Splenic flexure is a chronic gastric disorder which consider as a subtype of IBS. It is used to describe swelling, muscle contractions of the colon, and upper abdominal anxiety as a result of trapped gas in the colon.

Splenic Flexure Syndrome can cause irregular bowel complications. This syndrome can be managed by diet. Those people who suffer from this condition must be avoiding food rich with carbohydrates, especially artificial sweeteners.

Long chain carbohydrates are not break down or absorbed in the small intestine because of a deficiency of digestion enzymes. The undigested food passes into the large intestine, where harmless and normal bacteria break down the food. This process produces hydrogen, carbon dioxide, and, in about one-third of all people, methane gases, which are released through the rectum. Various bacteria as E. coli and Salmonella can support in the progress of Splenic Flexure Syndrome. Consumption of food fast can cause swallowing air which move through the digestive tract. All of these condition will can be caused splenic flexure.

Consumption of artificial sweeteners one of reason of splenic flexure syndrome due to accumulation of gases, so person has problems in gastrointestinal tract must be avoid artificial sweeteners.

Background & Aims: Ulcerative colitis (UC) and Crohn’s disease (CD) are Inflammatory bowel diseases (IBD) of unclear etiology that cause substantial morbidity and predispose to Colorectal-cancer (CRC). There are two isoforms of STAT3-α and β; STAT3α is pro-inflammatory and anti-apoptotic, while STAT3β has opposing-effects on STAT3α. We determined the contribution of STAT3 to UC and CD pathogenesis by comparing disease severity caused by dextran sodium sulfate (DSS; UC model) or 2, 4, 6-trinitrobenzenesulfonic acid (TNBS; CD model) in mice expressing only STAT3α (∆β /∆β ) and in wild-type (WT) mice treated with TTI-101, a small-molecule inhibitor of both isoforms of STAT3. Methods: Seven days following administration of DSS in drinking water or two days following a single intra-rectal administration of TNBS, ∆β /∆β mice, cage-control (+/+) mice and WT mice given TTI-101 or vehicle were examined for IBD manifestations; their colons were evaluated for apoptosis of CD4+ T cells, levels of STAT3 activation, IL-17A protein expression and transcriptome alternations. Results: IBD manifestations were increased in ∆β /∆β transgenic vs. cage-control WT mice and were accompanied by decreased apoptosis of colonic CD4+ T cells. Complementing and extending these results, TTI-101 treatment of WT mice prevented IBD, markedly increased apoptosis of colonic CD4+ T cells, reduced colon levels of IL17A-producing cells and down-modulated STAT3-gene targets involved in inflammation, apoptosis-resistance and colorectal-cancer metastases. Conclusion: STAT3, especially in CD4+ T cells, contributes to the pathogenesis of UC and CD and its targeting may provide a novel approach to disease treatment.

At first we need to present and clarify the renal failure patient and what is his condition and how these conditions is dealt with, as our topic actually is about problems related to managing the kidney patient problems or complications. An END STAGE RENAL FALIER PATIENT is a one who is suffering electrolyte imbalance in form of: Low calcium, taking supplements like 500 mg tablets 3 times a day and suffering from anaemia taking 5 tablets of folic acid once daily. MULTI VITAMINS FOR : Iron, vitamin B suffering from high blood pressure so at least taking one type of anti hypertensive medications (sometimes with malignant hypertension) high doses of several types of anti-hypertensive medications are prescribed (may reach 230/130 ). Also the patient on dialysis in continuous stress causing stress ulcer together with uraemia causing gastritis. Both of which recommend good management alternating between proton pump inhibitors and antacids to avoid aluminium hydroxide protective coating as it is not eliminated by on dialysis active vitamin D (HYDROXYCALCIFEROL). For calcium metabolism (absorption and bone deposition), other less common medications pain killers for: Itching body aches. Antibiotics for secondary infections and catheter related infections so in general a patient may take between 5-8 tablets 3 times daily. That’s why we are here to talk about HOW TO MAKE PILLS FOR (ESRF) PATIENT EASIER TO SWALLOW 1. Big tablets as calcium could be made chewable 2. Gastric medications should be combined and given as effervescence 3. Specific multi vitamin formulas for ESRF patients 4. Digestive enzyme supplement tablets should be prescribed 5. Folic acid is given as several formulas instead of taking up to like 8 tablets 6. If medications can be provided as syrup or powdered forms in capsules for example to be easily dissolved in water or drinking vial like packages

