MD FRCPI | Gastroenterology/Medicine | Music/Books/Art/Cultural Stuff | @dotMDconf |

Galway, Ireland (Gaillimh)
Joined November 2008
Alan Coss retweeted
What began as a children’s concert in the Palestinian village of Umm al-Kheir ended in confrontation. Shortly after the Sotna music project’s ceremony began, Israeli soldiers declared the area a closed military zone and ordered residents to leave. As the crowd dispersed, a settler drove toward Palestinians, including children, and assaulted a resident. | Tal Elkayam instagram.com/haaretzcom/
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Alan Coss retweeted
Great to see #UEGWeek opening with coeliac disease by Prof Sanders. This is a common condition but 70% of cases remain undiagnosed. Have a low threshold for testing, especially if patients have the following criteria ⬇️
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The most immoral army. The army of the deranged ones. Committing the monstrosity of the century. Every day, new brushes of horror.
Prof. Nick Maynard in Gaza says Israeli soldiers not only deliberately shoot children, they likely agree among each other to target different body parts on different days. Just for laughs. One day the doc see shot off ears, next day noses, then hands, other days genitals, etc etc
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Many tributes paid to GP and WiMIN founder Dr Sarah Fitzgibbon bit.ly/4hq9FxO
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It is with immense sadness to mark the passing of Dr Sarah Fitzgibbon. Sarah was a regular columnist for the Medical Independent since 2018. As the mountains of positive feedback we received over the years in response to her wonderful columns attested, she was a brilliant and much-loved writer. No matter the subject, Sarah always brought a lightness of style and wit that was inimitable. Her death is a huge loss to Irish medicine, from her cancer advocacy to her work on supporting women doctors with the establishment of WiMIN . We extend the deepest sympathies and best wishes to her family, friends, and colleagues at this difficult time.
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Alan Coss retweeted
Registration now open for Treabh Annual Galway IBD study day. Use the attached QR code or copy and paste the link below. eventbrite.com/e/19985430681…
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Fauci is public health hero now persecuted for doing all the right things facing down a lethal pandemic & a deranged president. Thanks BMJ for defending truth/medical integrity against dark age of arrogance/ignorance/cruelty/corruption. Lets hope others join in any way we can:
Republican members of the Senate committee have voted to hold Anthony Fauci in contempt of Congress. When politics replaces science as the arbiter of truth, the ultimate casualty is not Fauci: it is the health of the American public, argues this Opinion bmj.com/content/394/bmj-2026…
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Alexandre Yersin (1863 – 1943), co-discoverer of both the Diphtheria and Tetanus toxins and of the bacillus responsible for the bubonic plague. The bacteria was named in his honour: Yersinia pestis. He provided free medical care to the poorest in Vietnam, where he lived.
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The poetry of ageing bit.ly/4yOATVq As I approach 50, I realise, while it’s not really old, it has the sense of entering the ‘third age’, reflects Dr Sarah Fitzgibbon #poetry
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Alan Coss retweeted
dotMD@DotMDConf6 Jun 2022
Fantastic artwork by Dr. Ciléin Kearns (@artibiotics): 👉 artibiotics.com/blog/causes-… #medtwitter #graphicmedicine – at Galway, Ireland
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Alan Coss retweeted
dotMD@DotMDConf5 Nov 2023
Ten ways to be a healthier physician - via @TheRACP – at Galway, Ireland
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The upcoming Irish Society of Gastroenterology Summer Meeting in Limerick will highlight advances across a range of areas related to the specialty bit.ly/43mvdnd #gastroenterology
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Coffee is one of the only drinks with strong evidence that benefits the liver. Here's what decades of research actually says about how to drink it right: Coffee genuinely lowers liver disease risk. Meta-analyses show regular drinkers have about 35% lower risk of significant liver fibrosis and nearly 50% lower risk of liver cancer compared with non-drinkers. Aim for 2–3 cups a day, minimum. The effect is dose-dependent. The Hepatology socities such as AASLD and EASL says 3 or more cups daily is reasonable for liver benefit, if you tolerate it. Caffeinated works better than decaf. But decaf still helps. Caffeine blocks adenosine receptors that drive liver scarring. Decaf lowers chronic liver disease risk too, just by a smaller margin (UK Biobank, n=494,585). The target dose: ~300 mg caffeine/day, or 3 cups. Fibrosis protection kicks in around the 75th percentile of intake, roughly 308 mg caffeine, or 2.25 cup equivalents, per day - the AASLD 2023 advises 3+ cups for liver benefit. What a "cup" actually means One standard cup = 240 ml (8 oz), not a 60 ml tiny Indian "cup." A 240 ml filter coffee has ~95–165 mg