Gastroenterology & Hepatology

Imaging becomes more and more important for all clinical specialities, including gastroenterology. This issue is focusing on some very interesting and new applications of imaging procedures in liver, biliary tract, and digestive tube pathology. The content is representative for this “new era” of visual diagnosis that we live. In the article entitled “Preliminary study on hepatocyte-targeted phosphorus-31 MRS using ATP-loaded galactosylated chitosan oligosaccharide nanoparticles” is describing their preliminary work on MR spectroscopy for evaluating the hepatocyte uptake of ATP-loaded Gal-CSO (Gal-CSO/ATP) nanoparticles.

Gastroenterology has risen up out of the woodlands of medicinal claims to fame just in the course of recent years. It is Because of monstrous change in the field of finding and treatment. Gastroenterology has experienced twofold parting into hepatology and "empty organ" gastroenterology. Developments in colorectal disease screening, case endoscopy, solutions for hepatitis C and new biologic treatments are a portion of the ongoing advances in gastroenterology.

The Division of Gastroenterology provides a full range of advanced diagnostic and therapeutic endoscopic procedures including diagnostic and therapeutic ERCP for pancreatobiliary pathologies (papillotomy, stone extraction, stricture dilation and stenting, lithotripsy, peroral choledochoscopy and pancreatoscopy), endoscopic ultrasonography including fine needle aspiration cytology and biopsy and target therapy. Other advanced procedures including therapy for Barrettˇs esophagus and early cancer including radiofrequency ablation, cyrotherapy and endoscopic mucosal resection.

Gastroenterology, Hepatology and Nutrition the team of pediatric gastroenterologists, hepatologists, dietitians, clinicians and nurses is dedicated to helping children with common or complex gastrointestinal, liver and nutritional problems. The goals of the Gastroenterology Division are to provide outstanding medical care to persons with diseases of the gastrointestinal tract and liver, to train gastroenterology and to perform cutting-edge biomedical research to improve our understanding of digestive diseases.

Pediatric gastroenterology developed as a sub-specialty of pediatrics and gastroenterology. It is concerned with treating the gastrointestinal tract, liver and pancreas of children from infancy until age eighteen. The principal diseases it is concerned with are acute diarrhea, persistent vomiting, gastritis, and problems with the development of the gastric tract. The correct function of the gastric tract and the internal health is related to the nutrition that the child or its mother receives. From the prenatal period, correct nutrition can affect the developing of the system, short bowel syndrome (the most common one), necrotizing enterocolitis, gastroschisis or omphalocele to the postnatal period with diseases such as diarrhea.

Researchers are investigating new treatments for IBS. Serum-derived bovine immunoglobulin/protein isolate (SBI), a nutritional therapy, has shown some promise as a treatment for IBS with diarrhea. Studies also show that, in people who have IBS with diarrhea, a specially coated tablet that slowly releases peppermint oil in the small intestine (enteric-coated peppermint oil) eases bloating, urgency, abdominal pain and pain while passing stool. It isn't clear how enteric-coated peppermint oil might affect IBS, so ask your doctor before using it.

The Intestinal Rehabilitation Program is the latest treatments to help your child’s intestine work well if affected by disease (like short bowel syndrome), injury or a surgery that removed part of it. With recent advances in diet, medicine and surgery, we have greatly reduced the need for intestine organ transplants in children. Intestinal rehabilitation is the process of gradually restoring the intestine’s ability to digest food and absorb nutrients. This is done through diet, medicines and surgery other than organ (intestine) transplant. Total Parenteral Nutrition (TPN) is a complete form of nutrition given into the blood through a vein (intravenously) by a central line placed in the child’s chest, neck or groin.

Bariatric surgery (weight loss surgery) includes a variety of procedures performed on people who have obesity. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach (sleeve gastrostomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestines to a small stomach pouch (gastric bypass surgery). Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotropic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver.

The immune reaction of the gastrointestinal tract to the external stimulus or the failure to respond is an important aspect of the function of gastrointestinal tract system. The area of gastrointestinal disorders is currently having development in terms of research. Scientific progress in the area of gut immune system and the immune abnormalities includes the latest developments in organ transplantation of the liver and gut, HIV infection of the gut, and the recently discovered disease H. pylori gastritis.

