Phil Smith

Views entirely my own and do not represent anyone else. RT does not mean agree. Apologies for typos.

[Phil Smith @PhilSmithIsBack]

Back for a time limited period only.

[Frontline Gastro @FrontGastro_BMJ]

🚨 Liver transplantation after emergency admission for CLD: who gets access?

This nationwide English study of 82,402 patients with a first emergency admission for chronic liver disease found:

⚠️ 37.8% died within 1 year
🫀 Only 0.64% received liver transplantation
📉 Most deprived patients had ~half the transplant rate of the least deprived
🏥 Admission to a hospital with a transplant unit was associated with markedly higher LT use
🍷 LT rates were lowest in alcohol-related liver disease

🔗 https://t.co/isxujgpFCm

#FrontlineGastroenterology #Hepatology #LiverTransplant #Cirrhosis #HealthInequalities #LiverTwitter

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BASLedu @BSGtrainees @WorldGastroOrg @ulstergastro @pancreatitis_nl @SEEDendoscopia @EASLedu @AmCollegeGastro @Aegastro @SAGES_updates @WAGE_media @my_UEG @amergastroassn @NASPGHAN @UHSEndoscopy @ESGE_news @amergastroassn @BritSocGastro @ASGEendoscopy

[Frontline Gastro @FrontGastro_BMJ]

🟢 Optimising ERCP for CBD stones

Common bile duct stones are one of the commonest reasons for ERCP — but patient selection and procedural planning matter.

This practical review highlights:

🔎 Confirm stones first
MRCP / EUS / same-session EUS-ERCP where appropriate

⚠️ Anticipate difficult stones
Large >15 mm | multiple | impacted | unfavourable anatomy

🎯 Aim for first-session clearance
EPLBD | mechanical lithotripsy | cholangioscopy-guided lithotripsy

🏥 Refer complex cases early
Regional ERCP networks + MDT planning can reduce repeat procedures

🔗 https://t.co/ukNkyhQGPT

#FrontlineGastroenterology #ERCP #Endoscopy #Biliary #Gastroenterology

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BASLedu @BSGtrainees @WorldGastroOrg @ulstergastro @pancreatitis_nl @SEEDendoscopia @EASLedu @AmCollegeGastro @Aegastro @SAGES_updates @WAGE_media @my_UEG @amergastroassn @NASPGHAN @UHSEndoscopy @ESGE_news @amergastroassn @BritSocGastro @ASGEendoscopy

[Frontline Gastro @FrontGastro_BMJ]

Bariatric metabolic endoscopy in 2026 and beyond — where is the field heading? ⚖️🔎

This new @FrontGastro_BMJ review explores the evolving role of bariatric metabolic endoscopy, from endoscopic weight-loss therapies to metabolic disease management and the future interface between endoscopy, obesity medicine and surgery. 🧬🩺

A timely read for anyone interested in therapeutic endoscopy, obesity care and innovation.

Read more: https://t.co/WDjamyhZTa

#BariatricEndoscopy #MetabolicEndoscopy #ObesityMedicine #TherapeuticEndoscopy #Endoscopy #FrontlineGastro #GItwitter #Gastroenterology #Innovation #ClinicalPractice @medicalreg @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @ESGE_news @drkeithsiau @DrOmerAhmad @Dunnepdj @shraddha_gulati @CardiffGastro @DrBuHayee @poodocnisha @Sharm_Sub @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @zare_benjamin @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

ACLF recovery: is discharge hepatic reserve more informative than admission severity? 🏥🧬

In @FrontGastro_BMJ, this new paper tackles the ACLF paradox, showing why what remains at discharge may matter more than how sick the patient was at presentation. 📊🔎

Important reading for hepatology teams thinking about prognosis, recovery trajectories and post-discharge risk.

Read more: https://t.co/kFzZCx8beZ

#ACLF #Hepatology #LiverFailure #Cirrhosis #Prognosis #FrontlineGastro #GItwitter #LiverTwitter #ClinicalResearch #PatientOutcomes @KGananandan @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @EASLnews @AASLDtweets @DrLChina @acv69cardenas @GeriKeane @jamesbmaurice @drobeirne @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

Therapeutic upper GI endoscopy is moving fast — what’s new? 🚀🔦

Part 1 of this new @FrontGastro_BMJ update reviews advances in therapeutic upper GI endoscopy, highlighting emerging techniques, evolving indications and the expanding role of endoscopists in complex upper GI care. 🧑‍⚕️📸

A great read for anyone keeping up with innovation at the sharp end of endoscopy.

