Day 1 :
Keynote Forum
Kwak Yun Mi
Catholic University of Korea, South Korea
Keynote: What is the role of ERCP in the diagnosis of hemosuccus pancreaticus?
Time : 10:00-10:30 AM
Biography:
Kwak Yun Mi graduated medical school and trained about internal medicine until now, she is training fellowship of catholic hospital of Republic of Korea. She has interest in gastroenterology part of internal medicine and she hope that she will be a professional doctor of internal medicine of gastroenterology.
Abstract:
What is the role of ERCP in the diagnosis of hemosuccus pancreaticus?
Kwak Yun Mi*, Paik Kyu-hyun, Kim Ji Chang and Park Won SuK
Catholic University of Korea, South Korea
Abstract
Hemosuccus Pancreaticus (HP) is one of the rare causes of gastrointestinal bleeding, sometimes leading to a life-threatening condition. However, the diagnosis of HP is often delayed as its rarity and intermittent signs of bleeding, which still is challenging to determine the bleeding source for some patients. An 83-year-old man was transferred to our hospital to evaluate the source of intermittent upper gastrointestinal bleeding involving melena and worsening anemia. Initial upper and lower gastrointestinal endoscopies could not reveal any source of bleeding. Emergent upper endoscopy performed with hematochezia and hypotension confirmed a spurt of bleeding from the major duodenal papilla However, contrast-enhanced CT and angiography could not find the source of the bleeding from the major duodenal papilla. Here, Endoscopic Retrograde Cholangio Pancreatography (ERCP) for inducing the bleeding from the source and indicating the bleeding point was performed according to the decision of the multidisciplinary team Immediately thereafter, sequential angiography was performed, and HP due to the rupture of a pseudoaneurysm of the splenic artery could be diagnosed. As a result, it was possible to avoid surgical resection of the pancreas by accurately embolizing the bleeding focus of HP under a multidisciplinary team approach. The patient was discharged in a hemodynamically stable condition. There was no further gastrointestinal bleeding or procedure-related complications till 6 months of discharge.
Biography
Kwak Yun Mi graduated medical school and trained about internal medicine until now, she is training fellowship of catholic hospital of Republic of Korea. She has interest in gastroenterology part of internal medicine and she hope that she will be a professional doctor of internal medicine of gastroenterology.
Keynote Forum
Marakhouski Y
Belarusian Medical Academy of Postgraduate Education, Belarus
Keynote: An attempt to present medication for overlap syndrome dyspepsia with nonspecific/unspecified irritable bowel syndrome by patients’ self-assessment
Time : 11:00-11:30 AM
Biography:
Yury Marakhouski approved as Professor of Clinical Medicine in 2005 year by the Higher Certification Commission of the Council of Ministers of the Republic of Belarus. He is head of the Department Gastroenterology and Nutrition of the Byelorussian Medical Academy of Postgraduate Education. He has published more than 30 papers in reputed journals and serving as a member of the editorial board of several reputed journals (predominantly in Russia and Belarus). His Current Position is Head of Department of Gastroenterology and Nutrition, Byelorussian Medical Academy Postgraduate Education (BelMAPE). He is principal investigator on numerous clinical 18 and preclinical 6 studies and has been involved in the study of many medication including mesalazine, amino acids, anti-TNF.
Abstract:
- Irritable Bowel Syndrome |Microbiota and Diseases | Gastrointestinal Therapeutics | Haemorrhoids | Hepatology|Gastroenterology
Location: Rome,Italy
Session Introduction
Rasmus Rankala
University of Turku, Finland
Title: Cost of medication used to treat IBD
Time : 10:00-10:30 AM
Biography:
Rasmus Rankala is a Doctoral Student, Department of Internal Medicine, Turku University Hospital, University of Turku, Turku, Finland.
