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Looking Back at 2018’s Top 10, Peer Tested by You
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As we enter the fifth year of Healio Gastroenterology and Liver Disease, it is worth looking back at what made us stand out in 2018: the Peer Tested content from online and print as it fared throughout the year.
As a reminder, the publication is primarily built by the numbers. We utilize analytics to bring to you in the print pages what our peers are reading online. In this Top 10, it is encouraging to see that not only are physicians reading our online-first content, but some of our print-first articles resonated as well.
It is easy to see that our interests as physicians reflect those of the general public with cannabis and diet ranking as our most frequently read items, but our interests in keeping on top of the latest approvals and data reflects throughout the list as well.
I would like to thank you for recognizing the quality content – some of which were read more than 14,000 times by physicians – produced by the team and ask that you share Healio with your peers, fellows, mentors and friends. I look forward to 2019 and the news Healio will bring to me and my peers. Happy New Year!
Edward V. Loftus Jr., MD
Chief Medical Editor
Healio Gastroenterology and Liver Disease
1. Cannabinoid hyperemesis syndrome: What GIs should know
Cannabinoid hyperemesis syndrome is a condition experienced by chronic marijuana users who develop symptoms like nausea, vomiting and abdominal pain, which are characteristically relieved by hot showers.
In a study published in Basic & Clinical Pharmacology & Toxicology, Joseph Habboushe, MD, MBA, assistant professor of emergency medicine at New York University School of Medicine/Bellevue and cofounder of the medical reference MDCalc, wrote that the syndrome might be much more prevalent than previously thought.
In this interview with Habboushe, Healio broke down what gastroenterologists need to know.
“This is a common entity, so you should have it front of mind: when you see a cyclic vomiting patient, ask about marijuana and hot showers. The diagnosis is clinical. Do not over-test these patients. You do not need imaging. You do not need to scope these patients,” he said. READ MORE.
2. Diet, lifestyle outweigh genetic impact on gut microbiome
Genetics play a surprisingly minor role in shaping the gut microbiome, while environmental factors like diet and lifestyle appear to have the greatest impact, according to new research published in Nature.
These findings provide strong new evidence supporting the concept of modifying the gut microbiota to improve human health, investigators from the Weizmann Institute of Science in Israel concluded.
In this instance, Healio gathered two perspectives that placed context around these interesting findings:
William D. Chey, MD, said, “Their findings have potentially important implications regarding how the microbiome might influence the pathogenesis of a wide range of diseases.”
David L. Suskind, MD, said, “As our understanding of the associations between the microbiome and these diseases improve, so does our understanding of the potential interventions that may be effective for changing the microbiome for the better.” READ MORE.
3. Probiotics linked to brain fog, severe abdominal bloating
Using probiotics can lead to bacterial growth in the small intestine, causing brain fog and rapid abdominal bloating, according to research published in Clinical and Translational Gastroenterology.
“What we now know is that probiotic bacteria have the unique capacity to break down sugar and produce D-lactic acid,” Satish S.C. Rao, MD, PhD, FRCP, of the division of gastroenterology and hepatology of the Medical College of Georgia at Augusta University, said in a press release. “So, if you inadvertently colonize your small bowel with probiotic bacteria, then you have set the stage for potentially developing lactic acidosis and brain fogginess.” READ MORE.
4. Why a GI Dietitian Adds Value to a GI Practice
In this expert-written piece from one of our first Healio Hot Topic sections, Kate Scarlata, RDN, explained why dietitians like herself add great value to a gastroenterology practice.
“A collaborative care process in treating patients with GI disorders, allows the dietitian to fulfill gaps in the patient’s medical history that may or may not have been divulged or missed in the GI visit. Together, providers can piece together the patient’s full clinical picture to provide a better assessment and multi-faceted approach to care. In my clinical experience, this collaborative care process leads to improved patient satisfaction and outcomes,” she wrote. READ MORE.
5. Vitamin D supplements may ease IBS symptoms
Vitamin D could be effective in treating the painful symptoms associated with irritable bowel syndrome, according to a study published in The European Journal of Clinical Nutrition.
“It is evident from the findings that all people with IBS should have their vitamin D levels tested.” Bernard M. Corfe, MD, of the molecular gastroenterology research group and the academic unit of surgical oncology, in the department of oncology and metabolism at the University of Sheffield in the U.K., said in a press release. “A large majority of them would benefit from supplements.” READ MORE.
