Gastro Care 4 U

11/10/2025

🌏 Wrapping up the 1st GENIUS IUS Workshop in Manila 🇵🇭

What a fulfilling one and a half days of learning, discussion, and discovery!

Heartfelt congratulations to Professor Jose Sollano and the IBD Club of the Philippines for a seamlessly organised and truly meaningful workshop. The passion and curiosity from everyone in the room were contagious.

A big thank you as well to all the wonderful patients who became our best teachers today — your patience and participation brought the hands-on sessions to life. 💙

We had meaningful discussions on how to set up IUS services, and more importantly, how to convince hospital administrators on the value of investing in ultrasound for IBD care.

It’s inspiring to see so many already planning to advance into GENIUS Module 3 training, ready to bring intestinal ultrasound into their own practice.

Looking forward to this new journey of learning and collaboration as we continue to expand IUS practice across Southeast Asia. 🌏💪

10/10/2025

🌏 1st GENIUS IUS Workshop in Manila 🇵🇭

An inspiring start to the 1st GENIUS Intestinal Ultrasound (IUS) Workshop in Manila, beautifully organised by Professor Jose Sollano and the IBD Club of the Philippines.

Truly honoured to be invited as one of the IUS trainers alongside Dr. Yoon Kyo An and Dr. Sung Wook Hwang, sharing experiences and advancing IUS education in our region.

I had the privilege of speaking on “Why IUS and Its Application in IBD,” while Dr. Yoon delivered a superb session on “How to Perform IUS.”
Tomorrow, participants will immerse in a full day of hands-on training, translating knowledge into practice.

It’s heartening to see the growing enthusiasm for IUS across Asia, bridging expertise and collaboration to improve precision care for patients with IBD.

05/10/2025

Looking forward to another journey of IUS sharing and teaching in Manila this week— my tenth IUS workshop and IUS related lecture engagement this year. With three more workshops lined up before the end of 2025, I am truly grateful for the opportunity to give back and share what I have learned.

Intestinal Ultrasound (IUS) should be accessible to every clinician — it is a tool that is transforming how we diagnose and manage IBD. Through early diagnosis, tight monitoring, and timely intervention, IUS empowers us to act decisively and personalize care. That, to me, is a game changer in improving disease outcomes and redefining the way we care for our patients.

The IBD Club of the Philippines, in collaboration with GENIUS (Gastroenterology Network of Intestinal Ultrasound), proudly presents the country’s first-ever Hands-on Workshop on Intestinal Ultrasonography (IUS) in Inflammatory Bowel Disease.

Happening on October 10 at Seda Hotel BGC and October 11 at Healthway Cancer Care Hospital (HCCH), a select group of Filipino gastroenterologists will undergo expert training on IUS — a groundbreaking, less invasive procedure that is transforming the way IBD is diagnosed and managed worldwide.

As the Philippines’ first dedicated cancer care hospital, HCCH is committed to driving innovation, advancing modern medical practice, and serving as a hub for world-class expertise.

This milestone initiative underscores the shared leadership of the IBD Club and HCCH in shaping the future of gastroenterology and raising standards of care for patients in the country.

27/09/2025

✅ Just wrapped up my presentation on “The Yeast that Ease a Troubled Gut” today.

We explored how gut dysbiosis drives diarrhoeal illness, the unintended impact of antibiotics, and the growing role of microbiome-targeted therapies.

Key takeaways:
🔹 Saccharomyces boulardii CNCM I-745 is effective in restoring microbial balance.
🔹 It plays a dual role in both treatment and prophylaxis of antibiotic-associated diarrhoea and Clostridioides difficile infection.
🔹 Managing diarrhoea-related diseases today means not just treating symptoms, but also protecting and restoring the microbiome.

Grateful for the engaging discussions with colleagues, and excited to see how microbiome-based therapies will continue shaping our clinical practice. 🌱

21/09/2025

What a fantastic and engaging event yesterday at the Takeda IBD Expert Connect! I really enjoyed the small-group format, which led to a truly fruitful discussion about navigating the IBD treatment landscape.
​The energy from the crowd was amazing! We had a great back-and-forth and all agreed on the core message: early treatment, teamwork between specialties, and using safe medications are absolutely key for our patients' long-term success.
​A huge thank you to everyone who participated and made it such a dynamic session. Events like this, filled with passionate people, are what it's all about!

24/08/2025

Between academic talks, I had the chance to experience Kochi — a city where cultures, faiths, and history meet the sea.

Kochi was once a thriving spice port, the very reason the Portuguese first set sail eastwards. Their foothold here in the early 1500s marked the beginning of European colonisation in India, and it was from Kochi that they expanded to capture Melaka, Malayan peninsula in 1511 — reshaping global trade and power in the early 16th century.

From the sacred interiors of St. Francis CSI Church, where Vasco da Gama was once laid to rest, to the Santa Cruz Cathedral Basilica, elevated by Pope John Paul II in 1984 and adorned with Gothic arches, frescoes, and a rare seated statue of Jesus — the city’s spiritual heritage left a deep impression.

