Gastroenterology and Hepatology. Bench to Bedside

Section 1. Esophagus

A. Anatomy /Histology/Embryology
1. Lower Esophageal Sphincter
2. Barret’s esophagus
3. Webs, rings, diverticulae in esophagus
4. Cross sectional anatomy of esophagus: Tumor staging
5. Esophagus in portal hypertension
6. Tracheosophageal fistula
B. Physiology
7. Acid clearance mechanism and defects in GERD
8. TLESR
9. Neurophysiological basis of esophageal peristalsis [normal manometry values
C. Genetics
10. Genetic polymorphisms in GERD
11.Biomarkers in Barret’s esophagus
D. Pathology
12. Pathogenesis of achalasia cardia
13. Eosinophilic esophagitis: histopathology difference from reflux esophagitis
E. Pharmacology
14. Drugs acting on the LES

Section 2. Stomach

A. Anatomy and physiology
1. Cross sectional anatomy of stomach
2. Innervation of stomach- Types of vagotomy
3. Post GJ/gastrectomy anatomy
4. Parietal cell and the proton pump5. Chief cell
6. Enterochromaffin cells in stomach
7. Fundic gland: histology
8. Pyloric glands: histology
9. Gastric pacemaker
10. Blood supply –Arterial, venous supply of stomach and GE junction
11. Lymphatic drainage of stomach
12. Gastric volvulus
13. Intestinal metaplasia and atrophic gastritis
14. Gastric bed/ Lesser sac/Foramen of Winslow
B. Physiology
15. Gastric mucosal defense and its breakdown in peptic ulcer
16. Gastric proton pump
17. Neurohormonal control of gastric acid secretion
18. Gastric motility- Difference in fundus and body motility
19. Leptin 20. Motilin
21. Physiological basis of breath tests for H.Pylori
C. Genetics
22. H.Pylori virulence factors-cag, vac genes
23.Host genetic polymorphisms and outcome of H.Pylori infection 24. Host genetic polymorphisms and response to PPI
25. c-kit mutation and response to therapy in GIST
D. Pathology
26. Molecular pathogenesis of gastric cancer [Corea’s hypothesis]
27.Pathogenesis of H.pylori associated gastric lymphoma
28. NSAID associated gastric mucosal injury
29. Autoimmune gastritis
30. Granolomatosis gastritis
E. Microbiology
31. H.Pylori- structure, stains for H.pylori
F. Pharmacology
32. PPI/ H2 blockers
33. Dopamine antagonists
34. Serotonin antagonists

Section 3. Small intestine

A. Anatomy/ Histology/Embryology
1. Development of small intestine and malrotation
2. Meckel’s diverticulum
3. Neural plexuses: Meissner’s/Aeurbach’s plexus
4. Villous anatomy
5. Microvilli
6. Intraepithelial lymphocyte
7. Brunner’s gland
8. M cells
9. Paneth cells
10. Zona occludens
11. Toll like receptors
12. Intestinal stem cells
B.Physiology
13. MMC
14.Intestinal Pacemaker
15.Intestinal Permeability
16.Small Bowel Permeability (SIP)
17. Mucosal Defence
18. Immunoglobulin A
19. Defensins
20. Enterokinase
21. Cholecystokinin
22. Secretin
23.Incretins
24. Peptide YY- ileal brake
25. Brain gut axis
C.Biochemistry
26. Carbohydrate digestion
27. Protein digestion
28. Lipid digestion
29. Vitamin B 12 absorption
30.Iron absorption and metabolism
31. Copper absorption
32. Vitamin D metabolism
33.Bile acid transport: Enterohepatic pathway
34. Cholestrol metabolism
35.D-Xylose test
36. Vande Krammer test
37. Breath tests for malabsorption-physiological basis
38. Breath tests for SIBO-physiological basis
39. Intestinal adaptation
D. Pathogenesis
40. Protein losing enteropathy
41.Eosinophilic gastroenteritis
42.Celiac sprue
43. Tropical sprue
44. Intestinal tuberculosis
45. SIBO
46.Short gut syndrome
47. Radiation enteritis
48.Indeterminate colitis
49. Pathogenesis of IBD
E. Microbiology
50. Normal gut microbiota
51. Lifecycle of parasites
52. Bacterial toxins causing diarrhea
53. Opportunistic pathogens in HIV patients
54.ASCA and ANCA: Role in IBD
F. Pharmacology
55.Probiotics
56. ORS-New Vs old; super ORS
57.Zinc and its role in small intestinal diseases
58. Green banana diet
59. Vaccines for intestinal infection
60. Enteral nutrition-types and indications
61. Immunonutrition
62. 10.5-ASA preparation and small intestinal release
63. TPMT assay and azathioprine metabolism
64. Biologicals in I BD
65. Methotrexate and folic acid
G. Genetics
66. CARD/ NOD genes
67. Genetics in IBD/IBD genes -Indian scenario
68. Lactase genes

