Sept. 09, 2010
AGA eDigest AGA eDigest
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Clinical Practice

Education & Training



Eugene Chang, MD, AGAF
Basic Research Councillor

F. Taylor Wootton III,
Private Practice Councillor

The Push for a New Medicare Reimbursement System Continues — Get Involved

With Congress returning from recess, the AGA continues to meet with our allies on Capitol Hill to raise and maintain awareness of the issues of most importance to gastroenterologists and their patients, including physician reimbursement under Medicare.


Lead Story, continued
The sustainable growth rate (SGR) formula is deeply flawed and broken, and must be replaced. Members of both parties have long agreed that this formula is not sustainable and does not provide positive incentives for physicians. However, with the latest stop-gap measure set to expire on Nov. 30, 2010, the AGA and the entire physician community is concerned that Congress will not revisit the matter until after the elections, which means the SGR will not be addressed until the lame duck session.

Watch AGA's resident politico discuss the issues with the SGR and share ways you can become involved in your local communities leading up to the elections. For more information, subscribe to and read the AGA's policy blog, the AGA Washington Insider.

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GastroSlides Featured Image

Topic: Non-Alcoholic Fatty Liver Disease
Senior Author: Anna Mae Diehl, MD 

These slides illustrate the epidemiology, physiology, diagnosis and treatment of non-alcoholic fatty liver disease, including non-alcoholic steatohepatitis.  

Order these slides individually as you need them or purchase a one-year subscription and have access to the entire GastroSlides library of more than 4,000 images. Preview slides and order from



Honor 60th Anniversary of NIDDK with a Gift of Research to AGA Foundation

This year, the NIDDK is celebrating 60 years of research support for digestive diseases. The AGA and its foundation have funded 601 researchers, many in the early stages of their research careers. Many have gone on to make important contributions to the GI field. As a GI professional, you have been positively impacted by these medical advances. Please honor the valuable work of the NIDDK and help support the AGA foundation as we continue to fund promising young investigators who are not yet able to secure federal funding — individuals like Noah Shroyer, PhD, 2005 research scholar award (RSA) recipient.

alt“The RSA was awarded at a critical juncture in my career: fellow-to-faculty transition. The transition from fellow to faculty is perhaps the most difficult career transition, and extramural funding is therefore critical for success and for obtaining competitive NIH­-level funding. I have known several researchers who did not obtain extramural funding (such as an AGA foundation RSA) and were forced to abandon their research careers.” Dr. Shroyer went on to receive his first R03 grant from the NIH in 2009.

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New Research Award Funds Hepatitis C Translational Research

A new offering from the AGA foundation, the AGA-Vertex Pharmaceuticals Research Scholar Award in Hepatitis C Translational Research, provides $60,000 per year for two years to young investigators interested in translational research. The award is intended to support research involving the application of a basic science finding in hepatocellular function, hepatitis C virus biology, or other genetic or biological processes related to the prevention, diagnosis or treatment of viral hepatitis C or its sequelae.

The award will support young faculty (not fellows) who have demonstrated exceptional promise and have some record of accomplishment in research. To be eligible for the award, candidates must:

  • Hold an MD, PhD or equivalent degree and a full-time faculty position at a North American institution by July 1, 2011.
  • Be AGA members at the time of application submission.
  • Be in the beginning years of their careers: no more than five years shall have elapsed following the completion of clinical training or PhD award.
  • Devote at least 70 percent of their efforts to research related to the gastrointestinal tract or liver.

The application deadline is Jan. 28, 2011. For more information and to apply, visit the AGA foundation's Web site.

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Hepatitis C Resource

View a Webcast that explores clinical issues and challenges relevant to the management of hepatitis C virus-infected patients, focusing on those who have failed to respond to a previous course of interferon-based therapy.


Susceptibility Genetic Variants Associated with CRC Risk

Ten common low-penetrant genetic variants have been consistently associated with colorectal cancer risk. Little is known about the correlation between these variants and colorectal cancer phenotype. Characterization of such a correlation would improve colorectal cancer management and prevention programs. In a study appearing in Gastroenterology, doctors stated that colorectal cancer susceptibility variants at 8q23.3, 8q24.21 and 16q22.2 appear to be associated with cancer phenotype. These findings might be used to develop screening and surveillance strategies.

