WGO Announces the Theme for World Digestive Health Day 2021 and Prepares to Launch Year-long Campaign on 29 May - World Gastroenterology Organisation
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Celebrating 25 Years of e-WGN!
WORLD GASTROENTEROLOGY NEWS www.worldgastroenterology.org
Official e-newsletter of the World Gastroenterology Organisation
VOL. 26, ISSUE 1 MAY 2021
WGO Announces the Theme for
World Digestive Health Day 2021
In this issue and Prepares to Launch Year-long
Campaign on 29 May
Lilian Kow, BMBS, PhD, FRACS
President, IFSO
Senior Consultant Surgeon, Flinders Medical Centre
The Global Prevalence of Functional Clinical Associate Professor, Flinders University of South Austra-
Gastrointestinal Disorders – Results of lia; Co-Chair, WDHD; Adelaide, Australia
the First Global Study
Eamonn M M Quigley, MD, FRCP, FACP, MACG,
FRCPI, MWGO
Reem Ziad Sharaiha, MD, MSc
Associate Professor of Medicine at Weill Cornell Medical College
Director of Interventional Endoscopy and Attending Physician at
New York Presbyterian Hospital/Weill Cornell Medical Center
Co-Chair, WDHD; New York, New York, USA
James Toouli, MD, MBBS, PhD, FRACS, MWGO
WGO Past President, 2013-2015
WGO History Corner – An Interview Professor Emeritus, Flinders University South Australia
with Dr. Melvin Schapiro Co-Chair, WDHD
Melvin Schapiro, MD, MWGO Adelaide, Australia
The World Gastroenterology Organisation (WGO) has partnered with The Internation-
al Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) to celebrate
World Digestive Health Day 2021 with theme, Obesity: An Ongoing Pandemic. Led
by Co-Chairs Lilian Kow, PhD (Australia), Reem Sharaiha, MD (United States) and
James Toouli, MD (Australia), along with a Steering Committee of over 25 medical
experts from all over the world, the campaign aims to
• Raise awareness of the role obesity plays in health, disease and its management,
especially in countries that make up the memberships of WGO and IFSO.
• Provide gastroenterologists, surgeons, nutritionists their patients, and the lay public,
with an understanding of the latest basic and clinical research in the pathogenesis,
investigation and treatment of obesity.
• Translate the results of research into clinical practice and facilitate communication
between physicians, allied health professionals, healthcare payers, and the public.
• Provide simple messages for the general public in order to assist them in understand-
ing how obesity affects one’s daily life and its importance in one’s health.
Continued on page 4
WORLD GASTROENTEROLOGY NEWS MAY 2021
2
Contents
VOL. 26, ISSUE 1 WGO Announces the Theme for World Digestive
Health Day 2021 and Prepares to Launch Year-long
Editors
Campaign on 29 May 1
Anita Afzali, MD, MPH, FACG, AGAF Lilian Kow, BMBS, PhD, FRACS
Reem Ziad Sharaiha, MD, MSc
Abercrombie and Fitch Endowed Chair in James Toouli, MD, MBBS, PhD, FRACS, MWGO
Inflammatory Bowel Disease
The Ohio State University Wexler Medical
Center Editorial
Columbus, Ohio, USA
Message from the Editors 5
Anita Afzali, MD, MPH, FACG, AGAF
Mário Reis Álvares-da-Silva, MD, PhD Mário Reis Álvares-da-Silva, MD, PhD
Professor of Hepatology
Hospital de Clinicas de Porto Alegre Expert Point of View
Universidade Federal do Rio Grande do Sul
Porto Alegre, Brazil
The Global Prevalence of Functional Gastrointestinal
Disorders – Results of the First Global Study 6
Eamonn M M Quigley, MD, FRCP, FACP, MACG, FRCPI, MWGO
e-WGN Editorial Board Eosinophilic Esophagitis: Update on Treatments for an
• Dan Dumitrascu, Romania Emerging Disorder 8
• Sara Elfadil, Sudan
• Ernst Fredericks, South Africa John Fang, MD
• Waseem Hamoudi, Jordan Kavel Visrodia, MD
• Nassir Alhaboob Arabi Mohammad, Sudan
• VG Naidoo, South Africa
• Alejandro Piscoya, Peru
Gastro 2021
• Naoya Sakamoto, Japan
• Murat Saruç, Turkey Gastro 2021 11
• Michael Schultz, New Zealand
• Walid Sweidan, Palestine
• Lu Xia, China WDHD News
Managing Editor
Megan Uhlenhake, WGO Program Manager WGO and IFSO to Launch an Obesity-Focused
Webinar on World Digestive Health Day 12
Art Production
Jennifer Gubbin
Editorial Office Pakistan Society for the Study of Liver Diseases Webinar
WGO Executive Secretariat on ‘The Gut-Liver Axis’ 13
555 East Wells Street, Suite 1100 Zaigham Abbas, MBBS, FCPS, FRCP, FRCPI, FACP, FACG, AGAF
Milwaukee, WI 53202 USA
info@worldgastroenterology.org
https://www.facebook.com/WorldGastroOrg
https://twitter.com/WorldGastroOrg
https://www.instagram.com/worldgastroorg/
https://www.linkedin.com/company/world-gastro-
enterology-organisation-wgo-wgo-foundation
www.worldgastroenterology.org
©2021 World Gastroenterology Organisation. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form without the prior permission of the copyright owner.
WORLD GASTROENTEROLOGY NEWS MAY 2021
3
Contents
WGO News WGO History Corner
Spotlight: WGO Endoscopy, Other Procedures and Introducing WGO’s “History Corner” 30
Outreach Interest Group 15 James Toouli, MD, MBBS, PhD, FRACS, MWGO
Vivek Kaul, MD, FASGE, FACG, AGAF
WGO History Corner – An Interview with
Training Center Spotlight – Bangkok 16 Dr. Melvin Schapiro 31
Lubna Kamani, MD Melvin Schapiro, MD, MWGO
Training Center Spotlight – Porto Alegre 17 WGO Global Guidelines
Ysela Picon Perez, MD
WGO Global Guidelines Update 33
Training Center Spotlight – Rabat 19
Meriem Bakkar, MD Calendar of Events 35
World Hepatitis Day in Bangladesh 24
Faruque Ahmed, MD
World Hepatitis Day in India 25
M.S. Revathy, MD, DM
UEG Week Virtual 2020 26
UEG Week Virtual 2021 28
OPGE Event 29
©2021 World Gastroenterology Organisation. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form without the prior permission of the copyright owner.
