Gastroenterology Commons^™

Light-Dark Shift Promotes Colon Carcinogenesis Through Accelerated Colon Aging, Deepak Sharma, Phillip A Engen, Abu Osman, Darbaz Adnan, Maliha Shaikh, Mostafa K Abdel-Reheem, Ankur Naqib, Stefan J Green, Bruce Hamaker, Christopher B Forsyth, Lin Cheng, Ali Keshavarzian, Khashayarsha Khazaie, Faraz Bishehsari

Faculty, Staff and Student Publications

Colorectal cancer (CRC) is the third most common cancer worldwide, with rising prevalence among younger adults. Several lifestyle factors, particularly disruptions in circadian rhythms by light-dark (LD) shifts, are known to increase CRC risk. Epidemiological studies previously showed LD-shifts are associated with increased risk of CRC. To explore the mechanisms and interactions between LD-shift and intestinal aging, we investigated how the combination of LD-shifts and aging impacts colon carcinogenesis development. Our data showed that LD-shifts and aging increased colon tumorigenesis. Notably, LD-shift accelerated intestinal aging by altering aging-related pathways, such as intestinal barrier damage, accompanied by dysbiotic changes in the …

Dysregulated Klf4 Expression Plays A Pivotal Role In The Pathogenesis Of Pancreatic Intraductal Papillary Mucinous Neoplasms, Xiangsheng Zuo, Liang Wang, Yi Liu, Huamin Wang, Margarete Hafley, Mihai Gagea, Ru Chen, Yun Xiong, Sheng Pan, Imad Shureiqi, Robert S Bresalier, Daoyan Wei

Faculty, Staff and Student Publications

No abstract provided.

Microrna 133a Regulates Squalene Epoxidase Expression In Colorectal Cancer Cells To Control Cell Proliferation And Cholesterol Production, Ji Su Mo, Santosh Lamichhane, Grinsun Sharma, Soo Cheon Chae

School of Medicine Faculty Publications

Background/Objectives: Colorectal cancer (CRC) is one of the most common cancers worldwide, with high incidence and mortality rates. MicroRNAs are endogenous and non-coding RNAs that play a pivotal role in the development and progression of various cancers by targeting specific genes. Previously, we identified MIR133A to be significantly decreased in human CRC tissues. This study aims to identify the relationship with SQLE, one of the candidate target genes of MIR133A, and study their interaction in CRC cells. Methods: Through the luciferase reporter assay, quantitative RT-PCR (qRT-PCR), and Western blot analysis. Results: We identified SQLE as a direct target gene of …

Rethinking The Rise Of Early-Onset Gastrointestinal Cancers: A Call To Action, Benjamin A Weinberg, Caitlin C Murphy, David R Freyer, K Leigh Greathouse, Jan K Blancato, Elena M Stoffel, Julia L Drewes, Anne Blaes, John M Salsman, Y Nancy You, Hannah Arem, Reetu Mukherji, Priyanka Kanth, Xin Hu, Anne Fabrizio, Marion L Hartley, Marios Giannakis, John L Marshall

Faculty, Staff and Student Publications

Since the early 1990s, there has been a dramatic rise in gastrointestinal cancers diagnosed in patients under age 50 for reasons that remain poorly understood. The most significant change has been the increase in incidence rates of early-onset colorectal cancer, especially rates of left-sided colon and rectal cancers. Increases in gastric, pancreatic, and other gastrointestinal cancer diagnoses have further contributed to this trend. We formed a multidisciplinary Think Tank to develop a strategic, coordinated approach to studying early-onset gastrointestinal cancers. This area of research is challenging given multifactorial etiologies. We focused on epidemiology and the environment, the microbiome, and survivorship …