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GI Response to Injury Conference

Sept. 28-Oct. 1
Scottsdale, AZ

Pre-registration deadline approaching on Sept. 20. 

Obtain valuable insight into the pathophysiological basis of multiple gut mucosal diseases under the unified theme of mucosal response to injury.

Learn more and register


Undiagnosed Celiac Can Result in Symptoms

Outcomes of undiagnosed celiac disease are unclear. In a study published in Gastroenterology, doctors evaluated the morbidity and mortality of undiagnosed celiac disease in a population-based sample of individuals 50 years of age and older. With the exception of reduced bone health, older adults with undiagnosed celiac disease had limited co-morbidity and no increase in mortality compared with controls. Some subjects were diagnosed with celiac disease within a decade of serum collection, indicating that although most cases of undiagnosed celiac disease are clinically silent, some result in symptoms. Undiagnosed celiac disease can confer benefits and liabilities to older individuals.

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Celiac Patient Resource

Order copies of "Real Life Celiac Disease: Troubleshooting and Thriving Gluten Free" for your patients today. Through more than 50 case-based chapters, this book supports individuals with celiac disease and their families as they navigate the often complicated road from symptoms to recovery.


Risk Factors for Surgery in Pediatric Patients with Crohn's Lower than Reported

In a study published in Clinical Gastroenterology and Hepatology, doctors examined the incidence of Crohn's disease-related surgery in a multi-center, inception cohort of pediatric patients with Crohn's disease. In an analysis of pediatric patients with Crohn's disease, the five-year cumulative risk of bowel surgery was lower than that reported in recent studies of adult and pediatric patients, but similar to that of a recent retrospective pediatric study. Initiation of immunomodulator therapy at diagnosis did not alter the risk of surgery within five years of diagnosis.

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Crohn's Disease Resource for Your Patients

In "IBD Self-Management: The AGA Guide to Crohn's Disease and Ulcerative Colitis," your patients will learn how to cope with flares, get the nutrition they need, and understand their medication and surgical options.

Order your copy today.


Rabeprazole Is Effective in Treating Laryngopharyngeal Reflux

There is controversy about the efficacy of treating patients with laryngopharyngeal reflux (LPR) using PPIs. According to data published in Clinical Gastroenterology and Hepatology, twelve weeks of treatment with rabeprazole (20 mg, twice daily) significantly improved reflux symptoms, compared with placebo, in patients with LPR. Relapse of symptoms was observed six weeks after stopping PPI therapy, indicating the requirement for longer treatment duration in patients with LPR.

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Call on Your Legislators to Commemorate NIDDK's 60th Anniversary

The AGA is supporting legislation introduced by Reps. Frank Pallone, D-NJ, and John Shimkus, R-IL, that would commemorate the 60th anniversary of NIDDK. H. Res. 1444 not only recognizes the anniversary of NIDDK, but also the organization's leadership and achievements of supporting biomedical research and improving the quality of life for countless individuals.

The AGA, along with AASLD, the Digestive Diseases National Coalition and the American Urological Association, is supporting this resolution and working to secure co-sponsors so that this legislation can pass before the end of the 111th Congress. Reps. Pallone and Shimkus would like to move the legislation before the end of this congressional session, but need at least 100 co-sponsors to do so. Please contact your legislators and ask them to consider signing on to this resolution, which recognizes the achievements of this premier research institute that has contributed to research, research training, science education and improvement of overall health.

You can use the AGA's legislative tool, CapWiz, to contact your legislators and urge them to support this effort. If you have any questions, please feel free to contact Lauren DePutter at or 240-482-3221.

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Basics of GI Coding & Billing Webinar Now Online

An on-demand Webinar on the basics of coding and billing is now accessible on GI LEARN®. Presenter, Cecile M. Katzoff, MGA, CGCS, provided a comprehensive review of basic coding and billing principles, including:

  • How to select a current procedural terminology/health-care common procedure coding system code to define the service provided.
  • The importance of accurate International Classification of Diseases-9 code selection.
  • Categories of evaluation and management services (visits).
  • Coding multiple procedures during an endoscopy.
  • Using modifiers to maximize reimbursement.
  • Coding screenings.

