Afleveringen

  • The Development of GI Psychology with Megan Riehl, PsyD

    The Development of GI Psychology with Megan Riehl, PsyD

    · Gut Talk

    In this podcast episode, Megan Riehl, PsyD, discusses symptoms and solutions in GI psychology, building educational tools for patients and physicians on GI psychology and more.

    • Intro :02
    • Welcome to this episode of Gut Talk :23
    • The interview/about Riehl :33
    • Riehl on early influences on her career. :48
    • Growing up, how did your family system influence you? 2:12
    • How did you get into psychology, and who were the people that influenced you to go into this field? 3:45
    • How did you become interested in GI psychology? 5:27
    • Chey and Riehl on risk-taking behavior and building the GI psychology program at Michigan. 7:29
    • Were there other fields you were considering as a subspecialty in psychology? 10:23
    • Is there something physiologic about gastroenterology that makes the path to psychology more appropriate than other specialties in the health care system? 13:33
    • Can you explain the difference between a GI psychologist and a general psychologist, and what types of patients will benefit most from GI psychology? 16:12
    • Do you get inappropriate referrals from clinicians, such as patients with compliance and adherence issues or lack of belief in the validity of their diagnosis? 19:33
    • Do you think the term ‘GI psychologist’ is limiting, and have you thought of different words or terminology we can use to refer to this type of work? 22:20
    • Berry, Chey and Riehl on potential benefits, risks and the impact of digital therapeutics on behavioral health. 24:37
    • Berry and Riehl on the issues facing patients’ ability to access GI psychology, and how digital therapeutics can potentially address these issues. 28:04
    • What are the main types of interventions in GI psychology, and what do they do? 31:48
    • Riehl on her upcoming book, Mind Your Gut: The Whole-body, Science-based Guide to Living with IBS, co-written with Kate Scarlata, RDN. 36:09
    • Thank you, Megan 38:40
    • Thanks for listening 38:55

    Megan Riehl, PsyD, is a GI psychologist with expertise in psycho-gastroenterology and the management of GI conditions. She is the clinical director of the GI behavioral health program at the University of Michigan, where she has a full-time clinical practice, leads GI behavioral health trainings and provides peer consultation.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on X, formerly known as Twitter, @HealioGastro @sameerkberry @umfoodoc. For more from Megan, follow @DrRiehl on X, formerly known as Twitter.

    Disclosures: Berry and Chey report no relevant financial disclosures. Riehl reports she is a co-parent owner of GI OnDemand with Gastro Girl, Inc.

  • Creating the Field of GI Nutrition with Kate Scarlata, RDN

    Creating the Field of GI Nutrition with Kate Scarlata, RDN

    · Gut Talk

    In this podcast episode, Kate Scarlata, MPH, RDN, discusses how to help patients avoid over restricting their diets, the use of digital therapeutic tools in dietetics and more.

    • Intro :02
    • Welcome to this episode of Gut Talk :23
    • The interview/about Scarlata :31
    • Scarlata on her family and growing up in a family of nine children. 1:02
    • Who was more influential in shaping you? Was it your family, or people outside the family unit? 3:40
    • What got you interested in diet and nutrition? 6:27
    • Are there any defining moments personally or professionally that affected the direction of your career? 8:02
    • Can you tell us about your first job as a GI dietician and how it led to your role in the field today? 12:17
    • Berry and Scarlata on GI patient motivations and how they differ from the average patient. 16:51
    • Are there things that you think are unique from a dietetics perspective to build that rapport with the patient and walk them back from deeply rooted thoughts they may have about their diet? 17:49
    • Have you encountered situations with patients where you felt like you could not move forward without the assistance of other specialists such as a trained GI psychologist? 19:47
    • Chey and Scarlata on disordered eating and eating disorders and red flags to help identify and assist these patients. 22:25
    • Are you utilizing the FODMAP Gentle or bottom-up approach? 27:27
    • Berry, Chey and Scarlata on the emergence of digital automated tools developed to help patients get access to therapies without the use of a trained clinician. 29:11
    • Can you talk about the patient advocacy efforts you have been involved with, including the IBelieveinyourStory campaign and the EndHungerPain initiative? 34:43
    • Chey, Berry and Scarlata on the economic challenges facing multidisciplinary GI care and getting patients access to dietary needs including resources like Equip Health. 41:29
    • Scarlata on her upcoming book, Mind Your Gut: The Whole-body, Science-based Guide to Living with IBS, co-written with Megan Reihl, PsyD. 43:52
    • Thank you, Kate 45:06
    • Thanks for listening 45:17

    Kate Scarlata, MPH, RDN is a US-based dietitian with over 30 years of experience. Kate’s expertise is in gastrointestinal disorders and food intolerance. Kate is the author of numerous books and articles on digestive health topics including the New York Times Best Seller, The 21 Day Tummy Diet.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on X, formerly known as Twitter, @HealioGastro @sameerkberry @umfoodoc. For more from Kate Scarlata, follow @KateScarlata_RD on X, formerly known as Twitter.

    Disclosures: Berry and Chey report no relevant financial disclosures. Scarlata reports stock options with Epicured LLC and FODY Food Company, financial support from Dr. Schar, Mahana Therapeutics, Nestle Health Science, Olipop, Pendulum, QOL Medical.

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  • Private Practice Dietetics in GI with Tamara Duker Freuman, MS, RD

    Private Practice Dietetics in GI with Tamara Duker Freuman, MS, RD

    · Gut Talk

    In this podcast episode, Tamara Duker Freuman, MS, RD, CDN, discusses how the work of gastroenterologists and dieticians can inform each other, approaching GI conditions as new science emerges and more.

