Diagnosing bile acid diarrhoea is one of the most rewarding things to do - patients have often underestimated the effect on their life and are the most grateful after starting treatment
#lifechanging
#BAM
#BAD
I say it time and again but Bile Acid Diarrhoea is the most satisfying diagnosis to make - 20 years of symptoms improved within days of starting colestyramine
#bad
@jrfw51
@baduksupport
โCompletely changes my lifeโ
Remember to consider ๐จ BILE ACID DIARRHOEAโ in patients with chronic diarrhoea. Loved hearing this from a patient after a trial of colesevelam!
Dreadful to hear of 2 recent trainee deaths. I knew Rolland - he was an excellent doctor, colleague and friend (gifted me some lovely Columbian coffee). Never heard a bad word said about him. I wish him peace.
Thank you
@bodgoddard
for this nice touch.
Having just been on call for the last 72 hours I can tell you that Iโve worked with fantastic junior doctors who are the backbone of the NHS and are worth far more than ยฃ14 an hour. Solidarity
#JuniorDoctorsStrike
20th May 2020
My wife (
@DisneyLauren
) and I were still living away from our 1 YEAR OLD son and family so we could keep them all safe as we worked on COVID wards/ICU.
@10DowningStreet
@BorisJohnson
and the rest of those at the drinks should be ashamed!
Had to take and send this today to mini-me as he thinks I sell bikes. I think mainly because I donโt wear a white coat I canโt be a doctor. Wonder what IPC would say?! ๐
Thoughts after 7 days on call:
1. People are recovering from COVID19
2. Important to keep an open mind - not everyone has COVID19
3. People are suffering from the usual ailments but can also have COVID19
4. Change in PPE - thankfully we now wear masks throughout the hospital ๐ฅ
Low FODMAP diet for
#IBS
- up to 70-80% of patients have benefit. Aim to eliminate for 2-4 weeks, then gradual reintroduce to identify individual sensitivities then liberalise the diet after this. Not a one size fits all approach.
Hardly surprising - thatโs what happens when you get paid in claps!
Thousands of doctors planning to leave the NHS citing pandemic stress and burnout
๐จ ๐จ HALT-IT trial results out
โ no reduction in mortality from GI bleeding
โฌ๏ธ risk of VTE in the TXA group
โTXA should not be used for the treatment of GIB outside the context of clinic trialsโ
Working an extra Endoscopy list today - all patients sent via 2WW pathway. Conscious about these patients getting a timely endoscopy but in the back of my mind thinking all the time of how close to the taxation threshold this list takes me - not how it should be
@MattHancock
Cโmon
@SteveBarclay
@Jeremy_Hunt
take Tony up on this offer to fix the problem before you have an even worse workforce issue than we already do. Iโve no doubt that Iโll be forced to leave the NHS early with current conditions.
1/ Thank you very much once again for bringing up pensions
@MartynDaySNP
yesterday at
@CommonsHealth
to
@SteveBarclay
Some important answers in there (& some factually incorrect ones) so lets break them down, as its very important & shows govmnt (misguided) thinking
๐&RT
#twitterfriends
I am asking those who love the outdoors to post a picture. A picture that YOU took. No description. The goal is to regain peace and harmony without the negativity. Please copy the text, put a picture on your page and letโs look at these. Here is mine.
#Kenilworth
#medtwitter
is such a toxic place at times.
Plot: Essentially 1 person voices an opinion followed by (largely) negative comments
Subplot: lots of threads with lots more negativity
I thought we were a supportive bunch. Remember there is a draft option before tweeting. Use it?!
@MedCrisis
Surely it canโt just be any butter though? Sea salted - makes a big difference IMO.
Most off brand for me - I like wee dram of ๐ฅ (Iโm a gastroenterologist).
@Leicnut
And:
1. full history of presenting complaint
2. A drug history in the notes rather than โsee kardexโ
3. Social history inc occupation, functional status
4. A management plan that doesnโt start with โSenior reviewโ
I can dream....
Instead of the
#medtwitter
drama and negativity I see on twitter Iโm sharing my achievement for the month - all with a newborn. Glad Iโve largely been off twitter - better for the soul. Thanks as ever to my amazing wife. ๐โโ๏ธ ๐โโ๏ธ ๐ถ๐ป ๐ผ
@UKGastroDr
@SteveBarclay
Iโve been shocked with the silence this week. Clearly the government have no intention on negotiating. This strike is having more of an impact in patients. The junior doctors have my full support too!
Pregnancy considerations in IBD - great talk by
@DrAilsaHart
. Preconception planning important with the emphasis on conception during remission
#ECCO19
Plug for
@CrohnsColitisUK
info sheet for patients.
๐ฉ ๐ฉ ๐จ ๐จ
Remember that opioid induced constipation is common
Up to 87% in cancer pain
Up to 57% in chronic pain
๐๐๐ผ laxatives - consider co-prescription.
Worked at UHCW for 4 years as a consultant and never realised, until recently, that there is a nature reserve / tranquility garden on site. Great for a short break to clear your mind!
NYE as a parent:
1. Clear up child
#2
โs vomit
2. Comfort child
#1
3. Try to enjoy a film
4. Scrap plans and go to bed at 10pm
Happy new yearโฆ ๐ to
#GITwitter
@BritSocGastro
guidelines on EoE
๐ PPI for 3 weeks
โ๏ธ 6 x biopsies
Safe to take biopsies in food bolus obstruction
๐ PPI 1st line - repeat bx in 8-12 weeks, budesonide
Diet - 2 food exclusion
Dilatation
#BSGLIVE22
Constipation affects approximately one in 10 children worldwide.
How should you approach childhood constipation in primary care, especially where initial treatment has been unsuccessful?
Absolutely delighted to announce that
@l_satterthwaite
and I are expecting a beautiful bouncing baby later in the year! Super excited & a little bit scared!
Laurenโs been amazing so far and I know that she is going to just be the most perfect mummy!! ๐ถ๐ป ๐ผ โค๏ธ
@HappySocks_UK
As the end of my extended Christmas holiday comes to an end Iโm pleased to say that I havenโt checked anything work related at all - no emails, no admin, nothing.
Just a wonderful time with family - and baby with D&V ๐๐ผ
Never too late
There are people who had jaundice, ascites, encephalopathy, and variceal bleeding 2-3 years ago who are, today, loving life, working, and having ultrasounds read as "normal" with no red whatsoever in their lab panels
All because they stopped drinking alcohol
@drkeithsiau
@NEJM
Letโs start by removing work emails and WhatsApp groups from your PERSONAL mobile phone. Or mute after you walk out of the ๐ช. The lines of work and life have blurred so much - Iโm sure itโs what the employer wants but itโs terrible for the employee.