by Dr Yuri Gorelik (Frontline Gastroenterology Global Taskforce 2025-6)   Since the introduction of ChatGPT 3.5 in November 2022, artificial intelligence (AI) and specifically large language models (LLMs) have been set to revolutionize our daily and work life. Multiple LLM based GI utilities have been developed and researched. In this blog post I will try to provide a mini review in the form of a description of a GI practitioner workday powered by such LLM based utilities and products. Many of the specific LLM applications and use-cases I mention below are discussed in Frontline Gastroenterology’s narrative review of generative AI in colorectal practice (Frontline Gastroenterology, 2025). Morning Clinic Upon arrival at the clinic all previous follow-ups and clinic referrals for the clinic patients on your list are already summarized by one of the multiple published tools for such tasks. Soon after, the patients start to come in, all history taking and patient communication is scribed by an LLM such as the Google health medical speech to text tools (Google cloud). This text is also transformed into a structured text with clinical terms and specific disease-centered classifications. In IBD, multiple sources of medical data (notes, endoscopy, imaging) contain abundant unstructured information and such tools showed high accuracy in the identification and structuring of these texts. The need for natural language processing of IBD patient data was previously highlighted in Frontline Gastroenterology’s review on AI in IBD (Frontline Gastroenterology, 2022). Finally, each clinic comes down to patient recommendations and these are derived with the assistance of multiple LLM based decision support tools that provide recommendations based on the summary of the structured visit in the context of the relevant guidelines. Such tools can be extremely useful across multiple fields of GI, often where guidelines are inconsistent or complex and where clinicians must integrate multiple data sources with the current patient’s clinical data. Even common clinic complaints such as functional dyspepsia require integrating multiple symptoms and clinical data for optimal work-up and treatment, as described in a recent Frontline Gastroenterology guidance (Frontline Gastroenterology, 2025). Care is extended as the patients leaves with a link to chatbots that can answer questions specific to his condition. Afternoon in the Endoscopy Suite On to the endoscopy suite. Your list allows open access endoscopy received from multiple referral sites. These referrals should be evaluated to decide on appropriate settings, medication management, and type of preparation. At your location the referrals are managed by an LLM based tool which already analyzed the referrals and identified the requested procedures, the indications, pre procedural medication management (anti-coagulants, GLP-1 receptor agonists, etc.) and type of bowel preparation. Patients who come in for a procedure are well informed since a chatbot already addressed multiple concerns and questions they had regarding their upcoming colonoscopy. Just like at the clinic, during colonoscopy, you narrate findings, while an AI tool transcribes the report with high accuracy, and as clinic notes these reports will include LLM generated, guidelines-based recommendations. The patient will get an automatically generated concise letter explaining the findings and forward recommendations. Of course, the entire endoscopy is AI powered with various pathology detection and diagnosis tools, but this is a subject for a different post. Prior to heading home, you can deidentify your clinic notes and endoscopy reports from the day to a research AI agent, which is provided by all large models to look up or summarize any patient specific evidence that was not covered in guidelines or large reviews and evaluate some additional possibilities for patients. Guideline preparation in gastroenterology was already shown to benefit from augmentation with LLM-powered systematic reviews (using deep research AI tools such as those provided by all the major LLMs). If you are in a hurry, you can convert the findings to an audio podcast, using tools such as NoteBookLLM, to listen to on your way home. In summary, AI and specifically LLMs are set to revolutionize and potentially improve every aspect of our daily work as gastroenterologists, and the possibilities keep expanding. Worth mentioning that LLMs can also enable us to perform research by providing statistical and epidemiological advice and implementation and empower us to create our own tools with models that can automatically convert your prompts to apps (see vibe coding). Now briefly go over the daily description above and consider “is a human gastroenterologist really needed here and where?”, and if you are thinking “clearly in the endoscopy part” then robotics also has some surprises coming. (Visited 227 times, 1 visits today) Source link

