Physicians in Cyprus successfully treated Stylianos’ cancer, but the Kortas family had to search further from home for solutions to the lasting damage caused by the long and difficult treatment. They traveled to the United States where they found a physician who would change Stylianos’ life.

Northwestern Medicine interventional gastroenterologist Amrita Sethi, MD, still working in New York at the time, agreed to take Stylianos’ case. When Dr. Sethi joined Northwestern Medicine, Stylianos became the first international patient to receive care at the Center for Advanced Endoscopy at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois.

“No hospital in Europe accepted us because of my condition, so we requested [an appointment] at Columbia Hospital in New York. There we met Dr. Sethi, our doctor now,” said Stylianos. “I was excited that finally someone wanted to help me.”

A Journey of Survival

Stylianos was diagnosed with advanced lymphoma at age 14. During four rounds of chemotherapy, he experienced massive hemorrhages and severe infections that threatened his young life. As their son’s life hung in the balance, the family leaned on one another, their faith and their community to navigate these challenges.

“Four times Stylianos almost died. It was very difficult, but we gave our hope to God,” said his father Georgios Kortas, a Greek Orthodox priest. “Many times, Stylianos said to us that ‘If it's my time, I will be near God.’ And that gave us the power.”

Despite the challenges, the treatment was successful and Stylianos’ cancer entered remission. However, this was not the end of his medical challenges. He was left with complex gastrointestinal complications including chronic inflammation within the digestive tract, recurrent pancreatitis and significant narrowing of the upper small intestine (duodenal stricture) leaving him unable to digest or pass food. Stylianos was malnourished and rapidly losing weight, relying on intravenous feeding and nutritional formula while his parents and four brothers continued daily meals around him.

“We were cooking for everybody, and he was just taking his milk because he didn’t have any other choice,” said Maria Kortas, his mother. “We were waiting for somebody to help us with this.”

Physicians in Cyprus made one unsuccessful attempt at a specialized procedure called ERCP to remedy the complications, followed by two more attempts in London. The coils placed to control bleeding had migrated into Stylianos’ small intestine, causing obstruction and making it impossible to advance the endoscope, a thin, flexible tube with a light and camera used to see inside the digestive tract. When hospitals across Europe declined to take on his complex case, the family expanded their search to the United States.

A Slice of Hope

In New York, the family met with a team of physicians that included Dr. Sethi. The team determined that endoscopic intervention was the best approach. This allowed Stylianos to avoid major surgery, but left it as an option should the minimally invasive approach not succeed. 

“When I first met Stylianos and his family, they were scared and concerned that their son had not been able to eat for many months,” said Dr. Sethi, now medical director of the Center for Advanced Endoscopy. “He had really lost so much weight. He had been an athlete before. He had a vibrant life. And now he was failing to thrive.”

Between January 2025 and August 2025, the Kortas family traveled to New York three times to continue Stylianos’ care. Through multiple endoscopic procedures, Dr. Sethi successfully dilated the narrowed portion of his intestine and removed some of the coils allowing food to pass again.

“She was the first doctor who could treat him and make him eat after two years,” said Maria. “He was about 55 kilos (121 pounds) when Dr. Sethi first took care of him. Now he's 68 kilos (150 pounds).”

For his first solid food in months, Stylianos chose a cheesy slice of New York-style pizza. The moment marked more than a return to eating. It symbolized hope.

“When he ate the first piece of pizza, I remember he smiled. I will never forget it. For me and Maria, it was like we’re going to cry,” said Georgios.

Following Care to Chicago

While Stylianos experienced significant improvement following the procedures, ongoing endoscopic interventions would be necessary to maintain his health. When Dr. Sethi informed the family that she was relocating to Chicago in August 2025 to help launch the new Northwestern Medicine Center for Advanced Endoscopy, the family decided they would follow her.

“She advised us to continue care [in New York] and assured us she would continue to assist when needed,” said Georgios. “However, we could no longer trust any other physician. She became our doctor and we wanted to continue with her. We have complete trust in her.”

Even when he experienced new episodes of pancreatitis back home in Cyprus, Stylianos declined to proceed with any other physician. His parents supported the decision.

“I know Dr. Sethi is an excellent doctor and that’s why I believe following her here was the right choice,” said Stylianos.

A New Path Forward

In June 2026, the family arrived in Chicago for Stylianos to resume care with Dr. Sethi at the new Center for Advanced Endoscopy at Northwestern Medicine Central DuPage Hospital. Designed to treat the most complex digestive conditions, the center offers a level of care typically only available at large, academic medical centers.

