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Two guys talking **it - A Gastroenterology and Hepatology podcast

Two guys talking **it - A Gastroenterology and Hepatology podcast

By: A/Prof Jon Segal and Dr James Haridy
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About this listen

 “Two Guys Talking $#it” is a podcast where two Gastroenterologists break down complex topics into engaging, educational, and occasionally humorous conversations. From liver health to gut microbiota and everything in between, A/Professor Jonathan Segal and Dr James Haridy deliver insights, share the latest research, and discuss clinical pearls with the odd guest in tow. Comments, suggestions, questions please contact us on twitter @2guystalkingit or leave a comment below..A/Prof Jon Segal and Dr James Haridy Hygiene & Healthy Living Physical Illness & Disease
Episodes
  • #09: A/Professor Emma Halmos & Dr CK Yao - Food is Medicine.. or is it?

    #09: A/Professor Emma Halmos & Dr CK Yao - Food is Medicine.. or is it?
    Jun 5 2025
    Today we welcome two world-leading dietitians to talk all things diet in IBD and IBS....A/Prof Emma Halmos is a senior research dietitian at Monash University and the Alfred Hospital. Her scientific achievements have had a major impact in clinical practice nationally and internationally. The most notable was the pivotal feeding study that demonstrated the low FODMAP diet was efficacious in patients with IBS. A/Prof Halmos has been elected onto the D-ECCO (Dietitians of European Crohn’s and Colitis Organisation) committee and is a leading coordinator for the first ECCO guidelines on nutrition in IBD. Her current role at Monash University is leading research on novel dietary therapy to treat IBD and IBS.Dr CK Yao is a senior research dietitian at Monash University and the Alfred Hospital, and recent NHMRC emerging leader. In 2017, CK completed her PhD investigating dietary manipulation of gut microbial function and the application of gaseous biomarkers in patients with functional and inflammatory bowel disease. Dr Yao currently leads a research programme looking at optimising dietary strategies for patients with ulcerative colitis and those with an ileoanal pouch.We discuss the critical role of diet in managing inflammatory bowel disease (IBD), particularly Crohn's disease and ulcerative colitis. We explore various dietary patterns, the impact of emulsifiers and ultra-processed foods, and the importance of personalized dietary advice. We talk about the significance of dietitians in guiding patients towards healthier choices. This conversation delves into the complexities of dietary recommendations for various gastrointestinal conditions, particularly focusing on the Mediterranean diet, Crohn's disease, and IBS. We discuss cultural influences on diet, the importance of personalized nutrition, and the emerging trends in dietary therapy. Finally we touch on the new ECCO Diet in IBD guideline that is set to be published soon.As always comments, questions and feedback please send to: X: @2guystalkingitEmail: 2guystalkingit@gmail.comChapters00:00 Introduction with J & J4:20 On to our guests... Diet and IBD05:50 Dietary Patterns for Disease Prevention08:53 Therapeutic Diets and Active IBD11:58 Controversies in Dietary Recommendations15:02 The Impact of Emulsifiers and Ultra-Processed Foods18:07 Practical Dietary Advice for Patients in IBD21:02 Cultural Considerations in Dietary Recommendations23:57 Food as Medicine: A Discussion27:03 Exploring Diverse Dietary Patterns30:13 Conclusion and Future Directions32:26 Cultural Influences on Diet and Health34:40 Dietary Recommendations for active Crohn's Disease37:22 Understanding Pouch Patients38:11 Initial Assessment for IBS Patients44:25 Screening for ARFID48:03 Emerging Dietary Trends in IBS51:40 New Guidelines in IBD NutritionPapers discussedFitzpatrick JA, Gibson PR, Taylor KM, Anderson EJ, Friedman AB, Ardalan ZS, Smith RL, Halmos EP. Clinical Trial: The Effects of Emulsifiers in the Food Supply on Disease Activity in Crohn's Disease: An Exploratory Double-Blinded Randomised Feeding Trial. Aliment Pharmacol Ther. 2025 Apr;61(8):1276-1289. https://pubmed.ncbi.nlm.nih.gov/39967287/Fitzpatrick JA, Gibson PR, Taylor KM, Halmos EP. Development of Novel High and Low Emulsifier Diets Based upon Emulsifier Distribution in the Australian Food Supply for Intervention Studies in Crohn's Disease. Nutrients. 2024 Jun 18;16(12):1922. . https://pubmed.ncbi.nlm.nih.gov/38931276/Halmos EP, Gibson PR. Controversies and reality of the FODMAP diet for patients with irritable bowel syndrome. J Gastroenterol Hepatol. 2019 Jul;34(7):1134-1142. https://pubmed.ncbi.nlm.nih.gov/30945376/A FODMAP Gentle approach: https://www.monashfodmap.com/blog/gentle-fodmap-diet/The SCOFF Questionnaire: https://ceed.org.au/wp-content/uploads/2024/05/SCOFF.pdf
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    56 mins
  • #08: Professor Gideon Hirschfield - The Art and Science of PSC and Autoimmune Hepatitis

    #08: Professor Gideon Hirschfield - The Art and Science of PSC and Autoimmune Hepatitis
    Apr 28 2025

    Summary

    Dr Gideon Hirschfield is a leading expert in autoimmune liver diseases, including PSC, PBC, and autoimmune hepatitis. He’s helped shape how these conditions are understood and managed around the world, combining cutting-edge research with a real passion for patient care.

