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Frontline Gastroenterology
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#2A. BondH-Index: 5
Last.Simon LalH-Index: 23
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#1David N. Naumann (University of Birmingham)H-Index: 8
#2Sarah Potter-Concannon (University Hospitals Birmingham NHS Foundation Trust)
Last.Sharad Karandikar (HEFT: Heart of England NHS Foundation Trust)H-Index: 7
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Objective To investigate the agreement in comfort scores between patients, endoscopist and specialist screening practitioner (SSP) for colonoscopy, and which factors influence comfort. Design Prospective observational study. Setting Single-centre UK Bowel Cancer Screening Program colonoscopy service from April 2017 to March 2018. Patients 498 patients undergoing bowel cancer screening colonoscopy, with median age of 68 (IQR 64–71). 320 (64.3%) were men. Intervention All patients underwent screen...
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#2Amy Knott (University Hospitals Bristol NHS Foundation Trust)
Last.Faisal Fayyaz (Weston General Hospital)
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Identification of acquired von Willebrand syndrome (AVWS) was key to treating a patient with chronic gastrointestinal (GI) bleeding due to angiodysplasia. After exhausting endoscopic and pharmacological options, the patient was successfully treated with rituximab. A 78-year-old man developed chronic GI bleeding from caecal and jejunal angiodysplasia. Red cell transfusion was required weekly despite argon plasma coagulation. A diagnosis of AVWS was made from analysis of clotting factors. Therapie...
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An elderly patient with a history of laparoscopic cholecystectomy presented with recurrent abdominal pain. Imaging revealed a dilated common bile duct (CBD) with filling defects. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated multiple linear metallic clips with a halo of calculus material (figure 1). Attempts at removing the clips following a 10 mm sphincteroplasty resulted in horizontal impaction of clips beneath the trawling balloon (figure 2), increasing the risk …
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We applaud Verma and Chilton1 for publishing their survey on diathermy use for polypectomy which provides evidence of variation in UK practice. On behalf of Joint Advisory Group on Gastrointestinal Endoscopy (JAG),2 the UK quality assurance body for endoscopy, we wish to share our proposals of future workstreams pertinent to diathermy. Patient safety should be at the forefront of endoscopy practice. Diathermy is a modality which, if delivered inappropriately, has the potential for serious harm. ...
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New guidelines have been produced through collaborative work between the British Society of Gastroenterology (BSG), the Association of Coloproctology of Great Britain and Ireland, the British Society of Interventional Radiology, the Royal College of Radiologists, National Health Service Blood and Transplants and patient representatives. This is the first UK national guidance for lower gastrointestinal bleeding (LGIB). The focus is the in-hospital management of adult patients presenting with acut...
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The advent of monoclonal antibody therapies has revolutionised inflammatory bowel disease (IBD) treatment and delivered great benefits to patients. The optimal use of this class of drugs requires careful management and a clear understanding of their properties. In this review article, we consider how to maximise the benefit of our most novel biological agents, vedolizumab and ustekinumab. For each agent, we consider practical aspects including dose flexibility, evidence for use in combination wi...
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#1Jane Fletcher (University Hospitals Birmingham NHS Foundation Trust)H-Index: 1
#2Diane Woodham (University Hospitals Birmingham NHS Foundation Trust)
Last.Sheldon C. Cooper (University Hospitals Birmingham NHS Foundation Trust)H-Index: 6
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Difficulty with maintaining nutritional intake is common in patients with cancer. European guidance suggests that wherever possible nutritional support should first be provided by the oral or enteral route. Where this is not possible, for example, in malignant small bowel obstruction, parenteral nutrition (PN) may be considered. In palliative care, it is generally accepted that the significant risks and burdens of PN outweigh the potential benefits in patients with an expected survival
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‘Knowledge is of no value unless you put it into practice’ is a quote usually attributed to Anton Chekov. It is advice particularly relevant to therapeutic drug monitoring (TDM) of infliximab (IFX) in patients with inflammatory bowel disease (IBD). Several observational studies have identified low IFX trough levels, or antibodies to IFX, or both, as a factor in the loss of response to this drug in patients with IBD.1 In addition, intervention studies to prospectively adjust IFX dosing to maintai...
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