Nutritional care pathways in cancer patients with malignant bowel obstruction: A retrospective multi-centre study.

Introduction: Variation in access to parenteral nutrition (PN) in patients with intestinal failure secondary to malignant bowel obstruction (MBO) exists due to differing practice, beliefs and resource access. We aimed to examine differences in nutritional care pathways and outcomes, by referral to nutrition team for PN in patients with MBO.

Methods: This is a retrospective cohort study of MBO adults admitted to eight UK hospitals within a year and 1 year follow-up.

Investigating the Relationship between Home Parenteral Support and Needs-Based Quality of Life in Patients with Chronic Intestinal Failure: A National Multi-Centre Longitudinal Cohort Study.

Home parenteral support (HPS) is an essential but potentially burdensome treatment that can affect quality of life (QoL). The aims of this longitudinal study were to understand whether any changes in HPS over time were associated with QoL. The Parenteral Nutrition Impact Questionnaire (PNIQ) was used, and data were collected on HPS prescribed at three time points.

Impact of home parenteral nutrition on family members: A national multi-centre cross-sectional study.

Background & Aims: Home parenteral nutrition (HPN) is a necessary treatment for patients with chronic, type 3, intestinal failure (IF). HPN often requires lifestyle adaptations, which are likely to affect quality of life (QoL) in both patients and family members. The aim of this study was to identify the level of burden on family members who are involved with HPN care and to understand specific factors that contribute to any burden.

Results of the British Society of Gastroenterology supporting women in gastroenterology mentoring scheme pilot.

Introduction: Mentorship has long been recognised as beneficial in the business world and has more recently been endorsed by medical and academic professional bodies. Recruitment of women into gastroenterology and leadership roles has traditionally been difficult. The Supporting Women in Gastroenterology network developed this pilot scheme for female gastroenterologists 5 years either side of the Completion Certificate of Specialist Training (CCST) to examine the role that mentorship could play in improving this discrepancy.

Gender differences in leadership, workforce and scholarly presentation within a national society: a gastroenterology perspective.

In the UK, gastroenterology has been a male predominant medical speciality. Data regarding gender within workforce, academia and leadership at a national level are lacking. Data regarding scholarly presentation at the following annual conferences were collected and analysed; British Society of Gastroenterology (BSG) 2013, 2014, and Digestive Diseases Federation (DDF) in 2015.

Parenteral nutrition.

Over the last 50 years, parenteral nutrition has been recognised as an invaluable and potentially lifesaving tool in the physician's arsenal in the management of patients with intestinal failure or inaccessibility; however, it may also be associated with a number of potentially life-threatening complications. A recent NCEPOD report (2010) identified a number of inadequacies in the overall provision and management of parenteral nutrition and recommendations were made with the aim of improving clinical practice in the future. This paper focuses on the practical aspects relating to parenteral nutrition for adults, including important concepts, such as patient selection, as well as general management.

Factors associated with vitamin D deficiency in a multicultural inflammatory bowel disease cohort.

Objective: The aim of this study was to determine the prevalence of vitamin D deficiency in a multicultural inflammatory bowel disease (IBD) cohort and determine predictors of deficiency including ethnicity.

Design: Patients with IBD were recruited into a dedicated database over a 6-month period and evaluated retrospectively.

Setting: Department of Gastroenterology, St George's University Hospital, London, UK.

Attitudes and expectations of gastroenterology outpatients about the importance of diet and possible relationship to their symptoms.

Objectives: To evaluate gastroenterology outpatients' attitudes to the importance of diet and its relationship to their symptoms, as well as their expectations of dietary advice from health professionals.

Design: Prospective clinical audit.

Setting: Gastroenterology outpatient department of St George's Healthcare NHS Trust.

Nutrition support in intensive care units in England: a snapshot of present practice.

