Healio Disruptive Innovators Awards. This first-of-its-kind ceremony honored Disruptive Innovators in seven different categories, with each awardee changing the face of gastroenterology and pushing the status quo toward the betterment of the field.

As patients within gastroenterology become savvier in management of their diseases – notably with inflammatory bowel disease and irritable bowel syndrome – it is likely physicians will more and more frequently field questions about the role of the microbiome in disease and symptom management.

This month’s Healio Hot Topic focuses on irritable bowel syndrome and the grey areas we encounter as physicians when we evaluate and manage this most commonly diagnosed gastrointestinal condition.

Although we have seen the issues of appeals and insurance coverage in areas like hepatitis C where overly expensive drugs needed for 12 weeks are denied on the basis of cost or prerequisites, inflammatory bowel disease presents an additional layer of administrative hardships in that by the time a patient needs a biologic, chances are they are going to need it for an extended period of time, sometimes indefinitely. Yet, the arduous process continues to be a barrier to care in IBD.

Colorectal cancer screening is a huge topic for gastroenterologists. It’s at the core of what we do; colonoscopies and colon cancer screenings are a pivotal aspect of our practice so it is incumbent upon members of our specialty to be up to speed on our options.

In looking at this month’s cover story, one of the big takeaways for me is that much of the data on which current proton pump inhibitor risks are based comes from “outcomes research studies” using very large administrative databases, usually insurance company databases. In using large databases, you’re not often getting the full story.

Though I see some interesting mirrors between pediatric and adult gastroenterology in the management of constipation, this month’s cover story brings to light the added hurdles our pediatric gastroenterologists must conquer when treating their patients.

Common medical perception of drug-induced liver injury, or DILI, associates it with stigmatized drugs and well-known injurious medications such as acetaminophen, but today, the picture can look quite different.