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Gastroenterology Presentations

Celiac Disease

Terry Sigman completed her Pediatric residency and Pediatric Gastroenterology fellowship at ²»Á¼Ñо¿Ëù. She is presently the Director of the Division of Gastroenterology at the Montreal Children’s Hospital, ²»Á¼Ñо¿Ëù Health Centre, where she cares for patients with intestinal and liver disease both in the inpatient and outpatient setting. Her particular clinical interests are in children with inflammatory bowel disease, celiac disease and polyposis syndromes. She is also the Associate Chair of Pediatrics, Continuing Professional Development and Faculty Development Director for the Department of Pediatrics and Director of Physician Apprenticeship Course, Faculty of Medicine, ²»Á¼Ñо¿Ëù.

Learning Objectives:

1. Describe the classic and atypical presentations of CD – and what has changed over the years
2. Understand the various approaches to diagnosis of CD
3. Understand the management and its importance in the care for a patient with celiac disease

Approach to GERD/PPI and Beyond

Dr. Serge Mayrand obtained his medical degree from the University of Montreal in 1984 and completed his Internal Medicine and Gastroenterology Residency Training at ²»Á¼Ñо¿Ëù and the Montreal General Hospital in 1989. He then pursued a Research Fellowship Program in digestive motor disorders at the University of Toronto and the Toronto Western Hospital, under the supervision of Dr. N.E. Diamant. In 1992, he joined the Department of Medicine and the Division of Gastroenterology at the Montreal General Hospital and ²»Á¼Ñо¿Ëù Health Center, where he holds the position of Director of the Esophageal Motility Laboratory. He is also co-Director and co-Founder of the ²»Á¼Ñо¿Ëù Multidisciplinary Esophageal Clinic, devoted to the diagnosis and medical and surgical treatment of benign esophageal disorders. He was a member of the Executive Committee of the Quebec Association Of Gastroenterologists from 2001 until 2019 and served as Vice-President from 2019-2021. His main academic interests include esophageal diseases, particularly motility disorders and gastro-esophageal reflux disease and its complications such as Barrett’s esophagus, as well as eosinophilic disorders.

Learning Objectives:

1. Review the updated guidelines on the diagnosis and treatment ofgastro-esophageal reflux disease (GERD)
2. Define the role of endoscopy in the management of this condition.
3. Establish the relative contribution of the various lifestyle modifications and pharmacological therapies available
4. Recognize the importance of Eosinophilic Esophagitis (EoE) asan emerging cause of dysphagia/food bolus impaction, and briefly discuss its management

Approach to Dyspepsia: Helicobacter pylori Diagnosis and Therapy

Carlo A. Fallone, MD, CM, FRCP (C), AGAF, CAGF is an Associate Professor of Medicine at ²»Á¼Ñо¿Ëù, and full-time gastroenterologist at ²»Á¼Ñо¿Ëù Health Center (MUHC) where he is currently the chief of Endoscopy.ÌýDr. Fallone’s research activities include clinical trials, evaluation of diagnostic tests and decision tree analyses on the topics of Helicobacter pylori, gastroesophageal reflux disease, dyspepsia, gastrointestinal bleeding, and endoscopy. ÌýHe has published over 100 peer-reviewed articles, 4 book chapters and numerous abstracts and has lectured widely on these topics. He was part of the Canadian and the latest European Consensus groups on H. pylori and first authored the well-known Toronto Consensus on H pylori Treatment.

Learning Objectives:

1. Utilize a simple, comprehensive and evidence-based approach to the patient with dyspepsia
2. List the different methods of making a diagnosis of H. pylori infection
3. Describe the main recommended options for first line therapy of H. pylori infection
4. Understand choices for second line or rescue therapy depending on the treatment that previously failed

Abnormal liver profile

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Marc Deschênes is an Associate Professor at ²»Á¼Ñо¿Ëù in the Department of Medicine, Division of Gastroenterology & Hepatology & Transplantation, where he is the Director of the Division of Hepatology. His clinical interests are viral hepatitis, DILI and liver transplant and his research interests are outcomes research in liver transplant.

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Learning Objectives:

1. Understand approach using serum biochemistry to classify liver injury
2. Understand how to stage liver fibrosis using non invasive methods
3. Understand how to assess severity of hepatic dysfunction in patients with cirrhosis

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   Advances in the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease

Giada Sebastiani is Associate Professor of Medicine at ²»Á¼Ñо¿Ëù and Clinician Scientist at the Research Institute of ²»Á¼Ñо¿Ëù Health Centre in Montreal, Canada. She provides clinical services in the Division of Gastroenterology and Hepatology. She received a medical degree and specialized in internal medicine at the University of Padua, Italy. She had training in clinical and basic research at Harvard Medical School (US), University College of London (UK), University of Bordeaux (France) and Lady Davis Institute for Medical Research (Montreal, Canada). Her work focuses on fatty liver disease, liver fibrosis and non-invasive diagnostic tools in liver disease, with a current focus on at-risk populations, including people living with HIV, diabetics, patients with inflammatory bowel diseases and women with polycystic ovary syndrome. She is author of over 110 articles in peer-reviewed journals (including Gastroenterology, Hepatology, Journal of Hepatology, Clinical Infectious Diseases; h-index=38, total number of citations 5,644), 16 book chapters, 180 conference publications at national and international congresses. She is a founding and steering committee member of the Canadian NASH Network and panel member in the Consensus on Models of Care in NAFLD of the International Liver Foundation.

Learning Objectives:

1. Recognize and accurately diagnose nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH) in patients with suspected symptoms through a comprehensive assessment that includes a physical examination, medical history, laboratory/blood tests, and diagnostic imaging
2. Evaluate critically the most up-to-date efficacy and safety data of current and emerging NAFLD/NASH therapies, analyzing and interpreting potential risks and benefits of each therapy and identifying contraindications, drug interactions, and other safety concerns
3. Develop and apply an effective management strategy for NAFLD/NASH patients that incorporates the most suitable lifestyle interventions and pharmaceutical therapies while considering patient preferences and potential comorbidities