“This center was built specifically to help patients like Stylianos,” said Dr. Sethi. “We have the equipment, the space and, most importantly, the team, both in endoscopy and within the hospital, to support these very complex cases.”

The goal for Stylianos’ treatment was to unblock the pancreatic duct to control how fluid moved through his pancreas. Knowing that ERCP was not possible, Dr. Sethi used a more advanced method called EUS-guided ERCP to place a stent connecting the stomach and pancreas.

“The connection creates a new avenue for the pancreatic fluid to drain properly when the normal route is blocked or inaccessible,” said Dr. Sethi. “Our hope is that as things continue to drain, his pancreas function will return and he won't require additional help from enzyme supplements to digest food.”

Home, Away from Home

With the assistance of Northwestern Medicine Global Services, the family secured three weeks of housing at the Ronald McDonald House: Northwestern Medicine Central DuPage Hospital just across the street from the hospital. The House features all the comforts of home, including private bedrooms and bathrooms, daily meals prepared by volunteers, laundry facilities, a community kitchen, game rooms, play spaces, fitness equipment and more. 

“Families can stay as long as they are receiving treatment,” said Kelly Evans, regional director of programs and operations, west region for Ronald McDonald House: Chicagoland & Northwest Indiana. “We support our international families with the same comfort and care we do with any of our families. We communicate before they come so they're aware of all our amenities and prepared upon their arrival. When they arrive, we try to help them as much as we can for things like securing Ubers or finding grocery stores.”  

For the Kortas family, the proximity to the hospital and support offered at the Ronald McDonald House helped ease the stress of traveling far from home. 

“It’s not easy to leave your family and come here. It’s very far,” said Maria. “We didn’t know how far the House was from the hospital or what to expect. It’s very near and it’s very good.” 

Deep Dish & Best Wishes

Following the successful procedure, the Kortas family explored Chicago visiting iconic landmarks like “The Bean” and the “Home Alone House,” as well as enjoying an architectural boat cruise, a Segway tour, and river kayaking. They caught Chicago Wolves and Chicago Sky games and enjoyed the forest preserves around Winfield. Georgios and Maria focused on one of Chicago’s most recognized ambassadors.

“I played basketball and my wife played basketball. We grew up with Michael Jordan, so I would like to see his court,” said Georgios. “I think we learned Chicago from Michael Jordan.”

For Stylianos, his focus was on learning local history and trying Chicago’s iconic deep dish pizza, a meal that seemed impossible just months earlier. With Dr. Sethi’s blessing, the Northwestern Medicine team surprised Stylianos with a send-off celebration featuring both Chicago styles of pizza: deep dish and tavern‑style.

“Foods like pizza are what we use our pancreas for, but it can be very taxing on the pancreas,” said Dr. Sethi. “We'll always say ‘in moderation,’ but to see him eat pizza and know that he doesn't have to be in pain is wonderful. We've gotten him to a point where he can enjoy these small things and be a kid again.”

After starting his food journey with a New York slice, Stylianos gave his final verdict: Chicago-style deep dish reigns supreme.

“I think Chicago – the deep dish. The crust is amazing,” he said between bites of a cheesy slice.

Looking Ahead

Now stronger and continuing to regain weight, Stylianos is focused on resuming his life in Cyprus and planning his future. He will finish school next year and hopes to one day become a doctor. An ambition inspired by the woman who gave him his life and appetite back.

“When you go through these difficult situations, you're inspired by those people. Now he wants to be a doctor, like Dr. Sethi,” said Maria.

For Dr. Sethi, knowing the young patient she first met in a hospital bed struggling to eat is focused on his future is rewarding validation of what’s possible at the Center for Advanced Endoscopy.

“It's a gift to know that the work that you do has that kind of impact, not only immediately in helping somebody's health, but in their outlook and the way they think about how they can make an impact on others and give them purpose,” said Dr. Sethi. “Seeing young people be inspired in this way is the best outcome we can have as mentors and educators, roles that I can fulfill through the center.”

This journey has already delivered something simple and profound to the Kortas family: the ability to sit down together again and share a meal.

“We feel immense gratitude for the doctors and medical teams who helped our son. The doctors in Cyprus who kept him alive at the Pediatric Oncology Clinic, especially the director. As well as the intensive care doctor at Makario Hospital, who fought so hard to keep our Stylianos alive,” said Georgios. “They helped him beat cancer and emerge victorious through the challenging moments during his treatment. And when we needed further care, we found Dr. Sethi. She gave our son the chance to start eating again.”

The family hopes sharing their story can inspire others facing the same uncertainty.

