Biography:

Abstract:

Gastroesophageal reflux is a condition that occurs when gastric (GERD) or gastroduodenal (EDRD) content refluxes into the esophagus.  Depending upon the degree to which duodenal secretions contaminate the gastric refluxate the refluxed material can be acidic (pH less than 4 for gastric reflux), mildly acidic (pH ranging between 4 but < 7, mildly ascitic), or alkaline (pH greater or equal 7).  The patient's symptoms are a reflection of the degree of tissue inflammation plus or minus tissue injury (erosions or ulceration) produced rather than the specific nature of the refluxed material.  Continued uncontroled/chronic reflux leads to the complications of GERD/GDRD consisting of inflammation that can progress to erosions, ulcerations, or scarring (stricture), mucosal metaplasia (Barrett's esophagus) or adenocarcinoma.

GERD is a common disorder with a world prevalence that somewhat between 10 and 30% of the population being less commonly seen in Asia as compared to Europe or the Americas.  Clinical GERD is estimated to be seen in 7% of the population is  manifested as  ‘ heartburn" and accounts for 4% of the visits to primary care physicians and is the most common reason for referral to gastroenterologist.

Complicated GERD is manifested by “alarm signals” consisting of weight loss, odynophagia, dysphagia, regurgitation, anemia and a variety of extra- esophageal symptoms ascribed to GERD consisting of hoarseness, laryngitis, bronchitis, dental enamel erosion, otitis media, sinusitis, pseudo- angina, sleep dysfunction, asthma, pneumonitis, and pulmonary fibrosis.  In addition, as a consequence of the almost universal use of proton pump inhibitors for the treatment of GERD an increase in cases of community-acquired and hospital-acquired pneumonia have been reported in the elderly as a direct consequence of the reduction in the acid secretion by the stomach and the resultant increase in viable gastric microbial concentrations.

Risk factors for GERD are common in the population and consist of the existence of a hiatal hernia, obesity, type 2 diabetes mellitus, hypertension, hyperlipidemia, advanced age, chronic hiccups, asthma, and less often sinusitis, chronic recurrent otitis media and dental erosions.  Because heartburn can be treated very effectively with proton pump inhibitors there is no need for endoscopy or other invasive diagnostic procedures to establish a diagnosis in cases of simple heartburn, GERD, or GERD.  The use of endoscopy, pH monitoring, with without impedance determination, and esophageal manometry are reserved for those individuals manifesting "alarm symptoms", those who have failed treatment with a proton pump inhibitor and those being considered for reflux surgery.  Endoscopy is used to grade the severity of reflux inflammation and the identification of erosions or ulcerative disease and assess the patient for the more severe or advanced complications consisting of stricturing, Barrett's esophagus and/or adenocarcinoma.  Ambulatory pH monitoring is used to document reflux and define its character (acid, mildly acid, or alkaline), its frequency, and duration as well as its relationship with symptoms as reported by the patient.  Manometry enables a quantitative assessment of esophageal motility and measurement of the frequency of transient esophageal relaxations, and the duration of the reflux exposure as well as the ability to rule out the presence of achalasia, a contraindication to reflux surgery.

Reproducible therapies of GERD consist of the administration of proton pump inhibitor taken one to 2 hours before the first meal of the day for 12 weeks.  Failure to respond to find a symptomatic relief is managed by a doubling of the morning  proton pump inhibitor dose with or without the addition of an H2 receptor antagonist at that time which is utilized particularly for those with nocturnal reflux symptoms or sleep apnea.

Prokinetic agents are used exclusively when alkaline reflux is present to prevent alkaline reflux by increasing esophageal contractions (esophageal clearance), to increase lower esophageal resting pressure to prevent reflux ,  and enhancement of gastric and duodenal motility there by reducing the volume of gastric/duodenal content available for reflux.  The use of these agents is limited by the development of tolerance within a short period of time, their short duration of action, and their adverse effects consisting of tremor, fatigue and cardiac arrhythmias. 

A large number of abnormal anatomic variations at the gastroesophageal junction and physiologic and neuroendocrine reflexes occur  as high frequency in cases of GERD and our thought  to contribute to the pathophysiology of the disorder.  Disease consist in part consist of lower esophageal sphincter incompetence, reduced resting lower esophageal pressure, the presence of a hiatal hernia, reduced esophageal clearance, increased frequency of transient esophageal relaxations, esophageal, gastric and/or duodenal motility disorders.  With the exception of surgical repair of anatomic variants, the identification of these abnormalities has not contributed substantially to the treatment of GERD/GDRD.  This is particularly true of the research directed at the identification of neuro- and endocrine mechanisms that could contribute to esophageal dysfunction and reflux.