    • Intro :02
    • Welcome to this episode of Gut Talk :23
    • The interview/about Duker Freuman :30
    • How did your childhood environment and early education lead you to become a dietician? :41
    • Can you tell us about how your experiences have had an impact on the way you treat your patients as a dietician? 1:47
    • How Duker Freuman’s books, Bloated Belly Whisperer and Regular, provide information about clues that can help providers better understand the causes of patients’ symptoms. 3:22
    • Are dieticians trained differently than doctors when it comes to motivational interviewing versus fact-seeking to learn about patient history? 4:30
    • About the JAMA Network studies on Variations in Processes of Care and Outcomes for Hospitalized General Medicine Patients Treated by Female vs Male Physicians and Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians 7:12
    • What eventually drew you to dietetics, and then GI dietetics? 7:43
    • When you went into GI nutrition, was it already a recognized specialty? 10:52
    • Were you an early adopter of the low-FODMAP diet? 13:27
    • How did the GI community react to the news of low-FODMAP at the time? Was this science well-embraced by physicians when it came out? 14:50
    • With low-FODMAP, are you a top down or a bottom up person? Do you have a preference? 19:03
    • In your book you discuss the ten main causes for bloating. What are the main causes we should be thinking about, and which are the most common in your experience? 20:22
    • You talk about the “food baby twins”, gastroparesis and abdomino-phrenic dyssynergia, in your book. Can you tell us about that? 22:51
    • Do you have any recommendations for abdomino-phrenic dyssynergia, like diaphragmatic breathing, and what has worked that you have recommended to patients? 24:02
    • With the challenges of insurance reimbursement for dietetics and getting patients access to this type of information, can you provide enough value with one visit with a patient, or is multiple visits with a dietician required in order to move the needle? 25:19
    • What do you think about histamine intolerance? How do you identify it and is there a low-histamine diet that people can use now? … What about Mediterranean? 28:27
    • How have you trained yourself and the dieticians that you work with to think about and incorporate cultural and lifestyle sensitivity into dietary recommendations? Are there best practices to embrace that, or is this a challenge of dietetics? 36:01
    • What was it like joining New York Gastroenterology Associates (NYGA) when they became a large group practice? … What was it like bringing on additional dieticians and continuing to grow that part of NYGA’s care delivery? 39:40
    • Thank you, Tamara 43:41
    • Thanks for listening 43:59

    Tamara Duker Freuman, MS, RD, CDN, is a New York-based registered dietitian, author and nationally-known expert on medical nutrition therapy for gastrointestinal diseases.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc. For more from Tamara Duker Freuman, follow @tamaraduker on Twitter and @tamarafreuman on Instagram.

    Disclosures: Berry, Chey, and Duker Freuman report no relevant financial disclosures.

  • The Future of Endoscopy with Doug Rex, MD

    The Future of Endoscopy with Doug Rex, MD

    · Gut Talk

    In this podcast episode, Douglas Rex, MD, discusses the importance of intent-to-treat for colorectal screenings, how screening technology has transformed gastroenterology practice and more.

    • Intro :02
    • Welcome to this episode of Gut Talk :23
    • The interview/about Rex :32
    • Where did you grow up, and what was your childhood like? :52
    • What got you interested in medicine? 2:50
    • How did your journey with GI start? 4:33
    • How have those early days and formidable experiences of being in the lab impacted your career today and what you are more well-known for? 8:19
    • Discussion on the NEJM study and the debates surrounding methodologies for endoscopy 11:55
    • Rex, Chey and Berry on the importance on the issue surrounding intent-to-treat in the setting of colorectal cancer screening 14:57
    • Rex on the Multi-Society Task Force of Colorectal Cancer (MSTF) committee and how they come to decisions that influence how gastroenterologists practice daily 16:55
    • Was it a difficult decision to move the threshold for colorectal cancer screening from 50 to 45? 20:41
    • In an environment where there is a limited resource such as colonoscopy, are you struggling with volume at your institution? … What are some strategies that listeners can utilize to prioritize patients, seek other possibilities and manage volume? 22:28
    • What’s the right way to approach the screening problem? … Where will this lead us ten years from now if all of us are spending our time in the endoscopy suite because of continued reduction in the age of screening while the prevalence of functional conditions and chronic diseases is also rising? 25:51
    • How long do you think we’ll continue to rely upon screening colonoscopy as one of our primary means by which to screen for colon cancer? Are there any technologies on the horizon that will eat into the share of screening colonoscopy? 28:55
    • What is your perspective on AI and how it can impact not only adenoma detection rate and polyp detection, but also clinical workflows such as documentation time? … Are you concerned about the new generation of clinicians being trained on and relying on these tools? 34:07
    • What have you learned in terms of best practices for the right and wrong ways to work with industry? 38:07
    • Thank you, Dr. Rex 40:25
    • Thanks for listening 40:43

    Douglas K. Rex, MD, is a distinguished professor emeritus at Indiana University School of Medicine and a full-time clinical gastroenterologist at Indiana University Hospitals.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc. For more from Dr. Rex, follow @Rex_colonoscopy on Twitter.

    Disclosures: Chey and Berry report no relevant financial disclosures. Rex is a consultant for Boston Scientific, Braintree Laboratories, Medtronic, Norgine, and Olympus Corporation. He provides research support at Braintree Laboratories, Erbe USA Inc, Medivators, and Olympus Corporation and is a shareholder of Satisfai Health.

  • The Future of Care for Disorders of Gut-Brain Interaction with the ROME Foundation

    The Future of Care for Disorders of Gut-Brain Interaction with the ROME Foundation

    · Gut Talk

    In this podcast episode, Douglas Drossman, MD, and Johannah Ruddy MEd, discuss methods of destigmatizing chronic illness for patients and physicians, technology’s effect on the doctor-patient relationship and more.

