00:00:00: Hello, and welcome to this podcast on the best of UEG week, twenty twenty five.

00:00:04: My name is Mary Phillips.

00:00:05: I'm an advanced clinical practitioner in her pacifant crubulary diet ethics and privileged to be a member of the Scientific Committee of UEG.

00:00:12: And I'm delighted to be joined today by Lee Donnelly, who's an endoscopy education development lead for Northumbria, chair of the BSG nurses session and a board member for his Gina and also from the UK.

00:00:24: So thank you for joining us today, Lee.

00:00:26: Thank you very much for inviting me, Mary.

00:00:28: So, Lee, how did you enjoy UEG Week this year?

00:00:31: Well, as ever, UEG Week is always a privilege to absolutely attend.

00:00:37: I really love networking with my colleagues, seeing all my European friends, and it was just... wonderful, just a wonderful experience.

00:00:46: The conference centre was enormous, so there was lots to see and lots to do, and lots of interesting content as well.

00:00:53: So from my point of view, from a nursing perspective, we looked at some really interesting topics that hadn't really previously been discussed before, so I think it was very innovative this time, which was brilliant really.

00:01:07: Fantastic.

00:01:08: I found the same so many different sessions to go to.

00:01:11: There was never a time period where there wasn't an interesting session on and as an allied health professional linking in with the nurses sessions as well as as well as the clinical sessions were really really helpful to get that overview of how all of these sessions and multidisciplinary work complements each other.

00:01:26: Yes, absolutely.

00:01:28: And what was really good is that we had some joint sessions with the clinicians as well, which was brilliant.

00:01:34: So I had a really good mix of medical and non-medical professionals presenting.

00:01:38: Did

00:01:38: you have a particular favourite session?

00:01:41: Actually, I had a couple.

00:01:42: One of my favourite sessions was a discussion about my worst case.

00:01:47: which was really good and really insightful I felt.

00:01:50: So it was a session where people were talking about things that really went wrong but very honest and open about it and actually how they learned from that incident if you like and as a team how they managed to feed back and debrief and actually move on as a stronger team from that incident.

00:02:10: So that was one of my favourite sessions.

00:02:13: It's interesting.

00:02:14: we had a session called Never Waste a Good Disaster which is on a similar theme and was fascinating.

00:02:19: There was one session on the barriers to interpreting fecal estates which is something we come across all of the time and how detrimental that can be to the patient care if we get that wrong and again learning from our mistakes which is something you don't often see presented open and honestly but actually a really valuable learning tool.

00:02:37: absolutely completely agree and the fact that it was approached from a multidisciplinary point of view as well makes it much more insightful I think so that you know people can learn from from old perspectives because I very much think that sometimes professionals are seen as working in isolation but it's very much a team approach and obviously a team of commitment to patient care.

00:03:02: so I think it was a it was a really valuable session.

00:03:05: Were there any other sessions that really stood out for you?

00:03:07: Yes, there were some sessions where we discussed a bit about sustainability, which is something which is close to my heart.

00:03:15: I'm a real advocate for sustainability in green endoscopy.

00:03:19: And we looked at some things from an interesting perspective with regards to global health, which is really important, particularly in GI.

00:03:27: and how the impact of GI illnesses and diseases is increasing because of the effective climate change and actually how that's going to impact on our workload particularly with things like flooding and drought and production and crops and things like that but also the other environmental factors.

00:03:48: as well that impact but similarly from the endoscopy point of view looking at waste, looking at reusable accessories and all of those other things come with green endoscopy and when we think about it very much felt a few years ago that we're really going to be involved.

00:04:06: quite heavily in it but now I understand I'm much less ambitious than I was a few years ago now because it's just becoming so so complex.

00:04:14: but at least there's lots of engagement there and people are very interested.

00:04:18: And what about in dietetics?

00:04:20: Is there much environmental impact there?

00:04:23: or is there a lot of work and research going on around climate change?

00:04:28: Yeah, they're absolutely is.

00:04:29: And again, looking at the wastage and the kind of plastics that we use and reducing our use again, looking for reusable things.

00:04:36: You know, in the last few years, reusable syringes have come in for entral feeding and those aspects as well.

00:04:43: We've also had a big focus on recycling so that the plastics that we use for feeding, most of them are recyclable now and those kind of aspects people have looked at.

00:04:53: There's also quite a lot of work going on with using blenderized foods.

00:04:57: rather than commercial feeding products.

00:04:59: So that's coming through slowly as well, again, to try and reduce the carbon footprint of production.

00:05:06: So loads and loads of work going on, which is really exciting.

00:05:09: It is really exciting.

00:05:10: That's very interesting about, you know, blending foods instead of using the commercial products, because there's obviously a cost implication to that as well.

