Principal Investigator: A. Aziz Aadam, MD From development to implementation, new medical advancements often don’t enter into mainstream usage without education and training. Introduced in the 1990s in Japan, minimally-invasive endoscopic submucosal dissection (ESD) has become the standard of care for not only treating but also, most importantly, curing early gastrointestinal cancers. While widely accepted practice in Japan and Eastern countries, ESD hasn’t yet gain a foothold in western countries—mainly due to lack of available training from specialists skilled in performing ESD. Medical centers with the highest volumes of GI procedures typically provide the best ESD training experiences. At the moment, most of those centers operate outside of the United States. Endoscopists with an interest in learning the leading-edge technique must travel abroad and even with the instruction they receive, usually require more education and guidance to shorten the learning curve. Interest in developing ESD programs in this country has grown: Northwestern Medicine launched its ESD program in January 2016, joining the 15 to 20 centers in the country performing ESD. Supported by a grant from the Digestive Health Foundation, investigators led by A. Aziz Aadam, MD, in Northwestern Medicine’s Division of Gastroenterology and Hepatology, plan to bring much-needed ESD training closer to home. By creating an original video series, they intend to develop a premier educational tool for endoscopists from Western countries. Dr. Aadam and his co-investigators, including two Japanese endoscopic experts, will produce six 3D animated videos based on real-world examples. The videos will illustrate in detail the best strategies for treating the most commonly encountered lesions in the GI tract, focusing on those found in the...
Principal Investigator: Amanda Guentner, MD No one wants to hear the “C” word. Even the slightest hint of a cancer risk is, understandably, frightening—even when all signs point to a positive outcome. Chronic regurgitation of stomach acid can damage the esophagus and eventually lead to a condition known as Barrett’s esophagus (BE). Patients with BE are at risk for esophageal adenocarcinoma (cancer of the esophagus), which strikes about 3 to 4 Americans out of 100,000 each year. While a variety of advanced treatments such as endoscopic eradication therapy (EET) help to prevent cancer well before it ever starts, many patients overestimate their cancer risk. Being referred for treatment appears to further ramp up their anxiety. Despite patient education prior to and after EET, individuals facing a series of treatments often forget what they may have been told about their diagnosis, cancer risk and/or short- and long-term prognosis. This perceived lack of information, which has been linked to overall patient satisfaction, often pushes them over the top. Supported by the Digestive Health Foundation, researchers in Northwestern Medicine’s Division of Gastroenterology and Hepatology are evaluating the use of multimedia to enhance the patient experience pre- and post-EET therapy. Recent studies have shown them to be successful with patients who’ve undergone general and orthopaedic surgical procedures. The investigators plan to create an educational video for patients undergoing EET for Barrett’s esophagus through Northwestern’s Digestive Health Center and measure its impact on reducing patient anxiety. Led by GI fellow Amanda Guentner, MD, the team will produce a short video to reinforce the information patients typically receive during face-to-face consultations with their gastroenterologist and/or...
Principal investigator: Rena Yadlapati, MD Every physician strives for and every patient expects an accurate diagnosis—no matter what the health issue. Advancements in imaging and other technologies continue to enhance diagnostic capabilities for a range of diseases, including gastrointestinal disorders. But even the most sophisticated diagnostic tools can yield erroneous results in untrained and/or inexperienced hands. In the field of esophageal disorders, high-resolution esophageal manometry (HREM) is the gold standard for diagnosing certain disorders of the esophagus, including difficulty swallowing. The precision of HREM allows gastroenterologists to track esophageal motility or movement patterns to pinpoint functional problems of this essential digestive organ. While HREM provides invaluable information, the skill and knowledge of the GI specialists using this advanced technology varies widely across the country. From disparities in performance to interpretation of HREM data, the potential for inaccurate diagnosis that adversely impact patient care and quality of life is—unacceptably—too high. Already researchers at Northwestern Medicine have designed a web-based training program and conducted a pilot study: They observed learning curves for HREM among 20 gastroenterology trainees nationwide. Supported by a grant from the Digestive Health Foundation, the investigators led by Rena Yadlapati, MD, will now build on the success of their initial work. They plan to apply their methodology to a larger group of physicians (residents and faculty) with minimal experience with HREM to validate the existing data and determine key competency benchmarks. Dr. Yadlapati’s team will work with the Instructional Design & Development group at Northwestern University to create interactive training modules. They will then integrate interactive educational video and electronic handbooks, among other tools, into their training system....
Gastroesophageal reflux disease (GERD) is a common condition that often involves heartburn and/or regurgitation. If left untreated, scarring of the esophagus or “food pipe” may result. GERD leads to millions of outpatient visits annually. For some individuals, increased laxity at the end of the muscular esophagus may contribute to GERD. Assessing the extent of this laxity helps to determine the most appropriate strategies for treating the disease and preventing further damage to the esophagus. The motility of the esophagus—a tube that moves food from the throat to the stomach via muscular movement—can reveal much about its function and well-being. Manometry tests are currently used to measure the strength and muscle coordination of a patient’s esophagus while swallowing. During the manometry test, a thin, pressure-sensitive tube is passed through the nose and down the esophagus. While effective, manometry sometimes causes significant discomfort for the patient, which could hinder the diagnostic evaluation. Funded by the Digestive Health Foundation, researchers in Northwestern Medicine’s Division of Gastroenterology and Hepatology are investigating the expanded use of a new device, the functional lumen imaging probe (FLIP). Already commercially available and FDA-approved, the FLIP offers a promising alternative to manometry. Because it can be quickly performed during a sedated upper endoscopy, FLIP is much more comfortable for patients than previous techniques. Led by Dustin Carlson, MD, the Northwestern team recently developed a novel, customized, patent-pending FLIP analysis technique. Dubbed FLIP topography, it allows for the assessment of esophageal motility. To further evaluate and substantiate FLIP’s clinical viability, the investigators will use the device and new technique in 40 patients with GERD during standard-of-care endoscopy procedures. In...
