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Global summit on Pancreas, Gastroenterology and Digestive Diseases, will be organized around the theme “Implementing the new research ideas to eradicate pancreatic cancers”

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Both an organ and a gland, the pancreas. The body's glands are organs that manufacture and secrete chemicals. Two primary tasks are carried out by the pancreas: Produces chemicals (enzymes) that aid in digesting as part of its exocrine function. Function of the endocrine system: Releases hormones that regulate blood sugar levels. In the upper left abdomen, behind the stomach, is where the pancreas is situated. Other organs such as the liver, spleen, and small intestine surround it. It is spongy, six to ten inches long, and shaped like a fish stretched out horizontally over the abdomen or a flat pear.

 

 

The Gastrointestinal Oncology specializes in the diagnosis and multidisciplinary management of patients with pre-cancerous and cancerous conditions involving the esophagus, stomach, small intestine, colon, rectum, pancreas, retro peritoneum, and other intra-abdominal organs. Smoking is a risk factor. A diet high in animal fat, alcohol use, and chronic pancreatitis may all be risk factors. Hereditary pancreatitis patients are more likely to develop pancreatic cancer than the general population.

The main treatments for stomach cancer are:                                   

Surgery for Stomach Cancer                          

Chemotherapy for Stomach Cancer

Targeted Drug Therapy for Stomach Cancer

Immunotherapy for Stomach Cancer

Radiation Therapy for Stomach Cancer

 

Multiple episodes of pancreatic inflammation (pancreatitis), a serious condition affecting the digestive system, are brought on by hereditary pancreatitis. Typically, symptoms start in early childhood and can linger for a few days or more. Stomach pain, nauseousness, and vomiting are possible symptoms. Chronic pancreatitis, or a pancreas that is constantly inflamed, develops in people with hereditary pancreatitis. Symptoms of this include greasy stools, weight loss, and inadequate nutrient absorption from diet. The risk of type 1 diabetes and pancreatic cancer is higher in adults with hereditary pancreatitis. The PRSS1 gene, which is inherited in an autosomal dominant manner and is often defective, is the cause of hereditary pancreatitis. A clinical history, physical examination, and the outcomes of genetic testing are used to make the diagnosis.

 

Bleeding, bloating, constipation, diarrhoea, heartburn, discomfort, nausea, and vomiting are the most typical symptoms of digestive disorders. Gastroesophageal reflux disease, appendicitis, irritable bowel syndrome, lactose intolerance, and peptic ulcers (Stomach Ulcers) are among the common digestive problems.                                                                                                                                                                          Gastroesophageal reflux (Acid Reflux) disease in Infants & Adults: Infants and adults with gastroesophageal reflux (GER) (also known as acid reflux disease) frequently regurgitate and spit up. Infants with GERD may also experience other symptoms like irritability, weight loss, or vomiting. Infants with specific medical disorders and premature infants are more likely to get GERD.

Appendicitis: An appendix is a finger-shaped pouch that extends from your colon on the lower right side of your belly. Appendicitis is an inflammation of the appendix. The lower right abdomen is painful if you have appendicitis. But for the majority of patients, pain starts around the navel.

Peptic Ulcers (Stomach Ulcers): Peptic Ulcers are open sores that develop on the lining of the upper small intestine and the stomach. The most prevalent symptom of a peptic ulcer is stomach pain. H. pylori infection and long-term use of NSAIDs like ibuprofen (Advil, Motrin IB, and other brands) and naproxen sodium are the two primary causes of peptic ulcers (Aleve). Stress and peptic ulcers don't mix. However, they might exacerbate your symptoms.

 

When the immune system of the body targets the liver, it can result in inflammation and autoimmune liver diseases. If the liver inflammation is not addressed, it could eventually result in cirrhosis, which could cause liver cancer and liver failure.
The three most prevalent autoimmune liver illnesses are autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis, despite the fact that a variety of autoimmune ailments can affect the liver. These ailments can manifest alone or as a component of "overlap" illnesses.                                                Autoimmune hepatitis (AIH) which can cause cirrhosis and abrupt liver failure, can afflict both adults and children. Prior to liver failure, it is frequently asymptomatic and without any symptoms. Additionally, it may also be accompanied by general symptoms like weariness, nauseousness, abdominal discomfort, or joint pain

Primary biliary cholangitis (PBC) is a condition where the liver's biliary ducts are destroyed by the body's immune system, making it difficult for the liver to discharge bile. More frequently than men, it affects women. It cannot show any symptoms at all or it might show symptoms like weariness, itchiness, dry lips, dry eyes, elevated cholesterol, or bone damage. It could develop together with other autoimmune diseases. PBC can cause cirrhosis and liver failure if it is not addressed.

Primary sclerosing cholangitis (PSC) Inflammation and scarring of the bile ducts are characteristics of primary sclerosing cholangitis (PSC), which can make it difficult for bile to pass through. It may be asymptomatic, like other autoimmune liver illnesses, or it may be accompanied by symptoms like itching or jaundice. PSC can have an impact on both kids and adults. Occurs when the biliary ducts within the liver are destroyed by the body’s own immune cells, impairing the liver’s ability to excrete bile. It affects women more often the men. It may be asymptomatic or may be associated with symptoms such as fatigue, itching, dry mouth, dry eyes, high cholesterol or bone disease. It may occur in association with other autoimmune conditions. If left untreated, PBC can lead to cirrhosis and liver failure.

