BSG From Top to Bottom

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). The conversation ends with practical advice on gut health and pancreatitis prevention, plus priority areas for future research. A concise, evidence-based discussion for gastroenterologists and clinicians interested in the gut-pancreas axis.

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

Join Dr. Shahida Din, consultant gastroenterologist and Chair of the BSG IBD Section, for an in‑depth conversation with Professor James East, leading gastroenterologist, endoscopist, and co‑author of the new BSG IBD Surveillance Guidelines. They explore how cancer risk in IBD has evolved, when to start or stop surveillance, and the shift toward personalised risk assessment. The episode covers key updates on bowel prep, biopsy strategies, patient experience, and what clinicians should know to deliver high quality, patient centred surveillance. Stay tuned for Part 2 on endoscopic techniques and dysplasia management with Professor Pradeep Bhandari 

Part seven of seven: Dr Alexandra Kent, Consultant Gastroenterologist at King’s College Hospital, is joined by Professor Jimmy Limdi, Head of the IBD section at the Northern Care Alliance NHS Foundation Trust, to explore how Crohn's Disease recurrence is defined, predicted, monitored, and managed after surgery as recommended in the BSG IBD Guidelines. Together, they discuss the continuum of post-operative recurrence from histological and endoscopic changes to clinical and surgical relapse. They highlight key patient, disease, and surgical risk factors, including smoking and aggressive disease phenotypes. The episode covers best practice for post-operative monitoring, including the role of ileocolonoscopy, Rutgeerts scoring, faecal calprotectin, intestinal ultrasound, and cross-sectional imaging.