Clinical and translational research are transforming the practice of gastroenterology and hepatology faster than ever. The pace of change is so fast that clinicians, even recent graduates, can fall behind. AGA’s Spring Postgraduate Course provides a rapid way to catch up on the latest treatment advances.
This year’s course, titled Evidence that Will Change Your Practice: New Advances for Common Clinical Problems, includes a full day of sessions on Saturday, May 16, and a half day of sessions on Sunday, May 17, at DDW® 2015 in Washington, DC. Advance registration is required for the course, which will feature more than a dozen presenters discussing the most recent evidence in several areas of gastroenterology and hepatology.
“There have been a number of advances that affect large numbers of our patients in recent years that have been confusing, contradictory and changing so quickly that it becomes challenging to absorb all of the new treatment alternatives,” said Course Director Douglas A. Corley, MD, PhD, MPH, a gastroenterologist and research scientist III at Kaiser Permanente San Francisco Medical Center, CA. “In this course, we are aiming to provide concise summaries to guide therapy by having experts sort through recently published data as well as late-breaking studies which are still in abstract or pre-publication form.”
Few treatment areas have changed in recent years more than hepatitis C. Newly developed, targeted treatments have transformed hepatitis C from an a difficult-to-treat condition to a disease that can be cured in more than 90 percent of patients. Treatment options are rapidly expanding, both for patients who have failed prior treatments and for treatment-naïve populations. However, the most appropriate treatments for different patient populations and genotypes are both unclear and rapidly evolving. The course will provide the latest data regarding which patients are most appropriate for which agents and at what stage in their disease.
Food sensitivities are another area of burgeoning research. Gluten sensitivity, celiac disease and the more recently described FODMAPS (fermentable oligo-di-monosaccharides and polyols) all play important roles in gastrointestinal disease.
FODMAPS are insoluble carbohydrates that typically pass into the lower intestine where they are broken down by fermentation reactions. Most patients benefit from the fermentation of FODMAPS, which supply nutrients and support beneficial gut microflora. But a minority of patients develop symptoms that have previously been attributed to functional bowel disorders related to motility or sensation problems. Recent findings suggest that different individuals have different sensitivities to different FODMAPS, and that eliminating specific FODMAPS may have beneficial effects on their symptoms.
“New findings completely change how we treat these disorders,” Dr. Corley said. “But the real questions are what treatments are evidence based, what data support them, how can patients be identified and in what order treatments are indicated. The roles of gluten and non-gluten food components in patients’ symptoms have been hotly discussed in both the media and in the medical literature.”
A third area that will be reviewed during the Spring Postgraduate Course is the management of pancreatic cysts, which are often found on abdominal CT scans obtained for other reasons. New AGA guidelines on the management of pancreatic cysts will substantially change management recommendations. Expert presenters will examine the evidence behind the competing guidelines and offer their own recommendations for clinical practice.
Fecal microbiota transplant (FMT) is another area in transition. In a few tumultuous years, FMT has moved from a fringe concept to a clinical reality. There have been dramatic changes in the regulation of FMT by the Food and Drug Administration, as well as changes in transplantation techniques, resources and materials available for transplantation, indications, patient selection and donor selection.
Historically, FMT donors have been screened locally, Dr. Corley said. But the development of national groups of prescreened donors — a network akin to blood banks — is bringing new degrees of standardization to the clinical practice of FMT.
“There have been a number of areas in gastroenterology and in hepatology that have been so rapidly changing that guidelines and the literature have not been able to keep up with clinical practice,” Dr. Corley said. “This course allows participants to hear from experts who are deeply immersed and intimately familiar with the recently published studies, as well as those about to come out. This is your opportunity to acquire clear, evidence-based recommendations regarding how to best manage patients during these complicated, rapidly changing times.”