4th Edition of GLOBAL Congress on Advances in Gastroenterology and Hepatology

Clinical Gastroenterology

Clinical Gastroenterology is a branch of medicine that focuses on the study of the digestive system and digestive diseases. Meticulously it is a research of normal function and disorders of the esophagus, stomach, bile duct, liver, small intestine, pancreas, colon, rectum, and gallbladder. This includes a thorough understanding of the normal action of the gastrointestinal organs, including the passage of material through the stomach and intestine, the digestion and absorption of nutrients into the body, the elimination of waste from the system, and the function of the liver as a digestive organ. It includes common and essential conditions such as hepatitis, gastroesophageal reflux, peptic ulcer disease, colon polyps, cancer, colitis, nutritional disorders, gallbladder, bile disease, Irritable bowel syndrome (IBS), and pancreatitis.

Gastroenterologists are called doctors who specialize in this area. Typically, they have completed about eight years of pre-medical and medical education, one year of internship, three years of residency in internal medicine, and three years of fellowship in gastroenterology.

Gastroenterologists carry out a range of diagnostic and healing procedures, including endoscopic retrograde cholangiopancreatography (ERCP), esophagogastroduodenoscopy (EGD), colonoscopy, liver biopsy, and endoscopic ultrasound (EUS). Studies have shown that gastroenterologists perform better quality colonoscopy tests and robust consultative services compared to other physicians.

• Gastritis
• Gastroenteritis
• Gastric Ulcers
• Gastroschisis
• Implantable Gastric Stimulation
• Imaging and Scanning

Market Statistics:

The market for gastrointestinal treatments is expected to expand from $35.7 billion in 2015 to $48.4 billion by 2022, representing a compound annual growth rate of 4.45 percent.

One of the primary reasons driving the market's growth is the rising prevalence of GI disorders such as inflammatory bowel disease (IBD) and ulcerative colitis. Patients all around the world are experiencing an increased risk of disease recurrence as a result of shifting lifestyle patterns and bad eating habits. Furthermore, the market is being driven by the growing senior population, which is more sensitive to such disorders. 

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Gastroenterology Treatment

Gastroenterologists are responsible for a variety of conditions affecting the GI system. This could include:

Acid reflux, Hepatitis C, Polyps, or Growths, Ulcers, IBS, Jaundice, Hemorrhoids, Pancreatitis, or a Rare disease, colon cancer

What procedures are conducted by gastroenterologists?

These experts conduct a variety of non-surgical procedures. This could include:

•    Endoscopic ultrasound to view the upper and lower GI tract
•    Colonoscopy to detect colon cancer 
•    Endoscopic retrograde cholangiopancreatography for the identification of gallstones, scar tissue, or tumors in the bile duct region
•    Sigmoidoscopies to assess blood loss or abdominal discomfort
•    Liver biopsies to test inflammation and fibrosis
•    Endoscopies of the capsule to investigate the small intestine
•    Double balloon enterostomy to view the small intestine

Market Statistics:

In 2015, the global market for therapeutics and diagnostics for gastrointestinal disorders reached $49.6 billion. From 2016 to 2021, this market is predicted to increase at a CAGR of 4.3 percent, from about $51.8 billion in 2016.

The main causes of gastrointestinal problems in many locations are a growing geriatric population and changing lifestyle.

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Advances in Gastroenterology

Flexible sigmoidoscopy is one of numerous screening modalities advocated through America Preventive Services Task Force for colorectal cancer (CRC) screening. However, sigmoidoscopy is much less effective in detecting lesions at the proper facet of the colon than the left facet, and right-sided lesions are greater not unusual in older ladies. A take a look at that pooled outcomes from 3 randomized trials evaluating screening with the aid of sigmoidoscopy without a screening determined that the occurrence of CRC at 10 to 12 years was reduced in men however in ladies, best in those younger than 60 years. Current screening pointers do no longer suggest gender-primarily based alternatives for screening options. Gallbladder and Biliary Disease.

• Abdominal Imaging
• Ablation Therapies
• Hepatic Pathology
• Hepatic Lesions
• HELLP Syndrome

Market Statistics:

According to our new research study titled "Gastrointestinal Drugs Market to 2027 – Global Analysis and Forecast – by Drug Class, Route of Administration, Application, and Distribution Channel," the Gastrointestinal Drugs Market Size was valued at US$ 49,043.38 million in 2019 and is expected to reach US$ 71,300.28 million by 2027, growing at a CAGR of 4.9% between 2020 and 2027. The significant increase of COVID-19 infection propels market expansion.

Market for Gastrointestinal Drugs: Competitive Landscape and Key Developments:

Among the major players in the gastrointestinal medications market are Sanofi, GlaxoSmithKline plc, Bausch Health, AstraZeneca,  Johnson and Johnson Services, Inc., AbbVie Inc., Takeda Pharmaceutical Company Limited, Bayer AG, Celltrion Healthcare Co., Ltd., and Lexicon Pharmaceuticals, Inc. 

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Gallbladder and Biliary Disease

Biliary disease refers to diseases that affect the bile ducts, the gallbladder, and other structures that are involved in bile development and transport.
Bile is a liver-generated fluid that helps digestion. Bile drains from the liver to the first portion of the small intestine, or duodenum, via the bile ducts, and finally back to the bile ducts and liver. Several serious diseases can result if any duct in this complex system becomes diseased or blocked. Gallstones develop when the fragile balance of solubility of biliary lipids favors precipitation of cholesterol, unconjugated bilirubin, or bacterial degradation products of biliary lipids.

Risk Factors

The risk of developing biliary disease can be increased by hereditary factors, growing age, obesity, a high-fat diet, certain gastrointestinal disorders, and certain prescription medications.

Symptoms 

Although symptoms can vary among disorders of the bile duct, symptoms common to many of the disorders include:

Jaundice, Abdominal pain, Itching, Nausea or vomiting, Fever or chills, Loss of appetite, Light brown urine, and Greasy or clay-colored stools.

