Inflammatory bowel disease (IBD) continues to pose a complex and ongoing challenge for patients and healthcare systems alike. Conditions such as Crohn’s disease and ulcerative colitis, characterised by unpredictable flare-ups, chronic inflammation and the need for lifelong monitoring, place a considerable burden on NHS resources.
David Wynne, consultant paediatric ENT surgeon at the Royal Hospital for Children in Glasgow, highlights the challenges of diagnosing and managing reflux in infants and children. Drawing on his clinical experience, he discusses how a non-invasive diagnostic approach could support more accurate, evidence-based care for this complex patient group.
Inflammatory bowel disease (IBD) affects more than 500,000 people in the UK – a number that continues to grow year on year – and places a significant burden on the NHS, with annual costs estimated at around £720 million.1 The condition is characterised by unpredictable flare-ups and periods of remission, and can cause debilitating symptoms such as abdominal pain, episodes of mucoid and bloody diarrhoea, and fatigue, all of which have a profound impact on quality of life.
Diagnostics is the backbone of both emergency and planned care pathways in the NHS, guiding over 85 per cent of all clinical decisions made each year.1 Yet despite this critical role, diagnostic services in England have long struggled to meet demand. In many cases, these waits are for an initial diagnosis – the essential first step in determining whether a patient requires further investigation, ongoing treatment or, in urgent cases, immediate intervention for serious conditions such as advanced cancers.
Bile acid diarrhoea (BAD) is a common but often overlooked condition that can have a significant impact on a patient’s quality of life, affecting their mental health and productivity.1 The disorder can leave individuals housebound due to their unpredictable and uncomfortable symptoms, including persistent or intermittent diarrhoea, urgency, incontinence, flatulence and abdominal pain. This blog looks at challenges facing BAD detection, and the need for fast and accurate diagnostic testing to speed up triage and enable earlier treatment.
Point-of-care testing for atrophic gastritis can help relieve the pressure on endoscopy services. Patients with atrophic gastritis due to Helicobacter pylori (H. pylori) infection or autoimmune disease are known to have an increased risk of gastric adenocarcinoma, the 16th most common cancer in the UK and a frequent cause of death globally.1 British Society of Gastroenterology (BSG) guidelines1 state that non-invasive identification of high-risk patients prior to endoscopy is key for the early detection and diagnosis of cancer, and to improve cancer survival rates. Point-of-care testing (POCT) for atrophic gastritis with the GastroPanel® Quick Test NT is an effective triage tool that can be used both within and outside of secondary care settings, aligning with the current UK government’s drive to move healthcare away from hospitals2 and towards community and primary care environments. We asked our Market Access and Development Manager, Angela Gore, for her thoughts on the current diagnostic pathway, and how she envisages non-invasive POCT helping to reduce the strain on endoscopy services and allow high-risk individuals to be tested sooner.
Dr Cinzia Papadia MD FRCP – consultant gastroenterologist at Barts Health NHS Trust and honorary senior lecturer at Queen Mary University of London – recently led a study of the performance of BIOHIT HealthCare’s GastroPanel® in the identification of moderate to severe atrophic gastritis (AG) – a common precursor to gastric cancer – in dyspeptic patients. This blog provides an overview of the key findings and conclusions from this paper, which has now been published in BMJ Open Gastroenterology. It also explores the potential of routine clinical GastroPanel use to streamline current diagnostic pathways and improve access to urgent endoscopy procedures for those most at risk.
Rapid urease tests – such as the ULTRA-FAST UFT300 H. pylori Quick Test from BIOHIT HealthCare – are helping to quickly determine H. pylori infection during endoscopy procedures. However, these tests often operate outside the oversight of point-of-care testing (POCT) teams responsible for maintaining testing standards. In this blog, we explore the importance of bridging the gap between endoscopy and POCT teams, the role of internal quality controls in ensuring reliable results, and how H. pylori Control+ can enhance diagnostic confidence.