    • Intro :02
    • Welcome to this episode of Gut Talk :23
    • The interview/about Drossman and Ruddy :30
    • About Ruddy’s professional and personal background regarding DGBI patients 1:40
    • For Ruddy: What was the transformative moment that made you want to get so involved in patient advocacy? 3:39
    • For Drossman: How do doctors talk more effectively to patients? 5:49
    • Chey and Drossman on the objectification of patients and physicians 9:00
    • Are there ways to teach people to re-inject the joy of the patient-physician interaction? … How do physicians re-frame the way that they think about interacting with patients? 10:00
    • Ruddy, Chey and Drossman on the value of narrative history taking 13:35
    • Drossman on the connection between psychosocial information and the onset and perpetuation of patient symptoms 15:29
    • Why are there such big gaps in care for patients with disorders of gut-brain interaction and visceral hypersensitivity? 16:00
    • About the Linedale study on clear language versus qualified language for IBS diagnoses 18:55
    • Chey on the flipsides of confident diagnoses 22:22
    • Do gastroenterologists and primary care doctors have the tools available to treat these conditions? 24:15
    • Thoughts on how technology has affected the physician-patient relationship 27:38
    • How do you deal with the systematic pressures that exist on most brick-and-mortar gastroenterologists today? 31:21
    • Tell us about the main goals and contents of your book, The Patient-Doctor Relationship and Gut Feelings: The Patient’s Story 32:38
    • What are the common threads that emerged from your studies in the book for doctors to think about? 34:03
    • Ruddy’s patient insights on where physicians can think about prioritizing in their care 36:47
    • Thank you, Dr. Drossman and Ms. Ruddy 38:33
    • Thanks for listening 39:14

    Douglas Drossman, MD, is a professor emeritus of medicine and psychiatry in gastroenterology at UNC. He is a fellow of the American College of Physicians, a master of the American College of Gastroenterology, past-president of the American Psychosomatic Society.

    Johannah Ruddy, MEd, is an educator, researcher and writer and currently serves as the chief operating officer and executive director of the Rome Foundation. Ruddy co-founded and is the director of Tuesday Night IBS community on Twitter.

    Check out: Gut Feelings: Disorders of Gut-Brain Interaction https://romedross.video/GutFeelingsWebsite and The Patient-Doctor Relationship and Gut Feelings: The Patient’s Story https://romedross.video/patient-story

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc. For more from Dr. Drossman, follow him on Twitter @DDrossman. For more from Ms. Ruddy, follow her on Twitter @JohannahRuddy.

    Disclosures: Chey and Berry report no relevant financial disclosures. Drossman reports affiliation with Ardelyx, Rome Foundation. Ruddy reports affiliation with Biomerica, Mahana Therapeutics, Rome Foundation and Tuesday Night IBS.

  • Health Care Innovation & Non-Traditional Care with Shivan Mehta, MD

    Health Care Innovation & Non-Traditional Care with Shivan Mehta, MD

    · Gut Talk

    In this podcast episode, Shivan Mehta, MD, MBA, MSHP, discusses behavioral economics in patients and clinicians, the entrance of non-traditional entities in the health care space and more.

    Intro :02 Welcome to this episode of Gut Talk :23 The interview/about Mehta :30 How did you get to where you are now? What got you interested in medicine, and how did you end up with the role that you have today? :58 Can you elaborate more on the people who had an influence on you? 3:10 About behavioral economics 5:39 Are there tried and true theories in behavioral economics around what works to change patient behavior? 9:25 What about insurance companies with steerage? … Are there studies that show that those are different types of financial incentives, as opposed to paying someone? 15:45 Have we seen, or is there research on the effect of, pricing something lower in patients’ decision making in health care? 19:25 As an academic researcher and administrator, what do you think about the entrance of non-traditional entities in health care compared to the work that is being done by clinicians and at academic centers? 22:03 Do you see the move from fee-for-service to quality care happening? 26:41 Thoughts on the future of funding in health care 28:38 What do you think about the physician’s role in current and future innovation? 31:32 How do we create a generation of physicians who are thinking more innovatively and entrepreneurially? 34:51 Thank you, Dr. Mehta 41:43 Thanks for listening 41:50

    Shivan Mehta, MD, MBA, MSHP, is associate chief innovation officer at Penn Medicine and associate professor of Medicine and Health Policy at the Perelman School of Medicine.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc. For more from Dr. Mehta, follow @Shivan_Mehtaon Twitter.

    Disclosures: Chey and Berry report no relevant financial disclosures. Mehta serves on a clinical advisory board for Guardant Health and receives grant funding from the National Institutes of Health.

  • The Different Facets of GI Leadership with Amy Oxentenko, MD

    The Different Facets of GI Leadership with Amy Oxentenko, MD

    · Gut Talk

    In this podcast episode, Amy Oxentenko, MD, discusses the importance of adapting in her leadership roles and shares her thoughts on creating transparent, inclusive spaces in practice, and more.

    Intro :02 Welcome to this episode of Gut Talk :23 The interview & about Oxentenko :38 Were there people that influenced your decision to transition from advanced math to medicine? 1:59 How did you end up migrating towards a field like GI? 3:10 How did the smaller percentages of women in the field when you started make you feel and influence you as a gastroenterologist and leader? 5:36 About concerns on the sides of employers and prospective female employees regarding discussion of starting a family, parental leave in an interview 7:53 Can you tell us about the study you recently published on the biases towards female house officers? 11:55 Do you have advice for young women on how to approach that discussion with potential employers, and how we can handle this type of discussion? 13:54 Are there any life lessons you want to talk about in regard to the different roles you have had over the years? 15:54 What are your perspectives on what you learned from your experiences being a chair of medicine during the pandemic? 19:06 How did you adapt to a set of circumstances that are really different than your usual style of leadership? 22:15 Can you tell us about some of the tactical things you’re doing now to adapt to how patients have become accustomed to telehealth? 24:13 Are there any initiatives underway that may help the rest of us think about how to navigate this time as we all try to get back to normal and restore a sense of community? 27:21 About Maintenance of Certification (MOC) and Dr. Oxentenko’s efforts to create alternative pathways to the 10-year exam 29:31 As part of the executive chain and future president for the American College of Gastroenterology, where do you think the college should focus their attention in these next couple of years? 34:05 What are some of the tactical things that institutions can do to promote inclusivity that might not be as obvious? … What have you seen that actually moves the needle forward? 37:52 Thank you, Dr. Oxentenko 40:52 Thanks for listening 41:09

    Amy Oxentenko, MD, is chair of the department of Medicine at the Mayo Clinic in Arizona.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc. For more from Dr. Oxentenko, follow @AmyOxentenkoMD on Twitter.

