Latest news with #gastroenterology
Yahoo
5 days ago
- Health
- Yahoo
GSK's Linerixibat Poised to Address Substantial Unmet Need for the Treatment of Pruritus Associated with Primary Biliary Cholangitis, According to Spherix Global Insights
Despite new market entrants in the form of Gilead's Livdelzi and Ipsen's Iqirvo, US gastroenterologists report nearly half of PBC patients suffer from moderate to severe pruritus, underscoring an existing unmet need. EXTON, PA, July 17, 2025 (GLOBE NEWSWIRE) -- The treatment landscape for primary biliary cholangitis (PBC) has undergone a marked transformation over the past year, driven by the recent approvals of Gilead's Livdelzi (seladelpar) and Ipsen's Iqirvo (elafibranor). These additions to the therapeutic arsenal represent meaningful progress in disease management. However, new data from Spherix Global Insights' Market Dynamix™: Primary Biliary Cholangitis and Primary Sclerosing Cholangitis 2025 (US) reveal that pruritus—a persistent and often debilitating symptom—continues to pose a significant unmet need for many patients living with PBC. Among the 104 US gastroenterologists surveyed in the study, there was near-universal agreement on the importance of addressing pruritus—one of the most burdensome and distressing symptoms associated with PBC. Respondents estimated that approximately half of their PBC patients suffer from moderate to severe pruritus, a manifestation that significantly impacts quality of life and remains challenging to manage. As one specialist poignantly noted, 'Patients with cholestatic liver disease will go to the world's end to escape from pruritus and the insomnia it causes.' Most gastroenterologists surveyed also acknowledged a substantial unmet need for therapies specifically targeting PBC-associated pruritus. While Livdelzi has demonstrated a significant reduction in itch symptoms after six months of treatment, only about half of respondents reported that their patients on Livdelzi required no additional intervention for pruritus. The need for effective symptom control is even more pronounced among patients receiving Iqirvo, further highlighting the gap in adequate pruritus management and the continued demand for novel therapeutic approaches. In June, GSK announced that the FDA had accepted the New Drug Application (NDA) for its ileal bile acid transporter (IBAT) inhibitor, linerixibat, for the treatment of cholestatic pruritus in patients with PBC. The PDUFA target action date is set for March 24, 2026. Awareness of the IBAT class is already high among gastroenterologists, and most report they are likely to incorporate linerixibat into their treatment armamentarium if approved. As one specialist expressed, 'The results seem promising with a significant symptom reduction among moderate to severe pruritus. However, abdominal pain and diarrhea side effects are somewhat concerning and may limit real-world use.' Another echoed the sentiment, noting, 'It significantly improved symptoms of pruritus along with quality of life, which can be a challenging and quite debilitating symptom to treat.' If approved, linerixibat could represent a meaningful advancement for patients struggling with PBC-related pruritus—a symptom that continues to profoundly impair quality of life and remains inadequately addressed by current therapies. Spherix Global Insights will continue to closely track emerging developments across the PBC treatment landscape and pipeline through its Market Dynamix™: Primary Biliary Cholangitis and Primary Sclerosing Cholangitis service. Market Dynamix™ is an independent service providing analysis of markets anticipated to experience a paradigm shift within the next three to five years. Insights highlight market size, current treatment approaches, unmet needs, and expert opinions on the likely disruption introduced by pipeline agents. About Spherix Global Insights Spherix is a leading independent market intelligence and advisory firm that delivers commercial value to the global life sciences industry, across the brand lifecycle. The seasoned team of Spherix experts provides an unbiased and holistic view of the landscape within rapidly evolving specialty markets, including dermatology, gastroenterology, rheumatology, nephrology, neurology, ophthalmology, and hematology. Spherix clients stay ahead of the curve with the perspective of the extensive Spherix Physician Community. As a trusted advisor and industry thought leader, Spherix's unparalleled market insights and advisory services empower clients to make better decisions and unlock opportunities for growth. To learn more about Spherix Global Insights, visit or connect through LinkedIn. For more details on Spherix's primary market research reports and interactive dashboard offerings, visit or register here: NOTICE: All company, brand or product names in this press release are trademarks of their respective holders. The findings and analysis addressed within are based on Spherix Global Insight's analysis and do not imply a relationship with or endorsement of the companies or brands mentioned in this press release. CONTACT: Jim Hickey, Gastroenterology Franchise Head Spherix Global Insights 4848794284 in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Medscape
5 days ago
- Health
- Medscape
Diverticular Disease Demystified: Myths, Risks & Modern Care