By Jennifer Hess and Samantha Wladich, Riemer Hess LLC Living with chronic pain usually means adapting—again and again. People adjust schedules, modify tasks, try new treatments, and push through symptoms over and over. Many continue working not because they are well, but because they are trying to hold things together. When work finally becomes unsustainable, the long-term disability (LTD) process can feel confusing and discouraging. Pain conditions are frequently misunderstood in insurance reviews, and the way claims are evaluated often fails to reflect what daily life with chronic pain actually looks like. This article offers a general, educational look at how long-term disability claims are commonly evaluated for people living with chronic pain—and why those claims can be so difficult. Important note: This article is for general educational purposes only. It is not legal advice and is not a substitute for guidance specific to an individual’s situation or insurance policy. Hear more from these experienced attorneys during a FREE webinar, “Preparing for Your Long-Term Disability Claim,” at 1 p.m. ET on Tuesday, March 10. Register today. Why Chronic Pain Disability Claims Are So Often Challenged One of the biggest problems in pain-related disability claims is that pain often does not behave the way insurers expect disability to behave. Chronic pain can: fluctuate worsen with activity improve briefly and then return limit endurance, not just strength Insurance reviews, however, often look for steady decline, clear-cut test results, or visible impairment. When those markers are missing or unclear, insurers may conclude—incorrectly—that someone is still able to work. This disconnect is one reason long-term disability claims involving chronic pain often face higher scrutiny. A Common Scenario: When Working Through Pain Stops Working Consider this example, which reflects a pattern many people with pain will recognize. A professional living with chronic spinal pain continues working while undergoing physical therapy, medication changes, and injections. At first, they shorten their workday and recover at night. Over time, therapy triggers flares instead of relief. Medication causes brain fog. Recovery stretches into the next day. Sleep deteriorates. From the outside, it looks like they are still “functioning.” On paper, treatment is ongoing. But behind the scenes, the effort required to work becomes unsustainable. When work finally stops, insurers often ask:Why now?Why stop work if treatment was ongoing? Without context, the timing can be misunderstood. Function Matters More Than Diagnosis in Long-Term Disability Claims In most long-term disability claims, the diagnosis itself is not the deciding factor. Insurers focus instead on function. For people living with chronic pain, that usually means questions like: How long can you sit, stand, or walk? How often do symptoms flare? What happens after physical or cognitive exertion? How much recovery time is needed? Can this be repeated day after day? Someone may be able to complete tasks in short bursts and still be unable to meet the demands of regular, full-time work. Disability evaluations do not always capture that distinction unless it is clearly documented. Why ‘Trying Harder’ Isn’t the Same as Capacity A recurring theme in pain-related claims is the assumption that effort equals ability. In reality, chronic pain often limits: duration frequency consistency recovery People may push through pain at work for many reasons—financial pressure, professional identity, fear of losing benefits. That effort can later be misread as proof that work was sustainable. Understanding the difference between what can be done briefly and what can be done reliably is central to understanding disability in chronic pain-related cases. Variability Is Normal in Chronic Pain — Not a Red Flag Many people with chronic pain have good days and bad days. That variability is often used against them. Insurance reviewers may interpret fluctuating symptoms as: inconsistency exaggeration improvement In reality, variability is often one of the defining features of chronic pain. Short periods of relief do not mean the condition has resolved, especially when those periods are followed by flares or prolonged recovery. Clear explanation of symptom patterns over time helps prevent this misunderstanding. Why Baseline Function Matters When Disability Follows Treatment For many people, disability does not begin at diagnosis, or at the onset of undiagnosed symptoms or pain. It begins later—after months or years of treatment attempts and symptom progression. A baseline helps show: what functioning looked like earlier how endurance declined how treatment affected symptoms over time This matters because insurers often assume that treatment leads to improvement. When work ends after treatment begins, baseline documentation helps explain that disability developed despite care, not because care was avoided. Objective Evidence and Chronic Pain: What Insurers Look For In the disability context, “objective evidence” generally means information beyond self-report alone, such as: imaging exam findings functional testing documented observations by providers This does not mean pain must show up clearly on a scan to be real. Many pain conditions do not lend themselves to definitive test results. Still, insurers often weigh claims more heavily when some objective support exists—especially when policies scrutinize conditions labeled as “subjective,” which is often the case for pain-related diagnoses. Objective evidence is most effective when paired with clinical explanation and functional context. Treatment Does Not Always Mean Recovery