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Gastro 2016
August 11-12, 2016
Volume 6, Issue 4(Suppl) J Gastrointest Dig Syst 2016
ISSN:2161-069X JGDS, an open access journal
conferenceseries .com
August 11-12, 2016 Birmingham, UK
6th Global Gastroenterologists Meeting
Bariatric surgery and diabetes
Hala Aly Gamal El Din
Cairo university, Egypt
Egyptians are the fattest Africans, says WHO. Approximately 90 percent of type 2 diabetes mellitus (T2DM),the most
common form of diabetes, is attributable to excessive body fat. Bariatric/metabolic surgery is a legitimate and cost-effective
approach to the treatment of type 2 diabetes in obese patients in cases where treatment with diet, exercise, and medications
have proved to be insufficient, bariatric/metabolic surgery can be an alternative and/or additional treatment for obesity and
type 2 diabetes.
Crohn’s disease (in adults)
G Bhanu Prakash
Global Institute of Medical Sciences, India
Introduction: Crohn’s disease (CD) is of idiopathic etiology which is characterized by transmural inflammation of the various
parts of the gastrointestinal tract (most common location is terminal part of the ileum and ascending colon). Crohn’s disease
involvement in various parts of GIT are as follows:
Clinical manifestations: Patients can have symptoms for many years prior to diagnosis
Abdominal pain: Most common presentation is crampy abdominal pain in right lower guardant or in the peri umbilical
region. Pain is often relieved by defecation.
Diarrhea: Prolonged diarrhea without bleeding is suggestive of inflammatory bowel disease (IBD). Diarrhea is due to bile salt
malabsorption due to an inflamed or resected terminal ileum which often leads to steatorrhea.
Bleeding: Bleeding associated with diarrhea in uncommon in CD. (10% patients occasionally may show microscopic levels
of blood in guaiac or immunochemical test). Aphthous ulcers is most common earliest clinical manifestation. Mass and
tenderness in right iliac fossa is observed.
Other gastrointestinal involvement: Esophageal involvement may present with odynophagia and dysphagia. Gastroduodenal
CD, may present with upper abdominal pain and symptoms of gastric outlet obstruction. Reduction in the bile acid to
cholesterol ratio increases the risk of formation of pigmented gallstones due to impaired bilirubin metabolism.
Systemic symptoms: Fatigue is a common feature of CD. Weight loss and loss of appetite may also be related to malabsorption
and the degree of diarrhea.
Extraintestinal manifestations: 1) Arthritis - Most common extra intestinal manifestation of CD includes arthritis of
large joints. Central or axial arthritis, such as sacroiliitis, or ankylosing spondylitis can be seen. 2) Ophthalmic involvement
- Ophthalmic involvement includes uveitis, iritis, and episcleritis. 3) Skin changes - Erythema nodosum and pyoderma
gangrenosum. 4) Pulmonary involvement - Pulmonary manifestations of CD include bronchiectasis, chronic bronchitis,
interstitial lung disease, bronchiolitis obliterans with organizing pneumonia (BOOP), sarcoidosis, necrobiotic lung nodules,
pulmonary infiltrates with eosinophilia (PIE) syndrome, serositis, and pulmonary embolism. 5) Primary sclerosing cholangitis
is observed. 6) Fistulas - 1/3rd of the patients present with fistulas. More commonly perianal. 7) Secondary amyloidosis is
seen in severe forms of CD that leads to renal failure and multi organ dysfunction. 8) Venous and arterial thromboembolism
resulting from hypercoagulability. 9) Renal stones due to severe malabsorption are common. 10) Bone loss and osteoporosis
due to impaired Vitamin D and Calcium absorption is also observed. 11) Vitamin B12 deficiency leads to pernicious anemia.
J Gastrointest Dig Syst 2016, 6:4(Suppl)