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Dr Rami Sweis

Dr Rami Sweis
Consultant Gastroenterologist

Lead in Upper GI Physiology at UCLH; Honorary Senior Lecturer at UCL

Dr Sweis is a specialist in endoscopy with particular expertise in investigating and managing complex benign and malignant upper gastrointestinal disorders.

He has particular expertise in conditions such as achalasia, oesophageal spasm as well as reflux-related disorders such as heartburn and regurgitation. He also has a specialist interest in using advanced endoscopic techniques to classify and treat Barrett’s oesophagus. Furthermore he is an experienced colonoscopist.

Specialist in

  • Diagnostic and therapeutic Endoscopy and Colonoscopy
  • Reflux disorders:
    • Heartburn, Regurgitation, non-cardiac chest pain, belching
    • Impedance-pH and Wireless (Bravo) pH monitoring
  • Swallowing problems:
    • Achalasia, Oesophageal Spasm, Eosinophilic Oesophagitis and other (non-malignant) disorders
    • High Resolution (Impedance) Manometry
  • Barrett’s oesophagus:
    • Advanced endoscopic imaging techniques
    • Radiofrequency ablation and Endoscopic Mucosal Resection
    • Oesophageal and stomach dilatation and Botox
  • Abdominal pain, indigestion, dyspepsia, bloating, vomiting, Rumination Syndrome
  • Behavioural Modification Therapy with Diaphragmatic Breathing Training
  • Food intolerances and Coeliac disease
  • Ulcerative colitis, Crohn’s Disease, Microscopic Colitis
  • Diarrhoea and Constipation
  • Small bowel bacterial overgrowth
  • Irritable bowel syndrome
Training

Dr Sweis is a Consultant Gastroenterologist at University College London Hospital. He completed his Bachelor’s degree from the University of Illinois at Chicago (1994) and his medical education from Edinburgh Medical School (1999). He trained in Gastroenterology at Guy’s & St Thomas’ Hospitals, Kings College Hospital and South East Thames. He completed his PhD at Kings College London in 2012. He was appointed at UCLH in March 2014 as Consultant in Gastroenterology & Upper GI Medicine. He is also Upper GI Physiology Unit Lead at UCLH

Biography

During my training in Gastroenterology in SE Thames, I spent 4 years at St Thomas Hospital to complete a PhD in upper GI Physiology. I gained extensive experience in Oesophageal Physiology techniques including High Resolution Manometry (HRM) and ambulatory pH monitoring (catheter-based ph, Impedance-pH and wireless (Bravo) pH monitoring). My research has led to a number of publications which have had an impact on the international classification of oesophageal motor disorders and methods by which we investigate reflux disease. I continue to be an active member of the international HRM Working Group. I am also a member of the BSG Neurogastroenterology& Motility Committee and the Clinical Representative of the AGIP Committee. As a locum Consultant in East Kent I led the lower GI EMR service while I also trained at UCH in upper GI endoscopic techniques. I secured a position as Consultant in Upper GI Medicine at UCLH in March 2014. I am also upper GI Physiology lead at UCLH.

What drives me?

Being both an experienced upper GI physiologist and an advanced endoscopist, I find myself in the unique position. As the majority of upper GI conditions can have a variety of causes and treatments, I like to allow patients to take the lead in proposing how they would like me to proceed. In functional disorders in particular, I can treat many conditions medically as well as with behavioural modification therapy. I like to take my time and provide all the information possible (having undergone the physiology tests myself in the name of research!). Where endoscopic investigation/treatments are requested (or required), I take the patient through all the risks and benefits for every procedure so that ultimately the patient is in control every step of the way.

Research interests

Dr Sweis’ research centred on advancing the technology and methodology for investigating and treating reflux and swallowing disorders; primarily catheter and wireless (Bravo) pH-monitoring and High Resolution Manometry. He continues to publish and collaborate with fellow experts and oesophageal units in the UK and abroad, and is regularly invited to speak and train at national and international conferences. He is an active member of the international High Resolution Manometry Working Group, which is responsible for classifying oesophageal disorders. He is also a member of the Neurogastroenterology& Motility Committee of the British Society of Gastroenterology and the Clinical Representative of the Association of GI Physiologists (AGIP) Committee.

