Digestive Disease Week® (DDW) is approaching rapidly. One might say, with strong justification, that the overarching theme for DDW is a celebration of diversity. We are entering the era of “omics” and current research suggests a microbiome rich in diversity is associated with health, while a less-diverse biome is associated with digestive disorders – inflammatory bowel disease for example. Multiple abstracts and presentations will be related to research into microbiome alterations in disease. In nature, diversity is a key to survival.
Farmers know the value of diversity and the devastating effects of restricted diversity. When fields are restricted to a single crop year after year, artificial fertilizers must be used to restore fertility. Organic farmers understand the need for diversity in the form of crop rotation. No forest can survive for long without rich biological diversity. Even cancer reminds us of the importance of diversity. Restricted diversity in the form of cellular monoclonality is one of the hallmarks of malignant growth.
DDW, our annual hallmark meeting, emphasizes our need for diverse thoughts and intellectual discourse as we advance the science of gastroenterology, endoscopy, hepatology, and surgery. Biology does not tolerate restrictions on diversity for long. Diversity makes DDW great.
In this month’s issue of GI & Hepatology News, we are reassured that PPIs are not linked to cognitive decline. Sessile serrated polyps, often missed at colonoscopy and CT colography might be detected with noninvasive testing as the field of blood-based cancer screening advances. Pay attention to the exciting bleeding-edge technology emerging from the AGA Tech Summit – especially technologies to treat obesity. Read about some of the continuing barriers to CRC screening in underserved populations – if we are to achieve 80% screening rates we must focus on people challenged to access our health care system.
Finally, consider the AGA Clinical Practice Update about Barrett’s esophagus. I spent a morning with Joel Richter, MD, last month and he reminded me that our current surveillance system is failing to impact annual incidence of esophageal adenocarcinoma. Perhaps we should focus on a one-time screen for those most at risk, catching prevalent disease at an early stage.
John I. Allen, MD, MBA, AGAF
Editor in Chief