Ingest

Dyspepsia is a common presenting complaint in primary care, and encompasses a range of symptoms including GORD, nausea, and epigastric pain.  Having an approach to these patients is vital given how commonly we see these symptoms, and Mike Burkitt joins me in this episode to provide a really useful overview of dyspepsia, and how we can approach this symptom in clinical practice.  Mike also gives his thoughts on what to do when the endoscopy comes back normal in a symptomatic patient.  
Useful resources for dyspepsia include:https://cks.nice.org.uk/topics/dyspepsia-unidentified-cause/https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#upper-gastrointestinal-tract-cancers
A great video recorded by Dr Sophie Nelson and Dr Mike Burkitt covering dyspepsia can be found here: https://mft.nhs.uk/mri/services/gastroenterology-and-hepatology/

Dr Charlie Andrews discusses coeliac disease. Following the last episode on iron deficiency anaemia this episode focuses on coeliac disease, what it is, NICE guidance, when to suspect, how to test and a non biopsy pathway to diagnosis. First though a history lesson ……

Dr Charlie Andrews discusses iron deficiency anaemia (IDA) with Dr Sophie Nelson, a GP from Manchester with a special interest in gastroenterology and a self proclaimed geek when it comes to IDA. Dr Sophie Nelson is a committee member of the PCSG This podcast was recorded soon after the publication of updated guidelines for the management of IDA in adults by the BSG.

Following on from the episode on dysphagia Dr Charlie Andrews talks to patients about their experience of being diagnosed and living with achalasia. Achalasia affects about one in every 100,000 people and can occur at any age. The key symptom is dysphagia.

In this episode of Ingest I speak to Dr Mark Follows, a GPwER in gastroenterology, about dysphagia.  Mark bridges both primary and secondary care gastroenterology and provides an informative and authoritative overview of dysphagia. We look at the normal swallowing process, the differential diagnosis of dysphagia (including neurological, ENT and gastrointestinal causes), and how to investigate the patient with dysphagia. Mark talks about his approach to the patient with dysphagia, red flags and who to refer to and how urgently.  If your automatic reaction to the patient with swallowing difficulties is to refer directly to gastroenterology, I would recommend you listen to this episode to develop a deeper understanding of this symptom.   

I have a fascinating discussion with Professor Stephen Atwood, a surgeon and honorary professor at Durham university, about Eosinophilic oesophagitis (EoE), an important cause of dysphagia.  Rarely do I get to speak to someone who has first identified a disease, however this is exactly what Professor Attwood did in the 1980s, and he discusses how this discovery came about, and brings us up to speed on the risk factors for the condition, the causes of the disease, how the patient may present and how to manage the patient with EoE, including the latest treatment orodispersible steroid treatment Jorveza.