Gastroenterologist/Hepatologist and Co-Director of Research, Digestive & Liver Disease Specialists, Norfolk; Professor of Medicine, Eastern Virginia Medical School
For more than three decades, Dr. Michael Ryan has been a fixture in the fields of gastroenterology and hepatology in Hampton Roads, as a dedicated physician, leading professor and nationally prominent researcher.
Dr. Ryan, who co-founded the Norfolk-based Digestive & Liver Disease Specialists in 1987, has both built a major medical practice and contributed to several medical breakthroughs that have transformed his specialty, most notably a cure for hepatitis C.
Today, his goal is to write similar success stories for other chronic liver and digestive diseases, including hepatitis B, nonalcoholic fatty liver disease, primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), Crohn’s disease, ulcerative colitis and more.
At any given time, Digestive & Liver Disease Specialists’ research department has 30 to 40 ongoing clinical trials, often working in partnership with major pharmaceutical companies such as Gilead, GlaxoSmithKline, Merck and Pfizer. The non-alcoholic steatohepatitis (NASH) team alone has three research coordinators.
“We solved hepatitis C, and we’re not stopping there,” Dr. Ryan says. “Conditions such as NASH will be more difficult because they have many different molecular pathways. There are, however, many possibilities for treatments in development. It will take several years for FDA-approved medication to become available, but we will get there. We are making constant progress. I expect the first wave of medications to be approved in late 2019.”
Dr. Ryan, who is Fellowship-trained in his specialty and Board-certified in internal medicine, gastroenterology and transplant hepatology, has longtime privileges at Sentara Leigh and Sentara Norfolk General hospitals. He is an award-winning clinical professor at Eastern Virginia Medical School and a frequent lecturer locally and nationwide. Recent honors include the Sentara Southgate Leigh Outstanding Physician Award for 2017 and the 2018 Mason Edwards Award, given to “the medical staff member who has made a significant contribution to education both in the hospitals and the community.”
As a researcher, Dr. Ryan has authored or co-authored numerous articles in prominent medical journals, starting with his fellowship study on the once-doubted notion of reversing hepatic fibrosis. His practice of eight physicians, which operates as a division of Gastrointestinal & Liver Specialists of Tidewater, PLLC, also is heavily involved in preventative care, including promoting colonoscopies and helping to develop Cologuard, the non-invasive prescription screen.
After running several trials on the direct-acting antivirals that now can erase hepatitis C in 99.7 percent of cases, Dr. Ryan is passionate about educating primary care physicians on the critical need to screen patients and, if necessary, oversee the simple 8- to 12-week treatment protocol. He has served as Co-Director of the American Gastroenterological Association awareness committee on hepatitis C, acting as an advisor to the CDC.
“The problem is that 50 percent of people who have hepatitis C in the United States still don’t know it,” he notes. “In addition, the majority of patients identified with it are not being treated. It has resulted in more deaths than HIV over the past decade and increases the risk for non-liver disease such as cardiovascular and renal disease as well.”
A New York City native, Dr. Ryan was interested in science and medicine by late elementary school. By the time he was a freshman at Fordham University, he was teaching high school biology students in summer programs.
At the Johns Hopkins School of Medicine, Dr. Ryan originally planned to go into orthopaedics. However, he found himself drawn to the university’s liver and gastroenterology specialists, particularly Dr. Willis Maddrey, who would direct him to Yale New Haven Hospital for his combined GI/Hepatology fellowship.
NASH, which affects an estimated 8 percent of the America population, is an obvious research focus today. Largely due to rising obesity rates and unhealthy American diets, fatty liver diseases are soon to become the No. 1 cause of liver failure and transplants. They also cause primary cancer of the liver (hepatocellular carcinoma), which has now become the fifth-leading cause of cancer deaths in men and the eighth in women in the United States.
“I am optimistic that we will have effective medications in the next couple of years, as there are numerous compounds in development,” Dr. Ryan says. Probiotics also could play an important role in treatment, he adds.
New therapies have come on the market for PBC as well, he notes, while some animal models have produced positive results for trial PSC medications. In gastroenterology, the JAK Inhibitor shows promise for inflammatory bowel disease; Tofacitinib, sold under the brand name Xelijanz, has been approved for ulcerative colitis and may be an option for Crohn’s disease. So could the drug Filgotinib.
“It’s truly an exciting time in the field, with a lot of reasons to be confident that we are making headway against these devastating illnesses,” Dr. Ryan says.
Dr. Ryan is equally committed to educating the next generation of physicians, continuously working with internal medicine and family practice students at EVMS and teaching a monthly gastroenterology elective. As a provider, he is regularly named on best-of lists for regional physicians.
“Back 30 years ago, we really had almost no treatments for liver disease,” he says. “We have made so many advances since then, but we still have a great deal of research to do.”