Journal publications
2015

Rami Sweis &NataschaCieplik. Practical implementation tips: GORD in adults. Guidelines in Practice. 2015; 18 (11): 48–52.

Roberto Penagini, Rami Sweis, Aurelio Mauro, Gerson Domingues, Daniel Sifrim. Inconsistency in the diagnosis of functional heartburn: usefulness of prolonged wireless pH monitoring in patients with PPI refractory gastroesophageal reflux disease. J NeurogastroenterolMotil. 2015 Mar 30;21(2):265-72

Yu Tien Wang, Ling Fung Tai, EtsuroYazaki, JafarJafari, Rami Sweis, Emily Tucker, Kevin Knowles, Jeff Wright, Katharine Hamlett, Mark Fox, Daniel Sifrim. Investigation of dysphagia and reflux symptoms after antireflux surgery by high resolution manometry: impact of multiple water swallows and a solid test meal on diagnosis, management and clinical outcome. ClinGastroenterolHepatol. 2015 Sep;13(9):1575-83

Rehan Haidry, Gideon Lipman, Matthew Banks, Adil Butt, Vinay Sehgal, David Graham, Jason Dunn, Gupta A, Rami Sweis et al. Comparing outcome of radiofrequency ablation in Barrett’s with high grade dysplasia and intramucosal carcinoma: a prospective multicenter UK registry.. Endoscopy 2015 (pending publication)

Rehan Haidry, Matthew Banks, Adil Butt, Vinay Sehgal, David Graham, Jason Dunn, A Gupta A, Rami Sweis et al. Improvement over time in outcomes for patients undergoing endoscopic therapy for Barrett’s oesophagus-related neoplasia: 6-year experience from the first 500 patients treated in the UK patient registry. Gut 2015 ;64:1192-1199

2014

Mark Fox, John Pandolfino, Rami Sweis, Elad Kaufman, JafarJafari, Dieter Menne. Inter-observer agreement for diagnostic classification of esophageal motility disorders defined in high-resolution manometry. Dis Esophagus. 2014 Sep 3. doi: 10.1111/dote.12278

Mayur Kumar, Rami Sweis, Terry Wong. Eosinophilic oesophagitis: investigations and management. Postgraduate medical journal. 2014;90(1063):273-81.

Rami Sweis, Angela Anggiansah, Terry Wong, Gareth Brady, Mark Fox. Assessment of esophageal dysfunction and symptoms during and after a standardized test meal: development and clinical validation of a new methodology utilizing high-resolution manometry. NeurogastroenterolMotil 2014;26(2):215-28

2013

Rami Sweis, Emily Tucker, Angela Anggiansah, Terry Wong, EmmanouilTelakis, Kevin Knowles, Jeff Wright, Mark Fox. Measurement of esophago-gastric junction cross-sectional area and distensibility by an endolumenal functional lumen imaging probe for the diagnosis of GERD. NeurogastroenterolMotil 2013;25(11):904-10.

Rami Sweis, Elad Kaufman, Angela Anggiansah, Terry Wong, Peter Dettmar, Michael Fried, Werner Schwizer, Ravi Kant Avvari, Anupam Pal, Mark Fox. Post-prandial reflux suppression by a raft-forming alginate (Gaviscon Advance) compared to a simple antacid: documented by magnetic resonance imaging and pH-impedance monitoring: mechanistic assessment and clinical randomized, controlled, double-blind study. Aliment PharmacolTher 2013;37(11):1093-102.

Rami Sweis, Roy Anggiansah, Angela Anggiansah, Terry Wong, Derek Cooper, Mark Fox. The effects of obesity on oesophageal function, acid exposure and the symptoms of gastro-oesophageal reflux disease. Aliment PharmacolTher 2013;37(5):555-63.

2012

Rukiya Vardar, Rami Sweis, Angela Anggiansah, Terry Wong, MR Fox. Upper esophageal sphincter and esophageal motility in patients with chronic cough and reflux: assessment by high-resolution manometry. Dis Esophagus 2012;26(3):219-25.

Mark Fox, Rami Sweis. Future Directions in Esophageal Motility and Function – New Technology and Methodology. NeurogastroenterolMotil 2012;24 Suppl 1:48-56.

