Healio Gastroenterology rehash: Trending topics (so far); what do you want to read about?
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From the impact of Humira biosimilars flooding the U.S. market to shifting trends in colorectal cancer demographics, Healio has asked experts the big questions to stay abreast of the current hot topics in gastroenterology and hepatology.
So far this year, Healio has spoken with four registered dietitians who shared their insights on the importance of including nutrition interventions in gastrointestinal disease management, the expansion of artificial intelligence in inflammatory bowel disease, the impact of gaslighting in GI and an update on the hepatitis C virus elimination efforts.
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In case you missed any of these, Healio has compiled a list of our biggest stories from Healio Gastroenterology in 2023.
‘Keep the guardrails on’: As AI use expands in IBD care, physicians should remain cautious
Artificial intelligence has been used extensively in gastroenterology for polyp detection and is expanding into the inflammatory bowel disease space in an experimental and “research phase,” quickly making its way into clinical use.
“AI encompasses several different technologies that can engage text, images and other data with initial use cases aiming to reproduce expert opinion with the benefits of automation including standardization, reproducibility and speed,” Ryan W. Stidham, MD, MS, AGAF, associate professor of gastroenterology and internal medicine at Michigan Medicine, told Healio Gastroenterology. “As capabilities expand, artificial intelligence applications will move past recapitulating expert judgement and begin enhancing the clinician’s ability to assess patients and predict future outcomes.” Read more.
Evidence-based dietary strategies critical component of IBD care
When it comes to dietary management of inflammatory bowel disease, it is important to make the distinction between diet and nutrition. The results were also presented during the EASL Congress.
Essentially, diet is the food we eat, but nutrition is how our bodies use that food to support health. Diet and nutrition are an integral part of care for patients with IBD and can really make a difference in how people feel and respond to their medications. Read more.
Shifting trends in CRC demographics, severity prove you are ‘not too young to have cancer’
Despite a decline in the overall incidence of colorectal cancer in the U.S., recent population-based data from the American Cancer Society show an alarming shift to younger age and more advanced disease at diagnosis.
“Although there is still progress in reducing incidence and mortality overall, if you pull up the hood, it becomes apparent that there are very concerning patterns in terms of the rapid shift to a younger patient population,” Rebecca Siegel, MPH, epidemiologist and senior scientific director of surveillance research at the American Cancer Society, told Healio Gastroenterology. “Those younger patients have unique needs compared to patients in their 70s, which was the more typical patient 20 to 30 years ago. Not only are we seeing younger patients, but also more advanced disease.” Read more.
Personalized dietary plans increase compliance, improve outcomes in GERD
The impact of dietary factors on GERD symptoms can vary among individuals. While there are general dietary recommendations that can be beneficial for many people with GERD, each person may have unique trigger foods and tolerances.
Some foods commonly associated with triggering GERD symptoms include fatty or fried foods, spicy foods, citrus fruits, tomatoes, onions, garlic, chocolate, caffeine, mint and alcohol. Individuals may have varying sensitivities to these foods.
Though variation exists in the literature regarding dietary intervention for GERD, several common themes have emerged that can provide guidance in patient care. Read more.
HCV elimination represents ‘win-win-win’ for patients, public health, cost savings
Every year nearly 3 million patients are diagnosed with hepatitis B and C infections, ultimately leading to 1.1 million deaths worldwide, WHO reported.
In response to this immense public health burden, WHO and other international organizations have developed goals and plans for elimination. Although implemented by most countries with many on track to reach their goals, analyses have revealed a persistent reservoir of chronic hepatitis viruses and new infections remain a threat, Sheikh Mohammad Fazle Akbar, MD, PhD, and colleagues wrote in Infectious Diseases & Immunity. In the U.S., only 6% of states are on track to achieve HCV elimination by 2030, according to a 2020 report by Mark Sulkowski, MD, and colleagues. Researchers further reported 35% of states are not expected to meet their margins by 2040. Read more.
GI dietitians critical to celiac disease, gluten-sensitivity management
At some clinics in Sweden, the dietitian — not the doctor — is the focal point of care for celiac disease.
During a conversation I had at the International Celiac Disease Symposium, doctors expressed support for this system, given that the dietitian is the one best-versed in the patients’ treatment of celiac disease and other gluten-related disorders. Read more.
Power dynamics in patient-provider relationship offer ‘fertile arena for gaslighting’
The word “gaslighting” has taken on a life of its own in recent years, being used in the context of interpersonal relationships, political discourse and online chatter.
But really, it is just another name for something that many patients with gastrointestinal disease have been experiencing for decades.
“Gaslighting refers to a form of cognitive manipulation within an interpersonal relationship in which a more powerful person sows seeds of doubt in a less powerful individual, making them question their own perception, judgment, feelings and/or sanity,” Priya Fielding-Singh, PhD, assistant professor in the department of family and consumer studies at the University of Utah, told Healio Gastroenterology. “This can occur in different types of relationships and in different settings, including medical settings.” Read more.
Low-FODMAP diet for IBS ‘not intuitive,’ must be taught by a GI dietitian
Irritable bowel syndrome is a dysfunction in the communication pathway between the gut and the brain, which contributes to symptoms such as gas, bloating, abdominal pain, diarrhea, constipation and mixed bowel habits.
It is a functional disorder, which means there is no change to the structure of the digestive tract — no ulcers, strictures or blockages — but instead, a change in how the gut functions. Read more.
Humira exclusivity expires in 2023: Will biosimilar boom benefit patients or industry?
In 2021, Humira — the blockbuster biologic that has for years been the highest grossing drug in the world — accomplished something that no drug had previously achieved when its global revenues topped $20 billion.
More precisely, Humira (adalimumab) earned $20.7 billion in revenue in 2021 — including $17.3 billion just from U.S. sales — for its manufacturer AbbVie after coming just a few hundred million short of the $20 billion benchmark for three years in a row. However, while this news was no-doubt greeted warmly by the company, AbbVie’s fourth-quarter 2021 financial report included another figure that may have somewhat dampened any board-room festivities. Read more.