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August 2019. What Causes Bloating and What You Can Do About It
Featuring: Allison Fairbanks, ARNP
Published by: UW Medicine | Right As Rain
One week, you’re feeling fly in your favorite pair of jeans. The next, every waistband feels like a vice around your midsection. What gives? Bloating. Typical causes include diet, hormones and a sedentary lifestyle.
August 2019. Copper Deficiency in Liver Diseases
Featuring: Lei Yu, MD; Iris Liou, MD; Scott Biggins, MD, MAS
Published by: Hepatology Communications
Copper is an indispensable trace element. It serves as a cofactor for enzymes involved in cellular energy metabolism, antioxidant defense, iron transport, and fibrogenesis. Although these processes are central in the pathogenesis of liver disorders, few studies have attributed them to copper deficiency. A recent study describes in detail a case series of liver disease patients who presented with signs of copper deficiency based on serum and liver copper measurements.
August 2019. Increased Risk for HCC Persists Up to 10 Years After HCV Eradication
Featuring: George Ioannou, MD, MS
Published by: Gastroenterology
It is unclear if hepatocellular carcinoma risk declines over time after hepatitis C virus eradication. A recent study has identified that patients with cirrhosis before and after SVR treatment for HCV continue to have a high risk for HCC for many years.
August 2019. Pancreatic Cancer Patient Realizes Her Gift of Longevity
Featuring: Michael Saunders, MD; Teresa Brentnall, MD
Published by: UW Medicine | Newsroom
Miggie Olsson is 12 years out from a diagnosis of stage 4 pancreatic cancer. This puts her in the 1-3% of those patients who have survived five years and in an even smaller fraction who have lived more than 10 years. Long survival is “not common, but it’s not an absolute rarity anymore,” said a UW Medicine specialist in the disease.
August 2019. Seattle Metroplitan Magazine's Top Doctors 2019
Published by: Seattle Metropolitan Magazine
Congratulations to UWGI faculty who made the 2019 Seattle Metropolitan Magazine list of the best health care professionals in the Seattle area: Drs. Haritha Avula, Bryan Balmadrid, Jason Dominitz, Margaret Eugenio, Jason Harper, George Ioannou, Scott Lee, Michael Saunders, Lisa Strate, and Richard Tobin.
August 2019. You Are What You Eat: The Role of the GI Microbiome in Health
Featuring: R. William DePaolo, PhD
Published by: The Original Guide to Men's Health
In this 2-part podcast, learn how the health of your gut, from intake to exit, depends on your personal medical history and diet, and, we are now learning, the diversity and character of your gut bacteria — the microbiome. Highlights: Colonoscopies get a surprisingly good rap these days, stool samples are amazingly useful, and your diet is important because it feeds and influences not only you and your gut, but also your 100 trillion bacteria friends.
July 2019. Cytomegalovirus Hepatitis After Bone Marrow Transplantation
Featuring: George McDonald, MD
Published by: Journal of Viral Hepatitis
Mortality from Cytomegalovirus disease after marrow transplantation can be reduced by treatment with anti‐viral drugs based on detection of viremia and organ involvement. A recent study examined autopsy liver specimens to determine the frequency, extent, and outcome of cytomegalovirus hepatitis and whether cytomegalovirus hepatitis occurred in the absence of cytomegalovirus disease elsewhere.
June 2019. Editorial: Managing the Measurement of Colonoscopy Quality
Featuring: Jason Dominitz, MD, MHS; Cynthia Ko, MD, MS
Published by: American Journal of Gastroenterology
The adenoma detection rate (ADR) is our current best colonoscopy quality indicator, but it is not without limitations. In a recent issue of the American Journal of Gastroenterology, novel ADR benchmarks are proposed based on historical local colonoscopyresults.
May 2019. Screening Flexible Sigmoidoscopy vs Colonoscopy For Reduction of Colorectal Cancer Mortality
Featuring: Cynthia Ko, MD, MS
Published by: International Journal of Colorectal Disease
Colonoscopy and flexible sigmoidoscopy are both recommended colorectal cancer (CRC) screening strategies, but their relative effectiveness is unclear. What is the ability of each of these two modalities to reduce CRC mortality?
May 2019. Models Estimating Risk of HCC in Patients with Alcohol or NAFLD-Related Cirrhosis for Risk Stratification
Featuring: George Ioannou, MD, MS
Published by: Journal of Hepatology
Patients with cirrhosis of the liver are at risk of getting hepatocellular carcinoma (HCC or liver cancer) and therefore it is recommended that they undergo surveillance for HCC. However, the risk of HCC varies dramatically in patients with cirrhosis, which has implications on if and how patients get surveillance, how providers counsel patients about the need for surveillance, and how healthcare systems approach and prioritize surveillance. We used readily available predictors to develop models estimating HCC risk in patients with cirrhosis.