Detection and diagnosis

The tests carried out differ according to the alleged condition of the bile duct. However, tests typically conducted to diagnose certain disorders of the bile duct can include:

Blood tests, Endoscopic ultrasound, Liver function tests, Ultrasound, Computed tomography (CT) scan, Endoscopic retrograde cholangiopancreatography (ERCP), Magnetic Resonance Imaging (MRI), and Liver biopsy

Prevention of disease

Biliary disorders due to gallstones can be avoided by the surgical removal of the gallbladder. By eating a well-balanced diet, maintaining a healthy weight, and exercising regularly, the development of gallstones can also be avoided.

Treatment:

Medications / Antibiotics: Patients are treated with medicines to improve the flow of bile from the liver and antibiotics are used to treat the infection.

Hepatoportoenterostomy: Surgery to remove bile from the liver when bile ducts are blocked.

ERCP: This method can help to diagnose and extract gallstones from the bile duct.

Cholecystectomy: Removal of the gallbladder.

Market Statistics:

The Gallbladder Treatment Market is expected to be worth more than USD 33.7 billion by 2027, growing at a CAGR of more than 6% during the forecast period.

The following companies are major players in the Gallbladder Treatment Market: 

• Boston Scientific Corporation 
• Intuitive Surgical
• C. R. Bard, Inc. 
• Dornier MedTech 
• Koninklijke Philips N.V. 
• B. Braun Melsungen AG

According to a recent study analysis, the Global Biliary Stents Market was worth around USD 900 million in 2019. The market is estimated to grow at a CAGR of 6.78%, surpassing USD 1,425 million by 2026. Boston Scientific Corporation, Abbott Laboratories, Cook Medical, B. Braun Melsungen AG, CONMED Corporation, and others are among the market's leading players.

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Gastrointestinal Complications in Pregnancy

Gastrointestinal (GI) disorder additionally represents at some stage in being pregnant.Some girls have GI issues which might be unique to being pregnant.Other pregnant patients gift with continual GI disorders that require special care during being pregnant.Understanding the superiority of various GI disorders is vital to optimize care for these patients.Nausea, without or with vomiting, is common in early being pregnant, Other causes of nausea in pregnancy include urinary tract infections, gastroenteritis, peptic ulcer ailment, pancreatitis, biliary tract sickness,In later being pregnant, concerns also include hydramnios, preeclampsia, and onset of exertions.

• Gynoscopy
• Intra Hepatic Cholestasis of Pregnancy
• Multi visceral Transplant
• Ulcerative Colitis
• Hepatasis in Pregnancy
• Hyperemesis Gravidarum

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Gastrointestinal Disorders

Gastrointestinal motility can be described by the movements of the digestive system, and the transit of the contents within it.Gastrointestinal Disorder is related to gastrointestinal tract namely the esophagus, stomach, small intestine, large intestine, rectum, and the accessory organs of digestion, the liver, gallbladder, and pancreas.Gastrointestinal disorders include such conditions as constipation, hemorrhoids, irritable bowel syndrome, anal fissures, perianal abscesses, anal fistulas, perianal infections, diverticular diseases, colon polyps, colitis and cancer.Many of these can be minimized by maintaining a healthy lifestyle, practicing good bowel habits, and submitting to cancer screening.Less than 1% of digestive disease research funding, through the National Institutes of Health (NIH), is allocated for functional disorders.

• Intestinal Diseases
• Intestinal Obstruction
• Intra gastric Ballon
• Adjustable Gastric band
• Obesity
• Inflamation

Market Statistics:

The global gastrointestinal medicines market is predicted to increase at a CAGR of 4.4% from $46.68 billion in 2020 to $48.74 billion in 2021. The gastrointestinal therapeutics market is anticipated to reach $62.19 billion by 2025, growing at a CAGR of 6%.

The global gastrointestinal medicines industry is fairly fragmented, with only a few major competitors. In 2020, the top 10 competitors in the market accounted for 51.88% of the total market. Takeda Pharmaceuticals, AbbVie, Johnson & Johnson, Bausch Health, and AstraZeneca Plc are among the market's major participants.

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Gastrointestinal Pathology

Gastrointestinal pathology is the subspecialty of surgical pathology that deals with the diagnosis and classification of non-neoplastic and neoplastic diseases of the digestive tract and accessory organs, such as the liver and pancreas.

Every year, digestive diseases affect 1 in 5 Americans-at least 60 million individuals in the United States per year. Digestive Diseases account for About 50 million hospital visits, almost 25 million endoscopic tests, and more than 20 million gastrointestinal specimens directed to pathologists account-totaling $87 billion in direct medical costs due to gastrointestinal disease.

Approximately 8% of the 20 + million gastrointestinal biopsies currently performed each year are examined by pathologists with fellowship training in digestive health and disease, with 400 fellowship-trained gastrointestinal pathologists in operation in the United States. Highly trained general surgical pathologists, including those who have a particular interest in gastrointestinal pathology, study the remaining 90 to 92 percent of biopsies.
 

• Biopsy Pathology
• Inflammatory Bowel Disease
• Histomorphologic Patterns
• Barrett’s Esophagus
• Colorectal Cancer

Market Statistics:

The global anatomic pathology market is expected to grow at a CAGR of 7.1 percent over the forecast period, from USD 33.3 billion in 2020 to USD 46.8 billion in 2025.

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Gastrointestinal Pharmacotherapy

Therapy of pediatric functional gastrointestinal disorders is best done within the context of a multidisciplinary biopsychosocial approach. Pharmacotherapy is often sought by patients and families who hope to find a “pill” that will lead to rapid symptom relief. Yet, there is only scant published evidence for the efficacy of a variety of medical interventions in childhood functional abdominal pain and irritable bowel syndrome. This article reviews the pediatric studies that have addressed pharmacotherapy in children with pain predominant functional gastrointestinal disorders.