Many people living with chronic pain are deeply engaged in treatment long before disability becomes an issue. Insurers sometimes interpret continued treatment as proof that improvement should follow. In reality, chronic pain treatment often focuses on: management symptom reduction preventing decline Ongoing treatment does not guarantee restored work capacity. Modifying or stopping treatment can also be medically appropriate, particularly when side effects outweigh benefits or progress plateaus. The Question Disability Claims Are Really Asking: Sustainability Whether a policy applies an “own occupation” or “any occupation” standard, the real question is the same: Can this person work reliably and sustainably over time? For people living with chronic pain, the answer often hinges on endurance, recovery, and consistency—not whether isolated tasks are possible. Final Thoughts Long-term disability claims involving chronic pain are often difficult—not because pain is unclear or insignificant, but because the claims process does not easily account for

Women of all ages can get HIV — including those over 50 1 in 4 people living with HIV in the United States is a woman. More than 1 in 2 new HIV diagnoses are in people above age 50. Older women are more likely than younger women to be diagnosed at a late stage of the disease — possibly because they don’t know they’re at risk. Later diagnosis of the disease increases the risk of HIV-related illnesses and dying from the disease. How might menopause affect HIV risk? Women over 50 still have sex. In a recent study, 1 in 2 people over the age of 50 reported having sex in the last week. Since pregnancy is no longer an issue for post-menopausal women, they may not think about safe sex — or talk about it with their partners or providers. This means women may be less likely to use condoms to protect themselves from HIV and other sexually transmitted infections after menopause. But women in peri- and post-menopause may be extra vulnerable to HIV infection. Hormonal changes can cause vaginal thinning and dryness, leaving vaginal tissue prone to tearing — which increases the risk of HIV entering the body during sex. Some older women (and their healthcare providers) chalk health changes up to menopause when they could be something else For example, night sweats are a classic menopause symptom — but they’re also common in people with HIV. Preventing HIV through menopause and beyond You’re never too old to protect yourself from HIV. Start with these proactive steps: Use a condom if you’re not sure about your partner’s HIV status. Get tested for HIV. Ask your HCP about PrEP (pre-exposure prophylaxis), medication that can prevent HIV. This educational resource was created with support from Merck. Source link

Add topic to email alerts Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . “ data-action=”subscribe”> Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: A “top-down” infliximab/immunomodulator therapy reduced long-term risk for abdominal surgery vs. a “step-up” approach in newly diagnosed Crohn’s. It also lowered risk for disease progression and hospitalization. CHICAGO — Early treatment with infliximab and an immunomodulator was associated with more than five times reduced risk for abdominal surgery at 5 years among patients with newly diagnosed Crohn’s disease, according to a presenter. Follow-up PROFILE trial data presented at Digestive Disease Week showed that early control of inflammation during a 48-week treatment period also lowered long-term risk for disease progression and hospitalization. Nurulamin “Nuru” Noor, MD, speaks at Digestive Disease Week. Image: Robert Stott. “Historically, there has been a reluctance among some clinicians to use a ‘top-down’ approach due to potential concerns about overtreatment,” Nurulamin “Nuru” Noor, MD, clinical lecturer in gastroenterology at University of Cambridge, said at the presentation. “Over 5 years follow-up, we found no difference in safety outcomes between the two groups, either for serious infections or malignancies. “Patients receiving ‘top-down’ infliximab from diagnosis had a more than five times lower risk of Crohn’s disease-related abdominal surgery.” Prior data from the randomized, controlled PROFILE trial showed improved clinical outcomes at 48 weeks for patients who received the “top-down” therapy approach with infliximab and an immunomodulator compared with an accelerated “step-up” strategy, or conventional treatment. Noor and colleagues followed 386 participants for a median 5 years after the 48-week visit to evaluate whether early treatment can impact long-term outcomes of Crohn’s disease. They reviewed medical records for abdominal surgeries, hospital admissions and disease progression. Follow-up data were available for 358 patients (93%), of whom 182 received top-down therapy and 176 received step-up therapy. Analysis showed 28 Crohn’s-related abdominal surgeries were required among patients who received step-up therapy compared with six surgeries among those who received top-down therapy (adjusted HR = 5.23: 95% CI, 1.99-13.76). Time to surgery also was earlier in the step-up group. Patients who received top-down therapy were about 2.5 times less likely to experience disease progression and two times less likely to be hospitalized. “Our data