May 2019. What IBS Is Really Like -- And How To Keep It From Ruining Your Life
Featuring: Shoba Krishnamurthy, MD
Published by: UW Medicine's Right As Rain
There are an estimated 40 million people in the United States who have IBS, many of whom are young women. There are things suffers of IBS can do to learn more about how it affects them, and simple steps that can be taken to stop if from interfering with their lives.
May 2019. Editorial: Predicting Outcomes in Lower GI Bleeding - More Work Ahead
Featuring: Rebecca Kosowicz, MD; Lisa Strate, MD, MPH
Published by: Gastrointestinal Endoscopy
Lower gastrointestinal bleeding is a common symptom presented in the emergency room. However, management approach differs according to clinical presentation and source of bleeding. Triaging patients to the appropriate level of care is not always straightforward. What tools are available to identify risk factors and achieve optimal patient outcomes?
April 2019. Editorial: Benefits of HCV Eradication Beyond The Liver
Featuring: George Ioannou, MD, MS
Published by: Alimentary Pharmacology and Therapeutics
Many extrahepatic complications of HCV have been described, which can cause substantial morbidity, reduced quality of life and high healthcare costs. In order to capture the utility of viral eradication by anti-viral treatments accurately, it is necessary to determine the beneficial effects of SVR in reducing hepatic as well as extrahepatic complications of HCV.
April 2019. A Simple Measure of HCC Burden Predicts Tumor Recurrence After Liver Transplantation
Featuring: Philip Vutien, MD, MS; Kiran Bambha, MD, MSc; George Ioannou, MD, MS; Scott Biggins, MD, MAS
Published by: Liver Transplantation
Risk of recurrent hepatocellular carcinoma (rHCC) after liver transplantation (LT) depends on the pre-LT HCC burden, tumor behavior, and response to locoregional therapy (LRT). In December 2017, LT priority for HCC was expanded to select patients outside the Milan criteria who respond to LRT. A recent study developed and applied the novel recurrent hepatocellular carcinoma–initial, maximum, last classification system to provide and easily interpret assessment of a tumor’s dynamic disease course.
February 2019. Sporadic Colorectal Cancer: Is Surveillance Wasted on the Young?
Featuring: Daniel Bushyhead, MD
Published by: Digestive Diseases and Sciences
The national incidence of colorectal cancer is increasing in people younger than 50 years old. Although diagnostic colonoscopy is detecting more sporadic adenomas in young adults, there are no guidelines for post-polypectomy surveillance. What is the prevalence of sporadic adenomas, subsequent risk of metachronous neoplasia, and what are recommendations for clinical practice?
February 2019. For Whom is HCC Surveillance After SVR Cost Effective?
Featuring: George Ioannou, MD, MS
Published by: Clinical Gastroenterology and Hepatology
Risk of hepatocellular carcinoma persists after successful antiviral treatment of HCV among patients who develop advanced fibrosis or cirrhosis. Is ongoing screening cost-effective despite the uncertainty of actual HCC risk in these patients?
February 2019. Impact of Angiotensin II Signaling Blockade on Clinical Outcomes in IBD
Featuring: Jeffrey Jacobs, MD
Published by: Digestive Diseases and Sciences
Angiotensin II (AT II), in addition to hormonal effects, has pro-inflammatory properties that may play a role in inflammation in patients with inflammatory bowel disease. Preclinical in vivo studies, as well as translational data from subjects with IBD, further support the role of angiotensin signaling in mucosal inflammation. A recent study sought to investigate clinical outcomes in IBD patients taking an angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) in order to test the hypothesis that ACEI and ARB exposure is associated with improved outcomes.
January 2019. Diverticulitis of the Colon: Latest Data and Concepts
Featuring: Lisa Strate, MD, MPH
Published by: Gastroenterology
Diverticular disease, once a rarely diagnosed medical curiosity, is now one of the most common GI disorders among inpatients and outpatients. It was readily attributed to fiber deficiency, surgery and antibiotics became the primary treatments for diverticulitis, and research in the field stagnated. In the past 2 decades, there has been a resurgent interest in diverticular disease, resulting in new data and concepts regarding epidemiology, pathophysiology and treatment.
January 2019. Region’s 1st Hepatitis C Heart-Transplant Recipient Is Cured
Featuring: Renuka Bhattacharya, MD
Published by: UW Medicine Newsroom
UW Medicine is declaring success with the Pacific Northwest’s first heart-transplant recipient to purposely acquire the hepatitis C virus (HCV) from the donor organ and then have the disease eradicated by antiviral medication. Drs. Jason Smith and Renuka Bhattacharya helped formulate UW Medicine's HCV transplant protocol.
January 2019. New AGA Guideline Provides Recommendations for the Treatment of Mild-to-Moderate Ulcerative Colitis
Featuring: Cynthia Ko, MD, MS
Published by: American Gastroenterological Association
Most patients with ulcerative colitis (UC) have mild-to-moderate disease characterized by periods of activity or remission, but practice variations exist in disease management. A new clinical guideline from the American Gastroenterological Association (AGA) published in Gastroenterology, the official journal of AGA, addresses the medical management of these patients, focusing on use of both oral and topical 5-aminosalicylates (5-ASA) medications, rectal corticosteroids and oral budesonide, to promote high-quality care for UC patients.
December 2018. Don't Take My Colonoscopy Away!
Featuring: Rachel Issaka, MD, MAS; John Inadomi, MD
Published by: UW Medicine Newsroom | JAMA
In a recent Michigan survey of 308 veterans – all over age 50 and deemed at normal risk for colorectal cancer – more than one-fourth of respondents strongly objected to losing access to the cancer screening late in life, surprising researchers.
November 2018. Colorectal Cancer Screening: Is Colonoscopy The Best Option?
Featuring: Jason Dominitz, MD, MHS
Published by: Medical Clinics of North America
Colorectal cancer is the second leading cause of cancer death in the United States, but more than a third of age-eligible Americans are not up to date on screening. There are several available screening tests, which may cause primary care providers to ponder - which is the best test?
November 2018. Why Am I Always Bloated?
Featuring: Margaret Eugenio, MD
Published by: Woman's Day
Bloating is a normal part of the digestive process. What may not be normal though, is constantly feeling like your stomach is swollen. If that is the case, there are a few possibilities that may be putting your gut in a rut.
November 2018. Recent Advances in Management of Acalculous Cholecystitis
Featuring: Bryan Balmadrid, MD
Published by: F1000 Research
Acalculous cholecystitis is an uncommon but potentially devastating infection of the gallbladder. The diagnosis can be difficult to make, but early recognition is important. What are the factors that determine the appropriate treatment modality?
November 2018. The Do’s and Don’ts of Social Media: A Guide For Gastroenterologists
Featuring: Christina Surawicz, MD
Published by: American Journal of Gastroenterology
We all know about social media, and may have a love-hate relationship, but it is here to stay. With widespread use of social media in medicine, appropriate application by gastroenterologists can have advantages. What are the benefits and risks of social media, as well as relevance to fellows in training and staff?
October 2018. Population Health Interventions to Improve Colorectal Cancer Screening by Fecal Immunochemical Tests
Featuring: Rachel Issaka, MD, MAS
Published by: Preventive Medicine
There is clear evidence that screening by colonoscopy and stool-based tests is cost-effective and saves lives. However it remains underutilized. Fecal immunochemical test (FIT) use in screening is rapidly increasing. Are there interventions that could improve adherence to FIT-based CRC screening?
October 2018. What are the Benefits of a Sustained Virologic Response to Direct-Acting Antiviral Therapy for HCV Infection?
Featuring: George Ioannou, MD, MS
Published by: Gastroenterology
The effectiveness of direct-acting antivirals (DAAs) in eradicating HCV is firmly established and is one of the greatest triumphs of medical therapeutics in the last 20 years. What remains to be determined is the extent to which DAA-induced sustained virologic response (SVR) leads to short-term and long-term clinical benefits for patients.
October 2018. The Gut Microbiome and Brain Health
Featuring: R. William DePaolo, PhD
Published by: UW Medicine Memory & Brain Wellness Center
Shifts in the composition or function of the microbiome have been implicated in IBD, autism, and blood cancers. Researchers are now discovering that a disrupted microbiome, in certain contexts, may contribute to Alzheimer’s disease and related conditions that cause dementia.

“The role of the microbiome in health and disease is an exciting area at the forefront of science, but the field is in its infancy,” says Dr. William Depaolo, a UW Medicine gastroenterologist and director of the UW Center for Microbiome Sciences & Therapeutics. “I think about the microbiome like a biologist thinks about the deep sea. We know there’s something down there, and we finally have the technology to help us see who’s actually there and how they are influencing our bodies and brains.”
September 2018. Estimating Risk of HCC Post Antiviral Treatment of HCV
Featuring: George Ioannou, MD, MS
Published by: Journal of Hepatology
Most patients with hepatitis C virus, have been treated or will be treated with direct-acting antivirals. It is important that we can model the risk of hepatocellular carcinoma in these patients, so that we develop the optimum screening strategy that avoids unnecessary screening, while adequately screening those at increased risk. Herein, we have developed and validated models that are available as web-based tools that can be used to guide screening strategies.
September 2018. Liver Complications Following Antibody-Drug Conjugate Therapy
Featuring: George McDonald, MD
Published by: Hepatology
The advent of antibody-drug conjugates (ADC), designed to deliver a toxic moiety into tumor cells, has altered the approach to many cancers, particularly hematologic malignancies. However, unexpected toxicity has been seen after ADC therapies, through several potential mechanisms. Liver toxicity, specifically injury to hepatic sinusoids, is a major concern for development of
antibody-drug conjugates.
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