• Hepato biliary Diseases
• Therapy of Pancreatic Diseases
• Inflamatory Bowl Diseases
• Prokinetic Agents
• Gastro Duodenal Mucosal Protection

Market Statistics:

Market analysts predict the global gastrointestinal medicines market will increase from $46.68 billion in 2020 to $48.74 billion in 2021, representing CAGR of 4.4% over the next five years. The market is estimated to reach $62.19 billion in 2025, growing at a CAGR of 6%.

North America dominated the worldwide gastrointestinal medicines market in 2020, accounting for 48% of the total. The second-largest region, Asia Pacific, accounted for 24% of the global gastrointestinal medicines market. 

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Gastrointestinal Cancer

Gastrointestinal cancer refers to malignant conditions of the GI tract and accessory organs of digestion including the esophagus, liver, biliary system, pancreas, small intestine, large intestine, rectum, and anus. Symptoms refer to the infected organ and can involve obstruction, irregular bleeding, or other complications related to it.

Diagnosis also includes endoscopy, followed by a biopsy of suspicious tissue. Treatment depends on the location of the tumor as well as the type of cancer cell and whether it has penetrated or spread to other tissues.

Various Types of GI Cancers

A. Upper digestive tract

1. Esophageal cancer | 2. Stomach cancer | 3. Pancreatic cancer | 4. Liver cancer | 5. Gallbladder cancer | 6. Other

B. Lower digestive tract

1. Colorectal cancer | 2. Anal cancer | 3. Gastrointestinal carcinoid tumour

Around 27,510 new cases of gastric cancer are diagnosed each year. The average age at diagnosis is 68 years and is more common in males than females. The occurrence of stomach cancer has declined significantly since the 1930s. 

How is stomach cancer treated?

At present, all curative therapies for gastric cancer require surgery. In order to overcome this, radiation therapy and chemotherapy are prescribed for several patients.

1. Radiotherapy
2. Physiotherapy
3. Targeted therapies

Market Statistics:

The global stomach cancer/gastric cancer treatment market was valued at USD 2.61 billion in 2018 and is expected to grow at a CAGR of 15.3 percent to USD 8.20 billion by 2026, with a CAGR of 15.3%.

Stomach cancer is the world's fifth most prevalent cancer. Each year, 6,697 cases of stomach cancer are diagnosed, according to Cancer Research UK. There are three forms of stomach cancers. The most frequent type of stomach cancer is gastric adenocarcinoma, which accounts for 90% to 95% of stomach cancer occurrences. 

According to the World Health Organization, the number of cases of stomach cancer would rise from 1.03 million in 2018 to 1.24 million in 2025.

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Gastrointestinal Radiology

Upper gastrointestinal tract radiography, often known as upper GI, is an x-ray study of the esophagus, liver, and first section of the small intestine (also known as the duodenum). Images are created using a special type of x-ray called fluoroscopy and oral contrast content, such as barium.

An x-ray (radiograph) is a non-invasive diagnostic examination that helps doctors identify and treat medical conditions. Imaging using x-rays requires the exposure of a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most widely used type of medical imaging.

What are some typical uses of this procedure?

The upper GI test helps to determine the digestive process and can detect:

Ulcers, Tumors, Inflammation of the esophagus, intestine, and duodenum, Hiatal hernia, Blocking, Abnormalities of the GI muscular wall

The technique is also used to help diagnose the causes of symptoms such as:

Difficult swallowing, Chest and stomach pain, Reflux, Unexplained vomiting, and Severe indigestion Blood in the stool 

What are the advantages of this?

•  Upper GI radiograph is an extremely effective, non-invasive technique
• The findings of the upper GI sequence normally lead to a correct assessment of the esophagus, stomach, and duodenum
•  Since barium is not absorbed in the blood, allergic reactions are extremely rare
•   There is no radiation left in the patient's body following an x-ray test.
•  Typically, X-rays do not have any side effects in the usual diagnostic spectrum for this test

SUBTOPICS

• Barium Enema with air Contrast
• Barium Enema
• Dynamic Pelvic MRI
• CT Colonography (Virtual Colonoscopy)
• Herniography
• Intravenous Pyelogram
• Evacuation Proctogram (Defecography)

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Gastrointestinal Surgery

Gastrointestinal surgery is a procedure for diseases of the areas of the body that are involved in digestion. This includes the esophagus, liver, small intestine, large intestine, and rectum. It involves the liver, gallbladder, and pancreas as well. Surgery can be used to remove cancerous or non-cancer growth or damaged parts of the body, such as the intestine.

Below are gastrointestinal disorders that can be treated with surgery:

Appendicitis, Colon cancers and other stomach cancers, Diverticular illness, Disease of the gallbladder, Gastroesophageal reflux disease (GERD) and hiatal hernia, Inflammatory intestinal disorder, Rectoral prolapse, and Loss of weight

A surgical technique called an endoscopy is used to screen and diagnose conditions in the digestive system. The doctor puts a long, thin tube with a tiny camera in the body to see inside.

Options for General Intestinal Surgery

•    Endoscopic Surgery
•    Laparoscopic Surgery
•    Robotic surgery

Minimally Invasive GI Surgical Procedures

Listed below are some types of laparoscopic procedures that are done to treat GI conditions:

Adrenalectomy, Appendectomy, Bariatric Surgery, Cholecystectomy, Colon and Rectal Surgery, Foregut Surgery, Hiatal Hernia Repair, Nissen, Nephrectomy, Pancreatic Surgery, Retroperitoneum Surgery, and Splenectomy

Open GI Surgical Procedures

Abdominal Surgery, Adrenalectomy, Appendectomy, Nissen fundoplication, Roux-en-Y and Whipple Procedure

Recovery time will depend on the surgery and how invasive it is. With a few quick surgeries, including a colonoscopy, you can get back to your everyday activities right away. With more invasive surgery, you will need some time to recover, and some help with post-operative pain control.

SUBTOPICS

• Appendicitis
• Colon Cancer
• Gastrointestinal Cancer
• Rectal Prolapse
• Bleeding and Blood clots
• Minimally Invasive Surgery

Market Statistics:

In 2020, the global gastrointestinal stents market will be worth US$ 402.5 million. The market is expected to develop at a CAGR of 3.6% between 2021 and 2026, according to IMARC Group.