  • Humanity in Medicine with Mitch Albom

    Humanity in Medicine with Mitch Albom

    · Gut Talk

    In this podcast episode, Mitch Albom, best-selling author, journalist, and radio and TV broadcaster, discusses how his philanthropy and writing have informed each other, his experiences with doctors as a patient and more.

    Intro :02 Welcome to this episode of Gut Talk :23 About Albom :30 The interview :40 Where did you grow up? :52 Why do you think that [less people knowing their neighbors today] has happened? 2:07 You obviously have had incredibly rich interpersonal relationships that influenced who you became. Are those people that you grew up and interacted with characters in your books? 4:34 Are there philosophies that you learned as a student or growing up that inform, more than just the characters, but the recurring themes in your books? 7:12 How did you become such an avid philanthropist? Tell us about that journey. 11:02 How can we, as we’re interacting with young people, help them to understand that it’s not just about money? 16:08 How would you say philanthropy has impacted your writing since Tuesdays with Morrie? 20:16 What about the reverse? How does writing your books and your stories change your perspective on the lesson you’re trying to impart on your readers? 22:29 About Albom’s work in Haiti and introducing his kids to the new orphanage 26:15 Were there any insights that you gleaned from that experience [recent medical experiences and colonoscopy]? 36:51 Thank you, Mitch 46:15 Thanks for listening 46:36

    Mitch Albom is a Best-selling author, journalist, and radio and TV broadcaster.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc. For more from Mitch Albom, visit mitchalbom.com, saydetroit.org and havefaithhaiti.org.

    Disclosures: Albom, Berry and Chey report no relevant financial disclosures.

  • Discovering ERCP with Peter B. Cotton, MD

    Discovering ERCP with Peter B. Cotton, MD

    · Gut Talk

    In this podcast episode, Peter B. Cotton, MD, FRCP, FRCS, professor of medicine at the Medical University of South Carolina, discusses the development and invention of the ERCP procedure, the innovation of digestive disease centers and more.

    Intro :02 Welcome to this episode of Gut Talk :23 About Cotton :23 The interview :37 Where did you grow up? :37 How did you get interested in gastroenterology? 1:38 That [trainees wanting to come to the endoscopy lab and not go to the basic science lab] must have put you in a difficult situation at times. How did you navigate that? 6:12 Could you tell us a little more about what that was like, from an operational perspective, of overseeing the endoscopy center, and perhaps how that role of operating in an endoscopy center as a trainee impacted you innovation in ER cepheid advanced endoscopy? 7:03 How flexible is the shaft of those initial endoscopes, and did you use sedation? 8:49 Is it a correct characterization that the building and innovation and inventions at this early stage in your career was really just to get the job done as opposed to you seeking out a role that was focused on inventing? 9:56 You were the only gastroenterologist at Middlesex for many years, correct? 10:52 How did that transition to Duke occur? … Did that [clinical load] drive a lot of your decision-making or was it more than that? 11:50 Where did the ERCP start? 15:11 How were you able to collaborate with other gastroenterologists and radiologists and surgeons? …What was that collaboration between these investigators that were really trying to drive this procedure forward like back in the Sixties and Seventies? 20:23 Were you able to pass endoscopic videos back and forth, or was that not really the way cases were shared? 21:36 About the Digestive Disorder Center at NUSC and Digestive Diseases Centers 24:43 Has it worked out the way you had envisioned? … What are the potential downfalls as people think about that type of Digestive Health Center model? 27:43 Summary of Cotton’s memoir, The Tunnel at the End of the Light: My Endoscopic Journey in Six Decades 31:34 You also have written books for young children as well. What prompted you to writing and teaching one of the most complicated procedures to your book about “Fred the Snake”? 32:10 What are you most excited about with regards to opportunities facing younger gastroenterologists moving forward, and what advice would you give them to seize those opportunities? 34:54 Thank you Peter 36:42 Thanks for listening 36:58

    Peter B. Cotton, MD, FRCP, FRCS, is professor of medicine at the Medical University of South Carolina.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

    Disclosures: Berry and Chey report no relevant financial disclosures. Cotton reports no relevant financial disclosures.

  • Perspectives on Leadership, Education and the Future of Clinical Care in IBS with Lin Chang, MD

    Perspectives on Leadership, Education and the Future of Clinical Care in IBS with Lin Chang, MD

    · Gut Talk

    In this podcast episode, Lin Chang, MD, vice-chief of Vatche and Tamar Manoukian Division of Digestive Diseases, discusses her path to GI, her interest in IBS and some of the newest therapies coming down the pipe and more.

    Intro :02 Welcome to this episode of Gut Talk :22 About Chang :28 The interview :46 Where did you grow up? :49 Who are your early role models? 3:50 How far along in college were you before you decided to apply for medical school? 4:58 How did you get interested in GI? 5:32 What advice would you give to the residents and fellows that you interact with in that regard? 8:42 As you started your career you weren’t necessarily thinking that you were going to be a clinical/academic icon … didn’t you start mostly as a clinician? 11:56 Early on when we started working together … you were the only woman in the room. How were you able to break through that glass ceiling and get into the room? 17:38 What advice do you give your fellows who want to get more involved? 22:12 How did you get interested in a condition like IBS? 24:02 Could you explain to our listeners what it means by the biopsychosocial model when referring to IBS? 26:21 Do you think that, in actuality, these could be completely separate diseases? 29:03 Discussion on the layers of IBS 32:26 Do you mind summarizing your key takeaways from an American Gastrological Association clinical practice update on the role of diet in patients with IBS? 38:03 Another document we’re working on right now is the first joint society (AGA, ACG) clinical practice guideline on treatment of chronic constipation … would you like to say a couple words about that one? 42:04 What does your future look like? What are you thinking is next for Lin Chang? 44:39 In your role as program director, what are the trends that you’ve noticed amongst trainees? 46:46 What are you most excited about with regards to the newer therapies and treatment paradigms, the new care delivery models that are on the horizon to help patients with IBS? 49:13 Lin, this has been a great discussion 51:00 Thanks for listening 51:37