People living with long-term health conditions, such as inflammatory bowel disease, require regular monitoring and medical support to manage their symptoms and maintain their quality of life, but challenges such as illness or remote location often limit access to in-person care. In this blog, Tony Cambridge, Managing Director of Thornhill Healthcare Events and Consultancy and Lead Biomedical Scientist at University Hospitals Plymouth NHS Trust, England, discusses how the ongoing shift towards point-of-care testing with innovative user-friendly devices supports decentralised disease monitoring and personalised care.
The bacterium Helicobacter pylori (H. pylori) is a common cause of several gastrointestinal disorders, including dyspepsia, peptic ulcers and atrophic gastritis. The rapid diagnosis of H. pylori infection is therefore key to timely treatment and can help to prevent the development of digestive diseases. In this blog Paula Pendry, Endoscopy Sister at Northern Care Alliance NHS Foundation Trust, explains how performing a highly sensitive, specific urease test during routine gastroscopy procedures can be crucial for streamlining the diagnostic and treatment pathways for H. pylori.
Laryngopharyngeal reflux (LPR) – also known as silent reflux – is estimated to be responsible for up to 10 per cent of otolaryngology consultations, but is unfortunately still frequently missed due to gaps in the diagnostic pathway and the lack of a specific symptom profile.1 In this blog, Jane Shaw, Consultant Speech and Language Therapist, and Mark Watson, Consultant Laryngologist at Doncaster and Bassetlaw Teaching Hospitals NHS Trust, explore the challenges in the diagnosis of silent reflux, and explains how Peptest® can play a pivotal role in efficiently directing treatment plans and referrals to specialist services, avoiding unnecessary prescription of proton pump inhibitors.
There is mounting evidence demonstrating that atrophic gastritis is likely to be a contributory factor leading to osteoporosis because it causes low stomach acidity, which itself hinders calcium absorption and bone mineralisation. The rapid detection and treatment of atrophic gastritis could therefore play a significant role in preventing the development of osteoporosis in certain higher risk individuals. In this blog, Graham Johnson, Managing Director at BIOHIT HealthCare, explores the possible connection between the two disorders, and discusses how GastroPanel® could support healthcare providers in quickly identifying at-risk patients in need of endoscopy and early intervention.
Inflammatory bowel disease (IBD) disrupts the lives of over 250,000 people in the UK, costing the NHS an estimated £720 million per year.1 The condition is characterised by frequent and unpredictable relapses, with debilitating symptoms – including abdominal pain, diarrhoea and fatigue – significantly affecting quality of life for affected individuals. Ongoing management and close monitoring therefore remain essential to maintain control over disease activity. In this blog, Graham Johnson, Managing Director (UK) and Head of Global Sales for BIOHIT HealthCare, explores some of the latest and up and coming technologies that are empowering IBD patients to take more control over their condition.
Therapeutic drug monitoring (TDM) has emerged as a key strategy for optimising the treatment of inflammatory bowel disease (IBD). While biologics like infliximab (IFX) and adalimumab (ADM) work well for many patients, challenges like primary unresponsiveness and secondary loss of response (LOR) still occur. TDM strategies enable clinicians to monitor drug and anti-drug antibody (ADA) levels in patients’ bloodstreams, supporting tailored treatments and necessary dose adjustments. BIOHIT HealthCare recently sponsored a webinar, hosted by the Clinical Services Journal, that explored current and future trends in TDM for IBD management.
Peptest is a revolutionary non-invasive test for the diagnosis of silent reflux, also known as laryngopharyngeal (LPR) reflux. In this blog, Andrew Woodcock, Chief Scientific Officer at RD Biomed Limited, gives us the inside scoop on how Peptest uses lateral flow technology to provide a groundbreaking solution for the diagnosis of silent reflux in as little as 15 minutes.