suggest that the course of Crohn’s disease can be modified with therapy and this should be considered the standard of care,” Noor said. Published by: Sources/Disclosures Source: Noor N, et al. Profile trial 5-year disease modification outcomes. Presented at: Digestive Disease Week; May 2-5, 2026; Chicago. Disclosures: Noor reports educational or travel grants and/or speaker fees from AbbVie, Bristol Myers Squibb, Celltrion, Falk, Ferring, Johnson & Johnson, Eli Lilly and Co., Medfyle, Pfizer, Pharmacosmos, Spyre, Takeda and Tillotts Pharma. Please see the study for all other authors’ relevant financial disclosures. Ask a clinical question and tap into Healio AI’s knowledge base. PubMed, enrolling/recruiting trials, guidelines Clinical Guidance, Healio CME, FDA news Healio’s exclusive daily news coverage of clinical data Learn more Add topic to email alerts Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . “ data-action=”subscribe”> Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Source link

English + Infographic text Slide 2: VRS es la sigla del virus respiratorio sincitial. Es un virus común que causa infecciones en el pulmón y en las vías respiratorias. El VRS usualmente empieza a propagarse en el otoño y llega a su punto máximo en los meses invernales. Slide 3: La mayoría de personas experimentan síntomas moderados similares a los de la gripe y se recuperan en 1 o 2 semanas. Rinitis Congestión Tos Estornudos Sibilancia Fiebre Apetito reducido Slide 4: Pero algunas personas, especialmente bebés y adultos de edades avanzadas, pueden tener infecciones más graves y el VRS podría ser mortal. Las complicaciones que pueden causar dificultad para respirar incluyen: Infecciones de las vías respiratorias Bronquiolitis Neumonía Hipoxia (niveles bajos de oxígeno) Deshidratación Ataques cardíacos y accidentes cardiovasculares Slide 5: Puedes controlar los síntomas del VRS: Tomando antifebriles de venta sin receta Bebiendo muchos líquidos Descansando Si tienes hipertensión o si tomas medicamentos de venta con receta, asegúrate de hablar con tu proveedor de atención médica antes de tomar medicamentos de venta sin receta. Slide 6: El VRS puede empeorar trastornos pulmonares subyacentes tales como EPOC y asma. Las personas que tienen esos trastornos podrían requerir tratamientos para brotes si se contagian del VRS. Slide 7: Habla con tu proveedor de atención médica o ve a una sala de emergencias si: Tienes dificultad para respirar No puedes comer o beber Tienes dolor de pecho Slide 8: La prevención es la mejor medicina. Vacunarse es la mejor forma de protegerse de trastornos respiratorios graves. Slide 9: Las vacunas contra el VRS se recomiendan para: Bebés Adultos de 75 años o más Adultos entre las edades de 50 y 74 años que tienen un mayor riesgo de infecciones graves del VRS Slide 10: Logo Este recurso educativo se preparó con el apoyo de Moderna. Source link

By Brian Mittman, Markhoff & Mittman, PC Chronic pain can affect every aspect of your life, especially your ability to work. When pain makes work unsustainable, Social Security Disability Insurance (SSDI) is designed as a safety net. However, applying for SSDI with chronic pain is complex, since the Social Security Administration (SSA) does not approve claims based on having pain alone. This guide explains, in plain language, how SSA evaluates chronic pain-related claims, how to strengthen your application, and what to expect throughout the process. (This is not legal advice; consult a qualified attorney for personalized help.) Learn more during a FREE webinar, “Preparing for Your Social Security (SSA) Disability Claim,” at 1 p.m. ET on Thursday, March 12. Register today. How SSA Views Pain The SSA does not grant benefits for “pain” itself. Instead, it requires a medically determinable impairment—a diagnosed condition, supported by objective medical evidence such as imaging or lab findings—that could reasonably cause your pain. Examples include spine disorders, neuropathy, inflammatory arthritis, fibromyalgia, complex regional pain syndrome (CRPS), and other well-documented pain syndromes. Once a qualifying diagnosis is established, SSA looks at your symptoms: how severe and frequent your pain is, how long it has persisted, and how it impacts your ability to function. Your own statements are important, but SSA cross-checks them with your medical records, imaging, physical exams, medication lists, and sometimes reports from family or coworkers. The goal is to see a consistent story of how pain has altered your life—not just a list of medical terms. Crucially, SSDI is not about whether you can push through pain for a short period. It is about whether you can work reliably, full-time, week after week. If pain causes you to miss work, need frequent breaks, or prevents you from maintaining a consistent work schedule, that can be disabling. The Five-Step Disability Evaluation Every adult SSDI claim is reviewed using a five-step “sequential evaluation.” Chronic pain does not change the steps, but it influences how you present your case and the evidence needed at each stage. Step 1: Are You Working Above the Earnings Limit? SSA first checks if you are performing substantial gainful activity (SGA)—earning more than a set monthly amount, which changes yearly. If you are, you are not considered disabled at