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The Bottom Line IBD Nigel H 🎸🎸🎸🎸🥁 Interesting! As sedation doesn’t make any difference. Or does it? What doses of what drug(s) improve experience compared to nothing (I’ll accept nitrous oxide as nothing)?!

What a disgrace

The development of the anus was a major evolutionary step. Multinucleated organisms’ excreta sank to ocean bed, bacteria followed, leaving clear, oxygenated water in which more sophisticated animals developed. Pity so many of our 8 billion anuses are arseholes, destroying it all.

The final session of our Glasgow Gastro conference focuses on endoscopy and will be chaired by Dr John Morris. Speakers include Andy Veitch, Roisin Bevan and Mark McAlindon. Find out more about the conference and register here: ow.ly/gpYv50KugY0 Adrian Stanley

this made me laugh on saturday's Rotherham Titans game at Hull Ionians

If you needed ((or have had) OGD (EGD for my US buddies) what would (did) you choose? Please RT for a decent survey and see what we get?! Sheffield Gastro ACG BSG JAG Endoscopy Endoscopy Brothers & Sisters Capsula Endoscopica ASGE GI Endoscopy ESGE

Hey look! A big swing towards midazolam+opioid or propofol! What would be your choice?! Ask your friends too!

A very modern Conservative tragedy in 4 tweets.

OMG. Forget sedation in endoscopy. I was watching GoT tonight as my son has been badgering me to do so for years. But it’s nothing compared to this nut job bonkers shit show!

Old car goes to bed! #CarBubbleUK CarBubbleUK

That possible Matt? Maybe you already have the data? Writing up a paper…

Less than day 1, but LA still the popular option! Really?! Have you any more friends you can ask to vote? Not sure there is much of an evidence base for midaz+opioid, but it appears to be the most popular medication option... Pradeep Bhandari Simon Dunn Ashish Srinivasan MD PhD UHNM Endoscopy Training Centre

Agreed! TNE better tolerated and more acceptable than gastroscopy, but still an uncomfortable procedure. Magnet controlled capsule endoscopy best from patients’ POV, but x3 more costly - at the moment! Sheffield Gastro

Interesting! Once the capsule is made, there are no procedure related disposables and an ex chair of a water board told me they could be easily retrieved and, therefore, perhaps recycled. Is there a way of looking at this?

Maybe! PMID 32229221. PMID 24961149. All these studies done with pillcam ESO2 (no control), I think. Magnet controlled capsule done in A&E may achieve better results? We’ll see!

@lgblewis Ah but can you get sushi 24/7?

In the Egyptian city of Syene there was a famous well. Famous because at noon on the summer solstice the sun shone directly into the deep hole without any shadows. Why? Because Syene lies almost directly on the Tropic Cancer - on the solstice the sun shines directly overhead.