​Gastrointestinal (GI) tract issues rank among the most common health problems in the United States. A study by the American Gastroenterological Association found that between 60 and 70 million Americans live with one or more GI diseases, which can seriously impact overall health and wellness. In 2018, the National Institutes of Health reported that two out of three Americans experienced GI symptoms at any given time.

The GI tract is a key component of the human digestive system. Specific diseases and symptoms may impact the tract, which moves food throughout the body, or other parts of the digestive system, such as the liver, pancreas, and gallbladder. Gallstones, for instance, impact upwards of 25 million Americans, nearly 75 percent of whom are women. A gallstone is a solid lump that forms in the gallbladder as bile crystallizes. The stones vary in size from grains of sand to the size of a golf ball. Initial symptoms include sharp, stabbing pain in the abdomen, which, over time, can cause nausea and vomiting. Without medical or surgical intervention, gallstones can develop into more serious digestive problems, such as pancreatitis.

Gastroesophageal reflux disease (GERD) and gastroesophageal reflux (GER), also known as acid reflux, represent an even more common GI issue for Americans, impacting between 20 and 33 percent of the population. Many Americans experience GER following a large meal or after drinking too much coffee, while GERD involves reflux symptoms occurring at least twice per week. Often, individuals can minimize the discomforting symptoms via lifestyle changes, but advanced cases of GERD may demand medication or one of several surgical procedures.

Irritable bowel syndrome (IBS) is another common GI issue, impacting 10 percent of people in the United States every year. IBS symptoms include abdominal pain, bloating, constipation, and changes in bowel movements. Symptoms often impact a person's ability to go about their daily lives, though a combination of medication, probiotics, medical nutrition, and mental health therapies can mitigate symptoms.

A combined 3 million Americans live with ulcerative colitis or Crohn's disease, two painful inflammatory GI diseases. Ulcerative colitis involves inflammation of the large intestine, resulting in sores along the intestinal lining. The sores cause abdominal pain, as well as the repeated urgent need to have bowel movements. A chronic disease, ulcerative colitis may last for years without dissipating, and researchers have yet to develop a cure, though dietary changes and certain medicines can reduce symptoms.

Similarly, Crohn's disease impacts the body with severe and chronic inflammation. However, inflammation is not limited to the large intestine and can spread throughout the GI tract, all the way from the mouth to the anus. Crohn's is an especially painful disease, with additional symptoms including frequent diarrhea, cramping, and severe weight loss. Individuals living with Crohn's disease must take medication and practice various physical therapies.

Peptic ulcers can also cause abdominal pain. These open sores form along the lining of the stomach and the top of the small intestine due to bacterial strains that weaken the GI tract's protective outer layer and allow stomach acid to directly contact various tissues. Most treatment plans involve a regimen of antibiotics.

Finally, hemorrhoids impact close to 50 percent of Americans aged 50 and older. A hemorrhoid is a blood vessel in the rectum or anus that swells, causing severe itching and pain. Risk factors for hemorrhoids include chronic constipation and diarrhea, meaning they often accompany other GI issues, while treatment plans typically consist of stool softeners and refraining from straining the impacted area.

​Crohn's disease and ulcerative colitis are inflammatory bowel diseases (IBD) that disrupt daily life since individuals can experience unpredictable abdominal pain, diarrhea, and exhaustion. The National Center for Biotechnology Information found that these persistent symptoms lower the quality of life for over half of IBD patients.

People who experience these diseases often adjust their plans to accommodate sudden flare-ups, which can result in missing work or social events. People actively prepare for health issues, and this continuous adaptation creates unpredictability. IBD's psychosocial impact adds complication. Studies show that Crohn's disease and ulcerative colitis patients often experience stress from disease management, causing anxiety and sadness. Fear of symptom return can increase vigilance and affect mental health, according to the Crohn's & Colitis Foundation.

Patients may feel alone because stigma or misunderstanding makes communicating their disease difficult. This mental strain exacerbates physical obstacles, making it even more challenging to stay balanced. Patients with IBD experience major social adjustments. Frequent toilet access or dietary constraints can limit dining out and traveling. According to a Frontline Gastroenterology study, many patients avoid social engagements to avoid shame or discomfort, reducing their social networks. Friends and family may change as loved ones seek to understand the situation. This change in social relations often leads to loneliness as people navigate a less accessible world.

IBD disrupts work and career progression. Over 50% of patients report work-related issues, such as absenteeism and decreased productivity, according to PubMed. Unexpected medical visits or time off during flare-ups may negatively impact job performance and promotion opportunities. Some people opt for less demanding jobs to address their health needs, which can limit their career aspirations. This work-life change highlights the economic and personal costs of managing chronic illness.

