BSG Sponsored Endoscopy Training at Kamazu Central Hospital - Malawi
Endoscopy Training at Kamazu Central Hospital (KCH) Endoscopy Unit - Lilongwe-Blackpool Endoscopy Link 25th February – March 1st 2013.
Visit by Dr Mark Hendrickse(MH) Consultant Gastroenterologist, Blackpool Teaching Hospitals NHS Foundation Trust
Lilongwe is the largest city and capital of Malawi. Kamuzu Central Hospital(KCH) is the main government funded tertiary referral hospital, with an estimated number of beds varying from 600 – 1000 beds. Upper GI bleeding from portal hypertension complicating schistosomiasis and oesophageal cancer are major causes of morbidity and mortality hence the need to have a comprehensive endoscopy service. Through links with the Mersey school of Endoscopy and the Liverpool Malawi Welcome trust previous visits to KCH endoscopy unit in 2011 and 2012 by MH, Dr Paul O'Toole (POT) and colleagues initially involved a basic skills in gastroscopy course for surgical registrars, assessment of endoscopy nurse practice / training and decontamination, and subsequent follow up of trainee endoscopist / endoscopy nurse training evaluation. Recommendations on endoscopy unit expansion, decontamination requirements and support in nurse training were also made. After visits to the Blantyre endoscopy unit and participation in endoscopy nurse training programme in 2011, Rachel Jiya (RJ) and colleagues produced a comprehensive report detailing suggested developments / improvements required in the KCH unit. This has been forwarded to The Matron and the Hospital director at KCH.
Aims of current visit:
- To assess endoscopy training requirements of current trainees
- To provide small group teaching with all surgical trainees on:
- management of upper GI bleeding with particular emphasis on Variceal bleeding (including use of sengstaken tube)
- endoscopic therapy particularly variceal banding, oesophageal dilatation and stenting
- Review endoscopy training for surgical trainees committed to GI surgery
- Provide a refresher / enhanced skills course for those with endoscopy experience
- Basic skills course for those with no or very limited endoscopy experience
- Evaluate more experienced endoscopist (GM), and run a training the gastroscopy trainer course
- Set up meetings with Hospital director, Matron and Head of Department to take forward recommendations from previous visits / report by RJ and colleagues
- Assess current endoscopy unit equipment / facilities and future requirement
A full report of the visit may be downloaded below:
Cancer Genetics in Clinical Practice
A Guide to Cancer Genetics in Clinical Practice
BSG member Sue Clark has recently published a new textbook 'A GUIDE TO CANCER GENETICS IN CLINICAL PRACTICE' which has a significant gastroenterology content.
This book covers the basic concepts of cancer genetics. The common inherited cancer syndromes are each dealt with in greater depth, with the current management outlined. It is aimed at all clinicians who may encounter these conditions in their practice. The book sets out to facilitate identification of high-risk individuals and families, to inform interaction with geneticists and other sub-specialists, to provide a basis for patient management and to stimulate interest in these fascinating conditions.
View Flyer / Purchasing Details [ 38 Kb ]
Publication date: June 2009
GI Endoscopy & Related Procedures Course
The University of SheffieldCentre for Health
and Social Care Studies and Service Development
School of Nursing and Midwifery
Gastrointestinal Endoscopy and Related Procedures Course
- 20 credits diploma or degree level
- 10 study days
The overall aim of this module is to enable participants to critically evaluate and analyse existing practice, in order to broaden skills and knowledge specific to endoscopy and gastroenterology. This will be achieved through a process of reflection and will focus on key areas of practice, which include conscious sedation and informed consent. In addition, the physical, social and psychological impact on the patient with a gastrointestinal related condition will be explored from a clinical perspective.
- Registered nurses working within the speciality of endoscopy or gastroenterology. This can be ward or department based.
- Assessment is through a 4000 word reflective assignment.
To apply for a place on this course, please visit:
- Browse under G in the alphabetical list of programmes
- Choose Gastrointestinal Endoscopy and Related Procedures Course
- Submit an on-line form to reserve a place
- Download and complete an application form
- If appropriate obtain approval from your line manager
- If appropriate obtain approval from the Learning Beyond Registration (LBR) lead at your Trust
- Return the form to us at least five weeks before the start of the course
For further information contact Tracey Moore, Programme Leader/Contact
+44 114 222 2056
BSG Guidance on Coeliac Disease 2010
The Management of Adults with Coeliac Disease
There is clear evidence that coeliac disease is a common gastrointestinal disease affecting up to 1% of the adult population. Individuals may go undetected for many years. This is despite multiple presentations to both primary and secondary care. This may reflect that fact that affected individuals have subtle gastrointestinal symptoms or no gastrointestinal symptoms.
An active case finding strategy will increase the number of patients detected with coeliac disease. Testing for coeliac disease should incorporate an IgA level, Tissue Transglutaminase antibody and/or Endomysial antibody (depending on what is locally available). In patients with a positive antibody a duodenal biopsy should be undertaken to confirm the presence of villous atrophy. In patients who are antibody negative but the clinician is suspicious then a duodenal biopsy should still be undertaken having ensured that the patient is not on a self-imposed gluten-free diet (GFD).
The cornerstone of treatment is a GFD. Patients require regular dietetic support with the opportunity or access to a gastroenterologist should further problems arise. Follow-up may be in primary or secondary care as long as the support is adequate (as noted previously).
In patients with persisting symptoms they should be investigated carefully with particular reference to ensuring that refractory coeliac disease is excluded.
Guidelines for the management of inflammatory bowel disease
The management of inflammatory bowel disease represents a key component of clinical practice for members of the British Society of Gastroenterology. There has been considerable progress in management strategies affecting all aspects of clinical care since the publication of previous BSG guidelines in 2004, necessitating the present revision. Key components of the present document worthy of attention as having been subject to re-assessment, and revision, and having direct impact on practice include:
- The data generated by the nationwide audits of inflammatory bowel disease (IBD) management in the UK in 2006, and 2008.
- The publication of 'Quality Care: service standards for the healthcare of people with IBD' in 2009.
- The introduction of the Montreal classification for Crohn's disease and ulcerative colitis.
- The revision of recommendations for the use of immunosuppressive therapy.
- The detailed analysis, guidelines and recommendations for the safe and appropriate use of biological therapies in Crohn's disease and ulcerative colitis.
- The reassessment of the role of surgery in disease management, with emphasis on the importance of multi-disciplinary decision-making in complex cases.
- The availablity of new data on the role of reconstructive surgery in ulcerative colitis.
- The cross-referencing to revised guidelines for colonoscopic surveillance, for the management of metabolic bone disease, and for the care of children with inflammatory bowel disease.
- Use of the BSG discussion forum available on the BSG website to enable ongoing feedback on the published document http://www.bsg.org.uk/forum (accessed Oct 2010).
The present document is intended primarily for the use of clinicians in the United Kingdom, and serves to replace the previous BSG guidelines in IBD, while complementing recent consensus statements published by the European Crohn's and Colitis Organisation (ECCO) http://www.ecco-ibd.eu/index.php (accessed Oct 2010).
- Download full guideline [ 425 kb ]
- The provision of a percutaneously placed enteral tube feeding service
- BSG Response to White Paper: 'Healthy Lives, Healthy People'
- Chicago Classification Criteria of Esophageal Motility Disorders (EPT)
- Multidisciplinary teamwork contributes to significantly improved outcomes in advanced colon cancer
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