For those who fail extended proton pump therapy or develop complications including an esophageal stricture, Barrett's esophagus, esophageal cancer, chronic intractable reflux symptoms often manifested as chronic hiccups, or morbid obesity, surgery is the treatment of choice and consists of any variation of the Nyssen procedure done laparoscopically or any of the variations bariatric surgery.  These surgical procedures produce long-term benefit but often with minor relapses that necessitate the use of an additional acid inhibitory agent for a PPI or H2 receptor antagonists and occasionally a prokinetic agent as well.

Recently, a large variety of endoscopic procedures consisting suturing the lower esophageal sphincter, Silastic implants and endoscopic fundoplication have been developed with for use in the treatment of GERD, but these agents are agents are still investigational and have not yet obtained FDA approved

Biography:

He graduated in medicine and surgery, on 11/12/1981. The same year he entered graduate school in Digestive System Diseases directed by Prof.Aldo Torsoli, working in particular with his young researcher, now a professor of gastroenterology in Rome: prof. Enrico Corazziari. Since then I have always been interested in the study of the pathophysiology of the Digestive Tract and neurogastroenterology. Up to now, he focus my studies on organic and functional disorders of the digestive system. For years he work with the best specialists in every sector and structure, public and private, to understand and solve a 360 ° diagnostic and therapeutic issues of Gastroenterology.

He have to my credit numerous publications and participation at conferences. He maintain, the beginning of specialization, the study of the motility of the Digestive Tract.

He always run Digestive standard manometry, pH-metry, pH-Impedance, CH4 H2-Breath Test, Pelvic Floor Rehabilitation (pelviperineale pain urogineproctologico origin, urinary incontinence, obstructed defecation syndrome, fecal incontinence, etc.) its rehabilitation treatment.

Currently, in October 2014, my army activities at the Clinica Pio XI, Via Aurelia 559 Rome, with new and sophisticated equipment (manometry HIGH RESOLUTION with a neurological module for EMG).

Abstract:

Biography:

Abstract:

Introduction. American Gastroenterologists Association 2008 guidelines suggests antireflux surgery to be reserved for patients with esophagitis and intolerance to PPI and patients with poor control of the gastro-esophageal reflux symptoms, especially regurgitation. Laparoscopic Nissen-Rossetti fundoplication has become the gold standard, being a well tolerated operations and considering its good outcome in terms of symptoms relief.

Laparoscopic Nissen-Rossetti fundoplication. In 1939 Rudolph Nissen improvised a fundoplication to protect an esophagogastric anastomosis. Some years later he performed this procedure to treat gastro-esophageal reflux disease and published the first description of the procedure in 1956. What we now call Nissen-Rossetti fundoplication is the result of the contribution by Nissen’s favourite pupil, Marco Rossetti. Nissen-Rossetti fundoplication consists in an extensive mobilization of the posterior wall of the stomach, which enables a loose wrap of the anterior wall to be used for the total wrap, without the division of the short gastric vessels. This procedure showed good results in term of post-operative dysphagia. With the extensive application of laparoscopic surgery during the 1990s, the volume of antireflux surgery increased. At the present time Nissen-Rossetti compare favorably in terms of mortality and morbidity with appendectomy and cholecystectomy.

Technological innovations. Where is antireflux surgery going from now on? First of all, robotic-assisted surgery. Although as of now robot-assisted surgery still has an unacceptable high cost for benign pathology, numerous studies are reporting comparable results in terms of outcomes versus laparoscopic surgery.

An interesting new device is LINX^©, or Magnetic Sphincter Augmentation (MSA), a small flexible band of interlinked titanium beads with magnetic cores that works by restoring the continence of the lower esophageal sphincter. This device can be easily placed around the gastro-oesophageal junction in about 30 minutes.However it needs longer follow-up and has some limitation: it can’t be used in hiatal hernias larger than 3 cm, the safety and effectiveness of the LINX device has not been evaluated in patients with Barrett's esophagus or Grade C or D (LA classification) esophagitis and in patients with electrical implants such as pacemakers and defibrillators, or other metallic, abdominal implants.