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WORLD GASTROENTEROLOGY NEWS MAY 2021
Editorial | Expert Point of View | Gastro 2021 | WDHD News | WGO News | WGO History Corner | WGO Global Guidelines | Calendar of Events
• Provide the lay public general WGO, together with IFSO, call upon tionally, all are encouraged to join the
information that may be used Member Societies, Regional Affiliates, educational webinar planned for Sat-
to discuss with their health care and partner organizations to organize urday, 29 May – registration is free.
provider potential management of events to raise awareness around the Sign up today at www.wdhd2021.org
obesity that incorporates appro- 2021 theme. and follow #WDHD2021.
priate investigations , treatment, Please visit the WDHD website at: Together we can increase awareness
appropriate dietary and lifestyle www.worldgastroenterology.org/wgo- of the optimal care of gastrointesti-
advice relevant to their condition foundation/wdhd to learn more about nal and liver disorders worldwide.
and circumstances. the 2021 theme and discover the tools WGO greatly values your support
and resources being developed. Addi- of WDHD to ensure its continued
success.
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WORLD GASTROENTEROLOGY NEWS MAY 2021
Editorial | Expert Point of View | Gastro 2021 | WDHD News | WGO News | WGO History Corner | WGO Global Guidelines | Calendar of Events
Message from the Editors
Anita Afzali, MD, MPH, FACG, AGAF
Abercrombie and Fitch Endowed Chair in Inflammatory Bowel
Disease
The Ohio State University Wexler Medical Center
Columbus, Ohio, USA
Mário Reis Álvares-da-Silva, MD, PhD
Professor of Hepatology
Hospital de Clinicas de Porto Alegre
Universidade Federal do Rio Grande do Sul
Porto Alegre, Brazil
Visiting the past is a way of honoring wide awareness of the role of the Functional gastrointestinal dis-
the people who built WGO and antic- microbiome in human health. Let’s orders (FGIDs) has a high global
ipating the future of our organization. take a look at the activities that took prevalence and we treat and care
In this sense, we start this edition place around the world in this regard. for these patients commonly in our
with the inaugural e-WGN History’s Initiatives from Argentina, Brazil, clinical practice. Dr. Eamonn Quigley
Corner, an interview with Dr. Melvin Ghana, Italy, Kazakhstan, Russia, nicely summarizes results from the
Schapiro, past professor of Medicine Spain, United States and Uruguay, recently published global survey of
and Gastroenterology at the Univer- among others, have been successful, FGIDs from the Rome Foundation
sity of California at Los Angeles, past as well as “The Gut-Liver Axis” special and provides a global perspective on
President in 1994 World Congress Webinar, co-promoted by the Pakistan management of these disorders.
of Gastroenterology (WCOG) and Society for the Study of Liver Diseases Lastly, we highlight three recent
the 2009 Masters of WGO Award and the WGO, and moderated by Training Center Spotlights in Bang-
Recipient. Prof. Saeed Hamid, from Aga Khan kok, Porto Alegre, and Rabat and ap-
Next, the WGO celebrated World University Hospital, Karachi, Paki- plaud their efforts and commitment
Digestive Health Day (WDHD) on stan, who is also Chair of the WGO to teaching.
29 May 2020 with a 24-hour social Hepatology Interest Group. We hope you will enjoy this
media blitz. Co-Chairs of WDHD Also WGO celebrated World Hepa- e‑WGN edition.
2020 Drs. Eamonn Quigley (United titis Day (WHD) on 28 August 2020,
States) and Uday Ghoshal (India) led and some educational actions carried Be Well,
significant efforts to increase world- out in the East are discussed here. Mario and Anita
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WORLD GASTROENTEROLOGY NEWS MAY 2021
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The Global Prevalence of Functional Gastrointestinal
Disorders – Results of the First Global Study
Significant variations were noted
Eamonn M M Quigley, MD, FRCP, FACP, MACG, FR- between countries, but this was, in
CPI, MWGO part, attributable to survey method
Lynda K and David M Underwood Center for Digestive Disorders with much lower rates reported in
Houston Methodist Hospital and Weill Cornell Medical College household surveys in some countries.
Houston, Texas, USA
Looking at the data from the inter-
net surveys reveals more consistent
patterns – the range of prevalence
for any FGID ranging from a low
No one who practices gastroenterol- Task Force on IBS1. To put it simply, of 33.7% in Singapore to 50% in
ogy doubts that the various functional the true prevalence of FGIDs around Egypt and with most rates lying
gastrointestinal disorders (FGIDs) are the world remained unclear. Knowing close to the mean. Similarly, for most
common; gastroenterologists around the prevalence of, for example, IBS countries the prevalence rate for IBS
the world will tell you that irritable or chronic constipation is important lay between 3 and 5%; interestingly,
bowel syndrome (IBS), constipation, for many reasons, not least because of about half the rate that would have
dyspepsia and functional esophageal their impact on health care systems been recorded by Rome III criteria.
disorders are very common in their and the quality of life of the indi- IBS, like most FGIDs, was uniformly
daily clinics. But, as we have learned vidual sufferer. more common in females. With some
from many prior studies, data from The recently published global notable, exceptions, such as fecal in-
clinics are notoriously unreliable when survey of FGIDs from the Rome continence, the prevalence of FGIDs
it comes to prevalence data on FGIDs. Foundation represents, therefore, a tended to decline with age.
Many factors, such as referral bias, dramatic step forward. Involving the It was my great honor to represent
health care seeking behavior, access analysis of questionnaires (appropri- WGO in this endeavor. Its leadership
to health care, diagnostic approaches, ately translated and validated) from and Dr Ami Sperber, in particular,
locus of health care (primary care vs 73,000 respondents in the general deserve all of our thanks for carefully
specialist), as well as cultural norms adult population in 33 countries in 4 designing and meticulously executing
can individually and collectively continents, the results provide the best a project that many thought to be im-
influence the nature of the patient insight yet into the community preva- possible. Through their efforts and the
population seen in a given clinic set- lence of FGIDs. Most surveys were support of several sponsors, we now
ting and greatly confound studies of performed through the internet – for have a true global picture of these
presenting symptoms, co-morbidities, logistical reasons personal, house- common disorders – this first report
symptom severity and impact, as well hold interviews were performed in 9 represents but a snapshot from the
as pathophysiology and therapeutic countries. In each country a target was wonderful, multicolor photo album
response. True community surveys set for the number of surveys to be that is to come in several installments
were less common and, even here, completed to provide a representative in the coming months and years.
