GiT Updates and More

H.Pylori treatment in INDIA

❇️ Baveno VII consensus is the most recent international expert agreement on the diagnosis and management of portal hypertension and its complications in patients with advanced chronic liver disease.The Baveno Cooperation, a consortium of leading hepatology experts, updates these recommendations every five years, and they are endorsed by major scientific societies. Key advancements in Baveno VII include: 1. Non-invasive diagnosis of clinically significant portal hypertension (CSPH):Baveno VII introduced liver stiffness measurement (LSM) and platelet count-based criteria for CSPH in compensated advanced chronic liver disease (cACLD). CSPH is ruled out if LSM ≤15 kPa and platelet count ≥150 G/L, and ruled in if LSM ≥25 kPa. Patients not meeting these thresholds are classified as "grey zone" and require further risk stratification. 2. Spleen stiffness measurement (SSM): For patients not meeting Baveno VI criteria, Baveno VII recommends SSM ≤40 kPa as a safe threshold to rule out high-risk varices (HRVs) and avoid unnecessary endoscopic screening. SSM at both 50 Hz and 100 Hz has been validated for this purpose, with higher frequencies sparing more endoscopies without increasing missed HRV rates. 3. Recompensation of cirrhosis: Baveno VII formally defines "recompensation" as the removal of the primary etiological factor, resolution of decompensating events, and sustained improvement in hepatic function. This recognizes that patients with prior decompensation can achieve clinical improvement and favorable outcomes after etiological cure. 4. Risk stratification and management: The consensus emphasizes the use of non-invasive tests to stratify risk for hepatic decompensation and guide surveillance and prophylaxis. It also highlights the need for further research to refine personalized management strategies. Baveno VII criteria have been validated in various populations, including HBV-related cirrhosis and pediatric biliary atresia, demonstrating high sensitivity and negative predictive value for ruling out high-risk varices and predicting decompensation risk.However, limitations exist in certain subgroups, such as patients with hepatocellular carcinoma, where the criteria may not reliably rule in/out CSPH or large varices.

Bloating and abdominal distention #UEG

Modified Atlanta Classification of Acute Pancreas

🔆 Clinical #Pearls : ➡️ Gastritis is inflammation or erosion of the gastric lining and often presents with GI bleeding without pain. Severe, erosive gastritis can present with epigastric pain. NSAIDs or alcoholism in the history is a clue. The GI bleeding can range from a mild “coffee-ground” emesis, to a large volume vomiting of red blood, to a black stool (melena).

🔆 Clinical #Pearls : Ambulatory reflux (pH) testing (wire based or capsule based sensor) is indicated among patients presenting with typical reflux symptoms not responsive to proton pump inhibitor therapy.

🔆 TiP : In the esophagus, barium study is a good place to start with testing, but in the stomach, barium is very poor.

Doses of Vitamins

H Pylori Points

Clinical Suspicion of Fatty Liver Disease (MASLD)

Extra-Intestinal Manifestations in IBD ▶️ Starts with “E” = parallels IBD activity 🔹Episcleritis 🔹E. nodosum 🔹Elbows (peripheral lg joints) ▶️ Does not start with “E” = not parallel 🔹Uveitis 🔹Pyoderma 🔹Axial arthritis 🔹Also PSC

ACG 2025 Crhons disease Highlights

Polypectomy pearls by master endoscopist : 💠Cold snare in most cases: 🔹 All polyps </= to 10mm 🔹SSLs of any size 💠Hot snare in select cases: 🔹Any perceived risk of cancer 🔹Difficult to transect without electrocautery 🔹Anticipated fibrosis

Source : ACG Midwest Regional Post-Graduate course

Diagnosis and treatment of functional dyspepsia

A great algorithm for diagnostics and management of patients with Bloating

ESGE 2025 Standard UPPER GI ENDOSCOPY REPORT