Podcasts about Hepatology

In our fourth Summer School episode this season, hosts Dr. Amber Hildreth and Dr. Jordan Whatley have taken highlights from past episodes on liver disease and put them into a special episode full of clinical pearls.Former expert guests Dr. Bill Balistreri, Dr. Jorge Bezerra, Dr. Saul Karpen, Dr. Dennis Black, Dr. Amy Taylor and Dr. Rohit Kohli cover neonatal cholestasis, biliary atresia, PSC, AIH, and MASLD.Our Bowel Sounds Summer School series will include four episodes each summer on big topics in our field, artisanally crafted for the ears of learners of all stages from the young student to the seasoned attending.Learning Objectives:Understand the evaluation of neonatal cholestasisReview the natural history of PSCReview the diagnosis and management of AIHUnderstand the diagnostic evaluation and management of MASLD.Featured episodes:1. Bill Balistreri- Neonatal Cholestasis2. Jorge Bezerra- Advances in Biliary Atresia3. Saul Karpen- Updates in Biliary Atresia4. Dennis Black- Primary Sclerosing Cholangitis5. Amy Taylor- Autoimmune Hepatitis Management6. Rohit Kohli- Fatty Liver DiseaseAdditional Links:1. Guideline for the Evaluation of Cholestatic Infants2. AASLD PSC Guidelines3. AASLD AIH GuidelinesSend us Fan MailSupport the showThis episode may be eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

Five signs of fatty liver that are easy to miss, because they look like ordinary life. Nurse Doza walks through low energy, weight around the midsection, a fast-food pattern, hormone symptoms, and gallbladder issues, and explains what each one suggests about the liver underneath. Plus the two labs worth asking your provider about, the foods that ease the load, and where to start. Nothing here is a diagnosis. Featured Product Liver Boost (Detox) — $111 Liver Boost is a comprehensive formula designed to support phase I and phase II liver detoxification, with nutrients that support your antioxidant systems and glutathione production. If this episode had you thinking about how much your liver handles in a day — fats, blood sugar, and everything your body needs to clear out — this is the formula built to support that work while you make the diet and lifestyle changes that move the needle. It is not a replacement for those changes.

In children with Crohn's disease who achieve remission through exclusive enteral nutrition, what's the optimal dietary therapy to maintain remission without the use of medication or surgery? Frank Ruemmele (Université Paris Cité) talks through the CD-Hope randomised controlled trial and its implications for clinical practice. Click here to read the full article: https://www.thelancet.com/journals/langas/article/PIIS2468-1253(25)00262-6/fulltext The Lancet Gastroenterology & Hepatology in conversation with...  is part of the Lancet Group podcast offering.  Editorial team: editor-in-chief Rob Brierley, deputy editor Aisling O'Brien, and senior editor Bethany Gomersall Podcast editing: Matteo Simonetti Visit https://www.thelancet.com/multimedia to learn more about our multimedia offering.  Find the best science for better lives at https://www.thelancet.com/ Follow us today at... x.com/LancetGastroHep bsky.app/lancetgastrohep.bsky.social Linkedin.com Instagram Facebook youtube.com/thelancettv

Weight-loss medications, bariatric surgery, and fad diets are dominating conversations—but where does Endoscopic Sleeve Gastroplasty (ESG) fit in?In this episode, we speak with Dr. Mohit Shetti, Consultant in Medical Gastroenterology, Hepatology, Therapeutic & Bariatric Endoscopy, to understand how ESG is transforming the treatment of obesity.Is ESG a safe procedure? Who is the right candidate? How does it compare with weight-loss medications? Is it a cosmetic treatment or a medically recommended intervention? Dr. Shetti answers these common questions while explaining the science behind ESG, its benefits, potential risks, recovery, and the lifestyle changes needed for long-term success.Whether you're exploring weight-loss options for yourself or simply want to better understand obesity as a chronic medical condition, this episode offers evidence-based insights to help you make informed decisions.