    Today he discusses his work with autoimmune liver diseases, particularly primary sclerosing cholangitis (PSC) and autoimmune hepatitis. We discuss some key topics in PSC (including use of Ursodeoxycholic acid, cancer surveillance as well as the PSC/IBD phenotype), and Professor Hirschfield gives us a masterclass in the management of autoimmune hepatitis. He also offers advice for new hepatologists, highlighting the significance of clear diagnoses, individualized patient management, and clinical trials to drive us into the future.


    As always comments, questions and feedback please send to: X: @2guystalkingit

    Email: 2guystalkingit@gmail.com


    Chapters

    00:30 J & J Introduction

    06:15 Introduction to Professor Hirschfield and Autoimmune Liver Diseases

    07:41 The Role of Ursodeoxycholic Acid in PSC Management

    19:06 Understanding the Pathophysiology of PSC

    22:43 Cancer Surveillance in PSC Patients

    28:39 The Relationship Between PSC and Inflammatory Bowel Disease

    32:30 Vancomycin and PSC

    36:28 Management Strategies for PSC and IBD Patients including Pouches

    40:00 Management of Autoimmune Hepatitis: An Art and Science

    56:30 Proactive Approaches in Primary Biliary Cholangitis (PBC) Management

    1:01:05 Advice for Aspiring Hepatologists


    Keywords

    Hepatology, Autoimmune Liver Disease, PSC, Ursodeoxycholic Acid, Cancer Surveillance, Inflammatory Bowel Disease, Clinical Trials, Patient Care, Liver Transplantation, PSC Management, pouch studies, autoimmune hepatitis, management, PBC, hepatology, patient choices, liver transplant, treatment options, chronic diseases, clinical trials
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    1 hr and 6 mins
  • #07: Dr Simon Gabe - Rebuilding the gut: Intestinal rehabilitation

    #07: Dr Simon Gabe - Rebuilding the gut: Intestinal rehabilitation
    Apr 7 2025

    This is a really special episode with an incredible doctor (Jon says "the best clinician I have ever met").

    Today we welcome Dr Simon Gabe, an internationally renowned expert in intestinal rehabilitation. Dr Simon Gabe is a consultant in gastroenterology & intestinal rehabilitation at St Mark’s Hospital and chair of the NHS National Reference Centre for Severe Intestinal Failure at St Mark’s. This is also an Integrated Care centre for intestinal failure and a recognised ESPEN Training Centre. He has a wide clinical experience in dealing with complex nutritional problems, inflammatory bowel disease, fistula management, intestinal failure requiring enteral or parenteral support, home parenteral nutrition and consideration of intestinal transplantation. Dr Gabe is a past President of BAPEN. He co-founded the National Adult Small Intestinal Transplant (NASIT) Forum in the UK and has been an active member of a Clinical Reference Group within NHS England responsible for the development of a clinical network in England for all patients with Intestinal Failure (HIFNET). He currently co-chairs the HPN Clinical Advice and Management Group for NHS England.

    As always comments, questions and feedback please send to: X: @2guystalkingit

    Email: 2guystalkingit@gmail.com


    Chapters

    04:15 Introduction to Simon Gabe

    06:59 Understanding Intestinal Rehabilitation

    09:56 Defining Intestinal Failure

    13:29 Trends in Intestinal Failure Causes

    16:23 Bowel Length and Nutritional Support

    20:26 Managing Short Bowel Syndrome

    26:06 Barriers to Recognizing Intestinal Failure

    30:37 Patient Evaluation Process for Intestinal Failure

    33:07 Empowering Patients in Line Management

    36:21 Managing Line Sepsis: Best Practices

    43:17 Understanding Ehlers-Danlos Syndrome (EDS) and Nutrition

    50:14 Nutritional Support in Cancer Patients

    54:18 Enteral Support in Dementia Patients

    57:15 Addressing Intestinal Ischemia: A Call to Action

    Keywords

    Intestinal rehabilitation, intestinal failure, nutrition, gastroenterology, patient care, bowel length, short bowel syndrome, nutritional support, clinical practice, healthcare, line management, line sepsis, Ehlers-Danlos Syndrome, nutritional support, cancer patients, dementia, intestinal ischemia, patient empowerment, multidisciplinary team, intravenous nutrition
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    1 hr and 3 mins

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