Nucleus-Translocated Gclm Promotes Chemoresistance In Colorectal Cancer Through A Moonlighting Function, Jin-Fei Lin, Ze-Xian Liu, Dong-Liang Chen, Ren-Ze Huang, Fen Cao, Kai Yu, Ting Li, Hai-Yu Mo, Hui Sheng, Zhi-Bing Liang, Kun Liao, Yi Han, Shan-Shan Li, Zhao-Lei Zeng, Song Gao, Huai-Qiang Ju, Rui-Hua Xu

Faculty, Staff and Student Publications

Metabolic enzymes perform moonlighting functions during tumor progression, including the modulation of chemoresistance. However, the underlying mechanisms of these functions remain elusive. Here, utilizing a metabolic clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9 knockout library screen, we observe that the loss of glutamate-cysteine ligase modifier subunit (GCLM), a rate-limiting enzyme in glutathione biosynthesis, noticeably increases the sensitivity of colorectal cancer (CRC) cells to platinum-based chemotherapy. Mechanistically, we unveil a noncanonical mechanism through which nuclear GCLM competitively interacts with NF-kappa-B (NF-κB)-repressing factor (NKRF), to promote NF-κB activity and facilitate chemoresistance. In response to platinum drug treatment, GCLM is phosphorylated by P38 …

Navigating The Way To Colonoscopy Completion: A Quality Improvement Study, Jessica Duncan

Doctor of Nursing Practice Scholarly Projects

Abstract

Background: Colonoscopies are a highly effective method of colorectal cancer screening, yet their value is hindered by frequent last-minute cancellations and patient no-shows. The absence of a consistent, evidence-based pre-procedural education tool to address patient-level barriers remains a critical gap in healthcare delivery.

Local Problem: At a hospital-based medical practice in Kane County, Illinois, 7% of colonoscopy cancellations occur last minute, primarily due to preventable factors.

Methods: This quality improvement project compared last-minute cancellation and no-show rates between a control group receiving standard care and an intervention group provided with enhanced education and regularly scheduled follow-up contact through patient …

Reducing Colonoscopy Cancellations Saves Lives, A Quality Improvement Project, Jennifer L. Brosnan

West Chester University Doctoral Projects

One of Healthy People 2030’s objectives is to increase the proportion of adults screened for colorectal cancer. To address this objective, a quality improvement project was completed within an Ambulatory Surgical Center (ASC). An evidenced-based committee was formed with the primary goal to decrease the number of cancelled colonoscopies. The committee aimed to answer the PICOT question: For patients who cancel their colonoscopy, how does the development and implementation of an evidence-based practice (EBP) committee’s nursing interventions reduce cancelled colonoscopy rates and increase reschedule rates, compared to no implementation of an EBP committee’s nursing interventions, over three months?

Nursing interventions …

Overview Of Gastroenterology For Students, Jeff Vasiloff, Md, Mph

OHIO Open Faculty Textbooks

Overview of gastroenterology authored by Jeffrey Vasiloff, MD, MPH, Associate Clinical Professor, PA Program; Adjunct Professor, PT Program, College of Health Sciences and Professions, Ohio University Dublin Medical Campus; Physician Consultant: Ohio Association of Physician Assistants; Physician Volunteer: Franklin County & Columbus Medical Reserve Corps; Board Certification: Internal Medicine & Diabetes and Endocrinology.

Can Fat Absorption Be Enhanced With A Novel Medical Food?, Cassie Brown

2025

No abstract provided.

Laproscopic Robotic-Assisted Common Bile Duct Exploration For Primary Choledochlithiasis 20 Years After Cholecystetomy In A Hostile Abdomen, Enoch Wong, Kristen Payne, James Burdick, Hassan Ahmed

North Texas Research Forum 2025

Introduction: The incidence of concomitant cholelithiasis and choledocholithiasis is 5-20%. Primary choledochlithiasis more than 3 years after cholecystectomy is an even rarer event with only a handful of case reports in the literature. Robot-assisted laparoscopic common bile duct exploration with intraoperative choledochoscopy is a relatively recent development in biliary surgery. In this report, we describe the use of this technique in a patient with rare presentation and surgically challenging anatomy. Objective: To describe a minimally invasive approach for CBD exploration with extraction of choledocholithiasis in a surgically hostile abdomen and Roux-En-Y anatomy. Methods: This report describes the case of a …