Abstract:
Background: Inflammatory bowel disease comprising of Crohn’s Disease (CD) and Ulcerative Colitis (UC) are chronic diseases with a lifelong burden and often need continuous treatment throughout a patient’s life. Data regarding drug costs in IBD patients are limited. No earlier study has evaluated the drug costs of IBD patients in Finland. Our objective in this study was to assess the costs of commonly used drugs in IBD patients.
Methods: A structured questionnaire, hospital records and national registers were combined to assess the true costs of drug purchases by IBD patients. The study sample comprised of 561 patients.
Results: Total annual mean drug costs were 1428 €/patient. CD patients had higher annual costs than UC patients, 2369€ and 902€, respectively. CD patients using immunosuppressants, corticosteroids and biologics also had higher costs. Patients using biologics had higher costs. Faecal calprotectin had a positive correlation with costs. Women reported having a worse QoL but had lower total costs.
Conclusion: Drug costs are developing to be a major cost-driver in the total costs of IBD patients.
Discussion:
Inflammatory Bowel Diseases (IBDs) create significant overall treatment costs to a tertiary-level clinic and eventually to taxpayers. In the present study, the costs generated by the study group were significantly higher, almost 17-fold, compared with the costs generated by the age-matched and sex-matched control group during the same period. In this study, all costs are based on true costs collected from registers used to charge the final payer. These include all direct costs from the study period regarding patients both recently diagnosed with IBD and those diagnosed earlier. The present study findings of total costs in both UC and CD are consistent with the data from earlier studies, although there are major differences between these studies.
Marakhouski Y
Belarusian Medical Academy of Postgraduate Education, Belarus
Title: An attempt to present medication for overlap syndrome dyspepsia with nonspecific/unspecified irritable bowel syndrome by patients’ self-assessment
Time : 10:30-11:00 AM
Biography:
Yury Marakhouski approved as Professor of Clinical Medicine in 2005 year by the Higher Certification Commission of the Council of Ministers of the Republic of Belarus. He is head of the Department Gastroenterology and Nutrition of the Byelorussian Medical Academy of Postgraduate Education. He has published more than 30 papers in reputed journals and serving as a member of the editorial board of several reputed journals (predominantly in Russia and Belarus). His Current Position is Head of Department of Gastroenterology and Nutrition, Byelorussian Medical Academy Postgraduate Education (BelMAPE). He is principal investigator on numerous clinical 18 and preclinical 6 studies and has been involved in the study of many medication including mesalazine, amino acids, anti-TNF.
Abstract:
Introduction: At present, the Rome V criteria are being developed, with an emphasis on the key aspects for revision of a number of provisions, including elimination of diagnostic problems in the overlap syndrome (Address Diagnostic Overlap). On the other hand, the presence of the “overlap syndrome” worsens the course of and treatment outcomes in such conditions. And the most common symptoms overlap is the combination of Functional Dyspepsia (FD) and Irritable Bowel Syndrome (IBS).
Methods: The group for inclusion in the study was selected by questionnaire survey, subject to the basic Rome IV criteria and modified Leeds Dyspepsia Questionnaire validated using more than 18,000 cases. Treatment efficacy assessment was based on Patient-Reported Outcomes (PROs) obtained during the final treatment visit (Visit 3). Effects were detailed according to a special self-assessment questionnaire (medication and treatment satisfactory questionnaires TSQ) validated using 18,724 cases in an earlier study. Additionally, taking into account peculiarities of alverin action, the participants of the study had undergone a grip test. To assess safety a number of parameters available in routine clinical practice were determined during all visits: blood chemistry values, hematological blood values, urinalysis values. During the randomization visit, hsCRP was determined in all patients; values were below 5 mg/L. Fecal calprotectin was determined by rapid test kit for semi-quantitative, with the cut-off value 50 µg/L to exclude bowel inflammatory and only these patients included in the study. Group A with Meteospasmyl: 21 pts age: 46.5 (95% CI 39.7–53.4), median 45 (Q-25–Q-75=31–60), 23.8% (95% CI (Fisher's) 11.3–52.2%) of males. 5 volunteers were smokers (23.8% (95% CI (Fisher's) 8.2-47.2%). Group B with comparator: Height: age- 45.4 (95% CI 35.0–55.9), median 49 (Q-25–Q-75=37–53), 11.1% (95% CI (Fisher's) 0.3–48.2%) of males. Comparison of the analysis results in groups A and B showed that there was no statistically significant difference in height, weight and age. There is a difference in the number of smokers: Group A had a larger number of smokers.