Moreover, IBD sufferers must watch their diets. The Crohn's & Colitis Foundation advises patients to follow highly tailored diets because certain foods may trigger symptoms. Safe food identification often requires trial and error, which can complicate meal planning and preparation. Navigating menus or explaining dietary restrictions can be stressful for people at social meals. Patients must maintain a balanced diet and avoid triggers that worsen their symptoms, making daily life more complicated.

Physical limitations from IBD affect daily life and health. Studies from the National Center for Biotechnology Information suggest that fatigue can reduce energy and make routine tasks more challenging. Flare-ups, which can lead to a decline in physical fitness over time, may deter exercise. Reduced activity can worsen physical health and complicate disease management, impacting both body and mind.

Additionally, the financial burden of IBD increases in proportion to its severity. The costs of medicine, doctor's appointments, and surgery can be burdensome for patients. These fees and missed work cause financial stress, according to a study in Frontline Gastroenterology. For many, the need to prioritize health-related spending over other expenses reshapes budgeting and long-term financial planning. This economic pressure amplifies the difficulty of living with a chronic disease.

The influence of IBD goes beyond the arena of family planning and relationships. Research from the National Center for Biotechnology Information suggests that some patients worry about spreading IBD to their offspring, influencing decisions about raising a family. Additionally, the physical and emotional strains of the disease can strain personal relationships, as partners navigate the complexity of supporting someone with chronic illness. These issues modify personal aspirations and family dynamics, adding a dimension of consideration to life decisions.

For many, the combined impact of IBD on daily life underscores the need for more profound public awareness and support. Accessibility and empathy can help IBD patients lead fuller lives, shifting the focus from limitations to empowerment and resilience.

​In March 2025, the American College of Gastroenterology announced the efficacy and safety of the drug mirikizumab in treating moderate to severe Crohn’s disease. Researchers reached this conclusion after conducting a study spanning 33 countries in 324 centers. The study was crucial in developing advanced therapies for moderate to severe Crohn’s disease.

Digestive discomfort, including gas, bloating, and indigestion, can make daily activities challenging. These symptoms are intensified in people with Crohn's disease, which may also cause debilitating pain. This irritable bowel disorder causes weight loss, diarrhea, fatigue, fever, blood in stool, and malnutrition. Crohn’s can cause complications in other parts of the body, including inflammation in the eyes, skin, joints, liver, and bile ducts. It also can cause kidney stones, anemia, and delayed growth in children. The disease primarily affects the section connecting the small and large intestines, and its effects vary from person to person. Researchers have not yet developed a cure, but various therapies may help manage the disease.

The mirikizumab Phase 3 drug trial offered a different approach to the IL-23 inhibitor in managing the disease. The IL-23 inhibitor is a biological therapy that targets cytokine in the intestinal cavity commonly associated with driving intestinal inflammation. Mirikizumab is one of the few drugs that relies on the work of the IL-23 inhibitor. It is effective regardless of patient exposures, making it suitable for those who have used other biological therapies without success.

The study enrolled 1,150 participants ranging in age from 18 to 80 with moderate to severe Crohn’s disease. Researchers gave participants at least one biological or conventional therapy. Researchers split the cohort into three groups and administered doses of mirikizumab, ustekinumab (another drug that treats Crohn’s disease), or a placebo. The first group received an initial dose of 900 milligrams followed by 300 milligrams every four weeks. The second group received 6 milligrams per kilogram of their body weight for the first dose, followed by 90 milligrams every eight weeks. The last group received the placebo.

Patients who experienced previous biologic failures had higher response rates to mirikizumab than to ustekinumab. Additionally, participants experienced fewer adverse events while taking mirikizumab than those taking the placebo. Moreover, researchers found that patients reported a clinical response to treatment by week 12, a subjective measure that reflects how patients experience their symptoms. At week 52, more patients had experienced an endoscopic response and remission than those in the placebo group. Mirikizumab's outcomes were comparable to ustekinumab's, with patients reaching clinical remission in week 52.

While the study’s outcomes may be similar to those in real-world settings, it had some limitations. The study lacked controls that would have detected significant differences between mirikizumab and ustekinumab. Researchers reported that such a comparison would require additional study. Finally, the study did not explore extended intravenous therapy for participants who experienced a partial response or loss of response, an area that would require further investigation.

Ultimately, researchers stated that expanding research on the class of IL-23 inhibitors was necessary to shape future studies. This research should also include data on IL-23 and the effectiveness of one IL-23 inhibitor after the failure of another.

​The American College of Gastroenterology (ACG) is a leading medical society focused on advancing clinical care, research, and education in gastrointestinal health. Alongside its clinical guidelines, ACG equips physicians with practical tools for applying new evidence in real-world settings.

