Dr Nadeem Ahmad Afzal

 Professional experience

• More than 25 years of experience
• Consultant paediatric gastroenterologist, Southampton University Hospital NHS Trust (2004 - present)
• Honorary consultant paediatric gastroenterologist, Frimley Park Hospital NHS Foundation Trust (2017 - present)
• Consultant paediatric gastroenterologist, BMI Hampshire Clinic (2007 - present)

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 Sub-specialties

• Inflammatory bowel disease (IBD)
• Food intolerances and gut allergies
• Vomiting and Reflux
• Abdominal pain
• Diarrhoea
• Vomiting
• Bloating
• Abdominal Bloating
• Paediatric Endoscopy (diagnostic and therapeutic)
• Irritable bowel syndrome

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 Positions in public associations

• Member of the Board of Trustees, Lagan Foundation (2017 - present)
• Expert adviser for the Centre for Clinical Practice, NICE (2016 - present)
• Convenor, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (2014 - 2017)
• Editor-in-Chief, World Journal of Gastrointestinal Endoscopy (2011 - 2013)

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 Teaching posts

• Honorary senior clinical lecturer, School of Medicine, Southampton University (2010 - present)

 Education

• MBBS, King Edwards Medican University (1992)
• MRCP, Royal College of Physicians (1997)
• MRCPCH, Royal College of Physicians and Child Health (1997)
• MD, Queen Mary's, University of London (2010)

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 Publications and conferences

