Making changes within the NHS can feel complex and lumbering. The COVID-19 pandemic has accelerated change, with specialist units needing to demonstrate agility and innovation in ensuring patient access to services. Whilst doctors and patients alike may have found the pace of change hard to navigate, it is important to take stock and evaluate whether […]
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#FG Blog: Entering the black hole – dietary recommendations in IBD
‘One last thing doc, I’ve been reading online about the Paleo diet and that it’s been beneficial to other patients with colitis, what do you think?’ We have all been here. Most of us feel that we really should have the answer to questions regarding diet and inflammatory bowel disease (IBD) but what advice […]
How do you solve a problem like obesity?
There has been some debate in recent months in the liver community about the nomenclature of non-alcoholic fatty liver disease (NAFLD). Understandably, there is some concern that the name is confusing, focussed on what it is not rather than what it is. ‘Metabolic Associated Liver Disease’ (MAFLD) has been proposed as an alternative, but the […]
Are we actually providing a MDT approach to our IBD patients?
Jessica Anne Eccles1,2, Anna Ascott3, Rona McGeer4,5, Emma Hills6, Anja St.Clair Jones6, Lisa A Page7, Melissa A Smith6, Alana Loewenberger8, Jemima Gregory7 On so many occasions throughout my career I’ve reviewed a patient with inflammatory bowel disease where no matter what next “mab” I throw at them, no matter how much of their […]
Improving our end-of-life care in patients with advanced liver disease
How would you define a good death? The words ‘good’ and ‘death’ appear oxymorons; defining any death as ‘good’ may on the surface appear perverse. Yet all of us working in medicine will have witnessed patient deaths which in some sense were ‘better’ than others and, if pushed to reflect on our own mortality, identified […]
Rational Investigations in IBS
Reassurance is an interesting concept in modern medicine. I remember my blood pressure creeping up at the sight of an advert on the tube a few years back for a health check involving a ‘whole body MRI scan,’ fuming over the willingness of this private healthcare provider to offer false assurance of alleviating any anxiety […]
Hepatology notebook….New articles in FG
Early paracentesis in decompensated cirrhosis As I write this piece, the newspaper front pages are in overdrive over the spread of Coronovirus from central China. There has been talk of military evacuations of Brits in high incidence regions. The medical registrar WhatsApp group at my hospital is replete with protocols to follow should we encounter […]
Treat to target in IBD? Should this be part of an individualised treatment plan?
Acceptability of a ‘treat to target’ approach in inflammatory bowel disease to patients in clinical remission 1. Christian Selinger1,2, 2. Jenelyn Carbonell1, 3. John Kane1, 4. Mandour Omer1, 5. Alexander Charles Ford1,2 Historically the goal in inflammatory bowel disease was to enable the patient to have absence of symptoms, ideally in the absence of requiring […]
Gastropexy can be as safe as conventional percutaneous endoscopic gastrostomy (PEG), and biomarkers do not predict short-term or long-term outcomes: a 7-year follow-up audit
Porter, R.J., McKinlay, A.W. and Metcalfe, E.L. Gastropexy can be as safe as conventional percutaneous endoscopic gastrostomy (PEG), and biomarkers do not predict short-term or long-term outcomes: a 7-year follow-up audit. Frontline Gastroenterology. 2019 Nov 13. http://dx.doi.org/10.1136/flgastro-2019-101306 Gastrostomy, the process in which the stomach is anchored to the abdominal wall and a gastrostomy tract […]
Nutrition in Cirrhosis- a case-based review to chew on
Nutrition is important in the management of liver disease. I’m sure for anyone working with cirrhotic patients this is not news, and even for those without extensive nutrition training the fact that the skeletal, sarcopenic patients do very badly is a clear reality we experience regularly on the clinical coal face. However, the challenge we […]