|
Clinical
Activity
The Gastroenterology Service is an integral part of the Department
of Medicine of Hadassah Hospital. It is responsible for the
management of patients with digestive diseases, including
pancreatic, biliary and liver disorders incooperationwiththeunit
of liver diseases. The most common pathologies treated are
peptic and non-peptic dyspepsia, inflammatory bowel diseases,
neoplastic diseases of the digestive tract, motility and functional
disorders, pathological conditions of the small bowel, malabsorption
and maldigestion syndromes. The senior physicians of the Unit,
as well as the fellows, participate in the treatment of in-patients.
The management and follow-up of out-patients are carried out
in the Unit's Out-Patient Clinics. The Unit is also responsible
for service laboratories, including the clinical motility
laboratory and the different breath test examinations. An
important section of our clinical services includes a sophisticated
Endoscopic Unit, comprising upper and lower endoscopies, proctology
treatments, endoscopic laser therapy, ERCP, etc.
Research Activity
The main research projects of the unit focus on Inflammatory
Bowel Disease, Diabetic disorders of the GI tract, functional
bowel diseases and new treatments in perianal disorders. The
main research projects are:
1. ACE
inhibitors for the prevention of fibrosis in IBD and the role
of TGFBeta1: We have shown for the first time that
Captopril, an ACE inhibitor used in the treatment of Arterial
Hypertension, is effective in the prevention of fibrosis in
an experimental model of IBD. We found that this effect comprises
a depression of Angiotensin II and TGFBeta 1 that we determined
through molecular biology tests, including tissue measurement
of mRNA of TGFbeta1 by a semi-nested quantitative PCR. Similarly,
in collaboration with physicians of Asaf Arofeh Hospital,
our team carried out a study on the prevention of liver fibrosis
by Captopril.
2. The
impact of Stress on Inflammatory Bowel Diseases: Using
the rat model under acute and chronic stress, we have studied
different parameters of colitis and cytokins related to inflammation
and fibrosis. The role of Substance P was investigated in
this model of colitis.
3. Glutamine
and its beneficial effects in Experimental Colitis:
Extensive studies have been undertaken on the effects
of the AA Glutamine in the TNBS model of colitis in rats (cooperative
study with Prof Sevion and Levy from the Hadassah's School
of Medicine). Different aspects of its effects were considered,
including the role of anti-oxidants and the possible use of
Glutamine enemas in Ulcerative Colitis patients.
4. The
role of mast cells in the development of fibrosis in Inflammatory
Bowel Disease: A collaborative study with Prof. Levy-Shafer
from the School of Pharmacy in Ein Kerem. The influence of
mast cell activation and depression in the activity of IBD,
and the development of fibrosis, with in-vivo and in-vitro
experiments, were studied. This research is in its last stage
before publication.
5. Clinical
and basic research studies concerning GI Disorders in Diabetes
performed during the past few years:
Intestinal Transit Disorders in different experimental models
of diabetic rats: the role of Nitric Oxide.
Gastrointestinal disorders in a large diabetic population.
3) The influence of prokinetic drugs for the prevention of
hypoglycemic events in diabetic patients with gastroparesis.
6. Studies
regarding new therapeutic approaches in the treatment of proctologic
diseases: 1-Nitric Oxide, Botulinim Toxin and Capsaicine
for Refractory Fisura Ani: Studies with manometric correlation
in over 100 patients. 6) Capsaicine for the treatment of severe
and chronic Pruritus Ani has provided positive results in
40 patients.
7.
Functional
gastrointestinal disorders: Irritable bowel syndrome,
gastro esophageal reflux, dyspepsia and non-cardiac chest
pain. The development of specialized instrumentation for the
diagnosis of these disorders, and assessment of response to
therapy. Treatment of these disorders through hypnosis.
8. Biotechnology
and new advances in digestive endoscopy: we have been
active partners in the development of new metallic esophageal
and biliary stents, we are studying new approaches for the
potentially clogging status of biliary stents, which are important
in an early decision concerning the use of metallic or plastic
stents.
|
