Dr. Edith Ho joined Stanford University in February of 2020, where she currently holds the position of Clinical Associate Professor of Medicine in the Division of Gastroenterology and Hepatology. She specializes in the diagnosis and treatment of inflammatory bowel disease and also practices general gastroenterology. Previously, she joined faculty at Case Western Reserve School of Medicine as Assistant Professor of Medicine. She served as a gastroenterologist at the Cleveland Veterans Affairs Medical Center, where she was Director of the Inflammatory Bowel Disease Program. She was also the Co-Director of the Fecal Microbiota Transplantation Program, where she was lauded as the pioneer of the first fecal transplant program in the U.S. veterans affairs healthcare system nationwide.
Dr. Ho is a Diplomate of the American Board of Internal Medicine (ABIM) and the American Board of Gastroenterology, a Fellow of the American College of Gastroenterology (FACG), and a Fellow of the American Gastroenterological Association (AGAF). She serves on the Educational Affairs Committee of ACG where she chairs several abstract committees, directs regional post-graduate courses, and develops CME content for the American Journal of Gastroenterology. She also serves on the AGA Institute Clinical Guidelines Committee as a panel member and guideline author.
- Inflammatory Bowel Disease
- Ulcerative colitis
- Crohn's Disease
Clinical Associate Professor, Medicine - Gastroenterology & Hepatology
Clinical Associate Professor of Medicine, Stanford University (2020 - Present)
Honors & Awards
Undergraduate Research Grant, Stanford University
International Health Research Scholarship, University of Toronto, Canada
Gordeon Cressy Award for Outstanding Leadership, University of Toronto, Canada
Ontario Medical Association Leadership Award, Medical Association in the Province of Ontario, Canada
Franklin G. Ebaugh Jr. Resident Research Award, Stanford University Hospital and Clinics
Honorary Clinical Associate, University of Hong Kong, Department of Gastroenterology and Hepatology
Research Travel Grant, Asian-Pacific Association for the Study of the Liver (APASL)
Travel Grant, American Association of Study of Liver Disease (AASLD)
Research Initiative Program Grant, U.S. Veterans Integrated Service Network (VISN 10)
Outstanding Poster Presentation Award, American College of Gastroenterology Annual Scientific Meeting
Boards, Advisory Committees, Professional Organizations
Resident Advisor, New England Journal of Medicine (NEJM) (2008 - 2008)
Member, American College of Gastroenterology (ACG) (2011 - 2017)
Member, American Gastroenterological Association (AGA) (2011 - 2021)
Fellow and Physician Advisor, Doximity (2013 - 2018)
Faculty Member, Faculty of 1000 Prime Peer Review (2017 - 2020)
Fellow, American College of Gastroenterology (FACG) (2017 - Present)
Faculty Member, Faculty Opinions (2020 - Present)
Fellow, American Gastroenterological Association (AGAF) (2021 - Present)
Board Certification: American Board of Internal Medicine, Gastroenterology (2013)
Fellowship: UCSF Gastroenterology Fellowship (2013) CA
Board Certification: American Board of Internal Medicine, Internal Medicine (2010)
Residency: Stanford University Internal Medicine Residency (2010) CA
Internship: Stanford University Internal Medicine Residency (2008) CA
Medical Education: University of Toronto MD Program (2007) Canada
Current Research and Scholarly Interests
Dr. Ho plays an active role in the American College of Gastroenterology (ACG) Educational Affairs committee, where she chairs several abstract committees, directs regional post-graduate courses, regularly reviews physician course content, and develops CME content for the American Journal of Gastroenterology. She also serves as a guideline author for the American Gastroenterological Association on endoscopic therapies for weight loss and the medical management of luminal and perianal Crohn's disease. These guidelines shed new knowledge and set new standards of care for clinical practice here and abroad.
Dr. Ho’s research interests include investigating screening practices prior to initiating immunosuppressive therapy, and non-traditional therapies for inflammatory bowel disease.