You can also hear answers to your colleagues' questions that were addressed during the Webinar's Q&A session.

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Earn MOC with New GI SAM® Module

AGA has just released a second online module in the GI Self-Assessment Module® (GI SAM®) series, “Disorders of the Stomach and Viral Hepatitis.” Additional topics include “Disorders of the Pancreas and GI Motility” and “IBD and GI Bleeding.”

GI SAM is an interactive, intuitive series of online modules designed to assess and enhance your command of the treatment, diagnosis, symptoms and risk factors associated with gastroenterology- and hepatology-related topics. Unlike many self-assessment programs, GI SAM’s content and references are continually reviewed and updated for ongoing accuracy and updated treatment protocols. Offered only online, GI SAM is a convenient and easily accessible resource that you can use to prepare for board certification, fulfill American Board of Internal Medicine (ABIM) maintenance of certification (MOC) requirements or to brush up on the current advances in gastroenterology and hepatology.

Each GI SAM module includes:

  • Twenty-five questions with instant feedback.
  • Targeted references for further study.
  • Detailed images and videos to further clarify important points.
  • A detailed score report informing the user areas that need further review

The complete series will include eight modules covering 16 topics, giving you access to a wide variety of GI and hepatology topics. Each GI SAM module offers 10 points towards ABIM MOC and up to 10 AMA PRA Category 1 Credits™.

Learn more and order today.

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AGA Clinical Congress Offers Valuable Information for the Practicing Clinician

Those who are in clinical practice or are thinking of going into clinical practice should not miss this year's AGA Clinical Congress, which will be held Jan. 14 and 15, 2011, in Miami Beach, FL. More interactive and relaxed than larger clinical meetings, the congress offers an extraordinary educational experience that will provide attendees with an evidence-based approach to GI clinical care based on the most recent and best available research.

The format includes 30 general sessions, 14 small-group breakout sessions, the Don Powell lecture on managing patients on anti-thrombotic agents and a poster session where selected GI fellows in training will present their latest research. Almost 30 recognized experts will conduct this multi-faceted program that highlights six areas most important to the practicing clinician: IBD, liver disease, endoscopy, functional bowel disorders, esophageal diseases and GI malignancies. While the didactic lectures will expand attendees' clinical knowledge, the small-group breakout sessions will explore these six areas in greater detail and offer more time for questions and further discussion with the expert faculty.

In addition to a review of the latest clinical information, this year's congress will incorporate lectures that explore key data from the major clinical trials that took place over the last year. Experts will evaluate new therapies and management strategies and provide attendees with an understanding of how they may work in a clinical setting.

The congress also features the following events:

Congress attendees may register for one or more of these optional add-on programs at a discount.

Learn more and register.

This activity has been approved for AMA PRA Category 1 Credits™.

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New for Interns, Residents & Fellows

Submit an abstract at this year's congress. 

Selected abstracts will be presented during the wine and cheese reception on Friday, Jan. 14 and published in the February issue of Clinical Gastroenterology and Hepatology. Take advantage of this opportunity to gain valuable feedback on your research from the expert faculty and your colleagues. 

Abstract submission deadline: Oct. 1.

Learn more.


Prepare for Board Exam with Clinical Question of the Week

True or False? The mucosal immune system involves production of antibodies of all five immunoglobulin classes.

Find the answer to this question in the IBD chapter and answers to more than 400 board-like questions from DDSEP® 5.0, the fifth edition of the AGA Institute's popular digestive disease self-education program.

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Leadership Nominations Due Oct. 1

The AGA Nominating Committee, chaired by Robert S. Sandler, MD, MPH, AGAF, is in the midst of identifying candidates for the offices of vice president, basic research councillor, community private practice councillor and eight nominees for the 2011, 2012 nominating committee ballot.

AGA members are encouraged to submit nominations to ensure that the most qualified and committed candidates are selected to serve next year. Nominations must be submitted by Oct. 1.

