Ingest PCSG

Join Charlie Andrews as he discusses Hepatitis C with hepatologist Dr Kosh Agarwal and GP and clinical champion for Hepatitis C Dr Rik Fijten. They discuss the prevalence and presentation of Hepatitis C,  as well as how to test for the condition along with an overview of the treatment options available.



Hepatitis C is a chronic liver disease which carries significant morbidity and mortality if left untreated.  Fortunately, it is both easy to test for and the treatments available offer a fantastic cure rate of in excess of 95% with simple and relatively short tablet regimens.  



NHS England has set itself the target of eradicating the disease by 2025 through active case finding, simplifying the diagnostic process, and ensuring pathways are in place to provide rapid and effective treatments for the condition.  



Resources: 



For more information on Hepatitis C, the British Liver Trust offers useful patient-friendly leaflets and further information about the condition: Hepatitis C - British Liver Trust



The self-testing portal mentioned by Rik during the episode can be found here: Home - HepC (hepctest.nhs.uk)

In this episode, Dr Charlie Andrews speaks to Professor Mark Pritchard about neuroendocrine tumours (NETs) of the gastrointestinal tract.  You may be asking yourself: 'Do I really need to know about NETs in primary care, aren't they extremely rare?'  The answer to that is a resounding yes, you do need to know about NETs and Mark will tell you why in this episode!  



Neuroendocrine cancer is the 10th most prevalent cancer in England, and the second most prevalent cancer of the GI tract, with a rapidly rising incidence (371%) over the last 20 years.  NETs are commonly diagnosed at a more advanced stage due to late diagnosis as the signs and symptoms can be vague, or mimic other more common conditions such as IBS.  Mark provides lots of useful, practical advice about when to suspect this form of cancer in primary care, which patients may be a higher risk, and what to do if you are suspicious about this form of cancer in your patient.  



Listen on to find out more.    

Dr Charlie Andrews, a committee member of the Primary Care Society for Gastroenterology (PCSG), introduces Ingest, the podcast for primary care that focuses on when to suspect, how to diagnose and how to manage common gastrointestinal presentations and conditions.

In this episode Dr Charlie Andrews looks back at 2023 and highlights some key takeaways from Ingest in 2023.

In this episode, Charlie Andrews speaks to Dr Andrew Moore about this condition, which affects up to 1.5% of the population, with a risk of progression to cancer of 3-13% over the patient's lifetime (Cancer Research UK).  They discuss the typical presenting features, who needs an endoscopy to look for Barrett's, and how the condition is managed both in primary and secondary care. The BSG guidelines mentioned by Dr Moore in the episode can be found here: https://www.bsg.org.uk/clinical-resource/bsg-guidelines-on-the-diagnosis-and-management-of-barretts-oesophagus/



For more episodes about the oesophagus, you may find the following episodes of Ingest useful: Dyspepsia, Eosinophilic oesophagitis, Dysphagia and Achalasia. 



BSG guidelines on the diagnosis and management of Barrett's oesophagus - The British Society of GastroenterologyFitzgerald RC, di Pietro M, Ragunath K et al. Abstract These guidelines provide a practical and evidence-based resource for the management of patients with Barrett’s oesophagus and related early neoplasia. The Appraisal of Guidelines for Research and Evaluation (AGREE II) […]www.bsg.org.uk

In this episode, Charlie Andrews speaks to Professor Julian Walters about bile acid malabsorption and diarrhoea. With up to a third of patients with diarrhoea-predominant IBS having underlying bile acid diarrhoea, and with diagnosis rates for this condition being low, this episode is an important one for anyone working in primary care. We explore the role and physiology of bile acids, the causes and symptoms of bile acid malabsorption, the diagnostic tests used to make the diagnosis and the treatment of this common but underdiagnosed condition. Should we use 'trial of treatment' in primary care to support the diagnosis? Are people who have had their gall bladder removed at greater risk of bile acid diarrhoea? Can bile acid sequestrants impact the absorption of other medications? These questions, and lots more, will be discussed in this episode!