Ali Jaan

GI fellow @SouthwestCares. Former PGY-4 Chief Resident @rocregional. KEMU alumnus.

[Gastroenterology @AGA_Gastro]

⭐ Up to one-third of patients with #IBD in remission have IBS-like symptoms. A new Rome Foundation–IOIBD consensus defines this phenotype and outlines diagnostic and treatment strategies: https://t.co/w2GcoHzyZq

[Asad ur Rahman, MD, FACP, FACG @AsadurRahman87]

@APGNA1 and @appnaypc collaboration

[APPNA YPC @appnaypc]

We continue with our series. Next up is a session with APGNA on how to stand out as a fellowship candidate especially in competitive fields.

📆 Mar 29, 2026
🕕 11:00 AM CST

Register for this webinar:
https://t.co/4mfiAlXGxX

#GITwitter #MedTwitter

[Hanna Blaney, MD, MPH @BlaneyMD]

Many patients with cirrhosis or AH get cross-sectional imaging in the ED, with a lot of this imaging suggestive of "enteritis" or "colitis," with evidence of enteric/colonic wall thickening.
Many reflexively treat with cipro/flagyl, regardless of symptoms.

🛑
⤵️ (1/2)

[Johnson Thomas, MD, FACE @JohnsonThomasMD]

Liver fibrosis is often silent until it's advanced. How can we screen for it without immediate imaging or biopsies?
Enter the FIB-4 Score.
A quick tutorial on the most useful non-invasive screening tool for liver disease (especially MASLD/NAFLD). 🧵👇 #LiverHealth #MedEd #PrimaryCare

What is FIB-4? It's a calculated score that estimates the degree of liver scarring.

The beauty is its simplicity. You only need 4 routine clinical values:

1️⃣ Age 2️⃣ AST (liver enzyme) 3️⃣ ALT (liver enzyme) 4️⃣ Platelet Count

No fancy labs required. 🩸

Think of FIB-4 as a Triage Tool, not a diagnostic cannon.

Its greatest strength is its "Negative Predictive Value." It is excellent at RULING OUT advanced fibrosis. It helps identify low-risk patients who don't need expensive referrals or specialized testing right now.

How to interpret the score (Standard ages 35-65):

🟢 < 1.30 (Low Risk): High probability of no advanced fibrosis. Re-assess in 2-3 years. 🟡 1.30 – 2.67 (Indeterminate): The "Grey Zone." Needs a second look (e.g., FibroScan). 🔴 > 2.67 (High Risk): Suggests advanced fibrosis/cirrhosis. Refer to Hepatology.

⚠️ Important Clinical Pearl:

Age is part of the formula. Older patients naturally score higher, leading to false positives.

For patients aged > 65, the "Low Risk" rule-out threshold is raised to < 2.0 (instead of 1.30). Don't over-refer your older patients!

Summary: ✅ FIB-4 uses routine labs to triage liver risk. ✅ Great at ruling OUT disease (<1.30). ✅ Adjust the cut-off for age >65 (<2.0). ✅ High scores need specialist workup.

[Aimen Farooq @AimenKhanMD]

@MondayNightIBD @DaniyalRaza92 @DrJordanAxelrad @HelmsleyTrust @CrohnsColitisFn @nyulangone @MSHS_IBDCenter @DOMSinaiNYC @MSKCancerCenter @JosephHabibi_MD #IBDAlgorithm
Management of #IBD when there is concern for #malignancy  

📊 IBD associated with ⬆️ risk of cancers
⚖️ IBD therapy-associated CA w risk of undertreating 🔥
🎯 Optimizing IBD control w least systemic immumosuppressiom

🗳️PostConvo polls👇(Answers in #IBDAlgo😉)

[Elliot Tapper @ebtapper]

Ammonia is a liver function test

https://t.co/pdBGjkcqjy

[Aasma Shaukat MD MPH @AasmaShaukatMD]

Practical updates in Metabolic liver dz @AmCollegeGastro by expert &amp; leader @KanwalFasiha

📋Nomenclature MASH, metALD &amp; SLD are on a spectrum
📋Alochol use underreported for metALD
📋Resmitrom and Semaglutide for F2-3 MASH
📋GLP1-RAs role in MetALD?🧐

@BCMDeptMedicine

[Ramon Bataller @rabataller]

📊 How to interpret PEth blood levels for recent alcohol intake?