Four inflammatory bowel disease (IBD) experts explore case-based strategies for optimizing advanced IBD therapy and long-term disease management early in real-world practice. They discuss practical approaches for implementing treat-to-target via strategic treatment sequencing, therapeutic drug monitoring, and maintenance approaches while supporting individualized, evidence-based care for patients with IBD. Presenters Jessica R. Allegretti, MD, MPH, FACG, AGAF Medical Director, Infusion Services Director, Crohn's and Colitis Center Director of Clinical Research Director, Fecal Microbiota Transplant Program Division of Gastroenterology, Hepatology and Endoscopy Brigham and Women's Hospital Associate Professor of Medicine, Harvard Medical School Boston, Massachusetts Jordan E. Axelrad, MD, MPH, AGAF, FACG, FCCF Co-Director, Inflammatory Bowel Disease Center at NYU Langone Health Associate Professor of Medicine Division of Gastroenterology and Hepatology NYU Grossman School of Medicine New York, New York Russell D. Cohen, MD, FACG, AGAF Professor of Medicine, Pritzker School of Medicine Co-Director, Digestive Diseases Center Clinical Director, Inflammatory Bowel Disease Center Co-Director, Advanced IBD Fellowship Program The University of Chicago Medicine Chicago, Illinois Amy Stewart, MSN, FNP-C Lead Advanced Practice Provider Capital Digestive Care Washington, DC Link to full program: https://bit.ly/4wvm7l4 Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Co-hosts Ryan Piansky, a patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Science Advisory Council, interview Dr. Claire Beveridge about EoE and dysphagia. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:49] Co-host Ryan Piansky introduces this episode, brought to you thanks to the support of Education Partners AstraZeneca, GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:17] Holly introduces today's topic, research on eosinophilic esophagitis (EoE) and dysphagia.   [1:24] Holly introduces and welcomes today's guest, Dr. Claire Beveridge, a gastroenterologist at the Cleveland Clinic. Dr. Beveridge heads the EoE Adult Clinic and the Transition from Pediatric to Adult EoE Clinic.   [1:36] Holly, a speech pathologist, says she is very excited to dive into the research Dr. Beveridge did with EoE and dysphagia. Holly asks Dr. Beveridge to share some of her background.   [1:48] Dr. Beveridge was recruited to the Cleveland Clinic about five years ago to head the EoE Center. She loves the work they have done there.   [1:57] Dr. Beveridge says it's been nice to center everything on their EoE patients and have multidisciplinary care with speech-language pathologists, allergists, dietitians, pulmonologists, and more. It's been a great experience.   [2:15] Dr. Beveridge says the other thing they are really proud of is having a Transition Clinic. It can be tough for patients to transition from pediatric to adult care.   [2:23] Dr. Beveridge says this is something she was inspired to do when she was finishing her training at the University of Pennsylvania, where they had been doing some of that. It was really important to her when she joined Cleveland Clinic.   [2:34] Dr. Beveridge, with her Co-director, Dr. Sophia Patel, helps patients transition from pediatric to adult care.   [2:41] Holly speaks of the challenge of transitioning from pediatric care at a multidisciplinary clinic to adult care.   [3:08] Dr. Beveridge says you can't do any training at Northwestern without loving the esophagus. She did her residency there, got exposed to esophagology, and got to know Dr. Gonsalves and Dr. Hirano really well.   [3:33] Drs. Gonsalves and Hirano are really big names in EoE. Dr. Beveridge was fascinated by the disease. She loved the patients and wanted to help them and make them feel better. It's a burgeoning field.   [3:48] Dr. Beveridge says that it's only in the last few years that we have had FDA-approved medications for it, and that we have been jerry-rigging asthma medications to treat our patients.   [4:03] Dr. Beveridge says it's really exciting to see the treatment options we can offer.   [4:10] Ryan says it's exciting to see how EoE management has changed.   [4:16] Ryan says we see so many patients who are untreated or poorly treated for years, who have restructuring of their esophagus and present with dysphagia, or have strictures and rings leading to food impactions; the long-term effects of untreated EoE.   [4:34] Ryan says it's exciting that now we do have better treatment options for people, right off the bat.   [4:43] Dr. Beveridge conducted some research on EoE and dysphagia and presented a poster at the 2024 Digestive Diseases Week.   [4:51] The poster was titled, "Esophageal Luminal Diameter is Associated with Dysphagia and Eosinophilic Esophagitis: Implications for Endoscopic Dilation Therapy."   [5:11] Dr. Beveridge says dysphagia means issues with swallowing. It's a feeling of something getting stuck or something slowly moving down. There are also subtle symptoms that can happen.   [5:31] Dr. Beveridge says patients who have had EoE for a long time become accustomed to how they swallow. Things a patient may think are normal, like needing water and taking a sip after each bite, are learned accommodating behaviors.   [5:58] Dr. Beveridge says accommodating behaviors are that you're needing to imbibe extra water, you're modifying how you're eating, extra chewing, avoiding pills, avoiding other certain foods, and things like that that can be modifying factors.   [6:19] So, difficulty with swallowing, things getting stuck, slowly moving down, but also keeping in mind some of those modifying behaviors that we may end up using.   [7:23] Dr. Beveridge says her motivation was seeing patients in her clinic who were having persistent symptoms, and getting them into histological remission. The goal of treating your EoE is to get the eosinophils less than 15; close to zero is great.   [7:45] Dr. Beveridge says we have patients who, despite doing their endoscopies and taking biopsies, things look fine; they're still having issues with swallowing. Why is that the case?   [7:58] Dr. Beveridge says in a different research paper she had done, looking at some of the predictors for that, one of them was fibrostenosis. There are also other things that can contribute, like esophageal hypervigilance and a fear of swallowing.   [8:21] If a patient has had a food impaction, it's going to be scary to try to swallow again. Some of it is behavioral, but some of it is structural. At what luminal diameter (the size of the esophagus) is that causing a clinical problem for patients?   [8:45] A normal esophagus is 20 to 24 mm in diameter. Traditionally, around 14 to 16 mm in diameter has been when we say that patients get symptoms or they're feeling the issues with swallowing.   [9:03] Dr. Beveridge says a lot of those studies have never been done specifically for EoE patients.   [9:08] Dr. Beveridge wanted to know, if we exclude cancer, if we exclude acid reflux, and all of these other things, and just look at our EoE patients, what size of the esophagus are we looking at?   [9:20] Dr. Beveridge explained they specifically looked at patients whose histology was under control and then compared those who continued to experience symptoms with those who did not. The goal was to determine the histologic threshold at which patients begin to experience dysphagia.    [9:54] Dr. Beveridge says they saw this threshold at 16 mm (1.6 cm). That's still quite the difference from a normal esophagus of 20 to 24.   [10:08] Dr. Beveridge says our esophagus can definitely handle being smaller, but then, once you get to that 16 mm, for a lot of patients, it really does cause that feeling of things getting stuck or slowly moving down.   [10:20] Holly says what's cool about the retrospective data Dr. Beveridge looked at, and the parameters she placed in the research, is that when a patient goes in for an endoscopy, the doctor can measure and say maybe this is why dysphagia is going on.   [10:48] Holly finds that adult patients with food impactions are scared to eat the same food again. She loves having this data to share with patients and say, let's look at what your esophagus measures at. Let's do a smaller bite. Let's add a dip and liquid.   [11:12] Holly says data can push so much progress. Holly, having multiple chronic illnesses, loves when doctors can say, this is going to be safe. This is the mode that we're going to go with.   [11:30] Dr. Beveridge says in the retrospective study, they were looking at stuff that had already been done. We decided from here to assess patients more prospectively. All of this was based on chart review from when the note said symptoms or no symptoms.   [11:53] Dr. Beveridge says when she started this EoE clinic at the Cleveland Clinic, part of it was to standardize better how we were collecting data from patients to understand their symptoms.   [12:07] Dr. Beveridge has a standardized questionnaire for patients to understand if they are having heartburn and difficulty with swallowing, so she can know that at each point of their endoscopy.   [12:18] Dr. Beveridge says it will be nice, hopefully in the future, when she can give a little more detail and depth in terms of assessing this more prospectively and seeing if that same number holds up or if she needs to tweak it a little bit.   [12:34] Holly thinks it's fascinating. Numbers give us so much information, to know if my mm is this versus this, the next time, or during allergy season or not.   [12:53] Ryan says it's cool that you're able to look back at existing patient records and identify this information. Now we have that 16 mm number in mind to say maybe this is where we'll start to see increased risk of dysphagia in these patients.   [13:28] Dr. Beveridge says, how we had to do it retrospectively was based on the endoscopist estimating what the size is. Gastroenterologists recognize they're not always the best at estimating the size of the esophagus.   [13:50] Dr. Beveridge says, if your endoscope could not pass through, or it was snugly passing through, you know the diameter of the endoscope. If a dilation was done, at what size dilation do we start to see a disruption?   [14:19] Dr. Beveridge says, the goal of a dilation is to get a disruption because there's scar tissue we want to break open. A patient might think disruption means a perforation or something more scary, but that is the goal. We want to break open that scar tissue.   [14:42] Dr. Beveridge says, once we see that scar tissue break open a little bit, then we can estimate what the diameter is, based on the size dilator we used.   [15:10] Dr. Beveridge says for adults, we use a standard adult upper endoscope, and that's about 13 mm. The ones we use for kids are about 6 mm.   [15:35] Dr. Beveridge says the adult endoscope is around 13 mm, and it's around 14 to 16 mm when we start to see the symptoms.   [16:07] Dr. Beveridge says there are two main types of dilation that we do. One is the Savary dilator or wire-guided dilator, a long dilator that stretches the entire esophagus, from the mouth down to the stomach.   [17:20] Dr. Beveridge says another way of doing it is while you have the endoscope in, you thread a catheter. At the end of the endoscope, there's a balloon. You fill the balloon with saline up to different sizes. Typically, they go up by 3 mm, so 12 to 15 mm.   [18:01] Dr. Beveridge says the catheter balloon dilator is good for discrete strictures because the balloon isn't going to do the entire esophagus; it's just going to do one area of the esophagus, and you're watching it the whole time.   [18:19] For the wire dilator, you remove the scope. You're not able to see, so it's important to assess ahead of time how narrow things are, so you start at a safe dilation. You go in each time to see if there's starting to be disruption, and then you can do more.   [18:44] Holly asks if a gastroenterologist doing an upper endoscopy with sedation sees that it's tight, would the gastroenterologist automatically do a dilation? Or, can a patient with dysphagia symptoms request to have a dilation?   [19:28] Dr. Beveridge says, right before an endoscopy, she discusses it with the patient and gets consent. She asks, even if their symptoms are good, but in the endoscopy she sees a narrowing where she would recommend a dilation, if they're OK with that.   [20:05] Dr. Beveridge says, if they're having issues with swallowing, often she will ask if they're OK with her doing a dilation. If she sees a narrowing, she can focus on that area and dilate it.   [20:19] Dr. Beveridge says not everywhere in the esophagus can we see as well. The very beginning of the esophagus is challenging to see and challenging to evaluate on imaging.   [20:32] Dr. Beveridge talks about empiric dilation. You don't see a narrowing, but you want to rule it out, so you do a dilation at a safe size, like 16 or 18 mm, to make sure you're not missing something up high.   [20:58] Dr. Beveridge says she always talks about that with her patients. Most say, go ahead. Some patients definitely want dilation; other patients say no, they really don't.   [21:12] Dr. Beveridge then asks the patient if there's real narrowing that may cause a food impaction, would they want dilation then, or hold off for another day?   [21:30] Dr. Beveridge never wants to do something the patient is not comfortable with. She also doesn't want them to need another endoscopy unnecessarily, if she can avoid that for them in the moment.   [21:46] Dr. Beveridge mentions the BougieCap used in Europe. It's a cap you put at the end of the endoscope. You use your endoscope as the dilator. You watch the whole time. It is hard plastic that causes a nice dilation. We may see it come to the U.S.   [22:37] Dr. Beveridge speaks of the FLIP catheter, which is a catheter with a balloon that doesn't cause dilation but distends and helps measure the diameter.   [23:33] Holly asks if Dr. Beveridge gives tips to patients on how to prepare for dilation and the recovery process.   [23:49] Dr. Beveridge had an upper endoscopy. She says there's nothing like experience to understand it better. She didn't have a dilation, but the biopsies caused discomfort.    [24:21] Dr. Beveridge says a lot of her patients have been through upper endoscopies, so they know how it feels. She warns them that the biopsies and dilation can cause discomfort.   [24:33] What's challenging is that everyone is different. Some patients are going to be more hypersensitive to it, and other patients are going to say they felt nothing and they were fine.   [24:46] Dr. Beveridge says some patients need to modify their diet for a few days to avoid significant chest pain. You never want someone to have to go to the ER for significant chest pain when it will just heal over time, and there's no perforation.   [25:12] Dr. Beveridge says other patients will be like her, eating chips and pretzels and saying they're fine. Dr. Beveridge typically has them start with liquids, nothing too hot or too cold, and advance as tolerated.   [25:28] Dr. Beveridge says patients can always use TylenolⓇ and over-the-counter numbing agents. You'll still have patients who will get significant discomfort. For the most part, starting with liquids has worked for Dr. Beveridge's patients.   [25:44] Holly recommends over-the-counter when her patients call, after she talks to their GI. Holly says after she has an endoscopy, she starts on liquids and shakes. On day three, she's fine. Holly says individualized care is amazing. We all are different.   [26:14] In the pediatric setting, the parents get the counseling, and they have not had sedation, but on the adult side, you're talking with the patient, who had sedation. Sometimes they don't remember.   [26:40] Dr. Beveridge says when possible, she waits for family members to come back and tells them they're going to have to "be the memory" because the patient probably won't remember this conversation.   [26:55] If a patient says no, they don't want them to come back and hear about it, always respect that. But Dr. Beveridge always tells them, you may not remember what we say.   [27:30] Ryan asks about data on how many times someone may need dilations. Dr. Beveridge says it comes down to the patient, but the biggest issue can be uncontrolled inflammation.   [27:44] Dr. Beveridge says if a patient's EoE is not controlled, inflammation leads to continued scarring down. That's why we talk about dilation as being an adjunctive measure, but not a treatment for EoE. It doesn't do anything for the inflammation.   [28:03] Dr. Beveridge says she has patients who ask why she can't just do a dilation every now and then. Dr. Beveridge considers dilation to be safe when needed, but if you can avoid it, that would be nicer for everyone.   [28:21] Dr. Beveridge says there's no great data on whether you only need one, or whether you're going to need 10, but one big theme is just: have we gotten your inflammation under control? That's also true for other conditions, such as acid reflux.   [28:45] Holly wasn't diagnosed until she was in her mid-twenties, and she had several upper endoscopies as a teenager and college student to dilate her, to help the situation.   [29:17] Holly says she had to get more endoscopies to figure out her weird food triggers that are not typical for everybody, so even if she's treated, she still has inflammation. That's why she had so many upper endoscopies.   [29:30] Ryan talks about underlying issues causing inflammation. Dilation is not treating those underlying causes. It's just helping with one symptom of this dysphagia, by expanding the esophagus.   [29:50] Ryan asks, What changes in symptoms should patients expect after the dilation? Dr. Beveridge says, ideally, if there's been a stricture, you're going to start to feel like your swallowing is better. You can get pills and food down better.   [30:07] Dr. Beveridge says, immediately post-dilation, sometimes people feel a little bit worse. Everything you swallow may be uncomfortable for you. But if it's been a successful dilation, hopefully, you're going to feel that things are going down better.   [30:40] Holly says she is so grateful that Dr. Beveridge looked into this, and hopefully, there will be a new protocol in the future. Holly asks what other key takeaways from this research may interest Dr. Beveridge in researching something further.   [31:02] Dr. Beveridge says, making sure that we're not missing scar tissue is big and important. One thing that we're trying to look at with our Pediatric GI colleagues is what threshold we should be looking at for the pediatric patient population.   [31:19] Dr. Beveridge says a pediatric patient's esophagus is a different size than an adult patient's. Understandably, we are more cautious when doing a dilation in the pediatric patient population than we are with adults.   [31:34] Dr. Beveridge may recommend empiric dilation for an adult but will feel more cautious about that with pediatric patients than with adult patients. Understanding what that threshold should be for the pediatrics is going to be really interesting.   [31:57] Dr. Beveridge says the diameter threshold we discussed is going to be important to know about, but everyone is different. You may have a diameter of 14 mm, you feel fine, and you don't want a dilation; you can accommodate OK. That's reasonable.   [32:15] Dr. Beveridge says she has had patients who get up to 18 mm, and that helps them, but they need a little bit more. If someone needs more of a dilation, we do that. Yes, have a threshold to assess, but always assess for what's personal for your patient.   [33:04] Dr. Beveridge says not just to assess the luminal diameter, but a thing that is helpful for gastroenterologists to know will be if there are other factors at play. As in her study of dysphagia predictors, anxiety, depression, and hypervigilance can play roles.   [33:37] Dr. Beveridge has patients who have to have a critical narrowing for them to finally feel an issue. Other patients, if they have the slightest of narrowing, are feeling something. Some patients are just more vigilant of what's happening in their esophagus.   [34:07] Dr. Beveridge says there's definitely a role for asking if your anxiety is under control. If there's feedback in the nerves, should we ask your GI Psychologist to be involved in terms of CBT for your esophagus? Take a look at everything.   [34:27] Dr. Beveridge says another part of the study they looked at was: are there different thresholds of eosinophils that we should be looking at? Is it just less than 15, or do some patients need it to be lower? Less than six? Less than 10?   [34:43] Dr. Beveridge says look at it as a whole for your patient.   [34:53] Dr. Beveridge says next, she will be working on a very long-term project: Can we identify a non-invasive method of screening a patient, diagnosing a patient for EoE, or monitoring a response to therapy?   [35:13] Dr. Beveridge has looked at transnasal endoscopy, which is put into this category of minimally invasive. It's still invasive; you're putting a scope through someone's nose, but it doesn't require sedation, which is a nice thing for some patients.   [35:29] There's the EnteroTrack, which started in Colorado. A patient swallows a string, and it stays in their esophagus for an hour, and we look at the proteins to see if things are active or not active.   [35:45] Dr. Beveridge is also looking at the breath metabolome. If we breathe into a bag and take a look at all the volatile organic compounds that are in our breath, can we find a signature related to EoE?   [36:01] It's assessing about 100 different compounds, not looking at one in particular, but how the whole thing looks. What signature is there, based on looking at all the compounds?   [36:15] Dr. Beveridge presented some of that data at DDW and has a grant from the ACG to look at this and assess patients with and without EoE.   [36:33] Dr. Beveridge says further, doing longitudinal data of looking at patients once they've gotten into remission on treatment and seeing, do we then see a signature change?   [36:47] Dr. Beveridge says no one is under any illusion that endoscopies are going away. They will always be part of what we do in gastroenterology, but there are limitations: sedation, a full day away from work, nothing by mouth, and a driver, etc.   [37:04] If there are alternatives to help supplement that, it would be nice. One of the barriers for patients doing diet elimination is the number of endoscopies that are required. If there's a way to assess by breath if a food is a trigger, that would be good.   [37:32] Dr. Beveridge says that's the big thing she's looking at, but it will take years. It's not going to be a quick, easy one, but it's very interesting to take a look at.   [37:45] Holly speaks of how much treatment has changed since she was diagnosed. She has done all the scopes. She says this sounds amazing. She loves that people like Dr. Beveridge are thinking of how to make testing less invasive and more comfortable.   [38:12] Dr. Beveridge says another thing she is excited about is the transition of care. She recently did a survey and is analyzing the data to assess what the barrier is from the physician perspective in terms of helping our patients transition.   [38:40] Dr. Beveridge is also looking at doing a nice multi-center consensus to help this as well, led by Dr. Sophia Patel and Dr. Emily McGowan, who are fantastic in the EoE world, looking to see how we can make this better for our patients.   [38:58] Ryan says, with so much interesting work coming up, we'll have to have you back to chat about some of these additional projects. Everyone is super interested in less invasive stuff and better treatment pathways. Transition of care is an important part of that.   [39:11] Ryan appreciates Dr. Beveridge for joining the conversation and hopes to have her back on another episode so we can learn more about EoE and these different future research endeavors.   [39:20] For our listeners who would like to learn more about EoE today, you can visit apfed.org/EoE and check out the links in the show notes below. [39:27] If you're looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder, available at apfed.org/specialist.   [39:36] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at apfed.org/connections.   [39:46] If you have personally been impacted by eosinophilic disorders and are interested in sharing your experience, please check out apfed.org/shareyourstory.   [39:55] Ryan thanks Dr. Beveridge for joining us. This was a fun conversation and really insightful. Holly thanks APFED's Education Partners AstraZeneca, GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode:   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.orgapfed.org/specialist apfed.org/connections Claire Beveridge, MD Cleveland Clinic Education Partners: This episode of APFED's podcast is brought to you thanks to the support of AstraZeneca, GSK, Sanofi, Regeneron, and Takeda.   Tweetables (Edited):   "I have loved the work that we've done [at the Cleveland Clinic]. It's been really nice to center everything on our EoE patients and have nice multidisciplinary care with speech-language pathologists, allergists, dietitians, pulmonologists, and everyone." — Claire Beveridge, MD   "It's a little crazy to think that it's only in the last few years that we have had FDA-approved medications for [EoE], and that we have been jerry-rigging asthma medications to treat our patients." — Claire Beveridge, MD   "On the whole, dysphagia means issues with swallowing. … It's a feeling of something getting stuck or something slowly moving down. There are also subtle symptoms that can happen." — Claire Beveridge, MD   "The goal of a dilation is to get a disruption because there's scar tissue we want to break open." — Claire Beveridge, MD   "I am looking at the breath metabolome. If we breathe into a bag and take a look at all the volatile organic compounds that are in our breath, can we find a signature related to EoE?" — Claire Beveridge, MD   Guest Bio: Claire Beveridge, MD, is a Staff Member in the Department of Gastroenterology and Hepatology and heads the Eosinophilic Esophagitis (EoE) adult clinic as well as the transition pediatric to adult EoE clinic. Dr. Beveridge's specialty interests include: EoE, Achalasia, Barrett's esophagus, GERD, esophageal swallowing disorders, and esophageal motility disorders.

