GI & Hepatology Pathways

Assessment and management of acute liver failure including Kings College criteria for transplant

Management of acute decompensation in cirrhosis — ascites, encephalopathy, SBP, variceal bleeding

Assessment and management of acute flares in Crohn's disease and ulcerative colitis

Assessment of hepatitis B infection — acute vs chronic, treatment indications, monitoring

Systematic assessment of dysphagia — oropharyngeal vs oesophageal, urgent red flags

Lower Gastrointestinal Bleed clinical pathway.

Acute Pancreatitis clinical pathway.

BSG / Baveno VII — resuscitation, vasoactive drugs, antibiotics, urgent endoscopy with banding/glue, TIPS, secondary prevention.

Diagnostic paracentesis, antibiotics, albumin infusion, secondary prophylaxis with norfloxacin / cipro.

EASL/ICA — diagnosis of exclusion in cirrhosis, AKI workup, terlipressin + albumin, transplant referral.

Identify precipitants, lactulose to titrate to 2–3 soft stools/day, rifaximin for prevention, transplant referral.

NICE NG199 / IDSA — recognition, severity stratification, antibiotic choice (vancomycin / fidaxomicin), recurrence prevention.

Truelove and Witts criteria, IV steroids, infliximab/ciclosporin rescue, surgical referral on day 3 if no response.

ECCO/BSG — assess severity (HBI), exclude infection, induction therapy (steroid / EEN / biologic), maintenance.

NICE NG20 — serology (anti-tTG IgA + total IgA), biopsy confirmation, gluten-free diet, surveillance for complications.

Diagnosis (autoantibodies + IgG + biopsy + simplified IAIHG score), corticosteroid + azathioprine, monitor for relapse.

Differentiate PBC (AMA+, female, intrahepatic, UDCA-responsive) from PSC (M>F, IBD association, MRCP, no proven medical therapy).

Recognise hereditary iron overload (HFE C282Y) and Wilson's (low ceruloplasmin, urinary copper) — diagnostic workup and management.

EASL 2018 / BSG — surveillance criteria, BCLC staging, treatment by stage (resection, ablation, TACE, systemic, transplant).