Statement of the Problem: Functional GI disorders are increasingly researched to have a strong rooted relationship with underlying behavioral abnormalities that can be effectively addressed with Yoga in addition to standard medical care. Yoga is an ancient Indian discipline that entails practices to connect mental, spiritual and physical health to stimulate one's mind and body to become self aware and observant. Over centuries, this practice has revealed itself to offer therapeutic effects on multiple organ systems by virtue of a deeper connection between mental and physical health. Numerous gastrointestinal disorders have been discovered to have an underlying behavioral etiology. These primarily include IBS (Irritable Bowel Syndrome) (figure 1), FAPD (Functional Abdominal Pain Disorders) and IBD (Inflammatory Bowel Disease). This article will aim to review gastrointestinal disorders with an associated behavioral or mental preponderance that have been studied to benefit from the healing and therapeutic effects of yoga. Recent Publications 1. Konturek P. C., Brzozowski T., Konturek S. J. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of Physiology and Pharmacology. 2011;62(6):591–599. 2. Yoshihara K, Hiramoto T, Oka T, et al., Effect of 12 weeks of yoga training on the somatization, psychological symptoms, and stress-related biomarkers of healthy women. Biopsychosoc Med 2014; 8:1. Annie Shergill Banner - University Medical Center, USA Figure 1: Multiple Yoga postures that can be performed for symptomatic relief in Irritable Bowel Syndrome Journal of Gastrointestinal & Digestive System Volume 09 ISSN: 2161-069X Gastro Congress 2019 July 08-09, 2019 Notes: conferenceseries.com July 08-09, 2019 | Zurich, Switzerland 14th Euro-Global Gastroenterology Conference Page 22 3. Goodwin RD, Cowles RA, Galea S, Jacobi F. Gastritis and mental disorders. J Psychiatr Res 2013; 47:128. Yoga Therapy for Abdominal Pain-Related Functional Gastrointestinal Disorders in Children: A Randomized Controlled Trial.Korterink JJ1, Ockeloen LE, Hilbink M, Benninga MA, Deckers-Kocken JM. 4. Skowronek I, Handler L, Guthmann R. Can yoga reduce symptoms of anxiety and depression? J Fam Pract 2014; 63:398–407. 5. Effect of Yoga-Based Intervention in Patients with Inflammatory Bowel Disease.Sharma P1, Poojary G2, Dwivedi SN3, Deepak KK4.

With the commencement of clinical use, endoscopy now covers a wide range of usage for clinical examination and minimally invasive surgery. It is a great trend and reality for such techniques to go further into a state of routine approaches in clinical practice. Now, I am willing to introduce the excellence of initiation and development of gastrointestinal endoscopy in three selected facets. Endoscopic Retrograde Appendicitis Therapy--ERAT: Inspired by the success of ERCP for the treatment of suppurative cholangitis, we developed a new minimally invasive method for the treatment of acute appendicitis, and named as Endoscopic Retrograde Appendicitis Therapy (ERAT) in 2009. Typical steps of ERAT are: Cannulation into the appendiceal lumen, appendiceal lumen cleansing and decompression, endoscopic retrograde appendicography (ERA), appendicolithotomyremoval of appendiceal obstruction, plastic stent placement and release. Now, as a minimally invasive approach, ERAT can be used in almost all types of appendicitis, and might be golden criteria in differential and final diagnosis of appendicitis. We are sure that ERAT will be a popular method in the treatment of appendicitis and is worthy of promotion widely. LiuPOEM: Peroral endoscopic myotomy (POEM) was developed to provide a less invasive and permanent treatment for esophageal achalasia. Based on this technique, we initiated a modified POEM approach and named as Liu-POEM, which is no need for creating a tunnel and hence shortens operation time remarkably and alleviates patient’s pains. Now, Liu-POEM has been used by more and more endoscopists in the world. Pure NOTES: Since Natural Orifice Transluminal Endoscopic Surgery (NOTES) was first described by Anthony Kalloo, It has attracted tremendous interest from surgeons and gastroenterologists all around the world. Natural orifice transluminal endoscopic surgery (NOTES) uses transvisceral access to the peritoneal cavity through the mouth, colon, urinary tract, and/or vagina.Based on the techniques of conventional NOTES, we conducted the hybrid procedures for NOTES, i.e. Pure NOTES. Now, a number of endoscopic approaches can be completed by NOTES and Pure NOTES

