ASGE Recognized Industry Associate (ARIA) Training Program OPEN | October 2025-GI Tract in Disease_Liver_Gallbladder

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This document provides a comprehensive overview of diseases affecting the gastrointestinal tract's digestive organs, focusing on the liver, gallbladder, and pancreas.

<strong>Liver Diseases:</strong>
Cirrhosis is characterized by liver fibrosis and scarring from chronic injury, often irreversible but potentially reversible if caught early. Causes include nonalcoholic fatty liver disease (NAFLD), alcohol-associated liver disease, viral hepatitis B and C, autoimmune diseases, and genetic disorders like hemochromatosis and Wilson disease. Symptoms include fatigue, muscle wasting, jaundice, edema, and complications such as variceal bleeding and hepatic encephalopathy, managed through medications, endoscopic procedures, and liver transplantation. Hepatocellular carcinoma is a major complication of cirrhosis, with a poor prognosis but better outcomes with early surgical intervention. Alcohol-associated liver disease progresses from fatty liver to cirrhosis and cancer, treated with corticosteroids in severe cases. NAFLD is the most common liver disorder associated with obesity and diabetes, treated mainly via lifestyle changes.

<strong>Gallbladder Diseases:</strong>
Gallstones, formed from bile precipitates, mainly cholesterol or pigment stones, often present asymptomatically or cause biliary colic. Acute cholecystitis is inflammation due to a gallstone blocking the cystic duct, diagnosed by ultrasound and treated with antibiotics and cholecystectomy. Choledocholithiasis, gallstones in the common bile duct, can cause cholangitis—triad of pain, jaundice, and fever—treated with ERCP and stone removal.

<strong>Pancreatic Diseases:</strong>
Pancreatitis, inflammation of the pancreas, manifests acutely with severe abdominal pain and can be mild to life-threatening; chronic pancreatitis leads to pancreatic dysfunction causing malabsorption and diabetes. Causes range from gallstones and alcohol to trauma and medications. Treatment is supportive and involves removing any gallstone obstruction. Pancreatic cancer, mainly adenocarcinoma, carries a poor prognosis with symptoms like painless jaundice and weight loss. Diagnosis involves tissue biopsy, and treatment includes surgery and chemotherapy. Biliary obstruction from tumors may require stenting.

Overall, diagnosis relies on clinical presentation, labs, imaging, and biopsy, with management tailored to disease stage and severity, highlighting the importance of early detection and multidisciplinary care.

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Juan Carlos Bucobo, MD, FASGE

Keywords

gastrointestinal diseases

liver diseases

cirrhosis

nonalcoholic fatty liver disease

alcohol-associated liver disease

gallstones

acute cholecystitis

choledocholithiasis

pancreatitis

pancreatic cancer