British Society of Gastroenterology's podcast, From Top to Bottom, gives you all the latest insights shaping modern gastroenterology practice from inspirational interviews to guideline summaries from leading experts.
Whether you're a gastroenterologist, trainee, or other healthcare professional seeking practical, evidence based updates — this podcast keeps you current from top to bottom.
Impact of Anti-obesity Drugs on Gastric Motility and Implications for the Management of Dyspepsia
In this episode, Dr. Asma Fikree, Consultant Neurogastroenterologist at UCLH and Chair of the BSG Neurogastroenterology & Motility Section and Dr Maria Eugenicos, Senior Lecturer/Neurogastroenterologist, Western General Hospital, Edinburgh discuss the effects of anti-obesity medications on gastric motility, dyspepsia, and gastroparesis-like symptoms.
The discussion covers the management of nausea, vomiting and delayed gastric emptying, considerations before endoscopy and surgery, the phenomenon of tachyphylaxis, and practical approaches to dose titration. Dr. Fikree also examines the emerging evidence for GLP-1 therapies in patients with IBS and chronic gastrointestinal symptoms, highlighting both the benefits and limitations of these increasingly prescribed treatments.
8 Sept 2026
Gut Microbiome in Acute Pancreatitis
Professor Vikram Mitra (Chair, Pancreas Clinical Section, British Society of Gastroenterology) speaks with Professor Pramod Garg, President of the Indian Society of Gastroenterology, about the link between gut microbiome and acute pancreatitis.
Topics include whether admission microbiome can predict disease severity, which bacterial classes (notably Proteobacteria) are tied to worse outcomes, and what's known about how gut bacteria may drive pancreatic inflammation. They also discuss the case against prophylactic antibiotics, why early enteral nutrition beats bowel rest, mixed results on interventions like rifaximin, and key confounders in microbiome research (diet, ethnicity, drug use, disease etiology).
The conversation ends with practical advice on gut health and pancreatitis prevention, plus priority areas for future research.
A concise, evidence-based discussion for gastroenterologists and clinicians interested in the gut-pancreas axis.
12 Jun 2026
BSG IBD & Pregnancy
In this BSG Podcast episode, Consultant Pharmacist, Fiona Rees is joined by Gastroenterology Registrar, Dr Krishna Shah and Consultant Obstetrician & Gynaecologist, Dr Mandeep Kaler to discuss pregnancy and inflammatory bowel disease (IBD). They explore the importance of preconception counselling and achieving disease remission before pregnancy.
The conversation covers how IBD can affect pregnancy and how risks can be reduced with good disease control. They discuss practical approaches to managing flares and medication safety, reassuring that many treatments are low risk. The episode also highlights the role of multidisciplinary care between IBD and obstetric teams. Key topics include delivery planning, breastfeeding, and postpartum care. The speakers emphasise empowering patients with accurate information throughout their journey.
27 Mar 2026
BSG IBD Surveillance Guidelines - part two
In this episode of the BSG Top to Bottom podcast, Prof James East and Prof Pradeep Bhandari dive into the endoscopic aspects of the new BSG IBD Surveillance Guidelines. Building on part one’s focus on cancer risk and surveillance rationale, this discussion explores practical essentials, from bowel preparation and patient comfort to chromoendoscopy, lesion detection, and the nuances of managing dysplasia in IBD. The conversation also highlights training, service delivery, MDT decision‑making, and the evolving roles of advanced endoscopic techniques and surgery.
20 Mar 2026
BSG IBD Surveillance Guidelines - part 1
Join Dr. Shahida Din, consultant gastroenterologist and Chair of the BSG IBD Section, for an in‑depth conversation with Professor James East, leading gastroenterologist, endoscopist, and co‑author of the new BSG IBD Surveillance Guidelines. They explore how cancer risk in IBD has evolved, when to start or stop surveillance, and the shift toward personalised risk assessment. The episode covers key updates on bowel prep, biopsy strategies, patient experience, and what clinicians should know to deliver high quality, patient centred surveillance. Stay tuned for Part 2 on endoscopic techniques and dysplasia management with Professor Pradeep Bhandari
19 Dec 2025
BSG IBD Guideline - Post-op Crohn's Disease
Part seven of seven: Dr Alexandra Kent, Consultant Gastroenterologist at King’s College Hospital, is joined by Professor Jimmy Limdi, Head of the IBD section at the Northern Care Alliance NHS Foundation Trust, to explore how Crohn's Disease recurrence is defined, predicted, monitored, and managed after surgery as recommended in the BSG IBD Guidelines.
Together, they discuss the continuum of post-operative recurrence from histological and endoscopic changes to clinical and surgical relapse. They highlight key patient, disease, and surgical risk factors, including smoking and aggressive disease phenotypes. The episode covers best practice for post-operative monitoring, including the role of ileocolonoscopy, Rutgeerts scoring, faecal calprotectin, intestinal ultrasound, and cross-sectional imaging.
12 Dec 2025
BSG IBD Guideline - Luminal Crohn's Disease
Polychronis Pavlides, Consultant Gastroenterologist at King's College Hospital in London and Fraser Cummings, Consultant Gastroenterologist in Southampton and adult IBD service lead, discuss the first line treatment of Luminal Crohn’s Disease outlined in the newly updated BSG IBD Guidelines.