At various times of treatment, IBD patients are prescribed suppositories and rectal medication is the acknowledged first line treatment for mild to moderate active ulcerative colitis and other gastrointestinal disease and ailments. Yet, patient compliance with prescribed rectal medication is abysmal, roughly 30%, leading to advancement of disease and increased healthcare costs. A disposable suppository applicator with patented technology transforms the value proposition for patients when deciding to adhere to their doctors prescribed drug therapy. Patients identify quality of life issues as a leading factor in noncompliance with suppository treatment. Lying on the left side for 30 to 45 minutes to administer the medication and the need for protective undergarments due to leakage are barriers to compliance. The new technology allows gas flow during the administration of the medication and withdrawal of the apparatus reducing the time for administration from 45 minutes to less than 5 seconds and allows immediate resumption of daily activities, without the need for protective undergarments. The applicator increases patient compliance and offers a new conversation with patients for physicians prescribing appropriate suppository medication. Invented by a patient with firsthand knowledge of the encumbrances of suppository medication, the device is the first and only rectal suppository applicator cleared for marketing and distribution by the FDA. The patented, inexpensive, disposable device fits within the changing healthcare paradigm with a cost effective medical technology that incentivizes a behavioral change on the part of chronically ill patients to become more compliant with their prescribed rectal medication therapy.

Extraordinary advances in hepatology have occurred that impact the diagnosis and treatment of liver disease. Effective therapies for hepatitis B and C have been developed and continue to be refined. The treatment of hepatitis B infection is more complex as more therapeutic options become available. Hepatitis C therapy continues to evolve with remarkable success. Alcoholic liver disease remains a significant health problem and nonalcoholic fatty liver disease (NAFLD) is rapidly becoming a health problem of epidemic proportions. Approaches have been developed to manage the complications of cirrhosis and hepatocellular carcinoma. Liver transplantation has evolved from an experimental life-saving procedure to a standard therapy for end-stage liver disease. This conference will offer cutting edge technology presentations on recent advances in hepatology

Short bowel syndrome is defined as “reduction of functioning gut mass below the minimum amount necessary for adequate water and electrolyte absorption and adequate digestion and absorption of nutrients”. This may occur when there is less than 200 cm of functional gut remaining. Most digestion and absorption occurs in the first 150 cm. Vitamin B12 and bile salts are absorbed in the distal ileum. The distal ileum provides a brake, through the effects of Peptide YY (PYY), and the ileocecal valve. PYY inhibits vagally stimulated gastric acid secretion, and gastric and intestinal motility. Following small bowel resection, gastric hypersecretion occurs, and proton pump inhibitor therapy is therefore required in the early management of patients. Glucagon-like peptide 2 stimulates gut hyperplasia, and increases the absorptive capacity of the residual small bowel. The amino acid glutamine is also thought to enhance intestinal adaption. The presence of the colon is associated with increased PYY levels, providing a “colonic brake”. Colonic bacteria produces short chain fatty acids from non-absorbed complex carbohydrates, which contributes significantly to nutrient and fluid balances Problems of fluid and electrolyte balance generally occur when there is less than 120 cm small bowel remaining. Less than 50 cm of small bowel (with an intact colon), and less than 100 cm without a colon invariably necessitates long-term parenteral nutrition. Management of SBS involves use of antidiarrheal agents (loperamide, tincture of opium), to reduce diarrhea, and increase “dwell” time for absorption. In patients with an intact colon, dietary maneuvers include use of a high complex carbohydrate (60%), and a low fat diet. Patients should also be on a low oxalate diet to prevent the occurrence of oxalate stones. In patients without a colon, a high fat diet is generally implemented. Teduglutide, a GLP-2 analog has recently been shown to significantly improve intestinal absorption, with a deceased requirement for TPN. Surgical options include segmental reversal of the small bowel (Biachi procedure), and serial transverse enteroplasty (STEP procedure). Small bowel transplant is considered in patients who have developed lifethreatening complications of short bowel syndrome and TPN therapy