- AGA Clinical Practice Guidelines on the Medical Management ofModerate to Severe Luminal and Perianal Fistulizing Crohn'sDisease. Gastroenterology 2021; 160 (7): 2496-2508
- Spotlight: Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn's Disease. Gastroenterology 2021; 160 (7): 2511
- Providing the Best Care for Patients With Crohn's Disease: An Examination of the New AGA Clinical Practice Guidelines on the Medical Management of Moderate to Severe Luminal and Perianal Fistulizing Crohn's Disease. Gastroenterology 2021; 160 (7): 2557-2562
- AGA Clinical Practice Guidelines on Intragastric Balloons in the Management of Obesity. Gastroenterology 2021; 160 (5): 1799–1808
Opportunistic Infections Are More Prevalent in Crohn's Disease and Ulcerative Colitis: A Large Population-Based Study
INFLAMMATORY BOWEL DISEASES
2020; 26 (2): 291–300
Opportunistic infections (OIs) are more common in patients with inflammatory bowel disease (IBD); however, there have been limited large-scale studies of OIs in IBD. We investigated the epidemiological characteristics of OI in Crohn's disease (CD) and ulcerative colitis (UC) using a large population-based database.Data were collected from a commercial database (Explorys Inc., Cleveland, OH, USA) that provided electronic health records from 26 major integrated US health care systems from 1999 to March 2018. In this data set, we identified all CD and UC patients, based on Systemized Nomenclature of Medicine-Clinical Terms. Within these cohorts, we identified a variety of OIs and compared the prevalence rate of OI in individuals with IBD with that of controls (patients in the database between March 2013 and March 2018 without the diagnosis of IBD).Explorys included 153,290 patients with CD and 128,540 patients with UC between March 2013 and March 2018. The prevalence of OIs was 17.8% in CD, 19.2% in UC, and 7% in non-IBD controls. When compared with non-IBD controls, all OIs were more common in CD (prevalence ratio [PR], 2.54; 95% confidence interval [CI], 2.51-2.57) and UC (PR, 2.74; 95% CI, 2.71-2.77). Overall, viral infections were numerically more common, whereas bacterial infections had the highest PRs in CD and UC when compared with controls without IBD.We found significantly higher rates of OI in IBD. Our study suggests the need for close follow-up of IBD patients to diagnose and provide vaccinations where applicable for prevention of infections.
View details for DOI 10.1093/ibd/izz147
View details for Web of Science ID 000506807300024
View details for PubMedID 31314891
- Continuing Medical Education Questions: June 2020. The American journal of gastroenterology 2020; 115 (6): 812
- Inflammatory Bowel Disease Patients Prior to Starting on Anti-TNF Are Over 5 Times More Likely to Be Screened for Hepatitis B Infection Compared to Those Starting High Dose Corticosteroids LIPPINCOTT WILLIAMS & WILKINS. 2019: S447
- Continuing Medical Education Questions: April 2019. The American journal of gastroenterology 2019; 114 (4): 552
- Continuing Medical Education Questions: September 2019. The American journal of gastroenterology 2019; 114 (9): 1417
- Continuing Medical Education Questions: June 2018. The American journal of gastroenterology 2018; 113 (6): 802
Hepatitis B Virus Screening and Reactivation in a National VA Cohort of Patients with Inflammatory Bowel Disease Treated with Tumor Necrosis Factor Antagonists.
Digestive diseases and sciences
2018; 63 (6): 1551–57
Practice guidelines recommend screening for hepatitis B virus (HBV) infection prior to initiating treatment of inflammatory bowel disease (IBD) with anti-tumor necrosis factor (anti-TNF) therapy. However, the adherence to these screening guidelines and the clinical outcomes of HBV reactivation following anti-TNF use are not well known.This is a retrospective cohort study using the Veterans Health Administration datasets for IBD patients with filled prescriptions for anti-TNFs from 2003 to 2011. Laboratory testing was used to define HBV screening status in the 12 months preceding anti-TNF initiation. Logistic regression models were used to identify predictors of HBV screening. Cases of potential HBV reactivation were identified using ICD-9 codes for HBV infection or acute liver failure or by medications used for HBV infection treatment, and manually reviewed for verification.We identified 3357 IBD patients with filled prescriptions for anti-TNF medications. The HBV testing prior to anti-TNF initiation was 8.1% in 2003 and increased to 43.2% by 2011, with an overall rate of 23.7%. In multivariate analysis, African-American race, facilities with a higher volume of IBD patients, and facilities with an academic affiliation were associated with a higher probability of HBV screening. We did not identify a single case of confirmed clinically relevant HBV reactivation after anti-TNF initiation during 7210 patient-years of medication use.HBV screening rates prior to anti-TNF initiation are low among IBD patients, but have increased over time. Despite low rates of screening, clinically significant HBV reactivation after anti-TNF initiation in this US cohort was nonexistent.
