Staying on the Cutting Edge

Every day sees new developments in the science of medicine. The physicians of Premier Medical Group stay abreast of the news and make sure their patients benefit from the latest treatments.

Dr. Salvatore Buffa and Dr. Sunil Khurana attended this year’s American College of Gastroenterology Annual Scientific Meeting and Postgraduate Course in San Antonio. Considered the premier GI clinical event of the year, this gathering offers educational programs presented by internationally-known experts and rising stars in the field of gastroenterology. Presentations address current clinical GI issues and also examine scientific developments on the horizon.

Upon their return to the Hudson Valley, Buffa and Khurana shared the information they had gleaned with their fellow GI Associates. Among the issues that made an impression…

Proton Pump Inhibitors for GERD and Ulcer Disease

Properly prescribed, the class of drugs known as proton pump inhibitors (PPIs)—which include such medicines as Nexium, Prilosec and Prevacid— are highly useful in reducing gastric acid for the treatment of GERD and ulcers of the stomach and small intestines.

  • Recently, some questions have arisen about the safety of these drugs when taken by patients with cardiovascular disease who are also taking antiplatelet drugs like Plavix. New data presented from a major trial (called COGENT) showed no lowered survival in cardiac patients taking both drugs. In fact, PPIs substantially decreased GI bleeding in these patients.
  • Contrary to some published reports, long-term PPI use does not increase the risk of osteoporosis. There is a statistical increase of hip fractures in patients on these medications, but the increase is small — rising from 3 fractures per 10,000 patients to 9 fractures per 10,000 patients.

New Hepatitis C Treatment on the Horizon

A new class of medicines, called protease inhibitors, are expected to be available for the treatment of Hepatitic C in the near future. When used in combination with the standard treatment of interferon and ribaviran, the new antiviral agents have the potential to nearly double the response rate compared to that of standard treatment alone. We will be following development of these drugs carefully in order to make them available to our patients as soon as appropriate.

Inflammatory Bowel Disease and Pregnancy

Biologic therapy has been proven successful in treating ulcerative colitis and Crohn’s disease. Medications such as Remicade, Humira, or Cimzia — which block substances in the body that cause inflammation—have improved symptoms, healed mucosal damage and changed the natural course of the disease when initiated early.

  • The newest research makes it clear that women with IBD who become pregnant must prepare to discontinue these medicines in the 3rd trimester of their pregnancies. At that time, such medications are transferred across the placenta and will affect the fetus.

Celiac Disease Flare-ups

Patients with gluten sensitive enteropathy (celiac disease) sometimes experience flare-ups of their symptoms even though they are carefully following a gluten-free diet.

  • A number of potential causes for these episodes have been identified, including: unknowingly consuming products containing gluten, bacterial overgrowth, pancreatic insufficiency, microscopic colitis, irritable bowel syndrome and lymphoma.