They explore the importance of shared decision making and patient centred care along with practical guidance on choosing therapies, monitoring response, and aligning with STRIDE targets. This podcast also includes the challenges in comparative effectiveness and why sequencing remains complex.
5 Dec 2025
BSG IBD Guideline - Advanced Therapies in UC
Part five of seven: Krishna Shah, Gastroenterology Registrar and IBD Research Fellow at the Royal London Hospital and Dr. Kamal Patel, Consultant Gastroenterologist at St George's Hospital discuss the Advanced Therapies in Ulcerative Colitis section of the new BSG guidelines beginning with mesalazine, prednisolone and azathioprine through to thiopurines and anti-TNFs. They discuss the cost-benefit outcomes of the drug pathways advised in the BSG Guidelines including some of the potential adverse side-effects.
28 Nov 2025
BSG IBD Guideline - Perianal Crohn's Disease
Part four of seven: Professor Naila Arebi, Consultant Gastroenterologist and colleague, Consultant Colorectal Surgeon, Janindra Warusavitarne, both at St Mark's National Bowel Hospital, discuss the application of the BSG IBD Guidelines to provide optimal treatment using a holistic approach and deliver the best quality of care for patients.
They talk about the important relationship between surgeons and gastroenterologists in the diagnosis and treatment of Perianal Crohn’s disease, supporting this with systematic clinical research.
21 Nov 2025
BSG IBD Guideline - Acute Severe Ulcerative Colitis (ASUC)
Part three of seven: Trainee Gastroenterologist, Jennifer Tham, interviews, Dr. Bel Kok, Consultant Gastroenterologist at the Royal London Hospital and Honorary Senior Lecturer at Queen Mary University of London, to discuss the practical application of the latest ASUC guidelines. They explore the presenting symptoms and diagnosis of acute severe ulcerative colitis, including the use of statistical algorithms summarised in the IBD guidelines.
Given the severity and high risk profile of ASUC, rapid access to up-to-date guidance is essential to prevent delays in treatment. Jennifer and Dr. Kok also examine the updated therapies and management strategies outlined in the new guidelines.
14 Nov 2025
BSG IBD Guideline - De-escalation of Therapy
Dr. Shahida Din, Chair of our IBD Committee, and Dr. Jonathan Blackwell—both Consultant Gastroenterologists at the Edinburgh IBD Unit—are joined by Mrs. Fiona Rees, Consultant Pharmacist at University Hospitals Sussex, to explore the BSG IBD Guidelines with a focus on therapy de-escalation. Together, they discuss how best to manage patient expectations around treatment and outcomes.
They also take a detailed look at the role of Mesalazine, routes of administration, Thiopurines, anti-TNF therapies, Pulse Therapy, and the importance of continually reassessing treatment plans.
7 Nov 2025
BSG IBD Guideline - Methodology
Part one of a seven part series discussing different elements of the BSG IBD Main Guideline published in June 2025.
Prof. Gordon Moran from the University of Nottingham and Prof. Morris Gordon from the University of Central Lancashire (UCLan) discuss the new BSG IBD guidelines published in GUT, June 2025. In particular, they discuss insight on methodology used to produce the guideline, the difference in previous guidelines (e.g. ECCO Guideline) and the use of network meta-anaysis.
12 Sept 2025
Colorectal Polyps in Patients with Limited Life Expectancy
Dr. Jabed Ahmed and Dr. Ravi Ranjan discuss colorectal polyps in patients with limited life expectancy. The bowel cancer screening strategies rely on the long time a polyp takes before progressing to cancer by early detection and removal of polyps. Although polypectomy comes with risks of some significant complications the risk is deemed small compared to the benefit of cancer prevention. This risk benefit equation changes in patients with advanced age or multiple co-morbidities
This new BSG ACP guidance developed by a multidisciplinary guidance development group aims to provide a structural framework to support clinicians and the patients in decision making in such situations.
Dr. Ranjan is a Consultant physician and gastroenterologist at University Hospital of North Tees and completeing his MD at Newcastle University. He also coordinated the a BSG/ACPGBI guidance.
Video Interview with Dr. Ahmed and Dr. Ranjan: Colorectal polyps in patients with limited life expectancy
8 Aug 2025
BSG Sedation Guidelines in Gastrointestinal Endoscopy
Prof. Reena Sidhu, Consultant Gastroenterologist and Honorary Professor at the University of Sheffield, joins Dr. Jabed Ahmed, Gastroenterology Clinical Research Fellow at Imperial College Healthcare NHS Trust, to discuss the BSG Guidelines on Sedation in Gastrointestinal Endoscopy.
They cover key topics including commonly used sedation drugs, monitoring requirements, and the prevention and management of adverse events. The conversation also explores patient communication, special circumstances such as pregnancy, and the need for improved sedation training for trainees.
11 Jul 2025
Introduction to the BSG with President, Prof. Colin Rees
Prof. Colin Rees and Roisin Bevan chat about all things BSG. As well as being elected presisdent of the BSG, Colin is Professor of Gastroenterology at Newcastle University and an Honorary Consultant at South Tyneside and Sunderland NHS Trust.
18 Jun 2025
BSG From Top to Bottom - Trailer
This episode analyzes the trailer for "BSG From Top to Bottom," but lacks further descriptive information.
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