What Do You Consider to Be the Top Medical Advances of the Past 20 Years?

Ryan Syrek, Editor

Disclosures

May 27, 2015

Treatment of HCV: The recent introduction of highly effective therapeutic agents has transformed the treatment of HCV infection. The cure rate is nearly 95%; the drugs are easy to administer; treatment duration has been reduced; and so far, these drugs seem to be safe, with few adverse effects. With more drugs in the pipeline, the future of HCV treatment appears to be truly bright.

Endoscopic procedures: Capsule endoscopy and enteroscopes now allow examination of the entire small bowel and, in selected cases, allow therapeutic procedures to be performed. Multiple band ligators for esophageal varices permit treatment of several varices in one sitting, with minimal discomfort and complications.

Biologics for inflammatory bowel disease: Biologics have completely altered the approach to the treatment of inflammatory bowel disease, in particular Crohn disease. These drugs have improved patients' quality of life, allowed healing of resistant fistulae, and reduced hospitalization and surgical rates.

Fecal transplant for C difficile infection: A single therapy rarely dramatically changes the outcome of a serious, life-threatening illness. Fecal transplantation has a success rate of nearly 100% and is virtually free of adverse effects. With the introduction of easier methods of fecal administration, this treatment is likely to save multiple lives.

Treatment of HBV: Twenty years ago, the only drug available to treat HBV infection was interferon, which is toxic and difficult to use. Five additional drugs are now available. All these are administered as a single-dose oral pill, have low rate of adverse effects, and are effective in suppressing (although not eradicating) HBV. These drugs improve liver function and histology and help prevent propagation of infection.

Top gastroenterology advances selected by B.S. Anand, MD, Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine, Houston, Texas.

For more on the treatment of HCV, read here.

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