Section 4. Large intestine

A. Anatomy/ Histology/Embryology
1. Anal sphincters
2. Dentate line
3. Rectal folds (Valves of Houston)
4. SRUS-Histopathology
5. Adenomatous polyps- Types and significance
6. Juvenile and hamartomatous polyps
B. Physiology
7. RAIR
8. Fluid handling by intestine
9. Colonic motility
10. Defecation-mechanism
11. Intestinal fistulas
C. Biochemistry
12. Short chain fatty acids
13. Fecal occult blood test- Types, limitations
D. Pathogenesis
14. Ulcerative colitis
15. Pseudomembranous colitis16. Molecular pathogenesis of colonic cancer
17. Amebiasis
18. Microscopic colitis
19. Newer concepts in pathogenesis of IBS
20. Montreal classification of IBD
21. Pathogenesis of pseudo-obstruction

Section 5 . Liver

A. Anatomy/Histology/ Embryology
1. Hepayte
2. Cholangiocyte
3. Ito cell
4. Stellate cell
5. Hepatic stem cell
6. Kupffer cells
7. Hepatitis B- structure and replication
8. Hepatitis C –structure and replication
9. Hepatitis E- structure
10. Hepatic sinusoid
11. Venous drainage of liver- importance in Budd Chiari syndrome
12. Ligaments of liver, surface anatomy of liver
13. Segments of liver
14 .HBV mutants
15. IL-28B polymorphism and HCV
B.Physiology
16. Bilirubin metabolism and congenital disorders
17. Bile salt metabolism-enterohepatic shunts, congenital disorders
18. Liver as an immunological organ
19. Ammonia handling in liver, kidney, brain, muscles
20. Ethanol metabolism
21. Aminoacids- Branched chain : relevance in liver disease
22. Urea cycle and congenital defects
23. Eneterohepatic Circulation
C. Pathology
24. Necroinflammatory and fibrosis scores
25. Pathogenesis of alcoholic liver disease
26. NAFLD-Pathogenesis
27. Wilson’s disease
28. Hemochromatosis 29. Glycogen storage disorders
30. HCC-molecular pathway
31. Hepatic fibrosis- pro and antifibrotic mechanisms
32. Hepatic encephalopathy- pathogenesis
33. HRS- pathophysiology
34. Ascites in liver disease – pathogenic mechanism
35. NCPF: pathogenesis
36. EHPVO: pathogenic mechanisms
37. Pathogenesis of portal hypertension in cirrhosis – role of structural and functional reasons for portal hypertension
38. Pathogenesis of hepato-pulmonary syndrome
39. Pathogenesis of ALF
40. Endocrine complications in cirrhosis
D. Microbiology

41. Genotyping methods
42. ELISA
43. HBV life cycle
44. HCV replicon
45. Malarial, enteric, dengue hepatopathy
46. Mechanisms of HBV and HCV related HCC
47.HCV and steatosis

E. Pharmacology
48. Interferons
49 Ribavirin
50. Eltrombopag
51. Sorafenib
52. Nucleoside analogues/nucleotide in HBV therapy
53. L-Ornithine L- Aspartate
54. Lactulose and other ammonia lowering agents
55. Somatostatin analogues
56. Role of viral kinetics in HCV treatment
57. Role of HBsAg titre in HBV treatment
58. Side effects of oral antiviral therapy and its pathogenesis

