@TheBottomDoc

Gastroenterologist. Shining a light on bowel cancer. Inspector of endoscopy units, stomachs & bile ducts too. Some tweets my own.

 Lewisham, England
Joined December 2014
  • Tweets2.7K
  • Following1.2K
  • Followers1.6K
520Media
Dr John O'Donohue retweeted
David Beaton@davidbeaton8714 Apr 2025
🧵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): authors.elsevier.com/c/1ktHw…)
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Well, what sort of farewell cake did you expect at an upper GI surgeon’s retirement party? @LG_NHS Saying happy retirement to Mr Alek Uzkalnis!
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A very promising start to a @JAG_Endoscopy accreditation visit, right here!
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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
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Practical guide to management of bloating - all in one slide - Kyle Staller, Mass General Hosptial @DDWMeeting
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IBS microbiome subtypes in types of IBS: Mike Pimentel, Cedars-Sina @DDWMeeting IBS-C: methanogens IBS-D: hydrogen sulfide
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SIBO due to just two bacteria: E. coli and klebsiella
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The major gas/bloat producers in the gut:
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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)
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Bloating is equivocal:
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Management of reflux @DDWMeeting - hierarchy of management - where to use PCABS for PPI-refractory reflux -who are good candidates for an anti-reflux procedure
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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
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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!
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New treatment paradigm for PBC (Primary Biliary Cholangitis) - Dr Willscott Naugler, Portland, Oregon
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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.
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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
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EIGHT mistakes doctors make in treating IBD - AVOID THESE! David T Rubin, University of Chicago @DDWMeeting
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Choice of immunomodulatory therapies in IBD: The story in 2024, summarised in just three slides David T Rubin (University of Chicago) @DDWMeeting
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And contraindications:
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Pouchitis @DDWMeeting Major Takeaways from @AGA_Gastro Pouchitis Guidelines - Ed Barnes, Chapel Hill Probiotics, antibiotics, or immunomodulation for ‘Crohn’s’?
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