‘Gastrointestinal problems highly prevalent in Middle East’ Chief of Asian Institute of Gastroenterology in Kuwait

KUWAIT CITY, April 28: Gastrointestinal problems are highly prevalent in the subcontinent and the Middle East, but it’s overshadowed by the huge attention given to cardiac and other ailments, says eminent gastroenterologist and chairman of Asian Institute of Gastroenterology Prof D Nageswar Reddy.
The professor was in Kuwait on the invitation of Indian Doctors Forum (IDF) for the annual KMA-IDF Oration, 2013, held under the patronage of Ministry of Health, Kuwait, Sunday.

Professor Reddy is also renowned for being the first surgeon in the world to conduct the Natural Orifice Transluminal Endoscopic Surgery (NOTES), which has since attracted a lot of attention in the medical world.

The incidence of gastrointestinal infections in India is 30 percent of the total population, which is a sizeable number. This percentage is comparable to prevalence rates in the Middle East, especially Egypt, Saudi Arabia, Bahrain and Syria among others. “Gastrointestinal infections are high in Kuwait too.”
Some of the commonly found infections, Prof Reddy noted, include helicobacter pylori, “which is extremely common in the Middle East and India.” It causes ulcer and other complications in patients.
Helicobacter Pylori, however, is easily eradicable, and 80% of all cases are found in rural areas. The exact mode of transmission of this disease is not fully known, though. Prof Reddy said that genetic factors also play a significant role in the contraction of the disease.

Hepatitis is another commonly occurring gastroenterological infection; about 8 percent of the Indian population suffers from Hepatitis virus. And 2 percent of the population suffers from Hepatitis C, which together make up 10 percent of the population. Hepatitis incidence is high in Egypt too.

The professor stressed the gravity of Hepatitis saying that it can lead to serious liver diseases, including liver cancer.

Research is going on in the treatment of Hepatitis, and a vaccine for Hepatitis B has been discovered. Taiwan, which had a very high proportion of Hepatitis B infections, 20 percent of the population, has brought the disease under control by administering the vaccine through a national vaccination policy.
 The prevalence in Taiwan is now under 0.5 percent of the population, “which is a remarkable achievement to accomplish in a period of 10 years.” The professor also hailed the initiatives undertaken by China to eradicate Hepatitis B.

The lesson to take out from the Taiwan and China experience is that with cooperation between researchers and government, disease control can be very effective.

Cancer of esophagus is very common in the Iran-Kashmir belt. The professor said environmental and genetic factors as having a hand in this phenomenon. Genetically, he said people in the Middle East and subcontinent, have a tendency for truncal obesity, “which is due to the mutation of a particular gene.”
Asian Institute of Gastroenterology (AIG), which Prof Reddy is the chairman of, receives referrals from all over the world, and many doctors from the region, including Saudi Arabia, Egypt and Oman, go there for special training.

More than 400 international doctors, including the US and Europe, have been trained in the institute, located in Hyderabad in India, and is the only center outside of Europe to be recognized by the European Society of Gastroenterology. The Singapore government sends two doctors every year to the institute for special training.

Research is another area of focus at the Asian Institute of Gastroenterology. Prof Reddy noted that research funds for gastroenterology don’t pour in very enthusiastically like in some of the other branches of medicine, and the institute depends on government funds and native support.

The drug industry which finances major researches in heart diseases and other topics, is less inclined to spend on gastroenterological diseases, he noted without citing reasons.

However, the institute enjoys 200 percent tax exemption as the government fully appreciates its contributions for the enhancement of medical knowledge and service to patients.

The Indian government provides tax exemptions on all medical researches that truly benefit the patients. A vigorous whetting process precedes all such relaxations, and the Asian Institute of Gastroenterology passed muster by a huge margin.

The professor underlined the need for more interaction between Kuwaiti medical fraternity and their counterparts in India. He saw opportunities for exchange programs, where Kuwaiti doctors can benefit from the training facilities in his institute.

Endoscopy, transplantation and stem cell research are in highly developed stages at the institute, he added. Kuwaiti doctors from Farwaniya Hospital are already being trained at the Asian Institute of Gastroenterology.

To a question on how the institute benefits poor patients, the professor said all the doctors at the institute are non-practicing doctors, and only work for salary, so that patients are not charged whimsically.

The treatment facilities are so structured that 30 percent of the patients avail free treatment, 30 percent enjoy cost-to-cost treatment, and the remaining are charged with a profit margin to run the institute.
The institute’s Endoscopic Ultrasound Technology is the best in the world, and recently a big team of specialists from the US visited the institute to study it.

The NOTES surgical method, which was developed and tested at the institute for the first time in the world, is more advanced than laparoscopy and is a non-invasive procedure. However, Prof Reddy, said that the method has drawbacks as it’s highly operator dependent, and so not everyone can use it.

The NOTES method was first tested on a hen as its GI system is very close to humans. Leading doctors from reputed institutes like John Hopkins flew down to Hyderabad to learn about NOTES.

Dr Reddy has more than 200 publications in reputed medical journals, and a peer reviewer for many journals. He has contributed immensely to international text books on gastroenterology, and has been bestowed with many national and international awards. He has been honored with the prestigious Padma Shri Award by the government of India.

By: Valiya S. Sajjad Arab Times Staff

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