irritable bowel syndrome

Doctors Lisa and Sara talk to GP Dr Charlotte Bădescu about Ovarian Cancer. We focus on the important learning points about cardinal and other features of presentations to better understand this cancer as an abdominal cancer with symptoms that can and do often present much earlier than the diagnosis is often picked up. She talks us through the value of CA125 tests and the reasons not to be overly reliant on them, though they can be a useful tool in the tool box. The usefulness of ultrasound scans, both pelvic and transvaginal, as well as clinician continuity is discussed.  We go through 2 hypothetical cases based on real examples as well as Charlotte’s own diagnosis. An excellent episode for picking up great learning points to avoid missing this diagnosis in your own patients. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
NICE Guidelines: Suspected Cancer, Recognition and Referral (Dec 2021): https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#gynaecological-cancers
NICE guidelines on Ovarian Cancer (Published April 2011): https://www.nice.org.uk/guidance/cg122
GP network & resources: https://targetovariancancer.org.uk/health-professionals/GPs
Nurses network & resources: https://targetovariancancer.org.uk/health-professionals/nurses
Patient resources: https://targetovariancancer.org.uk/support-for-you
Shine Cancer Support: https://shinecancersupport.org/
ForteenFish Free Ovarian Cancer Webinar (you will need to log-on and search Ovarian Cancer): https://www.fourteenfish.com/
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback
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This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Dr Sarah Taylor about the changes being made to how Primary Care Clinicians refer patients for Suspected Lower Gastrointestinal Cancers. These changes are discussed in the context of referring in the Greater Manchester area, but you can view the  joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology below. This will change the way we manage patients. To help, we go through some potential cases. Good tips for how to mitigate potential risks with the changes included. We hope you find this useful.
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
Faecal immunochemical testing (FIT) in patients with signs or symptoms of suspected colorectal cancer (CRC): a joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG): https://www.bsg.org.uk/clinical-resource/faecal-immunochemical-testing-fit-in-patients-with-signs-or-symptoms-of-suspected-colorectal-cancer-crc-a-joint-guideline-from-the-acpgbi-and-the-bsg/
GatewayC FIT infographic: http://bit.ly/409mXUy
GatewayC Lower GI infographic: http://bit.ly/3XJpIKN
Raised Platelets and Cancer Risk: https://gpnotebook.com/en-au/simplepage.cfm?ID=x2019111783915921223
The Current NICE Guidelines last Updated December 2021: https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#lower-gastrointestinal-tract-cancers
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to GP Dr David Bartlett who works with the Neuroendocrine Cancer UK charity and GP Dr Will Evans who is a researcher specialising in rare diseases. We wanted to discuss how they  approach finding rare diseases in General Practice whilst balancing this with the risk of over investigating. We start with definitions and classifications before discussing where neuroendocrine cancers fit into this landscape. Their pearls of wisdom could help us keep our antenae up, referrals helpful and resources for clinicians and patients well stocked. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
British Journal of General Practice Article: Rare diseases in General Practice: Recognising the Zebras among the Horses. Evans, W & Rafi I (Vol 66, 2016): https://bjgp.org/content/66/652/550
Rare Disease UK: https://www.raredisease.org.uk/
Neuroendocrine Cancer UK: https://www.neuroendocrinecancer.org.uk/
Royal College of GPs eLearning on Neuroendocrine Cancers (search here): https://www.rcgp.org.uk/learning-resources/courses-and-events/elearning-courses
Medics for Rare Diseases: https://www.m4rd.org/
Information on Beckwith Wiedemann Syndrome: https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/beckwith-wiedemann-syndrome-bws/
Inattentional Bias Studies with Radiology:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964612/
https://pubmed.ncbi.nlm.nih.gov/17412097/
Mnemonic Family GENES Reference: Genetic red flags: clues to thinking genetically in primary care practice. Whelan et al. Primary Care: Clinics in Office Practice (Sept 2006): https://pubmed.ncbi.nlm.nih.gov/15331244/
Resource with helpful leaflets for Chromosomal Diseases: https://rarechromo.org/
OMIM: An Online Catalogue of Human Genes and Genetic Disorders: https://www.omim.org/
Gene Reviews: https://www.ncbi.nlm.nih.gov/books/NBK1116/
Orphanet Rare Disease Platform with Search Engine: https://www.orpha.net
Rare Disease Search Engine: https://www.findzebra.com/https://www.ndr-uk.org/browse
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Originally recorded in January 2020 and released in August 2020...