In 2025, the global market for robotic gastrointestinal surgery will reach $1.41 billion.

The global market for minimally invasive gastrointestinal surgical systems was valued at $5,021.8 million in 2020 and is expected to reach $10,441.0 million by 2031, rising at a CAGR of 6.8% from 2021 to 2031.

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Digestive Diseases

Digestive diseases are disorders of the digestive tract, also referred to as the gastrointestinal (GI ) tract. Indigestion, food, and drink are broken down into small pieces (called nutrients) that the body can consume and use as energy and cell building blocks. The digestive tract consists of the esophagus, the throat, the large and small intestines, the liver, the pancreas, and the gallbladder.

The first indication of problems in the digestive tract frequently involves one or more of the following symptoms:

Bleeding, Bloating, Constipation, Diarrhea, Heartburn, Incontinence, Nausea and vomiting, pain in the belly, Swallowing problems, or Weight gain or loss

Other digestive diseases include:

•    Gallstones, cholangitis, and cholecystitis
•    Rectal problems: Anal fissure, hemorrhoids, proctitis, and rectal prolapse
•    Esophagus problems: Stricture, achalasia, and esophagitis
•    Stomach problems: Gastritis, and gastric ulcers 
•    Liver problems: Hepatitis B or hepatitis C, cirrhosis, and liver failure
•    Pancreatitis and pancreatic pseudocyst
•    Intestinal problems: Polyps and cancer, Crohn disease, infections, ulcerative colitis, celiac disease, diverticulitis, short bowel syndrome, malabsorption, and intestinal ischemia
•    Gastroesophageal reflux disease (GERD), hiatal hernia, and peptic ulcer disease

Tests for digestive disorders can include colonoscopy, capsule endoscopy, endoscopic retrograde cholangiopancreatography (ERCP), upper GI endoscopy, and endoscopic ultrasound.

Many surgical operations are conducted in the digestive tract. That includes endoscopy, laparoscopy, and open surgical procedures. Organ transplantation can be performed on the liver, pancreas, and small intestine.

SUBTOPICS:

• Constipation
• Nausea and vomiting
• Diarrhea
• Bloating
• Radiologists

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Liver Diseases

Liver disease is a type of damage to or disease of the liver. The liver is a large organ in the upper right abdomen that helps absorb and removes waste products from the blood. 

Liver disorder shall contain the following conditions: 

•    Cirrhosis, or scarring of the liver 
•    Inflammation (hepatitis) from infectious (hepatitis C, hepatitis B) or non-infectious (chemical or autoimmune) causes 
•    Liver cancer
•    Metabolic disorder

Some of the signs and symptoms of liver disease are as follows:

•    Jaundice
•    Confusion 
•    Thrombocytopenia and coagulopathy.
•    Risk of bleeding symptoms, particularly in the gastrointestinal tract
•    Ascites: Deposition of fluid in the abdominal cavity.

The liver can be called a factory, and its many functions include:

•    Production of bile needed for the digestion of food, in particular, fats
•    Storing the extra glucose or sugar as glycogen, and then converting it back to glucose when the body requires it for energy.
•    Production of factors for blood clotting
•    Production of amino acids, including those used to help combat infection
•    Processing and storage of iron required for the development of red blood cells
•    The manufacture of cholesterol and other chemicals needed for the transport of fat
•    Conversion of waste materials to urea excreted in the urine
•    Metabolising drugs into their active ingredient in the body

Factors that can increase the risk of liver disease include: 

Heavy alcohol intake, Obesity, Diabetes of type 2, Tattoos or body piercing, Injection of medications using mutual needles, Exposure to other people's blood and body fluids, Unprotected sex, Exposure to certain chemicals or toxins, Family history of liver disease or Exposure to blood and bodily fluids of other individuals.

To prevent liver disease:

•    Drink alcohol with moderation
•    Get vaccinated
•    Using drugs carefully
•    Avoid contact with other people's blood and body fluids
•    Keep food safe
•    Be cautious with aerosol sprays
•    Maintaining a healthy weight

Treatment

Anti-viral drugs are available to treat infections such as hepatitis B. Other diseases can be treated by slowing down the progression of the disease, for example:

•    By using steroid-based medications for autoimmune hepatitis.
•    Hemochromatosis: Drains the volume of blood from the vein (venesection) in an iron overload condition.
•    Wilson's disease, a disorder in which copper builds up in the body, can be regulated by drugs that bind copper, enabling it to pass through the body in the urine.
•    In the case of cholestatic liver disease (cystic fibrosis) a medicine called ursodeoxycholic acid may be given.

Treatment for liver disease that causes or has contributed to liver failure may potentially require liver transplantation.

SUBTOPICS

• Liver cancer
• Liver Biopsy
• Liver transplant
• Cirrhosis and Portal Hypertension
• Hepatic Encephalopathy

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Gastroenterologist

A gastroenterologist is a medical specialist who specializes in disorders involving the digestive system's organs and structures.

Gastroenterologists diagnose, treat, and care for individuals with a variety of diseases associated with the gut. Long-term disorders, such as inflammatory bowel disease (IBD) and celiac disease.

Gastroenterology is a sub-study of internal medicine.

It relates to the study of the diseases and function of the GI tract and the digestive system.

Gastroenterology includes a full understanding of:

•    the GI organs
•    the passage of material through the intestines and stomach
•    the digestion of the nutrients and absorption 
•    the waste removal from the body
•    the liver

What is a gastroenterologist?

A gastroenterologist who specializes in illnesses that affect the digestive organs.

These parts of the body include the:

Esophagus, or food pipe, stomach, small intestine, colon, rectum, pancreas, gallbladder, bile ducts, or liver

A doctor must complete a 3-year internal medicine residency after medical school to become a gastroenterologist. They will undergo 2-3 years of intensive, advanced training, called a fellowship, following this residency.

Gastroenterologists also work closely with other healthcare specialists to provide treatment to a wide variety of individuals once they become certified.

