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Underwood Center for
Digestive Health

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Quarterly Digest

Directors' Messages

The Underwood Center saw a banner year in 2024. We witnessed great progress and a consolidation of the Center across the entire Houston Methodist System. The active participation of so many from each hospital brought ample fruit in the outputs of our various committees, and working groups and their deliberations were a testament to real collaboration, ideas sharing and a devotion to a common purpose. The values that epitomize Houston Methodist have been front and center in all these activities – note, for example, the focus on quality and access. We also welcomed our first research RFA in 2024, which attracted outstanding applications from across the system and augurs well for the future of clinical research at Underwood. What are we looking forward to in 2025? Our number one priority must be to deliver on each of the goals and objectives developed at our November meeting. These outputs provide a road map for our future and align well with the strategic goals we developed over a year ago. Meanwhile, much has changed or is changing around us, and we must ensure that our ambitions are realistic and achievable in the clinical, educational and research environments of the future. Indeed, one of our first tasks for 2025 is to examine critically how well our strategy aligns with the strategic plans of the various arms of our institution. I am delighted that our year got off to a fantastic start with, first, an outstanding Schmulen IBD lecture by Dr Peter Higgins and, second, the best attendance ever at our annual Underwood Symposium, featuring two outstanding guest speakers, Dr.s Vege and Thompson, and a full house for the hands-on program at the Bookout Center (formerly MITIE). A big thank you to this year’s organizers Drs. Kodali, Morris and Dacha!

At the end of 2024, we bade a sad farewell to Sharon Chui, who played such a fundamental role in getting us to where we are and, in particular, in making Underwood a reality across the entire system. Her dynamism, foresight, commitment and sheer hard work made so much happen and urged all of us to aim higher and be even better. We wish Sharon every success in her new venture at UCSF. Wishing all at Underwood the best.

Eamonn M.M. Quigley, MD David M. Underwood Chair of Medicine in Digestive Disorders Co-Director, Lynda K. and David M. Underwood Center for Digestive Disorders Chief, Gastroenterology and Hepatology, Houston Methodist Hospital Professor of Medicine, Weill Cornell Medicine Adjunct Professor of Medicine, Texas A&M Health Sciences Center College of Medicine

By all measures, G.I. Surgery has recorded one of its most productive clinical years, with growing numbers of patients seen and surgeries performed. We also continue to have some of the best surgical outcomes: top 10 in lowest mortality, length of stay and re-admission rates. These amazing quality outcomes are the greatest source of satisfaction for us and a major reason we have continued to push forward with more system quality initiatives, including the adoption of systemwide bundles for reducing colorectal surgical site infections and ERAS protocols to decrease opioid prescription and accelerate post colorectal -surgical discharge. In addition, we pioneered new procedures in our community, such as the first Electrohydraulic Lithotripsy and sphincteroplasty, which allows us to treat common bile duct stones non-invasively during laparoscopic cholecystectomy, and the first Single Anastomosis Duodenal Ileal Bypass (SADI). We also devoted a significant amount of time updating our weight management and bariatric surgery program and developed a more comprehensive approach to weight management. Our surgeons are now prescribing GLPI agonists and continuing to perform successful weight loss surgeries. We continue to perfect and teach minimally invasive laparoscopic and robotic gastrointestinal procedures for a large number of hiatal hernias to common bile duct exploration and colorectal procedures. We continue to lead in transplant oncology and in advanced robotic liver and pancreatic resection. In 2024, through our collaboration with our Underwood Cancer Center physicians and researchers, we published 162 papers, continuing our development as an Academic Center of Excellence. Most importantly to our faculty, we continued to train residents and fellows in every aspect of GI Surgery and teach medical students to prepare the physicians and surgeons of the future. Clearly, the surgeons and, for that matter, the whole of Underwood Center physicians have been productive and successful in helping thousands of our patients with their healthcare needs. I am certainly looking forward to topping these amazing accomplishments.

A. Osama Gaber, MD, FACS, FAST John F., Jr. and Carolyn Bookout Presidential Distinguished Chair in Surgery, Department of Surgery Chair, Department of Surgery Professor of Surgery, Academic Institute Full Member, Research Institute Program Director, Transplant Surgery Fellowship, Department of Surgery Houston Methodist Weill Cornell Medical College

Awards & Recognitions

Rachel Schiesser, MD was quoted by Time magazine in “5 Gastroenterologists on the 1 Thing You Should Do Every Day” where she advises readers to drink plenty of water every day for good digestion.

Eamonn Quigley, MD was interviewed for a recent article explaining the complexities of Small Intestinal Bacterial Overgrowth (SIBO) in Self magazine. He highlights the challenges in diagnosing SIBO, particularly due to the limitations of breath tests, and emphasizes the importance of addressing underlying causes, such as gut motility issues, for more effective treatment and long-term relief.

Todd Worley, MD, was quoted in a front-page article published by Community Impact – Spring/Klein regarding the rising demand for diabetes and obesity medications in the Houston area. You can read the full article here: Houston Area Health Care Providers See Rising Demand for Diabetes, Obesity Drugs.

Bincy Abraham, MD and David Victor, MD represented Houston Methodist at the Crohn’s & Colitis Foundation’s Winter Ball.