comparisons were hampered by meth- sample – all targets were met. Rome References:
odological differences between studies. IV diagnostic criteria for FGIDs were 1. Quigley EM, Abdel-Hamid H,
These shortcomings were highlighted employed in analyzing the results. Barbara G, et al. A global perspec-
in prior attempts to define global Overall, 49% of females and 36.6% tive on irritable bowel syndrome: a
prevalence1,2 which, thought identify- of males met criteria for at least one consensus statement of the World
ing FGIDs everywhere in every corner FGID - the most common disorders Gastroenterology Organisation
of the globe where they were sought, in all regions being functional consti- Summit Task Force on irritable
noted apparently dramatic variations pation, functional dyspepsia, proctal- bowel syndrome. J Clin Gastroen-
in prevalence between various studies gia fugax, functional diarrhea and IBS terol 2012;46:356-366.
from individual countries. One of at prevalence rates of 11.7%, 7.2%, 2. Lovell RM, Ford AC. Global
these reports emanated from a WGO 5.9%, 4.7% and 4.1, respectively. prevalence of and risk factors
7 WORLD GASTROENTEROLOGY NEWS MAY 2021 Editorial | Expert Point of View | Gastro 2021 | WDHD News | WGO News | WGO History Corner | WGO Global Guidelines | Calendar of Events for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol 2012;10:712-721. 3. Sperber AD, Bangdiwala SI, Drossman DA, et al. Worldwide Prevalence and Burden of Func- tional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology 2020 [epub ahead of print]. 4. Lacy BE, Mearin F, Chang L, et al. Bowel Disorders. Gastroenterology 2016;150:1393-1407.e5. 5. Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology 2006;130:1480-1491.
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Eosinophilic Esophagitis: Update on Treatments for
an Emerging Disorder
cade), symptoms include chest and/or
John Fang, MD abdominal pain, dysphagia and food
Professor of Medicine impaction. In school-aged children,
Chief, Division of Gastroenterology, Hepatology and Nutrition vomiting or pain are often present,
University of Utah Health
whereas in infants/toddlers feeding
difficulties and failure to thrive can be
the presenting symptoms. Adolescent
and adults often endorse compensa-
Kavel Visrodia, MD
tory maneuvers to avoid dysphagia/
Assistant Professor of Medicine impaction such as slow eating, careful
Division of Digestive and Liver Diseases
Columbia University Medical Center
chewing, increased fluid intake dur-
New York Presbyterian Hospital ing meals and food trigger avoidance
(meats, breads). Thus careful history
taking is important given the spec-
trum of clinical presentation.
The diagnosis of EoE relies on a
combination of clinical and endo-
Eosinophilic esophagitis (EoE) is a EoE is primarily a food antigen
scopic findings. Endoscopically,
chronic immune-mediated inflamma- driven allergic condition in which
esophageal changes such as mucosal
tory condition that results in esopha- T-helper type 2 (Th2) lymphocytes
edema, rings, white specks (exudates),
geal fibrosis, stricture and dysphagia. respond by secreting several cytokines
linear furrows and esophageal stricture
The condition was first described including IL-4, IL-5, and IL-13.
may be present (EREFS classification
in the literature only recently in the These cytokines initiate a cascade
system). Esophageal eosinophilia,
1990s. Since then, the global preva- of epithelial disruption, as well as
as defined by at least 15 eosinophils
lence has dramatically increased, in attraction/activation of eosinophils
per high-power field (eos/HPF), is
part due to its increasing recognition (via eotaxin-3), lymphocytes and mast
required to diagnose EoE. This must
and diagnosis. The current estimate cells, resulting in basal zone prolifera-
be present at a minimum in one of
of pooled prevalence is 34.4 cases per tion. Chronic inflammation ensues
at least 6 biopsies, which should be
100,000 inhabitants in the United leading to esophageal remodeling,
obtained from the proximal and distal
States and Europe, whereas the mag- fibrosis and stricturing. In contrast
esophagus due to the patchy nature of
nitude of this condition in developing to other allergic pathways, IgE does
the disease. Peripheral eosinophilia in
regions has not been well studied. not appear to be critically involved
EoE is uncommon and therefore not
In first degree relatives of patients in EoE pathophysiology, hence why
a sensitive enough test for diagnosis.
with EoE, the prevalence of EoE is IgE-based skin and blood testing to
Radiographic testing with barium
2.5% although in a recent study the identify food allergens in individu-
esophagram may also help stage sever-
prevalence of esophageal eosinophilia als with EoE is associated with low
ity of disease and guide endoscopic
is much higher at 14.6%. As the recog- accuracy. However, there is mounting
management by characterizing stric-
nition and the prevalence of EoE con- evidence for aeroallergen sensitization
ture burden. Functional luminal im-
tinues to rise, gastroenterologists are and an association with concurrent
aging probe (EndoFLIP) may be used
more likely to encounter this disease atopic conditions, including asthma,
to evaluate esophageal distensibility as
in routine practice. Fortunately, with a allergic rhinitis and atopic dermatitis
a marker of esophageal remodeling.
growing number of studies and trials, (eczema).
The differential diagnosis for EoE
our understanding of the disease and EoE is more likely to affect white
includes mostly rare conditions (acha-
its management has evolved signifi- males with atopy, but varies in pre-
lasia, allergic vasculitis, Crohn disease
cantly. In this brief update, we review sentation depending on the age of the
of the esophagus, etc). The main
the current concepts and treatment op- patient and duration of disease. In
exception to this is gastroesophageal
tions for this emerging disorder. adults (typically third to fourth de-
9 WORLD GASTROENTEROLOGY NEWS MAY 2021 Editorial | Expert Point of View | Gastro 2021 | WDHD News | WGO News | WGO History Corner | WGO Global Guidelines | Calendar of Events reflux disease (GERD), which can require multiple upper endoscopies loon pull through technique, where imitate or overlap with EoE. More- to determine recurrence of eosino- the inflated balloon is pulled up from over, patients with esophageal eosino- philia after re-introduction of each the gastroesophageal junction through philia who have a complete response food group as symptoms often do not the upper esophageal sphincter. Both to proton pump inhibitor (PPI) correlate accurately with histology. methods allow for dilation of the were previously considered to have a Therefore 2 and 4 food elimination entire length of the esophagus and distinct clinical entity, labeled PPI- diets of the foods with higher allergy provide feedback for when a mucosal responsive esophageal eosinophilia prevalence are effective in 40% and tear occurs. The goal is to obtain an (PPI-REE). However, EoE guidelines 50% of patients, respectively, and may esophageal diameter of 15-18 mm have now evolved to include patients be considered. Dietary consultation is which may need to be achieved with with eosinophilia whose symptoms useful but food allergy testing is not serial dilations. Initial concerns about are responsive to PPI, making this in most cases. higher than average perforation rates distinction of GERD and PPI-REE Drug therapy consists of PPIs or have not been borne out with experi- less important. topical steroids. PPIs (omeprazole 20- ence and techniques described above. Once EoE is diagnosed the goals 40 mg or equivalent) given twice daily However, post-dilation chest pain is of treatment are to prevent complica- for 8 weeks are effective in 40-60% of common and should be anticipated tions, stabilize disease, and reverse fi- patients. In PPI responders longterm (Table 1). Dilation therapy does brosis through improvement in symp- PPI therapy is effective in maintain- not address inflammation, suggest- tomatic, histologic and endoscopic ing remission and should be tapered ing combination with diet or drug parameters. Histologic improvement to the lowest effective dose. Topical therapy may be the most effective is traditionally defined as < 15 eos/ steroid therapy consists of flutica- strategy. HPF. Lower levels are likely associated sone spray (4 puffs 880 mcg BID) or EoE is a relatively recently rec- with improved outcomes. Endoscopic budesonide (1 mg BID) liquid for 8 ognized disease entity that causes improvement can be quantitatively weeks and is effective in 60-95%. The significant morbidity. Its prevalence is assessed with endoscopic reference fluticasone spray is swallowed (not increasing in the developed countries score (i.e. EREFS). Improvement in inhaled) directly while budesonide and likely increasing worldwide. endoscopic and histologic parameters is mixed into a viscous liquid before While primarily an allergic disease, are well correlated as measures of swallowing (using honey, sucralose, there also appears to be a familial inflammation. However, symptom syrup). Patients should rinse and spit genetic component. The 3 D’s: diet, improvement from dysphagia and with water after steroid administration drugs and endoscopic dilation are food impaction may not be as well and refrain from eating or drinking effective in the treatment of this correlated due to residual fibrosis for 30 minutes. Candida esophagitis disorder for the vast majority of and persistent esophageal strictures. complicates steroid treatment 5-10% patients. However, recurrence is near Therefore goals of therapy are to of the time. Specific esophageal deliv- universal and longterm maintenance resolve eosinophilia and maintain ery formulations have been approved treatment to control inflammation adequate esophageal caliber to control in Europe. Unfortunately histologic is still evolving. Understanding the symptoms. The present approach to and symptomatic reccurence is com- principles and nuances of endoscopic treatment can be summarized as the 3 mon after steroid treatment is stopped dilation is important, given that most D’s: Diet, Drug and Dilation. and the role of maintenance treatment adult patients will have esophageal Elimination diets are the corner- with topical steroids is unclear. strictures at some point in the clini- stone of management of EoE and Success rates of endoscopic dilation cal history. New biologic treatments directly address the pathophysiol- are similar to diet and drug therapy. targeting cytokines and esophageal ogy of the disease. Therefore they Endoscopic therapy provides immedi- directed delivery medications are be- are useful for both acute treatment ate relief in patients with very narrow ing investigated and will likely assume as well as maintenance therapy. The caliber esophagus who are at high a significant role in future treatment traditional 6 food elimination diet risk of food impaction. The goal is to paradigms for this disease. (milk, gluten, soy, eggs, nuts and dilate to the level of a controlled mu- seafood in descending order of allergy cosal tear. It can be difficult to predict prevalence) has a clinical success rate at which level (axially) it will occur of 70-75%%, but requires the greatest (Figure 1). The two primary methods dietary restriction. In addition, it may are Savary bougie dilation or the bal-
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WORLD GASTROENTEROLOGY NEWS MAY 2021
Editorial | Expert Point of View | Gastro 2021 | WDHD News | WGO News | WGO History Corner | WGO Global Guidelines | Calendar of Events
Dilation of entire esophagus since anatomi- References: Hirano I, Chan ES, Rank MA, Sharaf
cally and clinically significant strictures Lucendo AJ, Molina-Infante J, Arias RN, Stollman NH, Stukus DR,
may be located anywhere in the esophagus Wang K, Greenhawt M, Falck-
A´, et al. Guidelines on eosino-
and maybe difficult to ascertain endoscopi-
cally philic esophagitis: evidence-based Ytter YT. AGA Institute and
Start with small diameter dilators with goal
statements and recommendations the Joint Task Force on Allergy-
to dilate to a controlled mucosal tear at a for diagnosis and management in Immunology Practice Parameters
single endoscopy session children and adults. United Euro- Clinical Guidelines for the Man-
If using bougie dilator endoscopically pean Gastroenterol J. 2017;5:335- agement of Eosinophilic Esopha-
inspect mucosa for tears between dilator 58. gitis. Gastroenterology. 2020
sizes
Peterson K, Clayton F, Qeadan F, Gor- May;158(6):1776-178.
Gradually dilate to 15-18 mm with sessions
every 3-4 weeks man D, Robson J, Allen-Brady K, Madanick RD, Shaheen NJ, Dellon
Once the target lumen diameter is reached Fang JC. Esophageal Eosinophilia ES.Madanick RD, et al. A novel
repeat dilation should be reserved for Is Common Among Relatives of balloon pull-through technique for
recurrent dysphagia. This may be needed esophageal dilation in eosinophilic
Eosinophilic Esophagitis Patients.
only every 1-3 years
Clin Gastroenterol Hepatol. 2020 esophagitis (with video).
Table 1. Principles for endoscopic dilation for Nov 19:S1542-3565(20)31557-3. Gastrointest Endosc. 2011
EoE Online ahead of print. Jan;73(1):138-42
Richter JE. Eosinophilic Esophagitis Katzka DA. Eosinophilic Esophagi-
Dilation in the Community--Try tis. Ann Intern Med. 2020 May
It--You will Like It--But Start Low 5;172(9):ITC65-ITC80.
and Go Slow. Am J Gastroenterol.
2016 Feb;111(2):214-6.
Figure 1. EoE pre-dilation and post-dilation to
mucosal tear.11
WORLD GASTROENTEROLOGY NEWS MAY 2021
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Gastro 2021
The World Gastroenterology Organ- Gastro 2021 will take place from More information is available on
isation (WGO) is pleased to co-host 9 – 11 December 2021. The confer- the Gastro 2021 website: https://www.
its biyearly international conference, ence, as currently planned, will be in gastro2021prague.org.
Gastro 2021, with the Czech Society a hybrid format with sessions offered This event is also co-organized jointly
of Gastroenterology (CSG), in on-line for those unable to travel by the Czech Society of Hepatology,
Prague, Czech Republic. to Prague. Czech Society of Gastrointestinal On-
cology, and Czech Society of Surgery.
