Over View of Gastro Intestinal Diseases in UAE Volume 2 - Issue 1

Makki H Fayadh¹* and Salem Awadh Sabih²

• ¹ MRCP UK, FRCP ED, FRCP London
• ² MRCP UK, FRCP London

Received:February 27, 2019;   Published: March 05, 2019

*Corresponding author: Makki H Fayadh, MRCP UK, FRCP ED, FRCP London

DOI: 10.32474/CTGH.2019.02.000129

 

Abstract PDF

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Short Communication

One fifth of the population in UAE suffers from gastrointestinal diseases including obesity, reflux disease and fatty liver because of obesity, poor diets and close marriage, Acid reflux, ulcerative colitis and irritable bowel syndrome are increasing in recent years [1-3]. There are also a high number of sufferers of fatty liver, caused to a large extent by the excessive consumption of sugary drinks. Obesity is an issue that can affect the UAE’s development as a nation and needs to be managed immediately and effectively, vague discomfort is usually the only symptom of a fatty liver. Low fiber diets, lack of exercise and consuming large amounts of food and dairy products are responsible for the majority. Genetics combined with obesity are responsible for people suffering from many disorders. A case of fatty liver, if ignored, might escalate to an advanced liver problem later in life.

Increasing numbers of inflammatory bowel diseases specially in the young and more severe forms of Crohns disease. Increasing numbers of cancers especially colorectal cancers affecting younger populations. During our practice in UAE we came across many rare and unusual disease presentations that were missed because of either lack of awareness or failure to check detailed history including family history and proper physical examination. These diseases included: Celiac disease which affect 2.3% of the population, Inflammatory bowel diseases both ulcerative colitis & Crohns disease with obvious rise in Crohns disease, Studies on colorectal cancer showed that over 60% are discovered in an advanced stage and affecting younger populations and because of that the health authorities started the program to prevent, early detect colorectal cancer. Our initial study of over 6000 colonoscopies showed prevalence of polyps over 30% and colorectal cancer in about 1% of all colonoscopies,20% of colorectal cancers were below the age of 40 years. Many families with inherited colorectal cancers including Lynch syndrome were seen. Constipation is a real problem in UAE sometimes ending in severe disability and sometimes colectomies performed for some refractory cases. Missed diseases included over 10 cases of multiple auto immune IGG4 related diseases that presented as pancreaticobiliary manifestation or multiple auto immune diseases, pachymengitis & mesenteric panniculitis. Many cases of hyper elasticity syndromes associated with reflux disease & 10 cases of vascular compression syndromes mainly superior mesenteric artery syndrome [4-10]. 4 cases of Behcet disease with intestinal involvement, 3 cases of Cowden disease, 2 cases of tylosis with reflux disease and esophageal & colon cancers, 1 case of Gardner syndrome. 1 case of Chédiak–Higashi syndrome syndrome with albinism & colitis. We are running monthly meetings for these unusual presentations of common diseases and rare diseases in UAE. Awareness for young colleagues in all specialties is needed in these diseases [11].

References

1. Fox RI, Fox CM (2015) IgG4 levels and plasmablasts as a marker for IgG4-related disease (IgG4-RD). Ann Rheum Dis 74: 1-3.
2. Umehara H, Okazaki K, Masaki Y (2012) A novel clinical entity, IgG4- related disease (IgG4RD): general concept and details. Mod Rheumatol 22: 1-14.
3. Stone JH, Zen Y, Deshpande V (2012) IgG4-related disease. N Engl J Med 366: 539-551.
4. Umehara H, Okazaki K, Masaki Y (2012) Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011. Mod Rheumatol 22: 21-30.
5. Hamano H, Kawa S, Horiuchi A (2001) High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med 344(10): 732-738.
6. Wahab PJ, Meijer JW & Mulder CJ (2002) Histologic follow-up of people with celiac disease on a gluten-free diet: slow and incomplete recovery. Am J Clin Pathol 118: 459-463.
7. Lloyd KM, Dennis M Cowden’s disease (1963) A possible new symptom complex with multiple system involvement. Ann Intern Med 58: 136- 142.
8. Nelen MR, Padberg GW, Peeters EA (1996) Localization of the gene for Cowden disease to chromosome 10q22-23. Nat Genet 13: 114-116.
9. Starink T van der Veen J, Arwert F, Eriksson AW (1986) The Cowden syndrome: a clinical and genetic study in 21 patients. Clin Genet 29: 222- 233.
10. Starink TM (1984) Cowden’s disease: analysis of fourteen new cases. J Am Acad Dermatol 11: 1127-1141.
11. Salem OS, Steck WD (1983) Cowden’s disease (multiple hamartoma and neoplasia syndrome). A case report and review of the English literature. J Am Acad Dermatol 8: 686-696.