Conclusions. LNR procedure should be considered the gold standard to treat patient with refractory GERD. 2013 UK REFLUX trial concluded that a surgical policy is probably cost-effective, considering LNR in a 5 years follow-up provided a better health-related quality of life compared with medical management. Waiting for a mininvasive techniques standardisation and long term follow up, patients should be aware of the safeness and feasibility of laparoscopic Nissen-Rossetti fundoplication. 

Biography:

Antonio Iannetti has done his degree in Medicine and Surgery and Specialties in "Gastroenterology" and "Internal Medicine" at the University of Rome. 1980-1983 University of Los Angeles (USA), he is interested endoscopic sclerosis of esophageal varices and retrograde cholangiopancreatography-endoscopically. He is University Professor and Chair of Gastroenterology - University of Rome. He is head of the Digestive Endoscopy Service of the University Hospital Umberto I in Rome. He is an expert of the Ministry of Health for Gastroenterology. 

Abstract:

Introduction: The incidence of gastroesophageal reflux disease in the population of industrialized countries is high and ranges from 20 to 40% in the age groups between 45-64 years, with a further increase in the incidence in the age between 64-74 years. The natural history of the disease requires continuous recrudescence alternated with quiescent phases. In view of these epidemiological data, the importance of the social problem and the high health costs is cleared. It follows the interest of pharmaceutical companies, the companies of electromedical and producing toolkits endoscopic and surgical companies.

Objective: In this session, I intend, with the participation of colleagues internists and surgeons, to make a brief stock of the situation, about the gastro-esophageal reflux disease. I will make a tour of the clinical presentation, the increase of incidence, especially of so-called atypical forms and symptoms of gastro-pharingeal reflux (high reflux), emphasizing how many patients are refractory to therapy. Patients who benefit from medical treatment, they become dependent on care. Whereas, many are young and that medical therapy has adverse side effects, such as anemia, osteoporosis, and infections, is the need for alternative therapies. Physiotherapy global posture, for example, can be a transient and partial support. The ultimate solution is or should be surgical.

Considerations: Surgical therapy makes use of minimally invasive or laparoscopic method, which shortens the hospital stay. But an endoscopic surgery, easy, repeatable, free from postoperative complications, can be performed in day surgery, would be ideal for this type of chronic disease. In reviewing the different techniques, that have been proposed over the last 20 years, I relate the considerations, derived from the international literature. This presentation is concluded by presenting a last device, manufactured in Germany, derived from its precursor, the NDO Plicator, which is making use of the addition of heads polytetrafluoroethylene (PTFE), which retain the suture threads from the traction, exerted by the tissues, seem to improve the seal in time.

Conclusions: I carry scientific studies that have compared the operations, performed with GERD-X Plicator, to surgical interventions of fundoplication, with satisfactory results. My invitation is to continue to seek solutions with endoscopic surgery, which is the most appropriate technique for this type of pathology.

Biography:

Abstract:

Biography:

Abstract:

Biography:

Dr. Andrea Formiga has completed his PhD at the age of 25 years in Milan University Italy. In  2002 he has completed the postdoctoral speciality in general surgery. He is the director of the General Surgery Department of Istituti Clinici Zucchi of Monza (Italy) – Gruppo San Donato.

Member of International Advisory Board for Apollo Endosurgery

He has published many documents in surgical and endoscopic treatments for general surgery and obesity procedures.

He has partecipate to many national and international congresses.

Abstract:

The Endobarrier system is an innovative reversible endoscopic system indicated for the treatment of diabetes mellitus type II and obesity. The duration of treatment is one year.

The process involves a decrease in glycated hemoglobin of 2 points in the year of treatment with reduction and/or elimination of oral hypoglycemic agents and/or units of insulin administered daily, improved lipid profile and liver function tests, reduction of blood pressure, and weight loss of about 40% of excess body weight. The system is totally endoscopic, simulates the effect obtained with a laparoscopic gastric bypass but without making sections and/or removal organ.

Method: From March 2014 to November 2016 we performed 20 placements of Endobarrier system (15 men, 5 women), of whom 16 successfully concluded and extracts, 4 still in progress; 2 System extractions of foreign patients who had undergone placement in other countries (Australia, South Arabia), 1 missed positioning for non-compliant patient anatomy (inability to access the capsule in the duodenal bulb). The average hospital stay of patients was 1 day. The mean age of patients was 46 (24-63 aa) range. All positioning and extraction operations were performed under general anesthesia.

