Welcome to the Frontpage http://www.bsg.org.uk/index.html Tue, 23 May 2017 22:30:05 +0000 Joomla! 1.5 - Open Source Content Management en-gb Guidance on Decontamination of Equipment for Gastrointestinal Endoscopy: 2017 Edition http://www.bsg.org.uk/clinical/news/guidance-on-decontamination-of-equipment-for-gastrointestinal-endoscopy-2017-edition.html http://www.bsg.org.uk/clinical/news/guidance-on-decontamination-of-equipment-for-gastrointestinal-endoscopy-2017-edition.html 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.

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h.ellison@bsg.org.uk (howard) frontpage Tue, 25 Apr 2017 08:36:05 +0000
BSG statement on "Use of intravenous Hyoscine Butylbromide (Buscopan) during Gastrointestinal Endoscopy" http://www.bsg.org.uk/clinical/news/bsg-statement-on-use-of-intravenous-hyoscine-butylbromide-buscopan-during-gastrointestinal-endoscopy.html http://www.bsg.org.uk/clinical/news/bsg-statement-on-use-of-intravenous-hyoscine-butylbromide-buscopan-during-gastrointestinal-endoscopy.html 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.

 

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h.ellison@bsg.org.uk (howard) frontpage Tue, 04 Apr 2017 11:02:03 +0000
Simethicone Residue in Endoscopes http://www.bsg.org.uk/clinical/news/simethicone-residue-in-endoscopes.html http://www.bsg.org.uk/clinical/news/simethicone-residue-in-endoscopes.html 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.

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h.ellison@bsg.org.uk (howard) frontpage Tue, 28 Mar 2017 07:44:53 +0000
Research - Role of primary care in PBC management: clinician perspectives needed http://www.bsg.org.uk/clinical/news/research-role-of-primary-care-in-pbc-management-clinician-perspectives-needed.html http://www.bsg.org.uk/clinical/news/research-role-of-primary-care-in-pbc-management-clinician-perspectives-needed.html 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.

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h.ellison@bsg.org.uk (howard) frontpage Thu, 09 Mar 2017 11:36:56 +0000
UK guideline on transition of adolescent and young persons with chronic digestive diseases from paediatric to adult care http://www.bsg.org.uk/clinical/news/uk-guideline-on-transition-of-adolescent-and-young-persons-with-chronic-digestive-diseases-from-paediatric-to-adult-care.html http://www.bsg.org.uk/clinical/news/uk-guideline-on-transition-of-adolescent-and-young-persons-with-chronic-digestive-diseases-from-paediatric-to-adult-care.html 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

ABSTRACT

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
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h.ellison@bsg.org.uk (howard) frontpage Thu, 23 Feb 2017 11:47:00 +0000
Chair of the Research Advisory Committee on PHE Screening http://www.bsg.org.uk/clinical/news/chair-of-the-research-advisory-committee-on-phe-screening.html http://www.bsg.org.uk/clinical/news/chair-of-the-research-advisory-committee-on-phe-screening.html Public Health England are currently advertising for three Chairs for Public Health England’s cancer screening programme Research Advisory Committees (RAC). One for each of the below RACs:

  • Bowel Cancer Screening Programme (BCSP)
  • Breast Screening Programme (BSP)
  • Cervical Screening Programme (CSP)

The RACs are responsible for ensuring that PHEs screening programmes support good quality research without compromising the day to day function of the screening programmes. Candidates should be able to demonstrate experience in one or more of the following:

  • Experience in chairing a multidisciplinary group.
  • A detailed understanding of screening.
  • Experience in health services research (ideally in screening programmes).

Closing date: 07/12/2016

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h.ellison@bsg.org.uk (howard) frontpage Thu, 01 Dec 2016 13:27:47 +0000
BSG guidance on the use of faecal calprotectin testing in IBD http://www.bsg.org.uk/clinical-guidance/ibd/bsg-guidance-on-the-use-of-faecal-calprotectin-testing-in-ibd.html http://www.bsg.org.uk/clinical-guidance/ibd/bsg-guidance-on-the-use-of-faecal-calprotectin-testing-in-ibd.html Updated guidance document on use of faecal calprotectin – both in assessment of GI symptoms, and also in patients with known IBD.

