Endo Surge Clinic

06/06/2026

A recent study found that patients who had a positive f***l occult blood test (FOBT) but didn’t follow through with a colonoscopy had a fourfold higher risk for colorectal cancer (CRC) than the general population. By contrast, patients who had positive FOBT who underwent colonoscopy and had a negative result had a considerably lower incidence of CRC than the general population. More on the study: https://mdsc.pe/4eoheU1

23/05/2026

Digestive cancers continue to drive cancer mortality across Europe – yet earlier detection offers one of the greatest opportunities to shift outcomes.

Each cancer requires a tailored strategy to maximise impact 🎯

Discover the recommended approaches below ⬇️

🦠 Gastric cancer – targeted H. pylori screen-and-treat strategies in high-incidence countries and high-risk individuals are recommended, while broader population-level screening approaches remain under evaluation

🔍 Colorectal cancer – organised, population-based screening programmes are the cornerstone of early detection, typically using FIT with colonoscopy follow-up

⚠️ Liver cancer – targeted screening in high-risk populations is recommended, with surveillance focused on individuals with cirrhosis following risk stratification

🧬 Pancreatic cancer – population-wide screening is not recommended; structured, long-term surveillance is limited to high-risk individuals (e.g. genetic or familial risk)

Dive deeper into our latest position paper to explore the policy priorities needed to strengthen screening across Europe 👉 https://bit.ly/4mYFleR

We thank all our contributing member societies and endorsers for their valuable support: EASL - The Home of Hepatology​, European Pancreatic Club - EPC​, European Society of Gastrointestinal Endoscopy (ESGE)​, ESPCG - European Society For Primary Care Gastroenterology​, Digestive Cancers Europe - for Patients​, European Liver Patients' Association​, PCE Pancreatic Cancer Europe​, European Cancer Organisation

13/05/2026

📊 JAMA Clinical Guidelines Synopsis: infection is a leading cause of chronic , , and .

The American College of Gastroenterology guideline for adults in North America recommends bismuth quadruple therapy for 14 days as first-line treatment in treatment-naive patients, due to superior eradication rates compared with proton pump inhibitor (PPI) triple therapy.

Alternative regimens, including rifabutin triple therapy and potassium-competitive acid blocker therapies, are suggested based on drug availability and prior treatments. Clarithromycin-containing regimens are not recommended empirically due to resistance.

https://ja.ma/4u7WMwl

08/05/2026

Summary of the new NEJM Barrett’s Esophagus review⁠� (Clinical Practice, 2026):
🔬 Barrett’s Oesophagus — NEJM 2026 (Key Takeaways)

1) Pathogenesis & Risk
نتيجة
chronic acid + bile reflux → metaplastic transformation
Squamous → columnar epithelium with intestinal metaplasia
Considered premalignant with risk of adenocarcinoma �
New England Journal of Medicine +١

Major risk factors:
Chronic GERD
Male s*x
Age >50
Central obesity
Smoking
Family history

2) Cancer Risk
(Important nuance)
Relative risk ↑ significantly
(up to 30–125×)
BUT absolute annual risk منخفض (~0.3–0.5%)

➡️ Key message:
Not all Barrett’s needs aggressive therapy �
MDInteractive +١

3) Diagnosis
(Still gold standard)
Endoscopy + biopsies
≥1 cm columnar mucosa above GEJ

Histology:
intestinal metaplasia (goblet cells)
📌 Prague classification remains standard

4) Screening —
More selective approach
NEJM reinforces modern guideline trend:
❌ No population screening
✅ Screen only if:
Chronic GERD + ≥2 risk factors

5) Surveillance Strategy
Based on dysplasia:
الحالة
المتابعة
No dysplasia
Every 3–5 years

Low-grade dysplasia
Short interval or ablation

High-grade dysplasia
Endoscopic eradication

6) Management — Major NEJM Emphasis

A) Medical
PPI therapy for all
الهدف:
symptom control ± ربما chemoprevention
B) Endoscopic therapy (cornerstone)
For dysplasia:
Endoscopic mucosal resection (EMR)
Radiofrequency ablation (RFA)
✅ Preferred over surgery in most cases

C) Surgery
Reserved for:
Selected early cancer
Failure of endoscopic therapy

7) Emerging Concepts (Very exam-relevant)
Shift toward risk stratification instead of blanket surveillance
اهتمام متزايد بـ:
AI detection systems
Non-endoscopic screening tools
Recognition that:
“Most patients with Barrett’s will never develop cancer”

🔑 Clinical Pearls (NEJM-style)
Don’t over-treat non-dysplastic Barrett’s
Dysplasia = game changer
Always confirm LGD by expert pathologist
Ablation ≠ for everyone

🧠 Bottom line
Barrett’s today is managed as:
Risk-based premalignant condition — not a uniform cancer precursor

07/04/2026

Inguinal hernia is a condition where abdominal contents (usually intestine or fat) protrude through a weakened area of the inguinal canal in the groin. It often presents as a bulge that increases with coughing or straining and may reduce when lying down. Untreated cases risk incarceration (non-reducible) and strangulation, which is a surgical emergency due to compromised blood supply.

07/04/2026

𝐏𝐑𝐄𝐒𝐒 𝐑𝐄𝐋𝐄𝐀𝐒𝐄

𝐁𝐨𝐭𝐬𝐰𝐚𝐧𝐚 𝐨𝐛𝐬𝐞𝐫𝐯𝐞𝐬 𝐖𝐨𝐫𝐥𝐝 𝐇𝐞𝐚𝐥𝐭𝐡 𝐃𝐚𝐲 𝐭𝐨𝐝𝐚𝐲 𝐦𝐚𝐫𝐤𝐢𝐧𝐠 𝐭𝐡𝐞 𝐟𝐨𝐮𝐧𝐝𝐢𝐧𝐠 𝐨𝐟 𝐖𝐇𝐎

07/04/2026

Today as we celebrate world health day, we encourage all to work towards healthy living and a healthier environment. Let us all keep working together to strengthen healthcare systems and prioritise well-being of every individual.

02/04/2026

Access to care is an international issue, but in our country, we are worse off. It is reported that it takes a median 160 days from presentation to diagnosis. Endosurge clinic provides a pathway for improved access to early diagnostics and early treatment. Call 77190064 to make an appointment. Timely access, quality care.

14/03/2026

04/03/2026

Chronic is defined by recurrent loose or watery stools, with or without increased stool frequency, f***l urgency, or f***l incontinence, that lasts for at least 4 weeks.

Chronic diarrhea affects approximately 6% to 7% of US adults. Although a wide range of conditions can cause chronic, noninfectious diarrhea, irritable bowel syndrome with diarrhea (IBS-D) and functional diarrhea, a condition characterized by chronic diarrhea without abdominal pain, are the most common causes.

📄 This Review summarizes evidence-based strategies to diagnose and treat the most common causes of chronic, noninfectious diarrhea in adults. https://ja.ma/4r8M3zb