Inflammation of the pancreas is a characteristic of pancreatitis. Although it can cause serious consequences that can be fatal, this disorder can also be benign and self-limiting. The lungs and kidneys are only two of the other body organs that the acute form of pancreatitis can harm when it is at its worst.

Acute or chronic pancreatitis is the two categories.

Acute pancreatitis normally manifests rapidly, lasts a short time (a few days to weeks), and is curable with the help of the right medical care.

Chronic pancreatitis a chronic illness that can linger for months or even years, chronic pancreatitis often arises after repeated bouts of acute pancreatitis.

 

Pancreatic adenocarcinoma, an exocrine tumour originating from the cells lining the pancreatic duct, is the most prevalent type of pancreatic cancer. Less than 5% of pancreatic cancers are endocrine tumours, a much less frequent variety also known as neuroendocrine or islet cell tumours.

Pancreatic cancer chemotherapy although the primary treatment for pancreatic cancer is surgery, many individuals are initially inoperable since the disease has already spread to their blood vessels. At the Pancreas Center, we use chemotherapy and radiation therapy to reduce tumour size and are able to do surgery on a large number of patients with locally incurable pancreatic cancer who would not otherwise have a chance at recovery. Each patient's decision to have chemotherapy prior to surgery is complicated, and the surgeons, medical oncologists, radiation oncologists, radiologists, gastroenterologists, and others consider it in a multidisciplinary conference. Chemotherapy medications are used to treat cancer and are often Gemcitabine (Gemzar®), nab-paclitaxel (Abraxane), oxaliplatin, irinotecan, docetaxel (Taxotere®), cis-platinum (Platinol®), and 5-fluorouracil (5-FU) or capecitabine are all used to treat pancreatic adenocarcinoma. These medications are occasionally combined or administered singly.

 

The most frequent technique used to treat pancreatic cancer is a Pancreaticoduodenectomy, also known as the Whipple procedure. The method is named for Allen Old father Whipple, who invented it and was formerly chairman of the department of surgery at Columbia University. About 75% of pancreatic cancer tumours are found at the head of the pancreas, and it is used to treat those. The traditional Whipple and the pylorus-sparing Whipple are the two most popular forms of Whipple surgeries. The traditional Whipple procedure entails the removal of the gallbladder, part of the bile duct, the duodenum, and the head of the pancreas. In order to restore the flow of ingested material, the remaining stomach, bile duct, and pancreas are subsequently reconnected to the digestive tract. Depending on the location and histology of the tumour, a Whipple procedure normally takes 4 to 6 hours. The type of surgery needed mostly relies on where the tumour is located in your pancreas. Your doctor will advise undergoing the operation that safely preserves the most pancreases while removing the tumour and damaged tissue.

 

For the diagnosis and treatment of pancreatic diseases, endoscopic procedures like endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP)https://pancreas.cancersummit.org/abstract-submission.php are becoming more and more crucial. These procedures, when carried out by a qualified endoscopist, can improve pancreatic imaging resolution, provide a trustworthy diagnosis, and open the door to minimally invasive treatment options.

Endoscopic ultrasound (EUS) One of the most helpful imaging procedures for detecting pancreatic cancer is endoscopic ultrasound (EUS). It produces fine-grained pictures of the pancreas and its surrounding tissues, such as the liver, blood arteries, and lymph nodes, and is an outpatient operation. High frequency soundwaves are used by EUS to produce an image of the organs. A computer generates an image by using the sound waves' echoes, which are reflected off the interior organs. An endoscope, a small, illuminated tube, is inserted during an EUS procedure through the mouth and into the duodenum and stomach. The endoscope's tip is fitted with an ultrasonic probe. Small tumours can be seen because the endoscope enables the ultrasound probe to approach very close to the pancreas and its surrounding organs. The pancreas can be checked for tumours. The treatment known as fine needle aspiration allows the doctor to biopsy a suspicious cyst or suspected tumour thanks to the real-time needle guidance offered by the EUS procedure (FNA).

Endoscopic retrograde Cholangiopancreatography (ERCP) the bile and pancreatic ducts can be seen by the physician thanks to endoscopic retrograde cholangiopancreatography (ERCP). The examination is typically carried out when a patient displays jaundice-related symptoms, which may be an indication that a tumour is obstructing or restricting the ducts. Similar to EUS, ERCP is an outpatient operation that uses an endoscope, which is a long, thin, illuminated tube that is passed through the mouth, stomach, and duodenum. An endoscope is used to insert a tube known as a catheter into the pancreatic and bile ducts in order to perform the surgery. After injecting dye into the ducts with the catheter, an X-ray is taken. The doctor can act if a blockage or stricture is discovered by inserting a stent into the blocked duct. A stent is a tool that aids in maintaining the duct's opening so that bile and pancreatic juices can flow normally.

