Gaurav Nigam

1. How did you become interested in translational gastroenterology? 

My interest in translational gastroenterology developed through seeing how clinical questions at the bedside can be transformed into research that improves patient care. I was drawn to gastroenterology because it spans such a wide range of clinical problems, from acute emergencies to long-term inflammatory conditions such as inflammatory bowel disease (IBD), and endoscopy sits right at the heart of it, both as a diagnostic tool and as a treatment. What pulled me toward translational research specifically was the realisation that there was often a significant gap between what the evidence said and what was actually happening in practice. My Academic Clinical Fellowship at Oxford gave me my first real experience of working within the Translational Gastroenterology and Liver Unit (TGLU), and I could see how the unit approached that gap in a rigorous, clinically grounded way. That experience led me to pursue a DPhil, supported by an NIHR Doctoral Research Fellowship, combining national audit data, machine learning, and clinical epidemiology to develop evidence that can support better decision-making and ultimately improve outcomes for patients. 

2. What are you currently working on, and what importance does your work hold for patients with gastrointestinal conditions? 

My work focuses on improving the quality and consistency of care across several areas of luminal gastroenterology, and central to this is a simple question: why do patients with the same condition receive such different care depending on where they are treated, and what can we do about it? 

In acute upper gastrointestinal bleeding, which is one of the most common medical emergencies we see, too many patients still experience delays to endoscopy, inconsistent transfusion practice, or delayed access to specialist input. I have been using national audit data and machine learning approaches to understand where and why these gaps exist, and to develop tools that can help clinicians make faster and more informed decisions. The ambition is not just to describe what is going wrong, but to build something practical that can be used at the bedside. 

Alongside this, I have been involved in work on IBD endoscopy and early cancer detection, including contributing to the British Society of Gastroenterology guidelines on colorectal surveillance in IBD. For patients living with long-standing IBD, the risk of colorectal cancer is real, and the quality of their surveillance endoscopy can genuinely be life-changing. Being part of the group developing those national standards has been one of the most meaningful aspects of my work. 

Across both areas, the thread that connects everything is trying to use good evidence to make endoscopy safer, more consistent, and more focused on what matters to patients. 

3. What do you enjoy most about scientific research? 

I enjoy how data reveals information that is unexpected. There is something quite compelling about starting with a clinical question one has been sitting with for months, sometimes years, and then finding that the evidence either confirms one’s instinct or challenges it completely. I also enjoy the fact that research is rarely a solo endeavour. Some of the most stimulating conversations I have had have been with statisticians, data scientists, and patient representatives, people who see the same problem from a completely different angle. And when the work eventually feeds into a guideline, or shapes how a training programme is designed, or changes how a service is run, that sense of having contributed something lasting is very rewarding. 

4. What's the best part of being an Oxford University TGLU member? 

TGLU brings together clinicians and scientists working across gastroenterology, hepatology, IBD, endoscopy, and data science, alongside collaborations with specialists from many other disciplines and methodological experts. The range of expertise under one roof is something I have not encountered anywhere else. It means that whatever problem you are trying to solve, there is almost always someone nearby who can help you think about it differently. For my own work, being part of TGLU has meant access to methodological support through the Big Data Institute, a close working relationship with NHS Blood and Transplant, and the ability to develop clinically within Oxford University Hospitals' endoscopy service. But beyond the infrastructure, it is the culture of intellectual generosity and ambition that I value most. It is a place that encourages you to ask bigger questions, and then gives you the support to try to answer them.