  • Each member may nominate only one person per available position. (Each member may submit one nomination each for vice president, basic research councillor, community private practice councillor and up to eight nominations for members of the nominating committee.)
  • Officers and councillors on the AGA Governing Board and members of the current nominating committee are prohibited from proposing, supporting or endorsing candidates for nomination.
  • Only full members may be considered for vice president and councillor.
  • Only full members or senior members may be considered for the nominating committee.
  • Current and prior nominating committee members are not eligible to serve on the committee again for five years.
  • Letters of support from members are limited to two per nominee, specified in advance by the prospective nominee. The letters should not summarize the nominee's curriculum vitae (CV), but should address the nominee's personal qualities, strengths and weaknesses.

Nominate yourself or one of your colleagues. Nominations will only be accepted electronically. You must have your member ID number in order to submit your nominations electronically. To get your member number, call AGA Member Services at 301-941-2651 or e-mail

The deadline for receipt of nominations is Oct. 1, 2010. The committee chair will contact nominees to request CVs and determine interest and willingness to serve.

Vice President. The AGA Institute vice president is elected for a one-year term and succeeds automatically to the office of president-elect, the office of president and then to past president, serving one year in each office. In the absence of both the president and president-elect, the vice president would preside at meetings of the governing board and AGA Executive Committee. The vice president serves as a member of the executive committee (throughout the four-year tenure) and as liaison between the AGA Institute International Committee and the governing board. The vice president also serves as a member of the AGA Finance & Operations and the Executive Compensation committees, and as an ex officio member of the AGA Governing Board.

Councillors. AGA Institute councillors are elected from the membership for a three-year term. Councillors are directors of the AGA Institute and hence are responsible for managing and overseeing the activities of the AGA Institute. Further, the basic research councillor shall be actively engaged in basic research in a health-care institution and be responsible for representing the views of this constituency at governing board meetings. The basic research councillor serves as liaison between the AGA Institute Research Policy Committee and the governing board. The basic research councillor also serves as a member of the AGA E-Communications Advisory Board. The community private practice councillor shall be actively engaged in community private practice and be responsible for representing the views of this constituency at governing board meetings. The community private practice councillor also serves as liaison between the AGA Institute Practice Management & Economics Committee and the governing board. Both councillors serve as editors for AGA eDigest.

Nominating Committee. Nominating committee members serve for one year and are responsible for selecting future officers and councillors for the AGA Institute as well as the members who are placed on the ballot for election to the AGA Nominating Committee for the following year. The AGA Nominating Committee is comprised of nine members: the chair (past chair of the AGA Governing Board), four members elected from a ballot of eight candidates and four members appointed by the AGA Governing Board.

The nominating committee will hold two teleconferences in the fall and a face-to-face meeting in January.

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Friedenwald Medal Nominations Due Sept. 24

Nominate a colleague for the Julius Friedenwald Medal, the highest honor that the AGA bestows on a member. Nominations are due Sept. 24. Nomination instructions are online.



Free E-Book: TouchBriefings European Gastroenterology & Hepatology Review

TouchBriefings is an international publisher of cutting-edge information that specializes in meeting the needs of the pharmaceutical and medical communities in the U.S. and Europe. With more than 50 annual and bi-annual publications, Touch Briefings collates leading editorial from thought leaders, delivering insights to key developments and advancements.

As part of AGA's collaboration with TouchBriefings, AGA members receive free access to its publications, including the most recent edition of European Gastroenterology & Hepatology Review. Each issue features articles on international health, imaging and navigation, hepatitis, liver disease, probiotics, IBD, GERD, GI cancer, immune system regulation and pediatrics, written and reviewed by a panel of thought leaders in the field.

More free articles and resources are available on TouchBriefing's Web site,

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Gastro & CGH Video Abstracts of the Month

Watch Jaclyn Smith, PhD, MRCP, discuss her recently published Gastroenterology article, "Acoustic Cough-Reflux Associations in Chronic Cough: Potential Triggers and Mechanisms." Provide your thoughts and comments on this important study via the YouTube comments tool.

