Asst Prof GI @WSUMedicine, Alum @UIHealthCare @uabmedicine | #MedEd #CancerPrevention #HealthPolicy #AI #DEI #WCI 🪴Dad | T/RT =🚫endorse
Pacific North West
Joined March 2012
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An important and humbling milestone in life of every #Gastroenterologist Officially #ABIM Board certified 😇
Grateful to @uiowa, my PD @AdrianHolm12, co-fellows, the great @ibdtweets, and entire #GITwitter #LiverTwitter family for their support and help in #GIBoardReview
PNW_GI_MD #Ikigai=GI retweeted
Polypectomy pearls by master endoscopist, @Rex_colonoscopy:
💠Cold snare in most cases:
🔹 All polyps </= to 10mm
🔹SSLs of any size
💠Hot snare in select cases:
🔹Any perceived risk of cancer
🔹Difficult to transect without electrocautery
🔹Anticipated fibrosis
#ACGMWRegional
@AmCollegeGastro
PNW_GI_MD #Ikigai=GI retweeted
🚨 AI won’t replace doctors… but it can prevent them from learning how to think.
A critical article in @NEJM shows that if introduced too early in medical training, it weakens clinical reasoning.
✅ A good doctor will always need critical thinking.
N Engl J Med 2025;393:786
PNW_GI_MD #Ikigai=GI retweeted
“I don’t know” is not an admission of ignorance. It’s an expression of intellectual humility.
“I was wrong” is not a confession of failure. It’s a display of intellectual integrity.
“I don’t understand” is not a sign of stupidity. It’s a catalyst for intellectual curiosity.
PNW_GI_MD #Ikigai=GI retweeted
Extremely useful poster of oral budesonide preparations- clear description of use and dosage.
Thanks to @rachelcooney7 and Hannah Mughal for sharing with our team 🙏
@HelenSteed1 @BSGTrainees @SyedGerdezi @drkeithsiau @UmairKamran11 @MalikMagrabi @dr_aditi_kumar @GastroMJB
PNW_GI_MD #Ikigai=GI retweeted
Ever wondered why some colonoscopies are technically challenging or impossible?
Observe the 3-D reconstructions of CT- colonography in our recently published study: doi:10.1177/17562848231160625
PNW_GI_MD #Ikigai=GI retweeted
Exciting to see this out for #Patients with #EosinophilicEsophagitis who want to try #diet first.
We’ll know sooner if next med needed
Less endoscopy needed to get to answer
Adherence much easier!
#TLDR version: 1FED (cow #dairy) similar to 6FED pubmed.ncbi.nlm.nih.gov/3686…
PNW_GI_MD #Ikigai=GI retweeted
ECCO Guidelines on Inflammatory Bowel Disease and Malignancies. @IBD_MB #HannahGordon @UriKopylov @LissydeRidder @GionataFiorino @DrJordanAxelrad @ellul_pierre @J_Kirchgesner @IBD_FloMD @bverstockt @DignassAxel @NuhaZsurgeon @GianlucaPellino
Free access: academic.oup.com/ecco-jcc/ad…
PNW_GI_MD #Ikigai=GI retweeted
👉🏽 Reframe sorry w/thanks
❎ “Sorry I'm late”
✅"Thanks for being patient"
❎ “Sorry for being difficult”
✅"Thanks for being flexible”
❎ “Sorry for the questions”
✅ “Thanks for the helpful responses”
💡Gratitude not guilt
#MentoringMonday
#GITwitter – at Scottsdale, AZ
PNW_GI_MD #Ikigai=GI retweeted
The Real-World Effectiveness and Safety of Ustekinumab in the Treatment of Crohn's Disease: Results from the SUCCESS Consortium - PubMed @amjohnsonMD @PDulaiMD @AmJGastro pubmed.ncbi.nlm.nih.gov/3619…
PNW_GI_MD #Ikigai=GI retweeted
I predict Ryan Reynolds sharing his colonoscopy (and polyp) will do more for colorectal cancer awareness than half of anything we’ve tried as a GI profession…
…and I’m grateful for every second of it 🥹💙
@LeadFromBehind @brooksbell @CCAlliance @VancityReynolds #GITwitter
PNW_GI_MD #Ikigai=GI retweeted
Circumferential esophageal ESD, step by step in 2 minutes!
Lots of different strategies but here we used:
✅ Two tunnels, 1/3 circumference each
✅ External clip-line traction to septae between the tunnels
Regardless of approach, need to have a plan for inevitable stricture‼️
PNW_GI_MD #Ikigai=GI retweeted
Is there a need for mesalamine when therapy is escalated to biologic? Likely not! Do you use it along with biologics? @ibdseb @nuru_noor1 @ibddoctor @mchiorean4 @DCharabaty @JPAchkarMD #ACGIBDSCHOOL @AmCollegeGastro
PNW_GI_MD #Ikigai=GI retweeted
Another cool 😎Esophageal tip from @AllonKahn: When doing Barrett’s work, try to get good at recognizing NDBE from BE w/ dysplasia. My cheat sheets ⬇️🤣🤣🤣 @MayoClinicGIHep 🌅🏜#EsophagealFellowship. What are your favorite tips for managing BE and BE dysplasia?
PNW_GI_MD #Ikigai=GI retweeted
Please join us in this comprehensive 2-day hands-on 3rd Space Endoscopy Workshop Dec 1st-2nd. Interact and learn from 18 world-renowned faculty. Register here: web.cvent.com/event/974d1ad9… @DrHasan_Orlando @MN_GIMD @AdventHealthCFL
PNW_GI_MD #Ikigai=GI retweeted
For the FYF, important to think about your scope diameters especially when thinking about your approach to strictures & many other interventions!
Shoutout to our @Olympus_Corp rep for providing these charts to our fellows! #GITwitter
PNW_GI_MD #Ikigai=GI retweeted
🔊Just out🗞@JCO_ASCO @ASCO
🩸#LiquidBiopsies
🧬#ctDNA in the clinic
Review on #ColorectalCancer
Implications for other cancers
📚Primer to keep
🖊Authors @MallaMidhun @jonathanloree @pashtoonkasi @aparna1024
#OpenAccess @OncoAlert @DrawImpacts #CRCSM
📝ascopubs.org/doi/full/10.120… – at Manhattan, NY