SingHealth Gastroenterology

Gastroenterology Residency Program at SingHealth

[Rajesh R @rajeshrgastro]

🚨Been a while since you last set a PEG with the "push"/introducer technique?🤔 This is a 💎 refresher: https://t.co/Emr00gt2Oj

Kudos to @ravishnkr03 🇸🇬@carlosfrncscomd🇵🇭 and team! #GITwitter #MedTwitter #PEG #Endoscopy #Nutrition

[Rajesh R @rajeshrgastro]

Gold probe is a⭐️tool in our arsenal for bleeding GI lesions. I find it esp useful in positions that are difficult to clip e.g. in retroflexion. Helps that it is bipolar as well💪 What settings to use for gold probe? 👇 #GITwitter #Medtwitter #GIbleeding #Endoscopy

[Andrew Ong @AndrewOngML]

https://t.co/siTBSdBVai

Review on Evaluation & Management of Refractory #GERD with some nice algorithms that summarises the gist of the recent Lyon 2 Consensus

How you evaluate GERD depends on
1⃣ Type of symptoms
2⃣ Whether GERD is proven

#GITwitter

[Yi Yuan Tan @Yiyuan_Tan]

1/3 of IBD patients in biochemical remission have IBS-like symptoms, and those with altered anatomy require careful consideration of differentials.

An excellent paper on abdominal pain and IBS-like symptoms in IBD! 👇@AndrewOngML
https://t.co/0tlwBtkduy

#IBD #ibs #GITwitter

[Keith Siau @drkeithsiau]

Autoimmune hepatitis - diagnosis and management #LiverTwitter #MedEd

(Courtesy of @UEGJournal)
https://t.co/ojF6kRMFZe

[Keith Siau @drkeithsiau]

Gastric intestinal metaplasia (GIM) is a risk factor for gastric cancer but is often poorly understood and missed on endoscopy 🔦

Here is an excellent infographic from @AGA_Gastro 💡

https://t.co/ZEm8r6SZdi

[Keith Siau @drkeithsiau]

Sydney protocol biopsies for gastric atrophy / intestinal metaplasia 🎯 #GITwitter

[Andrew Ong @AndrewOngML]

https://t.co/zZ0wTZZwMF

Many GI physicians treat gastroparesis as a motor disease, but it is very much a sensorimotor disease where pain can be a dominant feature

Hence neuromodulation is shown in this @AGA_CGH article to be effective as mono or combination therapy

#GITwitter

[Malcolm Tan @IBDGastroDocSg]

Kimura-Takemoto classification
- classifies atrophic gastritis by locating the atrophic border in the stomach
- closed: border remains on the lesser curve
- open: border extends into anterior and posterior walls of the stomach

#GITwitter

[SingHealth Gastroenterology @shgastro]

#AIP #autoimmunepancreatitis #pancreas

[SingHealth Gastroenterology @shgastro]

Nasal unsedated seated PEG (nuPEG):
Push-type PEG placement under direct visualization with nasal endoscope
√ patients with high sedation and/or aspiration risk
√ can be done while on NIV

https://t.co/arwdMNzkoO

#gastrostomy #peg #nutrition

[SingHealth Gastroenterology @shgastro]

Gastrostomy tube for neurological patients
- stroke: after 2-3 week interval -> potential neurorecovery
- MND: do early before 10% weight loss -> increased mortality
- Parkinson's: no guidelines
- advanced dementia: not recommended

#gastrostomy #peg #nutrition

[SingHealth Gastroenterology @shgastro]

Irreversible electroporation (IRE) (part 2)
√ minimal collateral damage to adjacent vessels and bile ducts
√ avoids heat sink effect

× requires GA
× larger tumors 3-5cm = more probes + higher risk of recurrence
× avoid in patients with cardiac arrhythmia or epilepsy

#hcc #ire

[SingHealth Gastroenterology @shgastro]

Irreversible electroporation (IRE) for primary liver tumors and oligometastases
- creates nanopores in cell membrane, inducing apoptosis
- safe and effective for tumors near porta hepatis

#hcc #ire