    Lin Chang, MD, is the vice-chief of Vatche and Tamar Manoukian Division of Digestive Diseases, program director of the UCLA GI Fellowship Program and the co-director of the G. Oppenheimer Center for Neurobiology of Stress and Resilience.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

    Disclosures: Berry and Chey report no relevant financial disclosures. Chang reports no relevant financial disclosures.

  • Physician Entrepreneurship in GI with Joe Rubinsztain, MD

    Physician Entrepreneurship in GI with Joe Rubinsztain, MD

    · Gut Talk

    In this podcast episode, Joe Rubinsztain, MD, the CEO of ChronWell, discusses his path to becoming a doctorpreneur, the creation of gMed and more.

    Brought to you by Zeposia.

    Intro :02 Welcome to this episode of Gut Talk :22 About Rubinsztain :39 The interview 1:14 Tell us about your background … where did you grow up and how did you get interested in medicine? 1:16 What “aha moment” steered you into this nontraditional direction? 2:45 Was that the genesis of gMed or did something precede gMed? 3:54 Where did gMed occur in this whole awakening that you experienced? 4:27 Was it a success immediately or was it a steep uphill climb? 6:03 What were some of the main things that you learned from this journey? What were some of the durable themes that came out of that experience for you? 7:21 Was the EMR market just as saturated when you were starting gMed, and you were scaling the company? How did you sell this into physicians' offices? 9:47 Policy changes in health care can make or break a company … could you talk to us a little about the acquisition and leading up to that - how did it happen? 11:24 There must’ve been the temptation to go in a whole bunch of different directions … How did you resist that temptation and how did you decide to choose GI and dermatology? 13:09 Did you organically create those relationships or how did those come about? 15:44 It you were starting and scaling gMed now how would things be different with these integrated delivery systems and private equity consolidation? 17:25 Are the incentives aligned to make digital therapeutics an attractive option right now? 20:08 Do you think the future for digital therapeutics and the types of services that ChronWell provides are going to be driven more by the fee-for-service architecture or do you think GI as a specialty is closer to more bundled payments and value-based approach? 22:45 Could you tell us a little bit more about ChronWell, your transition from gMed to ChronWell and what you’re doing there now? 25:14 Who are you selling these services to? Is this a service that’s being provided the GI physician, a health plan, a self-insured employer? 27:20 Do you mind just telling our audience what you mean by the term ‘digital therapeutics’? 29:38 Are you subject to regulatory standards? Do these digital therapeutics need to be FDA approved or is it more like the Wild West? 31:01 As we transition to this accountable care/value-based system. Will there be the same level of profitability and interest on the part of equity in gastroenterology? 35:30 It also sounds as if artificial intelligence and machine learning are going to play a big role in what you’re building 38:15 Do you think the key thing there is the size of the data set or the quality of the data? 40:06 Should there be a medical school pathway for physician data scientists that specifically peg their careers for this type of development pathway? 41:55 What are the biggest misconceptions you think physicians, and more particularly GI physicians, have about the entrance of these early stage technology companies into health care? 43:49 What advice would you have for a young physician or someone in medical school who’s got these crazy thoughts of a non-traditional career? 46:56 Thank you, Joe 48:57 Thanks for listening 49:29

    Joe Rubinsztain, MD, is a physician entrepreneur and CEO/co-founder of ChronWell and founder of gMed.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

    Disclosures: Berry and Chey report no relevant financial disclosures. Rubinsztain is the CEO and co-founder of ChronWell.

  • Diversity, Equity and Inclusion in GI with Sophie M. Balzora, MD

    Diversity, Equity and Inclusion in GI with Sophie M. Balzora, MD

    · Gut Talk

    In this podcast episode, Sophie M. Balzora, MD, FACG, discusses how she found an interest in gastroenterology, the importance of having a true diversity, equity and inclusion initiative in the health care field and more.

    Brought to you by Zeposia.

    Intro :02 The interview :22 Can you tell us a bit about your background? :51 Was your dad educated as an internist in the United States or in Haiti? 2:32 How did you decide to become a gastroenterologist? 3:41 Tell us about what you’re doing these days and what’s your day-to-day role at NYU? 5:13 Was this a calling? Was it something early on that you knew you wanted to pursue, or did it more call on you? 7:23 Do you think we’re more likely to make substantive changes by taking smaller, more incremental changes, or making more sweeping changes? 9:37 What do the words “diversity,” “equity” and “inclusion” mean to you? What do you want the listeners to know for the remainder of the conversation? 11:09 What motivates you to work on these issues? 14:30 We’ve known about these inequities for a long time … Why do you think this is the case and what are we starting to do to close this gap? 16:04 How do we start to tackle the “Minority Tax” and ensure we’re not putting the sole responsibility to fix this system at the feet of Black and female patients and other people of color? 20:55 You have key leadership roles in numerous organizations … What are some of the initiatives you’ve been focusing on recently and are there any key learnings that you can share about how organizations can improve diversity, equity and inclusion? 24:09 Have you experienced any of the backlash or discriminatory gaslighting when it comes to the DEI initiatives and what are your thoughts on it? 29:38 What are the key things that will really make a difference in terms of driving substantive change in the DEI space as opposed to paying lip service? 33:11 What initiatives do you know going on at NYU or at the college to help improve our training mechanisms to deal with these types of issues? 35:26 If you were to have any wish in terms of DEI that would happen through the course of your career and by the time you finish up, what would it be? What do you think is realistic as a goal? 40:07 I want to thank you for all the work you’re doing 43:20 Thanks for listening 44:57

