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Gastroenterology’s virtual meeting of minds

By Catherine Reilly - 01st Dec 2021

The mid adult woman video conferences with co-workers from her home office during the coronavirus shutdown.

In advance of the Irish Society of Gastroenterology’s Winter Meeting, Catherine Reilly spoke to new President
Prof Deirdre McNamara about the excellent agenda and key aims for her presidency

While previously scheduled as a hybrid meeting, the Irish Society of Gastroenterology’s (ISG) Winter Meeting on 2-3 December will take place in a fully virtual format due to the escalation in Covid-19 cases.

This decision was made “to reflect the changing public health advice, the awareness that there is an increased risk of spread and to keep everyone safe”, outlined ISG President Prof Deirdre McNamara, Consultant Gastroenterologist at Tallaght University Hospital and Associate Professor of Gastroenterology at Trinity College Dublin. “While virtual is not optimal, it is a way of connecting and communicating… we have done that successfully in the last year or so.”

The Winter Meeting 2021 will be Prof McNamara’s first as ISG President. Asked by the Medical Independent (MI) about her objectives during the two-year term, Prof McNamara said improving the Society’s “green credentials” was among her aims. Going forward, when the public health situation allows, she would favour ISG meetings being held in a hybrid format and utilising e-posters, e-programmes, and eco-friendly venues where possible.

Promoting equality and diversity is another important objective for Prof McNamara, who has been “very impressed” by initiatives in higher education such as the Athena Swan gender equality programme. She suggested the Society could take a number of steps in this area, including “an assessment of where we are at” and promoting equality and diversity as much as possible within meetings and in the Society generally.

Prof McNamara noted that “raising awareness in itself often leads to changes where we did not know they were needed”. Some actions could be relatively straightforward such as examining, “do we have an equitable representation [in programmes], are we doing enough to make our meetings more open to female presenters, younger presenters, presenters with disabilities?”

Prof McNamara is the first ever female President of the ISG, which was established in 1962. The fact it took so long to have a female president was not deliberate on the Society’s part, according to Prof McNamara. Nevertheless, “for younger trainees and people joining the specialty it is nice to see that there is a woman president”, especially at a time when the specialty has become more diverse.

Professional development

Along with the aforementioned areas, Prof McNamara’s key focus is on ensuring the Society continues to facilitate and promote high-quality continuous professional development and education, which is vital to medical practice. “Our meeting focus is mainly about keeping ourselves upto-date on the latest and best advances in gastroenterology across the world. We always tend to have invited international speakers of renown so that our members can get the latest and best news delivered to them in a format that is easy to keep up-to-date.”

As Prof McNamara outlined, gastroenterology is a “very broad specialty” with five major subdivisions – endoscopy; inflammatory bowel disease (IBD); hepatology; small bowel and nutrition; and functional disease. The range of presentations at the Winter Meeting 2021 will cater to the broad expanse of interests in gastroenterology.

The conference will begin with a symposium on IBD and cancer, chaired by Dr Aoibhlinn O’Toole, Consultant Gastroenterologist, Beaumont Hospital, Dublin; and Prof Larry Egan, Consultant in Clinical Pharmacology and Gastroenterology, Galway University Hospital and NUI Galway. The first speaker will be Prof Sebastian Shaji, Consultant Gastroenterologist, Hull University Teaching Hospitals NHS Trust, UK, who will speak on the topic of ‘IBD and cancer: An approach to management’.

This is among the presentations that Prof McNamara is most eagerly anticipating, as it will describe a particularly complex area for clinicians. IBD is a chronic disease that people can live with for many decades. However, as cancer is more common in older age groups, more patients who are living longer with IBD are diagnosed with cancer. It is also known that chronic inflammation in IBD patients is a risk factor for the development of gastrointestinal and extraintestinal malignancies.

“And a lot of our drugs are immunomodulators, which means they affect the patients’ immune system and how that interacts with cancer treatments but also our own bodies’ surveillance of cancer cells…. Is there a downside to starting treatments in IBD if a patient develops cancer, but if their inflammatory bowel disease flares they really need treatment so what is the right treatment to choose, how do we select that, what are the best options? It is a very difficult area,” outlined Prof McNamara.

“We are all living longer, more of us are surviving cancer as well, so what is the best way, then, to prevent recurrence or relapses or manage that patient who has successfully survived cancer and is living still with inflammatory bowel disease? How do we balance the risks and benefits of therapy and so forth? That is a very interesting topic and [Prof Sebastian Shaji] has written several review articles on it.”