Early diagnosis of cancer is a huge priority in order to try to improve our cancer survival rates in the UK. Lisa and Sara took the opportunity to speak to Dr Sarah Taylor, GP in Fallowfield and Cancer Research UK Cancer Diagnosis Lead for Greater Manchester about this important subject.
It was recorded pre-Covid-19 and so some of the information given about services might have changed in your local area. We thought the general tips about picking up cancer as early as possible were incredibly useful however which is why we decided to release the episode. 
We cover why early diagnosis of cancer is a priority for the UK, learning points/common themes picked up from significant events in delayed cancer diagnosis, tools that we can use in primary care to help our pick up rate and useful resources for primary care.
Useful resources: 
Gateway C: https://www.gatewayc.org.uk/
Cancer Research UK Health Professional Section: https://www.cancerresearchuk.org/health-professional
Macmillan Health Professional Resources: https://www.macmillan.org.uk/about-us/health-professionals/resources
QCancer Score: https://www.qcancer.org/
Cancer Research UK Facilitator Programme: https://www.cancerresearchuk.org/health-professional/learning-and-support/about-our-partnerships/what-is-the-facilitator-programme
NICE Suspected cancer - recognition and referral: https://www.nice.org.uk/guidance/ng12
BJGP - Improving early diagnosis of cancer in UK general practice: https://bjgp.org/content/67/659/276
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

The COVID pandemic caused an upheaval to the endoscopy services for suspected upper and lower gastrointestinal malignancies. To talk us through the changes in how referrals are managed and what that means for us in general practice and our patients, we’re joined by GPwSI in Gastroenterology Dr Sophie Nelson and Consultant Gastroenterologist Dr Alistair Makin. Our discussion includes using FIT tests to risk stratify patients with suspected lower GI malignancies, the use of the Edinburgh Dysphagia Scale for suspected upper GI malignancies, a reminder of 2 week wait criteria, and little on iron deficiency anaemia and Helicobacter Pylori. 
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Greater Manchester Gastroenterology Webinar 24th Sept 2020. Speakers: Dr Sophie Nelson, Dr Varinda Athwal (LFTs), Dr Sarah Taylor (FIT testing), Dr Alistair Makin (GI cancers), and Dr May Aldean (advice and guidance) The link includes links to endoscopy pathways. https://gpexcellencegm.org.uk/resources/gm-gastroenterology-gp-education-webinar/#.YEYVCWj7SUk
Guidelines for managing patients with dyspepsia in primary care: https://gpexcellencegm.org.uk/resources/guidelines-for-managing-patients-with-dyspepsia-in-primary-care/#.YFEP4C2l23U 
NICE Gastrointestinal tract (lower) cancers - recognition and referral (Feb 2021): https://cks.nice.org.uk/topics/gastrointestinal-tract-lower-cancers-recognition-referral/
NICE Gastrointestinal tract (upper) cancers - recognition and referral (Feb 2021): https://cks.nice.org.uk/topics/gastrointestinal-tract-upper-cancers-recognition-referral/
Gateway C (an online cancer education platform for primary care): https://www.gatewayc.org.uk/
Greater Manchester Upper and Lower GI Cancer guidelines are available on TeamNet for Manchester clinicians
North West Iron Deficiency Anaemia Guidelines and Coeliac Guidelines: Not yet published but watch out for these soon!
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This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Consultant Gastroenterologist Dr Bliss about Irritable Bowel Syndrome. 
***THIS EPISODE HAS BEEN RE-UPLOADED WITH ADDITIONAL INFORMATION ABOUT CA125 BLOOD TESTS***
Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C
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This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.