Discover and read the best of Twitter Threads about #GI

Most recents (24)


#GI #GIbleed #urea

Elevated BUN: creatinine ratio favors UPPER over lower GI bleed.


1) Hb in stomach --> amino acids (aa).
2) aa absorbed by small intestine.
3) aa transported and taken up by liver.
4) In the liver, aa undergo deamination, leading to release of NH3. Image

5) NH3 (aka ammonia) is converted to urea by the urea cycle, leading to elevated blood urea levels.
6) Meantime, creatinine is not influenced by the protein/aa bolus.
7) Thus, BUN/creatinine ratio is increased.

So why does blood cause this bump in urea and increase in BUN/creatinine ratio, whereas a steak dinner does not?

Because blood has poor BIOLOGICAL VALIUE (the protein is poorly utilized by the body).

The LOWER the biological value of a protein, the HIGHER the urea.
Read 4 tweets

The 4th🗞️of the #GenderEquity series I had the privilege to lead w ⭐️#WomenInGI⭐️ is out


🎯Closing the #GenderGap in #GILeadership: The need for effective & comprehensive #Allyship @SiwanTG @AmyOxentenkoMD

A🧵& a 📣to action
1/ Let’s talk numbers #GenderDisparity in #GILeadership

#WomenInGI make up
⚠️19% of fellowship PD or Division chair

⚠️20% of Editorial boards of journals

⚠️5 or less Presidents of 🇺🇸 #GI societies founded >70 yrs; @BritSocGastro founded in 1937 had 2 & @my_ueg (‘1992) one
2/#GenderDisparity in #GILeadership
It’s not a pipeline🚰 issue
🧑🏼‍⚕️👩🏽‍⚕️Make up
🔺50% med students
🔺33% #GIFellows

🔺40% of graduating🧑🏼‍⚕️👩🏽‍⚕️ enter academia

⬆️ # of women in GI is not enough to close the gap

💎#Allyship from women leaders,men, institutions & self-promotion is needed
Read 9 tweets
1/11 #GITwitter is on 🔥 w #MedEd

It all started on one #MondayNight @DCharabaty

@MondayNightIBD was created & led the way for other platforms incl @ScopingSundays

👇#Tweetorial:Setting up Structured #MedEd Platforms on Social Media in @AGA_Gastro

📜 Image
2/11 Firstly ❓- Are #SoMe based #MedEd platforms & activities useful?

This survey by @DCharabaty & team 📝 at @DDWMeeting shows:

✅ Respondents suggesting change in practice based on discussions in 👆
✅ Enhances collaborations
✅ Promotes decision making
✅ Opport networking Image
3/11 Ready to get started ?

🟣Align Handle & Audience to your Educational Interest
🟣Create educational handle separate from your personal account
🟣Self-explanatory name & logo
🟣Determine 🎯 audience to curate content that will optimize engagement

Step-by-step guide 👇 Image
Read 11 tweets
🧵 Thread zum Thema #GI #gastrointestinale Probleme im Zuge von #LongCovid

Viele #longcovid (und auch #mecfs) Betroffene berichten von anhaltenden Verdauungsproblemen wie Durchfall - #Diarrhoea nach der Infektion.

Auch ich habe seit 11 Monaten eine gestörte Verdauung …

6 Monate nach der Infektion wurde es immer schlimmer, unverdaute Substanzen im Stuhl, anhaltender Wasser- und Kräfteentziehender Durchfall.

Ich lies eine #Mikrobiomanalyse einer Stuhlprobe durchführen. (Kosten: 130€)

Mit folgenden auffälligen Ergebnissen:

1. #leakygut, … heißt mein Darm ist löchrig und Stoffe die eigentlich ausgeschieden in die Toilette gehören, landen leider auch im Blut, woraufhin leider auch das Immunsystem wie zb #Mastzellen reagieren können.