• Use of Biosimilars in Paediatric Inflammatory Bowel Disease: An Updated Position Statement of the Paediatric IBD Porto Group of ESPGHAN. de Ridder L, Assa A, Bronsky J, Romano C, Russell RK, Afzal NA, Hauer AC, Knafelz D, Lionetti P, Strisciuglio C, Veres G, Winter H, Wolters VM, Sladek M, Vulto AG, Dias JA; Paediatric IBD Porto group of ESPGHAN. J Pediatr Gastroenterol Nutr. 2018 Aug 30. doi: 10.1097/MPG.0000000000002141. [Epub ahead of print]
• Endoscopy in Pediatric Inflammatory Bowel Disease: A Position Paper on Behalf of the Porto IBD Group of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. Oliva S, Thomson M, de Ridder L, Martín-de-Carpi J, Van Biervliet S, Braegger C, Dias JA, Kolacek S, Miele E, Buderus S, Bronsky J, Winter H, Navas-López VM, Assa A, Chong SKF, Afzal NA, Smets F, Shaoul R, Hussey S, Turner D, Cucchiara S. J Pediatr Gastroenterol Nutr. 2018 Sep;67(3):414-430. doi: 10.1097/MPG.0000000000002092.
• Is the incidence of paediatric inflammatory bowel disease still increasing? Ashton JJ, Cullen M, Afzal NA, Coelho T, Batra A, Beattie RM. Arch Dis Child. 2018 Nov;103(11):1093-1094. doi: 10.1136/archdischild-2018-315038. Epub 2018 Mar 8.
• Endoscopic and Histological Assessment of Paediatric Inflammatory Bowel Disease Over a 3-Year Follow-up Period. Ashton JJ, Bonduelle Q, Mossotto E, Coelho T, Batra A, Afzal NA, Vadgama B, Ennis S, Beattie RM. J Pediatr Gastroenterol Nutr. 2018 Mar;66(3):402-409. doi: 10.1097/MPG.0000000000001729.
• Challenges of modern day transition care in inflammatory bowel disease: From inflammatory bowel disease to biosimilars. Hakizimana A, Ahmed I, Russell R, Wright M, Afzal NA. World J Gastroenterol. 2017 Jul 7;23(25):4473-4479. doi: 10.3748/wjg.v23.i25.4473.
• Exome Analysis of Rare and Common Variants within the NOD Signaling Pathway. Andreoletti G, Shakhnovich V, Christenson K, Coelho T, Haggarty R, Afzal NA, Batra A, Petersen BS, Mort M, Beattie RM, Ennis S. Sci Rep. 2017 Apr 19;7:46454. doi: 10.1038/srep46454.
• Surgical Management of Crohn Disease in Children: Guidelines From the Paediatric IBD Porto Group of ESPGHAN. Amil-Dias J, Kolacek S, Turner D, Pærregaard A, Rintala R, Afzal NA, Karolewska-Bochenek K, Bronsky J, Chong S, Fell J, Hojsak I, Hugot JP, Koletzko S, Kumar D, Lazowska-Przeorek I, Lillehei C, Lionetti P, Martin-de-Carpi J, Pakarinen M, Ruemmele FM, Shaoul R, Spray C, Staiano A, Sugarman I, Wilson DC, Winter H, Kolho KL; IBD Working Group of ESPGHAN (IBD Porto Group). J Pediatr Gastroenterol Nutr. 2017 May;64(5):818-835. doi: 10.1097/MPG.0000000000001562.
• De novo and rare mutations in the HSPA1L heat shock gene associated with inflammatory bowel disease. Takahashi S, Andreoletti G, Chen R, Munehira Y, Batra A, Afzal NA, Beattie RM, Bernstein JA, Ennis S, Snyder M. Genome Med. 2017 Jan 26;9(1):8. doi: 10.1186/s13073-016-0394-9.
• Genes implicated in thiopurine-induced toxicity: Comparing TPMT enzyme activity with clinical phenotype and exome data in a paediatric IBD cohort. Coelho T, Andreoletti G, Ashton JJ, Batra A, Afzal NA, Gao Y, Williams AP, Beattie RM, Ennis S. Sci Rep. 2016 Oct 5;6:34658. doi: 10.1038/srep34658.
• Identification of Variants in Genes Associated with Single-gene Inflammatory Bowel Disease by Whole-exome Sequencing. Ashton JJ, Andreoletti G, Coelho T, Haggarty R, Batra A, Afzal NA, Beattie RM, Ennis S. Inflamm Bowel Dis. 2016 Oct;22(10):2317-27. doi: 10.1097/MIB.0000000000000890.
• Nutritional perspectives of children with Crohn's disease: a single-centre cohort observation of disease activity, energy expenditure and dietary intake. Wiskin AE, Haggarty R, Afzal NA, Batra A, Wootton SA, Beattie RM. Eur J Clin Nutr. 2016 Oct;70(10):1132-1137. doi: 10.1038/ejcn.2016.107. Epub 2016 Jun 22.
