In this episode of the BSG Top to Bottom podcast, Prof James East and Prof Pradeep Bhandari dive into the endoscopic aspects of the new BSG IBD Surveillance Guidelines. Building on part one’s focus on cancer risk and surveillance rationale, this discussion explores practical essentials, from bowel preparation and patient comfort to chromoendoscopy, lesion detection, and the nuances of managing dysplasia in IBD. The conversation also highlights training, service delivery, MDT decision‑making, and the evolving roles of advanced endoscopic techniques and surgery.

• (00:00:00) - Top to Bottom: Endoscopic Surveillance
• (00:01:03) - The BSG Guidelines on IBD
• (00:02:04) - IBD bowel prep
• (00:06:01) - Colonoscopy: Comfort and Safety
• (00:09:26) - BSG 5, Virtual Chromo Endoscopy
• (00:18:24) - Invisible dysplasia
• (00:21:09) - Who should be doing IBD endoscopy?
• (00:25:06) - Diabetes and colitis 6, Neoplasia management
• (00:34:11) - Segmental resection in IBD
• (00:38:51) - Intensive surveillance for colonoscopy patients with dysplasia
• (00:41:55) - Endoscopy and cancer: concordance

Join Dr. Shahida Din, consultant gastroenterologist and Chair of the BSG IBD Section, for an in‑depth conversation with Professor James East, leading gastroenterologist, endoscopist, and co‑author of the new BSG IBD Surveillance Guidelines. They explore how cancer risk in IBD has evolved, when to start or stop surveillance, and the shift toward personalised risk assessment. The episode covers key updates on bowel prep, biopsy strategies, patient experience, and what clinicians should know to deliver high quality, patient centred surveillance.
Stay tuned for Part 2 on endoscopic techniques and dysplasia management with Professor Pradeep Bhandari

Part seven of seven: Dr Alexandra Kent, Consultant Gastroenterologist at King’s College Hospital, is joined by Professor Jimmy Limdi, Head of the IBD section at the Northern Care Alliance NHS Foundation Trust, to explore how Crohn's Disease recurrence is defined, predicted, monitored, and managed after surgery as recommended in the BSG IBD Guidelines.

Together, they discuss the continuum of post-operative recurrence from histological and endoscopic changes to clinical and surgical relapse. They highlight key patient, disease, and surgical risk factors, including smoking and aggressive disease phenotypes. The episode covers best practice for post-operative monitoring, including the role of ileocolonoscopy, Rutgeerts scoring, faecal calprotectin, intestinal ultrasound, and cross-sectional imaging.