Summary

Dr Gideon Hirschfield is a leading expert in autoimmune liver diseases, including PSC, PBC, and autoimmune hepatitis. He’s helped shape how these conditions are understood and managed around the world, combining cutting-edge research with a real passion for patient care.

Today he discusses his work with autoimmune liver diseases, particularly primary sclerosing cholangitis (PSC) and autoimmune hepatitis. We discuss some key topics in PSC (including use of Ursodeoxycholic acid, cancer surveillance as well as the PSC/IBD phenotype), and Professor Hirschfield gives us a masterclass in the management of autoimmune hepatitis. He also offers advice for new hepatologists, highlighting the significance of clear diagnoses, individualized patient management, and clinical trials to drive us into the future.

As always comments, questions and feedback please send to: X: @2guystalkingit

Email: 2guystalkingit@gmail.com

Chapters

00:30 J & J Introduction

06:15 Introduction to Professor Hirschfield and Autoimmune Liver Diseases

07:41 The Role of Ursodeoxycholic Acid in PSC Management

19:06 Understanding the Pathophysiology of PSC

22:43 Cancer Surveillance in PSC Patients

28:39 The Relationship Between PSC and Inflammatory Bowel Disease

32:30 Vancomycin and PSC

36:28 Management Strategies for PSC and IBD Patients including Pouches

40:00 Management of Autoimmune Hepatitis: An Art and Science

56:30 Proactive Approaches in Primary Biliary Cholangitis (PBC) Management

1:01:05 Advice for Aspiring Hepatologists

Keywords

Hepatology, Autoimmune Liver Disease, PSC, Ursodeoxycholic Acid, Cancer Surveillance, Inflammatory Bowel Disease, Clinical Trials, Patient Care, Liver Transplantation, PSC Management, pouch studies, autoimmune hepatitis, management, PBC, hepatology, patient choices, liver transplant, treatment options, chronic diseases, clinical trials

This is a really special episode with an incredible doctor (Jon says "the best clinician I have ever met").

Today we welcome Dr Simon Gabe, an internationally renowned expert in intestinal rehabilitation. Dr Simon Gabe is a consultant in gastroenterology & intestinal rehabilitation at St Mark’s Hospital and chair of the NHS National Reference Centre for Severe Intestinal Failure at St Mark’s. This is also an Integrated Care centre for intestinal failure and a recognised ESPEN Training Centre. He has a wide clinical experience in dealing with complex nutritional problems, inflammatory bowel disease, fistula management, intestinal failure requiring enteral or parenteral support, home parenteral nutrition and consideration of intestinal transplantation. Dr Gabe is a past President of BAPEN. He co-founded the National Adult Small Intestinal Transplant (NASIT) Forum in the UK and has been an active member of a Clinical Reference Group within NHS England responsible for the development of a clinical network in England for all patients with Intestinal Failure (HIFNET). He currently co-chairs the HPN Clinical Advice and Management Group for NHS England.

As always comments, questions and feedback please send to: X: @2guystalkingit

Email: 2guystalkingit@gmail.com

Chapters

04:15 Introduction to Simon Gabe

06:59 Understanding Intestinal Rehabilitation

09:56 Defining Intestinal Failure

13:29 Trends in Intestinal Failure Causes

16:23 Bowel Length and Nutritional Support

20:26 Managing Short Bowel Syndrome

26:06 Barriers to Recognizing Intestinal Failure

30:37 Patient Evaluation Process for Intestinal Failure

33:07 Empowering Patients in Line Management

36:21 Managing Line Sepsis: Best Practices

43:17 Understanding Ehlers-Danlos Syndrome (EDS) and Nutrition

50:14 Nutritional Support in Cancer Patients

54:18 Enteral Support in Dementia Patients

57:15 Addressing Intestinal Ischemia: A Call to Action

Keywords

Intestinal rehabilitation, intestinal failure, nutrition, gastroenterology, patient care, bowel length, short bowel syndrome, nutritional support, clinical practice, healthcare, line management, line sepsis, Ehlers-Danlos Syndrome, nutritional support, cancer patients, dementia, intestinal ischemia, patient empowerment, multidisciplinary team, intravenous nutrition

Jon and James welcome Dr Beatriz Gros, a leading expert in inflammatory bowel disease (IBD). They discuss key findings from the recent European Crohn's and Colitis Conference in 2025.

Dr. Beatriz Gros (X: @bealoquebea Instagram: @dr.beatrizgros) is a consultant gastroenterologist based in Córdoba, Spain, specializing in inflammatory bowel disease (IBD). She serves as a Consultant Gastroenterologist at Reina Sofía University Hospital in Córdoba and has also worked as a Senior Clinical Fellow at the Western General Hospital in Edinburgh, UK. Dr. Gros has a particular interest in environmental factors associated with the development of IBD and predictors for disease flares, contributing to studies like the PREdiCCt study. She actively engages in medical education through social media platforms such as Instagram and Twitter, and is the creator of the educational website www.ibd-eii.com, which offers summaries of over 140 clinical trials and relevant IBD studies. Dr. Gros’ dedication to advancing IBD research and education has made her a respected figure in the gastroenterology community.

As always comments, questions and feedback please send to:

X: @2guystalkingit

Email: 2guystalkingit@gmail.com

Chapters

03:32 Introduction and Guest Introduction

05:30 Reflections on the ECCO Conference

08:10 Systemic antibody response predicting onset of IBD

13:12 Predicting Disease Onset and Flare Factors

13:45 The PREDICT Study and Its Implications

21:44 Dietary Insights and the Mediterranean Diet

23:30 The ADAPT Study on Emulsifiers and IBD

30:00 General dietary recommendations in IBD

33:48 Fiber consumption and Crohn's Disease development

39:40 The Role of Plant-Based Diets in IBD

43:18 Environmental factors in association with IBD

45:53 Understanding Environmental Factors in IBD

47:25 Linking IBD and Neurodegenerative Diseases and Vedolizumab

54:32 Proactive Monitoring in Ulcerative Colitis

Keywords

IBD, ECCO Conference, Bea Gros, PREDICT Study, Mediterranean Diet, Emulsifiers, Disease Prediction, Patient Care, Dietary Studies, Holistic Health, Crohn's Disease, Ulcerative Colitis, plant-based, fiber, environmental factors, probiotics, nutrition