‘Skin cancer and IBD’ will be the focus of a presentation from Prof Anne Marie Tobin, Consultant Dermatologist, Tallaght University Hospital; while Dr Nick Powell, Consultant Gastroenterologist and Clinical Reader in Gastroenterology, Imperial College London, UK, will present on ‘Cancer therapy and colitis’. ‘IBD and colorectal cancer: A clinical perspective’ will be the topic of a presentation from Mr James O’Riordan, Consultant Colorectal Surgeon, Tallaght University Hospital.

All of the symposia at the two-day meeting will be followed by panel discussions.

Nutrition and gastroenterology

Following parallel e-poster sessions, the day’s second symposium will centre on ‘nutrition and gastroenterology’, chaired by Prof Valerie Byrnes, Consultant Gastroenterologist, University Hospital Galway; and Dr Zita Galvin, Consultant Gastroenterologist, St Vincent’s University Hospital, Dublin. ‘Nutrition in IBD’ will be the topic of a presentation by Dr Lisa Sharkey, Consultant Gastroenterologist, Addenbrooke’s Hospital, Cambridge, UK; while another highly anticipated presentation will report on intestinal failure identification and management in Ireland, as presented by Dr Cara Dunne, Consultant Gastroenterologist, St James’s Hospital, Dublin, and Children’s Health Ireland, Crumlin.

Having undertaken additional specialist training in the UK, Dr Dunne brings “extensive extra knowledge” in intestinal failure to Irish clinical practice. According to Prof McNamara, Dr Dunne has “taken a great leadership role” in regard to developing a specialist unit in St James’s Hospital. “Because we haven’t had a specific focus on nutrition at the meetings before, I decided this was a really good opportunity to highlight what is available now, [Dr Dunne’s] successes to date and how we as colleagues would access [the service].”

The President of the British Society of Gastroenterology, Dr Alastair McKinlay, Consultant Gastroenterologist, Aberdeen Royal Infirmary, UK, will speak about keeping nutrition at the core of patient care in gastroenterology; while the day’s final presentation will centre on nutrition in liver disease and total parenteral nutrition (TPN)-induced liver damage, by Prof Johane Allard, Professor of Medicine, University of Toronto, Canada.

A posters awards ceremony and the ISG annual general meeting will conclude the first day of proceedings. The second day of the conference will begin with updates from the clinical advisory group of the National Clinical Programme for Gastroenterology and Hepatology and the National GI Endoscopy Quality Improvement Programme. This session will be chaired by Dr Murat Kirca, Consultant Gastroenterologist, Midlands Regional Hospital Mullingar; and Dr Orla Crosbie, Consultant Gastroenterologist, Cork University Hospital. Speakers will be Prof Colm O Móráin,Clinical Lead of the National Clinical Programme for Gastroenterology and Hepatology and Emeritus Professor of Medicine, Trinity College Dublin; and Dr Jan Leyden, Chair of the National GI Endoscopy Quality Improvement Programme and Consultant Gastroenterologist, Mater Misericordiae University Hospital, Dublin.

Following a panel discussion there will be parallel sessions covering the best clinical and scientific abstracts. Chairs will be Dr Sinead Smith, Assistant Professor, Department of Clinical Medicine, Trinity College Dublin; Prof David Kevans, Consultant Gastroenterologist, St James’s Hospital; Prof Anthony O’Connor, Consultant Gastroenterologist, Tallaght University Hospital; and Dr Karen Boland, Consultant Gastroenterologist, Beaumont Hospital.

The conference’s third symposium will examine ‘Infection and gastroenterology’, chaired by Consultant Gastroenterologist Dr Geraldine McCormack, Midlands Regional Hospital, Tullamore; and Consultant Gastroenterologist Dr Omar El-Sherif, St Vincent’s University Hospital. ‘C difficile infection treatment – recent guideline changes’ will be outlined by Prof Mark Wilcox, Professor of Medical Microbiology, School of Medicine, Leeds University, UK; while Prof Javier Gisbert, Consultant Gastroenterologist, Hospital Universitario de la Princesa, Madrid, Spain, will present on ‘European registry on H. pylori management: Most relevant results for clinical practice’.

‘Hepatitis E and others’ will be the subject of a talk by Prof Heiner Wedemeyer, Professor of Gastroenterology, University Hospital Essen and Hannover Medical School, Germany; while ‘Infection and inflammatory bowel disease’ will be examined by Dr Sarah O’Donnell, Consultant Gastroenterologist, Tallaght University Hospital. The 2021 Winter Meeting will conclude following the best abstract awards ceremony.

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