Results: The study results showed the high efficiency of the combination alverine with simethicone (Meteospasmel) according to self-assessment by patients with overlapping symptoms of UD and IBS-N: positive effect-86.7% (95% CI Fisher's=78.6-92.5) cases and a high Odds ratio (22.7, at 95% CI=8.9-58.4) compared with the control group (treatment without the use of Meteospasmyl). Treatment adherence higher in 12 times (Odds ratio) (95% CI=1.42-112.06) with Meteospasmyl (85.7% (95% CI=63.7-97.0), versus the control group (33.3% 95% CI=7.5-70.1). A high safety degree of this drug has been demonstrated, both in terms of clinical and laboratory parameters. Results were obtained confirming the effect of Metespasmyl on skeletal muscles with a significant increase in the grip strength of the right hand both at the 2nd week of treatment with Meteospasmyl (increase by 0.4 kg) and by the 4th week of treatment (by 0.6 kg), in contrast with comparison group (F test ANOVA (2;60)=7.2; p=0.0015; Kruskal Wallis test-H(2;63)=27.6161; p=0.00001). The applied method of multivariate analysis of variance with a hypothesis decomposition model confirmed the effect of Meteospasmyl on the increase in the values of hand dynamometry on the 28th day of admission (p trend less than 0.001).
Conclusion:
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New data were obtained on the option of overlapping UD and IBS-N.
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Patients' self-assessment of effectiveness in this variant of disorders was not previously studied.
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Meteospasmyl demonstrated greater efficiency and high safety profile.
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Meteospasmyl increased the functional state of skeletal muscles.
Kwak Yun Mi
Catholic University of Korea, South Korea
Title: What is the role of ERCP in the diagnosis of hemosuccus pancreaticus?
Biography:
Kwak Yun Mi graduated medical school and trained about internal medicine until now, she is training fellowship of catholic hospital of Republic of Korea. She has interest in gastroenterology part of internal medicine and she hope that she will be a professional doctor of internal medicine of gastroenterology.
Abstract:
Hemosuccus Pancreaticus (HP) is one of the rare causes of gastrointestinal bleeding, sometimes leading to a life-threatening condition. However, the diagnosis of HP is often delayed as its rarity and intermittent signs of bleeding, which still is challenging to determine the bleeding source for some patients. An 83-year-old man was transferred to our hospital to evaluate the source of intermittent upper gastrointestinal bleeding involving melena and worsening anemia. Initial upper and lower gastrointestinal endoscopies could not reveal any source of bleeding. Emergent upper endoscopy performed with hematochezia and hypotension confirmed a spurt of bleeding from the major duodenal papilla However, contrast-enhanced CT and angiography could not find the source of the bleeding from the major duodenal papilla. Here, Endoscopic Retrograde Cholangio Pancreatography (ERCP) for inducing the bleeding from the source and indicating the bleeding point was performed according to the decision of the multidisciplinary team Immediately thereafter, sequential angiography was performed, and HP due to the rupture of a pseudoaneurysm of the splenic artery could be diagnosed. As a result, it was possible to avoid surgical resection of the pancreas by accurately embolizing the bleeding focus of HP under a multidisciplinary team approach. The patient was discharged in a hemodynamically stable condition. There was no further gastrointestinal bleeding or procedure-related complications till 6 months of discharge.