Gastroenterology in Saudi Arabia

Faleh Z Al-Faleh

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EDITORIAL

Year : 1995 | Volume : 1 | Issue : 1 | Page : 1-2

Gastroenterology in Saudi Arabia

Faleh Z Al-Faleh
President, Saudi Gastroenterology Associatioin, Saudi Arabia

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How to cite this article:
Al-Faleh FZ. Gastroenterology in Saudi Arabia. Saudi J Gastroenterol 1995;1:1-2

How to cite this URL:
Al-Faleh FZ. Gastroenterology in Saudi Arabia. Saudi J Gastroenterol [serial online] 1995 [cited 2021 Feb 28];1:1-2. Available from: https://www.saudijgastro.com/text.asp?1995/1/1/1/34058

A dream has been finally fulfilled. The Saudi Gastroenterology Association (SGA) publishes its first issue of The Saudi Journal of Gastroenterology . The Journal has gone through a very difficult labour from its planning to publication.

The objective of this Journal is to reflect the activities of the SGA. It will be a forum for original research, review articles and case study. It will disseminate scientific information relevant to the Gastroenterology community in Saudi Arabia.

The history of gastroenterology in Saudi Arabia goes back to the mid-70s when Saudi physicians, who were interested and trained in gastroenterology, came back from their postgraduate studies abroad. It took them several years to establish structured and well equipped units of gastroenterology. In the 80s, a gastroenterology club in Riyadh, was initiated. This club was then the nucleus for the SGA which was approved by the King Saud University on 11.9.1408 (27.4.1988).

The gastroenterology and hepatology in Saudi Arabia has developed very markedly during the last 10-15 years. The SGA has now 100-150 active members, working in at least 15 centres or units. All the endoscopy procedures are performed in these centres including upper and lower endoscopy as well as laparoscopy and endoscopic retrograde cholongiopancreatography (ERCP). Therapeutic endoscopy procedures are now performed routinely. For the training of young clinicians in gastroenterology, the SGA, in collaboration with other centres is offering endoscopy and ultrasound course regularly. Four centres in Saudi Arabia are now performing liver transplantation. Thirty liver transplantations have been so far performed.

Which gastroenterology disease pattern occur in Saudi Arabia?. To answer this question, I will depend on some of the published data about the prevalence and pattern of disease and also on my experience working for the past 17 years as Internist and gastroenterologist. Every gastroenterologist will be expected, as every where, to deal with the following:

Liver problems
Peptic ulcer disease
Gallstone disease
Functional problem of the GIT
Malignancy of the GIT
Inflammatory Bowel Disease (IBD)

Liver disease seems to be a major health problem in Saudi Arabia. The main causes are hepatitis B and C. Most of the studies indicate a prevalence of hepatitis B to be between 5-10% ^[1] . The exposure rate of the population to hepatitis B infection is more than 50% ^[2] . The effect of hepatitis B vaccination programme in children, which was started in 1989, is expecteded to reduce dramatically the size of this problem in about 1020 years. Hepatitis C, as a cause of chronic liver disease started to exceed hepatitis B. Hepatitis C infection among children at the age of 10 years is about 0.9% ^[3] . Blood donor screening which is now mandatory suggests a prevalence range between 1-3% ^[4] . An epidemiological study which we conducted recently in Gizan revealed a steady increase in hepatitis C infection according to age, and it reaches 6% over the age of 50 years in males. In some of the Saudi Arabian regions like the South, schistosomiasis-induced fibrosis of the liver is an additional cause of liver disease. Also parasitic infections affect the liver in the form of granulomatous diseases. Gallstone disease seems to have increased markedly in the last 20 years. Prof. Tamimi found an increase in the rate of cholecystectomy within 10 years to be 978%^[5] .

The second problem which the gastroenterologist in Saudi Arabia expects to deal with is peptic ulcer disease. Peptic ulcer was seen in 18.8% of endoscoped patients at King Khalid University Hospital ^[6] . H.pylori infection is one of the main possible causes of peptic ulcer disease and evolution of gastric malignant disease. Its prevalence is similar to that in other developing countries with universal infection ^[7] . Functional problems of the the GI is similar to what has been reported in developed countries. Irritable bowel syndrome affects about 50% of the patients attending the GI Clinics. Non-ulcer dyspepsia is a very commonly encountered problem.