Along the waterfront, I witnessed both the grandeur of the Chinese fishing nets, timeless silhouettes from the 14th century, and the intimate skill of fishermen casting nets by hand. The joy of a fresh catch reminded me that Kochi’s soul still beats with the rhythm of the sea.

The journey continued through Jew Town, the Paradesi Synagogue, and Mattancherry Palace, where vivid murals and intricate carvings spoke of Kerala’s layered past. At the Dhobi Khana laundry, I was struck by the endurance of tradition — generations keeping alive the humble craft of hand-pressing clothes with charcoal irons.

And of course, no exploration is complete without food — a Kerala thali on a banana leaf, simple yet rich in flavour, reflecting the warmth of local hospitality.

Kochi is not just a destination; it is a living crossroads of spice, faith, and history. Truly an enriching exploration alongside the professional journey.

22/08/2025

Grateful for the opportunity to contribute at the 9th National Conference of Colitis and Crohn’s Foundation of India (CCFI) in Kochi, under the theme “Shaping the Future of IBD Care.”

I had the privilege of delivering a lecture on “The IL-12/23 Disconnect: A New Paradigm in IBD with Ustekinumab” and also presenting in the Rapid Fire sessions on “Approach to High-Grade Dysplasia in Flat Mucosa with Deep Remission in Longstanding UC” and “A Patient on PD-L1 Inhibitor Develops Bloody Diarrhoea.”

It was also a wonderful opportunity to reconnect with friends and colleagues from across India and around the world — always a great catch-up and exchange of ideas.

Many thanks to Dr. Mathew Philips and the CCFI for the kind invitation and for curating such an inspiring scientific program. Truly an honour to share ideas and learn alongside esteemed colleagues, all working toward better care for patients with IBD.

16/08/2025

Had such a meaningful couple of days discussing IBD care, thanks to the kind invitation from Takeda Philippines. It was wonderful meeting Prof. Sollano, Dr. Carla, Dr. Joseph Bocobo, Dr. Karen, and Dr. Jun Ruiz.

We explored how the right choice of biologics in Crohn’s disease and ulcerative colitis truly transform outcomes and quality of life. I also shared four patient journeys to highlight how point-of-care intestinal ultrasound supports diagnosis and tight monitoring. The energy and enthusiasm on intestinal ultrasound were inspiring, and I’m looking forward to returning to Manila this October for the intestinal ultrasound workshop as invited faculty.

A special thank you to Professor Sollano for such a wonderful dinner and evening — the setting at The Volt was unique, with amazing food and inspiring artwork. My personal favourite was a piece by Fernando Amorsolo, a perfect close to an enriching exchange.

10/08/2025

GUT 2025 marked the first-ever joint annual scientific meeting of the Malaysian Society of Gastroenterology & Hepatology with the UMMC Endoscopy Workshop — and what a success it was, drawing over 750 delegates!

I was honoured to serve as faculty for the AEG Endoscopic Ultrasound Pre-Congress Workshop alongside Dr. Thawee Ratanachu Ek (3rd Goh Khean Lee Distinguished Lecturer), Prof. Ida Hilmi, Dr. James Emmanuel, and Dr. Stanley Khoo. It was also a privilege to join Prof. Ida Hilmi and Dr. Nik Razima as panel speakers at the Johnson & Johnson Lunch Satellite Symposium on The Future of IBD Management – Exploring Advanced Treatments and Beyond — a truly energising and insightful discussion.

Congratulations to my mentor, Prof. Sanjiv Mahadeva, for delivering the prestigious 25th MSGH Oration — an inspiring talk on The Influence of Culture on Disorders of Gut-Brain Interaction in Asians

It was wonderful to reconnect with Professor Lawrence Ho, Professor Francisco Guarner, Professor Benedict Devereaux, Dr. Chua Tju Siang, Assoc. Professor Julajak and Assoc. Prof. Sunny Wong. Met with my Korean mentor, Prof. Jong Ho Moon’s outstanding nursing team from SoonChunHyang University School of Medicine, Bucheon — Head Nurse Ms. Kim Sang Yeun and Charge Nurse Ms. A Ri Song — and have an in-depth exchange with Prof. Honggang Yu from China, a pioneering AI researcher in digestive endoscopy and the driving force behind the ENDOANGEL AI GI system.

I am looking forward to in Penang!