We are pleased to present the Joint Steering Committee and Joint Scientific Program Committee:
Joint Steering Committee
WGO Representatives CSG Representatives
Naima Amrani, President Julius Spicak, CSG Board Representative
Cihan Yurdaydin, Past President Ondrej Urban, CSG President
Guilherme Macedo, President-elect Milan Lukas, CSG Past President
Joint Scientific Program Committee
WGO Representatives CSG Representatives
Carolina Olano, Uruguay, Co-Chair Tomas Hucl, Czech Republic, Co-Chair
Joost Drenth, The Netherlands Radan Bruha, Czech Republic
Goeffrey Metz, Australia Ilja Tacheci, Czech Republic
Gerhard Rogler, Switzerland
David Sanders, United Kingdom12 WORLD GASTROENTEROLOGY NEWS MAY 2021 Editorial | Expert Point of View | Gastro 2021 | WDHD News | WGO News | WGO History Corner | WGO Global Guidelines | Calendar of Events WGO and IFSO to Launch an Obesity-Focused Webinar on World Digestive Health Day The World Gastroenterology Organisation (WGO), together with the Internation- al Federation for the Surgery of Obesity and Metabolic Disorders (IFSO), invite its member societies, partners and health care professionals in the medical specialty to register for its first live global webinar event on Saturday, 29 May 2021, as part of its World Digestive Health Day (WDHD) campaign entitled Obesity: An Ongo- ing Pandemic. PROGRAM DETAILS The scientific program will begin at 11:00 UTC/07:00 New York/13:00 Ita- ly/16:30 India/19:00 China and is scheduled to last 4.5 hours. Sessions will feature hot topics in obesity (e.g. nonalcoholic fatty liver disease, cancer, and diabetes), clinical cases studies, and a discussion on the impact of the COVID-19 pandemic on patients with obesity. Each session includes time for Q&A, allowing attendees to participate in the discussions. Led by the WDHD co-chairs, Profs. Lilian Kow (Australia), Guilherme Macedo (Portugal), Reem Sharaiha (USA) and James Toouli (Australia), the WDHD scien- tific program features international faculty representing 13 different countries. The complete program can be found at: www.wdhd2021.org/program. FREE REGISTRATION & CONTINUING MEDICAL EDUCATION CREDITS Registration is open to all, including REGISTER HERE gastroenterologists, hepatologists, Registration will entitle you to: GI surgeons, and other health care professionals. There is no cost to register for the WDHD webinar on 29 May 2021. Registered attendees will receive access to all sessions and panel discussions, access to the we- binar recording, and an attendance certificate. To register, please visit the WDHD 2021 event website at www.wdhd2021.org/registration/. 3 European CME credits (ECMEC®s) have been granted by the European Accreditation Council for Continuing Medical Educa- tion (EACCME®), which may be converted to AMA PRA Category 1 Credits™.
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WORLD GASTROENTEROLOGY NEWS MAY 2021
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Pakistan Society for the Study of Liver Diseases
Webinar on ‘The Gut-Liver Axis’
teriodetes. Several factors affect the
Zaigham Abbas, MBBS, FCPS, FRCP, FRCPI, FACP, development and alteration of the gut
FACG, AGAF microbiome including birthing and
Department of Hepatogastroenterology infant feeding method, exposure to
Ziauddin University physical metabolic and psychological
Karachi, Pakistan
stress, environment, diet, medica-
tions, and stage of the lifecycle, and
comorbid diseases. The interaction
of gut microbiome with the host is
The World Gastroenterology Or- ated the Webinar. “There are a lot of mostly indirect and is mediated by
ganisation (WGO) selected the ‘Gut developments in the basic and clinical their metabolic products, also called
Microbiome’ as the focus of the research in the gut microbiome. postbiotics, which are released during
2020 World Digestive Health Day While the official date of WDHD food fermentation. Vast differences
(WDHD) campaign. The objective is 29 May 202, the initiative taken exist between the microbiomes of
of choosing this theme is to increase by WGO and related activities will apparently healthy people. Dysbiosisis
the awareness of the role of the gut continue throughout and beyond the an alteration in the microbial commu-
microbiome in health and modula- campaign year”. nity that results in decreased diversity
tion of different diseases. He introduced Prof. Zaigham and numbers of commensal bacteria.
The Pakistan Society for the Study Abbas from the Ziauddin University Studies suggest a relationship between
of Liver Diseases (PSSLD) orga- Karachi and current President of gut dysbiosis and chronic health con-
nized a webinar on 30 May 2020 in PSSLD who gave the first presenta- ditions such as inflammatory bowel
collaboration with WGO to com- tion on the ‘The Gut Microbiome disease, metabolic syndrome, cardio-
memorate WDHD 2020. The title and the Gut-Liver Axis.’ “We are vascular disease, obesity, and cancer.
of the webinar was “The Gut Liver not alone in our bodies. Living inside The Gut-Liver Axis is a bidirec-
Axis.” Prof. Saeed Hamid, from Aga every person are trillions of microor- tional relationship between the gut
Khan University Hospital, Karachi, ganisms. The gut bacterial microbiota microbiota and the liver. This recipro-
Pakistan, who is also Chair of the is comprised primarily of 4-5 main cal interaction is established by the
Hepatology Interest Group, moder- phyla including Firmicutes and Bac- portal vein, which transports gut-
Webinar on Gut Microbiome14 WORLD GASTROENTEROLOGY NEWS MAY 2021 Editorial | Expert Point of View | Gastro 2021 | WDHD News | WGO News | WGO History Corner | WGO Global Guidelines | Calendar of Events derived products directly to the liver bacterial overgrowth was common Steering Committee. He discussed and the liver feedback route of bile in chronic liver disease patients and ‘Therapies Targeting the Gut-Liver and antibody secretion to the intes- Intestinal microbiota on admission Axis’. Dr. Bajaj said, “Currently avail- tine. Dr. Abbas discussed the crosstalk predicted the risk for extra-hepatic able therapies are prebiotics, probiot- between bile acids and gut microbiota organ failure, acute on chronic liver ics, postbiotics, synbiotics, lactulose, and the role of the farnesoid X recep- failure, and death. The gut micro- rifaximin, and modified diets while tor (FXR). biome has a role in acute rejection emerging therapies are a fecal micro- Prof. Wasim Jafri, from Aga Khan after transplantation, acetaminophen- bial transplant, phage therapy and University and Director of the WGO induced hepatotoxicity, acute liver precision changes in the microbiota”. Karachi Training Center introduced injury, hepatocellular carcinoma, He concluded that microbiota could the next key speaker, Prof. Eamonn primary sclerosing cholangitis, and be managed in several ways to benefit Quigley. Prof. Quigley chairs the non-alcoholic and alcoholic fatty liver liver disease. Lynda K and David M Underwood disease. “In patients with cirrhosis and This online seminar was well-at- Center for Digestive Disorders, NAFLD the gut microbiota profile tended by participants from different Houston Methodist Hospital, and and systemic inflammation are signifi- parts of the world Including Prof. Ci- Houston, Texas, USA. He is Co-Chair cantly correlated and can concur in han Yurdaydin, WGO Past President of the WDHD 2020 Campaign. He the process of hepatocarcinogenesis”, and Chair of Nominations, and Prof. spoke on ‘Gut Microbiome and Liver he added. Kadir Docmeci, Past President Asian Disease’. He mentioned vascular, Professor Masood Siddiq, Past Pacific Association for the Study of lymphatic, and liver firewalls that President of PSSLD, introduced the Liver Diseases (APASL). captures gut bacteria entering the next speaker, Prof. Jasmohan Bajaj. bloodstream. He threw light on the He is Professor of Medicine at Vir- altered gut microbiota in chronic liver ginia Commonwealth University and disease and a role in hepatic encepha- Richmond VA Medical Center USA, lopathy. He said that small intestinal and a member of the WDHD 2020
15
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Spotlight: WGO Endoscopy, Other Procedures and
Outreach Interest Group
and reduction of “in-person” events.