What about cancer of digestive system? In an epidemiological study in patients attending King Faisal Specialist Hospital for cancer management, oesophageal cancer is number 3; liver carcinoma, number 4; stomach, number 10 among the most common ten cancers ^[7] . Also Bedikian, in the survey of alimentary malignancy at King Faisal Specialist Hospital ^[8] , found that liver, oesophageal and stomach carcinoma are the most common cancers. Among the upper GI malignancy, the primary upper gastrointestinal lymphoma seems to represent one of the common problems ^[9] .

IBD started to be reported increasingly since the eighties. A study which was conducted in our hospital evaluating 32 cases of ulcerative colitis, reported an average frequency of 12 cases per year ^[10] . The nature of the disease is not much different from that of western patients. Crohn's disease seems to be rare among Saudi patients and one should exclude intestinal tuberculosis before labelling a patient to have Crohn's disease.

Looking to the future, the SGA will have to address the quality of gastroenterology practice in Saudi Arabia especially in periphery areas and private sector to ensure acceptable standards of patient care programmes. Also the SGA has to act as a counselling body for hospitals, institutions and individual gastroenterologists who are establishing their gastroenterology units. Furthermore, the SGA is planning to develop a programme of Fellowship in Gastroenterology. To achieve all these objectives and goals, we need the full support and enthusiasm of all the members of SGA. Also we will be very thankful for the advice and contribution of the international advisory board of this journal.

References

1.	Al-Faleh FZ. Hepatitis B infection in Saudi Arabia. Ann Saudi Med 1988; 8(6):474-80.
2.	Al-Faleh FZ, Ayoola EA, Arif M, Ramia S, Al-Rashed R, Al-Jeffry M, Al-Mofarreh M, Al-Karawi M and AlShabrawy M. Seroepidemiology of hepatitis B virus infection in Saudi Arabian children: A baseline survey for mass vaccination against hepatitis B. Journal of Infection 1992; 24:197-206.
3.	Al-Faleh FZ, Ayoola EA, Al-Jeffry M, Al-Rashed R, Al-Mofarreh M, Arif M, Ramia S. Al-Karawi M, AlShabrawy M. Prevalence of antibody to hepatitis C virus among Arabian children. A community based study. Hepatology 1991; 14(2):215-18.
4.	Graham DY, Shabib MS, Al-Mofleh IA. It should be possible to eliminate peptic ulcer disease and gastric carcinoma from Saudi Arabia. Ann Saudi Med 1994; 14(3):179-82.
5.	Al-Tamimi T, Wosornu L, Al-Khozaim A, Abdulghani A. Epidemiology - Increased cholecystectomy rates in Saudi Arabia. The Lancet 1990; 336:1235-37.
6.	Laajam MA, Al-Mofleh IA, Al-Faleh FZ, Al-Aska AK, Jessen K, Hossain J, Al-Rashed RS. Upper gastrointestinal endoscopy in Saudi Arabia: Analysis of 6386 procedures. Quarterly J Med, New Series 1988; 66:249-21-25.
7.	Mahboubi E. Epidemiology of cancer in Saudi Arabia. Ann Saudi Med 1987; 7(4):265-76.
8.	Bedikian. Survey of alimentary malignancies at King Faisal Specialist Hospital and Research Centre. Ann Saudi Med 1987; 7(4):277-81.
9.	Al-Mofleh I. Complications of primary upper gastrointestinal lymphoma. Ann Saudi Med 1992; 12(3):297-99.
10.	Hossain J, Al-Faleh FZ, Al-Mofleh I, Al-Aska AK, Laajam MA, Al-Rashed R. Does ulcerative colitis exist in Saudi Arabia? Analysis of thirty-seven cases. Saudi Med J 1989; 10(5):360-62.