This transcript has been edited for clarity. Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School and Old Dominion University in Norfolk, Virginia. Welcome back to GI Common Concerns . Diverticulosis and diverticulitis are both incredibly common conditions. It's estimated that over 70% of people aged 80 or older who undergo colonoscopy will have diverticulosis. Approximately 4% of those will develop diverticulitis in their lifetime, and roughly 15% of those cases will be complicated disease. Patients frequently ask what they can do to prevent diverticulitis or its recurrence, and the evidence to inform such conversations has evolved in recent years. This video provides an update on where we are presently. Rethinking Dietary Causes We've long emphasized diet in the management of diverticulosis and diverticulitis, and we considered it axiomatic that patients need to avoid corn, nuts, and seeds. However, a 2008 prospective cohort study in men challenged that approach, observing no association between consuming those dietary components and the risk of developing diverticulosis or diverticular complications. Although that study was performed exclusively in men, the lifetime risk for diverticulitis is actually higher in women, at approximately 5% vs 3.1%, respectively. A recent prospective analysis published in Annals of Internal Medicine from researchers at University of North Carolina adds important insights. It used validated dietary questionnaires in a large cohort of women [who had a sister with breast cancer but did not have breast cancer themselves at enrollment]. This allowed investigators to determine incident cases of diverticulitis over time, without the risk of recall bias. Researchers identified more than 1500 incident cases of diverticulitis for nearly 415,000 patient years of follow-up. They reported no association between a primary diagnosis of diverticulitis and consumption of corn, nuts, or seeds, including fresh fruits with seeds. Similarly, there was no link between those foods and the development of complicated diverticulitis resulting in abscess surgery or fistula. Collectively, these findings indicate that our patients do not necessarily need to avoid these foods. Instead, we can advise them to adopt an anti-inflammatory diet, such as the Mediterranean diet, which this recent study in women indicated had risk-reduction benefits. My own patients find these diets very easy to follow and quite practical. Modifiable Risk Factors for Recurrence The recurrence rate for diverticulitis is notably high. Within the first year after complete recovery, 8% of patients have an episode of recurrence, and approximately 20% within 10 years. The risk increases with subsequent episodes. After a second episode, it rises to 18% at 1 year and 50% at 10 years. After a third episode, the risk for recurrence is 40% at 3 years. Therefore, it's important to identify for our patients anything they can prospectively and proactively do to prevent a recurrent episode. There are several commonsense risk factors our patients should avoid. Smoking reduction or abstinence has proven benefits. Alcoholism, but not alcohol in and of itself, is associated with a higher risk. Chronic nonsteroidal anti-inflammatory drug (NSAID) use is a known risk factor. Guidelines recommend the avoidance of regular NSAID use, although aspirin should be continued when justified for cardiac indications. Weight reduction, particularly among those with truncal obesity, seems to reduce the risk for diverticulitis. Vigorous physical activity also has an inverse, beneficial relationship for diverticulitis. Identifying all these approaches is a good, simple way to help patients going forward. Symptoms, Scans, and Supplementation The guidelines are shifting around the rush to use antibiotics for episodes of recurrence. For uncomplicated diverticulitis, antibiotics don't seem to do better than not using antibiotics. In general, we have shifted toward advising that patients adopt a clear liquid diet, avoid antibiotics, and inform us if they experience any alarm features, particularly fever or worsening pain. Exceptions to the recommendations to avoid antibiotics are made for patients who are frail, have multiple comorbidities, are immunocompromised, or have laboratory findings of severe inflammation, including C-reactive protein > 140 mg/L or a white blood count > 15,000. In such patients, antibiotics are still indicated right away. The extent of diverticulitis involvement on a CT scan would also be an indication for antibiotics. However, we don't want to rush to recommend a CT scan in all patients. This reflects our increasing awareness of the radiogenic risk of CT scans and abdominal CT scans, which I discussed in a recent video. CT scans are really overutilized, and we potentially need to take a step back in when we use them. Vitamin D status is another important factor, which I touched on in a recent article. Low vitamin D levels are associated with a higher risk for diverticulitis. I routinely check the vitamin D levels in my patients and generally recommend vitamin D supplementation, given its very low risk and potential prophylactic value in patients with a history of diverticulitis. Genetic Predisposition There's a strong genetic predisposition for diverticulitis, which we often overlook in our discussions with patients. Over 30 genetic loci have been associated with diverticulosis, and at least four seem to be associated with diverticulitis. This is key when considering patients with a family history of diverticulitis, including their siblings. In monozygotic twins, the risk is higher than in dizygotic twins, accounting for about 50% of the recurrence risk for diverticulitis. We need to be proactive when asking about family history in order to identify patients who are at greater risk for disease development or recurrence. Lastly, I always tell my patients that intermittent, lingering symptoms, such as cramping, are quite common. About 45% of patients experience intermittent symptoms after recovery, which is mostly attributable to visceral hypersensitivity. There may also be a microbiome-related explanation for motility-related muscular changes related to diverticular disease. We can assure patients that they don't need to be alarmed by such symptoms, nor must they seek out immediate help from their healthcare provider. These symptoms are different from the acute and persistent worsening pain typified for diverticulitis. Instead, we can consider treating them with antispasmodics or low-dose antidepressants to manage their symptoms. I hope this overview gives you practical, evidence-based tools for discussing the management of diverticular disease with your patients. These conversations can be a lot more meaningful when supported by the latest data, allowing us all to do a better job. I'm Dr David Johnson. Thanks for listening, and I look forward to chatting with you again soon.
CNET
09-07-2025
- Health
- CNET
What Your Poop Is Signaling to You About Your Digestive Health
Nobody enjoys talking about their bodily functions, and bowel movements are right up there in the uncomfortable stakes. But once you get beyond the embarrassment, there is a lot that you can learn about yourself if you know what to pay attention to. How often you poop, how long it takes and what your stools look like can reveal a lot about your health. Knowing what to pay attention to is important. That's why we spoke with three gastroenterologists about the frequency of regular bowel movements and other indicators to help you understand what's normal and when it might be worth reaching out to your doctor. Read more: Signs Your Gut Could Be Unhealthy and How to Fix It How often should you poop? You probably have someone in your family (if you're honest, maybe it's you) who's convinced they need to poop every morning. However, a healthy pooping schedule isn't the same for every person. You don't need to panic if you're not one of those people who goes to the bathroom like clockwork after your morning coffee. Dr. Lance Uradomo, an interventional gastroenterologist at City of Hope Orange County, explains, "The term 'regular' generally means that a person's bowel movement frequency is continuing without any change." In fact, the number of times you poop every week could vary dramatically from other people in your household with no cause for concern. Dr. Michael Schopis, gastroenterologist and attending physician at Manhattan Gastroenterology, says, "Normal poop frequency can range quite dramatically depending on the person. Pooping anywhere from every other day up to three to four times per day can be considered regular." As a general rule, Uradomo advises, "Three times a day to three times a week is considered a healthy range." However, the doctor warns, "It's important to recognize your own regular routine so that if the frequency suddenly changes, you can alert your doctor." Is it healthier to poop less or more often? Dr. Natasha Chhabra, a gastroenterologist at Gastroenterology Associates of New Jersey, says how often you poop may be less important than whether you're pooping enough. She explains, "Having adequate BMs [bowel movements] with complete evacuation is a great goal, as having a BM is one way our body rids itself of toxins and waste. Some can have a daily BM and still not feel that they have emptied." In other words, having less frequent but complete bowel movements may be healthier than having frequent small bowel movements. How often you should be pooping may also depend on how difficult it is for you to go number two. According to Schopis, "If it requires lots of straining and pushing to have a bowel movement or it requires you to spend 30 minutes on the toilet, then it's probably better for you to try and poop more often." He says you should introduce lifestyle changes to help induce pooping in this situation. The Mayo Clinic recommends eating high-fiber foods, staying hydrated and exercising as natural ways to prevent constipation. On the other hand, it's possible to poop too often. Schopis says, "If someone is going four to five times per day, it's watery and with significant urgency, then this person is probably pooping too much." The Mayo Clinic notes that everything from stomach viruses and bacterial infections to lactose intolerance may cause you to poop frequently. Antibiotics may also lead to temporary does healthy poop look like? Many doctors use the Bristol stool chart to help evaluate the health of bowel movements. The chart is a form scale, meaning that it rates stool based on factors like size and consistency. Bowel movements are rated from 1 to 7, with 1 being the most firm and 7 being entirely liquid. Bristol stool type 1-2: Rabbit or grape-like droppings that are quite hard and may be difficult to pass. Bristol stool type 3-4: Corn on the cob or sausage bowel movements that are soft and easy to pass. Bristol stool type 5-7: Mushy to liquid bowel movements that may or may not include some solid pieces. As Chhabra explains, "The middle of the chart (Bristol 3-4) describes a healthy BM, which is generally described as sausage or snake-like." Poop in these categories is also solid, while it may be either smooth or have some cracks on the surface. A healthy poop in the Bristol 3-4 categories indicates that someone is getting both enough water and enough fiber in their diet, according to Schopis. He notes that this type of stool is often easiest to pass, while "Bristol stool types 1-2 are often hard, pebbly and hard to pass, indicating constipation." If your poop floats, you could have excessive gas, be eating a diet with high-fat content or have a gastrointestinal tract issue. Your poop should sink more often than not. Color You also want to consider the color of your bowel movements. Uradomo reports that "healthy poop can be brown or even greenish but should never be black or contain blood. This could indicate the presence of cancer or other health problems." If your stool is particularly pale, you may want to talk to your doctor about your liver, pancreas and gallbladder