Department of Gastroenterology


The Gastroenterology Department

The digestive system starts in the mouth and ends in the anus, from which the liver branch, the bile ducts (gallbladder) and the pancreas all connect. The role of this system is to absorb the food we eat, analyze it and process it through the small intestine.
The pancreas is one gland, in addition to the liver, related to the digestive system.  In addition to its importance in the secretion of digestive juices and bicarbonate; it also produces various hormones, including insulin and glucogen.
The liver is an important metabolic organ. Its function is to form and dissolve sugars, proteins and fats. It also decomposes toxic substances in the body and removes them through the gallbladder.
The digestive system receives most of the blood supply through three main arteries:

  • Celiac artery.
  • Upper Mesenteric Artery.
  •  Inferior Mesenteric Artery. 

There are many tests and methods that help doctors to know the causes of the disease, and the diagnosis of various diseases of the digestive system

  • X-ray imaging: In this picture, it is possible to detect calcification in the pancreas, stones in the gallbladder, intestinal obstruction and gas dispersion.
  • Barium photography: Barium can be consumed through the mouth or inserted in the anus to show different conditions in the digestive system such as infections, tumors and ulcers.
  • Rectoscopy: In this test, a tube is inserted into the last part of the digestive system. The lining of the gastrointestinal tract can be seen and a sample can be taken for testing.
  • Colonoscopy: The large intestine is examined by a flexible optical device, which allows for direct observation of the entire length of the colon, biopsy and even eradication of small polyps.
  • Gastroscopy: The esophagus and stomach are examined by a flexible optical device that allows for direct observation of mucous membranes and biopsies. Sometimes, a small bleed can be stopped through this method.
  • Ultrasound (US): Allows scanning of the abdominal area.
  • Cholecystography: The examination is performed by filling the gallbladder with a contrast substance through oral pills, or by injecting them into the veins IVC.
  • CT: The examination allows in a very precise and clear way the different abdominal organs such as liver, spleen, pancreas, lymph nodes and others.
  • Endoscopic Retrograde Cholangio-Pancreatography (E.R.C.P): An endoscopic test that assists in the diagnosis of bile ducts and pancreas. This method can be used for diagnosis and treatment.
  • Nuclear medicine: There are different types of atomic scanning which use radioactive materials that facilitate the diagnosis of diseases of the digestive system; for example, the atomic survey of liver and spleen.
  • Percutaneous transhepatic cholangiography (P.T.C): A test for patients with bile duct obstruction done by injecting the needle through the skin down to the liver, and injecting the materials inside to diagnose the possibility of blockage of the bile ducts.

Diseases of the digestive system:

Esophageal Diseases: which include:

  1. The difficulty of swallowing (Dysphagia).
  2. Esophagitis.
  3. Hiatal Hernia.
  4. Esophageal spasm.
  5.  Achalasia.
  6. Divert icicle.

Peptic Ulcer: An ulcer is a hole in the gastrointestinal tract that is exposed to gastric acid and the Pepsin enzyme. This condition can occur in humans of all ages

Intestinal obstruction (Ileus): A condition in which there is an intestinal obstruction, varying in its degrees and locations, preventing the flow inside the intestine and its normal movement.

Diarrhea: A phenomenon in which the secretion of liquid feces occurs several times a day. Diarrhea can be severe (sudden onset and lasts a few days), or chronic. The term diarrhea is relative and includes an increase in secretion of fluid feces for the same person.

Constipation: The difficulty of movement inside the intestines or becoming abnormal, which is also a relative term, as it varies between one person and another as in diarrhea. Causes of constipation are varied and include various diseases that cause partial obstruction of the intestine such as tumors or inflammatory operations in the anus area. 

Irritable bowel syndrome: A syndrome characterized by a defect in the function of the colon leading to changes in bowel habits (such as intermittent constipation and diarrhea or abdominal pain). These symptoms are not serious in themselves, and do not lead to serious disease in the future, except that it is very annoying to the patient.

Crohn’s disease: Inflammatory diseases of the gastrointestinal tract caused by unclear reasons. Usually, it affects the peripheral part of the small intestine (Terminal Ileum) but it can also occur in other areas of the digestive system.

Ulcerative colitis: is one of the inflammatory diseases affecting the large intestine, caused by unknown reasons.  It usually affects the lower northern part of the large intestine, but can spread to the whole length of the intestines

MegaColon: The term means the increasing size of the large intestine as compared with its normal size. There are two types of colorectal enlargement: congenital or acquired Megacolon.

Acute Appendicitis: This is one of the most urgent medical conditions that require surgical intervention to remove the inflamed organ. There are factors that help to develop inflammation such as blockage of the appendix and bacterial spread within it.

Vascular disease of the intestine – Vascular inflammation: The lack of adequate supply of blood can cause intestinal ischemia and is similar to the condition that prevails in the heart when it does not get enough blood through the main arteries.

Gastrointestinal bleeding is an urgent condition that requires immediate hospitalization to determine the source of the bleeding and to try to stop it through many therapeutic methods, including surgical interventions.  Symptoms of gastrointestinal bleeding include bloody vomiting or the emergence of blood in the wastes or black pigments

Malabsorption: A condition in which there is the insufficient absorption of specific nutrients due to pathological reasons in the gastrointestinal mucosa, as well as improper digestion of food within the digestive system itself. The most common causes of malabsorption include Adult Celiac Disease and Whipple’s Disease.

