A beautifully written piece
In an era where clinical medicine has been relegated to a floor of competency instead of a asymptote of mastery, this is a fitting reminder of the beauty of our craft.
The Thing Itself: Medicine as Craft - Gastroenterology https://t.co/TWkfWIHMYW
Here are some of the highlights ‼️
1️⃣ Where to take photos
2️⃣ How to describe lesions
3️⃣ Barrett’s assessment
4️⃣ Gastric intestinal metaplasia
📸: @FrontGastro_BMJ
https://t.co/dW3kKoS1p3
A MUST-READ!
This is probably one of my most important papers where I try to teach how to fish rather than offer fish.
How I Read a Clinical Trial Report?
BG’s primer for Busy Clinicians.
Thank you @JCOOP_ASCO@EthicsdoctorP for the kind invitation. I hope the readers will find this useful.
https://t.co/HJhZlsBpU2
A very evocative piece by @jenna_taglienti
Beautiful writing
"The meaning of my work is profound.
The meaning of my presence at home is irreplaceable."
If there was one article you want to read as a clinician?
Read this
Via @jenna_taglienti - an absolutely stunning write in @JAMA_current
"Medicine can have extraordinary meaning. But it cannot substitute for being present in your own life. The world may need us as physicians.
But the people who love us need us as ourselves.
And that is the role no one else can fill."
Brilliant - and much love to you
'Time is Finite"
https://t.co/qPJkmtwxUe
Differentiating Intestinal Tuberculosis from Crohn's Disease
Challenging to Differentiate ITB from CD
· Microbiological test sensitivity is limited:
o AFB stain: 5.3 – 37.5%
o AFB culture: 23-46%
o PCR: 36.4 – 67.9%
· ITB cannot be confidently excluded even with negative results
🩸📉 Is the cancer risk in iron deficiency anaemia still as high as we think?
In this large single centre audit of 1253 consecutive referrals, the prevalence of gastrointestinal malignancy in fully investigated IDA has fallen to 5.6%, reinforcing the case for smarter risk stratification rather than automatic invasive investigation for all.
Prior colonic imaging within 5 years was associated with very low colon cancer yield, and long term proton pump inhibitor exposure showed a strong negative association with GI cancer risk.
🔎 The updated analysis suggests that adding PPI status may improve the predictive performance of the IDIOM score, though prospective validation is needed.
A timely contribution to the risk stratification debate in IDA pathways.
https://t.co/mJ05WrPycI
@PhilSmithIsBack@OTavabie@dr_aditi_kumar@TrevorTabone@eathar_s@IrenePerezMD@KGananandan@zare_benjamin@medicalreg@dtleiberman@BritSocGastro@BSGTrainees@Dukes_Club
We probably need to stop ERCPing every bole duct stone
Contrary to current paradigm of "no stome left behind" this @AGA_CGH retrospective propensity matched study shows that older adults with unsymptomatic choledocholithiasis fared better WITHOUT an ERCP
interesting read
So many wonderful insights and observations from Willem Bemelman after a 30 year career doing #IBD surgery at AMC. One of the truly great IBD surgeons that has thought so deeply about IBD pathophysiology.
Some points he made:
1. Fecal stasis is a big clue. We see inflammation in these areas such as the rectum, TI, appendix, blind limbs, etc.
2. Complicated disease is often the result of late diagnosis or suboptimal treatment.
3. High uncontrolled inflammatory burden leads to structural damage which is nearly impossible to reverse currently. Reducing the burden as early and effectively as possible is key. This can be done by surgery or medication.
3. Wound healing/repair is defective in CD as one can observe by anastomotic ulceration that we see much less frequently in other settings.
@mantaj_brar@AnthonydeBuck@SunHoLee15@ZaneCohenCentre@AntoninoSpin@pakotze
5
💊 Step 1 — Iron therapy comes first
Never start ESAs before correcting iron.
Start iron if:
💉 HD patient → Ferritin ≤500 & TSAT ≤30%
💊 Non-dialysis/PD → Ferritin <100 (TSAT <40%) or Ferritin 100–300 (TSAT <25%)
Why? EPO won’t work without iron substrate.
KDIGO calls this the “Iron First” approach.
A Long Obedience in the Same Direction
"In a world of scrolls and swipes, where distraction is currency and speed is king, staying faithful to any meaningful path is revolutionary. Because that’s where the gold is buried. That’s where meaning is found."
https://t.co/5El7AQwkiw
1/5
Iron Balance: The Math Behind Dietary Deficiency
Iron balance depends on one thing: how much you absorb vs how much you lose.
Losses ≈ 1 mg/day in men, 1.5–2 mg/day in menstruating women.
Absorption depends on what and how you eat.
Congratulations the 2025 #GoldenScope winners! They competed in the semi-finals this past weekend at ASGE IT&T, beating 65 teams. Way to go! Pictured in order: 1st place: Singapore General Hospital, 2nd place: Baylor College of Medicine & 3rd place: Cleveland Clinic. #GIFellows
Differentiating Intestinal Tuberculosis from Crohn's Disease
Challenging to Differentiate ITB from CD
· Microbiological test sensitivity is limited:
o AFB stain: 5.3 – 37.5%
o AFB culture: 23-46%
o PCR: 36.4 – 67.9%
· ITB cannot be confidently excluded even with negative results
Conclusion
1) Common symptoms (e.g. abdo pain, weight loss, anaemia) poorly differentiate ITB from CD
2) Strong predictors (e.g. perianal disease, EIMs, lung lesions, specific endoscopic features) have high diagnostic value but are uncommon (<50% of pts)
cont