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Medical specialties

Gastroenterology and Hepatology Diploma

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A decision-focused diploma in gastroenterology and hepatology: how to investigate and treat the conditions that fill clinics, endoscopy lists and wards, from reflux, bleeding and coeliac disease to inflammatory bowel disease (IBD), pancreatitis and liver disease, anchored on current UK and European guidance with US differences explained.

Twenty-five weekly sessions across five modules take you through upper gastrointestinal disease, IBD, lower gastrointestinal, pancreatic and nutritional problems, liver disease, and cirrhosis, liver failure and liver cancer, taught live by practising specialists you can question.

Course director
To be announced
Format
25 live weekly sessions on Zoom, in 5 modules
Dates
Confirmed when enrolment opens

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Micrograph of a liver biopsy stained with trichrome, showing pink nodules of liver cells separated by blue bands of scar tissue, the pattern of cirrhosis.
Image: liver biopsy showing cirrhosis by Ed Uthman via Wikimedia Commons, licensed under CC BY 2.0.

Who it is for

Senior trainees, fellows and early-career consultants in gastroenterology and hepatology, and physicians, GPs and specialist nurses who manage digestive and liver disease, worldwide.

The programme

25 one-hour sessions in 5 modules, each with its learning objectives. This is the draft programme: the course director reviews and refines it before enrolment opens, so session titles may change.

Module 1 · Sessions 1 to 5Upper gastrointestinal disease

  1. 1. Reflux disease and Barrett's oesophagus

    • Manage reflux symptoms with lifestyle advice and acid suppression, including stepping down proton pump inhibitors
    • Investigate refractory reflux symptoms before escalating treatment
    • Plan Barrett's oesophagus surveillance by segment length and dysplasia grade
    • Refer dysplasia and early cancer for endoscopic therapy at the right time

  2. 2. Dyspepsia, Helicobacter pylori and peptic ulcer disease

    • Apply a test-and-treat strategy for uninvestigated dyspepsia without alarm features
    • Choose a Helicobacter pylori eradication regimen using local antibiotic resistance
    • Confirm eradication and manage treatment failure
    • Reduce ulcer risk in patients who need anti-inflammatory, antiplatelet or anticoagulant drugs

  3. 3. Acute upper gastrointestinal bleeding

    • Risk-stratify upper gastrointestinal bleeding with the Glasgow-Blatchford score, including safe discharge of low-risk patients
    • Resuscitate with restrictive transfusion thresholds and correct clotting problems appropriately
    • Decide on the timing of endoscopy and the haemostatic options for non-variceal bleeding
    • Plan when to restart antiplatelet and anticoagulant drugs after haemostasis

  4. 4. Dysphagia, eosinophilic oesophagitis and oesophageal motility

    • Distinguish oropharyngeal from oesophageal dysphagia and choose the first investigation
    • Diagnose eosinophilic oesophagitis with adequate biopsies and start first-line treatment
    • Interpret a high-resolution manometry report using the Chicago Classification version 4.0
    • Compare balloon dilatation, surgical myotomy and endoscopic myotomy for achalasia

  5. 5. Coeliac disease

    • Test for coeliac disease correctly, including the need for gluten in the diet before testing
    • Decide when duodenal biopsy is needed to confirm the diagnosis in adults
    • Plan follow-up, including dietetic review, bone health and vaccination
    • Investigate persistent symptoms on a gluten-free diet, including refractory disease
Module 2 · Sessions 6 to 10Inflammatory bowel disease

  1. 6. Diagnosing inflammatory bowel disease and assessing severity

    • Use faecal calprotectin to decide who needs urgent investigation for suspected inflammatory bowel disease
    • Choose endoscopy, intestinal ultrasound or MRI to define disease extent and behaviour
    • Exclude infection and other mimics before starting treatment
    • Grade disease activity and recognise acute severe ulcerative colitis

  2. 7. Ulcerative colitis

    • Optimise aminosalicylate therapy for mild to moderate ulcerative colitis
    • Decide when to escalate to advanced therapy instead of repeating steroid courses
    • Manage acute severe ulcerative colitis, including rescue therapy and timely surgical referral
    • Set treat-to-target goals and monitor the response to treatment

  3. 8. Crohn's disease

    • Stratify Crohn's disease by the risk of a complicated course
    • Choose induction and maintenance therapy for luminal Crohn's disease
    • Plan combined medical and surgical care of perianal fistulising disease
    • Decide with the surgeon when resection is preferable to escalating drug treatment

  4. 9. Advanced therapies in IBD: choice, monitoring and safety

    • Compare the mechanisms, benefits and risks of the advanced therapy drug classes
    • Choose and sequence advanced therapy using patient factors and head-to-head trial evidence
    • Use drug level and antibody testing when a patient loses response
    • Screen for infection and plan vaccination before immunosuppression

  5. 10. IBD in special situations

    • Plan conception, pregnancy and breastfeeding with women who have inflammatory bowel disease
    • Recognise and co-manage joint, skin, eye and liver manifestations of inflammatory bowel disease
    • Schedule colonoscopic surveillance by individual cancer risk
    • Adapt treatment choices for older patients with comorbidity and for young people in transition
Module 3 · Sessions 11 to 15Lower gastrointestinal disease, pancreas and nutrition

