Introduction to Gastroenterology

Gastroenterology

What is gastroenterology?

Gastroenterology is the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver.¹

Reference:

What is a Gastroenterologist? - American College of Gastroenterology [Internet]. American College of Gastroenterology. 2022 [cited 20 April 2022]. Available from: https://gi.org/patients/gi-health-and-disease/what-is-a-gastroenterologist/

Prevalence in India

Burden of Gastroenterological Diseases in India in 2016:¹

There has been increase in the prevalence and mortality rate:

Pancreatitis
Liver cancer
Paralytic ileus and intestinal obstruction
Gallbladder and biliary tract cancer
Vascular intestinal disorders
Colorectal cancer
Inflammatory bowel disease

Mortality in India Due to Gastroenterological Disorders in 2016:¹

Prevalence of Liver diseases In India: Tenth most common cause of Death ^2,3,4

One in Five Affected from Liver Diseases

1 million Liver Cirrhosis Cases Diagnosed every year

9% to 53% General Population have NAFLD

40 million HBV cases detected

Prevalence of Gastrointestinal Diseases in India ^5,6,7,8

7.6% - 30% Suffer from gastroesophageal reflux disease (GERD)

22% Suffer from constipation

1.4 Million Suffer from Inflammatory Bowel Disease (IBD)

25% Pregnant Females Suffer from Constipation

114-200/Million Suffer from Pancreatitis

References:

Liver diseases-an overview - researchgate [Internet]. [cited 2022Apr20]. Available from: https://www.researchgate.net/profile/Siva-Krishnan-6/publication/331816198_LIVER_DISEASES-AN_OVERVIEW/links/5ca086daa6fdccd46045e7f4/LIVER-DISEASES-AN-OVERVIEW.pdf
Liver diseases-an overview - research gate [Internet]. [cited 2022Apr20]. Available from: https://www.researchgate.net/profile/Siva-Krishnan-6/publication/331816198_LIVER_DISEASES-AN_OVERVIEW/links/5ca086daa6fdccd46045e7f4/LIVER-DISEASES-AN-OVERVIEW.pdf
Nonalcoholic fatty liver disease: Indian perspective - de ... [Internet]. [cited 2022Apr20]. Available from: https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/cld.1141
Viral hepatitis- the silent disease facts and treatment ... [Internet]. [cited 2022Apr20]. Available from: https://ncdc.gov.in/linkimages/guideline_hep20158117187417.pdf
Bhatia SJ, Makharia GK, Abraham P, Bhat N, Kumar A, Reddy DN, et al. Indian consensus on gastroesophageal reflux disease in adults: A position statement of the Indian Society of Gastroenterology. Indian Journal of Gastroenterology. 2019;38(5):411–40.
22% of Indian adults suffer from constipation : Abbott 'Gut Health Survey' [Internet]. Press Release | Abbott India. [cited 2022Apr20]. Available from: https://www.abbott.in/media-center/press-releases/indian-adults-suffer-from-constipation.html#:~:text=The%20findings%20suggest%20that%2022,constipation%20associated%20with%20certain%20comorbidities
Kedia S, Ahuja V. Epidemiology of inflammatory bowel disease in India: The great shift east. Inflammatory Intestinal Diseases. 2017;2(2):102–15.
(PDF) prevention of pancreatic cancer - researchgate.net [Internet]. [cited 2022Apr20]. Available from: https://www.researchgate.net/publication/336305874_Prevention_of_Pancreatic_Cancer

Disease types

Classification of Liver Disorders: ¹

Alcoholic Liver Disease

It includes alcoholic fatty liver with or without hepatitis, alcohol hepatitis (reversible because of acute ingestion) to cirrhosis (irreversible).
Patients with severe alcohol use disorder mostly develop chronic liver disease; this is the most frequent cause of CLD.

Non-alcoholic Fatty Liver Disease (NAFLD/NASH)

NAFLD has an association with metabolic syndrome (obesity, hyperlipidemia, and diabetes mellitus).
Some of these patients develop non-alcoholic steatohepatitis, which leads to fibrosis of the liver.

Chronic Viral Hepatitis:

Chronic hepatitis B, C, and D infections are the most common causes of chronic liver disease.
Chronic hepatitis C, if not treated, may lead to hepatocellular carcinoma.

Cirrhosis is a final stage of chronic liver disease that results in disruption of liver architecture, the formation of widespread nodules, vascular reorganization, neo-angiogenesis, and deposition of an extracellular matrix.¹

The main causes of chronic viral hepatitis are.²

Genetic Causes: Alpha-1 antitrypsin deficiency, Hereditary hemochromatosis, Wilson disease

Autoimmune Causes: Primary biliary cirrhosis (PBC), Primary Sclerosing Cholangitis (PSC) or Autoimmune hepatitis (AIH)

Other Causes of Chronic Liver Disease: Drugs or Vascular. Budd-Chiari syndrome

Gastric Disorders:

The most common gastric problems are:

Gastritis: Inflammation of the stomach lining is called gastritis³

Peptic Ulcer: a sore on the lining of your stomach or duodenum⁴

Irritable bowel Syndrome: The presence of abdominal pain or discomfort with altered bowel habits in the absence of detectable structural and biochemical abnormalities⁵

Chronic Diarrhoea: Loose stools that last for at least four weeks.⁶

Constipation: a disorder in the gastrointestinal tract, which can result in the infrequent stools, difficult stool passage with pain and stiffness. Acute constipation may cause closure of the intestine, which may even require surgery ⁷

References:

Sharma A, Nagalli S. Chronic Liver Disease. Treasure Island (FL): StatPearls Publishing. 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554597/
Azer SA, Akhondi H. Gastritis. StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544250/
Gastritis and gastropathy. Definition & Facts for Gastritis & Gastropathy. NIDDK. 2019. Available from: https://www.niddk.nih.gov/health-information/digestive-diseases/gastritis-gastropathy/definition-facts
Peptic Ulcer. Symptoms & Causes of Peptic Ulcers (Stomach Ulcers). NIDDK. 2014. Available from: https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/symptoms-causes
Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014;20(22):6759-6773. doi:10.3748/wjg.v20.i22.6759
Chronic diarrohoea in adults (beyond the basics). UpToDate. 2022. Available from: https://www.uptodate.com/contents/chronic-diarrhea-in-adults-beyond-the-basics#:~:text=Chronic%20diarrhea%20is%20defined%20as,possible%20causes%20of%20chronic%20diarrhea
Forootan M, Bagheri N, Darvishi M. Chronic constipation: A review of literature. Medicine (Baltimore). 2018;97(20):e10631. doi:10.1097/MD.0000000000010631

Ventri Division Introduction

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