News Tue, 23 May 2017 10:29:19 +0000 Joomla! 1.5 - Open Source Content Management en-gb Streamlining diagnostic pathways for patients with vague symptoms The ACE Programme has recently published a report looking at the most effective ways to diagnose patients with non-specific but concerning symptoms. A number of projects across England piloted a range of different approaches to improve early diagnosis of cancer, demonstrating conversion rates ranging from around 3% to over 40%. With common symptoms including weight loss and non-specific abdominal discomfort, the pathways proved effective at identifying a range of gastroenterology-related pathology. This included pancreatitis, chronic liver disease and diverticulitis. The report links to a number of useful practical resources developed by the projects.

]]> (howard) News Mon, 15 May 2017 13:38:34 +0000
Survey: International Survey of Polypectomy Practice Professor Michael Bourke - Director of Gastrointestinal Endoscopy, Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia

I would be grateful if you can spend just a few minutes completing this survey on your colonoscopy and polypectomy practice. This really does not take long. If you do not perform colonoscopy you do not need to complete the survey.

This survey is trying to ascertain current international polypectomy practice. The study is led by our team in Sydney in partnership with the major gastreoenterrology societies. Further information and details can be found in the attached pdf letters.

If you respond (and enter your email address) we will follow up with the results in due course.

The survey contains some high quality polyp images and should be very interesting for colonoscopists. Please take a few minutes to ensure appropriate representation is collated from the UK.

]]> (howard) News Fri, 05 May 2017 12:28:40 +0000
Guidance on Decontamination of Equipment for Gastrointestinal Endoscopy: 2017 Edition The Report of a Working Party of the British Society of Gastroenterology Endoscopy Committee

April 2017

Flexible endoscopes are complex reusable instruments that require unique consideration with respect to decontamination. Their external surfaces and internal channels for air, water, aspiration and accessories are all potentially exposed to body fluids and other contaminants.

In contrast to rigid endoscopes, flexible endoscopes are heat labile and cannot be autoclaved. Most flexible endoscopes are classed as "semi-critical devices" as they come into contact with mucous membranes during use and present a moderate degree of infection risk if contaminated at the time of use. The process of flexible endoscope decontamination is referred to as "high level disinfection". This is the term given to a process that eliminates or kills all vegetative bacteria, mycobacteria, fungi and viruses, except for small numbers of bacterial spores.

The Health and Social Care Act: Code of Practice on the prevention and control of infections and related guidance was published in England in 2008 (updated in 2015). This stipulates the roles of decontamination leads and decontamination programmes. It emphasises the need for staff to be trained in decontamination processes and to hold appropriate competencies for their role. It decrees the need for monitoring systems to ensure that decontamination processes are fit for purpose and meet required standards. Finally it requires that there are systems in place for tracking reusable medical devices (such as endoscopes and reusable accessories) through decontamination processes, not only to assist with assuring their quality, but also to enable the identification of patients on whom the medical devices have been used. Similar guidance is employed in the other UK devolved nations.

The BSG first published guidelines on decontamination in 1998. Over the years many changes have occurred in recommendations for the decontamination of flexible endoscopes. In order to be responsive to these changes this document has been revised as guidance, this allows the flexibility to update this document in line with changes issued by Government agencies and other professional bodies.

 ]]> (howard) News Tue, 25 Apr 2017 08:36:05 +0000
BSG statement on "Use of intravenous Hyoscine Butylbromide (Buscopan) during Gastrointestinal Endoscopy" The MHRA has recently circulated a Drug Safety Update regarding the risk of serious adverse events following the use of intravenous Hyoscine Butylbromide (Buscopan) in patients with underlying cardiac disease.

Buscopan is commonly used during endoscopic procedures. It induces smooth muscle relaxation and reduces spasm in the gastrointestinal tract. It is used during upper GI Endoscopy and small bowel enteroscopy to reduce contraction and aid mucosal visualisation. During endoscopic retrograde cholangiopancreatography, it is used to facilitate access to the common bile duct during cannulation of the Ampulla of Vater. During colonoscopy, it is used to reduce haustral definition to optimise mucosal visualisation and lesion detection.