A gastroenterologist may work with:

•    Hepatologists, whose study in the liver
•    Radiologists, whose study in imaging
•    Oncologists, whose study in cancer

Gastroenterologists play a role in diagnosing, treating, and handling individuals with conditions such as:

Colon polyps, colon cancer, celiac disease, hepatitis, heartburn, or gastroesophageal reflux (GERD), gallbladder disease, irritable bowel syndrome (IBS), or pancreatitis

Gastroenterologists perform several methods to diagnose, treat, and manage conditions.

These procedures include:

•    Endoscopy
•    Colonoscopy and sigmoidoscopy
•    Polypectomy
•    Esophageal dilation

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Celiac Disease

Celiac disease is a chronic digestive condition evolving from an allergic response to gliadin, a protein found in wheat, barley, rye, and occasionally oats.

It causes inflammation and degradation of the inner lining of the small intestine and can contribute to malabsorption of minerals and nutrients.
Symptoms can include chronic diarrhea, weight loss, and tiredness. In certain cases, anemia is the only symptom.

Celiac disease affects approximately one in 141 Americans.

There is no remedy, and the only safe treatment is a gluten-free diet.
Quick facts about celiac disease:

Here are some of the key points concerning the celiac disease. 

•    Celiac disease is an autoimmune condition that causes people to become gluten-intolerant.
•    Long term effects include anemia and malnutrition.
•    A gluten-free diet is only recommended for those who have an allergy.

Some of the popular symptoms of celiac disease include:

•    Gastrointestinal symptoms, such as diarrhea, gas, abdominal cramps, nausea and vomiting, and bloating.
•    Foul-smelling stools with excess fat in them, bone and joint pain, depression, panic attacks and irritability, weakness and fatigue, easy bruising, nose bleeds, infertility, iron deficiency anemia, fluid retention, malnutrition and nutrition deficiencies, mouth sores and tooth discoloration, lack of vitamin B12, D, and K, migraine headaches, blood in the stools or in the urine, nerve damage or muscle cramps.

Many people with mild symptoms experience weakness and anemia, or maybe just vague abdominal pain, such as bloating, abdominal distention, and excess gas. 

Variations in symptoms can depend on:

•    The volume of gluten used
•    The age at which a person begins to eat gluten
•    The degree of damage to the small intestine

Diagnosis

The doctor will examine the patient and ask for signs and symptoms, and some tests may be required.

Blood tests can detect the following:

•    Antigliadin antibodies 
•    Endomysial antibodies
•    Anti-tissue transglutaminase antibodies
•    Blood is examined for antibodies to deamidated gliadin peptide (TTG) and occasionally antigliadine (AGA) and and andomysium (EmA) antibodies.

Small intestinal biopsy is known to be the most effective examination for celiac disease. The doctor uses endoscopy to take samples of the intestinal liner. Typically, multiple samples are collected to improve the precision of the diagnosis.

Conditions with similar symptoms to the celiac disease include:

•    Pancreatic Insufficiencies
•    Crohn's small intestine disorder
•    Irritable intestinal syndrome
•    Bacterial small intestinal overgrowth
•    Sensitivity to gluten

Diets

At present, the only cure is to stop life-long gluten.
Items with or without gluten
A broad variety of gluten-free branded items are available. These include gluten-free bread, pasta, cookies, etc.

An individual who has a gluten-free diet should avoid the following:
•    All foods made from wheat, bran, rye, bulgur and barley, enriched flour, including cereals, bread, croutons, pasta, rackers, cakes, and biscuits.
•    Beer and other cereal-based beverages
•    Oats

A variety of processed foods contain gluten, including:

•    Canned soup
•    Salad sauce, ketchup, and mustard
•    Soya sauce
•    Ice cream bars and candy bars
•    Canned and frozen meats and sausages

Foods that are healthy to eat

Cereals such as maize, millet, sorghum, teff, rice, and wild rice are healthy to eat.

Non-cereals such as amaranth, buckwheat, or quinoa are also harmless, such as bananas, potatoes, garbanzo beans and tapioca. They do not contain gluten and do not cause symptoms.

Treatment:

Scientists are studying medicines that function directly in the intestines, medications that impact the immune system, and vaccines to cure celiac disease.

However, there is no cure except for the avoidance of gluten.
If the person continues to eat gluten, this may affect their quality of life and may increase the risk of certain medical conditions.

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Hepatitis B

Hepatitis B is a liver disorder. This is caused by a virus. There is a vaccine to protect against it. If this occurs, it can cause organ scarring, liver failure, and cancer, and it can be life-threatening.

The signs and symptoms of hepatitis B vary from moderate to severe. 
They usually occur around one to four months after you have been infected, but you could see them as early as two weeks after your infection. 
Some individuals, usually young children, may have no symptoms at all. 

Signs and symptoms of Hepatitis B can include:

Abdominal pain, Fever, Dark urine, Loss of appetite, Joint pain, Weakness and fatigue Nausea and vomiting, and Jaundice.

Causes:

Hepatitis B infection is caused by the hepatitis B virus (HBV) virus. The virus is transmitted from person to person by blood, semen, or other body fluids. By sneezing or coughing, it does not spread.

Popular ways that HBV can spread is:

Sexual interaction: You could have hepatitis B if you have unprotected sex with someone who is sick. You may get the virus if the person's blood, saliva, semen, or vaginal secretions touch your body.

Sharing the needles: HBV spreads quickly by needles and syringes contaminated with contaminated blood. Sharing IV drug paraphernalia puts you at high risk for hepatitis B.

Mother to child: Pregnant women infected with HBV may be able to transmit the virus to their infants during childbirth. However, the infant must be vaccinated to prevent infection in almost all cases. Speak to your doctor about getting tested for hepatitis B if you are pregnant or want to become pregnant.

