Published online Jul 21, 2015. doi: 10.3748/wjg.v21.i27.8227
Peer-review started: January 28, 2015
First decision: March 10, 2015
Revised: March 24, 2015
Accepted: May 4, 2015
Article in press: May 4, 2015
Published online: July 21, 2015
Throughout history, many medical milestones have been achieved to prevent and treat human diseases. Man’s early conception of illness was naturally holistic or integrative. However, scientific knowledge was atomized into quantitative and qualitative research. In the field of medicine, the main trade-off was the creation of many medical specialties that commonly treat patients in advanced stages of disease. However, now that we are immersed in the post-genomic era, how should we reevaluate medicine? Genomic medicine has evoked a medical paradigm shift based on the plausibility to predict the genetic susceptibility to disease. Additionally, the development of chronic diseases should be viewed as a continuum of interactions between the individual’s genetic make-up and environmental factors such as diet, physical activity, and emotions. Thus, personalized medicine is aimed at preventing or reversing clinical symptoms, and providing a better quality of life by integrating the genetic, environmental and cultural factors of diseases. Whether using genomic medicine in the field of gastroenterology is a new approach or a new medical specialty remains an open question. To address this issue, it will require the mutual work of educational and governmental authorities with public health professionals, with the goal of translating genomic medicine into better health policies.
Core tip: New knowledge is growing on how genes are involved in the physiopathology of liver and gastrointestinal diseases and how environmental factors, such as diet, physical activity, and emotions modulate the onset and progression of chronic disease. In the era of genomic medicine, gastroenterologists and hepatologists should be determined to integrate genetic, environmental and cultural factors into medical practice to prevent or reverse medical symptoms.