  1. 11. Irritable bowel syndrome and disorders of gut-brain interaction

    • Make a positive diagnosis of irritable bowel syndrome using the Rome V criteria and minimal investigation
    • Explain the gut-brain model of symptoms to patients in plain language
    • Choose first-line and second-line drug treatment by symptom subtype
    • Refer for dietary or psychological therapy when first-line treatment fails

  2. 12. Chronic diarrhoea and malabsorption

    • Investigate chronic diarrhoea in a structured sequence that avoids unnecessary tests
    • Diagnose and treat bile acid diarrhoea
    • Recognise microscopic colitis and start treatment
    • Identify pancreatic exocrine insufficiency and prescribe enzyme replacement correctly

  3. 13. Colorectal cancer: symptoms, testing and surveillance

    • Use faecal immunochemical test results to decide who needs urgent colonoscopy
    • Investigate iron deficiency anaemia in line with UK guidance
    • Explain how bowel cancer screening works and what a positive result means
    • Assign post-polypectomy surveillance using current risk criteria

  4. 14. Acute and chronic pancreatitis

    • Diagnose acute pancreatitis and assess its severity
    • Manage fluids, nutrition and pain relief in the first 72 hours
    • Decide on antibiotics, urgent biliary drainage and the timing of cholecystectomy
    • Manage pain and exocrine and endocrine failure in chronic pancreatitis

  5. 15. Nutrition in gastroenterology

    • Screen for malnutrition and set a nutrition plan
    • Choose between oral, enteral and parenteral nutrition
    • Prevent and manage refeeding syndrome
    • Recognise intestinal failure and refer to a specialist service
Module 4 · Sessions 16 to 20Liver disease

  1. 16. Abnormal liver blood tests

    • Classify abnormal liver blood tests as hepatitic, cholestatic or isolated
    • Request a complete liver aetiology screen
    • Use non-invasive tests to stage liver fibrosis
    • Decide who needs referral to a liver clinic

  2. 17. Metabolic dysfunction-associated steatotic liver disease

    • Explain the change from non-alcoholic fatty liver disease to the steatotic liver disease nomenclature
    • Stratify fibrosis risk in primary and secondary care
    • Plan weight loss and cardiometabolic treatment as the core of management
    • Judge which patients may benefit from the new drug treatments for steatohepatitis

  3. 18. Alcohol-related liver disease

    • Screen for harmful drinking and deliver a brief intervention
    • Manage alcohol withdrawal safely in hospital
    • Assess the severity of alcohol-related hepatitis and decide on corticosteroid treatment
    • Support abstinence with medicines and psychosocial care

  4. 19. Viral hepatitis

    • Interpret hepatitis B serology and identify the phase of infection
    • Decide who needs antiviral treatment for hepatitis B
    • Treat hepatitis C with direct-acting antivirals and confirm cure
    • Prevent hepatitis B reactivation in patients starting immunosuppression

  5. 20. Autoimmune and cholestatic liver disease

    • Diagnose autoimmune hepatitis and start induction treatment
    • Treat primary biliary cholangitis and identify an inadequate response that needs second-line therapy
    • Monitor primary sclerosing cholangitis, including bowel and bile duct cancer surveillance
    • Recognise features that suggest an overlap syndrome
Module 5 · Sessions 21 to 25Advanced liver disease and practice

  1. 21. Cirrhosis and portal hypertension

    • Identify compensated advanced chronic liver disease and clinically significant portal hypertension without invasive tests
    • Use non-selective beta-blockers to prevent decompensation and variceal bleeding
    • Manage acute variceal bleeding with antibiotics, vasoactive drugs and endoscopy
    • Manage ascites with diuretics, paracentesis and albumin, and know when to refer for a transjugular intrahepatic portosystemic shunt

  2. 22. Hepatic encephalopathy, kidney injury and acute-on-chronic liver failure

    • Identify and treat the precipitants of hepatic encephalopathy and prevent recurrence
    • Diagnose acute kidney injury and hepatorenal syndrome in cirrhosis and start treatment
    • Diagnose and treat spontaneous bacterial peritonitis
    • Recognise acute-on-chronic liver failure and decide on escalation to critical care

  3. 23. Acute liver failure, drug-induced liver injury and transplant referral

    • Recognise acute liver failure and contact a transplant centre early
    • Assess suspected drug-induced liver injury and stop the likely cause
    • Identify patients with chronic liver disease who should be referred for transplant assessment
    • Care for liver transplant recipients in the general clinic, including drug interactions

  4. 24. Liver cancer

    • Identify patients who should be in hepatocellular carcinoma surveillance
    • Diagnose hepatocellular carcinoma using imaging criteria and know when biopsy is needed
    • Explain how staging guides curative and palliative treatment choices
    • Refer patients to the multidisciplinary team with the information it needs

  5. 25. Complex case decisions and running a gastroenterology service

    • Apply the course to complex cases in a panel discussion
    • Manage antiplatelet and anticoagulant drugs around endoscopic procedures
    • Design referral pathways and virtual clinics that keep patients safe
    • Build a personal plan for continuing development in gastroenterology and hepatology

What the diploma includes

  • 25 live sessions on Zoom, one evening a week, with recordings for the weeks you miss.
  • Practising specialists teaching live, so you can put your questions to them.
  • Weekly MCQs and a final written assessment.
  • A digital certificate carrying your final classification.

Lead or teach the Gastroenterology and Hepatology Diploma

We are looking for a course director and faculty from the specialty. Sessions are one hour in the UK evening, live on Zoom, and paid.

Apply to teach