In this Supplement Stack Series episode, Nurse Doza breaks down his Good Poops Protocol—a simple liver and gut detox built on three MSW supplements: the Gut glutamine powder, Liver Boost, and Berberine. He explains why gut issues often show up before liver and gallbladder trouble, how repairing the digestive tract may ease inflammation, and how pairing the two-month reset with a Mediterranean diet and better daily habits supports better energy, weight, and, of course, better poops. FEATURED PARTNER The Good Poops Protocol bundles three MSW Nutrition supplements—the Gut glutamine powder, Liver Boost, and Berberine—into one two-month liver and gut detox designed to help reset, repair, and support the digestive tract discussed in this episode. Because gut, liver, and gallbladder issues so often travel together, the protocol targets all three at once, and pairs best with a Mediterranean-style diet and simple daily habits.

Who's better at delivering palliative care to patients with liver disease: palliative care specialists, or hepatologists who have received liver disease-specific palliative care training?  That's the question we take a deep dive into on this week's podcast by breaking down the PAL-LIVER trial, published this year in JAMA Internal Medicine. We've invited three of the trial's authors, Manisha Verma, Chris Woodrell, and Marie Bakitas, to discuss this cluster-randomized clinical trial spanning 19 U.S. medical centers. We'll discuss: Why was this trial done? Do we really need to run a separate palliative care trial for every single organ disease? What kind of specialized palliative care training did the hepatologists receive? What exactly is meant by the finding that hepatologists were not statistically superior, but were shown to be statistically non-inferior? Lastly, we discuss whether these results change anyone's practice, and whether healthcare systems should decide which type of palliative care model to fund (primary vs. specialty.) —- References we discussed Developing palliative care interventions in liver disease using formative and summative qualitative evaluation. Hepatology 2026  Palliative Care for Advanced Liver Disease: Hepatology and Palliative Care Specialists Experiences. J Pain Symptom Manage 2026     

In this episode of Better Edge, Transplant Hepatologist Laura Lulik, MD moderates a panel discussion about the Northwestern Medicine Liver Transplant Tumor Clinic. The conversation covers advances in imaging, systemic therapies and innovative procedures, as well as the clinic's multidisciplinary approach.The panel includes: • Daniel Borja, MD, transplant surgeon• Aparna Kalyan, MD, medical oncologist • Robert Lewandowski, MD, interventional radiologist• Amira Borhani, MD, abdominal radiologist

nterested in one of the most unique and trainee focussed hepatology fellowships in Australia? Watch below ⬇️ ⬇️ ⬇️ Opportunity to tailor your experience in:1. Dedicated HCC clinic including prescribing immunotherapy with incorporated clinical trials 2. Specialised clinics in PBC and PSC-IBD3. Options to have specialised clinics in complex portal hypertension/advanced hepatology/MASLD/ARLD4. Dedicated experience as "consultant on the ward" 5. Portal hypertension endoscopy lists6. Be part of multiple investigator and the latest phase 3 trials 7. International collaborations 8. Learn from experts in clinical, research and public healthJoin us at the Sunshine Coast. What are you waiting for? To apply: https://lnkd.in/gG9dy_GFDeadline: 16th June

Dr. Kofi Clarke, Chief of Gastroenterology and Hepatology at Penn State Health Milton S. Hershey Medical Center, joins The Spark to discuss celiac disease and a new clinic designed to provide comprehensive care for patients throughout the region.In White Care: The Impact of Race on American Infrastructure, Prof. Cotten Seiler argues that the decline of U.S. infrastructure isn't just about cost—it's about race. He explores how, beginning in the mid-20th century, many white Americans withdrew support from public systems once their benefits expanded to include Black and Brown communities. From schools and public parks to transportation and healthcare, Seiler connects disinvestment and “white flight” to the deterioration of shared resources nationwide, including in Pennsylvania cities. This conversation reframes infrastructure as a reflection of who society chooses to care for—and who it doesn't.

We sit down with Jim Doyle to explore the timeless art of bonsai. With over 53 years of experience as part of the Susquehanna Bonsai Club, Jim shares the origins and cultural significance of bonsai, along with practical insights into how to care for these living works of art. From shaping techniques to long-term maintenance, he offers a fascinating look into the patience, creativity, and dedication behind bonsai cultivation—revealing why this ancient practice continues to inspire generations today.then,In this medical update, we highlight the launch of a new Celiac Clinic at Penn State Health Milton S. Hershey Medical Center, designed to provide the region's most comprehensive care for patients living with celiac disease. Dr. Kofi Clarke, Chief of Gastroenterology and Hepatology, discusses the clinic's multidisciplinary approach, advanced diagnostic tools, and personalized treatment plans aimed at improving patient outcomes. This episode explores how expanded resources and expert care are transforming the way celiac disease is managed in Central Pennsylvania.

Inflammatory bowel disease (IBD) is a debilitating, lifelong condition that changes how people plan their entire lives. In this episode, KT Park, Global Head of Gastroenterology and Hepatology, and Seppi Lin, Head of OMNI Early Clinical Development, explore the complex biology behind IBD. They discuss the role of genetics, the gut microbiome, and an individual's environment, as well as the exciting future of "immune reset" therapies that could offer hope for people with IBD. Read the full text transcript at www.gene.com/stories/the-abcs-of-ibd

Imaginemos el intestino de un recién nacido como un ecosistema que empieza a formarse desde las primeras horas de vida. En poco tiempo, millones de microorganismos colonizan el intestino y forman lo que conocemos como la microbiota, un sistema que hoy sabemos influye en inmunidad, el metabolismo y el desarrollo del sistema inmune. En la práctica clínica surgen muchas preguntas, ¿qué factores moldean la microbiota en los primeros años de vida y cuándo realmente tiene sentido utilizar probióticos en pediatría? En este episodio conversamos sobre este tema, que genera cada vez más interés entre pediatras. Nuestro invitado es el Dr. Diego Marmarusso, gastroenterólogo pediatra, que nos acompaña desde Argentina. El Dr. Diego Marmarusso es Jefe de Servicio Hospital Roque Sáenz Peña. Es docente Universitario (UCA) y coordinador del grupo Alergia Alimentaria del Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition - LASPGHAN - Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica. Instagram: @‌gastroinfantil.ok ¿Tienes algún comentario sobre este episodio o sugerencias de temas para un futuro podcast?  Escríbenos a pediatrasenlinea@childrenscolorado.org.

