Current Use of EEN in Pre-Operative Optimisation in Crohn's Disease.

Despite the increasing array of medications available for the treatment of Crohn's disease and a focus on mucosal healing, approximately 35% of patients with Crohn's disease undergo bowel surgery at some stage. The importance of nutritional optimisation before Crohn's surgery is well-highlighted by surgical, nutritional, and gastroenterological societies with the aim of reducing complications and enhancing recovery. Surgical procedures are frequently undertaken when other treatment options have been unsuccessful, and, thus, patients may have lost weight and/or required steroids, and are therefore at higher risk of post-operative complications.

Observed high incidence of buried bumper syndrome associated with Freka PEG tubes.

Background: Buried bumper syndrome (BBS) is an uncommon but significant complication of percutaneous endoscopic gastrostomy (PEG), which occurs due to overgrowth of gastric mucosa over the inner bumper of the gastrostomy tube. A high incidence of BBS was observed in patients with Freka PEG tubes.

Objective: To review case numbers of BBS and confirm the observed association with Freka tubes to determine whether change of practice should be considered.

Outcome measurement in clinical trials for Ulcerative Colitis: towards standardisation.

Clinical trials on novel drug therapies require clear criteria for patient selection and agreed definitions of disease remission. This principle has been successfully applied in the field of rheumatology where agreed disease scoring systems have allowed multi-centre collaborations and facilitated audit across treatment centres. Unfortunately in ulcerative colitis this consensus is lacking.

Review of surgical management of cystic hydatid disease in a resource limited setting: Turkana, Kenya.

Objective: Cystic hydatid disease is a zoonotic infection of humans caused by infection with the larval stage of Echinococcus granulosus. The prevalence rate (5-10%) in Turkana, Northern Kenya is among the highest worldwide. With an increase in foreign travel and migration of peoples, practitioners need to be aware of diseases common in these countries and their rarer manifestations.