🧵1/6
🚨 New from the British Society of Gastroenterology:
We analysed all UK colonoscopies from the National Endoscopy Database (2019–2020). That’s over 592,000 procedures. Findings below 👇
(📄 Free article link (limited time): https://t.co/Cp1UmqB0ru)
@goldstone_tony@HeldinEU@nhs_pensions But it might make sense atk wait a year for the recent pay increase of 8% to be ‘baked in’ to final salary calculation. which is ‘best of three’ last years. You’d have to live 12 years after retirement to see the gains, though!
How to identify the ‘sensory phenotype’ in bloating, and how to treat it:
Duloxetine, not SSRI, is best if diet and diaphragmatic breathing isn’t enough and pharmaceutical treatment needed
Kyle Staller, Mass General @DDWMeeting
What’s different between patients with bloating & normal controls?
Fernando Azpiroz, Hspital Val d’Hebron @DDWMeeting
Not amount of gas, or biomass.
It’s sensitivity to distension.
Perceived distension can be obesity, or descent of diaphragm (abdominophrenic dyssynergia)
Management of reflux @DDWMeeting
- hierarchy of management
- where to use PCABS for PPI-refractory reflux
-who are good candidates for an anti-reflux procedure
Not all FODMAPs are equal! Can we simplify FODMAP restriction in IBS-D?
Prashant Singh, Un of Michigan @DDWMeeting
FODMAP restriction difficult and can result in micronutrient malnutrition
In reintroduction phase, most symptoms due to fructans & galacto-oligosaccharides
Heather Patton, VA San Diego, CA @DDWMeeting
All patients with compensated cirrhosis should be subclassified as with or without Clinically Significant Portal Hypertension (CSPH)
- and pharmacotherapy used (eg carvedilol) to lower portal pressure
Note NEW terminology!
However, 40% of patients do not respond adequately to UDCA. Pruritus can be exacerbated by Obeticholic Acid - which can’t be used with decompensated cirrhosis. Elafibrinor, a PPAR agonist, shows promise and improves pruritus.
Don’t need endoscopy to screen for varices in patients with cirrhosis any more - Dr Willscott Naugler, Portland, ON @DDWMeeting
Concept of ‘Clinically significant Portal Hypertension’ - if > 10 mm Hg elevation is present, start on beta blockers to prevent varices, ascites