Step 1, regardless of your pain or diagnoses. If you are not working, or earning below SGA, your claim moves forward. Are you pushing yourself despite your pain because of bills and obligations? When you finally reduce hours or stop altogether, the timing should be supported in the medical records—notes about increased flares, missed days, reduced productivity, not just a sudden work stoppage with no context. Step 2: Do You Have a ‘Severe’ Medically Determinable Impairment? Here, SSA looks for at least one medically determinable impairment that has significantly limited, or is expected to significantly limit, your physical or mental ability to do basic work activities for at least 12 continuous months. Pain, by itself, is not enough; there must be a documented medical condition behind it. Conditions like degenerative disc disease, rheumatoid arthritis, or CRPS, supported by imaging or clinical findings, often meet this requirement. “Severe” means your condition significantly limits basic work activities like standing, walking, lifting, concentrating, or staying on a schedule. For chronic pain, this is where clear documentation starts to matter. If your records show only “doing well” or “stable” with minimal detail, SSA may decide your pain is not severe—even if your day‑to‑day reality is very different. A clear diagnosis along with comments about pain will move you forward. Step 3: Does Your Condition Meet or Equal a “Listing”? SSA maintains a list of impairments (the “Listings”) that are considered automatically disabling if certain criteria are met. There is no Listing for “chronic pain” itself. Some chronic pain conditions, like spine disorders or inflammatory arthritis, may meet a Listing. Other pain syndromes like fibromyalgia rarely do. Even if your condition doesn’t fit a Listing exactly, SSA considers whether your combined symptoms are as severe as a listed impairment. If you do not meet or equal a Listing, Social Security simply moves on to Step 4 to look more closely at what you can still do. Step 4: What is Your RFC—And Can You Do Your Past Relevant Work? SSA will assign you a residual functional capacity (RFC)—its assessment of what you can still do on a regular, sustained basis despite your impairments. This includes: How long you can sit, stand, and walk in a workday How much weight you can lift and carry How often you need to change positions or lie down Whether you can stay focused, concentrate, and keep pace How many days you would likely miss due to flares, fatigue, or medical appointments At Step 4, SSA compares your RFC to the easiest job you have done in the recent 5 years. If they believe you could still perform that job as it’s generally done, you will be found not disabled. If you cannot do that work, then you move on to Step 5. Step 5: Can You Do Any Other Work? If you can’t do your past work, SSA considers your RFC, age, education, and transferable skills to determine if there is other work you could do in the national economy. At this stage, the burden shifts: SSA must show there are jobs you can still perform. This is often where chronic pain cases are decided. SSA may point to sedentary, simple jobs and say, “You can sit and do these.” To overcome that, the record must show that even sedentary work is not sustainable—for example, because you cannot sit long enough, must lie down unpredictably, cannot maintain pace and concentration, or would miss too many days due to flares and treatment. Medication side effects and mental health issues related to pain also play a key role. Again, SSDI is about sustainability, not isolated moments of functioning. If you are just braving it out in short bursts, SSA needs to

Español + Flipbook text Slide 2: RSV stands for respiratory syncytial virus. It’s a common virus that causes infections in the lung and respiratory tract. RSV usually starts spreading in the fall and peaks in the winter months. Slide 3: Most people have mild symptoms similar to cold symptoms and recover in 1–2 weeks. Runny nose Congestion Cough Sneezing Wheezing Fever Reduced appetite Slide 4: But some people, especially infants and older adults, can have more serious infections, and RSV may be life-threatening. Complications that can cause difficulty with breathing include: Respiratory tract infections Bronchiolitis Pneumonia Hypoxia (low oxygen levels) Dehydration Heart attack and stroke Slide 5: You can manage the symptoms of RSV by: Taking over-the-counter fever reducers Drinking plenty of fluids Resting If you have high blood pressure or take prescription medicines, be sure to check with your healthcare provider before taking over-the-counter medications. Slide 6: RSV can worsen underlying lung conditions like COPD and asthma. People who have those conditions might need treatment for a flareup if they get RSV. Slide 7: Talk to your healthcare provider or go to the emergency department if you: Have trouble breathing Can’t eat or drink Have chest pain Slide 8: Prevention is the best medicine. Getting vaccinated is the best way to stay protected from severe respiratory disease. Slide 9: RSV vaccines are recommended for: Infants Adults ages 75 and older Adults ages 50 to 74 who are at increased risk for severe RSV Slide 10: Logo This educational resource was created with support from Moderna. Source link

