BSG From Top to Bottom

Consultant gastroenterologists Dr Hugo Penny, Sheffield Teaching Hospitals NHS Foundation Trust and Dr. Michael Fitzpatrick, Oxford University Hospitals NHS Foundation Trust, discuss why new Coeliac Disease treatments are needed and what is on the horizon. They review the drug pipeline, which targets the known antigen and immune response: cytokine inhibitors (e.g. IL-15), gluten-degrading enzymes, tissue transglutaminase 2 (TG2) inhibitors, and tolerogenic therapies. JAK inhibitors show promise in refractory coeliac disease.With no licensed therapies and no regulatory roadmap, several agents are in phase 2 trials, with anti-TG2 therapy furthest advanced. Trials currently focus on adults with ongoing disease despite at least 12 months on a GFD, with paediatric patients a likely future focus.

In this episode, Dr. Asma Fikree, Consultant Neurogastroenterologist at UCLH and Chair of the BSG Neurogastroenterology & Motility Section and Dr Maria Eugenicos, Senior Lecturer/Neurogastroenterologist, Western General Hospital, Edinburgh discuss the effects of anti-obesity medications on gastric motility, dyspepsia, and gastroparesis-like symptoms.

The discussion covers the management of nausea, vomiting and delayed gastric emptying, considerations before endoscopy and surgery, the phenomenon of tachyphylaxis, and practical approaches to dose titration. Dr. Fikree also examines the emerging evidence for GLP-1 therapies in patients with IBS and chronic gastrointestinal symptoms, highlighting both the benefits and limitations of these increasingly prescribed treatments.

Professor Vikram Mitra (Chair, Pancreas Clinical Section, British Society of Gastroenterology) speaks with Professor Pramod Garg, President of the Indian Society of Gastroenterology, about the link between gut microbiome and acute pancreatitis.

Topics include whether admission microbiome can predict disease severity, which bacterial classes (notably Proteobacteria) are tied to worse outcomes, and what's known about how gut bacteria may drive pancreatic inflammation. They also discuss the case against prophylactic antibiotics, why early enteral nutrition beats bowel rest, mixed results on interventions like rifaximin, and key confounders in microbiome research (diet, ethnicity, drug use, disease etiology).

To watch the interview, click here: https://www.bsg.org.uk/web-education/gut-microbiome-in-acute-pancreatitis

In this BSG Podcast episode, Consultant Pharmacist, Fiona Rees is joined by Gastroenterology Registrar, Dr Krishna Shah and Consultant Obstetrician & Gynaecologist, Dr Mandeep Kaler to discuss pregnancy and inflammatory bowel disease (IBD). They explore the importance of preconception counselling and achieving disease remission before pregnancy.

The conversation covers how IBD can affect pregnancy and how risks can be reduced with good disease control.
They discuss practical approaches to managing flares and medication safety, reassuring that many treatments are low risk. The episode also highlights the role of multidisciplinary care between IBD and obstetric teams. Key topics include delivery planning, breastfeeding, and postpartum care. The speakers emphasise empowering patients with accurate information throughout their journey.

In this episode of the BSG Top to Bottom podcast, Prof James East and Prof Pradeep Bhandari dive into the endoscopic aspects of the new BSG IBD Surveillance Guidelines. Building on part one’s focus on cancer risk and surveillance rationale, this discussion explores practical essentials, from bowel preparation and patient comfort to chromoendoscopy, lesion detection, and the nuances of managing dysplasia in IBD. The conversation also highlights training, service delivery, MDT decision‑making, and the evolving roles of advanced endoscopic techniques and surgery. 

Chapters

(00:00:00) - Top to Bottom: Endoscopic Surveillance
(00:01:03) - The BSG Guidelines on IBD
(00:02:04) - IBD bowel prep
(00:06:01) - Colonoscopy: Comfort and Safety
(00:09:26) - BSG 5, Virtual Chromo Endoscopy
(00:18:24) - Invisible dysplasia
(00:21:09) - Who should be doing IBD endoscopy?
(00:25:06) - Diabetes and colitis 6, Neoplasia management
(00:34:11) - Segmental resection in IBD
(00:38:51) - Intensive surveillance for colonoscopy patients with dysplasia
(00:41:55) - Endoscopy and cancer: concordance