Digestive diseases are disorders of the digestive tract, which is sometimes called the gastrointestinal (GI) tract. In digestion, food and drink are broken down into small parts (called nutrients) that the body can absorb and use as energy and building blocks for cells. Conditions may range from mild to serious. Some common problems include cancer, irritable bowel syndrome, and lactose intolerance. Tests for digestive problems can include colonoscopy, upper GI endoscopy, capsule endoscopy, endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound. Many surgical procedures are performed on the digestive tract. These include procedures done using endoscopy, laparoscopy, and open surgery. Organ transplants can be performed on the liver, pancreas, and small intestine. Many health care providers can help diagnose and treat digestive problems. A gastroenterologist is a physician specialist who has received extra training in the diagnosis and treatment of the digestive disorders.The digestive tract is made up of the esophagus (food tube), stomach, large and small intestines, liver, pancreas, and the gallbladder.

Neurogastroenterology encompasses the study of the brain, the gut, and their interactions with relevance to the understanding and management of gastrointestinal motility and functional gastrointestinal disorders. Specifically, neurogastroenterology focuses on the functions, malfunctions, and the malformations of the sympathetic, parasympathetic, and enteric divisions of the digestive tract. Function of neurons in the gastrointestinal tract is Peristalsis, Segmentation contractions, Secretion. The enteric nervous system is one of the main divisions of the nervous system and is the main focus of neurogastroenterology. The enteric nervous system refers to the entire system of neurons that govern the gastrointestinal system. It is capable of operating independently of the brain and spinal cord.

The Gastrointestinal Medical Oncology department is a team of highly specialized medical oncologists, scientists, physician assistants and research nurses who treat gastrointestinal malignancies, including cancers of the liver, bile duct, gallbladder, pancreas, large and small bowel, stomach, esophagus and rare tumors. In recent years, we have witnessed immunotherapy-based agents transform how we manage patient’s malignant melanoma, non-small cell lung cancer, genitourinary cancers, head and neck cancers and Hodgkin’s lymphoma to list a few. Unfortunately, the progress of immunotherapy-based agents in GI cancers has been slow, as a group, gastrointestinal cancers are the most common cancers

Gastrointestinal pathology is the subspecialty of surgical pathology which deals with the diagnosis and characterization of neoplastic and non-neoplastic diseases of the digestive tract and accessory organs, such as the pancreas and liver. Gastrointestinal pathology (including liver, gallbladder and pancreas) is a recognized sub-specialty discipline of surgical pathology. Recognition of a sub-specialty is generally related to dedicated fellowship training offered within the subspecialty or, alternatively, to surgical pathologists with a special interest and extensive experience in gastrointestinal pathology.

Liver disease (also called hepatic disease) is a type of damage to or disease of the liver. Liver disease can occur through several mechanisms. One general mechanism, increased DNA damage, is shared by some of the major causes of liver disease. These major causes include infection by hepatitis B virus or hepatitis C virus, alcohol abuse, and obesity. A common form of liver disease is viral infection. Viral hepatitides such as Hepatitis B virus and Hepatitis C virus can be vertically transmitted during birth via contact with infected blood.

In the gastrointestinal (GI) tract, normal physiological changes during pregnancy produce dramatic modifications. Pregnancy, therefore, poses a unique medical stress to the GI tract, and for many women, is a period of vulnerability for the development of new or exacerbation of existing GI disorders. These changes may cause new symptoms, worsen preexisting disease, or mask potentially deadly disease. A lack of experience in dealing with these symptoms can have devastating effects. The physician must be able to distinguish whether these symptoms are those of normal pregnancy or a potentially life-threatening complication such as preeclampsia. The physician must also know which medications are safe in pregnancy, as well as which tests are safe to perform during pregnancy.

HBV can cause acute and chronic infection. There is currently no role for molecular testing in the diagnosis of acute hepatitis B other than in the detection of asymptomatic patients during pretransfusion screening of blood products. To facilitate an understanding of the utility of molecular testing for chronic hepatitis B, the four stages of chronic hepatitis B infection that are currently recognized, as well as an additional entity, occult hepatitis B, that can be diagnosed only by sensitive nucleic acid amplification methods, are reviewed in detail, including available therapeutic age.