One such tool is Evidence-Based GI, a monthly online publication that summarizes high-quality research from general medicine journals. It highlights studies relevant to gastrointestinal care that appear in sources such as The New England Journal of Medicine, JAMA, and Annals of Internal Medicine. Rather than confining its focus to subspecialty publications, the series draws attention to broadly conducted trials that influence diagnosis, treatment, and screening decisions.

To support this broader scope, the editorial team applies strict inclusion criteria for each issue. They prioritize randomized controlled trials, meta-analyses, and large cohort studies whose findings directly impact patient management. By assessing methodological rigor, clinical relevance, and reproducibility, the team filters out irrelevant data, ensuring each article offers practical value.

Each summary delivers essential details in a structured and accessible format. Study design, outcome data, and interpretation are presented in plain language, along with metrics such as absolute risk reduction, the number needed to treat (the number of patients that must be treated to prevent one adverse outcome), and confidence intervals. Expert commentary adds context, helping busy clinicians apply findings without revisiting lengthy original texts.

This consistent approach supports uniform interpretation across care settings, reducing variability in how evidence is applied. When interpretation differs, patient outcomes may vary unnecessarily. By providing structured, unbiased explanations, the publication helps align clinical decisions across both high-volume and specialty environments.

Some featured studies serve as early signals for future guideline development. Evidence-Based GI brings new findings into professional conversations before formal recommendations are updated. This approach allows clinicians to engage with credible data while the broader community evaluates its adoption. These summaries bridge the gap between emerging research and long-term clinical standards.

The publication also extends access to professionals outside academic settings. Many readers may lack institutional journal subscriptions or regular entry to subspecialty conferences. Concise, well-structured updates ensure important findings reach a wider audience without requiring additional infrastructure.

Editorial neutrality strengthens the credibility of the content. Evidence-Based GI accepts no commercial sponsorship and maintains full independence in its editorial process. This transparency builds trust among readers and aligns with national efforts to ensure objectivity in medical education.

Recent summaries demonstrate the impact of this format on real-world care. A review of colorectal cancer screening intervals triggered internal audits at several institutions. Another study on dietary strategies for irritable bowel syndrome promoted the wider use of non-pharmacological interventions. These examples illustrate how curated content can drive meaningful and timely changes in clinical practice.

The publication also meets national standards for professional development. Its content qualifies as enduring material under the Accreditation Council for Continuing Medical Education (ACCME) criteria, contributing to measurable improvements and supporting accredited education that remains available over time. Structured summaries reinforce applied knowledge, not just exposure to information.

As research output continues to grow, tools that clarify clinical relevance will become increasingly vital. Evidence-Based GI meets this demand by filtering complex studies through a transparent, methodical lens. Its role reflects a broader shift in how medical professionals interact with new data, focusing less on volume and more on interpretation that leads to action.

​Healthcare disparities persist for underrepresented minorities, even as medical advancements continue. These inequities are pronounced in gastroenterology (GI), where minority populations face higher rates of certain conditions and varying care quality. Contributing factors include limited specialist access, cultural insensitivity, and inadequate representation in the medical profession.

EBMED.net addresses these challenges through education and advocacy. The organization provides Continuing Medical Education (CME) programs focused on GI issues and evidence-based medicine (EBM). These programs equip healthcare providers with current knowledge and practical tools to enhance care for diverse patient groups.

EBMED.net also promotes mentorship and sponsorship for women and underrepresented minorities in GI academia. By increasing diversity in the workforce, EBMED.net builds a medical community prepared to navigate cultural and social barriers.

EBMED.net initiatives aim to close care gaps and improve outcomes for underserved populations. The organization supports pathways for underrepresented minorities to enter GI fields, fostering a workforce attuned to their communities' needs. These efforts advance care approaches for populations disproportionately affected by GI conditions.

​Gastroenterologists focus on diagnosing and treating issues related to the gastrointestinal system, including the digestive tract, gallbladder, liver, bile ducts, and pancreas. Often called GI specialists, they handle several critical responsibilities.

Gastroenterologists perform technical procedures such as endoscopy, colonoscopy, and sigmoidoscopy. These procedures allow the direct examination of internal organs, providing essential insights for diagnosis and treatment planning.

During an endoscopy procedure, the gastroenterologist gets a clear view of the esophagus, stomach, and upper part of the small intestine using a scope. This is primarily a diagnostic procedure. It allows the gastroenterologist to diagnose and treat various digestive tract issues such as acid reflux, stomach ulcers, and celiac disease, among others.

The gastroenterologist also helps in the detection and prevention of colon and rectal cancer. Statistics show that colon and rectal cancers combined are one of the leading causes of cancer-related death in the United States for both men and women. Gastroenterologists help to prevent this through the colonoscopy procedure. This procedure allows them to carefully examine the colon and rectum and check for any visible signs of cancer tumors. In the event that precancerous or cancerous polyps are discovered they can be removed, usually in time to prevent cancer from either developing or advancing.

