UEG Podcast is on summer holiday and re-releases published episodes that we think deserve another listen. Enjoy!

In this episode, host Egle speaks with former UEG President Axel Dignass about what it takes to lead in times of crisis. Drawing on his experience during the COVID-19 pandemic, Axel reflects on the difference between being a boss and being a true leader. He shares thoughts on the value of empathy, transparency, and consistency, as well as how to build and sustain a resilient team. The conversation also touches on the challenges of going virtual, the importance of recognising team achievements, and the warning signs of toxic leadership. A must-listen for anyone looking to grow as a leader in uncertain times.

The headlines say colorectal cancer is surging in the under-50s. Michael Bretthauer, the colorectal screening authority behind the Nordic trials and the EU-funded ECOPOP consortium, thinks the panic is misplaced, and he has the population data to argue it.

Article on carcinoid tumours, Dr. Montminy

The 2024 EASL guidelines on MASLD are already out of date on treatment, and that's a good problem to have. In part 2, Pradeep Mundre and Professor Sven Francque (Antwerp), guideline co-author, walk through what works now. Lifestyle still earns the hardest numbers: 7% body weight loss for resolution of steatohepatitis, 10% for fibrosis regression. Resmetirom, a liver-targeted thyroid hormone receptor beta agonist, is now approved for F2-F3 fibrosis (though not in every EU country). Semaglutide has produced positive phase 3 data in MASH and an updated guideline is on the way. Sven also covers where pioglitazone, obeticholic acid, and bariatric surgery sit, the particularities of liver transplantation in this older, comorbid population, and an honest answer to what a hepatology trainee should expect from this field. Catch part 1 first if you missed it.

MASLD guidelines

Around 30% of adults now have steatotic liver disease, but only a small fraction will progress to cirrhosis. The clinical question is which ones. In part one of this two-part series, Pradeep Mundre speaks with Professor Sven Francque (Antwerp University Hospital), co-author of the 2024 EASL multi-society guidelines on MASLD. They work through the new nomenclature (MASLD, MASH, MetALD), why dysfunctional adiposity rather than BMI is the right lens for risk, and how to use FIB-4 as the gateway test in primary care: below 1.3 to reassure, above 2.67 to refer, gray zone in between. Sven also covers why lean MASLD turns up more often than expected in patients of Asian descent, and the narrow set of scenarios where liver biopsy still earns its place alongside FibroScan and ELF. Part 2 covers treatment and future directions and will be released on the 3rd of June 2026.

MASLD guidelines

Sphincter-preserving surgery has spared a lot of rectal cancer patients a stoma, but handed many of them a different problem they're rarely warned about. Low anterior resection syndrome (LARS) affects a large share of post-operative patients, and most of the work to fix it doesn't happen in the operating theatre.

Harald Rosen brings together Andreas Rink, Peter Christensen, and Franco Marinello. Three surgeons who manage LARS daily, for a candid roundtable on what's working, what isn't, and where European practice still diverges.

Among the takeaways: when diarrhoea-dominant LARS needs the gastroenterologist before any other treatment will stick; why transanal irrigation is the workhorse, but patients drop out; and the unsolved questions around phenotyping LARS and timing neuromodulation.

The full course, with case discussions and the treatment pyramid, is free on gutflix.eu.

EoE requires long-term management, but what does that look like in practice? In Part 2, Prof. Alex Straumann discusses the realities of treating a chronic, relapsing disease, where remission is achievable but a cure is not.

The episode explores how to approach maintenance therapy, manage persistent symptoms despite histological remission, and when to escalate treatment to biologics. It also addresses the practical limitations of dietary strategies and the ongoing challenge of identifying trigger foods.

Looking ahead, the discussion highlights key unmet needs in EoE, including the absence of reliable diagnostic tools for food triggers and the potential influence of modern food production on disease prevalence.

Part 2 will be released on Wednesday, the 29th of April.

Eosinophilic oesophagitis (EoE) is now a well-recognised condition. But it was not always so. In this episode, Prof. Alex Straumann shares how EoE was first identified, taking us back to the late 1980s when unusual cases of food impaction and eosinophilic inflammation did not fit any known diagnosis.

He discusses the clinical observations that led to recognising EoE as a distinct disease, the early case series that defined its phenotype, and the initial treatment approaches that shaped current practice. The episode also addresses key diagnostic challenges that remain relevant today, including the distinction from oesophageal eosinophilia and the limitations of symptom-based assessment.

In this episode, Pradeep Mundre speaks with Hannah Gordon about one of the most challenging areas in inflammatory bowel disease management: balancing effective treatment with cancer risk. As therapeutic options expand, clinicians increasingly face complex scenarios involving patients with prior malignancy in remission or those undergoing active cancer treatment. The discussion examines how cancer risk relates both to IBD itself and to immunosuppressive or biologic therapies. The episode highlights limitations in current evidence, differences across drug classes, and the importance of individualised decision-making. Emphasis is placed on multidisciplinary collaboration, patient communication, and navigating uncertainty in real-world clinical practice.

Resources below!

Resources mentioned in the show:

In the second part of this in-depth conversation, host Egle Dieninyte continues her discussion with Professor Nageshwar Reddy, shifting the focus from technological innovation to ethics, responsibility and the human dimension of endoscopy.

Professor Reddy shares how mobile endoscopy units have brought life-saving care to rural populations, and why cascade hygiene strategies are sometimes necessary when resources are limited.

The conversation then turns to a topic rarely discussed openly: mistakes. What constitutes a true medical mistake? How do we distinguish adverse events from preventable errors? And why should ERCP only ever be performed with strict indication?

Finally, Professor Reddy reflects on mentorship, generational change, work–home balance, and why compassion is not an innate trait — but a skill that can and must be cultivated.

A powerful conclusion to a two-part conversation on what it really means to practise endoscopy.