Gastroenterology
Newsletter 2025

About Dr Marius:

Dr Marius van Rijnsoever is an interventional endoscopist providing comprehensive, patient-centred gastroenterology care. He combines advanced endoscopic procedures with personalised medical, dietary, and natural therapies to manage a wide range of gastro-intestinal conditions.

Managing GI side effects of GLP-1 agonists

GLP-1 receptor agonists, such as semaglutide and liraglutide, are now commonly prescribed for type 2 diabetes and weight loss. Nausea, bloating and constipation are common but usually transient side effects. Advise patients to eat smaller meals, avoid fatty foods and titrate the dose slowly. Antiemetics or laxatives may help. Pancreatitis can be a side effect.

When to refer pancreatic cysts?

Refer all pancreatic cysts greater than 1 cm or with mural nodules, duct dilation or symptoms. A new chemoablation trial for IPMNs greater than 3 cm or with high-risk features has started at North Shore Hospital, involving gemcitabine/paclitaxel injection via EUS. Contact Dr Marius to discuss eligibility.

H. pylori testing in high-risk groups

H. pylori infection remains an important risk factor for gastric cancer, especially in Asian and Pacific populations. Consider testing and treating patients from high-prevalence areas, with a family history of gastric cancer, or unexplained dyspepsia. H. pylori stool antigen remains the first-line test.

Early MASLD risk stratification

MASLD, formerly NAFLD, affects 1 in 4 adults and carries risk of progression to cirrhosis. GPs can use FIB-4 score and NAFLD score to identify at-risk patients. Those with elevated scores should be considered for FibroScan or gastroenterologist referral. Remember to request an AST when you suspect “fatty liver disease”. The reference charts are below.

Colorectal cancer can be missed on FOBT

While FIT/FOBT is a useful screening tool, it only detects 70% of bowel cancers. Therefore, any patients with persistent bowel habit changes, iron deficiency anaemia or rectal bleeding should be referred for colonoscopy regardless of FIT result.

Fast-track endoscopy access

Waitemata Endoscopy can schedule most open-access procedures within 1 week. They provide exceptional care with a team of Auckland’s best endoscopists.

CME education at your practice

Waitemata Endoscopy can organise RNZCGP-accredited CME sessions. Enjoy a catered lunch while gaining CPD points with a tailored session at your practice.

MORE INFO

drmarius.com/gptools

IBD biologics options - quick comparison table

Need some friendly gastro advice?

contact me on 027 457 3078 or marius@drmarius.com

Private Clinic Referral:

Dr Marius van Rijnsoever
Waitemata Gastroenterology
7 Anzac St, Takapuna
P (09) 920 6746

EDI wmgastro
admin@wgastro.co.nz

Private Endoscopy Referral:

Dr Marius van Rijnsoever
Waitemata Endoscopy
212 Wairau Road, Glenfield
P (09) 925 4449

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.

GP Gastro Reference Sheet

Clinical Risk calculators

NZ Colonoscopy Surveillance

Summary guidelines. Excluded are patients with IBD, family or personal history of CRC, piecemeal resections and patients with other concerns.

This information is for educational purpose only. Guidelines continually change. Always consult your gastroenterologist or local guidelines.

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