]]> (howard) News Tue, 04 Apr 2017 11:02:03 +0000
'FIT for symptomatic patients' workshop - NHSE in partnership with the BSG and ACPGBI NHSE in partnership with BSG and ACPGBI ran a workshop on the 8th March, with clinicians from across the colorectal pathway, to scope activity and opinions on the potential use of FIT in symptomatic patients. Discussions focused on: what data collection was ongoing already, what the gaps were in our knowledge of FIT, and how clinicians could work collaboratively to fill the gaps in a timely manner. If you would like to find out more please see the summary of the meeting on the website, or contact Sophie Lumley at NHS England We are interested to hear about other projects that are either ongoing (as research or service evaluation) or currently in the planning stages, or hear from areas interested in collecting data on FIT in symptomatic patients.

]]> (howard) News Tue, 04 Apr 2017 09:20:51 +0000
Simethicone Residue in Endoscopes March 2017

Dr Helen Griffiths, Nurse Consultant & Decontamination Advisor British Society of Gastroenterology

A publication in 2016 in the American Journal of Infection control (Ofstead et al) outlined a potential risk following the identification of residual simethicone in endoscopes following the decontamination process in the United States.

At that time expert opinion in the UK concluded that the decontamination process was not well described and that bacteria found on processed scopes were suggestive of operator contamination and not compromised decontamination. Whilst not seen as a basis for modifying the use of simethicone at that time it has continued to be monitored.

Recently there has been an issue identified in the Republic of Ireland when a colonoscope was sent to Olympus for repair. Preliminary investigation showed what appeared to be signs of Simethicone residue ( Hypromellose, an ingredient of Infacol) in the auxiliary water channel of that colonoscope and subsequently a further two colonoscopes. At this time investigation is ongoing but evidence suggests that scopes were reprocessed in accordance with manufacturers instructions including use of MH-946 injection tube (octopus device).

Simethicone was administered via the flushing pump at a dilution of 25mls (40mgs/ml) in 2 litres of water.

There has been no evidence of resultant infection but until further investigation and testing on compatibility and following discussion with the Decontamination Professional Expert Communication Forum (DPECF) it is advised that Simethicone is administered either orally or via the biopsy port of endoscopes and NOT via either the water bottle or flushing pump devices. This will ensure that manual brushing of relevant channels can take place post procedure. The strength of the dilutent should also be kept to a minimum to achieve the desired effect.

]]> (howard) News Tue, 28 Mar 2017 07:44:53 +0000
Research - Role of primary care in PBC management: clinician perspectives needed The University of Birmingham and NIHR Birmingham Liver BRU in conjunction with UK-PBC are conducting research into perspectives of patients, GPs and specialists around PBC care and potential future changes including an increased role for primary care. We are looking for gastroenterologists and hepatologists in the West Midlands area to take part in qualitative interviews around the role of stratification. Please see advert below for further details or contact the study team led by Gideon Hirschfield for more details.

]]> (howard) News Thu, 09 Mar 2017 11:36:56 +0000
IBD Registry: March Headlines IBD Registry 2017 Roadshow Dates Announced


A series of half-day meetings to support clinical teams as they join the IBD Registry. The sessions provide protected time for teams to learn about the Biologics Audit and QI programme using the IBD Registry, and to develop local plans for Registry adoption. Each meeting will be tailored to local needs and aim to provide information, support and hands-on guidance. Experts from the Registry will be on hand to answer questions, and interactive workshops will provide practical support for teams to work together to develop your own plans. Free to attend due to generous industry sponsorship. Register at

Registry Participation

Participation continues to grow, with 91 sites now set up to enter data into the IBD Registry, and over 24,600 patient records submitted. If you have not yet registered to participate in the IBD Registry, would like help uploading your data, or have any other registry related queries please contact

Quarterly Data Submission

The next quarterly data submission will be at the end of March. If you need any help at all in preparing for this, please contact Data Manager Mark Allan by emailing

Trusts in England – 40% discount on audit subscriptions by 15th March

We've had an encouraging response to the request for subscriptions from Trusts in England to help the BSG maintain the Biologics Audit now that NHS England funding has been withdrawn.