The pursuit of optimal health and well-being in the UK is not merely a goal but a collective mission spanning diverse communities and authorities. Addressing health disparities requires a profound understanding of the multifaceted factors influencing health outcomes, from socio-economic conditions to lifestyle behaviours and cultural influences. BIOHIT HealthCare’s comparison of health statuses across English local authorities sheds light on the pressing need for targeted interventions to support communities facing significant health challenges. Leveraging data analytics and evidence-based research is crucial for identifying areas of need, prioritising interventions, and promoting equitable resource allocation. Recognising and addressing health disparities is not only imperative but also a strategic necessity for building a healthier, more resilient, and inclusive society. Collaboration among stakeholders is essential as we strive to navigate the complexities of healthcare disparities and ensure that every individual has the opportunity to thrive.
Helicobacter pylori infection is a common – yet potentially curable – cause of a number of gastrointestinal disorders, including dyspepsia, peptic ulcer disease, and precancerous conditions such as atrophic gastritis (AG). Fast and efficient diagnosis of H. pylori infection with a rapid urease test (RUT) during gastroscopy can therefore go a long way to help diagnose these conditions. In this blog, Win Ho, Area Sales Manager at BIOHIT HealthCare, explores how the H. pylori ULTRA-FAST UFT300 Quick Test from BIOHIT HealthCare plays a pivotal role in the diagnostic pathway, providing high sensitivity and specificity in record time.
Our gastric cancer blog series has so far investigated reasons for late diagnosis and explored successful screening programmes in high incidence countries. To round off the series, Professor Tamara Matysiak-Budnik – Professor of Gastroenterology and Digestive Oncology at the Institute of Digestive Diseases (IMAD), Nantes University Hospital, France – delves deeper into various European research projects, describing an ideal screening strategy, and elaborating on the integration of GastroPanel® into care pathways to detect precancerous conditions.
In the second blog of the gastric cancer series, Professor Tamara Matysiak-Budnik – Professor of Gastroenterology and Digestive Oncology at the Institute of Digestive Diseases (IMAD), Nantes University Hospital, France – continues her discussion around the challenges of diagnosing gastric cancer by exploring the option of national screening programmes and examining successful examples from high incidence countries.
Gastric cancer is responsible for over 4,000 deaths in the UK every year, approximately 54 % of which would have been completely preventable1 with earlier detection and prompt intervention. Despite this, very little progress has been made to improve the diagnosis of the disease in the last 30 years, and patients are often investigated only at a later, less treatable stage. In this series of blogs, Professor Tamara Matysiak-Budnik – Professor of Gastroenterology and Digestive Oncology at the Institute of Digestive Diseases (IMAD), Nantes University Hospital – discusses why gastric cancer is typically diagnosed later than other cancers, and how the situation can be improved with a multi-step screening approach that relies on endoscopy and serological tests.
Bile acid diarrhoea (BAD) is a lifelong and extremely upsetting condition, and often leaves patients housebound due to a fear of faecal incontinence or being unable to find a toilet when they need one. This distressing condition affects approximately 1-2 % of the UK population – a similar incidence to coeliac disease – as well as up to one third of patients diagnosed with diarrhoea-predominant irritable bowel syndrome (D-IBS).1 Despite being more prevalent than some better-known conditions of the gut – such as Crohn’s and ulcerative colitis – diagnosis is often delayed or missed. It is therefore important that clinicians consider BAD in patients presenting with chronic functional diarrhoea or irritable bowel syndrome with diarrhoea.
Graham Johnson, Managing Director at BIOHIT Ltd
Crohn’s disease (CD) and ulcerative colitis (UC) are two of the most frequently diagnosed inflammatory bowel conditions, affecting about 0.81 % of adults in the UK.1 Although both disorders are characterised by chronic inflammation and result in similar symptoms – mainly lower abdomen pain and swelling, diarrhoea, weight loss and fatigue – UC affects the large intestine, while CD can impact any part of the digestive tract.2 Treatments for these conditions typically target the chronic inflammation, but some advanced therapies – such as monoclonal antibody biologicals – also run the risk of inducing a humoral immune response. In this blog, we discuss how therapeutic drug monitoring (TDM) allows clinicians to gain a clear understanding of IBD progression and drug response to optimise patient outcomes.