An Unexpected Source Of Gi Bleeding: Enteric Muco-Submucosal Elongated Polyp In The Proximal Jejunum With Literature Review, Galvin Dhaliwal, Dev Patel, Ashvin Singh Dhaliwal, Aakriti Soni, Bilal Ashraf, Shane Sweeney, Sushovan Guha, Ahmed Ouni

Gulf Coast Division GME Research Day 2025

No abstract provided.

Turmeric, Red Yeast Paste, And Statins: A Recipe For Dili, John V. Nahas, Sinay Ceballos, Franklin Kasmin

East Florida Division GME Research Day 2025

Introduction Drug induced liver injury (DILI) contributes to a significant portion of acute liver injuries and acute liver failure in the west. DILI accounts for approximately 11% of acute liver failure cases in the US according to ACG. Insulting agents are numerous and well documented in the NIH LiverTox database, however the rarity and complexity of individual agents is a matter of ongoing study. Case Description/Methods A 52 year old man with PMH of HTN and HLD presents for a 2 week history of abdominal swelling, bilateral lower extremity swelling, decreased appetite, and positional shortness of breath. He endorses occasionally …

Comparing Human Milk-Derived Vs Bovine-Derived Fortifiers In Formula-Fed Preterm Infants On The Incidence Of Necrotizing Enterocolitis, Maya C. Kern

Nursing | Student Research Posters

Necrotizing enterocolitis (NEC) is one of the leading causes of death in infants < 32 weeks gestation and/or < 1500g. Human breast milk lowers NEC rates through immunologic, microbial, and gut-protective mechanisms. When maternal or donor milk is unavailable, infants require formula with fortification but the safest type of fortifiers remains unclear. Bovine-derived fortifiers may increase gut inflammation; human milk-derived fortifiers may offer more protection. Limited research exists comparing these fortifiers when infants are exclusively formula fed. Determining if human milk-derived fortifiers still reduce NEC risk could influence NICU feeding guidelines and improve outcomes.

Bundled Approach To Improve Colorectal Cancer In Primary Care, Elizabeth Reddiar

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test …

Irritable Bowel Syndrome Risk In Acne Patients: Implications For Dermatologic Care, Alex Y. Liu, Ana Ormaza Vera, Clinton W. Enos

Department Dermatology Faculty Publications

[Practice points]

• Clinicians should consider monitoring for early signs of irritable bowel syndrome (IBS) in adult patients with acne to facilitate prompt diagnosis and intervention.
• Clinicians should remain judicious when prescribing antibiotics for acne management to minimize potential disruptions to the gut microbiota and the risk for IBS.
• Isotretinoin may serve as a safer alternative to antibiotics in patients with acne, particularly those with gastrointestinal concerns.

Enhanced Anticancer Activity Of Novel Pyrimidine Nucleoside Analog In Pancreatic Cancer, Raviteja Bulusu, Joy Okoro, Esther Frimpong, Sunil Krishnan, Saunjoo Yoon, Bo Han, Xue Zhu, Edward Agyare

The Brown Foundation: Institute of Molecular Medicine

This study explores the synthesis, characterization, and therapeutic efficacy of AGY1, AGY2, AGY3, AGY4, and AGY5, which are novel 5-FU analogs designed to improve metabolic stability, prolong half-life, and anti-tumor activity against pancreatic cancer. The 5-FU molecule was chemically modified to bypass dihydropyrimidine dehydrogenase (DPD)-mediated inactivation, enhancing drug retention and increasing lipophilicity for improved cellular uptake. The analog cytotoxic activity was evaluated in 2D monolayer cultures and 3D pancreatic cancer spheroids and organoid models derived from MiaPaCa-2 and PANC-1 cells to simulate a more complex tumor environment. In the 2D model, AGY1, AGY2, AGY3, AGY4, and AGY5 displayed significantly higher …