At £2,500 per annum, the subscription is significantly less than the cost of one patient on biologics treatment for a year. Subscribers will receive benchmarked quarterly reports on the Biologics Audit KPIs focusing on quality improvement topics recommended in the last RCP Biologics Report. Later in the year, it is our intention to include reporting of HES data in relation to the Biologics data.

The BSG has offered to reduce the cost in the first year by 40% if a Trust provides a purchase order by 15th March 2017. We have written to the Chief Executives of all Trusts in England explaining the new arrangements for the Biologics Audit, putting the subscription cost in the context of overall expenditure on biologics for IBD, and reminding them that participation in the Audit is part of the NHS England Quality Accounts requirement.

Some teams have contacted us about submitting data to the IBD Registry if their Trust decides not to subscribe to the Audit. At present, you will still be able to submit data, but the Registry will not be able to provide the Trust with the benchmarked Biologics Audit reports. A copy of the letter to CEOs is available on request to


  • Teams can participate in the IBD Registry using their own choice of data entry systems to suit local needs (including some existing local systems)
  • Being part of the IBD Registry will give teams:
    • Robust local data to manage their biologics patients and IBD service more effectively, efficiently and safely
    • Evidence to benchmark the quality of their service as part of a national audit of the safety and appropriate use of biologics

With our thanks for your continued contribution to the IBD Registry,

Dr Stuart Bloom, IBD Registry Chair & Dr Fraser Cummings, IBD Registry Clinical Lead


  • DECEMBER : Publication of the IBD Registry initial report
]]> (howard) News Wed, 01 Mar 2017 10:25:59 +0000
UK guideline on transition of adolescent and young persons with chronic digestive diseases from paediatric to adult care Alenka J Brooks, Philip J Smith, Richard Cohen, Paul Collins, Andrew Douds, Valda Forbes, Daniel R Gaya, Brian T Johnston, Patrick J McKiernan Charles D Murray, Shaji Sebastian, Monica Smith, Lisa Whitley, Lesley Williams, Richard K Russell, Sara A McCartney, James O Lindsay


The risks of poor transition include delayed and inappropriate transfer that can result in disengagement with healthcare. Structured transition care can improve control of chronic digestive diseases and long-term health-related outcomes. These are the first nationally developed guidelines on the transition of adolescent and young persons (AYP) with chronic digestive diseases from paediatric to adult care. They were commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology under the auspices of the Adolescent and Young Persons (A&YP) Section. Electronic searches for English-language articles were performed with keywords relating to digestive system diseases and transition to adult care in the Medline (via Ovid), PsycInfo (via Ovid), Web of Science and CINAHL databases for studies published from 1980 to September 2014. The quality of evidence and grading of recommendations was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The limited number of studies in gastroenterology and hepatology required the addition of relevant studies from other chronic diseases to be included.

These guidelines deal specifically with the transition of AYP living with a diagnosis of chronic digestive disease and/or liver disease from paediatric to adult healthcare under the following headings;

  1. Patient populations involved in AYP transition
  2. Risks of failing transition or poor transition
  3. Models of AYP transition
  4. Patient and carer/parent perspective in AYP transition
  5. Surgical perspective
 ]]> (howard) News Thu, 23 Feb 2017 11:47:00 +0000
Thanksgiving service for Dr Basil C Morson A service of thanksgiving will be held on Tuesday 2 May 2017 at 10.30 am at St James' Church, Spanish Place in London to commemorate the life and works of Dr Basil C Morson.

All are welcome to attend. Please indicate your intention to attend this Service, which will be fully choral with the Choir of St James' Church with Iestyn Evans, Director of Music to - (Subject - BCM Service)

This Service precedes the Scientific Meeting The Past, Present and Future of Colorectal Cancer: The Legacy of Dr Basil C Morson to be held later on 2 May 2017 at The Royal Society of Medicine from 1.00 pm.

Further details may be obtained from the RSM:
Tel - 020 7290 3941
Email -

]]> (howard) News Wed, 22 Feb 2017 12:47:43 +0000