Read more: https://t.co/qbEkZmOnOk

#UpperGI #TherapeuticEndoscopy #Endoscopy #EndoscopyInnovation #Gastroenterology #FrontlineGastro #GItwitter #EndoscopyTraining #MedEd #ClinicalPractice @anjan_dhar6 @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @ESGE_news @drkeithsiau @DrOmerAhmad @Dunnepdj @shraddha_gulati @CardiffGastro @DrBuHayee @poodocnisha @Sharm_Sub @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

ERCP guideline adherence: how we measure it matters. 🧭🔎

This letter in @FrontGastro_BMJ explores methodological considerations in assessing guideline adherence in ERCP practice for common bile duct stones — reminding us that audit, benchmarking and quality improvement depend on getting the definitions right. 📊✅

A thoughtful read for anyone working in ERCP quality, biliary endoscopy and service evaluation.

Read more: https://t.co/yNLWpHPnpe

#ERCP #Choledocholithiasis #BiliaryDisease #Endoscopy #QualityImprovement #FrontlineGastro #GItwitter #Gastroenterology #ClinicalGuidelines #MedEd @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @ESGE_news @drkeithsiau @DrOmerAhmad @Dunnepdj @shraddha_gulati @CardiffGastro @DrBuHayee @poodocnisha @Sharm_Sub @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

EUS-guided cystogastrostomy in young children — feasible, safe and effective? 🧒🔬

This new @FrontGastro_BMJ retrospective analysis and systematic review examines EUS-guided cystogastrostomy in young paediatric patients, adding valuable evidence for managing pancreatic fluid collections in specialist centres. 🧩🏥

A key read for paediatric gastroenterology, HPB and advanced endoscopy teams.

Read more: https://t.co/6NIXBIJeqb

#EUS #Cystogastrostomy #PaediatricGastroenterology #PancreaticFluidCollections #Endoscopy #FrontlineGastro #GItwitter #Gastroenterology #HPB #ClinicalResearch @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @ESGE_news @ESPGHANSociety @NASPGHAN @drkeithsiau @DrOmerAhmad @Dunnepdj @shraddha_gulati @CardiffGastro @DrBuHayee @poodocnisha @Sharm_Sub @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

Diarrhoea and abdominal pain — routine presentation, or something more? 🧩🩺

This “Inside view” case in @FrontGastro_BMJ takes readers through a patient presenting with diarrhoea and abdominal pain, using clinical clues to sharpen diagnostic reasoning and avoid premature closure. 🔎📋

A great teaching read for gastroenterologists, trainees and anyone who enjoys a diagnostic challenge.

Read more: https://t.co/yaRI3av6XY

#Diarrhoea #AbdominalPain #DiagnosticChallenge #Gastroenterology #CaseReport #FrontlineGastro #GItwitter #ClinicalMedicine #MedEd @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @ESGE_news @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

Anorectal HSV in MSM: what should GI clinicians recognise? 🦠🔎

This systematic review in @FrontGastro_BMJ examines ano-rectal herpes simplex virus in men who have sex with men, highlighting symptoms, diagnostic considerations and relevance for gastroenterology, proctology and sexual health practice. 🩺💬

Important reading when assessing proctitis, anorectal pain or ulceration.

Read more: https://t.co/2BGJtBAlP9

#HSV #Proctitis #SexualHealth #MSM #InfectiousDiseases #FrontlineGastro #GItwitter #Gastroenterology #ClinicalPractice #MedEd @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @ESGE_news @BASHH_UK @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

Hepatitis B care keeps evolving — are you up to date? 🦠🧬

This @FrontGastro_BMJ update covers what’s new in Hepatitis B, from changing concepts in monitoring and treatment to practical implications for hepatology and gastroenterology clinics. 🩺📋

A concise refresher for anyone managing chronic viral hepatitis in modern liver practice.

