John M. Inadomi, professor of medicine at the University of California, San Francisco (UCSF) School of Medicine and chief of clinical gastroenterology at San Francisco General Hospital, has been appointed the fourth head of the Division of Gastroenterology, effective in July. Inadomi will also be appointed to the Cyrus E. Rubin Endowed Chair in Medicine, previously held by Sum P. Lee, who served as division head from 1995 to 2008. Toan Nguyen, professor of medicine, has been acting head of the division for the past two years... Read Article »

The American Association for the Study of Liver Diseases (AASLD), the leading international organization of scientists and healthcare professionals for preventing and curing liver disease, has selected Sum-Ping Lee, M.D., Ph.D., to be the recipient of their 2010 Distinguished Achievement Award. Dr. Lee, currently Dean of the Li Ka Shing Faculty of Medicine of the University of Hong Kong, was an active member of our GI Division for 23 years (1985-2008) and was the Cyrus E. Rubin Professor of Medicine and Head of the Division of Gastroenterology from 1995 to 2007...
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Chronic infection with hepatitis C virus(HCV) affects nearly 3 million Americans — including 153,000 in Washington — and is the leading cause for liver transplantation. Effective treatments are available but they are expensive, rife with side effects, and not readily accessible to all. Many people receive inadequate treatment or none at all. For patients in or near Seattle, outstanding specialized care for hepatitis is available at Harborview. The Hepatitis and Liver Clinic there is the largest provider of viral hepatitis care in the region, with four clinicians seeing patients five days a week. People living far from large medical centers have fewer options. Two efforts led by Department of Medicine faculty members are addressing the critical problem of access to care for this growing chronic disease: Jason Dominitz (GI) directs the eight-year-old VA Northwest Hepatitis C Resource Center, and John D. Scott (AID), assistant director of the Harborview Hepatitis and Liver Clinic, leads a new three-year telemedicine project for HCV in rural and underserved populations across the state... Read Article » | Read Full DOM Newsletter (Fall 2009) »

The UW Digestive Disease Center is the first in the Pacific Northwest to be using the world’s smallest flexible microscope, known as Cellvizio. Dr. Michael Saunders and Dr. Joo Ha Hwang are using the microscope to improve detection and speed treatment of various types of GI and biliary diseases. The Cellvizio tool allows them to view tissue inside a patient's body in real time at the cellular level so they can precisely pinpoint tissue that should be removed or treated. The Digestive Disease Center and their work with Cellvizio was recently featured in an article by the Seattle PI and broadcast in a KOMO 4 News HealthWorks segment.

Dr. Michael Saunders was named as one of Seattle Metropolitan Magazine’s Top Doctors of 2009, which highlights 347 practitioners in 80 specialties. Clinical Faculty members, Drs. David Gilbert (Polyclinic) Richard Kozarek (Virginia Mason) and J. Thomas Ylvisaker (Group Health), were also named Top Doctors of 2009 in the sub-specialty of Gastroenterology. Nearly 1,200 physicians, nurses, and physician’s assistants in King, Kitsap, and Snohomish counties nominated colleagues they would choose to treat themselves and their loved ones.

Dr. Kearney’s research focuses on the psychological aspect of functional GI disorders, including the effect of psychological and physical trauma in former POWs with irritable bowel syndrome. His particular interest is in the application of stress reduction techniques in health care. Dr. Kearney leads a Mindfulness-Based Stress Reduction (MBSR) program at the Seattle VA Puget Sound Health Care System, which has treated many patients with chronic physical and mental health conditions. MBSR is a validated program of mindfulness meditation and gentle yoga available at approximately 250 hospitals nationwide, and it is endorsed by the NIH-NCCAM as a model of mind-body intervention. Dr. Kearney’s program was recently featured in an article by the Seattle Times.

The gut microbiota is known to be integral to gastrointestinal health and disease. Psychological stress has been shown to significantly alter the gastrointestinal microbiota of rats, rhesus monkeys, and humans. These studies have consistently shown decreases in lactobacilli among other changes in species that correlate with an increase in diarrheal symptoms. While it is unclear whether stress causes diarrhea leading indirectly to a disruption in the native microbiota, or whether stress leads directly to changes in the microbiota that then lead to diarrhea; there is a growing body of evidence to support the latter. Differences in microbiota have also been shown to be present in irritable bowel syndrome (IBS) and predispose or protect against other forms of diarrhea including bacterial gastroenteritis and radiation-induced diarrhea. In addition, treatment with probiotics containing lactobacillus and other species has been shown to help alleviate IBS symptoms. Stress is hypothesized to act on the microbiota via the brain-gut axis through endocrine, immunological, and/or neurological pathways. Dr. Kearney, along with Dr. Chris Damman (future GI fellow), will analyze the fecal microbiota in IBS patients before and after an 8-week-stress reduction (MBSR) course compared with patients with PTSD and IBS undergoing usual care without a stress-reduction course.