Research stories

A First Line of Treatment

Endoscopic procedures have become increasingly utilized over the traditional laparoscopic surgical approach in treating gastric band erosion. However, no pooled analyses of this intervention’s effectiveness exist in the literature. That’s why Thomas R. McCarty, MD, MPH, Assistant Professor, Department of Clinical Medicine, published a systematic review and meta-analysis to fill these knowledge gaps.

Hoping to Improve Resection Outcomes

A groundbreaking study tested a new, risk-based management approach to cancer surgery, combining preoperative and postoperative assessments with escalating levels of care. The results? No significant difference in surgical outcomes between this innovative strategy and traditional care. Read on to discover what these findings mean for the future of elective major cancer surgeries.

Study Challenges Standard Surgery Protocols for Patients with High A1C

High A1C levels can delay revisional bariatric surgery. However, a new retrospective study suggests that an elevated A1C shouldn’t prevent patients from getting revisional bariatric surgery because it can help treat high blood glucose while having no associated negative effect on postoperative complications.

ACTIVE / ENROLLING CLINICAL TRIALS

View our comprehensive list of clinical trials for IBD, GERD, liver and more. We invite current Underwood Center members to submit their clinical studies to be spotlighted in upcoming newsletters.

Featured Publications

The learning curve for robotic living donor right hepatectomy: Analysis of outcomes in 2 specialized centers

Cheah, YL, Yang, HY, Simon, CJ, Akoad, ME, Connor, AA, Daskalaki, D, Han, DH, Brombosz, EW, Kim, JK, Tellier, MA, Ghobrial, RM, Gaber, AO & Choi.

https://doi.org/10.1097/LVT.0000000000000480

The Assessment of Gastrointestinal Transit by the Atmo Capsule: A Comparison With the SmartPill Capsule

Kuo, B, Lee, AA, Abell, T, Attaluri, A, Cline, M, Hasler, W, Ho, V, Lembo, AJ, Masoud, A, McCallum, R, Moshiree, B, Quigley, EMM, Rao, SSC, Stocker, A, Sanchez, M, Sarosiek, I, Surjanhata, B, Zhou, J & Chey.

https://doi.org/10.1016/j.cgh.2024.12.013

Risk of Infection in Patients With Inflammatory Bowel Disease Treated With Interleukin-Targeting Agents: A Systematic Review and Meta-Analysis

Ouranos, K, Saleem, H, Vassilopoulos, S, Vassilopoulos, A, Mylona, EK, Shehadeh, F, Kalligeros, M, Abraham, BP & Mylonakis.

https://doi.org/10.1093/ibd/izae031

EDUCATION

Personalized Treatment in Irritable Bowel Syndrome (IBS): Fantasy or Reality?”

At the 2nd Annual Hughes Sterling Lecture in November, Alexander Ford, MD, Professor of Gastroenterology at the University of Leeds, presented an insightful lecture on the challenges and opportunities in treating Irritable Bowel Syndrome (IBS). He discussed why current treatment options offer only modest relief, introduced the use of latent class analysis to classify IBS patients based on psychological factors, and outlined potential treatment strategies for different patient clusters. Dr. Ford also highlighted the critical research needed to advance personalized IBS treatments. Click here to watch the recording.

Inaugural Houston Methodist Neal Cancer Center GI Oncology Symposium

In December, the Inaugural Houston Methodist Neal Cancer Center GI Oncology Symposium delved into the latest developments in managing gastrointestinal cancers, featuring expert presentations on advancements in immunotherapy, molecular diagnostics, targeted therapies, and new surgical techniques. The Course Director, Maen Abdelrahim, MD, PhD, PharmB, presented on Transplant-Bridging Approaches in Hepatocellular Carcinoma. Dr. Sudha Kodali discussed Transplant Oncology for Hilar and Intrahepatic Cholangiocarcinoma. Dr. Joseph Galati covered the Current Status of Pre-Liver Cancer Disease: Management and Future Directions, while Dr. Ashish Saharia spoke on Risk Stratifications and Screening of Pancreatic Cancers.

Houston Cholangiocarcinoma Symposium with MD Anderson Cancer Center and Houston Methodist Hospital

The Cholangiocarcinoma Foundation, in conjunction with Houston Methodist and MD Anderson Cancer Center, hosted the 2024 Houston Cholangiocarcinoma Symposium to a full audience. This event drew together leading experts, researchers, healthcare professionals, patients and advocates to learn more about advances in the treatment of cholangiocarcinoma. Hosted by Dr. Sudha Kodali and Dr. Hop Tran Cao and Dr. Milind Javle, invited Houston Methodist Guest Faculty included Dr. Ashton Connor, Dr. Yee-Lee Cheah, Dr. Sudha Kodali and Michelle Bell.

10th Annual Underwood Symposium and Hands-On Lab

More than 170 healthcare professionals, including physicians, nurses, dieticians and staff, attended the 10th Annual Underwood Symposium on February 21. Directed by Sudha Kodali, MD, and Lee Morris, MD, the program showcased the latest evidence-based advancements in diagnostics, therapeutics and surgical techniques for digestive disorders, presented by faculty from various institutions. Notable speakers included Santhi Swaroop Vege, MD, from Mayo Clinic, who discussed advances in the assessment and management of acute pancreatitis, and Chris Thompson, MD, Professor of Medicine at Harvard Medical School, Director of Endoscopy and Co-Director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital, who spoke about endobariatrics in the age of Ozempic. This year's Lunch and Learn session featured Vani Konda, MD, from Baylor Scott & White, who presented on ways to use Endoflip in clinical practice.