Read more: https://t.co/fvhrpZvoQJ

#HepatitisB #HBV #ViralHepatitis #Hepatology #LiverDisease #FrontlineGastro #GItwitter #LiverTwitter #ClinicalPractice #MedEd @druppygill @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @EASLnews @AASLDtweets @DrLChina @acv69cardenas @GeriKeane @jamesbmaurice @drobeirne @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

Pancreatic cancer in 2021 — and the growing concern around early-onset disease. 📈🧬

This @FrontGastro_BMJ epidemiology paper examines pancreatic cancer and early-onset pancreatic cancer, highlighting patterns that matter for prevention, awareness and future research. 🔎📊

Important reading for clinicians and researchers tracking changing cancer burden across age groups.

Read more: https://t.co/4tzPEbncKW

#PancreaticCancer #EarlyOnsetCancer #CancerEpidemiology #HPB #Gastroenterology #FrontlineGastro #GItwitter #CancerResearch #PublicHealth #ClinicalResearch @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @ESGE_news @PancreaticCanUK @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

Hepatology at home — can hospital-level liver care be delivered safely beyond hospital walls? 🏠🩺

This @FrontGastro_BMJ paper describes a novel integrated pathway for managing patients with liver disease at home, sharing early experience from a service designed around patient-centred, multidisciplinary care. 🚑📋

A timely read for teams rethinking acute hepatology, virtual wards and care closer to home.

Read more: https://t.co/Ufw1gbo5vI

#Hepatology #LiverDisease #HospitalAtHome #VirtualWard #IntegratedCare #FrontlineGastro #GItwitter #LiverTwitter #PatientCentredCare #ClinicalService @TamCarg @DanLasserson @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @EASLnews @AASLDtweets @DrLChina @acv69cardenas @GeriKeane @jamesbmaurice @drobeirne @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

MASLD education: can a structured group programme improve understanding and engagement? 📚🍏

In @FrontGastro_BMJ, this prospective evaluation reports real-world experience of an AHP-led group education programme for people with metabolic dysfunction-associated steatotic liver disease. 🧑‍⚕️💬

A practical example of empowering patients and embedding lifestyle support into liver care pathways.

Read more: https://t.co/K9RZVZxe1w

#MASLD #MetabolicLiverDisease #PatientEducation #LifestyleMedicine #Hepatology #FrontlineGastro #GItwitter #LiverTwitter #ClinicalNutrition #PatientCentredCare @HallsworthKate @stumcp @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @EASLnews @AASLDtweets @BAPENUK @DrLChina @acv69cardenas @GeriKeane @jamesbmaurice @drobeirne @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

Liver transplant care at a distance: networks matter. 🌍🏥

This @FrontGastro_BMJ review explores how networked models can support patients who live far from transplant centres, helping deliver specialist input, shared care and equitable access across geography. 🤝🩺

Essential reading for hepatology teams thinking about regional pathways, outreach and post-transplant care.

Read more: https://t.co/FSvURcjVLU

#LiverTransplant #Hepatology #TransplantMedicine #ClinicalNetworks #SharedCare #FrontlineGastro #GItwitter #LiverTwitter #PatientAccess #HealthcareEquity @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @EASLnews @AASLDtweets @DrLChina @acv69cardenas @GeriKeane @jamesbmaurice @drobeirne @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

🚨 New in Frontline Gastroenterology

Are GLP-1 receptor agonists safe and effective in patients with IBD?

This systematic review & meta-analysis of 23 studies including >150,000 patients found GLP-1 RAs were associated with:

⬇️ BMI
⬇️ IBD-related surgery
⬇️ IBD-related hospitalisation
✅ No signal of IBD worsening

GI adverse effects remain important, with discontinuation reported in 11–24% of patients.

An important and timely synthesis as obesity and metabolic disease become increasingly relevant in IBD care.

🔗 https://t.co/y4TofrJktM

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BSGtrainees @WorldGastroOrg @ulstergastro @SEEDendoscopia @AmCollegeGastro @Aegastro @SAGES_updates @WAGE_media @my_UEG @amergastroassn @NASPGHAN @UHSEndoscopy @ESGE_news @amergastroassn @BritSocGastro

[Frontline Gastro @FrontGastro_BMJ]

🚇 Mind the gap in IBD transition care

How do adolescents with IBD — and their parents — experience preparation for transfer to adult services?