​Patients often question the need to reintroduce foods after completing the FODMAP diet, especially when their symptoms are under control. While concerns about symptom relapse are understandable, reintroducing offers important benefits that outweigh the risks in most cases.

Reintroducing allows greater flexibility in food choices. As individuals discover their tolerance for various FODMAP groups, they gain confidence in eating a broader range of foods. This freedom makes social eating and dining out less restrictive and reduces feelings of isolation.

Expanding the diet also provides a more diverse nutrient intake. The elimination phase of the FODMAP diet can limit key nutrients, so reintroducing foods helps ensure the body receives essential vitamins and minerals.

Additionally, many fermented foods and those rich in probiotics contain high FODMAP levels. These foods support gut health by fostering beneficial bacterial growth. Long-term elimination of such foods may reduce tolerance or increase sensitivity when reintroduced later, underscoring the importance of testing them early.

Successful reintroduction depends on adhering to a strict low FODMAP diet during the process. Adding foods from FODMAP groups previously tolerated should not be done until all tests have been completed. Keeping a detailed food and symptom diary helps track reactions and gauge readiness for the next test. For accurate results and better guidance, working with a dietitian during this phase is recommended. Ensuring symptoms subside before starting a new test is also crucial to the process. Reintroducing foods systematically helps patients build a sustainable and well-rounded diet while managing their symptoms effectively.

​Gastroenterology includes several specialties that can meet a physician’s different interests and career aspirations. Emerging trends and advances in medical knowledge have also provided more focused practice areas within the specialty, such as hepatology and inflammatory bowel disease.

Hepatology, or hepatobiliary medicine, addresses liver diseases such as cirrhosis, liver cancer, and viral hepatitis, as well as liver transplantation. It’s different from proctology, which deals with disorders of the anus, rectum, and colon, and is considered a sub-specialty of general surgery. Advanced endoscopy focuses on complex diagnostic and therapeutic procedures, including endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), and other specialized techniques.

Inflammatory bowel disease (IBD) specialists diagnose and manage chronic conditions like Crohn’s disease and ulcerative colitis. Another area, motility, concentrates on gastrointestinal movement disorders, including gastroparesis, irritable bowel syndrome (IBS), and esophageal motility issues.

Sub-specializing can refine a gastroenterologist’s skills and enhance their career trajectory. Focused expertise improves marketability, increases earning potential, and opens opportunities to lead practices or develop specialized programs within the field. However, one related area of specialization, pediatric gastroenterology, is a separate pediatric specialty rather than a subspecialty of gastroenterology.

​Irritable bowel syndrome (IBS) is one of the most common health conditions in the United States. According to About IBS, as many as 45 million individuals live with the condition, with an estimated two-to-one female-to-male split. Recent studies suggest the condition may be more prevalent than expected, partly because individuals may not recognize the symptoms.

IBS symptoms can vary depending on severity and where it occurs along the gastrointestinal tract, such as the stomach, small intestine, or large intestine. As the chronic condition develops, individuals may observe a change in the appearance and frequency of their bowel movements. Throughout the day, Americans living with IBS may experience abdominal pain in addition to cramping, bloating, and gas. Constipation and diarrhea are both symptoms of IBS and may occur in tandem.

IBS is a chronic condition that requires long-term treatment. Fortunately, most individuals can manage symptoms with simple lifestyle changes and stress management techniques. However, those living with more severe IBS may require medication and advanced medical counseling services.

​EBMed, a nonprofit educational organization established to provide continuing medical education (CME) and mentoring to women and underrepresented minorities to advance in their academic gastrointestinal careers, opened registration for the 2025 Great GI Debates on September 1. The upcoming Great GI Debates is scheduled for February 28 to March 2, 2025, at The Diplomat in Hollywood Beach, Florida. Interested participants may access the registration page on EBMed’s website.

GI fellows, internal medicine residents, and early-career gastroenterologists attend educational, mentoring, and networking events at the Great GI Debates. The CME, in particular, focuses on inflammatory bowel diseases, esophageal disorders, gastrointestinal motility disorders, acid-peptic disorders, and obesity management and endoscopic innovation.

The CME comes in three educational formats. The first is the “Debates,” which features two senior faculty members debating on a provocative clinical question while a third senior faculty member acts as a judge. In the second format, “Case Presentation,” an early-career faculty member presents a briefcase or patient presentation focusing on a specific treatment option to a panel of senior faculty members. The third format, “How I Do It,” highlights a leader who discusses how she manages patients by integrating clinical trial data and clinical experience.