Gastroenterology
Update 2023
Born in Holland and trained in Australia / New Zealand, I am an advanced interventional endoscopist specialising in gastroscopy, colonoscopy, endoscopic mucosal resection, endoscopic ultrasound and ERCP. My clinics are at Waitemata Gastroenterology and I perform endoscopy at WDHB and Waitemata Endoscopy.
New pancreas cancer prevention trial
With the help of a gut foundation grant, the first pancreatic cancer prevention trial in Australasia is starting at WDHB by injecting gemcitabine/paclitaxel chemotherapy into high-risk pancreatic cysts. This has been shown to be safe and effective in the CHARM I trial. Please contact me if you have patients with IPMN pancreatic cysts greater than 3 cm or worrying features to see if they are eligible.
PPI’s to prevent Barrett’s cancer
Proton pump inhibitors play a crucial role in preventing cancer development in individuals with Barrett’s oesophagus, where chronic acid reflux causes metaplasia. Even without reflux symptoms, patients should continue a PPI to prevent chronic acid exposure. This has been shown to reduce cancer development by 40%.
Endoscopic ultrasound for biliary pain
Small common bile duct stones are frequently missed on MRCP, CT or external ultrasound. If your patient has typical biliary pains, epigastric or RUQ, occurring about one hour after heavier meals, they could have small stones, sludge or microlithiasis. In idiopathic pancreatitis with no cause found on other imaging, EUS detects stones or sludge in 30% of patients.
New IBD medications funded in NZ
After extensive lobbying from gastroenterologists, PHARMAC has approved two new biologic treatments for inflammatory bowel disease for patients who have failed current anti-TNF treatment. Vedolizumab blocks lymphocyte translocation to the gut via α4β7 integrin. Ustekinumab mediates T-cell response by inhibiting IL12 and IL23.
New endoscopic reflux treatment
There is a new endoscopic treatment for refractory reflux called antireflux mucosal ablation (ARMA). This tightens the valve between the oesophagus and stomach by creating a horseshoe-shaped burn which then contracts. It has been shown to allow 85% of patients to stop their PPI and is a simple day-stay endoscopic procedure.
Endoscopic gastric bypass
Malignant gastric outlet obstruction from duodenal or pancreatic cancer has very poor outcomes. Endoscopic gastric bypass with an EUS-placed lumen-apposing AXIOS stent can give these patients good quality of life and permanently fix the obstruction. Dr Marius performs these advanced EUS techniques in Auckland, with 95% of 19 patients able to resume a normal diet.
Practice gastro update presentation
Nothing beats an interactive meeting to catch up on the latest developments in gastroenterology. I can come to your practice and provide a catered 30–60 minute presentation, with 1–2 slides per topic and time for questions in between.
Need some friendly gastro advice?
contact me on 027 457 3078 or marius@drmarius.com
Private Clinic Referral:
Attention:
Dr Marius van Rijnsoever
Waitemata Gastroenterology
15 Shea Terrace, Takapuna
P (09) 920 6746
F (09) 486 1268
EDI waitemas
gastro@wsurg.co.nz
Private Endoscopy Referral:
Attention:
Dr Marius van Rijnsoever
Waitemata Endoscopy
212 Wairau Road, Glenfield
P (09) 925 4449
F (09) 925 4450
EDI sxhospwe
admin@waitemataendoscopy.co.nz
This newsletter is for informational purposes only and the opinion of Dr Marius van Rijnsoever. For patient-specific advice please contact Dr Marius.
Presentations at GP CME Rotorua
I am presenting at the General Practice Conference and Medical Exhibition at the Energy Events centre in Rotorua in June on the latest advancements in gastroenterology.
| Date | Time | Session | Location |
|---|---|---|---|
| Friday, 9 June, 2023 | 4:30PM - 5:25PM | WS82 What is New in Endoscopy in 2023 | Room 10 |
| Friday, 9 June, 2023 | 5:35PM - 6:30PM | WS94 What is New in Endoscopy in 2023 (Repeated) | Room 10 |
| Saturday, 10 June, 2023 | 11:50AM - 12:00PM | Liver Diseases and LFTs | Plenary |
| Saturday, 10 June, 2023 | 12:30PM - 1:00PM | Panel Discussion (Saturday 2) | Plenary |
| Sunday, 11 June, 2023 | 8:50AM - 9:10AM | Endoscopic Gastric Bypass - A New Hope For Cancer Patients | Plenary |
| Sunday, 11 June, 2023 | 10:10AM - 10:30AM | Panel Discussion (Sunday 1) | Plenary |
I am an accredited preferred provider for Southern Cross for selected services.
I perform my endoscopy at Waitemata Endoscopy, with two world-class endoscopy facilities at Wairau Valley and Henderson. Open access and direct referrals are accepted.
WE - Harbour
At Southern Cross Hospital
212 Wairau Road, Wairau Valley
P: 09 925 4449
F: 09 925 4450
E: admin@waitemataendoscopy.co.nz
Healthlink EDI: sxhospwe
WE - West
Next to Waitakere Hospital
53 Lincoln Road, Henderson
P: 09 925 4449
F: 09 925 4450
E: admin@waitemataendoscopy.co.nz
Healthlink EDI: sxhospwe