Q&A with Digestive Health Institute Leaders

The newly opened Digestive Health Institute provides comprehensive care in a comfortable setting.

By Nancy Brands Ward

Almost everyone experiences problems with digestive health at some point. For some, it’s acid reflux, abdominal bloating or just plain discomfort. For others, it’s trouble swallowing, persistent irritable bowel syndrome or inability to maintain normal weight. For still others, it’s diverticulitis, Crohn’s disease or cancer of the pancreas, liver or colon.

Providence Saint John’s Health Center recently established the Digestive Health Institute to provide coordinated specialty care for patients in the community and across the nation. Saint John’s magazine spoke to the institute’s co-directors and longtime friends and collaborators, Anton J. Bilchik, MD, PhD, chief of general surgery, director of gastrointestinal and hepatobiliary and gastrointestinal (GI) research programs, and Rudolph A. Bedford, MD, gastroenterologist, about their goals for the institute.

What attracted you to specialize in gastrointestinal health?

DR. BEDFORD: It is one of the few medical specialties where we can intervene and have an effect on everything from uncomfortable to annoying to life-threatening diseases.

DR. BILCHIK: I realized early in my career that much disease begins in the gut. Over three decades of research we’ve learned so much about the immune system, microbiome and how GI health affects other organs and a range of diseases. After medical school, I did a PhD in gastrointestinal physiology to better understand pancreas cancer. Survival remains dismal, and it’s been my passion to identify treatments.

How long have you two worked together, and how is the institute an opportunity for you to expand your collaborative work?

DR. BEDFORD: I was the director of pancreatic biliary services at UCLA when Anton did his training there. Since joining Saint John’s, our collaboration and friendship has grown stronger as we work together to deal with everything under the sun in the gastrointestinal tract.

DR. BILCHIK: We’re a perfect dyad because both of us have special interests in complex GI problems, ranging from pancreas and liver malignancies to colorectal cancer. I wouldn’t be able to do the kind of surgeries I do without the close collaboration of such an excellent gastroenterologist.

Why did Providence Saint John’s feel it was important to create this institute?

DR. BEDFORD: The digestive system is central to everything from eating to eliminating, and problems with it affect a wide range of diseases. The institute provides a hub for highly coordinated care with a range of specialties under one symbolic roof.

Is it common for people to struggle with digestive system symptoms and either not get help or not get the right help?

DR. BILCHIK: Absolutely. Every person in some point in their life has digestive health symptoms, ranging from mild to severe—but unrecognized. A worst-case example is pancreas cancer, whose symptoms don’t appear until the cancer has already spread.

DR. BEDFORD: Too many patients have seen multiple doctors for different problems, and they suffer because of the lack of coordinated care.

What are the strengths of the institute?

DR. BEDFORD: We provide university-level quality of care, coordinated in a personalized, caring and intimate setting.

DR. BILCHIK: Patients with advanced problems come to us from across the country. We have expertise that most community hospitals don’t have. Saint John’s has been involved in GI research for more than 25 years. Our findings have led to improvements in treatments. We’ve led large, National Institutes of Health-funded clinical trials. We’re at the forefront of treating liver tumors and the leading edge of minimally invasive robotic surgery.

What are some of the institute’s goals surrounding colorectal cancer?

DR. BILCHIK: We’re working with Stand Up To Cancer to eliminate inequities among underserved groups in Santa Monica. We offer colorectal screening and colonoscopies without charge to those who test positive. We’ve also teamed with Harvard University to offer screening for underserved populations in Boston, Los Angeles and South Dakota. During the pandemic, screening rates dropped to 17%. Our goal is to get that up to 80%.

What are some of the non-cancer-related conditions you’ll see?

DR. BEDFORD: Most of what we see at the institute are non-cancer diseases: irritable bowel and fatty liver disease, pancreatic, esophageal or motility disorders, and more.

Why include a bariatric program in the institute?

DR. BEDFORD: Morbid obesity is a large factor in heart disease, stroke, colorectal cancers, diabetes and many more conditions. For those people who have difficulty losing weight and keeping it off, bariatric surgery combined with a metabolic weight-loss program can be lifesaving.