With significant waiting lists and growing demand for secondary care services, Advice and Guidance is being increasingly explored as one potential solution to this problem. In this episode, Charlie Andrews discusses an innovative and extremely successful use of advice and guidance in Northumbria with gastroenterologists Matthew Warren and Richard T…

Anton Emmanuel, a consultant gastroenterologist at University College Hospital London, talks to me about making the diagnosis of IBS. Anton has a specialist interest in functional diseases of the gut and is a Professor of neuro-gastroenterology at UCH. IBS is a common condition, and it is important for primary care clinicians to have a structured a…

Dr Charlie Andrews speaks to Dr Jeremy Shearman about everything related to high iron levels (hyperferritinaemia). We discuss how iron is regulated within the body, causes of raised iron levels, and then we dive into hereditary haemochromatosis - when to suspect, how to test, who to refer (and to whom!), and how the condition is managed. Useful lin…

In this episode, Charlie Andrews speaks to Melanie Orchard, a consultant surgeon, about diverticular disease and diverticulitis. This is something that we encounter frequently in primary care, and understanding how to approach this condition is extremely important. Melanie discusses a really pragmatic approach to patients with symptoms suggestive o…

Join Charlie Andrews as he discusses Hepatitis C with hepatologist Dr Kosh Agarwal and GP and clinical champion for Hepatitis C Dr Rik Fijten. They discuss the prevalence and presentation of Hepatitis C, as well as how to test for the condition along with an overview of the treatment options available. Hepatitis C is a chronic liver disease which c…

In this episode, Dr Charlie Andrews speaks to Professor Mark Pritchard about neuroendocrine tumours (NETs) of the gastrointestinal tract. You may be asking yourself: 'Do I really need to know about NETs in primary care, aren't they extremely rare?' The answer to that is a resounding yes, you do need to know about NETs and Mark will tell you why in …

Dr Charlie Andrews, a committee member of the Primary Care Society for Gastroenterology (PCSG), introduces Ingest, the podcast for primary care that focuses on when to suspect, how to diagnose and how to manage common gastrointestinal presentations and conditions.द्वारा PCSG

In this episode Dr Charlie Andrews looks back at 2023 and highlights some key takeaways from Ingest in 2023.द्वारा PCSG

In this episode, Charlie Andrews speaks to Dr Andrew Moore about this condition, which affects up to 1.5% of the population, with a risk of progression to cancer of 3-13% over the patient's lifetime (Cancer Research UK). They discuss the typical presenting features, who needs an endoscopy to look for Barrett's, and how the condition is managed both…

In this episode, Charlie Andrews speaks to Professor Julian Walters about bile acid malabsorption and diarrhoea. With up to a third of patients with diarrhoea-predominant IBS having underlying bile acid diarrhoea, and with diagnosis rates for this condition being low, this episode is an important one for anyone working in primary care. We explore t…

In this episode, Charlie Andrews speaks to Dr James Turvill about faecal calprotectin use in primary care. Dr Turvill is a gastroenterologist based in York, who was instrumental in developing the NICE-approved and widely adopted York Faecal Calprotectin Care Pathway. What is calprotectin? When should we use it in primary care? How should we interpr…

Marianne Williams is an extremely experienced dietician, innovator, digital technology advocate and winner of the NHS England Allied Health Professional of the Year prize for 2018. In this episode, Marianne shares her wealth of knowledge around all things IBS to discuss initial dietary management, the low FODMAPs diet, the role of probiotics, and g…

In this episode Charlie Andrews speaks to Dr Kevin Barrett about IBD flare management. On average, 50% of patients will flare annually, and often the GP surgery is the first port of call. We therefore need to know how to assess and manage patients presenting with symptomatic IBD. Kevin Barrett, IBD clinical champion for IBD for the RCGP and Crohns …

In this episode, Charlie Andrews speaks to Dr Kevin Monahan, lead author for the joint guidelines published by the BSG and ACPGBI in July 2022 outlining the role of FIT testing in patients with symptoms suggestive of colorectal cancer. These guidelines have informed how we use FIT in primary care, and in this episode he asks Dr Monahan how this gui…

Did you know that according to the British Liver Trust, up to 20% of the general population has non-alcoholic liver disease ('fatty liver disease') and the prevalence is predicted to rise over the coming years. Morbidity associated with this can be significant, with a proportion of patients with fatty liver disease developing fibrosis of the liver …

Join Charlie Andrews in this episode where he speaks to Cristian Costas about the management of people diagnosed with coeliac disease. Cristian is a dynamic dietician who is based in Bradford. He is passionate about coeliac disease and runs an innovative dietician-led service for those with coeliac disease in his area. Cristian shares with us his t…

In primary care, we are increasingly using FIT (Faecal Immunochemical Testing) to assess the risk of bowel cancer in patients with lower gastrointestinal symptoms, whilst the latest PCN DES IIF (Impact and Investment Fund) has given FIT a prominent role in risk stratifying 2-week wait referrals to secondary care. In this episode, Mo Thoufeeq, a gas…

In this episode, I am joined by Pearl Avery. Pearl has a unique role - she spends part of her week as an IBD nurse specialist, and part of her week as an ANP (Advanced Nurse Practitioner) working in a GP practice. Pearl has a fantastic understanding of both primary and secondary care and shares her experiences with me. We discuss her unique and inn…

I speak to Chris Lamb about IBD. Chris was lead author on the BSG IBD guidelines which were published in 2019. The full guidance can be found here: BSG-IBD-Guidelines-2019.pdf Chris is a fount of knowledge for all things related to IBD and I have a fascinating chat with him about the guidance and how these relate to primary care - we range over all…

In this episode, I speak to Professor Ramesh Arasaradnam. Ramesh co-authored the BSG guidelines on chronic diarrhoea in 2018, and is a fount of knowledge in this area.द्वारा PCSG

Affecting up to 20% of the UK population, dyspepsia is commonly seen in primary care. Following investigations, the majority of people (up to 89%) are found to have functional dyspepsia. As with any functional problem of the gut, such as IBS, making a confident diagnosis is sometimes challenging but extremely important for the patient, and manageme…

This edition of the podcast series Ingest published by the Primary Care Society for Gastroenterology (PCSG) features a very special guest from the world of gastroenterology. Dr Charlie Andrews talks to Nobel Prize laureate Professor Barry Marshall, the Director of the Marshall Centre founded in 2007 in his honour, the Western Australian Ambassador …

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 …

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 ......द्वारा PCSG

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…

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.द्वारा PCSG

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 gast…

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 th…