Vivek Kaul, MD, FASGE, FACG, AGAF Under Dr Des Leddin’s leadership,
Chair, WGO Endoscopy, Other Procedures & Outreach Interest teaching endoscopy by remote men-
Group toring (TERM) is an initiative that
Professor of Medicine, Division of Gastroenterology & Hepatology
University of Rochester Medical Center, Rochester, NY, USA
the committee is actively exploring,
despite its many challenges.
The committee remains dedicated
to disseminating cognitive and
technical resources related to endos-
WGO’s Endoscopy, Other Proce- with the goal of creating regional copy teaching/training and clinical
dures and Outreach Interest Group, colonoscopy training teams practice and expanding educa-
consists of representative members • Again with the BSG, developing the tional efforts throughout the globe.
from around the world whose shared ERCP Train The Trainers workshops Additional areas of focus for the
interest and expertise in endoscopy As a result of a unique collaboration be- committee include a commitment to
brings them together to help further tween a few group members, ANZGI- continued virtual education through
the endoscopy related missions of the TA, Provation, the National University webinars or similar platforms and
organization. of Fiji and the Fiji WGO training collaborating with other WGO
This committee started as an center, recently an electronic endoscopy committees in areas of mentoring
“endoscopy interest group” under reporting system was installed in Fiji. and clinical research. Committee
Dr Richard Kozarek. Over the years Additional recent projects include members also regularly contribute to
the endoscopy interest group turned collation of international advice on the the world congress (endoscopy re-
into the “Endoscopy, Procedures and management of endoscopy through the lated) program agenda development
Outreach Interest Group”. Few years Covid pandemic and these resources and also present/moderate sessions
later it was renamed to its current are available on the WGO website. The from time to time.
title. In recent years, Drs Grace Elta, committee has also initiated the first As we emerge from the pandemic
Mark Topazian and Andrew Veitch collaborative guideline between WGO, and look to future challenges, we are
have served as Chairs. the World Endoscopy Organization and grateful for the strength, combined
Since its inception the committee the European Society for Gastrointesti- talent and commitment of the
has been involved with several proj- nal Endoscopy “Resuming endoscopy WGO staff and leadership and our
ects globally. Notably, the develop- during COVID-19 pandemic: ESGE, group members. We are also proud
ment of a research project based in WEO and WGO Joint Cascade Guide- of our global collaborations that al-
WGO’s Training Centers, generating line for Resource Limited Settings. In low us to address unmet needs, from
the first global endoscopy needs as- addition, a paper on PPE guidance was the most basic to the most aspira-
sessment. The group strives to make generated and is posted on the WGO tional, through this platform!
endoscopy resources and opportu- website (see link). This was truly a A listing of current committee
nities available to WGO Training global effort involving 19 colleagues members can be found here.
Centers. In recent years, these have from 13 countries across low, middle https://www.worldgastroenterology.
included: and high resource settings! org/who-we-are/organization/com-
• Involvement in a research study The Endoscopy Interest Group is mittees-interest-groups/endoscopy-
assessing adequacy of endoscope concerned about sustainability and other-procedures-outreach-interest-
disinfection (the ATP study) will be contributing to the work of the group
• In collaboration with the Brit- WGO Climate Change Committee.
ish Society of Gastroenterol- Additionally, expanding endoscopy
ogy (BSG), enabling interested training through low-cost initiatives
Training Centers to host Training remains a key focus of the group to this
Colonoscopy Trainers workshops, day, especially in light of the pandemic16
WORLD GASTROENTEROLOGY NEWS MAY 2021
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Training Center Spotlight – Bangkok
Lubna Kamani, MD
Liaquat National Hospital and Aga Khan University Hospital
Karachi, Pakistan
Siriraj hospital is a World Gastroen- where I was the first doctor from Paki- again accepted and welcomed whole-
terology Organisation (WGO) train- stan to be accepted into this course. heartedly at the Siriraj hospital for
ing center for endoscopy in the heart My training went on very smoothly further training. WGO training cen-
of Bangkok, Thailand. There they run as the consultants and staff were ters are an excellent opportunity for
parallel training sessions throughout very helpful and co-operative. The young physicians to get advanced en-
the calendar year on basic to advanced consultants, in particular, guided and doscopic training, especially when the
diagnostic and therapeutic endoscopy assisted me by providing useful tips training is not available in their host
courses. The entire application process and tricks during procedures and also country. I believe that there should
for these courses is highly competi- by taking regular lectures. Also, they be more WGO training centers like
tive as they receive many applications provided me with reading material in Siriraj hospital where the maximum
from scores of international candi- the form of a textbook and atlas. number of trainees get selected and
dates, and only a handful are selected. This training not only allowed me trained, especially if they are from a
Fortunately, I was selected for a to grow as an advanced Endosco- country with limited resources.
three-month hands-on ERCP training pist, but it also helped me in patient I am very grateful to all my train-
course, which ended in January 2011, management. Furthermore, because ers in Siriraj hospital for providing
of this, I was able to help my junior impeccable training that reshaped my
consultants, teach and train gastro- Endoscopy career and made a differ-
enterology fellows in my department ence in my patient care.