“Without these doctors, but also without God's help and the prayers of so many people, our son would not be here today. We are deeply grateful,” said Georgios.

About the Northwestern Medicine Center for Advanced Endoscopy

Part of Northwestern Medicine’s Digestive Health Institute, the Center for Advanced Endoscopy is anchored by physicians who are leaders in their field, prominent researchers, and pioneers of endoscopic techniques used worldwide. As one of only a few stand-alone advanced endoscopy sites in the United States, the center is expected to draw individuals from around the globe seeking treatment for the most complex gastrointestinal conditions. 

For more information about the Center for Advanced Endoscopy at Northwestern Medicine Central DuPage Hospital, visit www.nm.org/cae. To make an appointment, call 630-933-4448.

Chicago, IL – June 24, 2026 – When Craig Conover of Chicago, Illinois, began experiencing discomfort from a bulge in his groin, he learned he had an inguinal hernia — a common condition that often requires surgery. The retired infectious diseases doctor knew it needed to be repaired but was concerned the standard approach with surgical mesh would not be a strong fit for his active lifestyle.

“The surgery with the best track record that doesn't involve mesh is called the Shouldice repair, and there's only a handful of surgeons in the United States that do this,” said Conover.

Luckily, he didn’t have to search far for a surgeon with the skillsets to execute such a technical repair. Megan Melland-Smith, MD, a gastrointestinal surgeon, joined the Northwestern Medicine Digestive Health Institute in October 2025, bringing with her a specialized expertise in hernia care, abdominal wall reconstruction and a track record for performing the tissue-based Shouldice repair.

“The overwhelming benefit is that you avoid a large piece of mesh in your groin,” said Dr. Melland-Smith.

Tissue-based technique with WWII roots

Most groin hernia repairs in the United States use surgical mesh, a permanent implant that reinforces the abdominal wall. The material resembles a flexible plastic net and remains in the body for life, but some patients prefer to avoid surgical mesh.

“Mesh has come a long way from an engineering standpoint and is very safe, but it is a foreign body. It's permanently implanted for the rest of your life,” said Dr. Melland-Smith. “Some people can get inflammation around the mesh, and others have a foreign-body sensation of their mesh. It can irritate nerves in the groin.”

The Shouldice technique offers a different option. Instead of mesh, surgeons repair the hernia using the patient’s own tissue. The procedure is performed through a small open incision in the groin and reconstructs the abdominal wall with a four-layer tissue closure. The method was developed during World War II at Shouldice Hospital in Toronto.

“Back then, there was no availability for surgeons to get a hold of any sort of plastic because all the plastic was being used for parachutes, so they couldn't use any mesh,” said Dr. Melland-Smith.

Today, the Shouldice repair remains an option for patients who want to avoid a permanent implant. The procedure is performed on an outpatient basis, allowing patients to return home the same day once awake and stable. Part of the patient appeal is that doctors can use a local numbing injection and light sedation, eliminating the need for a breathing tube and full anesthesia.

“It's an excellent repair for young, fit athletes because it avoids putting a piece of mesh into these young people, and that’s a huge advantage for them,” said Dr. Melland-Smith.

Returning to activity

Conover’s search for a team skilled in the Shouldice technique initially led him to a physician in Florida, but that physician in turn referred him to Dr. Melland-Smith at Northwestern Memorial Hospital.

“He said, ‘You know, you really don't have to come see me in Florida. Doctor Melland-Smith just left the Shouldice clinic in Canada, which specializes in this repair, and she's at Northwestern Medicine,’” said Conover. “So, I made an appointment and had surgery a few weeks later.”

A nerve block provides 12–18 hours of pain relief, and most patients experience groin tenderness for about two weeks. Patients may walk, climb stairs, and perform light cardio almost immediately after surgery. Long-term, patients like Conover will generally have no permanent activity restrictions and may return to full lifting and sports once healing is complete.

“I feel great and I’m ready to go back to all my normal activities,” said Conover. “My wife's ready for me to start mowing the lawn again!”

For more information on non-mesh hernia repair treatment options at Northwestern Medicine, visit nm.org.

WINFIELD, IL — April 30, 2026 — Northwestern Medicine is expanding access to highly specialized digestive health services with the opening of the new Center for Advanced Endoscopy at Northwestern Medicine Central DuPage Hospital in Winfield, IL. Supported by a $15 million investment, the center offers some of the most advanced gastrointestinal (GI) procedures available in the United States, bringing world-class endoscopic care to patients across the Chicago region and beyond.