10/08/2025

今天星洲日报医识力登场！原文链接： https://shorturl.at/cDRzV

便便卡肛排不出 小灌肠速效通便 惟勿频用

问：上次廖医生解答时提到“出口梗阻型便秘”的问题，我也面对相同的情况。

Q1：请问如何解决接近肛门部位的硬粪便？
Q2：是否有必要做进一步检查？

如果大便卡在肛门口排不出来，可以暂时使用一些肛门栓剂或微型灌肠剂（microenema），例如市面上常见的小容量肛用灌肠产品。这类灌肠剂能迅速软化靠近肛门的干粪块，并刺激排便反射，通常在几分钟内见效，适合短期应急使用。不过，这类产品不建议天天用，以免肠子变得越来越依赖该药的刺激。

平时最重要的是养成规律的排便习惯。建议每天早餐后固定时间尝试排便，因为这个时间点肠子的蠕动最强。如果有便意千万不要憋，越憋大便越容易干硬卡住。另外，坐厕所时可以在脚下放一个小凳子，让膝盖抬高，模拟蹲姿，这样肛门肌肉会比较放松，排便会顺畅些。

中长期改善方面，可以使用一些软便药，例如聚乙二醇（PEG）、乳果糖或乳酸镁。这些药物能增加粪便的含水量，使其保持柔软，有助于规律排便。同时应继续摄取充足纤维，像是洋车前子壳（psyllium）、麦麸等“非发酵性纤维”，它们有助于形成体积大、湿润的大便，减少靠近肛门处变干的问题。

如果这些方法都尝试过仍没有改善，就要考虑是否有出口性阻力，例如肛裂、痔疮、直肠下垂，或盆底肌肉协调失常。这种情况建议进一步由肠胃科或大肠外科医生评估，例如做肛门指检、肛门压力测定或排便造影。

便秘超过3个月宜排查

如果你的便秘问题已经超过3个月，影响生活，或者每次都排不干净，就应该考虑检查。尤其是你有在吃一些容易让肠子变慢的药物，或者有甲状腺、糖尿病等慢性病，更要留意。

如果排便时常常痛、流血、肛门有肿块，或者曾做过肛门手术，那更应该让医生检查，看看有没有结构上的问题。

常见的检查包括抽血（检查甲状腺和血钙）、肛门检查、或做一些功能测试（像肛门压力测定、排便造影）。找出真正的原因，才能选对治疗方式。

02/08/2025

Honoured to speak at the 🇰🇭 Cambodia Association of Gastrointestinal Endoscopy 8th Annual Scientific Meeting, where I shared insights on Biologic Therapy in IBD and the expanding role of Intestinal Ultrasound (IUS) in IBD monitoring.

Proud to represent the Asian Educational Network in IBD alongside Prof Ooi Choon Jin and Prof Raja Affendi during the IBD symposium.

It was also a pleasure to meet with good friend from Korea, Prof Hwoon-Yong JUNG 🇰🇷. What a wonderful catch-up!

In Cambodia, where access to biologics remains limited, Intestinal Ultrasound may become a pivotal tool for early diagnosis and tight disease monitoring in IBD. It also holds great promise in monitoring treatment response in intestinal tuberculosis—particularly relevant in regions with high TB prevalence.

The strong interest and thoughtful questions from the audience were truly encouraging. Although time constraints limited deeper discussion on IUS techniques, I’m glad the session helped spark a lot of interest in IUS.

We’ll be back—with a dedicated hands-on workshop to share the knowledge. Looking forward to continuing the journey of IBD care and monitoring pin Cambodia.

27/07/2025

This week couldn’t have ended more fittingly than with Sin Chew article today feature on gallbladder stones, bile duct stones, and bile duct inflammation. https://shorturl.at/CY3ZA

The article echoed what unfolded daily for this week's ERCP and cholangioscope—each case reinforcing the complexity and variability of biliary pathology.

Monday:
We started the week with a challenging case of recurrent pancreatitis attributed to sphincter of Oddi dysfunction. A papillotomy was successfully performed earlier, offering relief and a clear pathway forward for this patient’s recurrent flares. Patient came in for removal of previous biliary stent.

Tuesday:
An elderly patient with a history of recurrent bile duct infections was referred after multiple hospital admissions. Our ERCP with cholangioscopy uncovered stones previously missed in earlier imaging—a stark reminder of the value of direct visualization into the bile duct.

Wednesday:
A straightforward but satisfying case of bile duct stone with accompanying pain and liver enzyme derangement. Stone was successfully cleared, reaffirming the role of timely ERCP in acute biliary obstruction.

Thursday:
A sudden turn in an elderly lady on blood thinners—severe abdominal pain revealed multiple large bile duct stones. Due to bleeding risk, we opted for temporary biliary stenting, with plans to return for definitive therapy.

Friday:
What began as an admission for unrelated elective surgery turned urgent. Sudden abdominal pain and elevated liver enzymes prompted workup. CT and MRCP were unrevealing, but cholangioscopy confirmed bile duct stones, proving once again its indispensable role in occult choledocholithiasis.

Saturday:
Another case of abdominal pain and liver injury in a patient on antiplatelets. Imaging revealed dilated ducts and impacted stones. We proceeded with biliary stenting as a temporizing measure.

The weekend’s article emphasized that the presence of gallstones alone doesn’t mandate surgery, but rather symptoms and complications drive intervention. Precisely what we encountered this week. The week of stones.