    Sophie M. Balzora, MD, FACG, is a clinical associate professor at the NYU Grossman School of Medicine. She is vice chair of ACG's Diversity, Equity, and Inclusion Committee, senior associate editor of the American Journal of Gastroenterology, and co-founder of ACG's “#DiversityinGI” social media campaign. Balzora serves on the Patient Education Sub-Committee of the Crohn's and Colitis Foundation's National Scientific Advisory Committee, the social media team of the CCF's Inflammatory Bowel Disease Journal, and as a member of Fight CRC’s Health Equity Committee. She was also accepted into the inaugural cohort of the Office of Diversity Affairs’ Faculty Leadership Development Program through the NYU Langone Academy.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

    Disclosures: Balzora, Berry and Chey report no relevant financial disclosures.

  • Virtual Reality in GI with Brennan Spiegel, MD

    Virtual Reality in GI with Brennan Spiegel, MD

    · Gut Talk

    In this podcast episode, Brennan Spiegel, MD, MSHS, discusses virtual and augmented reality in gastroenterology from both a clinical and research perspective, as well as his thoughts on the future of the field.

    Intro :02 The interview :22 How did you decide to be a doctor? :23 What are your main takeaways from serving as editor of AJG over the last 6 years? 2:46 What was your journey that led to what you’re focusing on now? 5:47 Can you give us a sense of what these words mean when you say “virtual reality” and “augmented reality”? 7:29 As a professor of medicine, a gastroenterologist, a public health advocate and researcher, how did you come to think of this being your area of focus? 10:40 How does this work from a clinical perspective? 15:21 Can you tell us about how the clinical trials are run, what sham VR is and how are these high-quality trials designed? 19:53 Have we studied the biochemical response? 22:13 The discussion of virtual reality and its use in neuromodulation and nerve stimulation 25:07 Where do you think the biggest challenge is in this widespread implementation? 31:34 What about developing VR reimbursement strategies … Have you heard of virtual reality companies approaching things this way? 34:44 How do you think about intellectual property with VR? 37:38 Where do you think we stand in regard to regulatory hurdles? 39:52 Are there any risks? Are these things that are being studied? Are these valid concerns? 42:00 What do you want the listeners to take away from this? What’s the call to action? 44:31 Thank you, Dr. Spiegel 46:27

    Brennan Spiegel, MD, MSHS, is the director of health services research for Cedars-Sinai and the director of the Cedars-Sinai Master's Degree Program in health delivery science. He directs the Cedars-Sinai Center for Outcomes Research and Education.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

    Disclosures: Berry, Chey and Spiegel report no relevant financial disclosures.

  • New ACG IBS Guidelines with Brian E. Lacy, MD, PhD

    New ACG IBS Guidelines with Brian E. Lacy, MD, PhD

    · Gut Talk

    In this episode, Brian E. Lacy, MD, PhD, joins us to discuss the American College of Gastroenterology’s newest guidelines for irritable bowel syndrome, options for patients with IBS-D and IBS-C, and much more.

    Brought to you by Red Hill Biopharma.

    Intro :02 Can you briefly review the process that led to the final document? 1:31 All recommendations are not created equal in this guideline or any guideline … do you think that is a fair statement? 3:56 Do you have some key takeaways for listeners in regards to the diagnostic evaluation of patients with IBS? 4:38 There’s always this debate about fecal calprotectin or fecal lactoferrin or CRP … what do you do in your own practice? 6:13 What do you want to tell the listeners in terms of testing to adequately screen for Celiac disease in their patients with IBS symptoms? 7:49 Does it matter how you biopsy? 9:57 What was your perspective on some of the new serologies for IBS? 11:51 Can you review pelvic floor testing in patients with IBS and what the listeners should be thinking about and what they should do? 15:00 Do you see potentially IBS-D and IBS-C-specific guidelines coming out in the future? 17:14 Several commonly used therapies for IBS have weak recommendations or recommendations against their use. Can you talk about this or whether you use these therapies in your practice? 20:29 What do you tell patients when they ask you about whether they should get their stool analyzed or provide you with a report from testing they’ve already done? 26:10 Stool samples: are they even the best thing we should be measuring? 29:07 What’s the proportion of patients that possibly or potentially mismanaged getting colonoscopies, being started on expensive medications, being started on probiotics and how do we shift from this guideline and really getting this spread out in practice? 30:44 The growing list of options for patients with IBS and constipation 37:57 Opinions on the available options for patients with IBS-D? 39:49 Thank you again, Dr. Lacy 41:15

    Brian E. Lacy, MD, PhD, is a board certified gastroenterologist at the Mayo Clinic and the current co-editor in chief of the American Journal of Gastroenterology. He is the former editor in chief of Clinical and Translational Gastroenterology and was the co-chairman for the Rome IV Committee on Functional Bowel Disorders.

    Disclosures: Berry, Chey and Lacy report no relevant financial disclosures.

    We’d love to hear from you! Send your comments/questions to Dr. Berry and Dr. Chey at [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

  • Probiotics and Discovery with Eamonn Quigley, MD

    Probiotics and Discovery with Eamonn Quigley, MD

    · Gut Talk

    In this episode, Eamonn Quigley, MD, joins us to discuss his journey into gastroenterology, probiotics and pearls of wisdom to the next generation of physician investigators.

    Brought to you by Red Hill Biopharma.