Nutrition support is an important part of care management in critically ill patients, not only to prevent and treat malnutrition but also it has a significant impact on recovery from illness and overall outcome. There is little information available about present nutritional support practice for patients in intensive care units (ICU) in the UK. This survey was designed to evaluate the present nutrition support practice in ICU and high dependency units (HDU) in England.

Nutritional training in gastroenterology.

Despite the clear importance of nutritional knowledge for health professionals, such education has long been notoriously patchy at both undergraduate and postgraduate levels. Gastroenterologists in particular have a special responsibility to provide advice and expertise, not only in general nutrition but also in artificial nutrition support in the setting of extreme risk of malnutrition and intestinal failure. Recently, with the restructuring of undergraduate medical teaching and the advent of modernising medical careers, curricula have been examined in detail and training programmes have become competency based.

Systematic review: does gastro-oesophageal reflux disease progress?

Background: Gastro-oesophageal reflux disease affects approximately 20% of western populations. Barrett's oesophagus, associated with severe gastro-oesophageal reflux disease, is premalignant and regular endoscopic surveillance is generally performed. In contrast, mild gastro-oesophageal reflux disease is thought not to progress and is not generally subjected to endoscopic follow-up.

The role of the hiatus hernia in gastro-oesophageal reflux disease.

A sliding hiatus hernia disrupts both the anatomy and physiology of the normal antireflux mechanism. It reduces lower oesophageal sphincter length and pressure, and impairs the augmenting effects of the diaphragmatic crus. It is associated with decreased oesophageal peristalsis, increases the cross-sectional area of the oesophago-gastric junction, and acts as a reservoir allowing reflux from the hernia sac into the oesophagus during swallowing.

Diverticular disease of the colon: ethnic differences in frequency.

Background: Colonic diverticular disease is more common in Western populations than in developing countries.

Aim: To determine whether the frequency of colonic diverticular disease is different in British patients of Indian-subcontinent Asian origin compared with other ethnic groups.

Methods: All colonoscopies performed over a 3-year period in a London hospital were studied.

Detection and verification of Mycobacterium avium subsp. paratuberculosis in fresh ileocolonic mucosal biopsy specimens from individuals with and without Crohn's disease.

Mycobacterium avium subsp. paratuberculosis is a robust and phenotypically versatile pathogen which causes chronic inflammation of the intestine in many species, including primates. M.

Effect of octreotide on small intestinal motility in HIV-infected patients with chronic refractory diarrhea.

Octreotide has been used to treat HIV-associated diarrhea. We aimed to assess the effect of octreotide on small intestinal motility in a group of HIV infected individuals with chronic diarrhea. Small intestinal motility was measured continuously for 48 hr by ambulatory strain gauge manometry in 12 HIV seropositive subjects with chronic diarrhea.

Delayed gastric emptying in human immunodeficiency virus infection: correlation with symptoms, autonomic function, and intestinal motility.

Gastric emptying may be delayed in HIV infection. We aimed to characterize the pattern of gastric emptying in HIV seropositive subjects and correlate the findings with symptoms, as well as to identify possible etiological factors. Solid gastric emptying was measured using scintigraphy in 54 HIV seropositive subjects and 12 HIV seronegative controls.

Cardiac autonomic dysfunction in AIDS is not secondary to heart failure.

Objective: Heart rate variability (HRV) is a marker of cardiovascular autonomic tone, and is also known to be reduced in association with cardiac dysfunction. Abnormal autonomic function tests are common in HIV infected individuals, but the contribution of heart disease to such findings is not known. Spectral analysis of heart rate variability is a sensitive technique for measurement of cardiovascular autonomic function, which also allows differential assessment of parasympathetic and sympathetic components.

Small intestinal transit, absorption, and permeability in patients with AIDS with and without diarrhoea.

Background: Diarrhoea in AIDS is associated with anorexia and weight loss. The importance of gastrointestinal transit in such symptoms has not been addressed.

Aims: To assess jejunal to caecal transit times in subjects with AIDS related diarrhoea and weight loss and correlate these with measures of absorptive capacity and intestinal permeability.