2011

Rami Sweis, Mark Fox, Angela Anggiansah, Terry Wong. Prolonged, wireless pH-studies have a high diagnostic yield in patients with reflux symptoms and negative 24-h catheter-based pH-studies. NeurogastroenterolMotil 2011;23(5):419-26

Rami Sweis, Angela Anggiansah, Terry Wong, Elad Kaufman, Sabina Obrecht, Mark Fox. Normative values and inter-observer agreement for liquid and solid bolus swallows in upright and supine positions as assessed by esophageal high-resolution manometry. NeurogastroenterolMotil 2011;23(6):509-e198

ConstanzeDaum, Rami Sweis, Elad Kaufman, et al. Failure to respond to physiologic challenge characterizes esophageal motility in erosive gastro-esophageal reflux disease. NeurogastroenterolMotil 2011;23(6):517-e200.

2009

Rami Sweis, Mark Fox, Angela Anggiansah R, et al. Patient acceptance and clinical impact of Bravo monitoring in patients with previous failed catheter-based studies. Aliment PharmacolTher 2009;29(6):669-76.

Rami Sweis Angela Anggiansah, Terry Wong. Efficacy of Esophageal Impedance/Ph Monitoring in Patients With Refractory Gastroesophageal Reflux Disease, on and off Therapy. ClinGastroenterolHepatol 2009;8(3):313

2007

Mark Fox, Rami Sweis, Terry Wong, Angela Anggiansah. Sildenafil relieves symptoms and normalizes motility in patients with oesophageal spasm: a report of two cases. NeurogastroenterolMotil 2007;19(10):798-803

Rami Sweis, Leon Pee, Gray Smith-Laing. Discrepancies between histology and serology for the diagnosis of coeliac disease in a district general hospital: is this an unrecognised problem in other hospitals? Clinical Medicine 2009;9(4):346–8

1994

Deborah Hoshizaki, Thomas Blackburn, Catherine Price, Mita Ghosh M, Kathy Miles, Mark Ragucci, Rami Sweis. Embryonic Fat-Cell Lineage in Drosophila melanogaster. Development 1994;120(9):2489-99

Online publications:

Jan 2013

Rami Sweis, Terry Wong, Angela Anggianah, Roy Anggiansah, Guiping Sui, Andres Valdes, Mark Fox. The Chicago Classification 2012; present and future. NewWave; e-Newsletter of the BSG. (Jan 2013) http://bsg.org.uk/sections/agip-news-newwave/index.html

2010

Rami Sweis, Angela Anggiansah, Ian Forgacs, Terry Wong, Mark Fox. Laying on of the Healing Hands. British Society of Gastroenterology online interactive module. (2010) http://moodle.bsg.org.uk/

July 2009 and 2011

Philip Mairs& Rami Sweis. Alcohol withdrawal: a guide to management. BMJ Learning; (July 2009 and 2011) http://learning.bmj.com/learning/search-result.html?moduleId=10012160

2008

Rami Swes. A High Resolution Solution. British Society of Gastroenterology online interactive module. (2008) http://moodle.bsg.org.uk/

2011

Video abstracts DDW 2011:

2012

Mark Fox, Rami Sweis. Future Directions in Esophageal Motility and Function – New Technology and Methodology (2012) http://www.bsg.org.uk/sections/agip-articles/index.html

Book publications

2015

Mark Fox, Rami Sweis. Chapter 4: Spastic Esophageal Disorders (DES, Nutcracker, Jackhammer), In: Handbook of GI Motility and Functional Disorders. (SLACK Inc). 2015

2014

Rami Sweis. Oesophagus; Chapter 1. In: Diet and Nutrition for Gastrointestinal Disease (Wiley Blackwell), 2014

2013

Rami Sweis, Mark Fox. Free drinking and Solid Swallows using HRM. In: Manual of High Resolution Esophageal manometry (Uni-Med Science), 2013

2009

Rami Sweis, Abraham Botha. Pathophysiology and investigation of gastro-oesophageal reflux disease. In: Griffin SM, Raimes SA, eds. Oesophagogastric Surgery. 4th ed: WB Saunders (Elsevier), 2009: 229-250.

Membership of professional bodies

General Medical Council

British Society of Gastroenterology

British Medical Association

Medical Defence Union