key: cord-0955143-2rpiznfv authors: Pawlak, Katarzyna M.; Wauters, Lucas title: Guidelines, top‐notch science & social media—Jump on the bandwagon date: 2022-01-28 journal: United European Gastroenterol J DOI: 10.1002/ueg2.12203 sha: bf10e57bc5a7d095082b613ab48aa201f9c2f6d3 doc_id: 955143 cord_uid: 2rpiznfv nan While the cardinal symptoms of FD allow subdivision into epigastric pain (epigastric pain and burning) and postprandial distress syndrome (early satiation, postprandial fullness), the latter may overlap with nausea and vomiting in gastroparesis and in the presence of delayed gastric emptying. 1,2 Apart from the need of a gastroduodenoscopy for establishing a firm diagnosis of FD, endoscopy is also mandatory and useful to exclude a mechanical obstruction in gastroparesis, with a potential role for food stasis. 3 Although dyspepsia may be managed without endoscopy in primary care patients without alarm symptoms or risk factors, the presence of H. pylori needs to assessed and eradicated if positive 1 (Figure 1 ). Guidance for the 13 C-urea (UBT) and gastric emptying breath tests (GEBT) is also provided by the European guideline on the use of 13 C-breath tests from the European Association for Gastroenterology, Endoscopy and Nutrition, ESNM and European Society for Pediatric Gastroenterology Hepatology and Nutrition, among many other tests. 4 In this Delphi consensus with 43 experts from 18 European countries, the test-and-treat strategy for uninvestigated dyspepsia using the UBT received a high grade of recommendation. 4 Also, the GEBT is an established alternative to scintigraphy, which were both endorsed in the dedicated gastroparesis-consensus. 2, 4 Of note, readers are provided with all practical measures for the performance and interpretation of these tests, including the monitoring of pancreatic exocrine and liver function 4 ( Figure 1 ). In addition, the European guideline on hydrogen (H 2 ) and methane (CH 4 ) breath tests was recently published by a separate working group. 5 While their use for common abdominal symptoms (e.g., bloating, flatulence, pain, and diarrhea) is increasing, the lack of standardization among centers in different countries is hampering comparisons. Besides the need for validated symptom evaluation to establish carbohydrate intolerance, the importance of confounding factors is highlighted when testing oro-cecal transit time and suspected small bowel bacterial overgrowth (SIBO) 5 ( Figure 1 ). As rapid transit with early colonic fermentation of ingested sugars results in false-positive diagnoses, this can be minimized with concomitant scintigraphy or glucose rather than lactulose. 5 In a French monocentric and retrospective study, rotating rather than single antibiotics (quinolone or azole) were more effective for remission of SIBO using the glucose breath test, regardless of underlying disorders (including FD in up to 20%), which may be related to the use of proton pump inhibitors (PPI). 6 Indeed, only PPI were endorsed as an effective therapy for FD, with consensus for only two classes of prokinetics in gastroparesis. 1, 2 In the absence of currently approved treatments in Europe, these Numerous studies indicate that 25%-70% of patients on PPI have no appropriate indication for these drugs, and patients with liver cirrhosis are no exception. 8 However, PPI increases the risk of hepatic encephalopathy and deprescribing may be a valid strategy in this situation. 9 While all healthcare providers agree that this is an important clinical goal, it is vital to identify who has (and takes) the responsibility in starting but also stopping drugs in patients with liver cirrhosis. A review of prescriptions during multidisciplinary meetings might help. 9 Moreover, patients with decompensated cirrhosis, presenting with complications such as ascites, variceal bleeding, and hepatic encephalopathy, have a poor survival. 10 Patients with cirrhosis may develop sudden, acute-on-chronic, liver failure that results in hepatic and extra-hepatic organ failure and is an important source of liver related mortality. 10 Early identification of cirrhotics on the brink of decompensation may save lives and a cohort study published in the Journal found evidence that systemic inflammation drives decompensation risk. 11 These data suggest these patients should be singled out for early assessment for liver transplant eligibility. 