Watch Neal S. Leleiko, MD, PhD, discuss his recently published Clinical Gastroenterology and Hepatology article, "Factors that Determine Risk for Surgery in Pediatric Patients with Crohn's Disease."  Provide your thoughts and comments on this important study via the YouTube comments tool.

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New Blog Post

Read the latest post from The AGA Journals Blog: Reflux and Laryngitis — A Complicated Relationship.


Journal Editors' Picks

The editors of Gastroenterology and Clinical Gastroenterology and Hepatology (CGH) would like to bring to your attention the following highlighted articles from the September issues of the journals:



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Call for Papers on Clinical Trials: Gastroenterology

Gastroenterology is committed to advancing clinical practice in the field of digestive disease. Recognizing that clinical trials generally have the greatest impact of all studies on clinical practice, Editor Anil K. Rustgi, MD, and his associate editors strongly encourage authors to submit their manuscripts on clinical trials (diagnostic validation, therapeutic efficacy) of drugs, biological materials and devices in digestive, liver and pancreatic diseases, including studies at phases I, II and especially III, to Gastroenterology for consideration. The journal is also interested in publishing trials in endoscopic and imaging modalities.

There are several important reasons to submit clinical trial research for publication in Gastroenterology:

  • With an impact factor of 12.9, Gastroenterology is the premier journal in the field.
  • Gastroenterology is the journal that will directly reach the largest portion of physicians who care for and make treatment decisions for patients with GI or liver disease.
  • Authors who submit their manuscripts to Gastroenterology typically will receive decisions within three weeks or fewer.
  • Accepted manuscripts will be published online and indexed on PubMed within 10 days of acceptance.

To submit your manuscript to Gastroenterology, go to For important information on how to report clinical trials, go to To review the current and past issues of the journal, go to

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Place GI position listings and activity announcements in AGA eDigest.

For only $82.50, you can place an ad of 100 words or less in two consecutive issues and for $165 in four consecutive issues. Ads can also be placed in AGA Perspectives, AGA's bi-monthly magazine. If you place ads in both AGA Perspectives and AGA eDigest, you will receive a 10 percent discount. For more information, contact Alissa Cruz at or 301-272-1603.

Postdoctoral fellow position available immediately in beautiful Denver.

Immediate opening: A postdoctoral fellow is sought to work on a federally funded project in the gastroenterology and hepatology subspecialty at the University of Colorado Denver, Anschutz Medical Campus in Aurora.

Interested candidates must have a PhD and be a U.S. citizen or permanent resident. Experience in at least some of the following areas is preferred: immunology of intracellular pathogens, dendritic cell biology, cell biology, T cell immunity. Experience in at least some of the following techniques is preferred: flow cytometry, mammalian cell culture, and ELISA & ELISPOT. The ability to contribute productively in a team environment is essential, as is the ability to communicate effectively orally and in writing.

The University of Colorado offers an outstanding environment that nurtures research in basic, translational and clinical sciences, with a particularly strong immunologic community. Interested candidates should apply online at, job posting #809388.

Washington, D.C., Suburb/Northern Virginia — Outstanding opportunity for BC/BE gastroenterologist to join prestigious and very busy GI group with two physicians, a PA and NP on staff. 100 percent GI practice with office endoscopy center on site. Associated with premier university affiliated teaching hospital with house staff and medical students. Please e-mail CV to

Clinical Gastroenterologist

Beautiful beaches, tropical sunshine and welcoming waters.

Seeking BC gastroenterologist to join 100% 4-person GI practice expanding to serve rapidly growing population and hospital system. Practice maintains a premiere, majority physician-owned endoscopy center. Competitive salary plus productivity bonus. Opportunity for equal partnership in practice after two years and investment in endoscopy center. Call is shared among 4 providers.

Seeking motivated candidate committed to building practice. Group offers full range of services, including EUS/ERCP. Opportunity to develop practice to meet individual interests and needs. ERCP/EUS experience is a plus.

Contact: Kathleen Souza
Pali Momi Medical Center
Toll-Free Phone: 888-888-1855

Jobs. Talent. Better Connections.

Visit the career center today.

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