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ORLANDO -- This year's brought news of gastroenterologist burnout, the weekend effect's toll on the endoscopy suite, and rising colon cancer diagnoses in younger people. Here are a few more updates from the conference.

First Study to Use FMT for PSC

Fecal microbiota transplantation (FMT) from a rationally selected donor is levels among patients with primary sclerosing cholangitis (PSC), reported Jessica R. Allegretti, MD, MPH, of Brigham & Women's Hospital.

According to an open-label pilot study of PSC patients with concurrent inflammatory bowel disease and a mean baseline alkaline phosphatase level of 441.3 IU/L, half (n=3) had a 50% or greater decrease in alkaline phosphatase by week 26, with an average decrease of 250 IU/L among responders compared with 10 IU/L among non-responders (P=0.001).

Additionally, microbiome analysis found that pre-FMT alpha diversity was significantly less than that of controls and that diversity increased in all PSC patients one week after FMT and remained elevated in most patients.

"This will help us to better understand what role the gut microbiome plays in the disease and to develop more effective therapies for this disease," said Allegretti. "This is crucial given this is a disease that to date has no FDA-approved therapies."

Lynch Syndrome Screening Practices in the U.S.

Lynch syndrome screening by tumor microsatellite instability (MSI) and immunohistochemistry (IHC) is not routinely performed among patients with colorectal cancer, and discrepancies in who is responsible for ordering these tests may prevent reliable performance.

completed by 474 ACG members found that just 32.7% of surveyed gastroenterologists said it's a gastroenterologist's responsibility, reported Jordan J. Karlitz, MD, FACG, of Tulane Cancer Center and Chair of the ACG Public Relations Committee.

The survey found that 47.2% of respondents felt MSI/IHC should always be performed on colonoscopy, as opposed to surgical resection specimens, in early-onset CRC. Additionally, just one-third (30.4%) felt that if MSI/IHC was ordered on colonoscopy biopsy, surgery should be delayed until results became available and only 44.2% were familiar with guidelines for this scenario.

"Our survey demonstrated that providers do not feel that MSI/IHC testing should be routinely performed on colonoscopy biopsy specimens," stated Karlitz. "This in turn can prevent patients and surgeons from having valuable information that can assist with decisions regarding how much colon is removed in the operating room, which ultimately can affect the risk of developing a second CRC."

He called for further attention to guidelines and protocols regarding responsibility and timing of testing.

Probiotics for Kids with Abdominal Pain

A Cochrane systematic review of 13 studies suggested for functional abdominal pain in children compared with placebo, reported Morris Gordon, MBChB, MMed, PhD, of the University of Central Lancashire in the U.K.

Ten studies found a statistically significant reduction in the severity of pain using probiotics compared with placebo (mean difference -0.61; 95% CI -0.99 to -0.24), while seven found no statistically significant difference in adverse events between probiotics and placebo.

Sensitivity analysis of five studies on L. Reuteri, one of the most used agents, suggested a statistically significant reduction in pain severity (RR -0.70; 95% CI -1.25 to -0.16).

Further research on the longer term impact of probiotic therapy is suggested, concluded Gordon.

Other highlights from the annual scientific meeting included:

• Antihistamine Improves Quality of Sedation During Colonoscopy
• ACG: Half of Gastro Docs Experience Burnout
• Deep Learning May Help Detect Colon Polyps
• Electronic Nose Promising for Barrett's Esophagus Detection