The journey of a patient with CD starts at diagnosis. A crucial step is to identify and capture the illness early in the disease course…

BARIATRIC surgery is a safe and long-term treatment for weight loss; however, the rapid weight loss it induces is a major risk factor for the formation of cholesterol gallstones. The causal link between weight-loss and gallstone formation is not fully understood, but an important factor is the consequential imbalance in biliary lipids. Cholecystectomy at the time of bariatric surgery is the current standard treatment for gallstones, the evidence for the use of ursodeoxycholic acid (UDCA) prophylaxis is still under debate. Research led by Sylke Haal, Amsterdam UMC, University of Amsterdam, the Netherlands, was conducted to provide evidence for whether UDCA reduces the occurrence of gallstone disease after bariatric surgery.

RECENT breakthrough research was shared and debated on Day 2 of the United European Gastroenterology (UEG) Week Virtual Congress 2021 in the symposium session discussing the progress towards, and barriers to, the elimination of chronic viral hepatitis (HCV). The session featured experts in the field, including Sabela Lens, Division of Infection and Immunity, University College London, UK, and Jean-Michel Pawlotsky, National Reference Centre for Viral Hepatitis B, C and Delta, Department of Virology & INSERM U955, Henri Mondor Hospital, University of Paris-Est Créteil, France, who came together to share knowledge, challenge findings, and contribute to the fundamental goal of HCV elimination. The symposium looked at all aspects of eliminating HCV, from profiling the disease in the clinic to large-scale epidemiological characteristics of HCV within global populations.

President, Drossman Center for the Education and Practice of Biopsychosocial Care, DrossmanCare; Drossman Gastroenterology, DrossmanCare; President, Drossman Consulting; Professor Emeritus of Medicine and Psychiatry, University of North Carolina (UNC) School of Medicine; President Emeritus and Chief of Operations, Rome Foundation; Former Co-director, UNC Center for Functional GI and Motility Disorders, North Carolina, USA

OESOPHAGEAL cancer (OAC) is the seventh most common cancer in the world. Patients with this cancer are commonly treated with neoadjuvant chemotherapy, radiotherapy, or surgery. Unfortunately, over half of tumours are resistant to neoadjuvant therapy and survival rates are poor. A novel study, shared at the UEG Week Virtual, aimed to understand the genetic and transcriptomic changes in OAC.

Mary Ellen Sanders introduced ‘biotics’ as a family of four microbiome-targeted substances: probiotics, prebiotics, synbiotics, and postbiotics. Each type of biotic has the potential to impact the resident microbes of a host, which have diverse physiological functions, including promotion of fat storage and angiogenesis, immune development, synthesis of vitamins and amino acids, drug metabolism, modification of the nervous system, breakdown of food, resistance to pathogens, protection against epithelial injury, and modulation of bone-mass density.

I considered, at the time, and still consider, that gastroenterology is a very interesting and diverse specialty. In fact, it has a practical component (endoscopic techniques) and a clinical more reflexive component, mostly in the hepatology area. Altogether, it gives a myriad of opportunities and varied activities. Furthermore, it is in constant development, what represents a challenge, and makes it even more exciting. Regarding persons, several persons shaped my progression. My first mentor, Pinto Correia, was an outstanding scientist and educator in gastroenterology and was certainly my role model.

Details of a hypothetical 24-year-old female with a longstanding history of recurrent abdominal pain were presented. Over the previous 10 years, she had presented at the ED once or twice yearly with episodes of severe abdominal pain. At her last ED visit, her abdominal pain was debilitating and overwhelming (9–10/10 in severity). Liver function tests were mildly elevated, but blood counts, inflammatory markers, renal function tests, and urine analysis were all normal. Abdominal imaging (ultrasound and CT) and gynaecological examination were also normal. She was discharged from the ED without a specific diagnosis, but was referred for oesophagogastroduodenoscopy and colonoscopy, which were normal.

DETERMINING the timing of surgery remains a challenge for patients with adenomatous polyposis, an inherited autosomal dominant condition. This abstract was presented by Isabel Martin, St Mark’s Hospital, London, UK, at UEG Week Virtual, who noted: “Ideally intervention takes place before cancer is diagnosed, as afterwards the outcomes are very poor.” Upper gastrointestinal endoscopic surveillance was recommended following pancreaticoduodenectomy (PD) or pancreas-sparing duodenectomy (PSD). This review is of importance in a field where long-term data is lacking.

As a medical student I had keen interest in internal medicine and the challenge that comes with solving cases. That is why I really wanted to do a MD-PhD programme and I have been fortunate to do so. My PhD targeted hyper-IgD syndrome, which was, at that time, an ill-recognised inflammatory disorder, and it took me from phenotyping to assessing cytokine profiles to therapeutic trials.