ACG 2025

The American College of Gastroenterology (ACG) 2025 meeting is a prominent annual event where groundbreaking research, clinical studies, and advancements in gastroenterology are presented. At the ACG 2025 meeting, several impactful studies were showcased, providing significant insights into the prevention, diagnosis, and treatment of gastrointestinal disorders. Below are the highlights of four major studies presented at the meeting:

### 1. **Sessile Serrated Lesion Detection Rate (SSLDR) and Colon Cancer Prevention**

• Researchers analyzed data from over **115,000 colonoscopies** to evaluate the Sessile Serrated Lesion Detection Rate (SSLDR).
• Findings revealed that a **higher SSLDR is strongly associated with a reduced risk of post-colonoscopy colorectal cancer**.
• Key results:
• SSLDR between **4.5–8%** reduced the cancer risk by **62%**.
• SSLDR of **≥8%** reduced the risk by nearly **80%**.
• This study suggests that endoscopists should aim for SSLDR rates **higher than the current guideline minimum of 6%** to improve colon cancer prevention efforts.

### 2. **Inadequate Bowel Preparation (IABP) in Colonoscopies**

• This study analyzed data from **16.7 million colonoscopies** to assess the prevalence and consequences of inadequate bowel preparation (IABP).
• Despite guidelines recommending fewer than **10%** inadequate preps, real-world adherence was poor.
• Key findings:
• Only **32%** of patients with IABP underwent a repeat colonoscopy within a year.
• **57%** of patients with IABP were lost to follow-up for more than five years.
• Even high-risk patients rarely returned for follow-up, and many had **another inadequate preparation** during repeat exams.
• The study highlights the need for improved strategies, including **better bowel preparation selection, enhanced patient education, and navigation support** to ensure adequate preparation and follow-up care.

### 3. **Translumbosacral Neuromodulation Therapy (TNT) for Fecal Incontinence**

• Researchers evaluated the efficacy of **translumbosacral neuromodulation therapy (TNT)** in managing fecal incontinence.
• The study involved **109 patients** and demonstrated significant improvements in symptoms:
• Weekly incontinence episodes decreased from **7.7 to 2.8** and **8.3 to 3.5**, depending on the dose.
• TNT also improved nerve function, suggesting its potential to **regenerate neural pathways**.
• While the results are promising, TNT remains an **investigational therapy** at this stage.

### 4. **Resmetirom for Advanced Liver Disease**

• Resmetirom, a medication approved for managing **Metabolic Associated Steatohepatitis (MASH) with fibrosis**, was studied in patients with cirrhosis.
• Over a two-year period, the study revealed significant improvements:
• **20–28%** of patients no longer met the criteria for clinically significant portal hypertension.
• **35%** of patients improved from **F4 fibrosis (cirrhosis)** to **F3 fibrosis**, indicating a regression of liver disease severity.
• These findings represent a significant advance in the treatment of **advanced liver disease**, offering hope for patients with cirrhosis.

### Conclusion

The ACG 2025 meeting presented critical advancements in gastroenterology, highlighting the importance of:

• Improving detection rates for sessile serrated lesions to reduce colorectal cancer risk.
• Addressing challenges in bowel preparation and follow-up care for colonoscopies.
• Investigating innovative therapies like TNT for fecal incontinence.
• Expanding the use of resmetirom for patients with advanced liver disease and cirrhosis.

These studies underscore the ongoing efforts in the medical community to enhance patient outcomes and address significant gaps in care.