00:05:21: And are patients quite happy to blend their own foods, do you think?

00:05:25: I think in some areas, particularly pediatrics, it's quite popular.

00:05:30: The more complex feeding where peptide partially hydrolyzed feeds are needed and specialist feed products are used.

00:05:37: I think there's possibly at the moment less of a wind day for that.

00:05:40: But certainly seems to be quite acceptable for a particular subgroup of patients.

00:05:45: And we're looking at how we modify our plastics and deliveries to support that.

00:05:50: Obviously, the very fine feeding tubes can't be used, but the wider bore ones.

00:05:55: interesting to see from its sustainability what impact that has in years to come as well.

00:06:00: I think we're very much at the tip of the iceberg aren't we really?

00:06:02: and much more research is needed to sort of pursue things.

00:06:06: and one of the things that I was really quite pleased about the conference was there was a reduced amount of sort of freebies and literature, printed literature by industry, which was was really refreshing to see as well.

00:06:22: And because that does have a massive impact.

00:06:24: And as we know, conferences such as UEG Week has an enormous carbon footprint.

00:06:30: So it was really nice to see an industry engaging and also being very open and honest about the green credentials when having discussions and things.

00:06:38: So that was really nice.

00:06:40: Fantastic.

00:06:41: Were there any other clinical sessions that really jumped it out?

00:06:45: One of the other sessions that I really found interesting is that we had a privilege trans man came to discuss the care of trans patients in gastroenterology which was really very interesting and actually shared a lot of things and myths about caring for trans patients which is really important particularly in GI because as we know GI investigations are often embarrassing medications treatments and things and obviously illnesses can be really quite difficult to manage.

00:07:15: so having that discussion about how we care for trans patients and how we make sure that the environment is appropriate and that the language we use is correct and also that the literature we're producing our patient guidance and also our clinical guidance was really important.

00:07:33: so that was really such an enjoyable session and I felt that it sort of did bust quite a few myths about things and he was very open and honest and were able to have a really good conversation and that was incredibly popular.

00:07:48: Lots of discussion from the audience which was great to see that engagement.

00:07:52: so that was a really really good session.

00:07:55: Fantastic to see that kind of topic being openly addressed in these conferences because it's so vitally important to have patients feel comfortable and supported throughout their treatment.

00:08:05: so really really important.

00:08:07: We had a fantastic session in the opening plenary about fake news, which is something in dietetics that is really... a big issue for us.

00:08:16: So a huge amount of misinformation and poorly interpreted information that makes it into social media.

00:08:22: So I had a fantastic speaker talk about a particularly in gastroenterology where there are so many myths around diet and food supplements and how we can, as a profession, we need to really step up and make sure that the correct information is out there in the platforms that our patients access and looking at how we can have that really vital role in social media.

00:08:44: So addressing at the same time how we have to be careful in terms of accountability to making sure ourselves that the information we put out is correct and the potential liability aspects associated with that.

00:08:56: So really, really fascinating session.

00:08:58: I think we're drawing some themes here as some of the more important sessions that we've learned the most from have been not those that are particularly about the clinical topics but about how we practice in nursing and allied health professions in medicine and incorporate together really, really vital changes in practice as things evolve, looking at really important factors like sustainability, like social media impact and our changing populations.

00:09:24: So really, really interesting conference.

00:09:26: Absolutely and one of the other things just drawn on a little bit about that subject, another really interesting session was on the increasing impact of pancreatic cancer and its relationship to obesity.

00:09:38: And what came out of that was the use of GLP-I medications and whether that's going to have a positive impact on reducing incidence of cancer because of reduction.

00:09:49: And I suppose that really fits in with your fake news as well, because there's a lot of sort of misinformation out there about patients who are using GLP-I.

00:09:58: And at the minute, from an endoscopy point of view, there are some difficulties at the moment because we don't actually have any guidance about how long these patients need to fast

00:10:06: for.

00:10:07: how we manage bowel preparation and things like that.

00:10:11: So there's so much happening at the minute that's going to affect our practice from a nurse and allied healthcare professionals point of view.

00:10:18: And that social media is having a significant impact on that because we are seeing patients coming again with increased problems due to the GLP ones that they're taking because obviously they're getting them from a private point of view rather than through the GP at the minute.

00:10:36: And I think that's going to evolve as we learn more and more about these drugs in the future, isn't it?

00:10:40: We're still quite early into this kind of clinical practice around obesity management.

00:10:45: And yeah, I think I agree, worryingly, the number of people accessing these who don't really fit the criteria for them and not really maybe appreciating the true impact on the rest of their clinical management.

00:10:56: Yeah, absolutely.