Results: The mean preoperative BMI was 45.8, average BMI 37.8 postoperatively; preoperative Hb A1c 8.9 / postoperative HbA1c 6.6; PA values systolic / diastolic mean preoperative 134 / 85.7, PA values postoperative systolic / diastolic 124.7 / 71.8.

Complications: we found the appearance of a duodenal ulcer bleeding in the vicinity of the metal anchoring system of the system that was treated with medical drugs and with the removal of the system; in the same patient appearance of mild pancreatitis with high levels of amylase (400) and lipase (200) resolved spontaneously after removal.

One hepatic abscess in a foreign patient came to our attention from other structure to which it was addressed in urgency.

Conclusions:

The endoscopic endoluminal treatments are now having great expansion and interest even in the treatment of morbid obesity and diabetes

The Endobarrier System is an innovative totally endoscopic malabsorptive reversible treatment that can have an important role in the treatment of diabetes mellitus type II and obesity.

Our experience has shown the effectiveness and feasibility of Endobarrier system. It remains to evaluate the results in the time after removal.

Biography:

Kenji Sasaki completed his MD and, as an Immunologist, he completed his PhD at Tohoku University School of Medicine. He was trained at Miyagi Cancer Center. He is a Board Certified Fellow and Preceptor of Japan Gastroenterological Endoscopy Society, Board Certified Gastroenterologist of Japanese Society of Gastroenterology, Board Certified Member of the Japanese Society of Internal Medicine and Editorial Board Member of CRIM. He has published several papers on Gastroenterology in international journals and served as a Reviewer for Journal of Medical Microbiology, Journal of Pharmacology & Pharmacotherapeutics and Journal of Gastrointestinal & Digestive System.

Abstract:

Biography:

Omesh Goyal is working as an Associate Professor in Gastroenterology and Hepatology in a tertiary care institute in northern India. He has done lot of research work on chronic hepatitis C and complications of cirrhosis. His other major interest includes functional bowel disorders and ano-rectal manometry. He is a part of the Indian working group on Chronic Constipation which will formulate guidelines for constipation in India under the leadership of Dr Uday Ghoshal. His research work in has been acclaimed at international level. He won the National Scholar Award at UEG in Sweden and Best paper award in APICON in Hyderabad, India. He is working as an editor of the Journal of Gastrointestinal Infections and is an active member of various academic bodies.

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Biography:

Anna DePold Hohler is an Associate Professor of Neurology at Boston University School of Medicine.  Her research interests include “Autonomic research in Parkinson’s disease and postural tachycardia syndrome”. She has described the genetic association between POTS and Ehlers Danlos type III. Recently, she has explored gastrointestinal, sleep, and dermatologic disorders in this population. She has numerous publications and is an expert and frequent Reviewer.  She has dozens of publications and serves as an Associate Editor of Continuum, one of the premier neurology journals.  She is the recipient of numerous awards, including army achievement and commendation medals and two meritorious service medals for excellence in clinical and teaching skills while serving on active duty. She also received BUSM’s prestigious Stanley L. Robbins Award for Excellence in Teaching and several Neurology teaching awards, including two from the American Academy of Neurology (AAN). She co-chairs the AAN Quality Safety Subcommittee.

Abstract:

Postural Tachycardia Syndrome (POTS) is associated with a number of systemic effects including gastrointestinal (GI) dysfunction.  The most commonly reported GI symptoms are nausea, irregular bowel movements, abdominal pain, and constipation. Many POTS patients report GI symptoms more than once per week.  They often require a GI specialist. The POTS patients often have gastroparesis or delayed gastric emptying.  GI disturbances are frequent and prolonged in patients with POTS, impacting quality of life. Given the importance of the enteric nervous system to normal GI functioning, the same autonomic impairment leading to POTS may result in abnormal gut motility and ultimately subjective GI discomfort. Treatment of autonomic dysfunction in POTS and dietary changes may improve GI dysfunction associated with POTS. 

Biography:

Abstract:

Biography:

Deog-Yong Lee has completed his Doctor of Veterinary Medicine (DVM) and Ph.D. at Seoul National University. He is a Staff Scientist and team leader of enteric virus team in Division of Enteric Disease, KCDC. He has published more than 100 papers in reputed journals.