caffeine. A single espresso shot (30 ml) has only ~60–75 mg. Coffee-to-water ratio: 1:15 to 1:17. For filter/drip/pour-over: 15 g of ground coffee to 250 ml water. This is the standard brewing ratio and gives clean extraction of chlorogenic acids and caffeine. Choose medium roast, not dark. Medium roast has significantly higher chlorogenic acid (CGAs) content than dark roast. Dark roasting thermally degrades CGAs, the main antioxidant doing liver work. Arabica beats Robusta. Arabica beans are richer in CGAs and polyphenols, the antioxidants doing most of the liver-protective work. A note here: Arabica for polyphenols, Robusta for caffeine. Arabica (1.5% caffeine) has more CGAs and polyphenols. Robusta (2.7% caffeine) has more caffeine but a cruder phenolic profile. A 70:30 Arabica-Robusta blend is a reasonable compromise. Water temperature: 92–96°C. Just off a rolling boil. Too hot (>96°C) burns the grounds and extracts bitter compounds; too cool (<90°C) under-extracts CGAs and caffeine. Grind size matters. Medium grind (table-salt texture) for filter/drip. Coarse for French press. Fine for espresso. Brew time: 3–4 minutes for pour-over, 4 minutes for French press, 25–30 seconds for espresso. Filtered coffee is the safest daily choice. Paper filters trap cafestol and kahweol, naturally present plant diterpenes that raise LDL cholesterol if consumed daily in large amounts. Pour-over (V60, Kalita, Melitta) or drip machines with paper filters give you CGAs and caffeine without the cholesterol penalty. Espresso and French press: fine, but not unlimited. They retain more polyphenols but also more diterpenes (so more chances of increased lipids). Great occasionally; don't make them your 5-cups-a-day default if you have high cholesterol or heart disease. South Indian filter coffee: acceptable, with caveats. The metal filter does not remove diterpenes as well as paper, so limit to 1–2 cups/day if you have dyslipidemia. The decoction itself is rich in CGAs. Use less sugar. Skip condensed milk. BUT ULTIMATE: Drink it black. Or close to it. Sugar, syrups, flavored creamers and whipped cream cancel the liver benefit, especially if you already have fatty liver, diabetes, or obesity. Skim milk or unsweetened plant milk is fine. Instant coffee: still works. UK Biobank (n=494,585) showed instant coffee drinkers had similar reductions in chronic liver disease as ground coffee drinkers. Not as potent, but far better than no coffee. Cold brew: underrated for the liver. Medium roast + coarse grind + 6–7 hours at room temperature extracts CGAs and caffeine efficiently with lower bitterness. pH and CGA content are comparable to hot brew. Timing. Spread across the day. one at breakfast, one mid-morning, one early afternoon. Stop by 2 pm if you have insomnia. It helps across almost every major liver disease. Evidence supports benefit in fatty liver (MASLD), alcohol-related liver disease, hepatitis B and C, cirrhosis, and liver cancer. The mechanism isn't magic, it's chemistry. Chlorogenic acid cuts oxidative stress and liver fat. Caffeine inhibits stellate cell activation (that promotes scarring or fibrosis). Melanoidins and polyphenols reduce inflammation. Who should go easy. Pregnancy, children, those with uncontrolled heart rate and rhythmn issues (arrhythmias), panic disorder, or insomnia. And no, coffee does not undo a bad diet or bad choice - such as alcohol, herbal supplement or that Ayurvedic "liver tonic." Sources: Modi et al., Hepatology 2010; Kennedy et al., BMC Public Health 2021 (UK Biobank); Fuller & Rao, Sci Rep 2017; AASLD MASLD Clinical Care Pathway 2023; EASL 2016 CPG, Frontiers in Nutrition 2026 (Italian coffee cohort).
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We are very sorry to hear of John Byrnes death. John was a loyal and valued volunteer with Galway International Arts Festival for many years. Our sincere condolences to John’s family, friends and fellow volunteers. May his kind and gentle soul rest in peace. We will miss you John
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Patient advocates Mary and Peter tell us about their experience taking part in #BowelScreen, encouraging others to #choosescreening. BowelScreen is for everyone aged 57 to 71. It's a simple test you do at home, and it's free. 🔗www2.healthservice.hse.ie/or… #BowelCancerAwarenessMonth
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Alan Coss retweeted
So many fabulous women in healthcare who encourage and support each other, and will continue to inspire generations to come! #SundayWiMIN
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Alan Coss retweeted
The Countdown is ON to Conference 2026 in @GalwayBayHotel 20-22 March. Registration is open! For programme highlights and to meet some of our speakers: wimin.ie/conference2026 #womeninmedicine
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I wrote this at the start of the year when I was feeling more uncertain than usual about my future. I am delighted that I will continue to be an irritating backseat passenger in @WomenMedIreland & I look forward to seeing everyone in Galway on March 21st! wimin.ie/conference2026
Dr Sarah Fitzgibbon on setting up WiMin and stepping away from the organisation bit.ly/4cqygjP @SarahFitzWiMIN @WomenMedIreland
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