The Center for Advanced Endoscopy marks a key milestone in Northwestern Medicine’s broader effort to bring advanced, academically driven care closer to home for patients across the health system’s 11 hospitals.

“Combining the convenience of community‑based care with the expertise of a major academic medical center, this opening is a significant leap forward in our commitment to deliver complex care directly to the communities we serve,” said Ken Hedley, president of Northwestern Medicine Central DuPage Hospital. “Local patients now have access to the most advanced endoscopic procedures right here in the western suburbs, without the added burden of traveling far from home.”

With an emphasis on innovation and cutting-edge research, the Center for Advanced Endoscopy is anchored by physicians who are leaders in their field, prominent researchers, and pioneers of endoscopic techniques used worldwide. As one of only a few stand-alone advanced endoscopy sites in the U.S., the center is expected to draw patients not only from the Chicago-area, but also individuals from around the globe seeking treatment for the most complex gastrointestinal conditions. 

“These physicians are some of the most recognized and respected interventional endoscopists in the world,” said Hedley. “They’re changing how and where this level of care is delivered and putting Central DuPage Hospital on the map as a leader for complex GI care, research and innovation.”

A Global Destination for Advanced Endoscopy

Led by Amrita Sethi, MD, an internationally renowned endoscopist and the center’s new medical director, the Center for Advanced Endoscopy features minimally invasive diagnostic and therapeutic options for complex GI, pancreatic, biliary, metabolic and early‑stage cancer conditions. Patients will benefit from clinical expertise and technologies that offer faster diagnosis, improved outcomes, reduced recovery times and often eliminate the need for surgery.

“Our vision is to make Central DuPage Hospital a destination for advanced GI care, not just for this region, but nationally and globally,” said Dr. Sethi, who is also medical director of innovation and training for the Northwestern Medicine Digestive Health Institute. “We are bringing innovative therapies, minimally invasive diagnostics, clinical research, medical training and comprehensive patient support together under one roof.”

Spanning 20,000 square feet, the center features next‑generation technologies, including advanced imaging, flexible robotics, AI-enabled diagnostics and a planned hybrid OR with GI and interventional radiology (IR) capabilities. Patients will have consultations, diagnostics, treatments, and follow-up care all in the same location from a comprehensive team that includes physicians, nurses, technicians, advanced practice providers, nurse navigators and fellows. The center offers comprehensive diagnostic and therapeutic services for a wide range of gastrointestinal conditions, including:

• Complex pancreaticobiliary endoscopy
• Interventional endoscopic ultrasound
• Endoscopic antireflux therapies
• Endobariatric and metabolic endoscopy
• Endoscopic mucosal resection (EMR), endoscopic submucosal dissection (EMD) and third‑space endoscopy (all POEMs)
• Endoscopic therapy for Barrett’s esophagus and early esophageal cancer
• Advanced tissue resection and closure techniques
• Hybrid GI/IR/OR–supported proceduresStreamlined inpatient transfers for advanced therapeutic intervention

Bringing Advanced Care Closer to Home

The Center for Advanced Endoscopy builds upon Northwestern Medicine’s continued investment in digestive health. In 2023, the Digestive Health Institute launched a liver transplant service at Central DuPage Hospital, improving local access to advanced liver care and helping the health system achieve record transplant volumes.

“This investment underscores Northwestern Medicine’s commitment to bringing leading-edge, academically driven digestive care to more patients,” said Sri Komanduri, MD, globally recognized interventional endoscopist at the Center for Advanced Endoscopy and director of system integration for digestive health at Northwestern Medicine. “By combining top-tier talent, advanced technology, and a focus on innovation, Northwestern Medicine is setting the new standard for what GI care can look like in a community setting.” 

With both patient and referring physician experience prioritized, the new center is designed to reduce the need to travel long distances to access complex procedures that diagnose early cancers, remove tumors endoscopically, and treat conditions such as GERD, obesity, and pancreatic and biliary disorders. From the first phone call through recovery and follow‑up, dedicated nurse navigators guide patients through every step of their care journey, coordinating scheduling, providing timely updates, and communicating closely with referring physicians. The center also features direct physician‑to‑physician consultation pathways, enabling prompt review of imaging and pathology and ensuring seamless coordination so referring providers remain closely connected to their patients’ care.

“Patients should not have to choose between convenience and expertise and referring physicians should not have to sacrifice communication or continuity of care,” said Faisal Khan, MD, interventional gastroenterologist at the Center for Advanced Endoscopy. “At this center, patients receive academic‑level care close with rapid access when urgent issues arise, while referring providers benefit from direct collaboration and timely clinical updates. Our goal is to serve as an extension of the referring physician’s care team and deliver the highest level of care to their patients without the added burden and stress of traveling far from home.”

