This was Basic Science Course 2018

Read what happened this year or watch the recordings to learn about research in motility & neurogastroenterology.

Please sign-in and access the BORN module to begin interactive web-based training for endoscopists in the detection and delineation of Barrett´s Oesophagus Related Neoplasia now.

Over the last decade this training module has been developed and validated by members of the International Working Group for the Classification of Oesophagitis.
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This was Summer School 2018

158 trainees from 29 countries met for a weekend full of lectures and hands-on training.

Mistakes in clinical investigation of gastrointestinal motility & function

Symptoms related to abnormal motility and function are very common.

Symptoms related to abnormal gastrointestinal motility and function can occur from the moment food is swallowed to the time stool is passed into the toilet. A recent UEG survey indicated that dysphagia, heartburn, bloating, abdominal pain and changes to bowel habit are each reported by 5–15% of the general population.1 These symptoms are frequent reasons for seeking medical attention from general physicians and for referral to specialist gastroenterologists. Most patients with these symptoms do not have neoplasia, infection or inflammation on initial investigation, but rather so-called functional gastrointestinal symptoms.2,3

For patients with mild symptoms, negative tests provide reassurance and simple, symptomatic management might be all that is required (e.g. acid suppression, stool regulation). However, for those with severe symptoms that persist on therapy, ruling out life-threatening disease is not sufficient, and referral to the neurogastroenterology and motility (NGM) laboratory for physiological measurements is often indicated.

Clinical investigations aim to explain the cause of symptoms and establish a diagnosis that can guide rational treatment. Until recently, it could be argued that manometry, scintigraphy, breath tests and related tests rarely provided this information. As a result, only patients with suspected major motility disorders (e.g. achalasia, severe reflux disease or faecal incontinence) were routinely referred to the NGM laboratory for tests. Technological advances, such as high-resolution manometry (HRM), now provide objective measurements not only of motility, but also of function in terms of the movement (and digestion) of ingested material within the gastrointestinal tract. Furthermore, the ability to associate events (such as bolus retention, reflux or gas production) with symptoms provides an indication of visceral sensitivity and can identify what is causing patient complaints. Here, I discuss frequent mistakes in clinical investigation of gastrointestinal motility and function based on a series of consensus documents published by members of the International Working Group for Disorders of Gastrointestinal Motility and Function.

3rd EDS Surgical Skills Course (SSC)

Improve your surgical skills & register for this course on minimally invasive management of critically ill GI patients until July 1.

Enhance your knowledge with the UEG Library!

Find new educational online content from UEG Week 2017 subtitled into Spanish.

Mistakes in the endoscopic diagnosis and management of Barrett’s oesophagus and how to avoid them

Barrett’s oesophagus is the precursor to oesophageal adenocarcinoma, which carries a poor prognosis,1 and it is likely that all endoscopists and gastroenterologists will encounter Barrett’s oesophagus in their clinical practice.

Careful assessment and management of patients who have Barrett’s oesophagus with endoscopic surveillance and endoscopic endotherapy aim to reduce the risk of progression to invasive adenocarcinoma. Advances in endoscopic diagnosis and therapy should, therefore, help to reduce the risk of progression. As with all premalignant conditions and surveillance programmes,2 careful multidisciplinary management of the patient is important to reduce the risk of causing them to become unduly concerned. Here, we present some mistakes that in our experience are commonly made in the endoscopic diagnosis and management of Barrett’s oesophagus and give advice on how to avoid them. 

This was the YIM 2018

30 participants from 11 countries met for a 3-day basic research training in Vienna.

Gastric Polyps

Update yourself with the latest information on gastric polyps.

Take a course and get CME credits

Several UEG courses organised by UEG, are accredited by EACCME to award European CME credits.

Mistakes in short bowel and how to avoid them

Short bowel manifests as high stomal output or diarrhoea, dehydration and malnutrition.

Short bowel is a condition that occurs after single or multiple intestinal resections. The incidence of short bowel in Europe is 2 per million of the population1–3 and it carries with it lifelong morbidity and mortality. The initial recognition and management of short bowel in the adult population tends to occur in the postoperative period and in the secondary care setting, where specialist input from clinicians experienced in short bowel is often lacking.