by Dr Elissa Dabaghi (Frontline Gastroenterology Global Taskforce 2025-6)   Colorectal cancer remains one of the most prevalent causes of cancer-related deaths in the United States, where geographic location can significantly affect whether appropriate colorectal cancer care is available. Individuals living in low socioeconomic status areas have about a 37% higher risk of colorectal cancer and a 24% higher risk of cancer-related death than those living in higher socioeconomic status areas. Given the rapid integration of artificial intelligence into medicine, we must assess its potential impact on health equity. As the use of artificial intelligence (AI) in medicine grows, will this technology bridge or deepen existing socioeconomic disparities in access to colorectal care? Rural healthcare demonstrates the critical need to bridge the gap in healthcare disparities. The number of practicing general surgeons in rural communities has declined rapidly. Meanwhile, specialists, including colorectal surgeons, predominantly reside in urban communities. The general surgeon workforce in rural areas is projected to drop significantly in the next decade, while the workforce in urban and metropolitan communities is projected to almost double. Furthermore, there are substantial geographic barriers for patients living in rural areas. Some statistics show that 1 in 5 Americans residing in rural areas live more than 60 miles from a medical oncologist. These trends directly threaten colorectal cancer screening and treatment, as general surgeons perform over 50% of screening colonoscopies in these rural areas. With the growing use of technology and the implementation of AI, many wonder whether AI can help bridge this gap in healthcare, particularly in colorectal care, with regard to screening for colorectal cancer and potentially surgical planning. New systems, such as GI Genius, can identify colonic polyps that can be easily missed by the human eye. Certain studies have shown that this technology can decrease the adenoma miss rate from 32.4% to 15.5% when AI is utilized, with improvement seemingly most apparent in non-expert endoscopists. This is critical for reducing colorectal cancer risk over 5 years and can have a significant impact on rural healthcare, which already has limited access to specifically expert endoscopists. These AI systems could therefore help to both train less-experienced endoscopists to achieve higher adenoma detection rates and, beyond that may serve as expert-level support during these screenings going forward. However, it is important to mention that even with the implementation of AI-assisted polyp detection during colonoscopy, endoscopists remain essential to ensuring these systems are utilized effectively and appropriately. Endoscopists must understand the limitations of AI, and avoid overreliance, but rather utilize this technology as an adjunct to clinical judgement and shared decision-making, as highlighted by Frontline Gastroenterology’s review (1). Another potential utility of AI and machine learning algorithms in rural or resource-strapped settings is to triage patients who require urgent referral to specialist centers. Some AI-based prediction models have succeeded in stratifying colorectal cancer patients by one-year mortality risk, allowing the streamlining of care for more urgent cases as well as the tailoring of appropriate perioperative care to each patient. Additionally, although patients in rural areas often already use telemedicine for remote consultations and office visits, it could be interesting to pair AI with diagnostics in this setting. Patients in these rural areas who require endoscopic screening could choose to undergo a capsule endoscopy that integrates AI and machine-based polyp detection at their local center. This would ultimately facilitate more convenient (and likely, by extension, timely) colorectal cancer screening for patients that may not have access to specialist centers. Despite its promise, it is important to acknowledge the potential of AI to widen gaps in US healthcare, either through financial barriers or by creating additional limitations on access to resources. Additionally, implementing the use of AI in a rural healthcare system could be challenging due to the substantial investments and costs required to roll and maintain such systems (at all levels of care). Not only are these communities already financially stretched, but they may also lack the essential resources required to operate this technology (such as platform upgrades and even high-speed internet). Furthermore, many diagnostic AI systems are trained on data from large urban populations, which could lead to higher rates of incorrect diagnostic readings for rural populations with different demographics. As discussed in an article by Frontline Gastroenterology, the reliability of AI-driven predictions is dependent on high-quality data input (2). This article emphasizes that reducing irrelevant data input and systemic bias through precise and rigorous data selection to properly train the algorithm is essential to developing predictive tools that genuinely benefit patients of all demographics. Finally, given the relative ease of implementing these AI systems in large, urban healthcare facilities, as opposed to rural settings, there is a potential for this