Innovation, Research and Training

In addition to state-of-the-art clinical care, the Center for Advanced Endoscopy also aims to advance the science of digestive health through clinical research and professional training. The facility will host national and international training programs, support clinical trials, and foster development of new techniques and technologies.

“Active research is essential to bringing the latest advances directly to our patients,” said Dr. Sethi. “By participating in and generating new science, our patients benefit from what’s available now and what’s coming next.”

Enhancing GI Care Across Northwestern Medicine

The decision to build the center at Central DuPage Hospital reflects both community need and the hospital’s strong foundation of multidisciplinary care. While located in the western suburbs, the center’s leaders say the opening strengthens Northwestern Medicine’s Digestive Health Institute by making the highest level of GI care available to more patients.

“The western suburbs need this level of care and Central DuPage Hospital is well-equipped to offer it thanks to the robust surgical, oncology, radiology and pathology support required to treat complex cases,” said Dr. Komanduri. “The center enhances access to advanced endoscopy for patients across our health system, including those in the International Health program. It ensures that no matter how they receive care through Northwestern Medicine, patients have streamlined access to the most advanced endoscopic treatments available.”

For more information about the Center for Advanced Endoscopy at Northwestern Medicine Central DuPage Hospital, visit www.nm.org/cae. To make an appointment, call 630-933-4448.

About the Digestive Health Institute at Northwestern Medicine 

The Digestive Health Institute at Northwestern Medicine provides comprehensive, specialized care for a full range of gastrointestinal conditions including advanced diagnostics, innovative treatments, and access to leading research and clinical trials. With multiple convenient locations, Northwestern Medicine delivers high‑quality digestive care close to home. The program is ranked among the top gastroenterology and GI surgery specialty centers in the country 2025–2026 U.S. News & World Report.

OAK BROOK, ILLINOIS – Over the Fourth of July holiday weekend, Alex Timchak, 47, had a deep cough. Days later, the cough went away, but pain in his left side did not.

“That was new. I never had that before and after about a week, I decided I needed to reach out to my primary care doctor,” said Timchak, a psychiatrist who lives in River Forest, Illinois.   

Timchak says his primary care doctor told him imaging showed his pancreas was inflamed and the pancreatic duct was enlarged. He referred Timchak to a gastroenterologist at another health system. During an endoscopy, no mass was detected, but a biopsy was obtained near the area where the pancreatic duct looked abnormal. The biopsy results came back normal, and the gastroenterologist recommended follow-up imaging in a month.

“That didn't seem to make the most sense to me, so I made an appointment at Northwestern Medicine for a second opinion,” Timchak said. 

Getting a second opinion

Timchak went to see interventional gastroenterologist Sri Komanduri, MD, at the Northwestern Medicine Oak Brook Outpatient Center and underwent another biopsy.

While waiting for the results, Timchak and his wife visited their son, who attends college at the University of Alabama. They had just sat in the stadium for their first Alabama football game, when Dr. Komanduri called with the results.

“Fortunately for Alex, we did repeat that endoscopic ultrasound and what we saw was a small growth in the pancreas. However, when we took the biopsy of this lesion, this came back as what is called a neuroendocrine tumor, which is very different than a typical cancer of the pancreas or what we call adenocarcinoma,” Dr. Komanduri said. “The reason this is so different is it has a much slower growth rate and doesn't spread to adjacent organs anywhere nearly as quickly as the standard cancer of the pancreas.”

“I am not going to lie, I jumped up and pumped my fist and screamed loudly, ‘Yes’, because I knew that this was a completely different picture than what I was most fearing,” Timchak said.

Fearing the worst

Timchak had been worried he would suffer the same fate as his father, who died of pancreatic ductal adenocarcinoma at age 70. 

“I've got four amazing kids, a beautiful wife and a job that I love, and the thought of having to fight a really aggressive cancer that has a very low, five-year survival rate that was a lot to have to think about and work through,” said Timchak.

Learning he had a different form of cancer that was highly treatable was a gamechanger. 

Dr. Komanduri recommended a referral for consideration of surgery to remove the cancerous lesion. 

Moving forward, cancer-free

Surgical oncologist David Bentrem, MD, with the Robert H. Lurie Comprehensive Cancer Center at Northwestern Memorial Hospital, discussed surgical options with Timchak. They determined a Whipple procedure, which involves removing the head of the pancreas, the first part of the small intestine and the gall bladder and a portion of the bile duct, was the best course of action.

