Giving thanks in GI: 5 gastroenterologists on what they are most grateful for

'Tis the season for giving thanks. Five gastroenterologists share what makes them the most grateful this year.

Ask a Gastroenterologist is a weekly series of questions posed to GI physicians around the country on business and clinical issues affecting the field of gastroenterology. We invite all gastroenterologists to submit responses. Next week's question: What book (fiction of non-fiction) would you recommend all gastroenterologists read?

Please submit responses to Carrie Pallardy at by Wednesday, Dec. 3, at 5 p.m. CST.

Kenneth Brown, MD, co-founder of Atrantíl: I'm most thankful for my patients, their positive mindsets and the trust they've instilled in me time and time again to help them on the path to better health. After years of working so closely with a variety of patients, it's their optimistic attitudes and trust in me that inspires me daily to keep pushing the limits of the impact a GI doctor can have on a patient's quality of life. This ultimately led me to become involved in clinical trials, so that I was able to explore alternate and more effective gastrointestinal treatment options and bring my patients the most up to date technology and treatments.

Coupled with my passion for the profession, I spent eight of my 16 years in the medical field developing a groundbreaking new formula to help my patients who had tried and failed various treatments, and had no other alternative. We launched Atrantíl this year, in order to harnesses the power of active botanicals to treat various digestive issues. Atrantíl has not only helped more than 80 percent of patients find relief from suffering and improved their quality of life, but it's further increased the trust they patients have in me as their gastroenterologist, and for that, I’m extremely grateful!

Maxwell Chait, MD, FACP, FACG, FASGE, AGAF, ColumbiaDoctors Medical Group (Hartsdale, N.Y.): As I look back on the practice of gastroenterology over the past four decades this year, I am grateful for the astounding clinical and research advances made by my fellow gastroenterologists. There has been a reduction in colon cancer mortality, improvement in our treatments in IBD and acid peptic disorders, the cure of hepatitis C and better understanding of the gut microbiome with treatments ranging from H. pylori and peptic ulcer disease to the treatment of C. difficile colitis.

I am grateful for the many tools that have transformed the diagnostic and therapeutic capability of gastroenterologists to help patients who previously required surgical therapy. Flexible upper endoscopy and colonoscopy have become the standard for diagnosis and treatment of gastrointestinal disorders, such as GI bleeding, the placement of feeding tubes, treatment of Barrett's esophagus, treatment of achalasia by submucosal resection and the discovery and removal of benign and malignant tumors to prevent the development and spread of cancer. Capsule endoscopy has allowed for the visualization of the small bowel.

Endoscopic stents in the GI tract are able to open up passages and alleviate obstruction by tumors. Endoscopic ultrasound allow for biopsies to be taken of tumors outside the bowel, such as the pancreas and lymph nodes, previously only accessible by surgery. Endoscopic anastomoses between two sections of the GI tract are providing new natural orifice approaches in bariatric treatment and approaches to intra-abdominal surgery. There are many wonderful things to be thankful for in the GI field.

James F. Marion, MD, Professor of Medicine, Icahn School of Medicine at Mount Sinai; Director of Education and Outreach, The Susan and Leonard Feinstein Inflammatory Bowel Disease Center at The Mount Sinai Hospital (New York): I am most grateful for the clinical and research advances we've made over the years, my fellow gastroenterologists here and abroad, researchers and our patient care teams.

This year I had to recertify in GI for the third time, which I approached with predictable reluctance. However, by the time I sat for the exam, my appreciation and gratitude for this field I chose so many years ago had deepened considerably. In the decade since my last recertification, we have reduced colon cancer mortality, improved our treatments in IBD, and cured hepatitis C—for these advances and reductions in patient suffering we must be grateful.

I'm also grateful for the frequent opportunities to interact with gastroenterologists throughout the country and the world—in fact, it is my favorite part of my job. When I speak at our international GI meetings, I am always amazed by our ability to speak a common language of our work.

This Thanksgiving season we can also remember that we are part of a larger team that serves our patients—nurses, endoscopy techs, pathologists, surgeons, research coordinators, enterostomal therapists, nutritionists, among others. I'm truly grateful for this wonderful team helping us serve our patients.

Pankaj Vashi, MD, Medical Director, Gastroenterology/Nutrition and Metabolic Support, Cancer Treatment Centers of America at Midwestern Regional Medical Center (Zion, Ill.): I am thankful for the progress that is happening throughout the field of gastroenterology. With new and innovative technologies and procedures being made available to physicians, we are able to provide even greater levels of care to more and more patients. This is great news to us as physicians and for the millions of patients seeking proactive health measures and answers and relief from health challenges they are currently facing. I am thankful that we are on our way to eradicating hepatitis C with new potent and safer treatment regiments. And I am thankful for having deep understanding of the gut microbiome and the role it plays in our overall health and wellbeing.

Jerome D. Waye, MD, Director of Endoscopic Education, Professor of Medicine, Icahn School of Medicine at Mount Sinai; Director of the Center for Advanced Colonoscopy and Polypectomy, The Mount Sinai Hospital (New York): I am most grateful for the tools that have been developed that permit visualization of the lumen of the GI tract. These tools, mainly flexible endoscopy, have transformed both the diagnostic as well as therapeutic capability of physicians. It was only 60 years ago that the diagnosis of peptic ulcer was considered to be best made by listening to the symptoms described by the patient, and corroborated by a barium upper GI X-ray. That is no longer the case, and flexible upper endoscopy has become the standard for diagnosis, especially since Helicobacter pylori has been shown to be a culprit in the etiology of peptic ulcer disease and, if found by biopsy at the time of endoscopy,  needs to be treated by antibiotics.

In addition, flexible colonoscopy has repeatedly been shown to save lives by detecting colon cancer precursors, the adenoma, and by finding colon cancer at a curable stage. Screening by colonoscopy has become an accepted investigation in the United States, endorsed by the US government, and permits not only the discovery of polyps, both symptomatic and asymptomatic, but also the removal of these benign tumors to prevent the development of colon cancer, the third most common cancerous cause of death in America.

These endoscopic tools also are able to reduce suffering from tumors that are inoperable, and placing stents in the hepatobiliary tract to open cancerous clogged passages markedly alleviates the pain and distress associated with these tumors. Using endoscopic ultrasound, biopsies can be taken of tumors outside the intestinal lumen such as the pancreas or lymph nodes which were previously only accessible by surgery. New modalities of treatment are developed almost daily, and we can now use flexible endoscopes to make anastomoses between 2 sections of the gut; bariatric endoscopic techniques are being used and tested across the world; feeding tubes are now mainly placed by endoscopy and special approaches have been recently introduced to place instruments in the submucosal space to cut muscles in achalasia.

Flexible instrumentation has given gastroenterologists the ability to help in the diagnosis and treatment of patients who previously needed surgical intervention or died while suffering.  
We are most grateful for these advances in our specialty.

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