Clinical News

Lancet liver recommendations must be implemented to address crisis

Tuesday, 25 November 2014 00:00

The British Society of Gastroenterology (BSG) has today urged for the Lancet Commission UK Liver Disease Publication recommendations to be pursued "without delay" to "address the UK liver disease crisis".

Liver Disease mortality rates have increased by 400% since 1970 and is the third most common form of premature death in the UK.

The most common form of liver disease is alcohol-related, followed by fatty liver disease caused by obesity. The steep rise in both alcohol consumption and obesity in recent decades has led to increases in both conditions.

Incidences of chronic viral hepatitis are also on the rise, with annual deaths from hepatitis C having quadrupled since 1996, and significant increases in hepatitis B infection.

The Lancet report calls for wide-reaching, joined-up action including:

  1. Better detection of early disease in primary care
  2. Improved support services in community settings
  3. The establishment of Liver Units in District General Hospitals
  4. A national review of liver transplantation services
  5. Strengthening of continuity of care for children with liver disease surviving into adult life
  6. A range of population-level measures such as a minimum unit price for alcohol
  7. Promotion of healthier lifestyles with clearer government messaging and new regulations on the food industry
  8. Eradication of chronic HBV and HCV infection from the country by 2020
  9. Greater provision of medical training in hepatology
  10. A national campaign led by NHS England to increase awareness of liver disease in the general population

NICE Evidence Update: Acute Upper Gastrointestinal Bleeding

August 2014

A summary of selected new evidence relevant to NICE clinical guideline 141 'Acute upper gastrointestinal bleeding: management' (2012)

This Evidence Update provides a summary of selected new evidence published since the literature search was last conducted for the following NICE guidance: Acute upper gastrointestinal bleeding. NICE clinical guideline 141 (2012) A search was conducted for new evidence from 23 September 2011 to 20 February 2014. A total of 6061 pieces of evidence were initially identified. After removal of duplicates, a series of automated and manual sifts were conducted to produce a list of the most relevant references.

AUGIB Publication

Wednesday, 16 April 2014 15:02

In recent years a key area of concern for the BSG has been the lack of 24/7 provision of Acute Upper GI Bleeding (AUGIB) services. With a mortality rate of 10% and no notable improvement on this rate for years, the lack of out-of-hours coverage of services for AUGIB services is a challenge which must be urgently addressed.

Over the past year, the BSG has worked closely with NHSIQ to help identify areas which do not have AUGIB services available at all times, as well as how we can support gastroenterologists across the country to improve the availability of these services. Together we have produced a report which provides an overview of this project. Click here to read the report.

The survey, which is at the heart of this report, found that 23% of endoscopy units in England do not have AUGIB services that offer endoscopy patients 24/7 if required, and that 44% of units do not offer all acute admissions an endoscopy within 24 hours of admission with a GI bleed. You will note that the BSG, with support from NHS IQ, held workshops on this issue earlier this year.

The BSG will continue to campaign on this important issue and work with members and other bodies to promote improved provision of 24/7 AUGIB services.

If you would like support from the BSG around improving 24/7 access to AUGIB services in your Trust please contact the Chief Executive, This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Alcohol Treatment Matrix

Thursday, 03 April 2014 09:11

An innovative way of presenting evidence on alcohol treatment has been praised by several BSG members - the 'Go to Matrix' which presents a lot of clinical information in a clear way:

The Alcohol Treatment Matrix is concerned with the treatment of alcohol-related problems among adults (another deals with drug-related problems). It maps the treatment universe and for each sub-territory (a cell) lists the most important UK-relevant research and guidance. Across the top, columns move from specific interventions through how their impacts are affected by the widening contexts of practitioners, management, the organisation, and whole local area treatment systems. Down the rows are the major intervention types implemented at these levels. Inside each cell is our pick of the most important documents relevant to the impact of that intervention type at that contextual level. Visit the matrices page for articles, presentations, and a video explaining their genesis and construction.

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