A recent study by doctors at the University of Washington explained that patients who are significantly underweight or very severely obese prior to liver transplantation are at increased risk of death following transplantation surgery. These findings, from the largest known observation of liver transplantation at the extremes of BMI, are published in the August issue of Liver Transplantation.
[“Liver Transplantation at the Extremes of Body Mass Index,” André Dick, Austin Spitzer, Catherine Seifert, Alysun Deckert, R.L. Carithers, Jorge Reyes, James Perkins, Liver Transplantation, August 2009.]

The research team led by André A. S. Dick, M.D., Department of Surgery, Division of Transplantation, University of Washington investigated the impact of pre-transplantation Body Mass Index (BMI) on post-liver transplantation patient survival. The doctors hypothesized that individuals at the extremes of BMI were at increased risk of death following liver transplantation. In this study, patients with BMI < 18.5 kg/m2 were in the underweight group, with 1,827 transplanted, while those with BMI ≥ 40 kg/m2 were designated very severely obese, with 1,447 transplanted. Patients with BMI between 18.5 – 40 kg/m2 were assigned to a control group (68,172 patients) because they had similar survival rates.

Dr. Christina Surawicz, Professor of Medicine and GI Section Chief for Harborview Medical Center, was recently honored with the 2009 Berk/Fise Clinical Achievement Award in recognition of her distinguished contributions to clinical gastroenterology. Specific criteria for the award include, in addition to a career of distinguished clinical practice of gastroenterology, contributions in patient care, clinical science, clinical education, technological innovation, and public and community service. The American College of Gastroenterology (ACG) presents the award to one member or fellow only when he or she merits the recognition. Dr. Surawicz was presented the award at the ACG Leadership Dinner during the 2009 ACG Annual Scientific Meeting and Postgraduate Course in San Diego. Dr. Surawicz was also recently elected a Master of the American College of Gastroenterology (ACG), another rare honor conferred by the ACG upon physicians who have demonstrated distinguished service and leadership to the College and to the field of clinical gastroenterology, patient care and education. Dr. Surawicz is a past president of the ACG and has served it in many other capacities. She is also a past president of the Western Association of Physicians. In addition, Dr. Surawicz is Assistant Dean for Faculty Development in the UW School of Medicine, Adjunct Professor of Medical Education and Biomedical Informatics, and an Affiliate Member of the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center.

We are sincerely pleased to welcome three new faculty members to the GI Division. Dr. Brian Weston and Dr. Timothy Zisman have joined the UW Digestive Disease Center, and Dr. Lei Yu has joined the UW Liver Care Line. Dr. Weston’s expertise is in advanced therapeutic endoscopy, and he joins us from the Beacon Hospital in Dublin, Ireland. Dr. Zisman’s expertise is inflammatory bowel disease, and he joins us from the University of Chicago. Dr. Lei Yu is a recent graduate of our Gastroenterology and Advanced Transplant Hepatology fellowship training programs. His expertise in epidemiology and interest in nutrition will allow him to study a relatively unexplored aspect of liver disease. We are delighted to have them as part of the GI faculty and recently asked each of them to share a little bit more about themselves.

This year the GI Division welcomed four new trainees to the Gastroenterology Fellowship Program, Drs. Karlee Ausk, Margaret Eugenio, Arema Pereira, and Luke Richey. Joining the Advanced Transplant Hepatology Fellowship Program is Dr. Charles Landis. And joining the GI Training Grant are Drs. Tatiana Khokhlova and Elizabeth Poole.

Dr. Ness recieved his medical degree from the Mt. Sinai School of Medicine in New York and completed his residency and fellowship training at the Vanderbilt Medical Center in Nashville, Tennessee. His interests include hepatology and general gastroenterology. Dr. Procaccini received his medical degree from the University of Virginia in Charlottesville, where he also completed both his residency and gastroenterology fellowship. His interestes include endoscopy, acute and chronic liver disease, and inflammatory bowel disease. We look forward to Drs. Ness and Procaccini joining the GI Division's Clinical Faculty soon.

