In gastroenterology, a good bedside manner is a vital attribute. Visiting with an anxious patient before a colonoscopy, Adjoa Anyane-Yeboa, MD, MPH, knew what to say to calm him down.
“I could tell he was really nervous about the procedure, even though he wasn’t letting on,” said Dr. Anyane-Yeboa, a gastroenterologist with Massachusetts General Hospital in Boston. She put him at ease by cracking jokes and making him smile during the consent process. After it was over, he thanked her for making him feel more comfortable.
“I will have it done again, and I’ll come back to you next time,” said the patient.
GI doctors perform colonoscopies all day, every day, “so we sometimes forget how nervous people are. But it’s nice to be able to connect with people and put them at ease,” she said.
Dr. Adjoa Anyane-Yeboa
Interacting with patients gives her joy. Addressing health disparities is her long-term goal. Dr. Anyane-Yeboa’s research has focused on the barriers to colorectal cancer screening in the Black population, as well as disparities in inflammatory bowel disease (IBD).
“I think there’s a lot that still needs to be done around colorectal cancer screening,” she said.
In an interview, she talks more in depth about her research and her ongoing work to increase public knowledge and awareness about colorectal cancer screening.
Q: Why did you choose GI?
Dr. Anyane-Yeboa: When I got to residency, GI was the rotation that was the most fun. I was the most excited to read about it, the most excited to go to work the next day.
I remember people saying, “You should look at the people who are in the field and look at their personalities, and then think about which personalities match you best.” In residency I considered hematology, cardiology, and GI. The cardiologists were so serious, so intense, talking about research methods all the time. Whereas, the GI folks were joking, laughing, making fart jokes. I felt like these were my people, lighthearted and easy-going. And I genuinely enjoyed going to work every day and learning about the disorders of the GI tract. I still do to this day.
Q: Let’s discuss your research with IBD in Black populations and colorectal cancer screening.
Dr. Anyane-Yeboa: My two main areas of work are in IBD and minority populations, predominantly Black populations, and in colorectal cancer screening in minority populations, and again, mostly in historically marginalized populations.
With colon cancer, we know that there are disparities with incidence in mortality. Black individuals have had the second highest incidence in mortality from colorectal cancer. For me, being a Black female physician and seeing people who look like me, time and time again, being diagnosed with colorectal cancer and dying is really what drives me, because in GI, colon cancer screening is our bread and butter.
Some of the work that I’m doing now around colorectal cancer is in predominantly Black community health centers, working on increasing colorectal cancer screening rates in this population, and figuring out what the barriers are to screening and how we can address them, and what are some strategies that will work in a health center setting to get people screened.
Q: One study of yours surveyed unscreened Black individuals age ≥ 45 and found age-specific barriers to CRC screening in this population, as well as a lack of targeted messaging to incentivize screening.
Dr. Anyane-Yeboa: That mixed method study was done in partnership with the National Colorectal Cancer Roundtable and American Cancer Society.
In that study, we found that the most common barrier to screening was self-procrastination or delay of screening, meaning, “I’m going to get screened, just not right now.” It’s not a priority. What was unique about this is we looked at it from age breakdown, so 45-49, 50-54, 55-plus. With the younger 45-49 group, we don’t know as much about how to get them screened. We also saw that healthcare providers weren’t starting conversations about screening with these younger newly eligible patients.
We also described effective messages to get people screened in that paper as well.
Q: What changes would you like to see going forward with screening? What still needs to happen?
Dr. Anyane-Yeboa: In some of the other work that I’ve done, particularly with the health centers and younger populations interviewed in focus groups, I’m seeing that those who are younger don’t really know much about colorectal cancer screening. Those who do know about it have seen commercials about popular stool-based testing brands, and that’s how they’ve learned about screening.
What I would like to see is ways to increase the knowledge and awareness about colorectal cancer screening and colorectal cancer on a broad scale, on a more national, public-facing scale. Because I’m realizing that if they’re healthy young folks who aren’t going to the physician, who don’t have a primary care provider, then they might not even really hear about colorectal cancer screening. We need ways to educate the general public so individuals can advocate for themselves around screening.
I also want to see more providers discussing screening with all patients, starting from those 45-49, and younger if they have a family history. Providers should screen every single patient that they see. We know that every single person should be screened at 45 and older, and not all providers, surprisingly, are discussing it with their patients.
Q: When you’re not being a GI, how do you spend your free weekend afternoons?
Dr. Anyane-Yeboa: Saturday morning is my favorite time of the week. I’m either catching up on my TV shows, or I might be on a walk with my dog, particularly in the afternoon. I live near an arboretum, so I usually walk through there on the weekend afternoons. I also might be trying out a new restaurant with my friends. I love traveling, so I might also be sightseeing in another country.
Lightning Round
Texting or talking?
Texting
Favorite junk food?
Cookies
Cat or dog person?
Both; love cats, have a dog
If you weren’t a gastroenterologist, what would you be?
Fashion boutique owner
Best place you’ve traveled to?
Morocco
How many cups of coffee do you drink per day?