Fatty liver disease (MASLD) is a major cause of liver disease and even liver failure. But many are surprised to learn it's not primarily a liver problem. Growing evidence suggests the root issue may be metabolic dysfunction affecting the entire body, and that perspective can drastically change how we approach treating and preventing it.In this interview, Dr. Bret Scher sits down with Dr. Adam Wolfberg to discuss a newly published study in Hepatology examining how a ketogenic intervention may help prevent metabolic liver disease before it progresses.The conversation explores MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (metabolic dysfunction-associated steatohepatitis), conditions that now affect millions of people and are closely linked to obesity, insulin resistance, and type 2 diabetes.You'll learn:Why metabolic diseases are deeply interconnectedHow ketogenic interventions may improve liver healthWhat the new research found about preventing MASLD and MASHWhy weight loss alone may not explain the benefitsHow lifestyle interventions compare to pharmaceutical approachesWhy prevention is often overlooked in modern healthcareThe broader connection between metabolic health and chronic diseaseDr. Wolfberg also explains why treating metabolic dysfunction as a whole-body condition, rather than a collection of separate diseases, may change the future of medicine.

Editor's Choice:  Optimization of methylated DNA markers to rule out endometrial cancer in patients with abnormal uterine bleedingEditorial: Tampon-based methylated DNA testing for endometrial cancer: Promising innovation, but prudence before practiceHosted by: Charles N. Landen Jr., MD; University of Virginia Charlottesville, VA, USAFeaturing: Jamie N. Bakkum-Gamez, MD; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USAJohn B. Kisiel, MD; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USAJoy M. Davis MD; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USACheck out more content on the journal's homepage  at https://www.gynecologiconcology-online.net

Pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) is on the rise – what clinicians must know to identify, manage and act early. Learn more about MASLD.

Dr. John Pandolfino, Chief of Gastroenterology and Hepatology and Director of the Northwestern Medicine Digestive Health Institute, joins John Landecker to discuss a new technology Northwestern has been working on and developing that could allow doctors to make a “digital twin” of your body part to help with treatment.

Dr Philip Smith, Digital and Education Editor of Gut and Honorary Consultant Gastroenterologist at the Royal Liverpool Hospital, Liverpool, UK interviews Professor Amanda Muir from the Department of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA, on the paper "FOXM1 inhibition reduces IL-13-induced epithelial remodelling and inflammation in eosinophilic oesophagitis" published in paper copy in Gut in May 2026. Please subscribe to the Gut podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3UOTwqS) or Spotify (https://bit.ly/4rRJeUI).  

In this episode of Bowel Sounds, hosts Drs. Amber Hildreth and Jennifer Lee talk to Dr. Elizabeth Rand, a pediatric gastroenterologist in the Division of Gastroenterology, Hepatology and Nutrition at Children's Hospital of Philadelphia (CHOP), Medical Director of CHOP's Liver Transplant Program, Director of the Gastroenterology Fellowship Program and Director of the Advanced Transplant Hepatology Program. We talk everything about Fontan Associated Liver Disease (FALD), from diagnosis to management and future research opportunities in the field. Learning objectivesDescribe the pathophysiology of FALDUnderstand the management challenges in patients with FALDExplore the unanswered questions about FALD to help guide future research priorities Links:Single-cell multiomics guided mechanistic understanding of Fontan-associated liver diseaseSend us Fan MailSupport the showThis episode may be eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

ReferencesProgress in Cardiovascular Dis. 2024.84:60-67https://www.nih.gov/news-events/news-releases/breast-cancer-risk-younger-women-may-be-influenced-hormone-therapyNature Reviews Gastroenterology & Hepatology. 2019. volume 16, pages 411–428 Jpn J Clin Oncol. 2025 Jun 3;55(9):1000–1004Experimental Gerontology2001. Volume 36, Issue 2, February 311-326Guerra, DJ. 2026. Unpublished LecturesDylan, B. 1974. Forever Young The Bandhttps://open.spotify.com/track/5S6wwhjhS8jt68st9x7D3R?si=c4afc98267ca4081Kirwan, D. 1972. Dust. Fleetwood Machttps://music.youtube.com/watch?v=-i3w576gr9o&si=DD1GHxR74WuBpb6kHunter/Garcia. 1975. Crazy Fingers Grateful Dead.https://open.spotify.com/track/6Obp165E1szELuAP7p96Zb?si=a05d065c663b4503

Today, we're diving into autoimmunity—what it actually is, why it happens, and how ultra-processed foods may be contributing to the problem. Autoimmune disease is often misunderstood. Some will tell you diet has nothing to do with it. Others claim diet is the cure. The truth is more nuanced—and that's exactly what we explore in this episode. You'll learn: What autoimmunity really is (and why it's a case of mistaken identity) How inflammation and the immune system interact The critical role of gut health and the microbiome How ultra-processed foods disrupt intestinal integrity and immune signaling Why stress and hyper-palatable foods create a harmful cycle A practical experiment you can try to see how diet impacts your own biomarkers This isn't about selling supplements or pushing extremes. It's about understanding the science so you can make informed decisions about your health. As always, this episode is backed by scientific literature. Full citations are included below, with abbreviated versions available on shorter clips. If you're dealing with autoimmune symptoms—or just want to better understand how food impacts your immune system—this episode is for you.   Full citation list: Hall KD, et al. “Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake.” Cell Metabolism, 2019.     Supports the formulation argument: UPF intake increased spontaneous calorie intake and weight gain even with diets matched for presented calories, sugar, fiber, sodium, and macronutrients. This is your anchor for “hyper-palatability and formulation change physiology, not just psychology.”   Narula N, et al. “Association of Ultra-Processed Food Intake With Risk of Inflammatory Bowel Disease: Prospective Cohort Study.” BMJ, 2021.     Best human disease-level citation for the episode. Supports the claim that higher UPF intake is associated with greater IBD risk, making the gut-immune link clinically meaningful rather than purely theoretical.   Chassaing B, et al. “Randomized Controlled-Feeding Study of Dietary Emulsifier Carboxymethylcellulose Reveals Detrimental Impacts on the Gut Microbiota and Metabolome.” Gastroenterology, 2022.     Best emulsifier paper for human translation. Supports the claim that CMC can perturb the microbiota and metabolome and may contribute to barrier-hostile gut ecology in susceptible individuals.   Daniel N, et al. “Human Intestinal Microbiome Determines Individualized Responses to Dietary Emulsifier Carboxymethylcellulose.” Cellular and Molecular Gastroenterology and Hepatology, 2024.     Useful nuance paper. Supports the point that emulsifier sensitivity is not identical across all people and that host-microbiome context matters.   Shil A, et al. “Artificial Sweeteners Disrupt Tight Junctions and Barrier Function in the Intestinal Epithelium Through Activation of the Sweet Taste Receptor T1R3.” Nutrients, 2020.     Best citation for the “sugar-free does not mean barrier-neutral” point. Supports direct epithelial barrier effects of common artificial sweeteners in experimental models.   Peng L, et al. “Butyrate Enhances the Intestinal Barrier by Facilitating Tight Junction Assembly via Activation of AMP-Activated Protein Kinase in Caco-2 Cell Monolayers.” Journal of Nutrition, 2009.     Classic mechanistic citation for butyrate. Supports the claim that loss of fermentable fiber and reduced butyrate production can weaken barrier function.   Kumar KP, et al. “The Interplay Between the Microbiota, Diet and T Regulatory Cells in Maintaining Intestinal Homeostasis.” Frontiers in Microbiology, 2023.     Useful for the tolerance language. Supports the argument that diet and microbial metabolites shape Treg biology and mucosal tolerance.   Haase S, et al. “Sodium Chloride Triggers Th17 Mediated Autoimmunity.” Frontiers in Immunology, 2019.     Key citation for high salt and autoimmune-prone immune skewing. Supports the claim that excess salt can promote pathogenic Th17 biology relevant to autoimmune disease.   Wilck N, et al. “Salt-Responsive Gut Commensal Modulates TH17 Axis and Disease.” Nature, 2017.     Strong bridge between salt, microbiome, and Th17 signaling. Supports the point that salt is not just a blood pressure story; it is also an immune-story.   Vitales-Noyola M, et al. “Analysis of Sodium Chloride Intake and Treg/Th17 Lymphocytes in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus.” Journal of Immunology Research, 2018.     Helpful human-facing citation for salt and immune skewing in autoimmune populations. Use cautiously, but it strengthens translation from theory to autoimmune terrain.   Phuong-Nguyen K, et al. “Advanced Glycation End-Products and Their Effects on Gut Health.” Nutrients, 2023.     Good review for the AGE section. Supports the argument that AGE-rich processed foods may worsen oxidative stress, microbiota balance, and barrier function.   Chen Y, et al. “Dietary Advanced Glycation End-Products Elicit Toxicological Effects by Disrupting Gut Microbiota and Increasing Colon Permeability in Rats.” Journal of Toxicology and Environmental Health, 2021.     Useful mechanistic support for the processing-chemistry section. Reinforces the claim that dietary AGEs can alter microbial ecology and increase permeability.   Monteiro CA, et al. “Ultra-Processed Foods: What They Are and How to Identify Them.” Public Health Nutrition, 2019.   Dr. Brendan McCarthy is the founder and Chief Medical Officer of Protea Medical Center in Arizona. With over two decades of experience, he's helped thousands of patients navigate hormonal imbalances using bioidentical HRT, nutrition, and root-cause medicine. He's also taught and mentored other physicians on integrative approaches to hormone therapy, weight loss, fertility, and more. If you're ready to take your health seriously, this podcast is a great place to start.  

In this episode, I'm joined by Christina Jagielski, GI health psychologist and Clinical Assistant Professor in the Division of Gastroenterology and Hepatology at Michigan Medicine. Dr Jagielski specialises in the intersection of psychological trauma and gastrointestinal health, using evidence-based approaches such as cognitive behavioural therapy, acceptance and commitment therapy, relaxation training, and gut-directed hypnotherapy to support patients with a range of GI conditions. In this episode, we explore trauma-informed care in gastroenterology — including how trauma can shape gut symptoms, patient behaviour, and healthcare experiences. We unpack the biological and psychological pathways linking trauma and the gut–brain axis, the risk of re-traumatisation in clinical settings, and why patients with trauma histories often experience more severe symptoms and poorer quality of life. We also discuss practical strategies for clinicians and healthcare teams, including how to create safer, more compassionate environments through trauma-informed principles such as safety, transparency, choice, and collaboration. Whether you're a clinician, researcher, or someone living with a gut condition, this episode offers powerful insights into how care can be delivered in a way that heals, rather than harms. Please enjoy my conversation with Dr Christina Jagielski.