“By removing the lesion completely, we are eliminating the need for any further treatment. Alex will need monitoring and surveillance, but there’s no need for chemotherapy or radiation. The cure rate is over 90%,” Dr. Bentrem said. 

Two weeks before Thanksgiving, on November 14, the procedure was performed at Northwestern Memorial, successfully removing the cancerous tumor.

The tumor had clear margins and 24 lymph nodes were negative for cancer. Timchak said the operation and recovery all went as planned.

“To be able to get back to a point where I am almost back to my pre-surgical level of functioning is just such a blessing and a gift and it's because I have a supportive family and supportive colleagues, but also an amazing medical team here at Northwestern Medicine,” Timchak said.

Understanding pancreatic neuroendocrine tumors

Pancreatic neuroendocrine tumors (NETs) are less common than other types of pancreatic cancer and often misdiagnosed, which can delay diagnosis and treatment. 

Northwestern Medicine offers a multidisciplinary team of experts who specialize in NETs with care available at locations across Chicagoland, including pathologists with experise in identifying and diagnosing these rare tumors.

“Neuroendocrine tumors are rare in general,” said Dr. Komanduri. “With that said, when we're talking about all the growths that we see in the pancreas, even amongst that, the vast majority are adenocarcinoma, or cancers of the pancreas. However, a small percentage of them can be these neuroendocrine tumors which make the proper testing and diagnosis very critical, in terms of which direction you take the patient moving forward,” Dr. Komanduri said.

For more information about NETs and treatment options for pancreatic cancer, visit nm.org.

For many years, physicians have known that white blood cells called eosinophils can build up in the lining of the esophagus, the muscular tube that connects the mouth to the stomach. That cell buildup can cause inflammation that leads to difficulty swallowing and esophageal pain. The same white blood cell buildup can occur in the rest of the gastrointestinal tract, but these disorders are significantly more rare.

“This study is exciting for patients who suffer from these rare disorders, which previously had to be treated with medications called steroids that can have other harmful effects on the body,” said Nirmala Gonsalves, MD, lead author of the study and a gastroenterologist at Northwestern Memorial Hospital. “It shows that a special diet can heal severe inflammation in the lining of the stomach and intestine without involving medication. Once the patient’s gut is healed, we can introduce specific foods to try and identify which ones are triggering the disease. In the end, this process of food reintroduction can make the diet less restrictive and improve quality of life.”

Patients who participated in the first part of the trial used an elemental diet – liquid nutrients that are easily absorbed – as their sole source of nutrition for six weeks. When tests determined they achieved complete remission of their disease, the Digestive Health Center team at Northwestern Memorial Hospital carefully reintroduced foods that are likely to cause allergic reactions, and then tested for inflammation. While each patient had different results, common food allergens known to be triggers in eosinophilic gastrointestinal disease include cow’s milk, wheat, eggs, soy, nuts and seafood.

“This study is the first to show that food allergens are triggering eosinophilic disease in the stomach and small intestine of patients,” Dr. Gonsalves said. “This study also showed that after patients were on this diet, they had improvement in endoscopic findings, symptoms, and dysregulation of important genes thought to be involved in this condition. For patients who suffer from eosinophilic gastritis or eosinophilic duodenitis, this new approach can be life-altering, as it will allow patients natural alternatives to steroid therapy while helping to heal their inflammation.”

Physicians who performed colonoscopies assisted by artificial intelligence achieved a 13 percent increase in the detection and removal of colorectal polyps, according to new research by Northwestern Medicine shared May 9 at the Digestive Diseases Week conference in Chicago. Gastroenterologists using the FDA-approved Medtronic GI Genius^TM computer-aided detection system removed more adenomas, the most common type of colorectal polyp, compared to when the system was not available or used.

Previous research has shown that each 1 percent increase in the adenoma detection rate was associated with a 3 percent decrease in the risk of cancer within five years of a colonoscopy.

“This means that computer-aided colonoscopies could reduce future colon cancer diagnoses by up to 39 percent,” said Rajesh Keswani, MD, MS, director of endoscopy for Northwestern Memorial Hospital and director of quality for the Northwestern Medicine Digestive Health Center. “The results could even be more dramatic in suburban or rural hospitals, where fewer screening colonoscopies are performed and there may be more variation in quality.”

Over the six-month study period, 21 gastroenterologists at Northwestern Memorial Hospital performed 4,820 colonoscopies. Nine of the physicians used the computer-aided detection software most of the time, and polyp removal rates significantly increased among the physicians who used the software compared to those who did not.

