6 Reasons to Look for Cleveland Clinic at DDW 2017

There are many reasons to attend DDW 2017, which promises to be particularly exciting this year. John Vargo, MD, MPH, Chair of Gastroenterology & Hepatology, recommends taking special note of the following presentations of the more than 60 to be made by Cleveland Clinic staff and fellows:

1. “Evaluation of the optimal submucosal injection solutions for endoscopic submucosal dissection in the West: A blinded, randomized, controlled trial in a porcine model.” Amit Bhatt, MD. This study will help you understand how fluids used to perform endoscopic submucosal resection compare in terms of durability and quality of the procedure.

2. “Comparative effectiveness of colonoscopy bowel cleansing agents in 91,045 ambulatory patients in an open access endoscopy center.” Ari Garber, MD. This large study clearly revealed which colonoscopy prep works best and why.

3. “Increased biologic use and lower surgical rates in pediatric- versus adult-onset Crohn’s disease at a large tertiary care center over a 6-year follow up.” Jean-Paul Achkar, MD. Reduced need for surgery in pediatric patients on biologics shows that Crohn’s disease in children is different than adult-onset Crohn’s.

4. “Predicting the risk of cancer in a colon polyp and how that prediction affects the approach to resection.” Carol Burke, MD. A study in Western patients validate that grading schemes have a highly predictable value in determining whether polyps have progressed past the adenoma stage and may benefit from surgical removal.

5. “Chronic beta-blocker use is not associated with reduced in-hospital mortality in critically ill patients with liver disease.” Christina Lindenmeyer, MD. In critically ill patients with portal hypertension, beta-blocker use failed to provide the same level of protection as in outpatients.

6. “Serum chitinase-e-like protein 1 (YKL-40) predicts a shorter time to first surgery in complication naïve patients as well as a shorter time to surgical recurrence after first resection in Crohn’s disease.” Florian Rieder, MD. The presence of this marker predicted which Crohn’s patients are likely to develop fistulas or strictures or respond to medications.

4 compelling trends and topics to watch for:

As usual, DDW is the place to hear how your colleagues are handling patients with common and rare conditions. Dr. Vargo says there are four trends to watch for:

1. Endoscopic treatment of obesity. “With recognition of obesity as a multi-systemic disorder, we are seeing more research into the pharmacologic treatment of fatty liver disease and better prediction of outcomes. We will also see the result of innovative approaches to the treatment of obesity with endoscopic devices, including new techniques and longer follow-up data on durability and response.”

2. Use of personalized medicine for GI disorders. “I am struck this year by the increased use of genetics and biomarkers to predict outcomes and personalize treatment. For example, an individual’s genetic expression of Crohn’s may tell us how it should be treated and what to expect in terms of recurrence and complications.”

3. Advanced endoscopic techniques. “We are seeing the maturation of endoscopic techniques that were previously under the purview of surgical intervention. Examples include endoscopic pyloromyotomy for gastroparesis and peroral endoscopic myotomy (POEM) for achalasia. Full-thickness resections in the colon and stomach also will be featured.”

4. “Underwater colonoscopy.” Will the use of water instillation in the colon gradually replace carbon dioxide during colonoscopy? Exciting data comparing the adenoma detection rate between the two techniques will be presented.”

See you in Chicago

“Some of the most valuable information we glean at DDW comes not from presentations or poster sessions, but from the exchange of ideas with colleagues from around the world,” Dr. Vargo says. “Fellowship is one of the reasons I always make an effort to attend DDW. I very much look forward to seeing old friends and meeting new colleagues this year in Chicago.”

Follow Dr. Vargo on Twitter @JohnVargoMD and live-tweet #DDW17 with Cleveland Clinic physicians.