health. Smell According to Mount Sinai Hospital, smell also matters. While poop is never meant to smell pleasant, if it suddenly has a new or particularly foul odor, you could be experiencing a condition like chronic pancreatitis or ulcerative colitis. The good news is that changes to your diet can also produce really stinky stool. So if you just have one seriously bad-smelling BM, it could be from eating or drinking something fermented or consuming a lot of garlic. How long should it take you to poop? It shouldn't take you more than a few minutes to poop. Schopis says, "Ideally, someone should spend 5 minutes or less without any pushing or straining to have a bowel movement." Chhabra agrees, explaining, "Spending more than a few minutes having a BM should raise concern for constipation, particularly if you are straining." Uradomo offers a little more leeway, saying, "It should take a person between 5 and 15 minutes on the toilet to have a bowel movement." He warns that sitting on the toilet for longer than that can "lead to problems such as hemorrhoids, reduced circulation or pelvic floor dysfunction." Dusanpetkovic/Getty Images What are the signs of an unhealthy bowel? There are several key signs that you may have an unhealthy bowel. These include: Pain: Frequent pain while pooping may be a cause for concern. This could mean your stool is too hard or there is a larger GI issue. Blood: Blood in the bowl after you poop may also signal an unhealthy bowel. Uradomo warns, "Blood in the stool can be caused by a relatively minor problem like hemorrhoids, but it may also be an indicator of cancer, bowel disease or major internal bleeding." You should monitor bleeding closely and consult your doctor. Loss of bowel control: If you experience bowel (fecal) incontinence, you may be experiencing weakened rectal or anal muscles. Muscle and nerve damage resulting from childbirth may also affect your ability to control bowel movements. Black stool: Uradomo warns that black or tarry-looking stools can indicate bleeding in the upper gastrointestinal tract. This includes your esophagus, stomach and small intestine. Chronic diarrhea: If you often have diarrhea lasting more than a few days, you may be dealing with irritable bowel syndrome or Crohn's disease. Celiac disease can also cause frequent, pale diarrhea. When to talk to your doctor about your poop Any time you're experiencing painful pooping or the inability to have a bowel movement, it's worth talking to your doctor. The NHS warns that chronic constipation can lead to dangerous fecal impaction, and Healthline recommends seeking medical attention if it's been a full week without a bowel movement. Schopis says, "If you're finding that bowel movements control your life, either due to lack of frequency or going too much," it's a great idea to see a doctor. Black or bloody poop also signals that it's time for a medical evaluation. How to keep your poop healthy Sometimes lifestyle changes are all it takes to create healthier poop habits. For instance, make sure you drink enough water. Dehydration may lead to constipation or make your stool harder to pass. Chhabra also recommends eating fiber daily through whole fruits and vegetables. She says this "helps keep your bowel movements fuller and easier to pass." More specifically, Schopis advises people to aim for 2 to 3 liters of water per day and 25 to 30 grams of fiber per day to achieve healthy, normal bowel movements. Aside from this advice, you may want to consider exercising more to help your bowel run smoothly. The bottom line You don't need to poop every day, but you should track your habits and notice when there is a dramatic change. Symptoms like straining to poop or experiencing chronic diarrhea are signs that it's time to make an appointment with your doctor. In the meantime, eating fiber and drinking a lot of water are easy ways to help yourself to poop regularly.
RNZ News
09-07-2025
- Health
- RNZ News
Dr Susan Parry on her stellar medical career
When Susan Parry was growing up in the 1960s, she was discouraged from becoming a doctor. She prevailed and went on to hold senior clinical roles including Head of Gastroenterology at Middlemore Hospital. She helped to establish the National Bowel Screening Programme. Earlier this year she became an Officer of the New Zealand Order of Merit for services to her chosen field. Dr Susan Parry talks to Kathryn Ryan about her proudest achievements and the importance of work-life balance. Dr Susan Parry ONZM Photo: SUPPLIED/Health New Zealand
Washington Post
07-07-2025
- Health
- Washington Post
I'm a gastroenterologist. Here's why I tell my patients to eat this one fruit.
Is there something I can eat to help with constipation? A lot of high-fiber foods and supplements make me bloated, but I don't want to take a laxative. I get this question often in my gastroenterology clinic. Gut symptoms like bloating and constipation are incredibly common, affecting up to a third of the population. Many people don't want to take medication if there are more natural ways to help. But I also know that simply recommending people increase their fiber intake is vague and not always useful.