In this must listen episode, we sit down with Australia's leading liver expert Professor Jacob George to talk about one of the body's most important — and most overlooked — organs: the liver. This miracle organ keeps us alive. It filters, processes, stores, regulates, and protects us, yet most of us know very little about it until something goes wrong. Today that changes. We discuss the basics of the liver along with why fatty liver is now so common, how it links to insulin resistance, visceral fat, menopause, and metabolic disease, and why liver disease can develop silently for years. Professor George explains why liver health matters far beyond alcohol, and how it connects to blood sugar, cholesterol, hormones, inflammation, and long-term disease risk. The good news? The liver can recover if we get in early. We also cover the key tests to know, what can be missed, and the simple lifestyle changes that can help restore liver health and change your future trajectory. Please share this episode with those who need to hear it. If we want to live 120 healthy years we must make better choices for the liver. Join The Aging Project

A minority of patients requiring blood transfusions are increasingly requesting ‘unvaccinated' blood in the United States, per a new report published in the journal Transfusion. Our studio guest today, genito-urinary consultant Vanessa Apea, explains how this can lead to potentially dangerous delays and higher risks.Presenter Claudia Hammond speaks to Dr Angela Wu, from the Centre for Evidence-Based Medicine and Oxford Tobacco Addiction Group at the University of Oxford, about a new overview of the best available evidence worldwide for smoking cessation. The study, published in the journal Addiction, has found that nicotine‑containing e‑cigarettes appear to be more effective for stopping people smoking than other interventions.We hear how metabolic liver disease could affect nearly 1.8 billion people by 2050, according to new research published in The Lancet Gastroenterology & Hepatology journal. The growing number of cases means that many people are at risk of developing serious complications, however, the study also found that although more people are developing the disease, the overall impact on health has remained stable due to advances in treatment and care.We also hear from BBC World Service reporter Sen Nguyen in Vietnam as Hanoi plans to pilot a new low-emission zone from July to tackle air pollution. We hear what the proposed changes are and with the prevalence of diesel motorbikes in the city, how prepared are residents, workers and businesses for this change?And Claudia and Vanessa discuss whether living with friends may quietly be altering your gut bacteria, following new research published in the journal Molecular Ecology.Presenter: Claudia Hammond Producer: Jonathan Blackwell and Hannah Robins

In our April episode, gastroenterologist Dr. Preeti Mehta explained the connection between a healthy gut and a healthy mind. She also talked about the role stress plays in irritable bowel syndrome (IBS), a common digestive disorder that can often be managed with lifestyle changes. In this month's Key Note, Dr. Mehta discusses two other conditions that can be confused with IBS—and why getting the diagnosis right really matters. The Takeaway We want to hear from you! Please complete our survey: 1199SEIUBenefits.org/member-feedback. Drop us a line at our social media channels: Facebook // Instagram // YouTube. Find out where your health stands by making an appointment with your primary care physician. Don't have one? Find one at our Provider Directory: www.1199SEIUBenefits.org/find-a-provider. Visit the Healthy Living Resource Center for wellness tips, information and resources; www.1199SEIUBenefits.org/healthyliving. Get to know your numbers at www.1199SEIUBenefits.org/healthyhearts. Need support managing chronic conditions such as type 2 diabetes, hypertension or overweight? Learn about our partnerships: visit www.1199SEIUBenefits.org/the-choice-is-yours/ Browse healthy recipes and meal-prep tips at www.1199SEIUBenefits.org/food-as-medicine. Get inspired by fellow members through our Members' Voices series: www.1199SEIUBenefits.org/healthyliving/membervoices. Stop by our Benefits Channel to join webinars on building healthy meals, managing stress and more: www.1199SEIUBenefits.org/videos. Visit our  YouTube channel to view a wide collection of healthy living videos: www.youtube.com/@1199SEIUBenefitFunds/playlists. Sample our wellness classes to exercise body and mind: www.1199SEIUBenefits.org/wellnessevents   Guest Bio Preeti Mehta, MD, is a board-certified gastroenterologist and hepatologist with over 25 years of experience in digestive health care. She serves as Vice President of Digestive Disease Care, a multi-physician gastroenterology practice, and oversees two large Ambulatory Surgical Centers serving patients across Long Island and Queens. Dr. Mehta earned her Doctor of Medicine degree from the Icahn School of Medicine at Mount Sinai and completed her internship and residency in Internal Medicine at North Shore University Hospital in Manhasset, New York. She went on to complete a Research Fellowship in Hepatology at NewYork-Presbyterian Hospital, in affiliation with Weill Medical College of Cornell University and Rockefeller University. She also completed a Clinical Fellowship in Gastroenterology and Hepatology and an Advanced Endoscopy Fellowship in Endoscopic Ultrasound at the State University of New York. She is a member of the American College of Gastroenterology, the American Society for Gastrointestinal Endoscopy and the American Association for the Study of Liver Diseases.

In this episode of *PICU Doc on Call*, Drs. Monica Gray, Pradip Kamat, and Rahul Damania chat about a 17-year-old girl who ended up with acute liver failure after she intentionally took 22.5 grams of acetaminophen. She came in 48 hours later with really high transaminases and an INR of 5.5, so she was admitted to the PICU. The hosts break down how acetaminophen affects the body, walk through its four clinical stages, and discuss how to manage it—focusing on N-acetylcysteine as the primary antidote. They also touch on other treatments, like fomepizole. Thankfully, this patient recovered without needing a liver transplant, which really shows how important it is to have a team approach with intensivists, hepatologists, toxicologists, and psychiatry all working together.Show Highlights:Clinical case presentation of a 17-year-old girl with acetaminophen ingestion leading to acute liver failureMechanism of acetaminophen toxicity and its metabolic pathwaysEpidemiology of acetaminophen toxicity in pediatric populationsPathophysiology of acetaminophen overdose and its effects on liver functionClinical manifestations and progression of acetaminophen toxicity through various stagesEvaluation and diagnostic criteria for assessing acetaminophen toxicityManagement strategies for acetaminophen overdose, including the use of N-acetylcysteine (NAC).Discussion of adjunctive therapies such as fomepizole in severe cases.Importance of supportive care in managing complications of acute liver failureAn interdisciplinary approach to treatment involving various medical specialtiesReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter ***.Reference 1: 2019 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 37th Annual Report. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Brooks DE, Dibert KW, Rivers LJ, Pham NPT, Ryan ML. Clin Toxicol (Phila). 2020;58(12):1360.Reference 2: Pepin L, Matsler N, Fontes A, Heard K, Flaherty BF, Monte AA. Fomepizole Therapy for Acetaminophen-Induced Liver Failure in an Infant. Pediatrics. 2023 Oct 1;152(4):e2022061033. doi:10.1542/peds. 2022-061033. PMID: 37681263.Reference 3. Chiew AL, Buckley NA. Acetaminophen Poisoning. Crit Care Clin. 2021 Jul;37(3):543-561.Reference 4. Squires JE, Alonso EM, Ibrahim SH, Kasper V, Kehar M, Martinez M, Squires RH. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure. J Pediatr Gastroenterol Nutr. 2022 Jan 1;74(1):138-158. doi: 10.1097/MPG.0000000000003268. PMID: 34347674.

The Daily Quiz - Science and Nature Today's Questions: Question 1: Which Significant Did Dr John Pemberton Of Atlanta Georgia Invent In 1886? Question 2: What simple type of "camera" uses a hole in a screen to create a simply-viewed image of the sun? Question 3: What Process Is Used For Dating Ancient Organic Objects? Question 4: What is the word for a group of starlings? Question 5: What is the name of the science that studies the origin, history, and structure of the Earth? Question 6: A young sea lion is known as what? Question 7: What is the term for the cleaning process that birds engage in? Question 8: What is the sum of 1+2+3+4+5? Question 9: What is Hepatology the study of? This podcast is produced by Klassic Studios Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us Fan MailPaper Discussed in this Episode:Quantitative regression of qFibrosis with resmetirom: Exploratory histologic endpoints from the MAESTRO-NASH phase III clinical trial. Schattenberg JM, Bedossa P, Guy CD, et al. Journal of Hepatology 2026; https://doi.org/10.1016/j.jhep.2026.03.021.Episode Summary: In this deep dive, we explore how artificial intelligence is revolutionizing the way we measure liver disease recovery. We examine a groundbreaking 2026 Phase III clinical trial (MAESTRO-NASH) that compared traditional human pathologist staging against an AI-driven digital pathology tool called qFibrosis. The study forces us to reconsider our clinical gold standards by asking: what if AI can detect subtle biological healing that the experienced human eye completely misses?In This Episode, We Cover:• The Silent Epidemic: Understanding Metabolic dysfunction-associated steatohepatitis (MASH), a progressive, active form of fatty liver disease linked to cardiovascular risk and cirrhosis. We discuss why precisely tracking the reversal of liver fibrosis is crucial for patient outcomes.• The "Ordinal" Problem: Why the current "gold standard"—human pathologists assigning a simple ordinal score (like Stage F1, F2, or F3)—is subjective and fails to capture the dynamic, nuanced reality of fibrosis progression and regression.• The AI Microscope (SHG & qFibrosis): ◦ SHG (Second Harmonic Generation): An imaging technique that takes advantage of the physical properties of collagen to map out the three-dimensional architecture of the liver. ◦ qFibrosis: An AI-driven analysis tool that evaluates up to 184 distinct features of liver collagen (like string length, width, and intersections) across different regions of the liver lobule, providing a continuous, hyper-detailed assessment rather than a basic category.• The Showdown - Humans vs. AI: Using data from 966 patients in the MAESTRO-NASH trial, we compare how human pathologists and the AI evaluated liver biopsies at baseline and week 52 to test the efficacy of the drug resmetirom.• The AI's "Aha!" Moment (Seeing the Invisible): The most shocking finding of the study occurred in the "non-responder" group. Even when human consensus reads declared certain patients had no histological improvement, the AI detected significant, continuous reductions in liver fibrosis (qFC scores). The digital pathology tool was able to pick up on subthreshold, early matrix remodeling that was entirely invisible to standard manual scoring.• Mapping the Liver's Healing: The AI proved its biological accuracy by successfully linking its spatial data to real-world clinical outcomes. The AI found that specific regional changes—particularly in the portal tract—strongly correlated with non-invasive liver stiffness tests like Magnetic Resonance Elastography (MRE).Key Takeaway: AI isn't here to replace human pathologists; it is a hyper-sensitive tool designed to uncover hidden data patterns. By detecting continuous, region-specific changes in liver collagen, AI digital pathology can identify early therapeutic responses to MASH treatments that traditional staging misses, fundamentally changing how we track disease reversal and personalize medicineSupport the showGet the "Digital Pathology 101" FREE E-book and join us!