Normal small bowel length is 275–850 cm.4–7 It is accepted that when the length of small bowel is reduced to less than 200 cm it may be insufficient to enable adequate absorption of fluids and micronutrients. The symptoms of short bowel (often referred to in the literature as short bowel syndrome) are secondary to a reduction in intestinal surface area together with an increased motility of the remaining section of small bowel, with accompanying increased secretion into the lumen. These intestinal secretions vary in their electrolyte content and osmolality depending on the anatomical location, with the highest chloride and potassium loss from gastric secretions and high sodium loss from jejunal secretions.8 Clinically, short bowel manifests itself as a high stomal output or diarrhoea, dehydration and malnutrition. High stomal output or diarrhoea do not, however, necessarily equate immediately to short bowel; conversely, a small bowel longer than 200cm may be insufficient if it is diseased. Here, we discuss some of the pitfalls that are encountered in the recognition and management of short bowel and have suggested an algorithm for assessing and managing patients with a high stomal output. Although some of these pitfalls may appear obvious, they are addressed here because they are commonly encountered in clinical practice (summarised in table 1 at the end of the article).

Apply for the UEG Activity Grant until April 13, 2018!

Get endorsement for your educational project in the field of digestive health.

Mistakes in paediatric IBD and how to avoid them

Better clinical outcomes are increasingly being sought in young people with IBD

Around 1 in 10 cases of inflammatory bowel disease (IBD) will present before adulthood, with the median age at presentation being 11–12 years.1 IBD in children and young people is associated with more extensive disease, increased disease activity and a higher rate of complications compared with adult-onset IBD.2 Worldwide, estimates of paediatric IBD prevalence rates are lacking, but data suggest its incidence is increasing.3


Risk factors for paediatric IBD include immigration to high prevalence regions, particularly to countries that have Westernised diets, increasing geographical latitude, and European ancestry (versus belonging to an indigenous population).4 The risk may also be higher in children of certain ethnicities (South Asian, Hispanic, and East Asian).5

While the pathophysiology and clinical presentation of paediatric IBD is well understood, the role of genetics and personalised treatment is currently the focus of a significant amount of international research. Better clinical outcomes—including optimal nutrition, improved growth, better quality of life and increased disease remission rates with decreased occurrence of complications—are increasingly being sought in children and young people with IBD.4

This article discusses mistakes commonly made when identifying, diagnosing and managing children whom are suspected or confirmed to have IBD. The mistakes and discussion are based on published evidence where possible, plus our clinical experience of looking after children with IBD.

Prevention of cancer in the gastrointestinal tract and the liver

Learn how to manage patients with pre-neoplastic disorders.

Mistakes in tissue sampling during endoscopy and how to avoid them

Tissue acquisition is the most common manoeuvre performed during endoscopy.

Tissue sampling is the most common manoeuvre performed during endoscopic procedures and histological examination is part of almost every digestive disease investigation. The potential for mistakes is, therefore, widespread and knowledge of the adequacy of the indications and techniques used for tissue sampling during endoscopy, as well as the potential consequences, is indispensable for every gastroenterologist. As such, there are some questions that should always be posed before taking a biopsy sample or tissue acquisition during endoscopy: Why? What for? How? How many? (figure 1). This manuscript has been organized with these questions in mind. We’ve aggregated examples for the eight most frequent and most correctable mistakes made during tissue acquisition by endoscopy. In addition, most of the recommendations made in this article are supported by existing guidelines and evidence, with a few based solely on the authors’ experience. Figure 1 | Questions that should always be asked before a biopsy sample is taken or tissue acquired during endoscopy.

ESEGH application is open

See the key dates and get ready for the next European Specialty Examination in Gastroenterology and Hepatology.

Mistakes in managing H. pylori infection and how to avoid them

Careful practice can overcome declining eradication rates for H. pylori treatment.

The sequelae of Helicobacter pylori infection, a known Group 1 carcinogen, can lead to significant morbidity and mortality worldwide. Billions of people are infected with H. pylori, but the incidence of H. pylori infection is declining in many parts of Europe, with a study from the Netherlands showing a decline in seroprevalence from 48% in subjects born between 1935 and 1946 to 16% in those born between 1977 and 1987.1

In recent years, however, eradication rates for H. pylori treatment have been falling, which has led to a large number of patients in the community having inadequately managed infections. Most of the problems that have led to the decline in the success of eradication treatment can be easily overcome through careful practice, supported by the robust framework provided by international guidelines. Careful practice includes the correct management of dyspepsia, the appropriate use of diagnostic tests for H. pylori, acceptable, efficacious treatments that enable good patient compliance and adequate follow up to insure eradication has been achieved in all cases. Here, we discuss the mistakes that are made when managing patients infected with H. pylori. Most of the discussion is evidence based, but where evidence is lacking the discussion is based on the authors’ clinical experience of more than 30 years in the field.

Chronic Pancreatitis

Improve your understanding of Chronic Pancreatitis.

Biomarkers of Liver Disease

Enhance your knowledge of Biomarkers of Liver Disease

Polypectomy

Improve your understanding of good polypectomy practice and the use of standardised protocols

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