On February 17th, 2009, President Obama signed the Recovery and Reinvestment Act (ARRA) or Stimulus Package to restart the economy. The package contains extensive funding for science, engineering research and infrastructure, and more limited funding for education, social sciences and the arts. Dr. Teresa Brentnall has received an ARRA grant to support proteomic studies of chronic pancreatitis. Chronic pancreatitis, a destructive disease of the pancreas, is difficult to diagnosis and can present with a variety of symptoms. The incidence of chronic pancreatitis is not known; hospital admission and discharge summaries suggest at least 60,000 patients in the US per year, however these are under-estimates and it is clear that many patients have occult disease. The financial burden of pancreatitis to society is substantial: with loss of work and health care costs, the burden approaches $2.5 billion annually. There are currently no good bloods tests for the diagnosis of chronic pancreatitis; endoscopic studies and CT scan are the standard approaches for the diagnosis, with endoscopic ultrasound (EUS) combined with pancreatic function tests (PFT) being the most sensitive. The etiology of pancreatitis is multi-fold but all lead to progressive scarring and loss of pancreatic function; the understanding of the molecular events that underlie the progressive disease is limited. Dr. Brentall’s research group will study the protein changes that underlie the early and late stages of chornic pancreatitis using proteomic approaches. The discovery of these proteins will not only provide insight into the pathogenesis, but can also provide targets for biomarkers of disease. Overall, Dr. Brentnall and her research team believe that these proteomic studies can provide a better understanding of the events that underlie this debilitating disease, identify proteins that will be good candidates for biomarker development, and may ultimately lead to an inexpensive and non-invasive blood test for chronic pancreatitis.

Dr. Renuka Bhattacharya was recently highlighted as a new NIDA clinician. The NIDA Center for Functional Genomics at the University of Washington is a National Institute on Drug Abuse (NIDA) P30 Center. This center supplies the resources needed to apply cutting-edge genomic, proteomic, and bioinformatic technologies to the study of hepatitis C virus (HCV) infection and AIDS, chronic viral infections that are a direct consequence of drug abuse and addiction. They work with a variety of biologic resources, including serial liver biopsies from patients with recurrent HCV after liver transplantation, biopsies from patients co-infected with HCV and HIV-1, and experimental systems for HCV infection such as the SCID-beige/Alb-uPA chimeric mouse model and the HCV 2a in vitro infection system.

Carrying on in the tradition of Dr. David Saunders, the Gut Course (HuBio 551) was once again the highest rated second year medical course, as voted by the medical students. 2009 was the 40th year in a row that the Gut Course has earned this honor. This year, Drs. J. Donald Ostrow, Michael Saunders, and Bruce Silverstein served as course chairs and were supported by Drs. Charles Pope and Michael Schuffler, as well as by our gastroenterology fellows; Drs. Darby Robinson-O'Neill, Christine Schlenker, and Janelle Brown-Chang. The Gut Course also earned Dr. Bruce Silverstein the David R. Saunders Memorial Award for Excellence in Teaching, an award created by the Medical Student Association to honor the course's original chair, Dr. David Saunders, who earned four Distinguished Teaching Awards and the honor of Teacher Superior in Perpetuity for his dedication to the course. This award is given to a second-year course chair or lecturer who has demonstrated excellence in any and all aspects of teaching second year medical students. Dr. Silverstein commented that the award is a reflection of the dedication and hard work of the entire course's faculty and support staff. We are looking forward to 2010 and the 41st year of the Gut Course!

Dr. Schuffler spoke on the Pathologic Basis of Chronic Intestinal Pseudo-Obstruction Syndromes at the July 2009 AGMD Digestive Motility Symposium in Bedford, Massachusetts. The Association of Gastrointestinal Motility Disorders is composed of health professionals and lay people dedicated to educating about severe gastrointestinal motility disorders, such as chronic intestinal pseudo-obstruction and severe enteric dysmotility, and providing support to affected patients and their families. It publishes a monthly newsletter and holds a biannual conference which brings together health care providers who have a clinical and research interest in these disorders in order to share information and report new findings. The recent meeting, held on July 24-26th, was attended by several hundred people from around the country, including adult and pediatric gastroenterologists, surgeons, nutritionists, psychologists, patients and family members. About the Talk »