“We felt it was important to assess the use of AI in our group of already high-performing colonoscopists,” Dr. Keswani said. “Because of our commitment to high-quality colonoscopy, we were already doing better than the national guidelines recommended. But could AI make us even better? The answer is very clearly, ‘Yes.’”

By detecting and removing more polyps, physicians reduce the risk of colon cancer developing before a patient’s next colonoscopy.

“Most polyps do not become cancerous, but nearly all colorectal cancers begin as polyps,” said Dr. Keswani, who is part of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “We want to detect them in their earliest stages and remove them to prevent future diagnoses of cancer. There’s nothing better than telling a patient that their decision to have a screening colonoscopy may have saved their life.”

Based in part on this research, Northwestern Medicine recently purchased GI Genius devices to equip every endoscopy suite in its nine acute-care hospitals and in four outpatient locations in the Chicago suburbs.

“Patients who come to any Northwestern Medicine location for colonoscopies will now have access to this technology, which is improving the way we predict, detect and diagnose colon cancer,” said John Pandolfino, MD, chief of gastroenterology and hepatology at Northwestern Medicine. “This investment shows we’re committed to using and developing artificial intelligence and machine learning to improve the way we care for patients.”

Dr. Pandolfino leads the Center for Artificial Intelligence and Mathematics in Gastroenterology, a first-of-its kind program that was developed in collaboration with engineers at the McCormick School of Engineering at Northwestern University.

“Our team is constantly developing new ways to be more accurate and efficient in the care we provide,” Dr. Pandolfino said. “It’s incredibly gratifying to know this technology will be available to patients in every Northwestern Medicine location where colonoscopies are performed.”

It’s hard to say who was more taken aback by Chicago pastor Brenda Bravatty’s pancreatic cancer diagnosis: Brenda or Rajesh Keswani, MD, MS, an interventional gastroenterologist at Northwestern Memorial Hospital. Brenda felt perfectly healthy when she met Dr. Keswani as a precautionary measure after genetic tests revealed she was at high risk for pancreatic cancer. An MRI screening was normal, but Dr. Keswani knew that early-stage pancreatic cancer does not cause symptoms and is hard to detect with medical imaging. He recommended an endoscopic ultrasound to look for even the smallest sign of the disease.

After the procedure, Dr. Keswani sat with Brenda and her husband and shared shocking news.

“He said, I found something, and it’s so small, I can’t believe it,” Brenda said. “He called the next day and said the biopsy showed I had pancreatic cancer. I’d never had any health problems, and he was saying I had a serious disease. I could hardly believe what I was hearing.”

Although Dr. Keswani regularly performs advanced procedures to screen for pancreatic cancer, he said it is rare that it is caught as early as Brenda’s.

“I was really dismayed during her endoscopy,” Dr. Keswani, director of endoscopy for Northwestern Memorial Hospital and director of quality for the Northwestern Medicine Digestive Health Center. “She’d had a recent scan that didn't show anything, and it hits you that you’re about to diagnose someone with something that is life-altering. That is very humbling.”

Brenda’s diagnosis started a year of treatment that would keep her away from the church and ministry that were central to her life. The experience reinforced her trust in preventive care, but at the beginning, it tested her faith in God. She struggled to find hope in her diagnosis. After watching two of her brothers undergo pancreatic cancer treatment, Brenda knew the path would be difficult.

“I felt that I was sinking,” she said. “When I heard I needed chemo, I was shaking, I was so fearful. The chemo for pancreatic cancer is so strong, and I relied on my family and my friends to get through it. My faith in God was my daily companion, but there were moments when I really struggled to understand or make sense of this difficult situation that was happening to me.”

A couple of months after finishing chemotherapy, Brenda asked Dr. Keswani a question that would change her perspective.

 “I asked him, how often do you find pancreatic cancer so early, and he said, ‘Never,’" she said. "I knew my life is a miracle, and I started looking at my process as an opportunity.”

Devalingam Mahalingam, MD, PhD, hematology and medical oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, led the multidisciplinary team that developed Brenda’s care plan. He said the early detection of Brenda’s cancer gave her an advantage as she began treatment.

“It’s hard to detect pancreatic cancers early, and 80 percent of patients present with advanced disease that is not able to be curatively treated,” Dr. Mahalingam said. “Pancreatic cancer’s symptoms are quite insidious – vague abdominal pain, and new-onset diabetes. Often, those don’t immediately indicate the need for a pancreatic cancer evaluation.”