Graham Johnson, Managing Director at BIOHIT Ltd
Faecal microbiota transplantation (FMT) continues to earn itself a place in a gastroenterologist’s toolbox as a potential therapy for a range of conditions, including irritable bowel syndrome (IBS) and recurrent Clostridium difficile infection, with the latter approved by the National Institute for Health and Care Excellence (NICE) in 2022.1 However, suppliers of FMT donor stool material – such as independent manufacturer TML.science – face the challenge of standardising what is essentially an unusual medicine that by its very nature is highly variable.
The use of tumour necrosis factor-α antagonists (anti-TNFs) to treat inflammatory bowel disease (IBD) continues to be refined.1 Although popular biopharmaceuticals – such as infliximab and adalimumab – induce a clinical response in up to 85 per cent of IBD patients, the risk of primary unresponsiveness or secondary loss of response (LOR) to these therapies remains a prevalent issue.2 As a result, there is ongoing research to understand the complexities of the pharmacokinetics and pharmacodynamics of these biological medications.1
The treatment of inflammatory bowel disease (IBD) has evolved significantly since the widespread introduction of biopharmaceuticals such as TNF-α inhibitors infliximab (IFX) and adalimumab (ADM). Up to 85 per cent of patients with IBD have a clinical response to these therapeutics, but many show drug-unresponsiveness or secondary loss of response (LOR), often because of the development of anti-drug antibodies (ADAs) that lower the drug trough levels in the bloodstream.
Dr Christian Selinger, a Consultant Gastroenterologist at Leeds Teaching Hospitals NHS Trust
The medical management of Inflammatory bowel disease (IBD) has advanced dramatically in the last decade to include biological agents, but not every patient responds to therapy in the same way. In this blog, Professor Jimmy Limdi discusses the proactive use of therapeutic drug monitoring (TDM) to aid clinical decision making and optimise patient responses to therapy.
Professor Jimmy Limdi – Consultant Gastroenterologist and Head of the Section for IBD, Deputy Director for Research and Innovation at the Northern Care Alliance NHS Foundation Trust and Professor of Gastroenterology at the University of Manchester and Manchester Metropolitan University.
The gastroenterology community is getting more and more excited about the therapeutic potential of faecal microbiota transplantation (FMT) for a number of conditions, including irritable bowel syndrome (IBS). Surprisingly, however, lots of FMT studies haven’t reported a consistent set of patient responses.
Magdy El-Salhy, Professor of Gastroenterology and Hepatology at the University of Bergen
The human gut microbiota plays an essential role in digestion and immunity, and a microbial imbalance – known as dysbiosis – is often an indicator of gastrointestinal health conditions, such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). This highlights the importance of understanding the bacterial composition in a patient’s gut to help diagnose illness and to enable timely and appropriate treatment, from antibiotics or probiotics to faecal microbiota transplants or lifestyle changes.
Christina Casèn, Senior Vice President Clinical and Medical Affairs
Bile acid diarrhoea (BAD) is an unpleasant condition that affects approximately one in every 100 people in the UK, and results in debilitating and embarrassing symptoms, including chronic diarrhoea, faecal incontinence and excessive flatulence.
Graham Johnson, Managing Director at BIOHIT Ltd
Gastric adenocarcinoma is the 16th most common cancer in the UK, imposing a considerable burden on healthcare resources.
Cinzia Papadia, MD, FRCP, Consultant Gastroenterologist at Whipps Cross University Hospital
Therapeutic antibodies are widely used for treating a number of chronic inflammatory diseases –including arthritis, Crohn’s disease and ulcerative colitis – in patients that have not responded well to conventional therapies.
Jeremy Wright, Product and Sales Specialist at BIOHIT talks more about it in this latest blog.