Two
Favorite ice cream?
Don’t eat ice cream, only cookies
Favorite sport?
Tennis
Optimist or pessimist?
Optimist (glass half full)
Summary content
7 Key Takeaways
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1
Developed a paper-based colorimetric sensor array for chemical threat detection.
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Can detect 12 chemical agents, including industrial toxins.
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Production cost is under 20 cents per chip.
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Utilizes dye-loaded silica particles on self-adhesive paper.
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Provides rapid, simultaneous identification through image analysis.
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Inspired by the mammalian olfactory system for pattern recognition.
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Future developments include a machine learning-enabled reader device.
The guidelines emphasize four-hour gastric emptying studies over two-hour testing. How do you see this affecting diagnostic workflows in practice?
Dr. Staller: Moving to a four-hour solid-meal scintigraphy will actually simplify decision-making. The two-hour reads miss a meaningful proportion of delayed emptying; standardizing on four hours reduces false negatives and the “maybe gastroparesis” purgatory that leads to repeat testing. Practically, it means closer coordination with nuclear medicine (longer slots, consistent standardized meal), updating order sets to default to a four-hour protocol, and educating front-line teams so patients arrive appropriately prepped. The payoff is fewer equivocal studies and more confident treatment plans.
Metoclopramide and erythromycin are the only agents conditionally recommended for initial therapy. How does this align with what is being currently prescribed?
Dr. Staller: This largely mirrors real-world practice. Metoclopramide remains the only FDA-approved prokinetic for gastroparesis, and short “pulsed” erythromycin courses are familiar to many of us—recognizing tachyphylaxis limits durability. Our recommendation is “conditional” because the underlying evidence is modest and patient responses are heterogeneous, but it formalizes what many clinicians already do: start with metoclopramide (lowest effective dose, limited duration, counsel on neurologic adverse effects) and reserve erythromycin for targeted use (exacerbations, bridging).
Several agents, including domperidone and prucalopride, received recommendations against first-line use. How will that influence discussions with patients who ask about these therapies?
Dr. Staller: Two points I share with patients: evidence and access/safety. For domperidone, the data quality is mixed, and US access is through an FDA IND mechanism; you’re committing patients to EKG monitoring and a non-trivial administrative lift. For prucalopride, the gastroparesis-specific evidence isn’t strong enough yet to justify first-line use. So, our stance is not “never,” it’s just “not first.” If someone fails or cannot tolerate initial therapy, we can revisit these options through shared decision-making, setting expectations about benefit, monitoring, and off-label use. The guideline language helps clinicians have a transparent, evidence-based conversation at the first visit.
The guidelines suggest reserving procedures like G-POEM and gastric electrical stimulation for refractory cases. In your practice, how do you decide when a patient is “refractory” to medical therapy?
Dr. Staller: I define “refractory” with three anchors.
1. Adequate trials of foundational care: dietary optimization and glycemic control; an antiemetic; and at least one prokinetic at appropriate dose/duration (with intolerance documented if stopped early).
2. Persistent, function-limiting symptoms: ongoing nausea/vomiting, weight loss, dehydration, ER visits/hospitalizations, or malnutrition despite the above—ideally tracked with a validated instrument (e.g., GCSI) plus nutritional metrics.
3. Objective correlation: delayed emptying on a standardized 4-hour solid-meal study that aligns with the clinical picture (and medications that slow emptying addressed).
At that point, referral to a center with procedural expertise for G-POEM or consideration of gastric electrical stimulation becomes appropriate, with multidisciplinary evaluation (GI, nutrition, psychology, and, when needed, surgery).
What role do you see dietary modification and glycemic control playing alongside pharmacologic therapy in light of these recommendations?
Dr. Staller: They’re the bedrock. A small-particle, lower-fat, calorie-dense diet—often leaning on nutrient-rich liquids—can meaningfully reduce symptom burden. Partnering with dietitians early pays dividends. For diabetes, tighter glycemic control can improve gastric emptying and symptoms; I explicitly review medications that can slow emptying (e.g., opioids; consider timing/necessity of GLP-1 receptor agonists) and encourage continuous glucose monitor-informed adjustments. Pharmacotherapy sits on top of those pillars; without them, medications will likely underperform.
The guideline notes “considerable unmet need” in gastroparesis treatment. Where do you think future therapies or research are most urgently needed?
Dr. Staller: I see three major areas.
1. Truly durable prokinetics: agents that improve emptying and symptoms over months, with better safety than legacy options (e.g., next-gen motilin/ghrelin agonists, better-studied 5-HT4 strategies).
2. Endotyping and biomarkers: we need to stop treating all gastroparesis as one disease. Clinical, physiologic, and microbiome/omic signatures that predict who benefits from which therapy (drug vs G-POEM vs GES) would transform care.
3. Patient-centered trials: larger, longer RCTs that prioritize validated symptom and quality-of-life outcomes, include nutritional endpoints, and reflect real-world medication confounders.
Our guideline intentionally highlights these gaps to hopefully catalyze better trials and smarter referral pathways.
Dr. Staller is with the Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston.