Digestive Diseases News
Spring/Summer 2009

NIH Releases First Research Plan to Reduce Burden of Digestive Diseases

The National Institutes of Health (NIH) last April released the first long-range plan for tackling digestive diseases, which affect as many as 70 million Americans each year.

Opportunities and Challenges in Digestive Diseases Research: Recommendations of the National Commission on Digestive Diseases describes the impact of diseases ranging from foodborne infections to cancer and liver failure and maps out research priorities for the next decade.

“NIH-funded research has led to tremendous discoveries in peptic ulcer disease, viral hepatitis, and colorectal cancer. To build on these advances and break new ground, we’ll be looking for investigator-initiated projects and developing new initiatives that respond to the commission’s recommendations,” said Griffin P. Rodgers, M.D., M.A.C.P., director of the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “Of course, bringing in new investigators and utilizing NIH’s peer review system to identify projects with high scientific merit will continue to be high priorities.”

The report emphasizes the importance of cross-cutting research, encouraging multidisciplinary efforts to advance understanding of causes and improve diagnosis and treatment of digestive diseases. The high-impact goals recommended by the National Commission on Digestive Diseases include

• gaining a better understanding of basic biology of the digestive system
• improving the understanding of functional gastrointestinal and motility disorders such as irritable bowel syndrome
• identifying additional infection-causing microbes
• developing better tools to predict and detect cancers
• creating objective criteria to diagnose and evaluate inflammatory bowel diseases based on comprehensive genetic studies
• developing new treatment strategies for intestinal failure and regeneration, nutritional disorders and support, surgically modified gut—altered stomach following bariatric weight-loss surgery—and transplantation
• understanding the neuromuscular biology of diseases of the esophagus and oropharynx—pharynx and mouth
• improving treatments for diverse diseases of the stomach and small intestine
• developing better ways to categorize diseases of the colon and rectum
• identifying the biologic and genetic triggers for acute and chronic pancreatitis
• testing new approaches to detect, prevent, and treat diseases of the liver and biliary system—organs and ducts that produce and move bile to help digestion
• using bioengineering, biotechnology, and imaging to improve patient outcomes and treatments

Each year, about 105 million doctor visits are for digestive diseases, often driven by symptoms such as stomach pain, diarrhea, vomiting, or nausea. These diseases cost the United States $100 billion annually in direct medical costs. Prescription drugs for diseases such as gastroesophageal reflux are among the most commonly prescribed medications in the United States.

It was against this backdrop of human suffering and health care costs that former NIH Director Elias A. Zerhouni, M.D., established the commission in 2005. He charged the commission with reviewing current and needed digestive diseases research. The report identifies recent research advances and new and emerging opportunities for future study.

The 16 appointed members of the commission represent academic and medical researchers, health care professionals, and patient-advocacy groups. The commission also included 18 nonvoting ex officio members from the NIH and other federal agencies conducting digestive diseases research.

Research Guidepost

“The commission’s recommendations provide a guidepost for digestive diseases research to be addressed over the next decade,” said Commission Chair Stephen P. James, M.D., who also directs the NIDDK’s Division of Digestive Diseases and Nutrition. “We hope that this broad-based research plan leads to new findings that help reduce the pain and suffering experienced by the millions of people with digestive diseases.”

An estimated 20 NIH Institutes, Centers, and Offices invested more than $1.4 billion in digestive diseases research in fiscal year 2008. Current studies focus on understanding the fundamental mechanisms of digestive system development and function, as well as basic, translational, and clinical research on the digestive system in normal and disease conditions.

The NIDDK conducts and supports basic and clinical research and research training on some of the most common, severe, and disabling conditions affecting Americans. The Institute’s research interests include diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic, and hematologic diseases. For more information, visit www.niddk.nih.gov.

For information about digestive diseases, including free fact sheets and easy-to-read booklets, visit www.digestive.niddk.nih.gov. For more information about the National Commission on Digestive Diseases, see www2.niddk.nih.gov/AboutNIDDK/CommitteesAndWorkingGroups/NCDD.htm.

The commission’s report is available online at www2.niddk.nih.gov/AboutNIDDK/CommitteesAndWorkingGroups/NCDD/FinalResearchPlanPosting.htm.

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NIH Publication No. 09–4552
July 2009