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Biography:

Nevena Ilic has completed her MhD in Endocrinology at Belgrade University Medical School in 2009 and Master’s degree in Thyroid Diseases in Italy, 2014. She completed Internal Medicine Specialisation at Military Medical Academy Hospital, Belgrade in 2002. From 2014, she works as Prime Endocrinologist at Euromedik General Hospital, Belgrade, where she organized endocrinology service and several symposiums in Belgrade and Rome, where she was a speaker. She spoke at several international congresses. She has published three papers in reputed journals as a first autor and many papers as the one of co-autors. She is a member of European and Italian Endocrinology Society. 

Abstract:

The gastrointestinal tract is an organ essential for the digestion and extraction of nutrients, but it’s also body’s largest endocrine organ. First discovered hormones at the beginning of the 20th century were gastrin, secretin and cholecystokinin. Now, we discuss about more than 30 different regulatory peptide hormones and more than 10 types of endocrine cells found in stomach, small and large intestines, such as incretins (glucose-dependent insulinotropic peptide and glucagon-like peptide-1), peptide YY, oxyntomodulin, ghrelin, obestatin and others. The role of gut hormones in energy homeostasis has been studied over the past 20 years. A great deal of researches in last years had shown the relationship between gastrointestinal hormones, obesity and type 2 diabetes, starting with incretin concept. Now, we have therapies based on gut hormones as targets, for patients with obesity, diabetes and non alcoholic fatty liver. Latest data present gut peptides as novel regulators of intestinal lipoprotein secretion and thus may have a great role in cardiovascular risk. Studies confirmed that gut hormones play a critical role in the regulation of metabolic, water and salt homeostasis and the development of hypertension and cardiovascular diseases. Recent investigations explained molecular mechanisms connecting gut hormones, insulin resistance and malignancies as well as inflammation processes in organism. Gut-brain axis and metabolism in polycystic ovary syndrome and it’s treatment has been a subject of polemics on recent endocrinology debates. Finally, there is a link between gut, adipose hormones and reproductive system and fertility in both sexes.

Biography:

Purnama Andriana has completed his Digestive Surgeon education at Hasan Sadikin Hospital, Padjadjaran University, Indonesia. He attended many digestive surgery courses and fellowships, including Laparoscopic Colorectal Fellowship at Singapore General Hospital (2009), Minimal Invasive Surgery training at Academisch Medisch Centrum Amsterdam (2012) and, Endoscopy Laparoscopy training at Queen Mary Hospital, Hong Kong (2013). He has become Digestive and General Surgery Consultant Staff at Padjadjaran University, Indonesia.

Abstract:

Perforated gastric ulcer is still the most common indication for emergency gastric surgery associated with high morbidity and mortality. Outcome might be improved by performing laparoscopy. The aim of this study was to evaluate the outcome of laparoscopy at Hasan Sadikin Hospital. The outcome laparoscopy approach and the associated morbidity and mortality, operation time, conversion rate and hospital stay were assessed and compared with laparotomy. There were 30 patients (24 males, 6 females) with perforated gastric ulcer with mean age 72.14, non-malignant cause was documented during January 2015-Desember 2015. Patients with Boey’s score 0-1, ulcer diameter less than 2 cm at anterior site, underwent laparoscopic gastric perforation closure with omental patch and the rest were laparotomy. Observation from 15 patients underwent laparoscopy with no conversion, resulted in a better outcome from duration of operation 60-90 minutes (mean 79.57) than laparotomy 60-120 minutes (mean 85.73). Postoperative pain was found better outcome in laparoscopy VAS 3.93, laparotomy 6.27. Early diet was implemented in laparoscopy patients according to ERAS from POD one. Length of hospital stay in laparoscopy group was five days and 10-12 days (mean 10.5) in laparotomy. Incidence of surgical site infection was found in five patients, leakage from perforated site in six patients and mortality in six patients, all of them were found in laparotomy group. Laparoscopy closure of perforated gastric ulcer is a safe therapeutic method with strict selection of patient criteria. Based on low rates of morbidity and mortality, we should encourage laparoscopy implementation in gastric ulcer perforation case.