This month, Health Is the Key does double duty as we spotlight National Stress Awareness Month and IBS Awareness Month. If you're wondering what stress has to do with irritable bowel syndrome and other digestive disorders, you'll be glad you tuned in. We are lucky to be joined by Dr. Preeti Mehta, a gastroenterologist and founder of the private practice Digestive Disease Care. Dr. Mehta explains the effect the brain has on the digestive system and vice-versa. She also shares practical lifestyle habits that can support long-term gut health.    The Takeaway  We want to hear from you! Please complete our survey: 1199SEIUBenefits.org/member-feedback. Drop us a line at our social media channels: Facebook // Instagram // YouTube. Find out where your health stands by making an appointment with your primary care physician. Don't have one? Find one at our Provider Directory: www.1199SEIUBenefits.org/find-a-provider.  Visit the Healthy Living Resource Center for wellness tips, information and resources; www.1199SEIUBenefits.org/healthyliving. Get to know your numbers at www.1199SEIUBenefits.org/healthyhearts.  Need support managing chronic conditions such as type 2 diabetes, hypertension or overweight? Learn about our partnerships: visit www.1199SEIUBenefits.org/the-choice-is-yours/ Browse healthy recipes and meal-prep tips at www.1199SEIUBenefits.org/food-as-medicine.  Get inspired by fellow members through our Members' Voices series: www.1199SEIUBenefits.org/healthyliving/membervoices.  Stop by our Benefits Channel to join webinars on building healthy meals, managing stress and more: www.1199SEIUBenefits.org/videos. Visit our  YouTube channel to view a wide collection of healthy living videos: www.youtube.com/@1199SEIUBenefitFunds/playlists. Sample our wellness classes to exercise body and mind: www.1199SEIUBenefits.org/wellnessevents.   Guest Bio  Preeti Mehta, MD, is a board-certified gastroenterologist and hepatologist with over 25 years of experience in digestive health care. She serves as Vice President of Digestive Disease Care, a multi-physician gastroenterology practice, and oversees two large Ambulatory Surgical Centers serving patients across Long Island and Queens.  Dr. Mehta earned her Doctor of Medicine degree from the Icahn School of Medicine at Mount Sinai and completed her internship and residency in Internal Medicine at North Shore University Hospital in Manhasset, New York. She went on to complete a Research Fellowship in Hepatology at NewYork-Presbyterian Hospital, in affiliation with Weill Medical College of Cornell University and Rockefeller University. She also completed a Clinical Fellowship in Gastroenterology and Hepatology and an Advanced Endoscopy Fellowship in Endoscopic Ultrasound at the State University of New York. She is a member of the American College of Gastroenterology, the American Society for Gastrointestinal Endoscopy and the American Association for the Study of Liver Diseases. 

Welcome to Monsters on the Edge, a show exploring creatures at the edge of our reality in forests, cities, skies, and waters. We examine these creatures and talk to the researchers studying them.Joining us on this week's show:Terry Cullen's career in conservation began long before he stepped into a university lecture hall, sparked by a childhood fascination that saw him conducting fieldwork by age 13. By 17, he was already navigating the ecosystems of South America and the Caribbean, gathering the field experience that would define his life's work. In the summer of 1964, Terry founded the Dragonwood Wildlife Conservancy, a visionary project that has evolved over six decades from a modest sanctuary into a massive 400-acre Florida nature reserve supported by four satellite facilities across the United States.To complement his decades of hands-on experience, Terry pursued formal degrees in Zoology and Environmental Science, cementing his status as a leading expert in herpetology. His influence now spans the globe through senior roles in prestigious organizations like the IUCN Crocodile Specialist Group and the Species Survival Commission (SSC). From pioneering crocodilian DNA research to leading the Philippine crocodile conservation initiative, Terry has spent over 60 years bridging the gap between adventurous exploration and critical scientific preservation.Dragonwood Conservancy Websitehttps://www.dragonwoodconservancy.org/Click that play button, and let's unravel the mysteries of the UNTOLD! Remember to like, share, and subscribe to our channel to stay updated on all the latest discoveries and adventures. See you there!Join Barnaby Jones each Monday on the Untold Radio Network Live at 12pm Central – 10am Pacific and 1pm Eastern. Come and Join the live discussion next week. Please subscribe.We have ten different Professional Podcasts on all the things you like. New favorite shows drop each day only on the UNTOLD RADIO NETWORKTo find out more about Barnaby Jones and his team, (Cryptids, Anomalies, and the Paranormal Society) visit their website www.WisconsinCAPS.comMake sure you share and Subscribe to the CAPS YouTube Channel as wellhttps://www.youtube.com/channel/UCs7ifB9Ur7x2C3VqTzVmjNQ

In this special series on Metabolic-Dysfunction Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-associated steatohepatitis (MASH) our host, Dr. Neil Skolnik will discuss diagnosis and treatment of MASH using a case-based approach with two master clinicians, one a hepatologist and the other a primary care physician. This special episode is supported by an independent educational grant from Boehringer Ingelheim. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Alina M. Allen, M.D. Associate Professor of Medicine at Mayo Clinic in Rochester, Minnesota, where she serves as the Director of Hepatology and Director of the MASLD Clinic. Susan Kuchera, M.D. - Program Director of the Jefferson Health Abington Family Medicine Residency Program, Clinical Associate Professor of Family and Community Medicine in the Sidney Kimmel Medical College of Thomas Jefferson University Selected references: Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) in People With Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association. Diabetes Care 2025;48(7):1057–1082  

February 16, 2026 ~ Dr. Sumit Singla, MD, Senior Staff, Advanced Therapeutic Endoscopy. Chief of Gastroenterology and Hepatology, Henry Ford Health discusses the spike in colorectal cancer deaths in people under 50 after James Van Der Beek dies at 48. Hosted by Simplecast, an AdsWizz company. See https://pcm.adswizz.com for information about our collection and use of personal data for advertising.

Tune in to listen as expert faculty, Dr Christopher L. Bowlus and Dr Sonal Kumar, discuss recent developments in treating primary biliary cholangitis (PBC) with new and emerging agents, as well as strategies to integrate these advances into clinical practice.Topics covered include: Methods of Assessing PBC Disease ProgressionNewer Agents for Second-line Treatment of PBCPrioritizing Symptom Management and Quality of Life With PBC TreatmentPresenters:Christopher L. Bowlus, MDLena Valenta Professor and ChiefDivision of Gastroenterology and HepatologySchool of Medicine University of California Davis Sacramento, CaliforniaSonal Kumar, MD, MPHAssistant Professor of MedicineDivision of Gastroenterology and HepatologyWeill Cornell Medical CollegeNew York, New YorkLink to full program: https://bit.ly/43nHx6UGet access to all of our new podcasts by subscribing to the Decera Clinical Education Infectious Disease Podcast on Apple Podcasts, YouTube Music, or Spotify. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Pediatrician Dr. Paul Bunch consults Dr. Stavra Xanthakos from the Division of Gastroenterology, Hepatology and Nutrition and Dr. Nancy Crimmins from the Division of Diabetes and Endocrinology on GLP1s. Episode recorded on January 29, 2026. Financial Disclosure:  The following relevant financial relationships have been disclosed: Stavra Xanthakos, MD: Novo Nordisk - Advisor; TargetRWE - Grant/Research support*; Madrigal - Advisor* *Indicates relationship has ended All relevant financial relationships listed have been mitigated. Remaining persons in control of content have no relevant financial relationships. To Claim Credit: Click "Here" to launch website to access the CME course. After listening to the entire podcast, click "Post Test" and complete.   Accreditation In support of improving patient care, Cincinnati Children's Hospital Medical Center is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Specific accreditation information will be provided for each activity. Physician:  Cincinnati Children's designates this Enduring Material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nursing:  This activity is approved for a maximum 0.50 continuing nursing education (CNE) contact hours. ABP MOCpt2: Completion of this CME activity, which includes learner assessment and feedback, enables the learner to earn up to 0.50 points in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program. Cincinnati Children's submits MOC/CC credit for board diplomates. Credits AMA PRA Category 1 Credits™ (0.50 hours), ABP MOC Part 2 (0.50 hours), CME - Non-Physician (Attendance) (0.50 hours), Nursing CE (0.50 hours)    

In the second episode of the series, Vallier dives into clinical translation of research to different forms of liver disease, exploring how organoids may serve as an alternative to liver transplantation, and how immune compatibility differs between the two. Timestamps:00:59 – Organoids versus transplantation 02:52 – Organoid immune compatibility 04:58 – Chronic liver diseases 06:15 – Clinical application

In this final episode, Vallier explores the next steps for liver regeneration research, including stimulating liver regeneration with small molecules and lifestyle factors. He describes AI as a tool that should not be used in the wrong way, before wrapping up the discussion with his predictions for the next 5 years and the introduction of induced pluripotent stem cell clinical trials. Timestamps:00:55 – Research beyond organoids 02:01 – Lifestyle factors 03:47 – Research funding 04:13 – AI in biotechnology 05:13 – Future of regenerative medicine 07:04 – Vision for stem cell therapies

In this first deep dive, Vallier discusses the current state of liver regeneration research. He explores how pluripotent stem cells can generate hepatocytes and biliary cells, and describes how organoids integrate into tissues whilst providing new insights into liver disease. Timestamps: 00:53 – Liver regeneration at present 03:37 – Pluripotent stem cells 05:18 – Scaling clinical use of organoids 06:42 – Application to non-alcoholic fatty liver disease 09:22 – Ethical considerations

Ludovic Vallier joins the EMJ Podcast to answer rapid-fire questions about how regenerative technologies can be harnessed to tackle metabolic liver disease. From the biggest breakthroughs in regenerative hepatology to clinical misconceptions about stem cells, explore how this field of research is changing the liver disease landscape.

Welcome to Episode 52 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! NSAIDs National Institutes of Health. (2022). Nonsteroidal antiinflammatory drugs. LiverTox: Clinical and research information on drug-induced liver injury. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK548614/ LFTs / Drug-Induced Liver Injury American Association for the Study of Liver Diseases. (2023). Practice guidance on drug, herbal, and dietary supplement–induced liver injury. Hepatology. Retrieved from https://journals.lww.com/hep/fulltext/2023/03000/aasldpracticeguidanceondrug,herbal,and.28.aspx Toxicology Screening StatPearls Publishing. (2023). Toxicology screening. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK499901/ Academy of Diagnostic & Laboratory Medicine. (2023). Testing for drugs of misuse to support the emergency department. Retrieved from https://myadlm.org/science-and-research/academy-guidance/testing-for-drugs-of-misuse-to-support-the-emergency-department CT Utilization / Imaging American College of Emergency Physicians. (2022). The renewed necessity of robust clinical judgment in CT scan utilization. ACEP Now. Retrieved from https://www.acepnow.com/article/the-renewed-necessity-of-robust-clinical-judgment-in-ct-scan-utilization/ Appropriate Testing / Overuse Context Melnick, E. R., et al. (2023). GRACE-2: Guidelines for reasonable and appropriate care in the emergency department. Academic Emergency Medicine. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/acem.14495 More from us: Our CME courses: EM Boot Camp: https://courses.ccme.org/course/embootcamp/about EM Boot Camp Pharmacology Workshop: https://bit.ly/2I44xld Bouncebacks! Medical & Legal: https://courses.ccme.org/education/bouncebacks-medical-and-legal Mastering Emergency Imaging: https://courses.ccme.org/education/mastering-emergency-imaging Advanced EM Boot Camp: https://courses.ccme.org/course/advancedbootcamp/about Advanced ECG Workshop: https://bit.ly/aembc-ecg Advanced Imaging Workshop: https://bit.ly/aembc-imaging EM & Acute Care: https://courses.ccme.org/course/ema/about National EM Board Review: https://courses.ccme.org/course/nembr/about High Risk Emergency Medicine: https://courses.ccme.org/course/hrem The Heart Course: https://courses.ccme.org/course/theheartcourse The Cadaver-Based Procedures & Suturing Courses: https://courses.ccme.org/course/cadaver EM:Prep LLSA Review: https://courses.ccme.org/course/em-prep/about EMCert Module Mastery: https://courses.ccme.org/course/emcertmodule USC Trauma Course: https://courses.ccme.org/course/usc-trauma ACOEP Scientific Assembly: https://courses.ccme.org/course/acoep Mastering Acute Care Charting - 2023 Updates: https://courses.ccme.org/course/macc Flourishing in Medicine: https://courses.ccme.org/course/flourishing-in-medicine The DEA Licensee SUD Training Course: https://courses.ccme.org/course/dea ACOFP On-Demand: https://courses.ccme.org/education/acofp25-clinical-selects The Airway and Lung Course: https://courses.ccme.org/education/airway Mastering Pediatric Emergencies: https://courses.ccme.org/course/pediatric-em Innovations in ED Management: https://courses.ccme.org/course/innovationsined American Osteopathic Association Courses: https://aoa.coursehost.net EM Cases Summit: https://courses.ccme.org/education/em-cases-summit-2024 IncrEMentuM Conference – On-Demand: https://courses.ccme.org/education/incrementum-2025 Our social media: TikTok: https://www.tiktok.com/@ccmecourses Instagram: https://www.instagram.com/ccmecourses Facebook: https://www.facebook.com/CenterForMedicalEducation LinkedIn: https://www.linkedin.com/in/rickbukata Our podcasts: The 2 View Podcast (Free): Subscribe on Apple Podcasts https://apple.co/3rhVNZw​ Subscribe on Google Podcasts: http://bit.ly/2MrAHcD​ Subscribe On Spotify: http://spoti.fi/3tDM4im Risk Management Monthly Podcast (Paid CME): https://www.ccme.org/riskmgmt ** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional. The information in this video is for informational purposes only and not for the purpose of providing legal advice. You should contact your attorney to obtain advice with respect to any particular issue or problem. Nothing here should be construed to form an attorney-client relationship. ** emergencymedicine #cme