upon my return. In these years, I have
also written a few manuscripts on this
topic. As I moved on in my career, the
hospital I worked at wished to start an
EUS program and I could not think
of any other training center to attend
for to get this started. In 2019, I was17
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Training Center Spotlight – Porto Alegre
Ysela Picon Perez, MD
Universidad Ricardo Palma
Trainee, Porto Alegre Training Center
Lima, Peru
that we were facing a coronavirus pan-
demic. A few days later, the pace of
the activities were affected, the volume
of patients decreased, some activities
were suspended. In this circumstance,
Dr. Mario Reis as head of the Service
as an immediate response, started an
online course to be at the forefront
with the new virus knowledge and
The opportunity to participate in outpatient consultation, review clini- the necessary protection measures to
daily activities at the Porto Alegre cal cases in detail, participate in both continue with the assistance activities
Training Center (WGO) is an interdisciplinary clinical meetings to attend to patients in optimal condi-
enriching experience both profession- (pathology, radiology) and in online tions, clinical rounds, and virtual
ally and personally. The Hospital de meetings with national and interna- academic activities began.
Clinicas de Porto Alegre has 792 beds, tional assistants through the ECHO Four days after the pandemic was
provides care through the unique project (Extension for Community declared, Peru closed the air borders
health system (SUS) and has a high Healthcare Outcomes). These activi-
volume of patients with liver diseases ties facilitate feedback and internaliza-
(HCV, alcohol, NASH, metabolic, tion of concepts and knowledge. The
Transplanted), this has allowed me to hospital is a university center with
evaluate patients and discuss with the varied academic activity, and they
assistants in the medical rounds, inter- have a research center, which is one of
act with gastroenterology residents, be its strengths. The organization has the
at the side of the assistants during the passion with which their post-gradua-
tion students develop their projects is
admirable, I have had the satisfaction
of participating in a research group
and sharing with colleagues both
Brazilian and foreign. This experience
has motivated me to participate in
this group.
I am a Peruvian gastroenterologist,
eleven days after my arrival at the
Pictured above: Dr. Picon Perez attends an
online meeting with trainers.
training center, the WHO declared18
WORLD GASTROENTEROLOGY NEWS MAY 2021
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indefinitely and declared a curfew un- that allow me to provide timely care
til the end of June. In this situation, to patients with liver disease and open
my return date has been left open, a door for the Peruvian health system
uncertainty tests my ability to adapt, to provide everyone with an opportu-
it is a challenge to see it as an oppor- nity for liver transplantation.
tunity to act responsibly, in solidarity, I feel happy and fortunate to be in
and continue with the goals set. It is this center, I thank this opportunity
a challenge to get my best version out given to WGO, Professor Mario Reis
and return to my country with tools director of the Training Center for
his unconditional support, as well as
assistants, residents and administra-
tive staff, for the experiences and
knowledge shared during this period,
they are all very friendly and have
made my integration to the team
possible by making me feel part of
them. Maintaining this scholarship
is having a door to contribute to the
development of professionals with an
interest in hepatology, an experience
that motivates us to be better in this
field, to contribute to the care of our
patients, and the development of our
care services.19
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Training Center Spotlight – Rabat
terology, hepatology and endoscopy
Meriem Bakkar, MD while keeping pace with the most
Gastroenterology Unit recent learning tools. French is the
National Institute of Oncology adopted teaching language to facilitate
Ibn Sina University Hospital
Rabat, Morocco
knowledge sharing and access to
information, as some of the physicians
may not be fully familiar with English
terminology. RTC also aims to create
a link between the African doctors
and the international gastroenterol-
ogy’s community. Finally, it is also a
training platform for trainers. These
goals are reached with the collabora-
tion and support of several scientific
societies1.
Multiple modern and didactic
training tools are available in our
center: a conference room with a si-
multaneous translation booth, devices
for endoscopy trainings with com-
puterized simulators, mannequins,
I am Meriem Bakkar, gastroenterolo- Pr M.Classen and Pr N.Amrani’s and animal models (EASIE models),
gist and hepatologist and a proud goal to optimize digestive health ultrasound units, and a multimedia
member of the World Gastroenterol- care worldwide: creation of Rabat library.
ogy Organisation’s (WGO) Training Training Center
RTC’s Main Activities
Center in Rabat. I am absolutely hon- The demand for the prevention
The center offers 2 kinds of train-
oured to be given the opportunity to and treatment of digestive disorders
ings:
share some perspective on the WGO worldwide was such that the WGO
Rabat Training Center (RTC). started to envisage a global approach 1-Short term program: The annual
Ten years ago, I attended the RTC that contributes to level the playing intensive educational course
as a student. It was a fundamental field for developping countries. Pr The center provides a short-term
part of my training and education Meinhard Classen played an impor- training program by organizing a 15
in Gastroenterology. Thanks to an tant role enhancing and boosting day annual course. It is an educa-
unfailing support of my professors, digestive healthcare in those countries. tional event that gathers on average
the training I received enabled me to With these objectives and with the 70 young physicians and international
continue to build my learning and agreement of the Moroccan Ministry experts. The course includes a theo-
trace my path towards my dream of of Higher Education and the WGO, retical part with interactive courses
becoming a gastroenterologist and a the Rabat Training Center was created
hepatologist. in 2001. It is located at Mohammed 1 Société Nationale Française
Today, thanks to my devoted teacher V University, Faculty of Medicine and de Gastroentérologie (SNFGE)- The
Pr Naima Amrani’s trust, I have the Pharmacology. It is aimed at French Belgian Society of Gastrointestinal
privilege to join WGO’s mission aim- speaking physicians, mostly from Endoscopy (BSGIE)- Société Ma-
ing to tackle the disparities in educa- Africa. rocaine des Maladies de l’Appareil Di-
tion worldwide and training the next RTC’s main goal is to promote gestif (SMMAD)- Société Marocaine
gastroentelogists generation in Africa. high standards training in gastroen- d’Endoscopie Digestive (SMED) and
many others….20
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and clinical cases led by carefully interest in endoscopy practice. I have tional event held in Rabat in January.
selected speakers. Participants thus acquired motivation to keep improving Doctors from all Africa follow 2 weeks
acquire robust knowledge and get my practical skills at home and now, I course covering all different parts of
updates on digestive pathology as well am confident to do upper gastrointes- our very large specialty. They have the
as the recent guidelines. tinal endoscopies without supervision. opportunity to hear from international
Practical workshops in endoscopy To attend this course enabled me to experts in each field, to see experts doing,
and abdominal ultrasound for all choose gastroenterology and hepatology to handle different devices, and test
the attendees complete the train- as my future career in medicine and has their skills under supervision on animal
ing program. Hands on sessions are opened my mind to further trainings” models. This event does a fantastic job
organized for the participants who aiming at improving medical care in
are split into small groups according Africa. This happens under the warm
to their level and experiences. Various supervision of Pr Naima Amrani and
stations are available, from the learn- her wonderful team.”
ing of technical aspects in diagnostic
endoscopy with the help of simulators
and mannequin devices to advanced
therapeutic procedures on animal
models. All the stations are supervised
by an expert.