technology to drive patients away from local already struggling rural hospitals to these centers. This can place further strain on the finances of these institutions, and ultimately potentially worsen healthcare accessibility through their closure. Finally, as things currently stand, healthcare insurance systems and Medicare do not offer differential reimbursement rates for the use of AI-assisted technology, which could represent a challenge for rural hospitals in generating the initial financial outlay required to deploy this technology. In conclusion, we must ensure that AI reduces and prevents the worsening of disparities in colorectal care, and healthcare in the US as a whole. This includes strengthening and training these algorithms on rural populations to prevent inequities in underserved areas, as well as ensuring adequate funding for AI-assisted care to be implemented in these rural hospitals, which already have limited resources. Overall, however, there is great potential for AI to augment, not replace, rural providers and enhance triaging patients, risk stratification, and access to expert and specialized support. References Olabintan O, Fearnley L, Iniesta R, et al. Artificial intelligence in endoscopy: navigating risk, responsibility and ethical challenges. Frontline Gastroenterology Published Online First: 17 November 2025. doi: 10.1136/flgastro-2025-103107 https://fg.bmj.com/content/early/2025/11/17/flgastro-2025-103107 Ashton JJ, Brooks-Warburton J, Allen PB On behalf of the British Society of Gastroenterology artificial intelligence in IBD special interest group, et al. The importance of

By Nayeli R. Hevezi Chronic pain will always be frustrating and exhausting. However, the pain shouldn’t make us lose sight of the beauty around us. With the current state of the world, it’s hard to look for the little things that make what’s going on less scary, especially when you have chronic pain. A flare-up plus global warming? No, thank you! Teenagers with chronic pain tend to have our lives planned around our pain. We constantly have to make sure that we are feeling strong enough or well enough to partake in activities and participate in normal teenage things. But recently, I have found that my pain doesn’t define me. You’re allowed to have fun and live your life with joy and happiness. You shouldn’t have to sacrifice your own happiness and enjoyment for your pain. For example, I recently finished writing my debut novel, Annotation, which revolves around two teenagers, one of whom has chronic pain. The book is a rom-com but also ties in what it’s like to be a teenager with chronic pain. It shows how even with the pain we experience, it doesn’t mean we have to stop looking for the light in the world. I wrote this book as a way to cope with my own pain and feelings regarding being a teenager and dealing with chronic pain, and it is my hope that my book can reach other teenagers who can relate and find a safe escape within my book. In addition to my book, in autumn of 2024 I created a book account on Instagram. I created it after seeing many teenagers post about books and shared interests. I decided to join the book community on Instagram as a way to post about my own interests and to meet other like-minded individuals. And much to my delight, I have met hundreds of people because of my book account. I have found real friends who support me and never fail to make me laugh. Along with those friends, I have also found friends who have chronic illnesses and experience similar chronic pain to me. We are able to connect on so many levels, which makes our friendship feel deeper and more meaningful. I have found that even just talking to them for a few minutes can turn a bad day into a good one. Having friends who are able to empathize with what we experience is always a heartwarming feeling. Research regarding chronic pain is nowhere close to where it needs to be. As teenagers who are already dealing with enough stress in our lives, having that extra pain completely wears us out, so having one or two good friends who are able to be there for you when you’re in pain is amazing! Our pain does not need to overshadow the sweetness in our lives. Finding hobbies that distract you or allow you to cope with your pain may end up turning into a passion of yours, and hopefully you can allow some whimsy into your life. —by Nayeli R. Hevezi Source link

English El 22 de mayo de 2026 es el Día Mundial de la Esofagitis Eosinofílica (EEo). Más de 470,000 personas en Estados Unidos viven con esofagitis eosinofílica (EEo), un trastorno que alguna vez se consideraba infrecuente pero que se ha vuelto cada vez más común en las últimas dos décadas. Saber lo que es la EEo puede ser útil para determinar si te está afectando. ¿Qué es la esofagitis eosinofílica (EEo)? La EEo es un trastorno inmunitario crónico (a largo plazo) que afecta el esófago, es decir, el conducto que conecta tu boca con tu estómago. La EEo ocurre cuando un tipo de glóbulo blanco denominado eosinófilos se acumula en la mucosa de este conducto. Esta acumulación causa inflamación (hinchazón) crónica en el esófago que puede causar los síntomas de la EEo. ¿Cuál es la causa de la EEo? Si una persona tiene EEo, su sistema inmunitario inunda el esófago con glóbulos blancos como una reacción a desencadenantes