Risk factors:

Hepatitis B spreads from an infected person by contact with blood, semen, or other body fluids. Your risk of infection with hepatitis B increases if you:

•    Had unprotected sex with multiple sex partners or someone who is infected with HBV
•    Share needles during the use of IV drugs
•    Men having send with men
•    Live with someone who has a chronic infection with HBV
•    Is a child born to an infected mother
•    Have a job which exposes you to human blood

Complications:

Serious complications may result from chronic HBV, such as:
Cirrhosis: Inflammation associated with hepatitis B infection may lead to significant liver scarring (cirrhosis), which may affect the ability of the liver to function.

Liver cancer: People with chronic hepatitis B infection are at increased risk of developing liver cancer.

Liver failure: Acute liver failure is a disease in which the essential functions of the liver are shut down. When this happens, a liver transplant is required to support life.

People with chronic hepatitis B may develop kidney disease or inflammation of their blood vessels.

Prevention:

Hepatitis B vaccine is normally administered as three or four doses over a span of six months.

The vaccine for hepatitis B is suggested for:

•    The newborn
•    Children and teenagers who are not vaccinated at birth
•    Health care staff, emergency workers 
•    Anyone with a sexually transmitted infection, like HIV
•    People who are having sex with men
•    People who have multiple sex partners
•    Sexual partners of those with hepatitis B
•    People who inject or share illicit drugs with needles and syringes
•    People with chronic diseases of the liver
•    People with end-stage renal disease

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Barretts Esophagus

Recurrent or continuous exposure to stomach acid might lead to the condition known as Barrett’s esophagus; people with long-term gastro-esophageal reflux disease (GERD) have a higher chance of being diagnosed with this health condition. In this particular condition the flat pink lining of the swallowing tube that connects the mouth to the stomach (esophagus) becomes damaged by acid reflux, which eventually causes the lining to be thickened and red. While frequent heartburn and chest pain are often reported as common symptoms, but many people with Barrett’s esophagus might be asymptomatic as well. Treatments in case of mild condition are basically medical monitoring and medication, in severe cases patients needs to undergo surgery. In rare case, it also develops into oesophageal cancer.

• Diagnosis and Screening
• Treatment and Prognosis
• GERD
• Epidemiology
• Barrett's Esophagus Metaplasia
• Epithelial Dysplasia

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Crohn Disease

Crohn's disease is one of the most common types of inflammatory bowel disease (IBD). It causes inflammation of the digestive tract that leads to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition. Inflammation in this condition can involve different part of the digestive tract in different people which often spreads into the deeper layers of the bowel. It is a chronic inflammatory bowel disease can be painful, debilitating, and sometimes it may also lead to life-threatening complications. Unfortunately, there is no cure for Crohn's disease yet, therapies are available to reduce the symptoms and even bring about long-term remission as well as healing of inflammation. Steroids and immunosuppressants help to slow the progression of the disease and if these aren't effective, patients are suggested to undergo surgery. Patients with Crohn's disease must have regular screening for colorectal cancer due to increased risk. Crohn's disease mostly causes abdominal pain, diarrhoea, weight loss, anaemia and fatigue.

• Screening and Diagnosis
• Treatment and Management
• Ileocolitis
• Gastroduodenal Crohn’s
• Jejunoileitis
• Crohn's Granulomatous
• Crohn's Disease Pathophysiology
• Inflammatory Bowel Disease

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Cirrhosis

Cirrhosis is a life- threatening liver disease in which liver is permanently damaged as the healthy liver tissue is replaced with scar tissue. Scar tissue causes decline in your liver function. It blocks blood flow through the liver and also slows the liver’s ability to process nutrients, hormones, drugs or the natural toxins (poisons). It also reduces the production of proteins and other substances synthesized by the liver. Cirrhosis is a late-stage result of liver disease which   eventually leads to liver failure. Patients are often advised to go through liver transplantation. Hepatitis and chronic alcohol abuse are most common causes. Fatigue, weakness and weight loss occurs as initial symptoms in some patients whereas some patients are asymptomatic in beginning phases and in later stages, patients might have jaundice (yellowing of the skin), gastrointestinal bleeding, abdominal swelling and confusion.

• Diagnosis and Treatment
• Prevention and Prognosis
• Stages of Liver Cirrhosis
• Types of Liver Cirrhosis
• Compensated Cirrhosis
• Decompensated Cirrhosis
   

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Hepatitis C

Hepatitis C is a viral infection that leads to liver inflammation which may cause severe liver damage. The hepatitis C virus (HCV) mostly spreads through contaminated blood. There is currently no effective vaccine against hepatitis C. With the development of medical science, chronic HCV is now curable with antiviral oral medications taken every day up to two to six months. Recently developed drugs have the potential to eradicate the virus. Mostly patients are asymptomatic but some people may experience fatigue, nausea, loss of appetite and yellowing of the eyes and skin. The virus causes both acute and chronic hepatitis, ranging from a mild illness to a serious, lifelong illness including liver cirrhosis as well as liver cancer.

• Hepatitis Vaccine
• Hepatitis C Virus
• Hepatitis and HIV
• Hepatitis C Complications
• Prevention and Cure
• Alternative Medicine

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Liver and Intestine Transplant

Liver transplant is unfortunately the final treatment option for people suffering from end-stage chronic liver disease. It may also be a treatment option in rare cases of sudden failure of a previously healthy liver. In this surgical procedure a liver that no longer functions properly (liver failure) is replaced with a healthy liver from a deceased donor or a partial healthy liver from a living donor. A liver transplant is also called as a hepatic transplant. The five-year survival rate after liver transfer is around 75 percent.

Similarly an intestine transplant is the process of removing a patient’s diseased small intestine and replacing it with a healthy donor intestine. A preferred treatment option for children who suffers from irreversible intestinal failure for restoring digestive function. However, intestinal transplants are most challenging and least frequently performed organ transplants. Over the last one and a half decades, intestinal transplant outcome has shown  significant improvement and number of transplants has steadily increased over the years.