Whipple’S Procedure Under Combined Segmental Spinal And Epidural Anesthesia With Enhanced Recovery: A Case Report, Abhirami Ravindran, Imran Ahmed Khan, Naresh Wamanrao Paliwal

Digital Journal of Clinical Medicine

The Whipple’s procedure (pancreaticoduodenectomy), is a complex surgery performed for various indications, usually under general anesthesia (GA). However, GA carries a significant perioperative risk, especially in patients with comorbidities. Combined segmental spinal and epidural anesthesia (CSSE) with low doses of local anesthetics and adjuvants may be a feasible alternative owing to hemodynamic stability, potentially reducing complications and promoting enhanced recovery.

We present a 43-year-old male with periampullary adenoma with high-grade dysplasia who underwent a Whipple’s procedure under CSSE due to high-risk features (e.g., severe jaundice, low blood pressure, and anemia) and chronic smoking and alcoholism. Thoracic epidural (T7–T8) and spinal …

Clinical Significance Of "S" Isoform Of Dclk1 In Different Gastric Cancer Subtypes Using Newly Produced Monoclonal Antibody, Mahdieh Razmi, Ali-Ahmad Bayat, Nafiseh Mortazavi, Elham Kalantari, Leili Saeednejad Zanjani, Sima Saki, Roya Ghods, Zahra Madjd

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background

Materials and methods

American Society For Gastrointestinal Endoscopy Guideline On Gastrostomy Feeding Tubes: Methodology And Review Of Evidence, Divyanshoo Rai Kohli, Natalie Cosgrove, Wasif M Abidi, Jorge D Machicado, Madhav Desai, Nauzer Forbes, Neil B Marya, Nikhil R Thiruvengadam, Nirav C Thosani, Omeed Alipour, Saowanee Ngamruengphong, Sherif E Elhanafi, Sunil G Sheth, Wenly Ruan, John C Fang, Stephen A Mcclave, Rodrick C Zvavanjanja, Dhruvil K Radadiya, Amir Y Kamel, Bashar J Qumseya

Faculty, Staff and Student Publications

This article from the American Society for Gastrointestinal Endoscopy (ASGE) provides a full description of the methodology used to inform the final guidance outlined in the accompanying summary and recommendations article for strategies to manage endoscopically placed gastrostomy tubes. This article was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and specifically addresses the utility of PEG versus interventional radiology-guided gastrostomy (IR-G), the need for withholding antiplatelet and anticoagulant medications, appropriate timing to initiate tube feedings, and appropriate selection of the gastrostomy technique in patients with malignant dysphagia. In patients needing enteral access, the ASGE suggests …

Balancing Regeneration And Resistance: Targeting Dclk1 To Mitigate Gastrointestinal Radiation Injury And Oncogenesis, Landon L. Moore, Jerry Jaboin, Milton L. Brown, Courtney W. Houchen

Department of Medicine Faculty Publications

Ionizing radiation (IR) poses a dual challenge in medicine; while essential for cancer therapy, it inflicts collateral damage to normal tissues, particularly the gastrointestinal (GI) tract. High-dose IR triggers acute radiation syndrome (ARS), characterized by crypt stem cell depletion, mucosal barrier disruption, inflammation, and potential progression to fibrosis and secondary malignancy. Emerging evidence identifies the epithelial kinase doublecortin-like kinase 1 (DCLK1)—highly expressed in GI tuft cells and cancer stem-like cells—as a master regulator of post-IR responses. DCLK1 integrates DNA repair (via p53/ATM), and survival signaling (via NF-κB, TGF-β, and MAPK) to promote epithelial regeneration, yet these same mechanisms contribute to …