Section 6. Bile duct, Gall bladder and Pancreas

A. Anatomy/ histology/ embryology
1. Pancreas development- Pancreas divisum, Annular pancreas, Ducts of Morgagani, Santorini
2. Choledochal cyst- Todani classification, types
3. Lesser sac anatomy-pancreatic pseudocyst
4. Sphincter of Oddi
5. Pancreatic stellate cells
6. Pancreatic stem cells
7. Pancreas- endocrine functions- Pancreatic neuroendocrine tumors
B. Physiology
8. Bile production- bile acid dependent and -independent mechanisms
9. Gallbladder bile Vs duodenal bile- changes in compositon
10. Neurohormonal control of pancreatic secretion
11. Neurohormonal control of biliary secretion
12. Normal pressures in pancreatic and bile ducts 13. Pancreatic enzymes- functions and feedback regulation
C. Pathology
14. Microlithiasis
15. Gallstone formation- supersaturation, nucleation, gallbladder dysmotility
16. Gallstone- types and composition
17. Pathophysiology of alcoholic chronic pancreatitis
18. Pathophysiology of acute pancreatitis
19. Pancreatic malignancy-molecular mechanism
20. Cystic neoplasms of pancreas-Difference from pseudocyst
21. Autoimmune pancreatitis
22. Gallbladder carcinoma- etiopathogenesis 23. PSC
24. PBC
25. Pain in chronic pancreatitis- pathophysiology
D. Pharmacology
26.Octreotide
27. Pancreatic enzyme supplements
28. Ursodeoxycholic acid
29. Statins

E. Genetics
31. Genes in chronic pancreatitis with relevant Indian data
32. Genetic polymorphisms in gallstone disease

Section 7. Miscellaneous

1. SiRNA
2. Genetics of celiac disease
3. Cannabanoid receptors
4. Cadherins
5 . Carcinoids in GI / Carcinoid syndrome
6. CMV disease in GI and Liver
7. Role of Integrins: development of biologics like natalizumab
8. Wnt: GI Stem cells B-catemin 9. Hedgehog: role in pancreas
10. EGFR/ receptor tyrosine kinases/ K Ras
11. IFN signalling: antiviral immunity
12. Overview of innate immunity
13. T cell subsets: Th1, Th2, Th17
14. B cells / Eosinophils
15. TGF B pathway
16. G Coupled protein receptors
17. Small GTPases : Rho/ Rac/ CDC 42
18. Angiogenesis
19. GWAS
20.Transcription factors
21. Oncogenes
22.Tumor suppressor genes
23.Telomerase
24. Liver nuclear receptors
25. Role of Vit D in GI diseases
26. Apoptosis
27. Gene therapy in Gastroenterology
28. Stem cells in Gastroenterology

The book aims to be a handy compendium to the very voluminous texts of gastroenterology and hepatology existing in the knowledge market and provides the reader with an easy understanding of the bench knowledge (basic sciences) as they apply to bedside practice (clinical gastroenterology). With introduction and contributions from Prof Eamon Quigley, Former president of World Gastroenterology Organization and American College of Gastroenterology, the book covers the recent advances in the basic sciences that form an important pillar of the knowledge, thereby linking basic sciences such as anatomy, physiology, biochemistry, molecular medicine, etc. to clinical conditions, diseases and new therapeutic approaches in gastroenterology and hepatology. The book is written in a simple easy to read format, with a lot of diagrams and flowcharts, making it a handy guide. It also discusses in-depth about very common clinical conditions encountered in hospital settings such as ulcerative colitis, pseudomembranous colitis, colonic cancer, amebiasis, and various other syndromes and diseases. This book is a useful read for fellows and trainees in Gastroenterology and Hepatology, as well as gastroenterologists, hepatologists and physicians interested in digestive disorders.

Dr.Gourdas Choudhuri, MD (Medicine), DM(Gastroenterology), FACG, FAMS, FICP, FRCP, Chairman and Head, Department of Gastroenterology and Hepato-biliary Sciences, Fortis Memorial Research Institute, Gurgaon, Haryana, India

 

Dr. A. C. Anand MD (Medicine), DM (Gastroenterology), FICP, FSGEI, FRCP(London), FRCP (Edinburg), FACP, FACG, FAMS, Professor and Head, Department of Gastroenterology & Hepatology
Kalinga Institute of Medical Sciences, Bhubaneshwar, India

Dr Piramanayagam P, MD (Medicine), DM Gastroenterolgy), Consultant, Department of Gastroenterology, Apollo Hospitals 21, Greams Lane, Off Greams Road Chennai, India