In this episode of Bowel Sounds, hosts Dr. Temara Hajjat and Dr. Amber Hildreth and talk to Dr. William Balistreri, Dorothy M. M. Kersten Professor of Pediatrics at the University of Cincinnati, Director Emeritus of the Pediatric Liver Center at Cincinnati Children's Hospital, Medical Director Emeritus of Liver Transplantation, and Program Director Emeritus of Transplant Hepatology Fellowship. We talk about the history of the Hepatitis B virus and vaccine, and the new ACIP vaccination recommendations.Learning objectivesUnderstand the history of Hepatitis B infection and vaccination in the United StatesExamine the impact of the ACIP vote to overturn the recommendation for universal Hepatitis B vaccination for newbornsApply knowledge gained to clinical practice Support the showThis episode may be eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.Support the showThis episode may be eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

Send us a textMicroplastics are everywhere—but what are they doing inside the human body?In this episode of Causes or Cures, Dr. Eeks speaks with Dr. Christian Pacher-Deutsch about his lastest study and the growing evidence that micro- and nanoplastics may affect the digestive system, the gut microbiome, and long-term health. He explains why this problem has reached crisis level. Rather than focusing on dramatic claims or quick fixes, this conversation explores what the science actually shows, including how probiotics may help mitigate some of the harmful effects of microplastics...not by breaking them down, but by supporting gut integrity and immune balance.We discuss:What microplastics and nanoplastics are, how they're formed, and where human exposure comes fromWhy nanoplastics may be especially concerning due to their size and biological interactionsThe range of health effects microplastics have been linked to, including immune, neurological, reproductive, and carcinogenic effectsHow microplastics may disrupt the gastrointestinal tract, including digestion, inflammation, barrier function, and gut permeabilityWhat the microbiome is and why it plays a central role in healthWhy probiotics were considered as a potential solution, and what the research foundWhy probiotic bacteria are unlikely to directly degrade plasticsHow probiotics may still help reduce inflammation and support the gut's protective barriersWhether certain bacteria appear more protective than othersThe role of industry collaboration and whether probiotic formulations are being exploredWhether probiotics can realistically help us get ahead of the microplastic crisis, or if they are only part of a larger solutionPractical ways people can reduce exposure, and where reduction may be unrealisticHow diet, including probiotic- and prebiotic-rich foods, might help mitigate riskWhat this research changed about Dr. Pacher-Deutsch's own habitsWhat's next in microplastics and health researchThis episode offers a clear, evidence-based look at microplastics inside the human body—without panic, hype, or false promises.GUEST BIO: Dr. Pacher-Deutsch is a scientist and researcher in the Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria; Center for Biomarker Research in Medicine (CBmed), Graz, Austria. Work with me? Perhaps we are a good match. You can contact Dr. Eeks at bloomingwellness.com.Follow Eeks on Instagram here.Follow Public Health is WeirdOr Facebook here.Or X.On Youtube.Or TikTok.SUBSCRIBE to her WEEKLY newsletter here!Support the show

Pediatrician Dr. Jill Schaffeld consults Dr. Scott Pentiuk and Dr. Alex Nasr from the Division of Gastroenterology, Hepatology, and Nutrition on ingested foreign bodies. Episode recorded on July 31, 2025.  Resources discussed in this episode: Ingested Foreign Bodies - Community Practice Support Tool Financial Disclosure:  The following relevant financial relationships have been disclosed: None All relevant financial relationships listed have been mitigated. Remaining persons in control of content have no relevant financial relationships. To Claim Credit: Click "Launch Activity." Click "Launch Website" to access and listen to the podcast. After listening to the entire podcast, click "Post Test" and complete.   Accreditation In support of improving patient care, Cincinnati Children's Hospital Medical Center is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Specific accreditation information will be provided for each activity. Physician:  Cincinnati Children's designates this Enduring Material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  Nursing:  This activity is approved for a maximum 0.50 continuing nursing education (CNE) contact hours. ABP MOCpt2: Completion of this CME activity, which includes learner assessment and feedback, enables the learner to earn up to 0.50 points in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program. Cincinnati Children's submits MOC/CC credit for board diplomates.   Credits AMA PRA Category 1 Credits™ (0.50 hours), ABP MOC Part 2 (0.50 hours), CME - Non-Physician (Attendance) (0.50 hours), Nursing CE (0.50 hours)

In this special series on Metabolic-Dysfunction Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-associated steatohepatitis (MASH) our host, Dr. Neil Skolnik will discuss Epidemiology, Importance, Screening, Diagnosis and Treatment of MASH. This special episode is supported by an independent educational grant from Boehringer Ingelheim. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Alina M. Allen, M.D. Associate Professor of Medicine at Mayo Clinic in Rochester, Minnesota, where she serves as the Director of Hepatology and Director of the MASLD Clinic. Selected references: Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) in People With Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association. Diabetes Care 2025;48(7):1057–1082

Featuring: Emma Levine, MD, University of Chicago MedicineThe GI Research Foundation was able to produce this podcast with a sponsorship from Metro Infusion Center.In this episode, Dr. Levine, a current fellow with The University of Chicago Gastroenterology, Hepatology and Nutrition Fellowship training program, shares her 2025 GI Research Foundation Young Investigator Awards study on the reciprocal relationship between sleep and inflammation in IBD. We talk about why poor sleep is so common in people with IBD and how it can worsen disease activity—even when symptoms seem under control. Dr. Levine explains how her team is using metabolomics to uncover biomarkers that link sleep and inflammation, and why mindfulness-based approaches like yoga nidra and gut-directed hypnotherapy could be game-changers. It's a fascinating look at how improving sleep might become a safe, non-drug strategy to help manage IBD.To access other episodes of Visceral: Listen to Your Gut and learn more about the GI Research Foundation's support of clinical and laboratory research to treat, prevent, and cure digestive diseases, please visit https://www.giresearchfoundation.org/.Available on Apple Podcasts, Spotify, and everywhere else you listen.

https://BetterHealthGuy.comWhy You Should Listen:  In this episode, you will learn about the many pieces that contribute to the puzzle of Long COVID. About My Guest: My guest for this episode is Dr. Robin Rose.  Robin Rose, DO, author of "The 28-Day Gut Fix," is a double board-certified specialist in Gastroenterology and Internal Medicine, specializing in gut health and Long COVID.  She is founder and CEO of Terrain Health where she practices next-generation precision healthcare, integrating systems biology with an innovative approach that requires a deep understanding of each person's biochemical, genetic, and lifestyle factors.  Her comprehensive approach prioritizes patient-centered care by creating healthcare interventions that are more precise, personalized, predictive, participatory and preventative.  Her philosophy is deeply rooted in healing her patients from the inside out so they will age LESS.  Dr. Robin received her bachelor's degree in Behavioral Neuroscience from Lehigh University, graduating with honors. She then went on to obtain her master's degree in Neuropsychology from New York University. Dr. Robin received her medical degree from the New York College of Osteopathic Medicine, graduating with honors, and was inducted into the Psi Sigma Alpha Osteopathic National Honor Society. She did her postgraduate training in Internal Medicine, followed by fellowship in Gastroenterology and Hepatology, at Beth Israel Medical Center in New York City, and holds board certifications in both disciplines.  Dr. Robin practices longevity medicine teaching women and men how to achieve their best selves by restoring and optimizing gut health, balancing hormones, and proactively managing metabolic, cardiovascular, and brain health.  Maximizing these outcomes will pave the way for optimal healthspan and performance and looking and feeling your best! Key Takeaways: What is Long COVID? What are the symptoms or phenotypes of Long COVID? How does SARS-CoV-2 act as a bacteriophage impacting our microbiome? Who is more likely to develop Long COVID? Should ongoing exposures be avoided even if someone already had COVID? What are ACE2 receptors?  Furin cleavage site?  Receptor binding domain? What testing is used to explore Long COVID? Is there a direct test available for spike protein? What role does coagulation and vascular health play in Long COVID? How do MCAS, POTS, and EDS enter the Long COVID discussion? What is the role of neuroinflammation in Long COVID? Has cognitive decline accelerated during the pandemic era? What role do mitochondria play in Long COVID? What iron dysregulation pattern is commonly observed? Have more cancers been seen since the start of the pandemic? Do EMFs play a role in those struggling with Long COVID? How is treatment of the sensitive patient approached? What is the high-level treatment methodology for those struggling with Long COVID? How are bacteriophages addressed and the microbiome restored? What is a spike protein binder? What is the role of senolytics in removing spike proteins from the body? Where does autoimmunity enter the COVID conversation? What is Vedicinals®9? Is there a place for Ivermectin? How should the sinuses be supported? Do EBOO or TPE play a role in Long COVID recovery? Connect With My Guest:  TerrainHealth.org Related Resources: Vedicinals® USA Vedicinals®9 Sequesterol® Senolescence® Neuralescence® Night Use code BETTERHEALTH for 25% off Our Wellness Journey Spike Protein Testing - https://ourwellnessjourney.us Interview Date: November 17, 2025 Transcript: To review a transcript of this show, visit https://BetterHealthGuy.com/Episode225. Support the Show: To support the show and Buy Me a Coffee, visit https://betterhealthguy.link/BuyMeACoffee. Additional Information: To learn more, visit https://BetterHealthGuy.com. Follow Me on Social Media: Facebook - https://facebook.com/betterhealthguy Instagram - https://instagram.com/betterhealthguy X - https://twitter.com/betterhealthguy TikTok - https://tiktok.com/@betterhealthguy Disclosure: BetterHealthGuy.com is an affiliate of Vedicinals USA. Disclaimer:  The content of this show is for informational purposes only and is not intended to diagnose, treat, or cure any illness or medical condition. Nothing in today's discussion is meant to serve as medical advice or as information to facilitate self-treatment. As always, please discuss any potential health-related decisions with your own personal medical authority. 