00:10:57: And, you know, we're seeing patients increasingly in my practice coming through all the time now and they're increasingly more difficult to manage because of this and often patients don't disclose that they're on these medications as well.

00:11:11: And in the UK, they don't have to disclose to the GP either that they're on the medication.

00:11:15: So again, you know, unless they tell us we're managing them without that background knowledge.

00:11:21: And then I guess stressing the importance of that and other over-the-counter medications as well.

00:11:26: I mean, again, linking in with the fake news aspects, some of the herbal remedies and high dose vitamins and minerals that some patients are taking that cause us a real problem when they come into hospital with drug interactions, et cetera.

00:11:39: And really the people really supporting the use of these products over social media, not really again understanding the impact that this will have on other clinical conditions and interventions.

00:11:49: It's a really important session.

00:11:50: Tasman or that social media does actually affect.

00:11:54: how patients manage their illnesses as well.

00:11:56: There was a recent report that I read that said that most patients get their medical information from social media now, which is really quite worrying, I think, and very impactful for us to consider in our day-to-day practice.

00:12:12: And I think as we see more and more apps supporting clinical management and providing guidance, it's really important that we're at the forefront of that, not lagging behind the people who perhaps are not.

00:12:23: giving the most accurate clinical information on them.

00:12:25: So it's a really important topic that I was pleased to see that addressed.

00:12:30: And the plenary is to really understand the push from a UEG perspective, the importance of that topic.

00:12:36: And I was just going to ask you about.

00:12:39: one of the sessions that you attended was about the novel substrates in pancreatic cancer and highlighting the need for multimodal intervention.

00:12:47: How did you find that session?

00:12:49: Thank you for

00:12:49: asking.

00:12:49: That was a really insightful session because it really pushed the importance of, as you mentioned earlier, the multidisciplinary support for patients.

00:12:59: And we heard about a fascinating study that was carried out by Dr.

00:13:03: Una Griffin in Dublin, looking at multimodal intervention for patients with pancreatic cancer undergoing neoadjuvant chemotherapy.

00:13:11: And they used a model using fish oils and pancreatic enzymes and physical activity and demonstrated the improvements that they could see in muscle mass, the tolerability of chemotherapy.

00:13:21: But also what was really important was that the patients really tolerated the intervention and seemed to get almost a quality of life benefit from it as well.

00:13:30: And I think that's one of the things we're always cautious with with pancreatic cancer is that these patients are going through such a lot.

00:13:37: that should we be pushing an invasive intervention on top of everything that they're handling.

00:13:42: But it really stressed the importance of when we have that multidisciplinary approach that we can address their symptoms, their nutrition impact symptoms, nausea or or thrash, diabetes control, pancreatic enzyme use, and actually having people proactively managing those symptoms for patients and the impact that has on getting them through their neo-adjuvant or adjuvant or even palliative chemotherapy to give them a better outcome and a better quality of life as they go through it.

00:14:08: So it triggered some really interesting debates and I think a really important conversation to be have with patients where we draw that line between an aggressive intervention and where we move back into a slightly more palliative approach.

00:14:22: So yeah, lots of really interesting debates.

00:14:24: over that topic.

00:14:26: And it's so important really that, you know, the care of these patients has to be collaborative and, you know, managing their symptoms is so important to them as well, isn't it?

00:14:35: Making sure that they're as comfortable as possible during this part of their life, whether undergone treatment.

00:14:41: Absolutely.

00:14:42: From an endoscopy perspective, there was a lot of practical endoscopy this year, wasn't there?

00:14:46: There was a lot of practical endoscopy and live endoscopy, which is always brilliant to see, really engages the audience.

00:14:53: But what I found really enjoyable about those sessions, particularly live discussion.

00:14:59: is again looking back at the allied health care professionals and the nursing is to see that actually how the team work together and how very much it's a team approach and you know we can never work in isolation and it's very important that everyone works well together in gels together and that's always so nice to see.

00:15:18: And it's always really nice as well that the teams do and reduce all the members of staff as well, which I think is really important, that it's not just about the endoscopist performing the procedure, but it's about everyone else who's assisting in the room.

00:15:32: Because without the nurses, without the domestic teams, without the other professionals linking in with those patients, we wouldn't be able to perform the procedures and care for those patients with such a high standard as we clearly do across UK and Europe.

00:15:48: It's just fantastic to see the team working together.

00:15:52: And I think that's one of the things that always jumps out for me for UEG is that networking and ability to develop more teams whilst you're at the conference.

00:16:01: You meet people from all over the world, from really diverse backgrounds, who've got such a breadth of experience that there's always something to learn from, even when you're talking to people in the social side of it.