• Types of Organ Donors
• Causes of Chronic Liver Injury 
• Transplant risk and Complications
• Operative Techniques in Intestinal Transplants
• MELD Score
• Transplantation Cost 
• Multivisceral Transplantation
• Intestinal Failure 

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Kidney and Pancreas Transplant

A kidney transplant is one of the most frequently performed organ transplantation, a surgical procedure that places a healthy kidney from a living or deceased donor into a person who is suffering from end stage kidney failure. Kidney transplant can be deceased-donor or living-donor transplantation depending on the source of the donor organ. When kidney loses its filtering ability, harmful levels of fluid and waste retention occurs in the body, which eventually raises blood pressure and results in kidney failure (end-stage kidney disease). When kidney function declines to a certain level, patients needs either dialysis or transplantation to sustain their life. 
Similarly a pancreas transplant is an organ transplant that involves implanting a healthy pancreas into a person who loses pancreatic function mostly due to long term diabetes. The pancreas produces juices that helps to digest food and hormones such as insulin and glucagon and maintain optimal blood sugar levels that helps the body to use and store energy from food.
A pancreas transplant is suggested to those people whose pancreas no longer can supply sufficient insulin to the body. .A pancreas transplant can manage the damage to other organs including the kidneys that may result from type 1 diabetes. Pancreas transplants are mostly suggested to persons with type 1 diabetes along with severe kidney disease or other life-threatening consequences from uncontrolled glucose levels. 

• Chronic Kidney Disease
• Deceased-Donor Kidney Transplant
• Living-Donor Kidney Transplant
• Preemptive Kidney Transplant
• Kidney Transplant Cost and Success Rate
• Diabetes Mellitus
• Glomerulonephritis
• Polycystic Kidney Disease
• Types of Pancreas Transplant

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Peptic Ulcer Disease

Peptic ulcers are open sores which develops on the inside lining of the stomach and the upper portion of the small intestine. The most common symptom observed in case of peptic ulcer is stomach pain. The most common causes of peptic ulcers are infection with the Helicobacter pylori (H. pylori) as well as long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs.  Stress and spicy foods do not cause peptic ulcers but it contributes to make the symptoms worse. The sore may develop on the lining of the esophagus, stomach or small intestine when stomach acid damages the lining of the digestive tract. Treatment usually includes medication to decrease stomach acid production and antibiotics.

• Anatomy and Pathophysiology
• Diagnosis and Treatment
• Helicobacter Pylori (H. pylori)
• Gastric Ulcers 
• Duodenal Ulcers 

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GI Bleeding

Gastrointestinal (GI) bleeding itself is not a disease but it is a symptom or indication of a disorder associated with digestive tract. The level of bleeding ranges from mild to severe and sometimes it can be life-threatening. The blood mostly appears in stool or vomit but it is not always visible, though it may cause the stool to look black or tarry. Sophisticated imaging technology is used to locate the cause of the bleeding and the treatments depends on the source of the bleeding.

• Upper GI Bleeding
• Lower GI Bleed
• Gastrities
• Iron Deficiency
• Typhoid Fever
• GI bleeding Diagnosis and Treatment
• Prognosis and Epidemiology

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GI Infectious Disease

GI tract infections are common and diarrhea is still the most common cause of death in developing and underdeveloped countries (Approx 2.5 million deaths/year). Pathogens causing these infections can be transmitted to humans in three ways: in food, in water or person to person. There are an enormous number of microbes that cause disease in the intestines such as Bacteria (E. coli, Salmonella, Shigella, Campylobacter, Clostridium), viruses (Norwalk agent, Rotaviruses), and parasites (Giardia, Entamoeba, Ascaris). An infection of the intestines causes diarrhea or dysentery, nausea, vomiting, and abdominal cramping. There are numerous ways of categorizing this set of diseases. These diseases are categorized either based on location in the intestines or by how the disease was transmitted or what infectious agent does to the host. A lot of these infections are self-limiting and do not require treatment. However, some might spread to other sites in the body and require treatment to prevent further damage. 

• Bacterial Gastrointestinal Infections 
• Viral Gastrointestinal Infections 
• Parasitic Gastrointestinal Infections 
• Stomach Flu
• Enteric Fever
• Acute Self-Limited Colitis
• Mycobacterial Infections of the GI Tract
• Fungal Infections of the GI Tract
• Parasitic Infections of the GI Tract
• Diarrheal Disease
• Gastric Ulcer Disease

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Gastroenterologists

Gastroenterologists are doctors who are trained to diagnose, treat and manage diseases of the gastrointestinal tract and liver. They must obtain 5-6 years of specialized education after medical school. The unique training that Gastroenterologists complete helps them to acquire the ability to provide accurate and early diagnosis. They provide comprehensive care for patients with a wide variety of gastrointestinal ailments. Gastroenterologists perform research involving gastrointestinal endoscopic procedures as well and they are considered as experts in the field. Gastroenterologists are efficient to perform higher quality colonoscopy examinations which translates into more accurate detection of polyps and cancer Also called “GI doctors, as experts they also help both adults and children learn what they need to do to keep their system healthy.

• Gastroenterologist Training
• Gastroenterologist Scope and Opportunities
• Hepatologists
• Gastrologist
• Gastro-Oncologist

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Inflammatory Bowel Disease

Inflammatory bowel ailment (IBD) is a collection of inflammatory situations of the colon and small intestine.Crohn's disorder and ulcerative colitis are the important sorts of inflammatory bowel disease.It is mainly to notice that now not most effective the Crohn's ailment affect the gut; it can also affect the buccal hollow space, esophagus, stomach and the anuswhile ulcerative colitis mainly influences the colon and rectum.Inflammatory bowel diseases belongs to the elegance of autoimmune diseases, in which the frame’s very own immune machine assaults factors of the gastrointestinal device.

• Ulcerative Colitis
• Crohn's Disease
• Abdominal Pain and Cramping
• Race or Ethnicity
• Primary Sclerosing Cholangitis
• Fistulas

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Pediatric Gastroenterology

Pediatric Gastroenterology is subjected with treating the GIT, liver and pancreas of children from infancy until adulthood.Testing is performed the usage of PH Probes, Liver Biopsies, Breath Test, Endoscopic Procedure.The important purpose of the take a look at of pediatric gastroenterology is to lower infant and toddler rate of deaths, manipulate the unfold of infectious ailment, and promote healthful.