Did you know that a single crumb of bread is enough to cause an autoimmune response in children with celiac disease? Dr. Pankaj Vohra, Professor of Pediatrics and Board-Certified Pediatric Gastroenterologist, joins medical student Andrea Smith to discuss the evaluation and management of celiac disease, as well as essential guidance for following a gluten-free diet. Specifically, they will: Review the epidemiology of celiac disease and identify common symptoms and presentations of celiac disease Describe the pathophysiology of celiac disease including histopathological changes to the duodenum Identify diagnostic tests and criteria for diagnosing celiac disease in the pediatric population Identify common sources of gluten and the basics of identifying gluten on food labels Discuss typical management of celiac disease including appropriate screening tests and managing accidental gluten ingestion Special thanks to Dr. Rebecca Yang and Dr. Neeharika Bade for peer reviewing this episode. CME available free with sign up: Link coming soon! References: Bolia, R., & Thapar, N. (2023). Celiac Disease in Children: A 2023 Update. In Indian Journal of Pediatrics. Springer. https://doi.org/10.1007/s12098-023-04659-w Gidrewicz, D., Potter, K., Trevenen, C. L., Lyon, M., & Butzner, J. D. (2015). Evaluation of the ESPGHAN celiac guidelines in a North American pediatric population. American Journal of Gastroenterology, 110(5), 760–767. https://doi.org/10.1038/ajg.2015.87 Hill, I. D., Fasano, A., Guandalini, S., Hoffenberg, E., Levy, J., Reilly, N., & Verma, R. (2016). NASPGHAN clinical report on the diagnosis and treatment of gluten-related disorders. Journal of Pediatric Gastroenterology and Nutrition, 63(1), 156–165. https://doi.org/10.1097/MPG.0000000000001216 Husby, S., Koletzko, S., Korponay-Szabó, I., Kurppa, K., Mearin, M. L., Ribes-Koninckx, C., Shamir, R., Troncone, R., Auricchio, R., Castillejo, G., Christensen, R., Dolinsek, J., Gillett, P., Hróbjartsson, A., Koltai, T., Maki, M., Nielsen, S. M., Popp, A., Størdal, K., … Wessels, M. (2020). European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. In Journal of Pediatric Gastroenterology and Nutrition (Vol. 70, Issue 1, pp. 141–156). Lippincott Williams and Wilkins. https://doi.org/10.1097/MPG.0000000000002497 Nenna, R., Tiberti, C., Petrarca, L., Lucantoni, F., Mennini, M., Luparia, R. P. L., Panimolle, F., Mastrogiorgio, G., Pietropaoli, N., Magliocca, F. M., & Bonamico, M. (2013). The celiac iceberg: Characterization of the disease in primary schoolchildren. Journal of Pediatric Gastroenterology and Nutrition, 56(4), 416–421. https://doi.org/10.1097/MPG.0b013e31827b7f64 Sahin, Y. (2021). Celiac disease in children: A review of the literature. In World Journal of Clinical Pediatrics (Vol. 10, Issue 4, pp. 53–71). Baishideng Publishing Group Co. https://doi.org/10.5409/wjcp.v10.i4.53 Salden, B. N., Monserrat, V., Troost, F. J., Bruins, M. J., Edens, L., Bartholomé, R., Haenen, G. R., Winkens, B., Koning, F., & Masclee, A. A. (2015). Randomised clinical study: Aspergillus niger-derived enzyme digests gluten in the stomach of healthy volunteers. Alimentary Pharmacology and Therapeutics, 42(3), 273–285. https://doi.org/10.1111/apt.13266 Schuppan, D., Mäki, M., Lundin, K. E. A., Isola, J., Friesing-Sosnik, T., Taavela, J., Popp, A., Koskenpato, J., Langhorst, J., Hovde, Ø., Lähdeaho, M.-L., Fusco, S., Schumann, M., Török, H. P., Kupcinskas, J., Zopf, Y., Lohse, A. W., Scheinin, M., Kull, K., … Greinwald, R. (2021). A Randomized Trial of a Transglutaminase 2 Inhibitor for Celiac Disease. New England Journal of Medicine, 385(1), 35–45. https://doi.org/10.1056/nejmoa2032441 Tack, G. J., van de Water, J. M. W., Bruins, M. J., Kooy-Winkelaar, E. M. C., van Bergen, J., Bonnet, P., Vreugdenhil, A. C. E., Korponay-Szabo, I., Edens, L., von Blomberg, B. M. E., Schreurs, M. W. J., Mulder, C. J., & Koning, F. (2013). Consumption of gluten with gluten-degrading enzyme by celiac patients: A pilot-study. World Journal of Gastroenterology, 19(35), 5837–5847. https://doi.org/10.3748/wjg.v19.i35.5837 Husby S, Koletzko S, Korponay-Szabó IR, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54: 136–160

We have a classic episode for you. Update your approach to cirrhosis evaluation and management with Dr. Scott Matherly Associate Professor of Hepatology and Gastroenterology at Virginia Commonwealth University  Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro, disclaimer, guest bio Case from Kashlak; Definitions Cirrhosis Diagnosis and Initial Evaluation  Cirrhosis Physical Examination  Decompensated Cirrhosis Management  Ascites and TIPS MELD and transplant consideration Outro Credits Written and Produced by: Elena Gibson MD Infographic and Cover Art: Edison Jyang MD Hosts: Paul Williams MD, FACP; Elena Gibson MD     Reviewer: Emi Okamoto MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Scott Matherly MD  Sponsor: Aura For a limited time, visit AuraFrames.com and get $45 off Aura's best-selling Carver Mat frames - named #1 by Wirecutter -  by using promo code  CURB at checkout.  Sponsor: DoxGPT Check out DoxGPT by Doximity and see how it can simplify your clinical workflow, from patient care to paperwork. Visit doxgpt.com Sponsor: Master Class Head over to MASTERCLASS.com/CURB for the current offer. Sponsor: Continuing Education Company   Visit CMEmeeting.org/curbsiders to learn more and use promo code Curb30

The treatment for locally advanced rectal cancer has undergone numerous changes and is now used routinely in clinical practice. Please join us in a thorough discussion of current evidence and ongoing research of total neoadjuvant therapy in locally advanced rectal cancer with leaders in the field including Drs J. Joshua Smith, Julio Garcia-Aguilar, Emmanouil Fokas, and Benjamin Schlechter Hosts:  ·      Dr. Janet Alvarez - General Surgery Resident at New York Medical College/Metropolitan Hospital Center ·      Dr. Wini Zambare – General Surgery Resident at Weill Cornell Medical Center/New York Presbyterian ·      Dr. Phil Bauer, Graduating Colorectal Surgical Oncology Fellow at Memorial Sloan Kettering Cancer Center  ·      Dr. J. Joshua Smith MD, PhD, Chair, Department of Colon and Rectal Surgery at MD Anderson Cancer Center Guests: 1.     Julio Garcia-Aguilar, MD, PhD Benno C. Schmidt Chair in Surgical Oncology Chief, Colorectal Service, Department of Surgery Director, Colorectal Cancer Research Center, Memorial Sloan Kettering Cancer Center Professor of Surgery, Weill Cornell Medical College 2.     Benjamin Schlechter, MD Senior Physician in the Gastrointestinal Cancer Center at the Dana-Farber Cancer Institute Assistant Professor of Medicine, Medicine, Harvard Medical School 3.     Emmanouil Fokas, MD, DPhil Professor and Chairman | Department of Radiation Oncology, Cyberknife and Radiotherapy | Faculty of Medicine, University Hospital Cologne Learning objectives:  ·      Define locally advanced rectal cancer (LARC) and describe the clinical staging that qualifies patients for total neoadjuvant therapy (TNT). ·      Explain the rationale for transitioning from traditional chemoradiotherapy (CRT) plus surgery to total neoadjuvant therapy in rectal cancer management. ·      Compare the designs, treatment regimens, and long-term outcomes of major TNT trials including RAPIDO, PRODIGE-23, OPRA, and CAO/ARO/AIO-12/16. ·      Evaluate organ preservation strategies—such as the watch-and-wait approach—after TNT and identify which patients are appropriate candidates based on clinical or near-complete response. ·       Summarize emerging research directions including: ·      Integration of circulating tumor DNA (ctDNA) in surveillance and response prediction. ·      The role of immunotherapy in mismatch repair proficient (MSS) and deficient (dMMR) tumors. References:  1.     Garcia-Aguilar, J. et al. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. JCO 40, 2546–2556 (2022). https://pubmed.ncbi.nlm.nih.gov/35483010/ 2.     Verheij, F. S. et al.Long-Term Results of Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy: The Randomized Phase II OPRA Trial. JCO 42, 500–506 (2024). https://pubmed.ncbi.nlm.nih.gov/37883738/ 3.     Fokas, E. et al. Randomized Phase II Trial of Chemoradiotherapy Plus Induction or Consolidation Chemotherapy as Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer: CAO/ARO/AIO-12. JCO 37, 3212–3222 (2019). https://pubmed.ncbi.nlm.nih.gov/31150315/ 4.     Fokas, E. et al. Chemoradiotherapy Plus Induction or Consolidation Chemotherapy as Total Neoadjuvant Therapy for Patients With Locally Advanced Rectal Cancer: Long-term Results of the CAO/ARO/AIO-12 Randomized Clinical Trial. JAMA Oncol 8, e215445–e215445 (2022). https://pubmed.ncbi.nlm.nih.gov/34792531/ 5.     Williams H*, Fokas E*, et al. Survival among patients treated with total mesorectal excision or selective watch-and-wait after total neoadjuvant therapy: a pooled analysis of the CAO/ARO/AIO-12 and OPRA randomized phase II trials. Ann Oncol 2025 May;36(5):543-547. https://pubmed.ncbi.nlm.nih.gov/39848335/ 6.     Gani, C. et al. Organ preservation after total neoadjuvant therapy for locally advanced rectal cancer (CAO/ARO/AIO-16): an open-label, multicentre, single-arm, phase 2 trial. The Lancet Gastroenterology & Hepatology 10, 562–572 (2025). https://pubmed.ncbi.nlm.nih.gov/40347958/  Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US