    Intro :26 Who was the person or persons that got you interested in GI? 1:01 Was endoscopy available at the time that you started your GI training or did that come later? 3:39 What’s the story behind emigrating to the United States? 4:29 The legacy of Sid Phillips 6:54 Where did your travels take you after Mayo Clinic? 9:21 When did you start looking at the microbiome? 9:27 How did that partnership shape your thinking? 13:25 Tell us the story behind Bifidobacterium infantis 35624 17:56 What should patients and providers look for when they’re considering a probiotic to purchase? 23:10 How do you frame this to patients when they’re so motivated to try probiotics for a disease or a symptom for which there’s not strong data? 28:39 How durably can you really shift a healthy person’s microbiome? 30:18 Is there something that you wish GI doctors were doing differently with regards to probiotics from what they’re doing now? 34:53 What do you think we need to get to a point where we can prescribe probiotics in a precision medicine perspective? 35:59 Do you think it’s going to be more microbiome or more metabolome that will really be the place to look for biomarkers? 38:13 What are some of the big challenges that you think are unique to running clinical trials of probiotics? 40:26 What has your experience been with regards to collaborative approaches with investigators outside of GI? 41:54 Where do we move forward from here? What are the types of questions that young investigators should be thinking about in the near-term future? 43:31 What advice would you give to other physician investigators, perhaps younger ones, who want to follow in your footsteps? 45:50 Thank you, Dr. Quigley 51:05

    Eamonn Quigley, MD, is the chief of the division of gastroenterology and hepatology at Weill Cornell Medical College at Houston Methodist Hospital, past president of the American College of Gastroenterology and past president of the World Gastroenterology Organization.

    Disclosures: Berry and Chey report no relevant financial disclosures. Quigley discovered Align Probiotic (Procter & Gamble).

    We’d love to hear from you! Send your comments/questions to Dr. Berry and Dr. Chey at [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

  • Douglas Drossman, MD: The Rome Criteria and What’s Next for Rome V

    Douglas Drossman, MD: The Rome Criteria and What’s Next for Rome V

    · Gut Talk

    In this episode, Douglas A. Drossman, MD, joins us to discuss his path into medicine, the history and influence of brain-gut interactions and what gastroenterologists can expect for Rome V criteria.

    Intro :22 Drossman’s experiences growing up in New York :33 Drossman’s experience performing in a rock and roll band 1:20 How did Drossman migrate from playing in a rock band to going to medical school and choosing a career in functional GI disorders? 2:14 The history of functional GI disorders and the brain 6:05 The influence of brain-gut interactions on motility and sensation and the evolution of opinions 9:29 The formation of Rome and its impact on the field of functional GI disorders 13:33 Were there other frameworks that were considered at these meetings early on before Rome criteria ever evolved or came out aside from symptom-based diagnosis? 20:15 In the various iterations of Rome, what are your proudest moments? 27:06 What can gastroenterologists expect for Rome V? 31:00 The transformative nature of behavioral therapy 33:13 Has there been research on how disorders of brain-gut interaction vary by different countries and different types of upbringings and culture? 37:12 Why is it important for providers to better communicate with patients? 42:19 Are you going to alter the way you do your notes given the fact patients will have free access to everything that you write? 47:41 What advice would you give to fellows, younger faculty to have the same sort of impact and really fight for what they believe in? 48:44 What can you tell us about Rome V? 50:17 Thank so much, Dr. Drossman 51:24

    Douglas A. Drossman, MD, is professor emeritus of medicine and psychiatry at University of North Carolina, and president emeritus of Rome Foundation.

    Disclosures: Berry, Chey and Drossman report no relevant financial disclosures.

    To order Drossman’s new book Gut Feelings: Disorders of Gut-Brain Interaction and the Patient-Doctor Relationship A Guide for Patients and Doctors, visit https://romedross.video/GutFeelingsWebsite

    To learn more about the Rome Foundation, visit theromefoundation.org

    We’d love to hear from you! Send your comments/questions to Dr. Berry and Dr. Chey at [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

  • Gil Y. Melmed, MD, MS: Practical Considerations for IBD Management, Telehealth and COVID Vaccination

    Gil Y. Melmed, MD, MS: Practical Considerations for IBD Management, Telehealth and COVID Vaccination

    · Gut Talk

    In this episode, Gil Y. Melmed, MD, MS, joins us to discuss the available evidence regarding COVID-19 risk among patients with IBD, the pandemic’s effect on elective procedures, the future of telehealth for gastroenterologists and the importance of vaccination in these patients.

    Editor's Note: This episode was recorded in August 2020.

    Intro :22 Addressing questions about COVID-19 and the risk to IBD patients :35 Any insight to why patients with IBD aren’t at increased risk? 3:48 How are you dealing with deferral of elective procedures? 5:50 Is there any discussion about what the red lines will be in terms of closing down again? 9:32 How are you adjusting to telehealth? Do you think we’ll see an acceleration of remote care for our IBD patients? 11:53 Are there unique challenges to telemedicine for patients with IBD? 14:23 If we seize the moment, things may change for the better 15:51 Challenges may be different between tertiary care centers and community practices 18:22 Have you noticed an improvement in appointment compliance with telehealth? 19:05 How has the pandemic impacted your research? 21:03 Immunizations we should focus on for IBD patients 24:44 Differences in viability of the vaccination based upon the aggressiveness of immunosuppression 27:40 Do you check follow-up titers? 29:28 Are there other vaccines besides yellow fever we should avoid? 30:45 How will politicizing the pandemic effect our patients in terms of vaccination? 31:42 The threshold for an effective vaccine is 50%, according to the FDA 34:27 The prolonged nature of the pandemic may force payers to continue remunerating for virtual care 37:36 Of the various IBD treatment candidates, are there any that gastroenterologists in the trenches should pay attention to? 39:32 How are you addressing questions from IBD patients regarding travel, school and work? 41:45 We need to adapt and move quickly as information keeps coming 44:46 Are there formal mechanisms in place for sharing information as it pertains to the pandemic? 46:15 Thank you for your time, Dr. Melmed 48:24

    Gil Y. Melmed, MD, MS, is co-director of the Inflammatory Bowel Disease Center and professor of medicine at Cedars-Sinai Medical Center.

