Clinical Articles

Authors Maura Corsetti Victoria Wilkinson-Smith Learning points The reader will learn how to apply the evidences of the literature in the management of chronic constipation in clinical practice Readers will learn how to define refractory constipation Readers will learn how […]

Authors Professor Adrian Stanley   Learning Points Endoscopic therapy is required for peptic ulcers with spurting or oozing active bleeding (Forrest 1a or 1b lesions) or visible vessels (Forrest 2a) Ulcers with adherent clots (Forrest 2b) should have the clot […]

Authors Professor Ailsa Hart   Introduction Fistulising perianal Crohn’s disease (pCD) represents a major issue for patients and has a cumulative risk of over 25% at long-term follow-up. The phenotype of rectal and perianal involvement in CD is predictive of […]

Authors T H Tranah, J S Nayagam, D Joshi  Institute of Liver Studies, King’s College Hospital, London SE5 9RS, UK   Learning points: Duodenal varices are rare and clinically challenging causes of portal hypertensive bleeding associated with significant mortality; they […]

Authors Dr Aditi Kumar Professor Matthew Brookes Introduction Inflammatory bowel disease (IBD) is a chronic and relapsing inflammatory disorder of the gastrointestinal tract.1 Diarrhoea is the presenting complaint in the majority of patients, with 85% reporting it as their initial […]

Authors Dr Paul Horn Prof Philip N Newsome Key learning points How to diagnose NAFLD and NASH How to risk-stratify patients with NAFLD and NASH Stage-dependent treatment of liver disease Introduction With the increasing obesity epidemic, non-alcoholic fatty liver disease […]

Authors Dr Ashish Goel Dr Will Lester & Dr Dhiraj Tripathi Key learning points Portal vein thrombosis can present in the acute or chronic setting in patients with or without cirrhosis The cornerstone of therapy is anticoagulation, which is mandatory […]

Management of hepatic encephalopathy Authors Dr McPherson Dr Thompson Introduction Hepatic encephalopathy is a debilitating complication of cirrhosis. It is defined as brain dysfunction caused by liver insufficiency and/or portosystemic shunting [1] and is associated with an greater risk of death than […]

Authors Dr Andreyev Dr Poon highlight Case Study A 34-year-old woman presented with a long history of abdominal bloating and diarrhoea. Her medical history included ileocaecal resection for Crohn’s disease. Blood tests, faecal calprotectin, colonoscopy to neo-terminal ileum, including random […]

Authors Professor Gleeson Dr Min provide a guide Introduction About 50% of patients with cirrhosis develop ascites within 10 years of diagnosis [1,2]. The main drivers are sodium retention due to splanchnic arterial vasodilatation and perceived hypovolaemia (acting via the renin–angiotensin–aldosterone […]

Authors Dr Matthew Kurien Dr Suneil Raju Introduction Microscopic colitis (MC) is a common inflammatory bowel condition that is characterised by watery diarrhoea. It can have a chronic, intermittent or chronic-recurrent course. Associated symptoms are weight loss (seen in 42% of patients), abdominal pain (41%) and nocturnal […]

Author Dr Peter Paine Case study A 35-year-old lady was referred by surgeons for a gastroenterology-nutrition opinion. At 18 years old, while living in social care, she had received a diagnosis of irritable bowel syndrome that had settled after self-management. […]