The five-year survival rate for stomach cancer in England and Wales is just 21 %, a figure that is considerably lower than other countries in Europe. The key to improving survival rates is earlier diagnosis.
GastroPanel is a blood test designed to establish gastric cancer risk in patients awaiting gastroscopy. The easy-to-understand and detailed test output provides clinicians with a non-invasive diagnostic method of identifying atrophic gastritis, highlighting individuals who are at high risk of developing gastric cancer in the future.
In our latest blog, Laura Baker, Marketing Manager at BIOHIT calculates how this simple blood test could save the NHS up to £69 million per annum.
In 2019 it seemed unimaginable that lateral flow tests would become a common household item. But the global COVID-19 pandemic, certainly brought to light the opportunities that point-of-care testing can offer.
In this blog Laura Baker, Marketing Manager at BIOHIT Ltd discusses how lateral flow technology could be the answer to many of the NHS’s burdens.
Bile acid diarrhoea (BAD) is a condition that affects approximately one to two per cent of the UK population, and up to one third of patients with diarrhoea-predominant irritable bowel syndrome (D-IBS). Despite being considered a common disorder in the world of gastroenterology, BAD diagnosis is often delayed or missed, leaving patients with debilitating symptoms that significantly impact their quality of life. In this blog, Graham Johnson, Managing Director at BIOHIT Ltd discusses the current challenges of diagnosing these patients, and a simple, cost-effective test that could be slotted into current care pathways to help shed some light on this underdiagnosed condition.
Three years since the personalised anti-TNF therapy in Crohn’s disease study (PANTS) was first published. This blog discusses the findings.
Iron deficiency anaemia (IDA) is a major disease burden all over the world, resulting in symptoms including extreme fatigue and breathlessness. The major contributors to iron deficiency are poor dietary intake, malabsorption, gastrointestinal (GI) disorders, and blood loss. It has been reported that almost a third of men and most postmenopausal women presenting with IDA have an underlying GI abnormality[1], and unexplained IDA in such at-risk individuals is an accepted indication for fast-track secondary care referral in the UK.
Graham Johnson, Managing Director at BIOHIT, talks about the association between IDA and atrophic gastritis-induced achlorhydria. Along with sharing his experience and knowledge in this field, he also sheds light on the new guidelines by the British Society of Gastroenterology for the diagnosis and management of IDA in adults.
The risk of gastric cancer increases when a person suffers with atrophic gastritis – a pre-neoplastic condition of the gastric mucosa that is characterised by loss of normal antral or oxyntic glands. Recognised as a somewhat insidious condition, atrophic gastritis is associated with subtle or vague symptom presentation that’s difficult to distinguish, and therefore getting the right diagnosis early is very important.
In this blog we look a little closer at atrophic gastritis (AG) and gastric intestinal metaplasia (GIM), and show how an understanding of these conditions and their timely diagnosis can both streamline NHS resources and improve patient outcomes.
Faecal tests have been widely used by clinicians as informative, non-invasive tools that contribute to the differential diagnosis and monitoring of a wide range of gastrointestinal (GI) conditions. However, our growth in understanding of the GI tract – both normal and diseased – has created a need for new assays that take advantage of this convenient sample type, and potentially offer more analytes and quicker results.
Gastro-oesophageal reflux disease (GORD) occurs when excessive amounts of stomach contents – including acid, bile, pepsin and digested food and drink – enter the lower oesophagus, causing symptoms such as heartburn and indigestion. Medication for reflux, such as proton pump inhibitors (PPIs), suppress stomach acid and help to relieve these ‘classic’ reflux symptoms.
Dyspepsia affects between 20-40 % of the population, with GPs in the UK commonly seeing patients with various symptoms relating to the upper gastrointestinal (GI) tract. These patients are well managed at the primary care level, but there can be a gap in the patient pathway for refractory cases or those presenting with something potentially more sinister. This blog discusses the current limitations in managing patients with GI problems, and a potential solution to help streamline the screening process for gastric cancer.