    We’d love to hear from you! Send your comments/questions to Dr. Berry and Dr. Chey at [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

    Disclosures: Berry, Chey and Melmed report no relevant financial disclosures.

  • Dr. Barry Marshall: Curiosity and Persistence in the Discovery of H. pylori

    Dr. Barry Marshall: Curiosity and Persistence in the Discovery of H. pylori

    · Gut Talk

    In this podcast episode, we interview Barry Marshall, AC, FRACP, FRS, FAA, the legendary Nobel Laureate who discovered that peptic ulcer disease was caused by the bacteria Helicobacter pylori, not excess acid. Marshall fought for years against the notion that ulcers were caused by acid and finally infected himself with the bacteria and underwent endoscopy to prove his point. His research has saved countless lives, as untreated ulcer disease can lead to gastric cancer. We discuss numerous facets of his life and his pioneering work. Before antimicrobial therapy against Helicobacter, patients suffered for years without the right therapy.

    Intro :35 About Dr. Marshall :37 The interview 3:30 Tell us about your upbringing. What was your childhood like? 3:38 How did you meet Robin Warren? 6:35 What was your ah-ha moment that made you want to follow it through? 13:11 Were you met with skepticism? 41:13 How did you interact with the naysayers at the time? 51:46 What drove you to infect yourself with H. pylori? 1:01:28 What was it like to win the Nobel prize? 1:10:14 What advice do you have for young faculty members or GI fellows embarking on an investigative career? 1:18:18 Thank you, Dr. Marshall 1:22:30

    Barry Marshall, AC, FRACP, FRS, FAA, is an Australian physician, Nobel Prize Laureate in Physiology or Medicine, and professor of clinical microbiology at the University of Western Australia.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

    Disclosures: Berry and Chey report no relevant financial disclosures. Healio was unable to confirm relevant financial disclosures for Marshall at the time of publication.

  • Peter Gibson, MD: Nutrition, Innovation and Entrepreneurship

    Peter Gibson, MD: Nutrition, Innovation and Entrepreneurship

    · Gut Talk

    In this episode, Peter Gibson, MD, discusses the advent of FODMAPs, the importance of integrated care and preventive medicine, and how his research led to the development of a widely popular medical app.

    Intro :23 About Peter Gibson, MD :24 The interview 1:36 What part of Australia are you originally from? 1:42 How did you get interested in medicine and, in particular, GI? 2:12 At first you were mostly in IBD, is that right? 2:45 How did you end up being one of the foremost experts in functional bowel disease? 3:50 Was including dieticians accepted by the GI community at large? 6:57 How did the concept of FODMAPs come to be? 8:16 Are there cultural differences regarding medical education and the importance of dietary interventions in nutrition? 11:50 Is collaboration key? 15:52 Why do you think having a behavioral psychologist and nutritionist on the team still hasn’t taken off? 18:25 We just completed a review on integrated care for Gastroenterology that should be published this year 21:37 The approach to Western medicine is reactive; thinking preventively is still a long way’s off 24:12 Are these services covered for patients with functional GI disorders in the U.S.? 25:53 Why did you choose “FODMAP”? 27:56 What are the FODMAPs that most commonly cause problems? 31:49 Do you see a way to use precision avoidance with FODMAPs in the near future? 35:50 How did you get into designing a mobile app? 39:12 Do you think the app is something that could replace the need for a dietician? 44:41 Did you ever deal with people who dissuaded you from trying to commercial some of your research? 47:42 How do you feel about other companies capitalizing on the FODMAP research? 50:06 What are some of the best practices/things you’ve learned on studying the way diet impacts disease? 52:11 What is the biggest misconception of FODMAPs among GI doctors? 56:50 If you had a magic wand that could change one thing about the way we care for patients with functional GI disease, or GI disease in general, what would you do? 59:24 Thank you so much for spending time with us, Dr. Gibson 1:01:58

    Peter Gibson, MD, is director of gastroenterology at Monash University, he discovered the low-FODMAP diet and past president of the Gastroenterological Society of Australia.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

    Disclosures: Berry and Chey report no relevant financial disclosures. Gibson works for Monash University, creator of the Monash University FODMAP diet app.

  • Health Policy with Congresswoman Dingell (D-Mich.)

    Health Policy with Congresswoman Dingell (D-Mich.)

    · Gut Talk

    In this episode, we spoke with Congresswoman Debbie Dingell (D-Mich.) about her history in politics and her passion for advocating for health issues, as well as her thoughts on COVID-19 and how health care providers can effect change by engaging with their representatives.

    Intro :10 About Congresswoman Dingell :14 The interview 2:38 Can you talk to us about your background? 2:40 What positions did you hold at GM? 3:35 Were you with GM during the auto crisis? 4:06 How did you get involved in politics? 4:55 Women’s health issues 6:22 Can you talk about Congressman Dingell’s health care advocacy work? 7:07 Do you think we’re entering an environment where people will be more likely to engage in meaningful public health conversations? 9:46 Can you talk about your brush with health care issues? 12:45 What are your feelings on us cooperating on an international basis to reach a solution on COVID-19 as quickly as possible? 16:07 How are you interacting on Capitol Hill? 18:42 What will happen with the election? 20:41 Do you think, at the national level, some regulations on state licensure for physicians will roll back to their old ways? 21:59 The aftereffects of COVID-19 25:20 What are some of the misconceptions that physicians or providers have about the role of a congressperson and their ability to affect change? 26:59 Health care costs 30:59 How can our listeners engage with their congressperson or senator? 33:25 If you were advising Vice President Biden, what advice would you give him leading up to the election? 37:01 What advice would you have for President Trump 37:50 Thank you so much for spending time with us, Congresswoman Dingell 38:02

    Congresswoman Debbie Dingell (D-Mich.) represents the 12th District of Michigan in the U.S. House of Representatives.

    We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc

    Disclosures: Berry and Chey report no relevant financial disclosures.

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