• Pediatric Diabetes
• Peptic Ulcers
• Peristalic Reflex
• Portal Hypertension
• Portal Vein Embolization

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Pancreatic and Biliary Disease

The pancreas is a gland which produces juices that help smash down food and hormones and help control blood sugar stages.There are two kinds of pancreatitis, that are differs in their causes and signs, and require exceptional remedy.Acute pancreatitis is a rapid-onset inflammation of the pancreas, maximum frequently due to alcoholism or gallstones.Chronic pancreatitis is an extended-standing irritation of the pancreas.This occurs while digestive enzymes begins digesting the pancreas itself.Pancreatic most cancers, Cystic fibrosis, a genetic sickness in which thick, sticky mucus can also block the tubes in pancreas.

• Pancreas Divisum
• Pancreas Transplant
• Pancreatic Cancer
• Pancreatitis
• Biliar tract Diseases
• Bilio Pancreatic Diversion

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Bariatric Surgery

Bariatric surgical operation is a weight loss surgery consists of an expansion of tactics accomplished to the humans who have obesity. Weight loss is finished with the aid of lowering the scale of the stomach with a gastric band or thru elimination of a part of the stomach (sleeve gastrectomyor biliopancreatic diversion with duodenal transfer) or by means of resecting and re-routing the small gut to a small belly pouches (gastric skip surgery).

• Laparoscopic Adjustable Gastric Banding (LAGB) 
• Gastric Balloon
• Gastric bypass–Roux-en-Y Gastric bypass
• Gastric sleeve– Vertical Sleeve Gastrectomy
• High Cholesterol Levels

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Colorectal Oncology

Colorectal most cancers, also known as bowel cancer, colon most cancers, or rectal cancer, is any cancer that influences the colon and the rectum.It is the second main purpose of cancer dying in girls, and the 1/3 for men.However, because of advances in screening strategies and enhancements in remedies, the dying rate from colorectal cancer has been falling.Colorectal most cancers can be benign, or non-cancerous, or malignant.A malignant cancer can spread to different components of the body and harm them.

• Diarrhea or Constipation
• Fatigue or Tiredness
• Chemotherapy
• Radiation Therapy
• Stool DNA Test
• Flexible Sigmoidoscopy

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Endoscopy and Hepatology

Endoscopy is a method that permits a physician to view the internal of someone's body.Originally, endoscopy was most effective used inside the esophagus, belly, and colon.Now, doctors use endoscopy to diagnose illnesses of the ear, nose, throat, coronary heart, urinary tract, joints, and stomach.This technique can be used to analyze uncommon symptoms or treat a number situations.It also can be carried out to perform a biopsy, where a small tissue sample is taken for similarly analysis.

• Laparoscopy
• Amnioscopy
• Endoscopic Spinal surgery
• Viral Hepatitis
• Gastrointestinal Bleeding

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Esophageal and Gastric Disease

Many people experience a burning sensation in their chest occasionally, caused by stomach acids refluxing into the esophagus, normally called heartburn.Extended exposure to heartburn may erode the lining of the esophagus, leading potentially to Barrett's esophagus which is associated with an increased risk of adenocarcinoma. Some people also experience a sensation known as globus esophagus, where it feels as if a ball is lodged in the lower part of the esophagus.

• Gardner's Syndrome
• Dentigerous Cysts
• Sideropenic Dysphagia 
• Hamartoma
• Echocardiography

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Pancreatic Diseases

The pancreas is a gland which produces juices that assist wreck down meals and hormones and assist manipulate blood sugar ranges.There are two types of pancreatitis, which are differs in their causes and symptoms, and require different remedy.Acute pancreatitis is a speedy-onset inflammation of the pancreas, most often as a result of alcoholism or gallstones. Chronic pancreatitis is a protracted-status irritation of the pancreas.This occurs when digestive enzymes starts digesting the pancreas itself.Pancreatic most cancers, Cystic fibrosis, a genetic disorder in which thick, sticky mucus may additionally block the tubes in pancreas.

• Pancreatitis
• Diabetes mellitus
• Cystic Fibrosis
• Exocrine Pancreatic Insufficiency
• Pseudocysts
• Neoplasms

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Gastro Esophageal Reflux Disease

Gastro esophageal Reflux Malady or Gastro esophageal reflux sickness - GERD, is a digestive turmoil that influences the lower esophageal sphincter, the ring of muscle between the esophagus and belly.Many individuals experience the sick effects of indigestion or corrosive heartburn introduced on by way of GERD Reflux intends to circulation returned or return.Along those lines, gastro esophageal reflux is the arrival of the belly's substance pass down into the throat.Gastro esophageal reflux takes place whilst the LES is feeble or unwinds improperly, allowing the belly's substance to movement up into the esophagus.

• Esophageal Manometry
• Esophageal Adenocarcinoma
• Heart Palpitations 
• Dumping Syndrome
• Hiatal Hernia

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Gastrointestinal Immunology

The gastrointestinal (GI) tract is the most effective organ whose function is controlled with the aid of its personal intrinsic enteric apprehensive gadget (ENS), however its miles moreover regulated.The GI nervous and immune systems are highly included of their commonplace intention that is to unite digestive capabilities with protection from ingested environmental threats.This evaluation discusses the physiological significance of enteric neuroimmune integration by way of summarizing the modern-day expertise of developmental pathways, cell agency, and molecular mechanisms of neuroimmune interactions inGut Immunology check verifies the immune response within the intestine by way of measuring two biomarkers, calprotectin and eosinophil protein X (EPX).The ordinary and inflammated gut includes many unique immune cells, including IgA-secreting plasma cells, CD4 and CD8 T cells, regulatory T cells and gdT cells.

• Proctology
• Transplant Rejection
• Phagocytosis
• Receptor-Mediated Endocytosis
• Peripheral Tolerance

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