Read 17 tweets
@MondayNightIBD 1/ 📣 #GITwitter #IBDTwitter
It’s a new🔥#Back2Basics session with #GI #Fellow @JosephHabibi_MD

Let’s talk AZA/6-MP in IBD

#IBDPolls 1️⃣&2️⃣👆🏽
✅Role as Mono/combo therapy
✅Escalation consideration
✅TPMT & NUDT15 testing
✅Side effects & counseling Image
@MondayNightIBD @NavreetChowlaMD @MilestoneIBD @IBD_FloMD @tinahamd @DrCoreySiegel @HorstIBDDoc @MLongMD @LauraRaffalsMD @doc_ibd @IBDBen 2/ AZA trials in IBD:

🔹Corticosteroids needed to induce remission
🔹Takes ~12 wks for AZA/6MP to become effective, so taper steroids accordingly
🔹AZA/6-MP effective for maintenance of remission (mainly in UC); Not effective for induction ImageImage
@MondayNightIBD @NavreetChowlaMD @MilestoneIBD @IBD_FloMD @tinahamd @DrCoreySiegel @HorstIBDDoc @MLongMD @LauraRaffalsMD @doc_ibd @IBDBen @IBDHorizons @IBD_Houston @IrisWangMD @LoriPlung @vaibhav_manu @KatieFalloonMD @amneethansmd @ManuelBragaMD @Chatterjee_MD @SuhaAbushamma 3/ AZA in today’s practice

1⃣CS-sparing monotherapy for maintenance of moderate IBD
2⃣Combo w/ TNFi to
↑ TNFi levels
↓ Ab formation
2nd MOA for severe/complex IBD not responsive to mono💉
Perianal Crohn’s

Read 18 tweets
Read 7 tweets
@MondayNightIBD @DCharabaty 1/12
📣#GITwitter #IBDTwitter

Welcome back to #MondayNightIBD #Back2Basics w @dunleavy_katie @john_damianosMD

🎯How do you approach a pt w #IBD in remission who has new or persistent #GI symptoms?

Check out our review📜…

#NeuroGI #GastroPsych #DGBI
@MondayNightIBD @DCharabaty @john_damianosMD 2/12 #MondayNightIBD #B2B

👩🏼‍⚕️have been studying “IBS-type symptoms” in #IBD for 30 yrs. But there is more work to be done to help characterize cohort & dz mechanism!

It’s important bc:
👨‍👩‍👧‍👦Affects pts QoL, mental health, sleep
🥼Causes ⬆️HC utilization, ⬆️MD visits & 💊narcotics Image
@MondayNightIBD @DCharabaty @john_damianosMD @MarcelYibirin @VictorChedidMD @LauraRaffalsMD @Spencerkelley7 @RomyChamoun @JosephHabibi_MD @ayshaslam999 @GroverDheera @yaransarkis @BassiMehak 3/12 #MondayNightIBD Persistent/New GI Sx in #IBD
1⃣R/o active🔥/#IBD complication (abscess, stricture):🔦, 🩻, CRP, FCP, ⚠️R/o infx like C. Difficile!

2⃣🤔Consequences of✂️: adhesion, bile acid diarrhea

3⃣🤔 #DGBI
🚩25% pts w #IBD in endo remission have #IBS @LancetGastroHep Image
Read 6 tweets
Are you interested in #GIFellowship?

Hear from PDs & #GIFellows

✅ Application pearls
✅ LORs
✅ Tips forPersonal Statement
✅ Interviews

Who should attend?
🎯 Prospective applicants
🎯 Anyone who mentors residents


To warm up before this-a 🧵below: Image
1/16)To start, learn perspective of #GIFellows of what makes one a competitive applicant. Part I of this series covers:

✳️ Deciding on a career in #GI
✳️ Self assessment
✳️ Finding mentors
✳️ Scholarly work

All authors were fellows at time of this 📜

👉… Image
2/16) In part II of this series from above, it covers:

👉 Building your resume
👉 Building your brand
👉 Issues pertaining to minorities / #WomenInMedicine
👉 LORs
👉 Personal Statement
👉 Where to apply
👉 Interviews
👉 What happens if you dont match

📎… Image
Read 17 tweets
#2 B-COMPLEX/MULTI VITAMIN. Buy a liposomal or other form that increases bio-availability. Take 1 capsule w/Breakfast and Lunch. If you have stomach upset, try sublingual (under tongue) EZ Melt B-Complex in AM & Multi w/iron for Dinner.…
#3 OMEGA 3s. Fish Oil, Krill Oil, Algae Oil are all good sources of Omega 3. Be careful the EPA/DHA ratio. EPA helps with inflammation/DHA helps with cognition. You need both! Opt for a 1:1 or 2:1 ratio of DHA to EPA (2:1 ratio eg. 800 DHA/400EPA)…
Read 93 tweets
I'll be adding short important points which would hopefully help in remembering certain concepts during #PLAB preparation, to this thread🧵every now and then as I take them out from my scattered notes. Feel free to comment your tips and tricks which would help others, as well 👇
Please don't take any of these as medical advice 😂🙏. Real life stuff is much more nuanced. These are just clinchers for the sake of the exam.
1. Drug contraindications...
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
Read 60 tweets
🌬️ Breath testing for #SIBO: everything you need to know! 🎈 😮‍💨 💩 🦠 🐄 📈

#MedTwitter #medicine #science #GITwitter #GI #microbiome #IBS #diet #nutrition…
To kick things off: how do you diagnose #SIBO?
#SIBO is a disorder characterized by excessive colonization of the small intestine by organisms usually found in the colon, especially Gram-negative bacteria.

