NIH Plan To Reduce The Burden Of Digestive Diseases

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The National Institutes of Health announced the release of the first long-range plan for tackling digestive diseases, which affect as many as 70 million Americans each year.

Opportunities and Challenges in Digestive Diseases Research: Recommendations of the National Commission on Digestive Diseases describes the impact of diseases ranging from foodborne infections to cancer and liver failure, and maps out priorities for research over the next 10 years.

"NIH-funded research has led to tremendous discoveries in peptic ulcer disease, viral hepatitis, and colorectal cancer. To build on these advances and break new ground, we’ll be looking for investigator-initiated projects and developing new initiatives that respond to the commission’s recommendations," said Griffin P. Rodgers, M.D., director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the NIH. "Of course, bringing in new investigators and utilizing NIH’s peer review system to identify projects with high scientific merit will continue to be high priorities."

The report emphasizes the importance of cross-cutting research, encouraging multidisciplinary efforts to advance understanding of causes and improve diagnosis and treatment of digestive diseases. The high-impact goals recommended by the commission include:

* Better understanding of basic biology of the digestive system

* Improving the understanding of functional gastrointestinal disorders and motility disorders such as irritable bowel syndrome

* Identifying additional infection-causing microbes

* Developing more efficient tools to predict and detect cancers

* Developing objective criteria to diagnose and evaluate inflammatory bowel diseases based on comprehensive genetic studies

* Developing new treatment strategies for intestinal failure and regeneration, nutritional disorders and support, surgically modified gut (altered stomach following bariatric surgery for weight loss), and transplantation

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* Understanding the neuromuscular biology of diseases of the oropharynx (mouth and pharynx) and esophagus

* Improving treatments for the diverse diseases of the stomach and small intestine

* Developing more efficient ways to categorize diseases of the colon and rectum

* Identifying the biologic and genetic triggers for acute and chronic pancreatitis

* Testing new approaches to detect, prevent and treat diseases of the liver and biliary system (organs and ducts that produce and move bile to help digestion)

* Using bioengineering, biotechnology, and imaging to improve patient outcomes and treatments

Each year about 105 million visits to doctors’ offices are for digestive diseases, often driven by symptoms such as stomach pain, diarrhea, vomiting or nausea. The diseases cost the United States $100 billion in direct medical costs every year. Prescription drugs for diseases such as gastroesophageal reflux are among the most commonly prescribed medications in the United States.

It was against the backdrop of human suffering and health care costs that the former NIH Director Elias A. Zerhouni established the commission in 2005. He charged the commission with reviewing current and needed research on digestive diseases. The report identifies recent research advances and new and emerging opportunities for future study.

The 16 appointed members of the commission represent academic and medical research, health care professionals and patient-advocacy groups. The commission also included 18 nonvoting ex officio members from the NIH and other federal agencies conducting digestive diseases research.

"The commission’s recommendations provide a guidepost for digestive diseases research to be addressed over the next decade," said commission chair Stephen P. James, M.D., who also directs NIDDK’s Division of Digestive Diseases and Nutrition. "We hope that this broad-based research plan leads to new findings that help reduce the pain and suffering experienced by the millions who suffer from digestive diseases."

An estimated 20 NIH institutes, centers, and offices invested more than $1.4 billion in digestive diseases research in fiscal year 2008. Current studies focus on understanding the fundamental mechanisms of digestive system development and function, as well as basic, translational and clinical research on the digestive system in normal and disease conditions.

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