Gastroenterology and Hepatology
Upper and lower GI disease, liver, pancreas and biliary disease.
- Gastro-oesophageal Reflux Disease Reflux of gastric contents causing heartburn and regurgitation. Recognising it, when to endoscope, and stepping through lifestyle, PPI and surgical treatment.
- Barrett Oesophagus Metaplastic change of the distal oesophagus from chronic reflux, and the main precursor of oesophageal adenocarcinoma. Diagnosis, surveillance and endoscopic treatment.
- Peptic Ulcer Disease and Gastritis Mucosal ulceration and inflammation driven mainly by H. pylori and NSAIDs. Recognition, endoscopy and biopsy, eradication therapy, and the complications to watch for.
- Helicobacter pylori Infection A leading cause of peptic ulcer disease and gastric cancer. Microbiology, when and how to test, and eradication therapy.
- Upper GI Bleed A common GI emergency. Resuscitation, Glasgow-Blatchford and Rockall scoring, and the endoscopic management of variceal and non-variceal bleeding.
- Lower GI Bleed Fresh rectal bleeding from a source distal to the ligament of Treitz. Causes, Oakland scoring, CT angiography versus colonoscopy, and haemostatic options.
- Mallory-Weiss Tear A mucosal tear at the gastro-oesophageal junction from forceful vomiting. The classic history, and how to tell it from Boerhaave syndrome.
- Variceal Bleeding A life-threatening complication of portal hypertension. Terlipressin and antibiotics, band ligation, rescue TIPS, and prophylaxis.
- Oesophageal Cancer Progressive dysphagia and weight loss. Adenocarcinoma versus squamous cell carcinoma, urgent referral criteria, staging and treatment.
- Gastric Cancer Late presentation with vague dyspepsia, weight loss and anaemia. H. pylori and the Correa cascade, the classic examination signs, staging and treatment.
- Colorectal Cancer The fourth commonest UK cancer. Risk factors and genetic syndromes, FIT and screening, referral criteria, staging and surgical management.
- Inflammatory Bowel Disease Crohn's disease and ulcerative colitis compared: telling them apart, investigating, inducing and maintaining remission, and acute severe colitis.
- Coeliac Disease An autoimmune reaction to gluten causing villous atrophy and malabsorption. Who to test, the gluten challenge caveat, and lifelong management.
- Irritable Bowel Syndrome Abdominal pain with altered bowel habit and no structural disease. Positive diagnostic criteria, what to exclude, and stepwise treatment.
- Constipation A common symptom with a wide differential. Drug and metabolic causes, assessment, choosing a laxative, and managing faecal impaction.
- Malabsorption Impaired nutrient absorption causing steatorrhoea, weight loss and deficiency states. A structured approach to causes, investigation and treatment.
- Infectious Gastroenteritis Acute diarrhoea and vomiting from infection. Identifying the organism from the history, assessing dehydration, and when to treat.
- Clostridioides difficile Colitis Antibiotic-associated diarrhoea and pseudomembranous colitis. The 4 Cs, two-stage stool testing, severity assessment and treatment.
- Toxic Megacolon Colonic dilatation with systemic toxicity complicating severe colitis. Causes, the Jalan criteria, and emergency medical and surgical management.
- Diverticular Disease and Diverticulitis From asymptomatic diverticulosis to acute diverticulitis. Terminology, the Hinchey classification, and when antibiotics or surgery are needed.
- Intestinal Ischaemia Acute and chronic mesenteric ischaemia and ischaemic colitis. Pain out of proportion to signs, and why early CT angiography saves lives.
- Alcohol-Related Liver Disease Steatosis, alcoholic hepatitis and cirrhosis. Recognising each stage, scoring severity, and managing withdrawal and decompensation.
- Metabolic Dysfunction-Associated Steatotic Liver Disease The commonest liver disease worldwide, driven by obesity and insulin resistance. New terminology, non-invasive fibrosis scoring, and management.
- Viral Hepatitis Hepatitis A to E compared: transmission, clinical course, and how to interpret hepatitis B serology and hepatitis C testing.
- Autoimmune Hepatitis Chronic immune-mediated hepatitis with raised IgG and autoantibodies. Type 1 versus type 2, interface hepatitis, and immunosuppressive treatment.
- Liver Cirrhosis The irreversible endpoint of chronic liver injury. Causes, Child-Pugh and MELD scoring, decompensation, complications and surveillance.
- Ascites and Spontaneous Bacterial Peritonitis Peritoneal fluid, most often from cirrhosis. Using the SAAG to find the cause, managing ascites, and diagnosing and treating SBP.
- Liver Failure Acute and acute-on-chronic liver failure. Paracetamol overdose, the King's College criteria, and emergency management.
- Hepatic Encephalopathy Reversible neuropsychiatric dysfunction driven by ammonia. Grading, finding the precipitant, and treatment with lactulose and rifaximin.
- Hepatocellular Carcinoma The commonest primary liver cancer, arising almost always in cirrhosis. Surveillance, radiological diagnosis without biopsy, and BCLC-directed treatment.
- Liver Abscess Pus within the liver, presenting with fever and right upper quadrant pain. Distinguishing pyogenic from amoebic, and why you must find the source.
- Haemochromatosis An autosomal recessive iron overload disorder causing cirrhosis, diabetes and cardiomyopathy. HFE genetics, transferrin saturation, and venesection.
- Wilson Disease A copper storage disorder causing liver disease and neuropsychiatric symptoms in the young. Kayser-Fleischer rings, diagnosis and chelation.
- Acute Pancreatitis Acute pancreatic inflammation, usually from gallstones or alcohol. GET SMASHED, diagnostic criteria, Glasgow-Imrie scoring and management.
- Chronic Pancreatitis Irreversible pancreatic fibrosis causing chronic pain, steatorrhoea and diabetes. Faecal elastase, enzyme replacement and pain management.
- Pancreatic Cancer The poorest survival of any common cancer. Painless jaundice, Courvoisier's law, referral criteria, staging and the Whipple procedure.
- Liver Function Test Interpretation A structured approach to abnormal liver blood tests: hepatitic versus cholestatic patterns, isolated abnormalities, and what to exclude.