Biography:

Ulrike Stein completed her Diploma degree at Martin-Luther University Halle, Germany and PhD at Humboldt University Berlin. For her Post-doctoral studies, she joined the laboratory of Dr. R H Shoemaker at National Cancer Institute/NIH Frederick as Feodor-Lynen-Fellow of Alexander von Humboldt foundation. She received her Habilitation at Charité Universitätsmedizin Berlin and appointed as Professor. She heads the research group of Translational Oncology of Solid Tumors at Experimental and Clinical Research Center, Charité Universitätsmedizin and Max-Delbrück-Center for Molecular Medicine in Berlin. Her research is focused on “Understanding and intervening in tumor progression and cancer metastasis formation”. She has published more than 130 papers in reputed journals. She is an Editorial Board Member and Reviewer of several journals. She received various national and international scientific awards.

Abstract:

Biography:

Kondratskyy Y is Head of Esophageal and Gastric Tumors department at National Cancer Institute, Ukraine. He is the recipient of numerous awards for his expert research works in related fields. His research interests reflect in his wide range of publications in various national and international journals.

Abstract:

Biography:

Baris Cankaya completed his Graduation at Ankara University Medical Faculty in 2000. He has been working as Anaesthesiology Specialist at Marmara University Training Hospital. He has attended academic meetings, nationally and internationally. His academic interest includes “Microcirculation, fluid therapy, resuscitation, patient safety and perioperative analgesia”. Some of his certificates are EPLS provider Berlin 2015, NLS provider Athens 2015 and MECOR Level I October 2014. He attended international workshops like ECMO workshop 2015, Leicester and Airway workshop, ICISA 2014, and Tel Aviv.

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Biography:

Esam Elshimi is working at Menoufia University, Egypt. He is the recipient of numerous awards for his research works in related fields. His research interests reflect in his wide range of publications in various national and international journals.

Abstract:

Biography:

Esam Elshimi is working at Menoufia University, Egypt. He is the recipient of numerous awards for his research works in related fields. His research interests reflect in his wide range of publications in various national and international journals.

Abstract:

Biography:

Hüseyin Sancar Bozkurt has completed his PhD at the age of 24 years from Trakya University and  Ä°nternal Medicine at the age of 30 from Çukurova University. He has completed gastroenterology education at the age of 33 years from Adana BaÅŸkent University. He has published multiple national and international papers.

Abstract:

Biography:

Statement of the Problem: Functional constipation (FC) and constipation-predominant irritable bowel syndrome (IBS-C) are a part of functional bowel disorders, and have a significant personal, healthcare, and social impact. Evaluation by anorectal manometry is essential in these cases for targeted treatment. Data on the anorectal manometric abnormalities in these patients is scarce. We aimed to study the anorectal manometric abnormalities in patients with functional constipation and constipation-predominant IBS in northern India. Methodology & Theoretical Orientation: A total of 114 consecutive patients with the history of chronic constipation who underwent anorectal manometry from January 2013 to December 2016 in a tertiary care institute were enrolled. Standard laboratory tests and colonoscopy were normal. Twenty-six healthy volunteers served as controls. Finding: The mean age was 46.7 years, 75.4% were males, and the median duration of constipation was 60 months. Sixty-two patients satisfied ROME IV criteria for functional constipation (FC) and 52 had Irritable bowel syndrome- constipation predominant (IBS-C). A comparison of the anorectal motor and sensory manometry parameters along with healthy controls is shown in the table. The resting anal pressure and the squeeze pressure were similar in all subgroups. Dyssynergic pattern of defecation was seen in significantly more patients in the FC group (p<0.001). The first sensation threshold was significantly higher among FC patients. The thresholds for the desire to defecate and maximum tolerable volume were significantly higher among FC and IBS-C patients compared to controls. Conclusions and significance: Dyssynergic pattern of defecation is seen in significantly more patients with FC compared to IBS-C. Patients with FC have marked the elevation of all sensory thresholds, while IBS-C patients have similar first sensation threshold with the elevated threshold for urge and maximum tolerance.

Abstract:

Omesh Goyal is working as an Associate Professor in Gastroenterology and Hepatology in a tertiary care institute in northern India. He has done a lot of research work on chronic hepatitis C and complications of cirrhosis. His other major interest includes functional bowel disorders and ano-rectal manometry. He is a part of the Indian working group on Chronic Constipation which will formulate guidelines for constipation in India under the leadership of Dr. Uday Ghoshal. His research work in has been acclaimed at international level. He won the National Scholar Award at UEG in Sweden and Best paper award in APICON in Hyderabad, India. He is working as an editor of the Journal of Gastrointestinal Infections and is an active member of various academic bodies.

Biography:

Shuaib Meghji is currently studying at University Hospital Southampton, UK.

Abstract: