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Harvard University just released free online courses. No payment Required. Here are best courses you don't want to miss in 2025:

Anorectal Diagnosis Grid Helpful to consider four hallmarks features of anorectal lesions: ▪️Pain ▪️Bleeding ▪️Drainage ▪️“Weird” tissue Very practical approach to place diseases on this grid/axis. 🙏 Mark Zhao, MD, MAS UCSF Surgery 🔗 vumedi.com/video/non-surg…

Conferences i.e. Digestive Disease Week can feel overwhelming — even for the best of us. #GIFellows applying for advanced, IBD, or jobs, & #IMResidents getting ready for fellowship season - it’s a lot! 🤯 To follow up on GI Guy (Karl Kwok, MD, FASGE, D-ABOM) “Your network is your net worth” comment, a few tips I’ve

Cold vs Hot Snare Resection Cold for: ▪️Everything ≤10 mm (even 0-Ip) ▪️SSLs of any size ▪️Flat adenomas (G-LST) 10-20 mm ▪️ Flat adenomas (G-LST) > 20 mm 🙏 Douglas K. Rex, MD #DDW2025

Management of LI-RADS 4 Lesions ▪️LR-4 management is size-based ▪️<1 cm: CT/MRI q3mo x1yr ▪️1–2 cm: Multidisciplinary review ▪️≥2 cm: Proceed to biopsy ▪️Stable 2 yrs? Downgrade to LR-3 ▪️Transplant eligible? Stage lesion ▪️Consider bx if growing ▪️No empiric tx recommended

Varices Needing Treatment ▪️50% have varices; CTP B: 85% ▪️Incidence: ~8% develop small varices ▪️Progression: ~8% to large varices ▪️Bleeding risk: ~16% yearly ▪️Risk: large varices, red signs ▪️Risk ↑ with CTP B/C ▪️VNT = large or red wale ▪️Red wale = higher bleed risk

NILDA not for all patients! ▪️Platelets may mislead in ITP ▪️Splenectomy invalidates platelet count ▪️Avoid in AIH, Hep B flares ▪️MASH w/ inflammation not ideal ▪️Obese MASH = poor PPV ▪️Use ≥35 kPa in obese MASH ▪️Presinusoidal PH not detected ▪️Hepatic congestion = false (+)

Carvedilol preferred NSBB! ▪️Reduces vascular resistance too ▪️Start: 6.25 mg once daily ▪️Titrate to 6.25 mg BID ▪️Max dose: 12.5 mg/day ▪️No HR target needed ▪️Maintain SBP ≥90 mmHg ▪️Adverse: ortho BP, constipation ▪️No endoscopy if on therapy #DDW2025

Gastric Varices Management ▪️GOV1 vs GOV2/IGV1 matters ▪️Active bleed? Start endoscopic control ▪️Use CT to assess vasculature ▪️Triphasic CT → shunt decision ▪️Options: EVL, TIPS, BRTO, CYA, combo #DDW2025

Why is shunt important for gastric varices? ▪️Shunt supplies variceal blood ▪️Shunt → higher recurrence post-EGD ▪️Risk of systemic embolization ▪️Enables IR access to varices ▪️Needed for BRTO, PARTO, CARTO ▪️TIPS improves ascites ▪️BRTO/TIPS may worsen encephalopathy

Endoscopy through stoma ▪️Use gastroscope for ileoscopy ▪️Use peds scope for colostomy ▪️Review stoma 1st ▪️Check for stenosis, prolapse, fistula ▪️Photo-doc peristomal findings ▪️Advance scope ≥10 cm past fascia ▪️Identify loop vs end ostomy ▪️Mucous fistula may be present

Introduction of AI in GI Training Didactics (0–6 mo) ▪️What is AI ▪️AI pros & cons ▪️Validating models ▪️Clinical use Feedback (6+ mo) ▪️Size polyps ▪️Track metrics ▪️Review WT ▪️Set benchmarks Diagnostics (12+ mo) ▪️Spot polyps ▪️Biopsy help 🔗 cghjournal.org/action/showPdf…

Come join Jerry Edelson at #DDW2025 Endohepatology – Ready for Prime Time? 📅 Date: Mon, May 5 ⏰ Time: 10:00 AM – 11:30 AM (PDT) 👨‍⚕️ Speaker: MAJ Edelson 📍 Location: Room 4 – SDCC Digestive Disease Week

EUS-PPG vs HVPG ✅ Sedation needed ❌ No IV contrast ✅ Direct pressure check ✅ Pre-sinusoidal eval ✅ Widely available ✅ Endoscopy-capable ? MASLD accuracy unclear ❌ HVPG lacks key advantages Thoughts #livertwitter?

How to perform endo tx for gastric varices ▪️Use 22–23g injection needle ▪️Prepare CYA + water ▪️Needle out before puncture ▪️Inject varix away from base ▪️1 mL glue + 1 mL water ▪️Repeat until bleeding stops ▪️Confirm varix firmness ▪️Watch for embolization risk

Endohepatology – Ready for Prime Time? Ready for Prime Time: ✅ EUS-LB ✅ EUS-SWE ✅ EUS-PPG ✅ EUS-guided Rx of bleeding GV ✅ EUS-guided paracentesis Almost Ready: ⚠️EUS-guided ppx of GV Not Ready: ❌EUS-guided PSO 🙏 Jerry Edelson at #DDW2025 Thoughts #livertwitter?

🧬 Molecular features of serrated vs conventional colorectal neoplasia ▪️Conventional → KRAS+ ▪️SSLs → BRAF+, CIMP-high ▪️SSL w/ dysplasia → +MLH1, +MSI ▪️TSAs → CIMP-high, ± BRAF ± KRAS ▪️Lynch CRC → MSI only ▪️CIN CRC → KRAS+ ±BRAF 🔗pubmed.ncbi.nlm.nih.gov/22710576/