The COVID-19 pandemic forced many hospitals to suspend or severely delay endoscopy services, resulting in a massive backlog of associated referrals after each wave. During these unprecedented times, patients still require investigation through endoscopy, but the heightened strain on the healthcare system has potentially delayed the diagnosis of gastrointestinal (GI) problems, resulting in poorer outcomes for these patients.
Helicobacter pylori is a gram-negative bacterium that commonly infects the stomach. For most people, infection doesn’t trigger any problems, however, it can cause gastric and duodenal ulcers or, more alarmingly, lead to mucosal damage resulting in gastric atrophy (GA) or gastric intestinal metaplasia (GIM), which are both pre-neoplastic conditions. H. pylori is therefore recognised as a group 1 (carcinogenic) pathogen, and must be carefully considered in the care of patients presenting with gastrointestinal problems.
Lactose intolerance (LI), or hypolactasia, is a common digestive problem whereby the body cannot digest lactose, the sugar found in milk and dairy products. It is caused by a shortage of the enzyme lactase in the small intestine, which breaks milk sugar into glucose and galactose to then be absorbed into the bloodstream. Prevalence of this condition is estimated to be at least 5%, however although lactase activity begins to decrease after weaning, roughly a third of the adult population worldwide retains the ability to digest lactose.
The word ‘microbiome’ is on everyone’s lips at the moment; there is growing awareness of what this actually means and a real emphasis on balancing your diet to achieve a healthy balance of gut bacteria. Our understanding of how the microbiota in the gut actually influence health and wellbeing is expanding at a rapid pace, and it’s now well recognised that every bacterial species naturally at home in the human gut has its own unique function.
One million people in the UK are affected by bile acid diarrhoea (BAD), but many sufferers are not aware of the term or understand what’s causing their symptoms. This common condition – also known as bile acid malabsorption – is a form of chronic diarrhoea, characterised by erratic and urgent loose bowel motions, with painful abdominal cramping.
According to Cancer Research UK statistics[1] there are 6,600 new cases of gastric cancer (GCa) per year in the UK, 70% of which are diagnosed at a late stage leading to poor prognosis and limited treatment options. The percentage of sufferers that survive for more than 5 years with the disease is just 21.6%, far fewer than our counterparts in Europe, and there are 4,400 deaths per year.
Dysbiosis is an imbalance of the microbiota in the gut compared to a normal and healthy reference microbiome. Identifying and quantifying the severity of dysbiosis is a very useful tool across a wide range of diseases, particularly for irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), and also to direct treatment or help weight loss.
Diagnostic testing for the detection and management of SARS-CoV-2, the respiratory virus responsible for the global COVID-19 pandemic, is evolving at pace. New tests that enable faster virus detection closer to the patient, or have less invasive sampling methods that facilitate the collection of good quality samples for testing, may produce significant benefits for society and the economy.
Therapeutic drug monitoring (TDM) measures specific drugs in a patient’s bloodstream over time, which is important for developing long term individualised care plans for patients with chronic inflammatory diseases such as inflammatory bowel disease (IBD) and rheumatoid arthritis.
Bile acid diarrhoea (BAD) – also known as bile acid malabsorption (BAM) – is a form of chronic diarrhoea, estimated to affect 1 % of people in the UK. The condition can be painful and debilitating, with sufferers experiencing numerous and daily episodes of watery and urgent bowel motions with faecal incontinence at times.
Reflux is an increasingly recognised term that many people associate with heartburn and indigestion. As many as 20 to 40 % of the UK population are affected by repeated episodes of gastric contents coming up from the stomach and into the oesophagus, causing immediate discomfort that sufferers are acutely aware of.
Reflux is a common condition that occurs when the contents of the stomach pass through the lower oesophageal sphincter (LOS) and up into the oesophagus. This can cause symptoms such as heartburn, difficulty in swallowing, nausea and inflammation of the oesophagus.