Lissa M Cruz

Gastroenterologist | Advanced Endoscopy Fellow

[Sociedad Española de Patología Digestiva (SEPD) @sepdigestiva]

Actualizaciones en lesión hepática inducida por fármacos (DILI) 💊⚠️
1️⃣ Evaluación
2️⃣ Nuevas causas identificadas
3️⃣ Escalas RUCAM y 🆕 RECAM
📸: https://t.co/KCS55Eo8FR

[Sociedad Española de Patología Digestiva (SEPD) @sepdigestiva]

Manejo del sangrado por úlcera péptica: actualización de las guías ESGE presentada en #ESGEDays2026 🩸🆕

📸: https://t.co/MexNYOKQDw

[Keith Siau @drkeithsiau]

PPIs: When to start and how to stop 💡

[Keith Siau @drkeithsiau]

Antidotes for anticoagulant reversal: June 2026 review in NEJM 🆕💊

📸: https://t.co/Hdplm5Gl1R

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Tips for Colon Polypectomy

I would also add: have clips and injector needles available, know how to perform a submucosal cushion, do not perform polypectomy in dirty colon

[Douglas G. Adler MD, FASGE, FACG, AGAF @DouglasAdlerMD]

Wild video of Hepatocellular Cancer (HCC) eroding into the duodenum. Note the uninvolved ampulla a few cm away. Patient presented with melena. #gitiwtter #surgery #hcc #hepatology

Have you seen a case like this one?

[Oliverio @LuisOliverio]

Las nuevas Guías Latinoamericanas de Pancreatitis Aguda (2026). Puntos importantes:

🟢 Cambio en el paradigma (gracias a WATERFALL Trial y otros): reanimación hídrica moderada a 1.5 ml/kg/h, con bolo SOLO en caso de haber hipovolemia franca.
🟢 No uses antibióticos profilácticos, solo en caso de necrosis pancreática infectada.
🟢 La CPRE es urgente (<24 horas) solo si hay colangitis aguda, sino no.
🟢 Menos es más; intenta diferir por lo menos 4 semanas la intervención de colecciones pancreáticas. Y si se necesita, idealmente endoscópico transluminal guiado por ultrasonido.
🟢 La hipertrigliceridemia es una causa (sobre todo si >500-1,000 mg/dL). El tratamiento: insulina en infusión.

Las voy a leer a fondo para actualizar las apps (https://t.co/FZoAsLTFc2).

[Douglas G. Adler MD, FASGE, FACG, AGAF @DouglasAdlerMD]

Zenker's diverticulotomy with an SB knife for dysphagia.

These procedures are literally life changing for these patients. They go from choking and sputtering to eating normally again.

Are you doing this in your practice?

#gitwitter #surgery #dysphagia #esophagus

[AJG - The American Journal of Gastroenterology @AmJGastro]

Vonoprazan High-Dose Dual, Vonoprazan Triple, and Rabeprazole Reverse Hybrid Therapies for First-Line Treatment of Helicobacter pylori Infection: A Multicenter Randomized Trial
Hsu &amp; Tai, et al.

📕 https://t.co/fuM2Ii7JIU

[Keith Siau @drkeithsiau]

Diagnosis and management of gastric
premalignant conditions - summary of ACG 2025 guidelines 📍

[Keith Siau @drkeithsiau]

Is it possible to get diarrhoea symptoms after gallbladder surgery?

The answer is yes - it’s called bile acid diarrhoea (BAD) and it’s more common than we think.

[Keith Siau @drkeithsiau]

Updates in Drug Induced Liver Injury 💊⚠️

1️⃣ Assessment
2️⃣ Newly identified causes
3️⃣ RUCAM and 🆕 RECAM scores

📸: https://t.co/Qm78H4I4Ii

[Lissa M Cruz @LM_CruzMD]

Thankful for this award in the research of incidental oncological lesions at digestive disease week

[Mohsen Subhani @MohsenSubhani]

Gastric polyps

When do you perform polypectomy?
&amp;
When to take biopsy?

Latest AGA guidelines

@smkahlon @SyedGerdezi @helpatologist @SN_gastro @AmerGastroAssn @BritSocGastro @my_ueg @AGA_Gastro

[Keith Siau @drkeithsiau]

The OCULUS trial settles the longstanding debate: whether to continue to hold GLP-1/GIP agonists like Mounjaro before upper endoscopy. These were the results👇

📸: https://t.co/UIcNCAs1m3

[Dr. Chokri Ben Lamine @abouabdrahman0]

📊 FibroScan Interpretation — Quick Pearls

🟢 Liver Stiffness (kPa) = Fibrosis Stage
➡️ F0–F1 🟢 → No / Mild fibrosis
➡️ F2 🟡 → Moderate fibrosis
➡️ F3 🟠 → Advanced fibrosis
➡️ F4 🔴 → Cirrhosis

📌 Cutoffs (approx):
🟢 ~7 kPa → F1
🟡 ~9.5 kPa → F2
🟠 ~12.5 kPa → F3
🔴 >12.5–14+ kPa → F4 (cirrhosis range increases progressively)

⚠️ Interpretation caveats:
🔸 Inflammation ↑ → falsely ↑ stiffness
🔸 Cholestasis / congestion → falsely ↑
🔸 Post-prandial state → ↑ readings → fast ≥3h

🟡 CAP Score (dB/m) = Steatosis
➡️ 238–260 → S1 🟡 (11–33% fat)
➡️ 260–290 → S2 🟠 (34–66% fat)
➡️ >290 → S3 🔴 (≥67% fat)

📌 Clinical use:
🧠 Combine stiffness + CAP → fibrosis + steatosis phenotype
🧪 Always correlate with ALT/AST, platelets, imaging, etiology

🚨 High-risk flags:
🔴 F3–F4 → screen for portal HTN + HCC
🔴 Rapid rise → reassess cause (flare, congestion, drug)

#FibroScan #Hepatology #LiverFibrosis #NAFLD #Cirrhosis #KFSHRC

[Gastroenterology @AGA_Gastro]

🌟Hot off the press! Our newest special issue introduces an enhanced global conceptualization of disorders of gut–brain interaction from the Rome Foundation.

📖Browse the issue here: https://t.co/lNmQChnbyE

#GutBrainAxis #Neurogastroenterology #DGBI

[Keith Siau @drkeithsiau]

Chickenpox-like lesions within the colon. What goes through your mind?

[AJG - The American Journal of Gastroenterology @AmJGastro]

Postcolonoscopy Colorectal Cancer in Fecal Immunochemical Test-Positive Individuals: Prevalence, Predictors, and Root Cause Analysis in a Nationwide Cohort
Wilson &amp; Bilal, et al.

📕 https://t.co/KyA4VVIr6k

@nataliejowilson @BilalMohammadMD @MLongMD @JasmohanBajaj

[GIE @GIE_Journal]

In Articles in Press: "Accuracy of Virtual Scale Endoscopy in colorectal polyp size measurement: Grading of Recommendations Assessment, Development and Evaluation–assessed pairwise and network meta-analysis" by Elgendy et al. https://t.co/QdSHQaRVjQ

@DouglasAdlerMD @Babupmohan2