(NB: the more we learn, it seems the *type* of bacteria is more important than the *number!*)
Read 26 tweets
🆕European guidelines on fecal incontinence, which affects about 8️⃣% of people. 💩

#MedTwitter #medicine #GITwitter #GI #Surgery #SurgeryTwitter

Read 11 tweets
@MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita 📣 #IBD patients & caregivers:

#IBDPoll 1️⃣

📊Thinking abt your IBD needs, what's been the biggest hurdle to your care?
📝 In the replies, elaborate. What’s helped your care?

Please share your #PatientExperience w #MondayNightIBD 👇🏽

@MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita #MondayNightIBD #PatientExperience
#IBDPoll 2️⃣

🧐Thinking about your culture’s expectations

📊 Have you tried Complementary and Alternative (CAM) Therapies (ex: ayurveda, homeopathy)?

What drove you to try these therapies? Please share your experience.

SE=side effects
@MondayNightIBD @southasianIBD @ibdesis @Empoweringpts9 @DCharabaty @ownyourcrohns @crohnsbabble @LivingWithUmeed @vkckiranpullela @TheMaveilousGut @dunung_ruchita Thank you @MondayNightIBD for shining a spotlight on 🌏 #SouthAsianIBD pt experience!

I'm Madhura from 🇮🇳, co-founder Team @ibdesis. We are proud to lead #PatientExperience on #MondayNightIBD!

We hope to improve care for our community around the 🌍 through @SouthAsianIBD.
Read 22 tweets
Don’t miss a new accredited #tweetorial launching TOMORROW here on @cardiomet_CE. #Interventional #cardiologist, #researcher, & #SoMe education leader @DLBHATTMD will be talking all about #aspirin, its role in #cardiovascular wellness & prevention, and new approaches to . . .
1) Welcome to an #accredited #tweetorial on the foundational role of #aspirin in #cardiovascular care. There are new approaches to #aspirin formulation & dosing. This program is accredited for 0.50h CE/#CME. I am @DLBHATTMD. #FOAMed #cardiotwitter #medtwitter Image
Read 49 tweets
Don’t miss a new accredited #tweetorial launching TOMORROW here on @cardiomet_CE. #Cardiologist, #SoMe education advocate, and true #Renaissance man @CMichaelGibson will be discussing a novel #aspirin prep that has PK/PD like plain #ASA . . .
. . . but a different site of absorption--with greater predictability than ECASA. DON'T MISS IT!! @DLBHATTMD @cpcannon @AnnMarieNavar @DrM_ODonoghue @DrMarthaGulati @practicalcardio @GuyattGH @DrMauricioCohen @SVRaoMD @ASPCardio @PlateletDoc @stephanamayer #FOAMed #CardioTwitter
1) Welcome to a #tweetorial where we’ll explore how changing the formulation of #aspirin & where it's absorbed in the GI tract can ⬇️the risk of acute GI injury, but still maintain predictable absorption. This program is accredited for 0.50h CE/#CME. I am @CMichaelGibson. #FOAMed Image
Read 42 tweets
Functional abdominal pain (centrally mediated abdominal pain syndrome) by Dr. Brian Lacy at @AmCollegeGastro #ACG2021

#GITwitter #GI #FGID #DGBI
A common scenario!
Read 23 tweets
Preventing complications of #IBD, with the amazing @MLongMD at @AmCollegeGastro #ACG2021

The best treatment is prevention!
Read 18 tweets
Kindly note that out of the given names in the tweet, only “Bardhaman Sitabhog” has got Geographical Indication #GITag.
Langcha, Chandrapuli & Narkel Naru are yet to get GI.