11 Social media (SoMe) still remains the bone of contention in the corridors of academia. However, it seems that during the COVID-19 pandemic, SoMe became a blessing in disguise allowing it to hold up or even improve the institutional and personal visibility, additionally remaining one of the main sources for staying up-to-date. Since the @UEGJournal appeared on Twitter in 2019, a rising interest in the UEG journal's shared content was continuously observed. A reflection of this is the increasing followers' number of the UEG Journal Twitter account, reaching almost 6000 over barely 3 years. In 2021, we put emphasis on visual graphic content presentation in SoMe, as a distinction for 29 manuscripts published in UEG journal, covering the various GI fields including inflammatory bowel diseases, 12, 13 endoscopy, 14 pancreas, 15, 16 obesity, 17 gut, 18 GI tract physiology, 19 and the European guidelines. 1, 2 We believe that an eye-friendly summary presentation form of published papers will beef up the UEG Journal overview and amplify the authors' effort. Another aspect of using SoMe platforms in 2021 was releasing eight episodes of the UEG Journal podcast series, giving voice to the authors, allowing for the entire route of their study process presentationfrom the initial idea to the final publication of the paper. 6, 7, [20] [21] [22] [23] [24] [25] The New Year is accompanied by new intentions and resolutions for further improving UEG Journal's presence in SoMe and thus continuing to provide the best access to top-notch science. United European gastroenterology (UEG) and European society for Neurogastroenterology and motility (ESNM) consensus on functional dyspepsia United European gastroenterology (UEG) and European society for Neurogastroenterology and motility (ESNM) consensus on gastroparesis Editorial: an important milestone for systematizing gastroparesis practice European guideline on indications, performance and clinical impact of 13C-breath tests in adult and pediatric patients: an EAGEN, ESNM, and ESPGHAN consensus, supported by EPC. United European guideline on indications, performance, and clinical impact of hydrogen and methane breath tests in adult and pediatric patients: European Association for Gastroenterology, Endoscopy and Nutrition, European Society of Neurogastroenterology and Motility, and European Society for Paediatric Gastroenterology Hepatology and Nutrition consensus The effectiveness of rotating versus single course antibiotics for small intestinal bacterial overgrowth. United Eur Gastroenterol European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations. United The incidence and outcome of postoperative hepatic encephalopathy in patients with cirrhosis. United Deprescribing medications that may increase the risk of hepatic encephalopathy: a qualitative study of patients with cirrhosis and their doctors Identifying the four shades of acute decompensation of cirrhosis Patterns of acute decompensation in hospitalized patients with cirrhosis and course of acute-on-chronic liver failure. United European Safety and efficacy of combining biologics or small molecules for inflammatory bowel disease or immune-mediated inflammatory diseases: a European retrospective observational study Diversion proctocolitis and the problem of the forgotten rectum in inflammatory bowel diseases: a systematic review Endoscopic retrograde cholangiopancreatography-related adverse events in Korea: a nationwide assessment Serum phosphate is associated with mortality among patients admitted to ICU for acute pancreatitis Mortality in acute pancreatitis with persistent organ failure is determined by the number, type, and sequence of organ systems affected Morbid obesity but not obesity is associated with increased mortality in patients undergoing endoscopic retrograde cholangiopancreatography: a national cohort study Gut fermentation syndrome: a systematic review of case reports The gastrointestinal tract in hunger and satiety signalling Endoscopic management of duodenal adenomatosis in familial adenomatous polyposis-a case-based review Coeliac disease enteropathy and symptoms may be aggravated by angiotensin receptor blockers in patients on a gluten-free diet Plasma procalcitonin may be an early predictor of liver injury in acetaminophen poisoning: a prospective cohort study. United European COVID-19 in gastroenterology: where are we now? Current evidence on the impact of COVID-19 in gastroenterology. United International consensus on methodological issues in standardization of fecal calprotectin measurement in inflammatory bowel diseases Young GI angle: what are the steps for a successful clinical research career? The voyage to Ithaca. United