Dr Barney Hawthorne, Chair BSG IBD Section Committee, October 2016.

Differentiation between inflammatory bowel disease (IBD) and functional gut disorders, and the determination of mucosal disease activity in established cases of IBD remain the cornerstones of disease diagnosis and management. Non-invasive, accurate biomarkers of gut inflammation are needed due to the variability of symptoms, the inaccuracies of currently available blood markers and the cost and invasive nature of endoscopy. Numerous biomarkers have been used and/or considered with some in current use...

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h.ellison@bsg.org.uk (howard) frontpage Tue, 01 Nov 2016 13:24:08 +0000
BSG Statement on the findings of the IBD Audit Report http://www.bsg.org.uk/clinical/news/bsg-statement-on-the-findings-of-the-ibd-audit-report.html http://www.bsg.org.uk/clinical/news/bsg-statement-on-the-findings-of-the-ibd-audit-report.html Commenting, Dr Barney Hawthorne, Chairman of the IBD Section at the BSG, said:

"The British Society of Gastroenterology (BSG) welcomes the findings of the latest round of the UK IBD Audit published today by the Royal College of Physicians, particularly noting the data on the use of biosimilar versions of infliximab in the NHS, and welcomes the contribution of BSG members to the findings.

"In February this year the BSG has published a guidance document supporting their use in IBD patient care. The guidance advocates their use when prescribed by brand name, and emphasises the importance of ongoing pharmacovigilance for patients receiving these drugs through ongoing data collection through the UK IBD Registry.

"With the NHS facing significant increasing financial pressures, biosimilars contribute towards improving IBD patient care and outcome while creating efficiency savings of up to £3million annually in this therapeutic area alone. We are encouraged by the reports key findings, including biosimilar versions of infliximab being shown to be as effective as other originator versions. It is vital that the reductions in costs to the NHS are used to reinvest in improvements to IBD services.

"The BSG have worked hard with partners to develop a wider IBD programme in the UK – encompassing the IBD Audit, BSG’s IBD Registry and IBD Standards – and hope that this collaboration will continue to benefit patients with IBD."

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h.ellison@bsg.org.uk (howard) frontpage Thu, 22 Sep 2016 06:27:46 +0000
BSG 2016 Journal Prizes http://www.bsg.org.uk/education/news/bsg-2016-journal-prizes.html http://www.bsg.org.uk/education/news/bsg-2016-journal-prizes.html Gut prize (£350) for best basic science oral communication: OC-031 (A genome-wide association study identifies pnpla3 and slc38a4 as risk loci for alcoholic hepatitis), presented by Stephen Atkinson during the Liver Free Papers session.

Frontline Gastroenterology prize (£250) for the best patient benefit in gastroenterology oral communication: OC-038 (Making the change: switching to infliximab biosimilars for IBD at North Bristol NHS Trust), presented by Louise Chung during the Gastroenterology Service Free Papers session.

BMJ Open Gastroenterology prize (article processing is free for one submission) for the best clinical science oral communication: OC-017 (international multicentre study assessing the effects of anti-thrombotic use in patients with upper GI bleeding), presented by Philip Dunne during the Gastroduodenal Free Papers session

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h.ellison@bsg.org.uk (howard) frontpage Wed, 06 Jul 2016 12:02:49 +0000
Conference Report: Improving Outcomes for Gastrointestinal Cancer in the UK http://www.bsg.org.uk/clinical/news/conference-report-improving-outcomes-for-gastrointestinal-cancer-in-the-uk.html http://www.bsg.org.uk/clinical/news/conference-report-improving-outcomes-for-gastrointestinal-cancer-in-the-uk.html On 7 December 2015, the British Society of Gastroenterology and the Royal College of Physicians held a joint conference: GI cancer in the UK: can we do better? The meeting was timely as, although outcomes for patients with most gastrointestinal cancers in the UK have steadily improved in the past 10 years, survival figures remain substantially worse than in many other comparable nations.

An extensive write up of the meeting, covering screening, early diagnosis, specific tumour sites and the interface between primary and secondary care were covered by leading UK experts.

This has been published in Frontline Gastroenterology and can be access through the link below.

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h.ellison@bsg.org.uk (howard) frontpage Wed, 15 Jun 2016 08:21:00 +0000