• pANCA and ASCA in Children with IBD-Unclassified, Crohn's Colitis, and Ulcerative Colitis-A Longitudinal Report from the IBD Porto Group of ESPGHAN. Birimberg-Schwartz L, Wilson DC, Kolho KL, Karolewska-Bochenek K, Afzal NA, Spray C, Romano C, Lionetti P, Hauer AC, Martinez-Vinson C, Veres G, Escher JC, Turner D; paediatric IBD Porto group of ESPGHAN. Inflamm Bowel Dis. 2016 Aug;22(8):1908-14. doi: 10.1097/MIB.0000000000000784.
• Utilisation of magnets to enhance gastrointestinal endoscopy. Rahman I, Patel P, Boger P, Thomson M, Afzal NA. World J Gastrointest Endosc. 2015 Dec 25;7(19):1306-10. doi: 10.4253/wjge.v7.i19.1306.
• Colectomy in pediatric ulcerative colitis: A single center experience of indications, outcomes, and complications. Ashton JJ, Versteegh HP, Batra A, Afzal NA, King A, Griffiths DM, Beattie RM, Stanton MP. J Pediatr Surg. 2016 Feb;51(2):277-81. doi: 10.1016/j.jpedsurg.2015.10.077. Epub 2015 Nov 6.
• Endoscopic Versus Histological Disease Extent at Presentation of Paediatric Inflammatory Bowel Disease. Ashton JJ, Coelho T, Ennis S, Vadgama B, Batra A, Afzal NA, Beattie RM. J Pediatr Gastroenterol Nutr. 2016 Feb;62(2):246-51. doi: 10.1097/MPG.0000000000001032.
• The role of magnetic assisted capsule endoscopy (MACE) to aid visualisation in the upper GI tract. Rahman I, Afzal NA, Patel P. Comput Biol Med. 2015 Oct 1;65:359-63. doi: 10.1016/j.compbiomed.2015.03.014. Epub 2015 Mar 24. Review.
• Exome analysis of patients with concurrent pediatric inflammatory bowel disease and autoimmune disease. Andreoletti G, Ashton JJ, Coelho T, Willis C, Haggarty R, Gibson J, Holloway J, Batra A, Afzal NA, Beattie RM, Ennis S. Inflamm Bowel Dis. 2015 Jun;21(6):1229-36. doi: 10.1097/MIB.0000000000000381.
• Presenting phenotype of paediatric inflammatory bowel disease in Wessex, Southern England 2010-2013. Ashton JJ, Coelho T, Ennis S, Batra A, Afzal NA, Beattie RM. Acta Paediatr. 2015 Aug;104(8):831-7. doi: 10.1111/apa.13017. Epub 2015 May 20.
• Therapeutic upper gastrointestinal tract endoscopy in Paediatric Gastroenterology. Rahman I, Patel P, Boger P, Rasheed S, Thomson M, Afzal NA. World J Gastrointest Endosc. 2015 Mar 16;7(3):169-82. doi: 10.4253/wjge.v7.i3.169. Review.
• Pharmacological treatment of children with gastro-oesophageal reflux. Tighe M, Afzal NA, Bevan A, Hayen A, Munro A, Beattie RM. Cochrane Database Syst Rev. 2014 Nov 24;(11):CD008550. doi: 10.1002/14651858.CD008550.pub2. Review.
• Parental knowledge of coeliac disease. Tomlin J, Slater H, Muganthan T, Beattie RM, Afzal NA. Inform Health Soc Care. 2015;40(3):240-53. doi: 10.3109/17538157.2014.907806. Epub 2014 Apr 30.
• Rising incidence of paediatric inflammatory bowel disease (PIBD) in Wessex, Southern England. Ashton JJ, Wiskin AE, Ennis S, Batra A, Afzal NA, Beattie RM. Arch Dis Child. 2014 Jul;99(7):659-64. Epub 2014 Apr 12.
• Surgery for children with Crohn's disease: indications, complications and outcome. Blackburn SC, Wiskin AE, Barnes C, Dick K, Afzal NA, Griffiths DM, Beattie RM, Stanton MP. Arch Dis Child. 2014 May;99(5):420-6. doi: 10.1136/archdischild-2013-305214. Epub 2014 Jan 6.
• A very high amylase can be benign in paediatric Crohn's disease. Venkataraman D, Howarth L, Beattie RM, Afzal NA. BMJ Case Rep. 2012 Jul 10;2012. pii: bcr0220125917. doi: 10.1136/bcr.02.2012.5917.
• Next generation exome sequencing of paediatric inflammatory bowel disease patients identifies rare and novel variants in candidate genes. Christodoulou K, Wiskin AE, Gibson J, Tapper W, Willis C, Afzal NA, Upstill-Goddard R, Holloway JW, Simpson MA, Beattie RM, Collins A, Ennis S. Gut. 2013 Jul;62(7):977-84. doi: 10.1136/gutjnl-2011-301833. Epub 2012 Apr 28.