Cysts in or on the pancreas that are abnormally fluid-filled are known as pancreatic cysts. Please utilise the navigation on the left to find details about the various forms of cysts, many of which are benign (non-cancerous), and some of which are connected to pancreatitis, or pancreatic inflammation. Serous cystadenomas, mucinous cystadenomas, intraductal papillary mucinous neoplasm (IPMN), and cystically degraded pancreatic neuroendocrine tumours are all examples of cystic neoplasms of the pancreas. The examination, diagnosis, and treatment of each of these categories of pancreatic cysts will be covered in this section. Pancreatic cysts are being diagnosed more frequently as a result of greater availability to high-quality abdominal imaging. 1-2% of people who have an abdominal CT or MRI for a reason unrelated to the pancreas are found to have pancreatic cysts. Inflammatory in the presence of pancreatitis, cysts form.

Polypeptides are the main kind of gastrointestinal (GI) hormones, which are generated in and secreted by specialised gut endocrine cells. Chemical transmitters produced by these cells play a role in GI motility, secretion, absorption, growth, development, and the control of food intake. The enteric and central nervous systems both include a large number of the peptides that are found in the GI tract. Here, a general discussion of the synthesis, secretion, and control of GI peptides, as well as their function in the development of disease and clinical use, will be provided. The control and purposes of the various GI peptides are covered individually. See "Physiology of somatostatin and its analogues" and "Physiology of cholecystokinin" and "Secretin," as well as "Physiology of gastrin" and "Ghrelin" and "Pancreatic Polypeptide, Peptide YY, and Neuropeptide Y" and "Insulin action".

Synthesis- The GI tract is filled with enteroendocrine cells that produce gastrointestinal (GI) peptides. But certain cell types exhibit geographical specialisation (table 2) [3]. This selectivity can be connected to the receptor's position and the peptide's physiological function. Until recently, it was thought that an enteroendocrine cell generated only one hormone, with the exception of the L cell, which also produced peptide YY (PYY). However, it was found by single-cell RNA analysis that there is more diversity than was previously thought [4]. For instance, almost all enteroendocrine cells express secretin, which is thought to only be produced by S cells. Proglucagon, PYY, and cholecystokinin are frequently expressed in the same cell type. Given these fresh discoveries, it is conceivable there will soon be an enteroendocrine cell classification scheme. By converting DNA into messenger RNA (mRNA), which is then translated into the precursor proteins known as preprohormones, all GI peptides are produced. Ribosomes, which are intricate organelles made up of several proteins (more than 50) and numerous big RNA molecules, are where translation takes place.

The condition when the tissues in your digestive tract have experienced persistent (chronic) inflammation is referred to as "inflammatory bowel disease" (IBD). There are numerous kinds of IBD.

Ulcerative colitis: It is characterised by inflammation and sores (ulcers) on the rectum and colon's lining.

Crohn's disease: This type of IBD, which usually affects the deeper layers of the digestive tract, can cause inflammation of the lining of your digestive tract. Crohn's disease most usually affects the small intestine. The large intestine and, less frequently, the upper gastrointestinal system can both be harmed by it. Both Crohn's disease and ulcerative colitis frequently cause diarrhoea, rectal bleeding, stomach pain, tiredness, and weight loss. For other people, IBD is just a minor illness. Others find it to be a crippling condition that could lead to complications.

An inflammation of the lining of your digestive tract is known as viral gastroenteritis. Adenovirus, norovirus, and rotavirus are some of its potential causes. Rotavirus vaccinations are available for infants. Vomiting, diarrhoea, and nausea are signs of viral gastroenteritis. Although gastroenteritis is frequently referred to as "the stomach flu," it is not the same as influenza. Only your respiratory system, including your nose, throat, and lungs, is impacted by the flu (influenza). In contrast, gastroenteritis affects your intestines.

Resulting in indicators and symptoms like:

Diarrhea that is often watery and not bloody; if it is, you likely have a different, more serious infection

Low-grade fever; nausea and vomiting; discomfort and cramping in the stomach; sporadic headaches or muscle aches.

Neurogastroenterology is the study of the relationship between the nervous and digestive systems. One essential GI function regulated by the neurological system is motility, or the coordination of muscles that move food through the digestive tract from swallowing to faeces. The term "motility disorders" refers to a wide spectrum of gastrointestinal problems.

Pelvic floor physical therapy, as well as counselling and biofeedback

Nutritional and dietary guidance

20,000 protein-coding genes are expressed in human cells, with 60 percent of these genes expressed in a typical adult liver. In the liver, about 400 genes are expressed more specifically, with 150 of them being highly specific to liver tissue. Hepatocytes express the majority of the associated liver-specific proteins, which are then released into the bloodstream to create plasma proteins. Other liver-specific proteins include liver enzymes such as HAO1 and RDH16, bile-producing proteins such as BAAT and SLC27A5, and drug transporter proteins such as ABCB11 and SLC2A2. The fibrinogen beta chain proteins, apolipoprotein A II, coagulation factors F2 and F9, complement factor related proteins, and apolipoprotein A II are all liver-specific proteins.