View details for DOI 10.1007/s10620-018-5042-3
View details for PubMedID 29663266
- Continuing Medical Education Questions: October 2018. The American journal of gastroenterology 2018; 113 (10): 1430
- Continuing Medical Education Questions: January 2018: Prophylactic Therapy of Cyclic Vomiting Syndrome in Children: Comparison of Amitriptyline and Cyproheptadine: A Randomized Clinical Trial. The American journal of gastroenterology 2018; 113 (1): 141
- Differences in Drug Treatment Practices Among Younger and Older Veterans With Inflammatory Bowel Disease NATURE PUBLISHING GROUP. 2017: S407
IgM Nephropathy After Treatment with Oral 5-Aminosalicylic Acid Derivatives in a Young Patient with Ulcerative Colitis
LIPPINCOTT WILLIAMS & WILKINS. 2017: S57
View details for Web of Science ID 000393902100176
- Continuing Medical Education Questions: April 2017. The American journal of gastroenterology 2017; 112 (5): 703
- Continuing Medical Education Questions: September 2017: Fecal Incontinence Is Associated With Mortality Among Older Adults With Complex Needs: An Observational Cohort Study. The American journal of gastroenterology 2017; 112 (9): 1438
- Medical management of Crohn's Disease Current Therapy in Colon and Rectal Surgery. Philadelphia Elsevier. 2017; 3: 213–216
- Nivolumab-associated nausea and vomiting as an immune adverse event. European journal of cancer (Oxford, England : 1990) 2017; 84: 367–69
- Fear of Failure: Engaging Patients in Antimicrobial Stewardship after Fecal Transplantation for Recurrent Clostridium difficile Infection. Infection control and hospital epidemiology 2017; 38 (1): 127–29
- Continuing Medical Education Questions: April 2016. The American journal of gastroenterology 2016; 111 (4): 492
- Fecal Microbiota Transplantation by Freeze-Dried Oral Capsules for Recurrent Clostridium difficile Infection. Open forum infectious diseases 2016; 3 (2): ofw091
Ulcerative Colitis: What is the Optimal Treatment Goal and How Do We Achieve It?
Current treatment options in gastroenterology
2015; 13 (1): 130–42
The treatment paradigms and therapeutic options for ulcerative colitis (UC) have rapidly evolved during the past decade. Traditionally, the treatment target has focused on achieving successful induction and maintenance of steroid-free clinical remission. This has been shown to provide a better quality of life and a reduction in complications, hospitalizations, and surgery. Recent studies, however, suggest that achieving "mucosal healing" or endoscopic remission may be the optimal treatment endpoint. In this review, we will examine the treatment goals for UC and the efficacy of each therapy to reach these targets. We will also review the therapeutic options available for UC: mesalamines, steroids, immunomodulators, and biologics, including the first anti-integrin inhibitor, approved in May 2014, for the treatment of UC. Therapeutic drug monitoring, which measures serum drug level and anti-drug antibody concentrations, is emerging as an important clinical decision tool in patients on tumor necrosis factor (TNF)-antagonists. These evolving treatment strategies allow gastroenterologists to optimize control of the disease and offer patients a better quality of life.
View details for DOI 10.1007/s11938-014-0044-5
View details for PubMedID 25619458
Preemptive adefovir versus lamivudine for prevention of hepatitis B reactivation in chronic hepatitis B patients undergoing chemotherapy.
