Digestive Disease and Nutrition

Clinical and training programs

Care for adult patients is offered in the broad areas of digestive disease (including the gastrointestinal tract, liver, and pancreas) and disorders of nutrition. Special clinics and protocols are in place for the care and study of patients with chronic viral hepatitis, chronic liver diseases, and pancreatico-biliary diseases. Faculty of the Division also direct the Special Center for Study of Disorders of Iron and Porphyrin Metabolism, the Liver, Biliary and Pancreatic Center, and Co-Direct the Program in Liver Transplantation.

Training is offered for basic science graduate students, medical students, MD/PhD students, residents and fellows in the disciplines of digestive disease, nutrition, transplan-tation hepatology, biochemistry and molecular biology. This training is accomplished by a combination of regular clinical and research conferences, journal clubs, pathology, radiology, and surgical combined conferences, and opportunities for original research work in the Division's laboratories.

Research

Basic research activities, funded by the National Institutes for Health, are focused on the hepatic metabolism of porphyrins, heme, and iron in health and disease, and the regulation of cholesterol and bile salt metabolism. Numerous state-of-the-art techniques, including hepatocyte culture, transient and stable transfection studies, trans-genie and gene "knockout" methods, and other modern molecular biological procedures are used in these studies. Another research focus is on molecular events that play a key role in the development of malignancies of the GI tract, liver and pancreas. Laboratories are fully equipped to carry out biochemical, molecular biological, pharmacological, and physiological studies in these areas.

Clinical research activities include several studies on anti-viral and other therapies for chronic viral hepatitis, new therapies for alcoholic liver disease and inflammatory bowel disease, effects of aging on GI function, and studies of cytokine and adhesion molecule expression in liver biopsies of patients with chronic viral hepatitis. We also study non-invasive imaging techniques (CT, MRI) for assessing iron overload, the usefulness of endoscopic ultrasound in the diagnosis of lesions of the GI tract, pancreas, or liver and biliary tree, and the diagnostic utility of biliary and pancreatic manometry, and methods to improve care of patients before, during, and after liver transplantation.