CCE Gastrointestinal Disorders: Penn Medicine

July 10, 2009

Groundbreaking gastrointestinal cancer research and cutting edge programs in interventional endoscopy and inflammatory bowel disease are highlights of a GI division that claims to do it all, and do it all well.

Penn Medicine Center
Philadelphia, Pennsylvania

Groundbreaking gastrointestinal cancer research and cutting edge programs in interventional endoscopy and inflammatory bowel disease are highlights of a GI division that claims to do it all, and do it all well.

Research

Boasting one of 15 GI/Liver centers funded by the National Institutes of Health (NIH), researchers at the Penn Medicine Center for Molecular Studies in Digestive and Liver Diseases have developed both animal and three-dimensional culture models of colon, pancreatic, and esophageal cancers, and are using the animal models for imaging studies that could result in earlier detection and new therapies.

The center receives $12 million a year through the NIH, one of the highest in the U.S. for GI divisions, says Anil Rustgi, MD, chief of the division of GI, and goes toward bridging basic science to translational applications for GI cancers, irritable bowel disease, liver disease, and luminal GI diseases.

One project in esophageal carcinogenesis, which will receive a $7.5 million grant renewal from the National Cancer Institute over the next five years, is one division of the center devoted specifically to finding new ways to treat esophageal cancer.

"We have many physician-scientists who are leaders in their fields, nationally and internationally," says Rustgi "and we are very excited about the advances we've made in terms of diagnosis, and, we hope, in therapy."

Another avenue for research is the joint Penn GI and Children's Hospital of Philadelphia (CHOP) GI center, which helps adolescents with digestive, liver and pancreatic diseases transition from pediatric care to adult care.

The joint center works to bring CHOP and Penn physicians together to discuss medical histories and future treatment options to make the transition process seamless for the patient, as well as focus on research and education for students, residents, and fellows.

Clinical care

The faculty of the IBD group is a leader in therapy, according to Rustgi, with many key studies coming from the division. With a faculty of seven, plus a team of nurses, coordinators, nutritionists, and collaboration with surgery, pathology, and radiology, the group pursues conventional and novel therapies for the treatment of ulcerative colitis and Crohn's disease, says Rustgi.

A very active area of focus for the IBD group is the physiology lab, says Metz, with Penn being one of a few places in the country doing gastric analysis. Primary care physicians dealing with difficult inflammatory bowel cases can refer them to Penn for extensive physiology testing, says David Metz, MD, associate chief, GI division for clinical affairs, Penn Medicine.

"We do a lot of physiology testing for reflux disease for the difficult-to-manage patient, and we have a close relationship with the laparoscopic surgeons for achalasia management," says Metz.

In addition, he says there are always active clinical trials being conducted using investigational agents, specifically for the treatment of Crohn's disease and hepatitis.

Another area of focus for Penn is the interventional endoscopy program, which uses new technology and minimally invasive tools to more quickly and accurately detect and treat digestive diseases. Over 20,000 endoscopic procedures are performed annually at Penn, including endoscopic ultrasound with fine-needle aspiration, mother-daughter cholangioscopy, and complicated stenting procedures, says Metz.

A third area of expertise is liver disease, says Rustgi. The Penn liver transplant center performs 150 transplants per year and has more than 400 patients on the waiting list. According to data from the United Network for Organ Sharing and the Scientific Registry of Transplant Recipients, the center exceeds national averages in terms of graft survival and patient survival, Metz says.

All-encompassing division

Penn's GI Division is all-inclusive in clinical, basic science and translational research, says Metz. "There is nothing we don't do, and everything that we do is in a specialist forum so that we have expertise to cover all the bases."

That is a key factor for referring physician Carol Fleischman, MD, an internist in Radnor, Pennsylvania.

"I feel very confident referring patients to Penn Gastroenterology because of the clinical excellence and varied expertise of their staff."