00:16:13: So the amazing UEG night, again, this year, which was quite spectacular, but having that opportunity to just sit and chat to people you've never met before, who've just got a very different experience that we can all learn from.

00:16:25: And I think that's one of the really vital parts of having a conference like this.

00:16:30: that's so accepting of multi-professionals, drawing in different disciplines within medicine, allied health, nursing, and bringing that whole team together.

00:16:41: And that's a really important part of UEG.

00:16:43: Absolutely agree.

00:16:44: And it's such a friendly conference.

00:16:45: And, you know, I don't think, as you say, you can underestimate that support you get.

00:16:50: from your peers and others and it's very friendly and you know.

00:16:53: when people are having lunch and they just sit down at tables and talk to each other and and ask each other you know about how they're finding things.

00:17:01: it's just.

00:17:02: it's so nice and it's It's that sort of friendly approach, and particularly in Estina, the nursing society, we always talk about it as an Estina family, where we'll always come together from all countries across Europe, and it's like we've never been apart really.

00:17:17: And sharing the practices that are often very much different from country to country, but will all have that sort of common goal, where the care of the GI patient is at the centre of everything that we do.

00:17:29: And I think that that's very apparent during something like you.

00:17:34: And I did touch on about how conferences like EOEG Week have a huge carbon footprint, but you can't underestimate the value of that face-to-face communication for learning.

00:17:46: And like you say, for network and in collaboration and that peer support, I don't think you can underestimate that.

00:17:52: And that's something you do lose

00:17:54: on

00:17:54: hybrid sessions because it's just not the same.

00:17:58: I think that is important.

00:18:00: And the other thing that UEG do within the week, which again, helps slightly reduce that carbon footprint is also really vital is bringing in all of the committees and all of the guideline development so that it all occurs in the same week.

00:18:14: And that particularly as an Allied Health professional where I have very limited study leave to be able to attend all of those meetings all crammed into that one session rather than have to commit to other times at other times of the year.

00:18:27: attend other guideline committee meetings I think is a really valuable logistical plan in supporting attendance for people with limited study leave.

00:18:36: so I think that's really important too.

00:18:38: Yeah, I completely agree.

00:18:40: It's very important and it just makes sure that the background work where, you know, maybe it's not be working clinically at UEG but we're doing very important work to benefit patient care.

00:18:51: and then that change in patient care has to be done on a face-to-face level.

00:18:56: so it is important to get that together.

00:18:59: So one of the things that jumped out within the poster session was all the little pockets of poster presentations this year.

00:19:04: Did you get the opportunity to go to any of those?

00:19:07: I did.

00:19:08: I really liked that.

00:19:08: That was something that was really good because you often find poster sessions are quite a bit rushed and, you know, very busy and you don't get to communicate very well with the authors or sort of ask questions related to the poster.

00:19:22: So this time I thought it was really good.

00:19:24: And from a nursing perspective, we did actually have quite a few posters that were submitted, which is always excellent from a nursing perspective because I don't know if it's the same for other allied health.

00:19:36: care professionals but nurses often lack the confidence to put posters and things into conferences and and sort of say that increase this year for UEG was fantastic and the quality of the presentations and the quality of the work and the posters was just outstanding I thought.

00:19:51: Yeah I thought the technology worked really well for it this year as well.

00:19:54: It was a bit dubious to see all the poster sessions in one hall but the way they had the microphones and the headsets meant that you You weren't distracted by the other sessions going on at all, and you could hear really clearly the presenters for the poster session and to have the opportunity to ask questions in small groups must be a lot less intimidating for the presenters as well, so I know I really enjoyed the poster sessions this year.

00:20:17: Yeah, no, absolutely.

00:20:18: I completely agree.

00:20:19: And often you find that people who submit a post are something like this.

00:20:23: It's the first time they've submitted anything.

00:20:26: So having those smaller groups is a lot less intimidating.

00:20:30: And it's much more, again, going back to that friendliness and supportive nature that UEG we cast.

00:20:37: It's just really nice to give them the opportunity to have that discussion in smaller groups and to be able to ask those pertinent questions about their work.

00:20:44: Tilly, thank you so much for your insights on this year's UEG meeting.

00:20:49: We're obviously off to Barcelona next year for UEG twenty twenty six.

00:20:54: Really looking forward to that and hope to see you there.

00:20:58: Thank you very much.

00:20:59: Can't wait for next year.

00:21:01: Really looking forward to it.

00:21:03: Barcelona obviously a beautiful city, so it'll be wonderful.

00:21:07: So hopefully we'll catch up again next year.

00:21:10: Thank you and thank to everybody for listening and we look forward to seeing you all in Barcelona, twenty twenty six.