Food Allergy: Local or systemic food allergies, caused by the body’s immune system response to any food substance that has a sensitivity against it. Allergy symptoms can be abdominal swelling, burning in the mouth, vomiting, abdominal pain, diarrhea and joints pain.

Peritoneum disease: When a peritoneal membrane is suspected, it requires a quick diagnosis of the cause, which can be one of the following:

  • Existence of air in the peritoneal cavity: This occurs if there is a hole in the stomach or intestine, which requires intensive medical care.
  • Peritoneal inflammation: This occurs when bacteria pass from one intestine to the surrounding peritoneal membrane (as in appendicitis). This is an emergency that calls for rapid medical intervention.
  • Aspiration: the presence of a lot of liquid in the peritoneal cavity due to diseases such as liver diseases or malignant diseases.

In these cases, failure to provide treatment for the patient leads to rapid loss of fluid and carotene, disorders in the pH base, sepsis, creating abscesses in the abdominal cavity and death.

Diseases of the gallbladder and bile ducts:

Gallstones are formed from different components, but mostly they are the gallbladder salts, cholesterol and calcium salts, as well as Bilirubin (the toxins coming from the liver). Stones can be found in the bile ducts (this is called Choledocholithiasis), or in the gallbladder itself (this condition is called Cholelithiasis). Bile ducts narrowing are not necessarily caused by stones, but other diseases can cause it.

Examples of gallbladder and bile ducts diseases include:

  • Acute Cholecystitis: Acute cholecystitis usually develops in patients who have gallstones.
  • Bronchitis: In patients with biliary duct inflammation, the inflammation of the intestine is escalated along the common bile duct, patients suffer from fever, chills, and jaundice.
  • Narrowing of the bile ducts: The presence of biliary inflammation can cause the appearance of a scar. As a result, narrowing of the bile duct may develop, which at certain stages require surgical intervention for repair.

Pancreatic diseases: Includes pancreatitis which can be a severe disease. Symptoms include severe pain in the upper abdomen accompanied by fever, low blood pressure, nausea and vomiting. While in chronic inflammation, pancreatic tissue is destroyed by fibrosis, which appears after inflammation. Cystic Fibrosis is an inherited disease. In this disease, the secretion of the digestive system is viscous, thus closing the external outlet pipes.

Liver diseases: The liver is an organ with many different metabolic functions. The lack of these functions leads to disorders in the metabolic functions and the emergence of various diseases such as

– Acute viral hepatitis.
– Hepatitis (Fulminant Hepatitis).
– Toxic Hepatitis.
– Chronic active hepatitis.
– Cirrhosis.

 The most common tumors in the digestive system:

Carcinoma: Carcinoma is one of the most common tumors in the organs of the digestive system, with different causes of tumor for each body part. For example:

  1. In the esophagus: The disease is often diagnosed in smokers, alcoholics and patients with dyspepsia (Sideropenic Dysphagia).
  2. Gastric carcinoma:  may appear in patients with chronic and active hepatitis. Also, Gastric carcinoma may be caused by a hereditary reason.
  3. Large intestine: Carcinoma in the large intestine is the most common cancer type in the body. It is constantly on the rise and is a serious epidemiological problem. Unfortunately, the symptoms of this tumor cannot be diagnosed early, so it might be found after the tumor has become advanced or has spread to several areas In the body.
  4. Gallbladder and bile ducts: Because of its location, the tumor blocks the bile duct which may lead to clear jaundice without any other symptoms, and this is called mild jaundice.
  5. Liver: Liver tumors can be primary or secondary. The most common primary tumor is hepatocarcinoma, which is often seen in patients with cirrhosis. Secondary tumors are tumor ramifications from other organs such as the stomach or lungs.
  6. In the pancreas: it is a malignant tumor that is often found in the pancreatic ducts. If the tumor is located in the upper part of the pancreas, it can cause jaundice, but if it occurs in the pancreas itself or at the end of the pancreas, it usually causes severe pain.

From the physiological aspects of such diseases:

  • Jaundice: A condition that increases the concentration of bilirubin, which affects the deposition of bilirubin in the tissues and with it shows the typical yellow color of the patient.
  • Portal Hypertension: A condition in which there is increased pressure in the portal blood system, where the venous blood flows from the spleen and intestine towards the liver.
  • Neurological disorders in liver diseases: These disorders may range from confusion to deep consciousness loss (Hepatic Coma).
  • Change in medications disassembles: Patients with impaired liver function are unable to discharge and disassemble medications.
  • Endocrine changes: In patients with liver disease, there are different conditions resulting from changes in the endocrine system, such as hypoglycemia and other conditions.
  • Metabolic changes: The patient’s liver is unable to function in controlling the concentration of blood sugar, and patients may suffer from hypoglycemia.
  • Blood changes: Various liver diseases may affect blood cells, which lead to the development of anemia and coagulation disorders.
  • Kidney changes: The kidney may be damaged in patients with liver disease, from toxins that cause damage to the liver and kidneys.
  • Skin changes: Some liver patients may complain of severe itching in the skin, and in some patients with cirrhosis, we can find vascular tumors (enlargement of the arteries).
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