UEG Podcast

Michael Bretthauer on the real epidemiology of colorectal cancer in the under-50s: a genuine rise from a tiny baseline, the carcinoid confounder inflating the numbers, lifestyle versus genetics, why screening ages shouldn't drop yet, and the ECOPOP trials testing endoscopic resection against surgery.

The 2024 MASLD treatment guidelines are already changing. Pradeep Mundre and Professor Sven Francque (Antwerp), guideline co-author, cover weight-loss targets (7% and 10%), resmetirom in F2-F3 fibrosis, semaglutide's positive phase 3 in MASH, plus pioglitazone, bariatric surgery, and liver transplantation in this population.

Around one in three adults has MASLD, but only a few percent reach cirrhosis. Pradeep Mundre and Professor Sven Francque (Antwerp), co-author of the 2024 EASL guidelines, cover the new nomenclature, dysfunctional adiposity versus BMI, and how to use FIB-4 to decide who needs a hepatologist.

Sphincter-preserving surgery spares most rectal cancer patients a stoma, but hands many of them low anterior resection syndrome (LARS). Three European surgeons join Harald Rosen in discussing follow-up, where transanal irrigation lands, when to involve the gastroenterologist, and where sacral neuromodulation fits.

EoE requires long-term management, but what does that look like in practice? In Part 2, Prof. Alex Straumann discusses the realities of treating a chronic, relapsing disease, where remission is achievable but a cure is not.

The episode explores how to approach maintenance therapy, manage persistent symptoms despite histological remission, and when to escalate treatment to biologics. It also addresses the practical limitations of dietary strategies and the ongoing challenge of identifying trigger foods.

Looking ahead, the discussion highlights key unmet needs in EoE, including the absence of reliable diagnostic tools for food triggers and the potential influence of modern food production on disease prevalence.