Using the validated Mind the Gap questionnaire, this study found:

👦 Adolescents: moderate overall satisfaction
👨‍👩‍👧 Parents: greatest gap = care environment
✅ Provider characteristics rated most positively
📋 Structured patient/parent-reported measures can guide service improvement

🔗 https://t.co/izkhezJbBt

#FrontlineGastroenterology #IBD #PaediatricGI #TransitionCare #Gastroenterology

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BSGtrainees @WorldGastroOrg @ulstergastro @SEEDendoscopia @AmCollegeGastro @Aegastro @SAGES_updates @WAGE_media @my_UEG @amergastroassn @NASPGHAN @UHSEndoscopy @ESGE_news @amergastroassn @BritSocGastro @ASGEendoscopy @ESPGHANSociety
@BSPGHAN

[Frontline Gastro @FrontGastro_BMJ]

Checkpoint inhibitors and cholangiopathy — a rare toxicity worth recognising early. 🧬🧪

This @FrontGastro_BMJ paper explores checkpoint inhibitor-induced cholangiopathy, an important phenotype of immune-related liver injury that can challenge diagnosis, monitoring and management. 🔎🩺
A valuable read for hepatology, oncology and acute GI teams seeing patients on immunotherapy.

Read more: https://t.co/dpoqDVLr4t

#CheckpointInhibitors #Cholangiopathy #Hepatology #Immunotherapy #LiverInjury #FrontlineGastro #GItwitter #LiverTwitter #Oncology #ClinicalResearch @EdmondAtallah @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @EASLnews @AASLDtweets @DrLChina @acv69cardenas @GeriKeane @jamesbmaurice @drobeirne @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

IBS symptoms — or could this be endometriosis? 🤔🌸

In @FrontGastro_BMJ, this practical guide gives gastroenterologists tips on when to suspect endometriosis in patients labelled with IBS, especially where pain patterns, cyclical symptoms or treatment response do not quite fit. 🧠🩺

A useful reminder that gut symptoms can cross specialty boundaries — and patients benefit when we ask the right questions.

Read more: https://t.co/UkhLMchy7B

#IBS #Endometriosis #DGBI #PelvicPain #GutBrainAxis #FrontlineGastro #GItwitter #Gastroenterology #WomensHealth #ClinicalPractice @overdotdot @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @ESGE_news @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

Nutrition in cirrhosis: practical, powerful and too often under-prioritised. 🍽️🧡

This @FrontGastro_BMJ review offers a practical approach to nutrition in people with cirrhosis — from screening and sarcopenia to protein targets, late evening snacks and multidisciplinary support. 💪🩺
Essential reading for hepatology teams aiming to make nutrition a core part of liver care.

Read more: https://t.co/zIH44ZGKEv

#Cirrhosis #Nutrition #Sarcopenia #Hepatology #ClinicalNutrition #FrontlineGastro #GItwitter #LiverTwitter #DietitianTwitter #PatientCentredCare @bhmullish @lukelikeslivers @ImperialNHS @imperialcollege @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @EASLnews @AASLDtweets @BAPENUK @DrLChina @acv69cardenas @GeriKeane @jamesbmaurice @drobeirne @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman

[Frontline Gastro @FrontGastro_BMJ]

Centrally mediated GI pain: when symptoms are severe, persistent and hard to treat 🧠🩺

This practical review in @FrontGastro_BMJ offers a structured approach to managing patients with centrally mediated disorders of gastrointestinal pain — from diagnosis and communication to multidisciplinary, biopsychosocial care. 💬🧩

Essential reading for clinicians managing complex DGBI and chronic abdominal pain.

Read more: https://t.co/JdH2iaDxpS

#DGBI #GutBrainAxis #ChronicPain #AbdominalPain #Neurogastroenterology #FrontlineGastro #GItwitter #Gastroenterology #PatientCentredCare #ClinicalPractice @joostalgera @tom_vangils @hanstornblom @BritSocGastro @my_UEG @AmCollegeGastro @DDWMeeting @ESGE_news @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman