Carl Kay, MD
@CarlKayMD
Army GI @CRDAMC | Asst Prof of Med @USUhealthsci Husband | Girl Dad x2 | Interests: Pickleball, QI, & #MedEd via @SAUSHEC_GI @IUMedSchool & @WheatonCollege
1/ Collated thread for new GI fellows ⭐️GI Fellow Resources ⭐️ ▪️Websites ▪️Guidelines ▪️Apps ▪️Podcasts ▪️Textbooks ▪️Board study ▪️Social media 📲 bit.ly/3KwqCVG (hyperlinked 📄) #GITwitter

✅ The concept of “capsule chromoendoscopy” to detect gut inflammation 💊 💙 Pill ingested, if there ist inflammation 💩 stool turns blue cell.com/device/fulltex…
Many surprises in this @AGA_CGH meta analysis JAKi no better than placebo for ileal disease Stronger effect of Vedo for ileal than for colonic disease A progress towards positioning in #IBD Will patients with refractory ileocolonic disease benefit from a JAKi+Vedo combo?
ACUTE PHASE RESPONSE (APR) The acute phase response kicks in within hours of infection or injury: ⬆️ CRP, ferritin, fibrinogen, haptoglobin ⬇️ Albumin, transferrin Also: leukocytosis, thrombocytosis, anemia See thebloodproject.com/acute-phase-re… #Hematology #MedTwitter #AcutePhase
My Japanese teachers would say: "No AI system will detect lesions in suboptimal endoscopy" 🎯 Poor prep = missed cancers, regardless of technology. High-quality technique took LESS time and found more lesions. Master basics before buying gadgets.
CIRROXABAN Study is finally here! 🔬 First DB RCT evaluating rivaroxaban in cirrhosis 💡 Complication-free survival benefit in Child‑Pugh B7 (HR 0.26 [95 % CI 0.07–0.90]). ⚠️ Mild bleeding ↑, but no increase in severe events. 📄 journal-of-hepatology.eu/article/S0168-…
Evaluation of Patients With Laryngopharyngeal Symptoms: The Role and Strategy for Reflux Testing 📕Read Here: journals.sagepub.com/doi/full/10.11… #MedTwitter #GITwitter #SurgTwitter #MedX #GIX #SurgX @RenaYadlapati @UCSDHealth @UCSD_G @WalterChanMD @BrighamGI @BrighamWomens
🧵 GI Endoscopy Findings in Rheumatology – A Visual Thread Autoimmune diseases often leave visible footprints in the gut. Here are 10 key endoscopic findings linked to systemic rheumatic diseases 👇 #RheumTwitter #GastroTwitter #Endoscopy #Autoimmune #MedTwitter…
APP GI Immersion FOCUS Course 📍 San Antonio, TX 🗓️ Aug 2, 2025 ▪️GI CME just for APPs ▪️Military GI-led sessions ▪️High-yield, case learning ▪️Liver + luminal focus ▪️Earn 7.75 CME ▪️Hotel discount available ▪️Limited seats — register now 🔗 cmetracker.net/UTHSCSA/Publis…

📹 Starting GI fellowship? This review in @foregut_journal breaks down how to approach endoscopy before and after antireflux surgery—what to look for, how to recognize failure, and why anatomy matters. 🔗 doi.org/10.1177/263451… @SAGES_Updates @AmCollegeGastro @drkeithsiau…
🆕 ACG 2025 IBD Preventive Care 🦠 Vaccines ▪️PCV 20/21 for all adults ▪️Zoster ≥19 if suppressed ▪️Flu q1y (high dose ≥65) ▪️HBV if non-immune ▪️RSV ≥60 if risk factors 🧬 Cancer ▪️Cervical: if immunotherapy ▪️Skin: q1y, esp if on thiopurines/JAKs 🔗bit.ly/acg-ibd-preven…

Everything (history, phys exam, 🩸 tests, biopsy, response to treatment) is a diagnostic test with imperfect sensitivity & specificity You are not a computer. Patients are not multiple choice test questions We have to learn to live in the grey zone Biopsy performance in AIH👇
Phenomenal letter by Gideon and @bjornsson_s Do we *always* need a biopsy to diagnose autoimmune hepatitis ? Nope! Or more eloquently put 👇👇👇
Great to see this in @JHospMedicine @SocietyHospMed Offer naltrexone to patients with cirrhosis and etoh use disorder!!
Future of AI in Gastroenterology ▪️AI: takes history ▪️AI: reads images ▪️AI: lists diagnoses & DDx ▪️AI: knows facts ▪️You: make eye contact ▪️You: do the scope ▪️You: share wisdom ▪️You: heal humans Must watch! 👏@BrennanSpiegel #EBMed 🎥vumedi.com/video/the-futu…

Fantastic work led by @JIFortea 1⃣In compensated cirrhosis, carvedilol reduced the risk of first decompensation. 2⃣In decompensated cirrhosis, carvedilol reduced the risk of further decompensation. @sepdigestiva @AEEHLiver @EASLnews @AASLDtweets sciencedirect.com/science/articl…
Hepatic encephalopathy is horrible It can present as disorientation and coma. But often causes poor quality of life, falls, and other trauma We want to prevent it. How can we predict it?
Submucosal Lifting Agents 💉 Saline lifts short, cheap 🟦 Gel lifts last longer ⚠️ Can leave tattoo artifact 🔬 Mimics mucin or cancer ⏳ Longer lift = better EMR 📸 Document lift agent used 📄 FDA cleared ≠ inert Summary of lifting agents below 👇 🔗 cghjournal.org/action/showPdf…

Are “hematochezia” and “bright red blood per rectum (BRBPR)” clinical synonyms? Explain in comments. #GIX #GITwitter
Severe UC Pathway @AmJGastro ▪️≥6 bloody stools + signs ▪️Check C. diff & CMV ▪️Stop 5-ASA; start IV steroids ▪️Check sx & CRP daily ▪️No steroid response → rescue meds ▪️Rescue: IFX, JAKi ▪️Response → maintenance ▪️No response/complication → ✂️ 🔗 journals.lww.com/ajg/fulltext/2…

🚨 New ACG Crohn’s Guidelines (2025) ▪️Scope at 6–12 mo post-op ▪️Early advanced therapy = key ▪️Anti-TNF, IL-23, JAKi > mesalamine ▪️High-risk = smoking, prior surgery, penetrating dz ▪️Surgery for abscess >2cm or strictures 🔗 bit.ly/acg-crohns-2025