• No relation between disease activity measured by multiple methods and REE in childhood Crohn disease. Wiskin AE, Wootton SA, Cornelius VR, Afzal NA, Elia M, Beattie RM. J Pediatr Gastroenterol Nutr. 2012 Feb;54(2):271-6. doi: 10.1097/MPG.0b013e318236b19a.
• Nutrition and inflammatory bowel disease: primary or adjuvant therapy. Tighe MP, Cummings JR, Afzal NA. Curr Opin Clin Nutr Metab Care. 2011 Sep;14(5):491-6. doi: 10.1097/MCO.0b013e328349eb4d. Review.
• Constipation in children. Afzal NA, Tighe MP, Thomson MA. Ital J Pediatr. 2011 Jun 13;37:28. doi: 10.1186/1824-7288-37-28. Review.
• A British Society of Paediatric Gastroenterology, Hepatology and Nutrition survey of the effectiveness and safety of adalimumab in children with inflammatory bowel disease. Russell RK, Wilson ML, Loganathan S, Bourke B, Kiparissi F, Mahdi G, Torrente F, Rodrigues A, Davies I, Thomas A, Akobeng AK, Fagbemi A, Hyer W, Spray C, Vaish S, Rogers P, McGrogan P, Heuschkel RB, Ayub N, Fell JM, Afzal NA, Green M, Murphy MS, Rao P, Shah N, Ho GT, Naik S, Wilson DC. Aliment Pharmacol Ther. 2011 Apr;33(8):946-53. doi: 10.1111/j.1365-2036.2011.04603.x. Epub 2011 Feb 22.
• Body composition in childhood inflammatory bowel disease. Wiskin AE, Wootton SA, Hunt TM, Cornelius VR, Afzal NA, Jackson AA, Beattie RM. Clin Nutr. 2011 Feb;30(1):112-5. doi: 10.1016/j.clnu.2010.07.014. Epub 2010 Aug 21.
• Recognition and treatment of genitourinary complications in paediatric Crohn's disease using Infliximab. Afzal NA, Shenoy MU, Haque S, Wilcox D, Shah N. Acta Paediatr. 2010 Jul;99(7):1042-6. doi: 10.1111/j.1651-2227.2010.01731.x. Epub 2010 Feb 23.
• Linezolid an oral treatment option for staphylococcal liver abscess in chronic granulomatous disease. Erlewyn-Lajeunesse M, Walker W, Basarab A, Eren E, Afzal N, Godfrey K, Faust SN. Pediatr Infect Dis J. 2009 Nov;28(11):1036-7. doi: 10.1097/INF.0b013e3181ba6caa.
• Impact of disease activity on resting energy expenditure in children with inflammatory bowel disease. Wiskin AE, Wootton SA, Culliford DJ, Afzal NA, Jackson AA, Beattie RM. Clin Nutr. 2009 Dec;28(6):652-6. doi: 10.1016/j.clnu.2009.05.007. Epub 2009 Jun 9.
• Current pharmacological management of gastro-esophageal reflux in children: an evidence-based systematic review. Tighe MP, Afzal NA, Bevan A, Beattie RM. Paediatr Drugs. 2009;11(3):185-202. doi: 10.2165/00148581-200911030-00004. Review.
• Erythema ab igne and Crohn's disease. Tighe MP, Morenas RA, Afzal NA, Beattie RM. Arch Dis Child. 2008 May;93(5):389. doi: 10.1136/adc.2008.137968.
• Latent coeliac disease in childhood? Morenas RA, Tighe MP, Moore I, Afzal NA, Beattie RM. Gut. 2008 May;57(5):715-6. doi: 10.1136/gut.2007.148064.
• Medium-term outcome of endoluminal gastroplication with the EndoCinch device in children. Thomson M, Antao B, Hall S, Afzal N, Hurlstone P, Swain CP, Fritscher-Ravens A. J Pediatr Gastroenterol Nutr. 2008 Feb;46(2):172-7. doi: 10.1097/MPG.0b013e31814d4de1.
• Outcome of childhood ulcerative colitis at 2 years. Howarth LJ, Wiskin AE, Griffiths DM, Afzal NA, Beattie RM. Acta Paediatr. 2007 Dec;96(12):1790-3. Epub 2007 Oct 30.
• Infliximab delays but does not avoid the need for surgery in treatment-resistant pediatric Crohn' disease. Afzal NA, Ozzard A, Keady S, Thomson M, Murch S, Heuschkel R. Dig Dis Sci. 2007 Dec;52(12):3329-33. Epub 2007 Sep 5.
• Topical application of mitomycin-C in oesophageal strictures. Rosseneu S, Afzal N, Yerushalmi B, Ibarguen-Secchia E, Lewindon P, Cameron D, Mahler T, Schwagten K, Köhler H, Lindley KJ, Thomson M. J Pediatr Gastroenterol Nutr. 2007 Mar;44(3):336-41.
• Inflammatory bowel disease. Beattie RM, Croft NM, Fell JM, Afzal NA, Heuschkel RB. Arch Dis Child. 2006 May;91(5):426-32. Review.