2015; 9 (2): 224–30
This proof-of-concept study compared lamivudine (LAM) with a newer antiviral agent, adefovir dipivoxil (ADF), in preventing hepatitis B virus (HBV) reactivation in chronic HBV patients undergoing chemotherapy.Hepatitis B surface antigen (HBsAg) positive patients intended to undergo chemotherapy were randomized to receive either LAM 100 mg daily or ADF 10 mg daily. Anti-viral therapy was started 1 week prior to chemotherapy and until 6 months after completing chemotherapy. The primary outcome was HBV reactivation rate. All patients with viral breakthrough were screened for resistance mutations by direct sequencing.Seventy treatment-naïve patients were consecutively randomized 1:1 to LAM or ADF. The median baseline HBV DNA levels were similar (LAM 3.36 vs. ADF 3.17 log10 copies/mL, p = 0.860). The median duration was 8.3 months on LAM and 10.6 months on ADF (p = 0.220). HBV reactivation was observed in 13/35 (37.1%) on LAM compared with 10/35 (28.6%) on ADF (p = 0.611). The median time to HBV reactivation was 4.6 and 8.1 months, on LAM and ADF respectively. Among these 13 patients, 8/13 (61.5%) on LAM had developed drug resistance mutations but none on ADF had developed drug resistance mutations to ADF (p = 0.003). Both drugs were well tolerated and no severe drug-related toxicities were reported.In this randomized clinical study, adefovir and lamivudine demonstrated similar efficacy in preventing hepatitis B reactivation in HBsAg-positive patients undergoing chemotherapy. In patients whose hepatitis B reactivated, adefovir was associated with a lower resistance profile.
View details for DOI 10.1007/s12072-015-9612-6
View details for PubMedID 25788197
Expanded use of aggressive therapies improves survival in early and intermediate hepatocellular carcinoma
2014; 16 (8): 758-767
Despite the increasing annual incidence of hepatocellular carcinoma (HCC) in the USA, now estimated at 2.7 cases per 100 000 population, only a small proportion of patients receive treatment and 5-year survival rates range from 9% to 17%.The present study examines the effects of multimodal treatment on survival in a mixed-stage HCC cohort, focusing on the impact of radical therapy in patients with Barcelona Clinic Liver Cancer (BCLC) stage B disease.A retrospective review of the medical records of 254 patients considered for HCC treatment between 2003 and 2011 at a large tertiary referral centre was conducted.A total of 195 (76.8%) patients were treated with a median of two liver-directed interventions. Median survival time was 16 months. In proportional hazards analysis, radiofrequency ablation (RFA) and resection were associated with significantly improved 1- and 5-year survival among patients with BCLC stage 0-A disease. In patients with BCLC stage B disease, RFA conferred a survival benefit at 1 year and resection was associated with significantly improved survival at 5 years.As one of few studies to track the complete course of sequential HCC therapies, the findings of the present study suggest that HCC patients with intermediate-stage (BCLC stage B) disease may benefit from aggressive interventions not currently included in societal guidelines.
View details for DOI 10.1111/hpb.12214
View details for Web of Science ID 000339665600010
View details for PubMedID 24467780
View details for PubMedCentralID PMC4113259
Functional abdominal pain causing Scurvy, Pellagra, and Hypovitaminosis A.
2014; 3: 35
Severe vitamin deficiency disease is rarely seen in developed countries. We present an atypical case of a young man with scurvy, pellagra, and hypovitaminosis A, caused by longstanding functional abdominal pain that severely limited his ability to eat.
View details for DOI 10.12688/f1000research.3-35.v1
View details for PubMedID 24715978
View details for PubMedCentralID PMC3976101
A 13 year-old boy with post-transplantation lymphoproliferative disorder presenting with obscure gastrointestinal bleeding: a case report.
2014; 3: 88
One well recognized and potentially serious complication of chronic immunosuppression in organ transplant recipients is post-transplantation lymphoproliferative disorders (PTLD). This accounts for 20% of all malignancies in transplant recipients, which is four times higher than the general population (1,2). The diagnosis of PTLD is often difficult, due to various manifestations resulting in late diagnosis. We report an unusual presentation of PTLD in a pediatric patient where the diagnosis was achieved only after extensive investigation.
View details for DOI 10.12688/f1000research.3252.1
View details for PubMedID 25254098
View details for PubMedCentralID PMC4168743
Prospective study of risk factors for hepatitis C virus acquisition by Caucasian, Hispanic, and Asian American patients
JOURNAL OF VIRAL HEPATITIS
2012; 19 (2): E105-E111
Commonly known risk factors for infection with hepatitis C virus (HCV) include blood transfusion, injection drug use, intranasal cocaine use, and body tattoos. We hypothesized that Asian Americans infected with HCV may not identify with these established risk factors present in Caucasians and Hispanics, and our aim was to conduct a survey of risk factors in HCV-infected patients in these ethnic groups. In this prospective study, 494 patients infected with HCV completed a detailed risk assessment questionnaire at a liver centre in Northern California from 2001 to 2008. Among subjects participating in this study, 55% identified themselves as Caucasian, 20% as Hispanic, and 25% as Asian. Asian Americans were older, less likely to smoke or consume alcohol, and have a family history of cancer compared with Caucasians and Hispanics. The laboratory profiles were similar, and genotype 1 was the most common infection in all groups (74-75%). The great majority of Caucasians (94%) and Hispanics (86%) identified with commonly known risk factors, which was in contrast to 67% of Asians (P < 0.0001). The most common risk factors in Asians were blood transfusions (50%) and acupuncture (50%). Furthermore, 74% of Caucasians and 66% of Hispanics identified more than one major risk factor, while only 20% of Asians reported having more than one risk factor (P < 0.0001). Survey for established risk factors for acquisition of HCV may be more appropriate for risk assessment of Caucasians and Hispanics, but not for Asian Americans. These findings may guide the development of HCV screening in our increasingly diverse population.
View details for DOI 10.1111/j.1365-2893.2011.01513.x
View details for Web of Science ID 000299097400014
View details for PubMedID 22239506
- Epidemiology of Hepatitis A Virus and Hepatitis B Virus Infection in the United States. Year in Hepatitis Vaccinations. 2009; 3
- Community and Population Health. The Toronto Notes 2007: Comprehensive Medical Reference. Toronto Notes for Medical Students, Inc.. 2007; 23rd ed.
- Cultural Barriers to Initiating Insulin Therapy in Chinese Individuals with Type 2 Diabetes Living in Canada. Canadian Journal of Diabetes 2006; 30 (3): 390-396
- Lymphatic System and Lymph Nodes Exam. Essentials of Clinical Examination Handbook. The Medical Society, University of Toronto, Canada. 2006; 5th ed.: 115–122
- HIV/AIDS-Related Knowledge, Attitudes, and Practices of a Rural Community in Kep, Kingdom of Cambodia. University of Toronto Medical Journal 2005; 82 (2): 82-87
Estimating DNA repair by sequential evaluation of head and neck tumor radiation sensitivity using the comet assay
5th International Conference on Head and Neck Cancer of the International-Society-of-Head-Neck-Cancer
AMER MEDICAL ASSOC. 2002: 698–702
The alkaline comet assay is a microelectrophoretic technique for detecting single-strand DNA breaks, and may be used as an indirect measure of hypoxia by determining the radiation sensitivity of individual cells.To assess the ability of the comet assay to estimate the rate of DNA repair after irradiation in patients with head and neck cancer.The comet assay was used to evaluate DNA damage in fine-needle aspirates of lymph nodes containing metastatic squamous cell carcinoma in patients with head and neck cancer 1, 2, and 3 minutes after treatment with 500 rad (5 Gy) of irradiation. The amount of DNA damage (measured as the "tail moment" of the comet) is proportional to the number of DNA single-strand breaks after irradiation, which in turn depends on the oxygen concentration in each cell.The mean +/- SD of the median tail moment of the 1-minute postirradiation comets was 29.4 +/- 14.2 (n = 27). After 2 minutes, the mean median tail moment decreased to 25.4 +/- 13.6 (n = 25), representing a mean decrease of 11.9% in those patients with both 1- and 2-minute comet assays. Assuming a linear rate of repair, this decrease in DNA damage corresponds to a repair half-life of 4.2 minutes. A 3-minute assay was also performed on samples from a smaller number of patients (n = 9), with a mean value not significantly different from that of the 2-minute assay of the samples from this group.The comet assay is a promising tool for evaluating radiation sensitivity in individual cells. The rate of DNA repair early after irradiation is consistent with data in the literature.
View details for Web of Science ID 000176264300013
View details for PubMedID 12049567