At the end of this intensive course a Dr. Asma Labidi, Winner of the
certificate of attendance are delivered Evaluation 2017, Tunisia
to the participants. An evaluation “The areas of training were various and
takes place and gives access to the best there was a great balance between theory
candidates for another participation. and practice: conferences on various
The event also offers great opportuni- fields of hepatology, GI oncology, and
ties for networking and exchanging motility disorders, hands-on endoscopy Dr. Danny DeLooze
views and contacts between the pro- workshops. It was a great opportunity - Trainer: Gent, Belgium
gram attendees and the experts. for me to make contacts with interna- “Since 2011 I have been participating
The RTC Annual Course through tional experts as well as colleagues from as lecturer/expert at the yearly WGO
some Trainees’ Testimony many African countries. Fortunately, I course in Rabat, Morocco. From the first
had the chance to be there once again time onwards, I was impressed by the
and it was a great honor for me to make professional framework that is set up to
a case presentation to my colleagues teach gastro-entero-hepatology to young
there. It was a very nice experience” African gastroenterologists. Every year,
I am surprised by the knowledge the
students have: I always give talks in an
interactive way with lots of questions for
the audience and I am surprised by the
answers I get from them. They are very
well prepared and exhibit a high level
of theoretical background. The African
Dr. Félicien Shikama, Rwanda students are eager to get practical infor-
“I was very impressed by the content of mation, not only during the lectures but
the course as it includes both theoretical also during the breaks they come to the
and practical sessions with great experts experts with lots of questions for their
from different countries. Many inter- daily practice. This WGO center plays a
esting topics in gastroenterology and crucial role in the formation and ongo-
hepatology are discussed. I was very Dr. Jean Christophe Saurin ing education of the African gastroenter-
interested in practical sessions and it - Trainer: Lyon, France ologists.”
was my first time ever to be trained on “I’m happy to have participated the past
animal models. Since then I got more 10 years to this very important educa-21
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Pictures from the 2020 WGO RTC Course
Dr. Alan Barkun
- Trainer: Montréal, Canada
“It is truly a life-changing event for both
participants and Faculty. Participants
are highly motivated, multi-country,
multicultural group of colleagues who
bring with them an openness of mind
and genuine thirst for learning that
in my experience is both unusual and
extremely gratifying for all both speakers
and attendees. The entire group becomes
essentially a family whose members learn
continuously together and from each
other, in a multitude of learning sessions
that include didactic, small group, and
hands-on opportunities.”
Dr. Nada Lahmidani
- Trainer: Fès, Morocco
“I was delighted to take this course a
few years ago as an apprentice and then
come back later as an expert. I warmly
congratulate this dynamic, professional,
and very reactive team. It is a unique
experience to meet eminent experts from
all over the world. An opportunity to be
seized by all gastroenterologists. Great
job. Great team! ”22
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Long term program: Training fel- ogy department led by Professor Naima term programs) and now I am regularly
lowships Amrani. The WGO center in Rabat invited as a French WGO expert of
In its effort to fulfill the global educa- helped train the first female gastroenter- Cameroonian origins. It offers a quality
tional mandate, the RTC offers a great ologist in Benin. After getting my degree, training in a pleasant environment at
opportunity to African physicians to I returned to my home country where the service of young gastroenterologists
add to their curriculum a cutting edge I am taking care of patients suffering under the leadership of the Director of
long term program allowing up to 5 from digestive diseases. I hope that this the Center, Professor Naima Amrani. It
years fellowships. They get academic training of young doctors from subsaha- is a model for transferring skills and it
and practical training and are exposed ran Africa will continue, it is in the best integrates specific needs of each trainee.”
to the clinical and technical aspects interest for its population.”
of hepatology, gastroenterology and Collaboration with Scientific
endoscopy. Both practical training Societies
with patients and theoretical courses The RTC also plays a major role in
at the University Hospital Ibn Sina in promoting gastroenterology at a na-
Rabat occur under the supervision of tional level. Its team is always pleased
confirmed specialists. The Moroccan to participate or organize hands on
specialty degree is delivered at the end sessions and courses either at national
of this training program. congresses or with a small group of
Medium-term programs are also residents in gastroenterology and
implemented for gastroenterologists practicing specialists in order to offer
who want to learn or update their them a continuing medical education
skills in all our specialty branches Dr. Ghislaine Ngatcha, Cameroun
especially in endoscopy. (For more
especially in diagnostic and therapeu- “I spent 4 years of training in gastro-
additional information, you can visit
tic endoscopy. They can benefit from enterology, hepatology and digestive
WGO RTC website: http://wgo-rtc.
the didactic means of the center and endoscopy at the WGO center in Rabat.
um5s.ac.ma).
the technical platform at the hospi- It allowed me to perform upper and
tal. WGO RTC is proud of having lower endoscopies, as well as thera- A leader is one who knows the
trained several specialists in Africa peutic endoscopic procedures (ligation way, goes the way and shows the
who now practice successfully gastro- of esophageal varices, foreign bod- way (John C. Maxwell)
enterolgy in their countries. ies removal, polypectomy, dilation of
stenosis…). Currently in Cameroun, I
Feedback from gastroenterolo-
practice gastroenterology and hepatology
gists on how RTC succeeded in
thanks to the WGO center in Rabat that
meeting their needs in terms of
taught me everything.”
education and formation
Dr. Saké
Alassan
Khadidjatou,
Benin
“After obtaining
my state doctor-
ate in general
medicine in Be-
nin, I benefited
from a long Dr Enam Sobkeng Goufack, Château
term training Thierry, France
in gastroenterol- “Rabat training center is particularly
useful for the development of gastroen- Pr. Naima Amrani. WGO RTC
ogy in Rabat. Director
It took place at terology in Africa. It has truly been a
driving force and inspiration in my pro- All of these achievements couldn’t
the RTC and at the University Hospital be realized without Professor Naima
in the Gastroenterology and hepatol- fessional development. I first attended
this center as a trainee (short and long Amrani’s hardwork, generosity, vision,You can also read