Here’s a concise &amp; practical table to guide you.

[Shrinivas Bishu @IBDimmunology]

non-invasive detection of post-op #CD. What’s your go-to?

✅@AGA_CGH SR/MA

2 interesting points

▶️recurrence rate is highly-variable 21-98%! Why?

▶️IUS looks GREAT - but I have Q’s about this…..(see next tweet)

https://t.co/yOpEDLDvH2

[Ali Jaan @Ali_jaanMD]

Steroid tapering in UC: Is a 6-week steroid taper as effective as a 10-week taper in UC?

• ✅ 10-week taper (vs. 6-week taper inferior) → higher steroid-free remission at 6 months with comparable relapse rates and adverse effects

👉 Bottom line: 10-week taper works better.

[Vishal Sharma @drvishal82]

❓How fast should we taper steroids in Ulcerative Colitis?

Longer taper (10 weeks) better than a shorter course (6 weeks)

- Balancing relapse vrs adverse effects
- Setting of 5-ASA + Thiopurine use
- Probably not applicable to advanced therapy

https://t.co/gCqnyk9Uvl

[Mariam Naveed, MD, FACG @MN_GIMD]

Day 2 of @AmCollegeGastro 2nd Year Fellows Course agenda is packed with high yield topics!

Starting off with a phenomenal talk by
@ebtapper breaking down “Portal Hypertension”

Some high-yield pearls:
⭐️Treat ascites to improve survival and quality of life
⭐️Sodium restriction alone often fails and worsens malnutrition
⭐️Diuretics work when dosed correctly and monitored
⭐️Build systems: paracentesis clinics reduce harm
⭐️HE is common, underrecognized, and treatable
⭐️Lactulose = induction dosing when admitted with HE, not just aiming for 2-3 BMs per day 
⭐️Rifaximin reduces recurrence
⭐️TIPS works in the right patient: good kidneys, heart, bilirubin, minimal HE

[Elliot Tapper @ebtapper]

When used wisely albumin can help patients with cirrhosis says the best meta-analysis on this in @HepCommJournal

https://t.co/wKMh5zoXHw

But these trials are small and misuse - SO COMMON - outside of trials is harmful. How to thread the needle?

[Keith Siau @drkeithsiau]

Masterclass review on functional dyspepsia - via @Prof_NickTalley (NEJM 2026)

1️⃣ Pathophysiology ⚙️
2️⃣ Differentials 🤔
3️⃣ When to investigate 🔦
4️⃣ Medical management 💊

📸: https://t.co/RWr0NyKUQh

[John Damianos, M.D. @john_damianosMD]

A fasting-mimicking diet induced clinical response and remission significantly more than usual diet in open-label trial of patients with mild-moderate Crohn disease.

https://t.co/l6VaJMHaFA

[JAMA @JAMA_current]

The most common chronic liver disease worldwide, metabolic dysfunction–associated steatotic liver disease (MASLD) affects approximately 30% to 40% of the general adult population.

This Review summarizes the diagnosis, treatment, and prognosis of MASLD. https://t.co/cnge8XGwQ6

[Keith Siau @drkeithsiau]

When to take biopsies during OGD - latest UK guidance 🎯🆕

📸: https://t.co/ujeAE2f7mq

[Asad ur Rahman, MD, FACP, FACG @AsadurRahman87]

Accumulating evidence of aspirin as a potential onco-preventative agent in IBD patients. Prospective study needed to analyze if it’s truly helpful as we continue to add aging patients in the compounding prevalence bucket of IBD epidemiology https://t.co/8TcPyP5gmT

[Sarah McGill @SarahMcGillMD]

2025 Best GI papers @GuildConference
🎤Achalasia ⬆️s all-cause mortality (esoph cancer and aspiration)
🤢 prucalopride for gastroparesis in guide
🎯 ing seropositive for celiac diagnoses doubles diagnoses
🥑 Mediterranean diet helps IBS
#MedTwitter #GITwitter #audreycald #evande

[Elliot Tapper @ebtapper]

Important! This is what we are up against, friends

https://t.co/lje2nz8pEX