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GI News

Gastro Group completes study on Colonoscopy in the Community
We have just completed a study on Colonoscopy in the Community—a review of findings of colon polyps, colon cancer, and the relationship of family history to these conditions. We found that 10% of patients who had colon cancer had a recurrence within four years of their surgery. We therefore recommend annual colonoscopy for the first five years after colon cancer is diagnosed. See office research for more information on this study.

Gastro Group completes study on Barrett's Esophagus
Barrett’s Esophagus- A 12-year study of the incidence of adenocarcinoma and dysplasia in our patient population here in Orlando. We found only a 0.5% incidence of adenocarcinoma in patients who have Barrett’s Esophagus, which is consistent with the most recent national studies. We presented this data at the American College of Gastroenterology in Baltimore on November 3, 2003. See office research for more information on this study.

Gastro Group completes study on Colon Cancer in the Community
We presented our abstract on Colon Cancer in the Community – Occurrence, Recurrence and Characteristics in a One Year Review, at the American College of Gastroenterology National Meeting on October 31, 2004, at the Gaylord Palms Convention Center in Orlando, Florida. See office research for more information on this study.

Gastro Group Studies Gastric Cancer
Gastric Cancer is said to be caused by H. Pylori bacteria in many parts of the world. A study by our group showed that only 12% of our patients with cancer had H. Pylori on biopsy of the stomach. This suggests that H. Pylori may not be a carcinogen as suspected by some. See office research for more information on this study.

Gastro Group Studies Microscopic Colitis
Microscopic Colitis is a cause for diarrhea in adults and is becoming more common over the past decade. Little is known about this, and less about what causes it. We studied our patient population and only found 28 patients, (78% women) who had this disease. 10% of these patients also had Celiac Sprue. See office research for more information on this study.

Virtual Colonoscopy
The examination of the colon via a specific type of CT Scan is known as Virtual Colonoscopy.  It has been studied for the past 8-9 years, and only recently have we received some exciting study reports that have shown it to have promise as a screening test for colon polyps.

This test requires the patient to take a full colonoscopy  preparation (laxatives), then take a CT Scan (radiation) and have air pushed into the colon through the rectum during the x-ray.  This is done without sedation and the air may cause abdominal cramping.  If polyps are suspected, the patient is referred for colonoscopy, and polyp removal. 

The current problems with Virtual Colonoscopy are that:  1) It may miss polyps smaller than 1cm, but they are rarely ever malignant);  2) It may think a polyp is present, when in fact there are none;  3) There are very few radiologists who currently have any training in this procedure; 4) It is not covered by insurance companies;  5) It takes the radiologist too long to read the study at the present time.

In the future, Virtual (or CT) Colography will likely be one option for those who pursue screening colonoscopy.  That would include all those over 50 years of age without any rectal, colonic or gastrointestinal problems.  If symptoms of bleeding, diarrhea, constipation or abdominal pain were present, colonoscopy would be the choice test.  Hopefully, the kinks will be worked out soon, and Virtual Colonoscopy will be in general use before the year 2008.

Gastro Group Studies the Terminal Ileum
”Endoscopic Appearance of the Terminal Ileum in 100 Normal Patients” accepted for poster presentation at the 70th Annual Scientific Meeting 10/05 in Honolulu, Hawaii. See office research for more information on this study.

Gastro Group Studies The Time for Colonoscopy Evaluation in Community
“Observed Colonoscopic Withdrawal Time From the Cecum to the Anus in a Community Setting,” accepted for poster presentation at the 70th Annual Scientific Meeting 10/05 in Honolulu, Hawaii. See office research for more information on this study.

"The Risk of Colorectal Cancer in Ulcerative Colitis in a Population-Based Setting"
This editorial in the journal Gastroenterology reviewed our findings of extremely low incidence of cancer, even in patients with long standing Ulcerative Colitis. This reflects our experience over the past 15 years. There is likewise a very low incidence of any type of dysplasia that has been found on surveillance biopsies. This may be due to changes in the disease process itself, or due in part to the better chronic medical treatment most patients receive. In either case this is excellent news for our patients.
See office research for a copy of the editorial.

"Prevalence of Barrett's Esophagus among Symptomatic Patients in a Community GI Practice"
This study revealed a much lower prevalence (or cases of Barrett's per year) than was previously thought. There is not much community data available in general and less in this country. We are the first community report on these figures. Fewer than 0.5% of patients had a long segment Barrett's, and 1% of patients had a short segment Barrett's Esophagus.
See office research for more information on this study.

"Does the Timing of Laxatives Make a Difference in Colonoscopy Prep Outcomes?"
This study revealed that by starting the preparation late in the afternoon, as opposed to the morning, the patients had much cleaner colons and that means a better exam. They likely spent more time drinking fluids all day. That helped hydrate the colon. Also, patients did not have to miss much work. They only had to get home by 5pm the day prior to the procedure, helping them to avoid the costs of lost wages and the costs to their companies of an absent employee.
See office research for more information on this study.

"Rapidly Rising Prevalence of Microscopic Colitis"
This study, over the past 15 years, revealed a sharp rise in the number of cases of Microcopic colitis since 2004. It is still relatively rare, but it has now significantly exceeded the number of cases of Crohn's disease and Ulcerative colitis that we see. We are the first to report this observation, and will keep a vigilant eye for further developments. This is now the most common (of the unusual) causes of diarrhea, excluding bacterial and viral diseases.
See office research for more information on this study.

Current Ongoing Studies

1. The Prevalence of Barrett’s Esophagus in the Community.  We feel that the prevalence in texts are overstated, and will try to establish the number of people we can expect to find in a community population with this condition.
 
2. A study to see if there is any association between ischemic bowel disease and irritable bowel syndrome (IBS), as has been suggested by some doctors.
 
3. A study on the value of endoscopic procedures in diagnosing the cause of microcytic anemia and normocytic anemia.
 
4. Continuing to collect data on Microscopic Colitis in a prospective fashion.
 
5. Prevalence of Celiac disease in the Orlando Community.
 
6. Endoscopic ultrasound findings in clinical community practice.
 
7. Comparative incidence rates of Microscopic Colitis vs. Ulcerative Colitis.
 
8. Annual prevalence of Barrett's Esophagus in the Orlando Community.
 
9. Small bowel endoscopic findings in the Community: Does it alter medical therapy?
 
10. The diagnostic yield of small bowel x-rays in the community setting.
 
11. The value of small bowel series in the work up of hemoccult positive stools and anemia.