tales como ciertos alimentos y alérgenos ambientales que tocan la mucosa del esófago. Esta reacción anormal del sistema inmunitario se conoce como inflamación tipo 2. Alérgenos tales como polen, moho, polvo y pelos de animales pueden desencadenar la EEo. Pero reacciones inmunitarias a alimentos son la causa principal de la EEo. Los alimentos que pueden desencadenar la EEo incluyen: Productos lácteos Manies y frutos secos Trigo Pescados y mariscos Huevos Soya Nota: No todas las personas que tienen EEo tienen reacciones a los mismos alimentos y las pruebas no pueden predecir en una forma confiable qué alimentos la desencadenan. ¿Cuáles son los síntomas de la EEo? La EEo es diferente a edades distintas. Los bebés y los niños pequeños podrían no querer comer y podrían escupir o vomitar más frecuentemente, tener dolor de estómago, tener alteraciones de sueño y no desarrollarse apropiadamente. Para niños más grandes y adultos, los síntomas principales de la EEo son: Dificultad para tragar Alimentos que se atoran en la garganta después de tragarlos (impactación) Acidez Dolor de pecho Dolor estomacal Alimentos que suben después de tragarlos (regurgitación) Estos síntomas podrían ser intermitentes, aparecer cada cierto tiempo o ser constantes. Incluso si no tienes síntomas, podrías tener EEo porque es un trastorno crónico y de por vida. Lee: Cuando le diagnosticaron EEo a mi hijo, el mundo de nuestra familia se puso de cabeza >> ¿A quién le afecta la EEo? La EEo puede afectar a personas de cualquier edad, pero ciertos factores de riesgo podrían hacer que una persona sea más propensa a tener ese trastorno. Tus probabilidades de tener EEo son mayores si tienes: Alergias alimentarias Alergias ambientales (polen, polvo, pelos de animales, etcétera) Asma Rinoconjuntivitis (rinitis alérgica estacional) Eccema u otros trastornos cutáneos que causan manchas con picazón e inflamación Antecedentes familiares de EEo u otros trastornos alérgicos ¿Cómo se diagnostica la EEo? Puesto que los síntomas de la EEo son similares a los de otros problemas médicos que afectan el esófago, tales como enfermedad por reflujo gastroesofágico (ERGE) o alergias alimentarias, puede ser difícil diagnosticarla. Si tu proveedor de atención médica (HCP, por sus siglas en inglés) piensa que podrías tener EEo, te referirá a un gastroenterólogo (doctor GI), que es un doctor que diagnostica, trata y controla trastornos del sistema digestivo. Evaluará tus síntomas y hará algunas pruebas, las cuales podrían incluir: Endoscopía superior y biopsia: Una sonda larga y delgada (endoscopio) con una luz y una cámara se usan para visualizar la mucosa de tu esófago y tomar muestras para verlas bajo un microscopio. Se requiere una endoscopía y una biopsia para el diagnóstico de EEo. Análisis de sangre: Se realizan pruebas de sangre para detectar alérgenos, cantidades anormalmente altas de eosinófilos y otras señales de reacciones alérgicas. Toma en cuenta que análisis de sangre en forma individual no pueden diagnosticar con certeza la EEo o identificar desencadenantes alimentarios. Esponja esofágica: Se usa una esponja pequeña adherida a un hilo para tomar muestras en tu esófago sin realizar una endoscopía. ¿Cómo se trata la EEo? Si bien la EEo es un trastorno crónico de por vida que no tiene cura, puede tratarse. Gastroenterólogos tratan y controlan la EEo. Alergólogos también podrían ser parte de tu equipo médico. Si bien no pueden diagnosticar ni tratar la EEo en sí, pueden ayudar a controlar trastornos que coexisten con la EEo, tales como alergias alimentarias. El mejor tratamiento para ti depende de tu situación médica específica. Algunas opciones terapéuticas para la EEo son: Cambios dietéticos tales como reducir el consumo de ciertos alimentos que podrían desencadenar la EEo. Inhibidores de la bomba de protones (IBP), los cuales son medicamentos que reducen el monto de ácido que tu estómago genera. Corticoides, los cuales son medicamentos que son útiles para reducir la inflamación. La EEo se trata usando corticoides líquidos que se tragan para que entren en contacto directo con la mucosa de tu esófago para reducir la inflamación. Biofármacos (anticuerpos monoclonales), un tipo de tratamiento que se dirige específicamente a ciertas células o proteínas relacionadas con la inflamación, reduciéndola y haciendo que tragar sea más fácil. Dilatación esofágica, un procedimiento en el cual se usa un endoscopio para ensanchar el esófago para hacer que tragar sea más fácil, pero que no trata la inflamación subyacente. La dilatación normalmente se usa con medicamentos o cambios de dieta. Los tratamientos podrían cambiar con el tiempo a medida que tu reacción o estilo de vida cambie, por lo que deberías reevaluar tus opciones terapéuticas con tu proveedor de atención médica frecuentemente. Puesto que no se puede determinar si el tratamiento está funcionando en función exclusiva de los síntomas, se necesitarán endoscopías y biopsias en forma repetitiva para evaluar el tratamiento y la actividad o progreso de este trastorno. Tú y tu proveedor de atención médica, juntos, podrán determinar un plan para tratar tu EEo en forma continua. Disfrutar tu vida al máximo con EEo Si piensas que podrías tener síntomas de EEo, particularmente si también tienes alergias, asma u otros trastornos que incrementan tu riesgo, habla con tu