Carl Kay, MD

1/ Collated thread for new GI fellows ⭐️GI Fellow Resources ⭐️ ▪️Websites ▪️Guidelines ▪️Apps ▪️Podcasts ▪️Textbooks ▪️Board study ▪️Social media 📲 bit.ly/3KwqCVG (hyperlinked 📄) #GITwitter

🤔 Should we be doing routine terminal ileal intubation during colorectal cancer screening colonoscopy? 🔦 💡 No, according to the results of a newly published meta-analysis 👇

The Augmented Colonoscopy With Computer-Aided Polyp Characterization Study: Prospective Study Comparing the Diagnostic Reliability of Optical Diagnosis of Trainees With Experts Without Artificial Intelligence Bernhofer & Prosenz, et al. 📕 doi.org/10.14309/ajg.0…

“You may choose not to use OpenEvidence or GPT… You may choose not to play around with Claude… but to not be intrigued by it, by the possibilities, to even explore whether it might help you or your patients, to me, at some point begins to border on malpractice.” @Bob_Wachter

@EdwardLoftus2 @AimenKhanMD @ShahidaDin1 @DrAyushdoc @ACG_EBGI @IBDMD @MLongMD @DrCoreySiegel @AmCollegeGastro @AmJGastro @JasmohanBajaj @EdBarnesMD @DCharabaty @ibdtweets @UmaMahadevanIBD @MaiaKayalMD @JosephHabibi_MD @MccutchenDr @jalpa_devi @kehutchins77 @HannahWFiske @guthealingg @JHashashMD @jensemineriomd @AdamFayeMD @ReezwanaCMD @IBD_FloMD @tinahamd @ibdgijami @FarrayeIBD @Realcecum @SophieBalzoraMD @BenjamminGold @KajaliMishra @DrSamirAShah1 @SunandaKaneMD @IBD_Houston @YOGI_IBD @P_DeepakIBDMD @IBDimmunology @DrMikeDolinger @CathyLuMD @iUSCAN @BowelUltrasound @CrohnsColitisFn @saia_gi @J_Kirchgesner @bruce_sands1 @MLutzMD @HorstIBDDoc Do you believe in the clinical value/negative predictive value of peripheral PCR?

@AimenKhanMD @ShahidaDin1 @DrAyushdoc @ACG_EBGI @IBDMD @MLongMD @DrCoreySiegel @AmCollegeGastro @AmJGastro @JasmohanBajaj @EdBarnesMD @DCharabaty @ibdtweets @UmaMahadevanIBD @MaiaKayalMD @JosephHabibi_MD @MccutchenDr @jalpa_devi @kehutchins77 @HannahWFiske @guthealingg @JHashashMD @jensemineriomd @AdamFayeMD @ReezwanaCMD @IBD_FloMD @tinahamd @ibdgijami @FarrayeIBD @Realcecum @SophieBalzoraMD @BenjamminGold @KajaliMishra @DrSamirAShah1 @SunandaKaneMD @IBD_Houston @YOGI_IBD @P_DeepakIBDMD @IBDimmunology @DrMikeDolinger @CathyLuMD @iUSCAN @BowelUltrasound @CrohnsColitisFn @saia_gi @J_Kirchgesner @bruce_sands1 @MLutzMD @HorstIBDDoc Lots of people with CMV colitis in #IBD will not be viremic so can’t rely on peripheral PCR alone for Dx

1/ ⏰for #EBGI Tweetorial🧵w/ @AimenKhanMD “ACG Clinical Guideline Update: Ulcerative Colitis in Adults.” 📜Summary: bit.ly/4pKUlws 📰 Article: bit.ly/4r0EQBE #GITwitter

@CarlKayMD doing what he does best and inspiring all of us here at @UTHealthGastro to use social media intentionally and responsibly! Glad to have you back at Thursday conference giving such an important (often ignored) aspect of GI practice!

@JamesHaddadMD @RobertBechara @endoscopyjrnl Love this! Thanks for sharing/highlighting!

Great to see validation of a sensible strategy - pooling low risk polyps reduces cost burden & carbon footprint without altering surveillance interval. The 🔑 is excellent optical dx 🔎 (cc: @RobertBechara) thieme-connect.com/products/ejour… #GITwitter #colonoscopy @endoscopyjrnl

@jhemming @GI_Pearls @WalterChanMD @waikitlo_md Agreed. Very cautious about ever taking biopsies distal to 4 cm for GEJ. This almost never helps anyone and only adds to ambiguity. Furthermore, I do all biopsy forceps interruptions of Schatzki rings AFTER all pathology jar(s) complete.

@GI_Pearls @CarlKayMD @WalterChanMD @waikitlo_md Out of habit I still do seperate jars but I don’t think it really matters. I do make a point that my distal Bx are 4-5cm from the GEJ and I combine mid and prod sample

Nice chart of distribution of eosinophilia in EOE from @WalterChanMD and @waikitlo_md group. #GITwitter #endoscopy

@GI_Pearls @WalterChanMD @waikitlo_md Do you put in separate jars (despite the cost) in order to glean histologic insight? Maybe more importantly, do you believe in endoscopically “normal” EOE?

@CarlKayMD @WalterChanMD @waikitlo_md I don’t think so. It just proves that biopsies need to be taken from multiple locations. I’m open for o changing my mind though.

@TheGastrologer How do you get insurance coverage for this? Or do you use samples?

Great study confirming what many already practice - the newer agents for constipation absolutely have a role in bowel prep; I use ibsrela for prep — Linzess likely as effective

Might be the beginning of the end for the systematic review field. I always knew it was only a matter of time before AI started taking this over.

Marginal ulcer after RYGB Mgmt ▪️Stop smoking/NSAIDs ▪️Treat H. pylori ▪️Remove foreign body ▪️Open-cap PPI BID x3m ▪️Sucralfate 1g QID ▪️No response ➡️ H2RA ➡️ misoprostol ➡️ PCAB ▪️Refractory ➡️ endo therapy ▪️Failure ➡️ surgical revision 🔗 journals.lww.com/ajg/citation/2…

Lifting weights is associated with better academic performance.

AI won’t replace GI clinicians. But clinicians who understand AI will define the future of GI care. Excited to help shape the new @AmCollegeGastro consensus on responsible AI across endoscopy, clinical practice, education, ethics. 🚀 📄 Read here: journals.lww.com/ajg/abstract/9… ✨

🔥 EIP - esophageal intramural pseudodiverticulosis @EndoCollabcom @theendoscopist EndoCollab.com

A picture is worth 1,000 tracings. In esophageal manometry. Tips & hints from @JPandolfinoMD ▪️Technique first ▪️Patterns > single metrics (IRP ≠ Dx) ▪️Respect physiology & hernia! ▪️Trust clinical context ▪️Use complementary tests wise @ebmedgi

Esophageal EoE pearls from @JPandolfinoMD: ▪️Watch them eat ▪️Fix the plumbing ▪️Treat the patient, not the number ▪️Be reasonable with diet ▪️Follow-up is therapeutic @ebmedgi

Chicago Classification v4.0 (HRM) ▪️Dx = sx + metrics + provocation ▪️IRP → EGJ outflow ▪️DCI/DL/breaks → peristaltic vigor & pattern ▪️IBP → pressurization phenotype ▪️MRS/RDC required → assess LES relaxation & contractile reserve @ebmedgi

How do I write scientific papers, reviews, grants, and abstracts? Sharing 30 years of experience in one practical table. ⬇️

VS System for Diagnosing Early Gastric Cancer with NBI