• Colonic Crohn's disease in children does not respond well to treatment with enteral nutrition if the ileum is not involved. Afzal NA, Davies S, Paintin M, Arnaud-Battandier F, Walker-Smith JA, Murch S, Heuschkel R, Fell J. Dig Dis Sci. 2005 Aug;50(8):1471-5.
• Endoluminal gastroplication in children with significant gastro-oesophageal reflux disease. Thomson M, Fritscher-Ravens A, Hall S, Afzal N, Ashwood P, Swain CP. Gut. 2004 Dec;53(12):1745-50.
• Diagnostic role of upper gastrointestinal endoscopy in pediatric inflammatory bowel disease. Castellaneta SP, Afzal NA, Greenberg M, Deere H, Davies S, Murch SH, Walker-Smith JA, Thomson M, Srivistrava A. J Pediatr Gastroenterol Nutr. 2004 Sep;39(3):257-61. Erratum in: J Pediatr Gastroenterol Nutr. 2005 Feb;40(2):244. Srivistrava, Anshu [added].
• Improvement in quality of life of children with acute Crohn's disease does not parallel mucosal healing after treatment with exclusive enteral nutrition. Afzal NA, Van Der Zaag-Loonen HJ, Arnaud-Battandier F, Davies S, Murch S, Derkx B, Heuschkel R, Fell JM. Aliment Pharmacol Ther. 2004 Jul 15;20(2):167-72.
• Constipation with acquired megarectum in children with autism. Afzal N, Murch S, Thirrupathy K, Berger L, Fagbemi A, Heuschkel R. Pediatrics. 2003 Oct;112(4):939-42.
• Portal Vein Thrombosis and Pancreatic Failure. Afzal N, Brueton M, Fell J, Baker A. Int J Gastrointest Cancer. 2001;29(2):107-112.
• Diarrhoea and gastroenteritis in the infant and young child. Afzal N, Thomson M. J Fam Health Care. 2002;12(6):146-50. Review.
• Use of unlicensed and off-label medications in paediatric gastroenterology with a review of the commonly used formularies in the UK. Dick A, Keady S, Mohamed F, Brayley S, Thomson M, Lloyd BW, Heuschkel R, Afzal NA. Aliment Pharmacol Ther. 2003 Feb 15;17(4):571-5.
• Refeeding syndrome with enteral nutrition in children: a case report, literature review and clinical guidelines. Afzal NA, Addai S, Fagbemi A, Murch S, Thomson M, Heuschkel R. Clin Nutr. 2002 Dec;21(6):515-20. Review.
• Diverticular disease in adolescence. Afzal NA, Thomson M. Best Pract Res Clin Gastroenterol. 2002 Aug;16(4):621-34. Review.
• A child with oesophageal strictures. Afzal NA, Albert D, Thomas AL, Thomson M. Lancet. 2002 Mar 23;359(9311):1032. No abstract available.
• Portal vein thrombosis and pancreatic failure. Afzal NA, Brueton MJ, Fell JM, Baker A. Int J Pancreatol. 2001;29(2):107-11.
• Complementary medicine use in children and young adults with inflammatory bowel disease. Heuschkel R, Afzal N, Wuerth A, Zurakowski D, Leichtner A, Kemper K, Tolia V, Bousvaros A. Am J Gastroenterol. 2002 Feb;97(2):382-8.

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 Prizes and awards

• The Southampton paediatric GI services has been cited as a best practice example for standard 9 of Facing the Future: Standards for acute general paediatric services. https://www.rcpch.ac.uk/resources/immediate-telephone-specialist-advice-wespghan
• Timothy Martin Postgraduate Award. 1st prize for best research and presentation at the annual research meeting at Surrey and Sussex healthcare.
• 1st Prize for best presentation at the Royal Society of Medicine.
• 2nd prize for poster presentation ‘Electronic paediatric gastroenterology information for the primary and secondary healthcare professional’
• Distinction in Pharmacology & Therapeutics (2nd year MBBS)
• Bronze Medal for third position in FSc (A-level equivalent) Federal Board examinations. Awarded Merit Scholarship (Awarded to top 20 students of nearly 700 institutions in Pakistan and abroad all under Federal Board).

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 Professional membership

• ESPGHAN IBD Porto Group
• BSPGHAN IBD Group