In this episode, Dr Charlie Andrews speaks to Professor Mark Pritchard about neuroendocrine tumours (NETs) of the gastrointestinal tract.  You may be asking yourself: 'Do I really need to know about NETs in primary care, aren't they extremely rare?'  The answer to that is a resounding yes, you do need to know about NETs and Mark will tell you why in this episode!   Neuroendocrine cancer is the 10th most prevalent cancer in England, and the second most prevalent cancer of the GI tract, with a rapidly rising incidence (371%) over the last 20 years.  NETs are commonl ..read more

Dr Charlie Andrews, a committee member of the Primary Care Society for Gastroenterology (PCSG), introduces Ingest, the podcast for primary care that focuses on when to suspect, how to diagnose and how to manage common gastrointestinal presentations and conditions ..read more

In this episode Dr Charlie Andrews looks back at 2023 and highlights some key takeaways from Ingest in 2023 ..read more

In this episode, Charlie Andrews speaks to Professor Julian Walters about bile acid malabsorption and diarrhoea. With up to a third of patients with diarrhoea-predominant IBS having underlying bile acid diarrhoea, and with diagnosis rates for this condition being low, this episode is an important one for anyone working in primary care. We explore the role and physiology of bile acids, the causes and symptoms of bile acid malabsorption, the diagnostic tests used to make the diagnosis and the treatment of this common but underdiagnosed condition. Should we use 'trial of treatment' in primar ..read more

In this episode, Charlie Andrews speaks to Dr James Turvill about faecal calprotectin use in primary care. Dr Turvill is a gastroenterologist based in York, who was instrumental in developing the NICE-approved and widely adopted York Faecal Calprotectin Care Pathway. What is calprotectin? When should we use it in primary care? How should we interpret the result? Can any medications or conditions affect the result? Listen on to find the answers to these questions! The care pathway can be found here: https://www.yorkhospitals.nhs.uk/seecmsfile/?id=941. It is recommended that you have a look ..read more

Marriane Williams is an extremely experienced dietician, innovator, digital technology advocate and winner of the NHS England Allied Health Professional of the Year prize for 2018.   In this epsiode, Marianne shares her wealth of knowledge around all things IBS to discuss initial dietary management, the low FODMAPs diet, the role of probiotics, and gives us some great advice about how we can maximise our (often short) patient consultations with newly diagnosed IBS patients.  Marianne also discusses her innovative dietetic-led gastroenterology clinic for IBS patients with us.&nbs ..read more

In this episode Charlie Andrews speaks to Dr Kevin Barrett about IBD flare management.  On average, 50% of patients will flare annually, and often the GP surgery is the first port of call.  We therefore need to know how to assess and manage patients presenting with symptomatic IBD.  Kevin Barrett, IBD clinical champion for IBD for the RCGP and Crohns and Colitis UK (2017-2021) shares his wealth of knowledge about IBD flare management.  We discuss how if can affect patient's quality of life, common symptoms of IBD flare, calprotectin testing and the management of IBD flare ..read more

In this episode, Charlie Andrews speaks to Dr Kevin Monahan, lead author for the joint guidelines published by the BSG and ACPGBI in July 2022 outlining the role of FIT testing in patients with symptoms suggestive of colorectal cancer.  These guidelines have informed how we use FIT in primary care, and in this episode he asks Dr Monahan how this guideline has changed clinical practice, they discuss when it should be used and what to do if you have ongoing concerns about your patient's symptoms.  In addition, they discuss specific situations such as iron deficient anaemia, rectal blee ..read more

Did you know that according to the British Liver Trust, up to 20% of the general population has non-alcoholic liver disease ('fatty liver disease') and the prevalence is predicted to rise over the coming years.  Morbidity associated with this can be significant, with a proportion of patients with fatty liver disease developing fibrosis of the liver as the disease progresses.  Diagnosing fatty liver disease and identifying those at risk of progression to fibrosis is therefore important.  In this episode I speak to Dr Helen Jarvis, a GP with a specialist interest in liver disease ..read more

In primary care, we are increasingly using FIT (Faecal Immunochemical Testing) to assess the risk of bowel cancer in patients with lower gastrointestinal symptoms, whilst the latest PCN DES IIF (Impact and Investment Fund) has given FIT a prominent role in risk stratifying 2-week wait referrals to secondary care.   In this episode, Mo Thoufeeq, a gastroenterologist in Sheffield, talks to me about what FIT is, how it differs from previously used FOBT (and why it is a more effective test!), and how we are using FIT in both symptomatic and asymptomatic patients.  He shares his top ..read more