Wrongly mentioned that Bengal has got GI for Sitabhog.
Actually, GI product name is- Bardhaman Sitabhog
#Sitabhog is a part of Mahaprasad of Shree Jagannatha Temple Puri Odisha @JagannathaDhaam @SJTA_Puri

Similarly, Rasagola is offered as bhog on #NiladriBije #RathYatra

Still, reports wrongly mention that Bengal has GI tag for Sitabhog & Rosogolla.

Actually, Bengal has #GITag for-
“Bardhaman Sitabhog”
“Banglar Rasogolla” among others.

Using Sitabhog & Rosogolla etc is wrong.

The correct names & spellings must be used while sharing information.

Read 6 tweets
While we're beginning to understand more and more about the #microbiome, research on the #mycobiome (fungi 🍄) is in its infancy. Here is my summary of 🔑 points from @aeprobio's seminar on the latest research on fungi and the gut!


Bacteria in the #gut outnumber fungi as a class, but at the individual species level can occur in the same numbers.
Most #gut fungi belong to Ascomycota or Basidiomycota
Read 43 tweets
Thank you so much to @DrPraegers for having me to discuss the effects of plant-based diets on the #gut #microbiome! Here are my slides for all to see! 😃


#medicine #medtwitter #diet #nutrition #GITwitter #GI #guthealth #health
Just as we do things for heart health and brain health, our #microbiome is an organ of its own (the size of a 🥭), so we need to take care of it!
Read 30 tweets
Buckle up! This 🧵 is a deep dive into the #physiology of defecation, the mechanics of pooping! 🧰 🚽 💩…

#medicine #MedEd #science #GITwitter #GI #gut #motility #constipation #IBS
Defecation requires
1. intact #GI tract
2. coordination of many systems: neural (enteric nervous system, modulated by the peripheral somatic, autonomic and the CNS); muscular (smooth and striated); hormonal (endocrine and paracrine); and cognitive (behavioural and psychosocial)
#Constipation is the3⃣rd most common #GI symptom

💰 Annual cost of fecal incontinence and constipation: $1,594 - $7,522
Read 31 tweets
Traducción del hilo del Dr. John Damianos de la universidad de Yale acerca de las últimas evidencias en el tratamiento de los síntomas del Síndrome del Intestino Irritable #SII mediante la dieta y complementos alimenticios.
🚨¡Lo último en #dieta y suplementos para #SII!

En esto hilo voy a resumir "Complementos alimenticios y dieta como opciones de tratamiento en el síndrome del intestino irritable" ( @APandT ) por @ProfWhelan y @EiriniDimidi #medicina…
Prebiótico, inmunomodulador.
Ensayo reciente: Sin diferencia entre aloe y placebo para los síntomas del #SII o la frecuencia/calidad de las heces. Sin diferencia en el microbioma (pero los que respondieron tenían un microbioma diferente).…
Read 18 tweets
Here are the new @BritSocGastro guidelines for #IBS in @Gut_BMJ! I'll summarize in 🧵 ⬇️⬇️⬇️!


#GITwitter #GI #gut #braingut #motility #DGBI #FGID #microbiome #probiotics #MedTwitter #MedEd…
Doctor-patient communication
🧑‍⚕️A strong 🧑‍⚕️-😷 relationship is fundamental to the management of #IBS
😷Patients want their 🧑‍⚕️ to ⬆️empathy, support and information about the nature of IBS, diagnosis, and treatment options
🩸New pt: CBC, CRP or ESR, celiac serology and, if <45 w diarrhea, fecal calprotectin
➕Make POSITIVE diagnosis based on @RomeFoundation criteria
➡️Refer to #GI when: diagnostic doubt, pt w symptoms that are severe or refractory to 1stline tx,or when pt wants specialist
Read 16 tweets
Foods in our #diet can alter the pro-inflammatory vs anti-inflammatory milieu of the intestinal #microbiome.

See 🧵 below for the findings!


#GITwitter #GI #gut #nutrition…
🥖 🥜 🐠 🌰
Breads, legumes, fish and nuts⬇️several pro-inflammatory pathways:
🫓⬇️pathogenic growth factors & endotoxins
🫓⬇️ pathogenic E. coli, Bacteroides fragilis, parabacerioides
🫓⬆️ammonia detoxification pathway
🌰🐟 🍑🥦
Nuts, oily fish, fruit, vegetables & cereals ⬆️short-chain fatty acid producers
🫑⬆️Faecalibacterium prausnitzii, roseburia hominis, and more

Bacteria ferment fiber and pectins to acetate and butyrate.

SCFAs have anti-inflammatory effects on the mucosa!
Read 20 tweets

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