Brenda had surgery called a Whipple procedure and then took several weeks to recover. When she felt stronger, she began a rigorous course of chemotherapy that included a cocktail of three intravenous drugs given every two weeks.

“Brenda completed six months of chemotherapy and she tolerated the treatment really well because she had a positive attitude and she stayed physically active,” Dr. Mahalingam said. “We recommended physical therapy so she could maintain her energy throughout her treatment. It worked so well that she was able to share some of that energy with our staff and with other patients who were also at our cancer center for care.”

Those conversations with other patients reinvigorated Brenda’s faith, and she used each infusion appointment as an opportunity to help others.

“When I was in the waiting area, I saw people who were crying. I talked to them and said, ‘I’m going through this too,’” Brenda said. “Every time a nurse performed a procedure on me, I said, ‘you are doing something that has great value.’”

Throughout the treatment process, Brenda realized she wanted to help others become more intentional about their health. She returned to her ministry, where she helps women overcome domestic violence, single parenthood, emotional issues and other challenges that often make personal health a lower priority.

“Preventive care is so important, and so many people in the Latino community need to hear that,” she said. “I’d always been so healthy that I really am fortunate that I followed up with Dr. Keswani after my genetic screening. That really wasn’t in my nature.”

Dr. Keswani said many pancreatic cancers do not have genetic causes, but for Brenda, there was little that could be done to prevent the disease because of her genetic mutation. Since her cancer was detected early, she wasn’t yet experiencing symptoms that would have made her recovery even more difficult.

“It’s hard to say someone is lucky when they have pancreatic cancer, but with Brenda you have to recognize the blessing of early detection,” Dr. Keswani said. “It’s a story of hope because medicine is advancing. More blood tests are being developed, and artificial intelligence will help us detect pancreatic cancer earlier. If we’re going to make a dent with this disease, it’s going to be with early detection. Brenda was proactive, and it has changed her life.”

Research shows there is a strong two-way connection between the gut and the brain. During the holidays, additional stress and other psychological factors can affect a person’s gut health, exacerbating symptoms and triggering chronic digestive health issues.

“Holiday parties and gatherings can bring a lot of fun, but long to-do lists, changes to normal routines and extra time with family and friends can also cause a lot of stress,” said Kate Tomasino, PhD, gastrointestinal psychologist and co-director of the Behavioral Medicine for Digestive Health Program at Northwestern Memorial Hospital in Chicago.

“Stress can impact a person’s digestive functioning. Some people say their stomach churns, or others say their stomach feels tied up in knots. Those are very real responses that can affect a person’s digestive health. Some people experience cramping and diarrhea, and others can experience constipation. Patients are relieved to learn that there are ways to address stress so patients can get more out of life.”

Dr. Tomasino uses treatments like cognitive behavioral therapy and medical hypnosis to help patients cope with diagnoses like inflammatory bowel disease, irritable bowel syndrome, gastroesophageal reflux disease (GERD), and other chronic digestive health issues. She also recommends diaphragmatic breathing, yoga and exercise to help patients manage stress during the holidays.

“Many of the patients we treat are currently receiving care from a gastroenterologist, but everyone can experience digestive health issues,” Dr. Tomasino said. “The techniques we use with our patients can help anyone cope with stress, and we even suggest that people look at apps that offer breathing, mindfulness and even behavioral therapy support.”

During the holidays, many people prepare for parties by skipping meals early in the day. When they attend those parties, they may also overindulge in food and alcoholic beverages that trigger a landslide of symptoms.

“Sometimes people think it’s a good idea to skip meals because they’ll be eating rich foods at a holiday party, but it’s better for your gastrointestinal tract to eat consistent meals,” Dr. Tomasino said. “Alcohol is another thing that can make stress and gastrointestinal symptoms worse. We tell patients to eat healthy, regular meals and to get physical movement every day so they’re more prepared for a few holiday indulgences.”

As part of the Digestive Health Center at Northwestern Memorial Hospital, Dr. Tomasino works with a multidisciplinary team that helps patients control symptoms and manage their condition or disease. The Behavioral Medicine for Digestive Health Program is one of the largest in the nation.

“Stress can disrupt the communication between the brain and the gut, and gastrointestinal conditions themselves can be stressful,” Dr. Tomasino said. “We work closely with gastroenterologists, hepatologists, allied health providers and dietitians to help patients get the well-rounded treatment they need. Some benefit from medications or procedures, and many others find they need fewer medications after learning how to manage their responses to stress. I tell patients that even though psychological factors may be part of their issue, their symptoms aren’t in their head. They’re very real and very treatable, and the evidence-based care we provide can be life-changing.”