6. FDA accepts new drug application for prucalopride for chronic idiopathic constipation
Shire announced that the FDA has accepted a new drug application for prucalopride for the treatment of adults with chronic idiopathic constipation, according to a press release.
Though this article trended into the #6 spot on our countdown, it is likely due to the announcement coming in March 2018. The follow-up coverage looking at the FDA’s unanimous vote for approval in October and subsequent announcement of the approval on December 17 should be noted in this roundup.
“As a gastroenterologist, it’s important for me to help patients with CIC find a treatment that works well for them,” Brooks Cash, MD, chief of the Division of Gastroenterology, Hepatology, and Nutrition at the University of Texas Health Science Center at Houston, said in the release. “It’s exciting to be able to now offer my patients a new treatment option that addresses colonic peristalsis.” READ MORE.
(See page 18 for our Cover Story on constipation in the opioid era to hear more from Cash.)
7. Oral JAK inhibitor Xeljanz shows promise in Crohn’s disease
In this study presented during the Crohn’s & Colitis Congress in 2018, Xeljanz (tofacitinib, Pfizer) induced remission in subgroups of patients with moderate-to-severe Crohn’s disease who showed objective evidence of disease activity at baseline, according to a post hoc analysis of a phase 2 trial.
“Greater proportions of tofacitinib patients were in clinical remission as compared to placebo when efficacy outcomes were analyzed using some more objective baseline criteria for active disease than CDAI,” Bruce E. Sands, MD, concluded. “Greater proportions of patients achieved composite remission, composite response, and PRO2-75 remission ... compared with placebo, but there has to be caution of course that these are all post hoc analyses. Nevertheless, I think they support further investigation of JAK inhibition in Crohn’s disease.” READ MORE.
Follow us on Twitter @HealioGastro for our onsite coverage of the Crohn’s & Colitis Congress in February.
8. FDA approves low-volume colonoscopy prep Plenvu
The FDA has approved Plenvu as a pre-colonoscopy cleansing preparation, according to a press release from Salix Pharmaceuticals.
Plenvu (NER1006) is a low-volume glycol-based bowel preparation developed for whole-bowel cleansing, with a focus on the ascending colon. It will have the lowest total volume of any bowel preparation currently available in the United States, according to the press release.
“With the FDA approval of Plenvu, physicians can now offer their patients a new preparation option for colonoscopies that features a lower-volume, one-liter [polyethylene glycol based] bowel preparation,” Mark McKenna, senior vice president and general manager of Salix Pharmaceuticals said in the press release. “Studies have shown that high-volume bowel preparations can often be a deterrent to patients fully completing their preparation regimen.” READ MORE.
9. Herbal, dietary supplement-induced liver injury more common in young women
Analysis of the Spanish Drug-Induced Liver Injury registry showed that cases of herbal and dietary supplement-induced liver injury were more common in young women than older patients or men and correlated with hepatocellular injury and high levels of transaminases.
“Herbal and dietary supplement-induced liver injury (HILI) is an increasing health care problem,” Maribel Lucena, MD, from the University of Málaga, Spain, told Healio Gastroenterology and Liver Disease. “This study provides relevant information about clinical features associated with HILI, and highlights the importance of identifying all medicinal products, prescription drugs as well as herbal and dietary supplement products, taken by patients who develop liver abnormalities.” READ MORE.
10. Fecal transplant shows promise in IBD, other chronic conditions
In a presentation during the Interdisciplinary Autoimmune Summit, Jessica R. Allegretti, MD, MPH, discussed the promising field of fecal microbiota transplant (FMT) in the realm of IBD and other autoimmune conditions. In this interview with Healio, Allegretti compared the human microbiome to the rainforest, broke down the five Ds of FMT and gave a glimpse into the future.
“I don’t think this will be a universal magic bullet for all that ails you, but I do think we can learn a lot from FMT about what the microbiome is doing and what role it is contributing to the pathogenesis of a lot of these disease with the hopes that we can engineer better, more targeted therapies based on what we’ve learned, and I assume in a few years from now we probably won’t be doing FMT in its current state anymore. We’ll have better, more directed therapies for each individual disease,” she said. READ MORE.