Fifty years of Australian pediatric gastroenterology

Abstract

When the Gastroenterological Society of Australia (GESA) began 50 years ago there were very few pediatric gastroenterologists in the world. The ‘Mother’ of Paediatric Gastroenterology was Australian Charlotte (‘Charlo’) Anderson who established one of the world's first pediatric gastroenterology units in Melbourne in the early 1960s. Her earlier work in Birmingham had identified gluten as the component of wheat responsible for celiac disease and helped separate maldigestion (cystic fibrosis) and mucosal malabsorption. The first comprehensive textbook of Paediatric Gastroenterology was edited by Charlotte Anderson and Valerie Burke in 1975. Rudge Townley succeeded Charlotte Anderson in Melbourne and went on to further develop small bowel biopsy techniques making it a safe, simple, and quick procedure that led to much greater understanding of small bowel disease and ultimately the discovery of Rotavirus by Ruth Bishop et al. and subsequently to Rotavirus immunization. Australian Paediatric Gastroenterology subsequently developed rapidly with units being established in all mainland capital cities by the end of the 1970s. The Australian Society of Paediatric Gastroenterology Hepatology and Nutrition (AuSPGHAN) was established in the 1980s. Australians have contributed significantly in many areas of gastroenterology in infants, children, and adolescents including celiac disease, cystic fibrosis, liver disease, transplantation, gastrointestinal infection, allergy, indigenous health, inflammatory bowel disease, gastrointestinal motility, and the development of novel tests of gastrointestinal function and basic science. There have also been major contributions to nutrition in cystic fibrosis, end‐stage liver disease, and intestinal failure. The future of Australian Paediatric Gastroenterology is in good hands.

Early liver biopsy, intraparenchymal cholestasis, and prognosis in patients with alcoholic steatohepatitis

“…Among other histological lesions commonly observed in ASH[20] bilirubinostasis was also the sole predictor of outcome. Interpretation of intrahepatic cholestasis is especially challenging in patients with decompensated cirrhosis at risk of developing biliary tract disease, infection or sepsis.…”

“…Steatosis results from recent, heavy alcohol intake[16,20]. Major steatotic changes were present in the majority of patients, associated with recent and heavy alcohol intoxication.…”

Remedy Experience of Severe Abdominal Infection after Orthotopic Liver Transplantation

“…Cardiac dysfunction was often accompanied by hypotension. With low blood volume and increased fluid, a vicious cycle was formed, with resultant acute abdominal compartment syndrome (6)(7)(8). The patients' intra-abdominal pressure increased sharply, and abdominal infection symptoms were aggravated, causing a secondary blow to the patient and leading to further deterioration.…”

“…Immunosuppressive agents were adjusted according to blood CD 4 + CD 8 + results. In severe abdominal infection, immunosuppressive agents were withheld.…”

Fifty years of Australian gastroenterology and hepatology: A golden era of contributions to the region

“…These have been garnered from international exchange, including with Asia, and from the increasingly strong Australian Research Institutes. Yet, from the start, Australian investigators, for the most part working in Australia but also studying abroad, have made substantial contributions to a host of important gastrointestinal and liver disorders, in adults and in children; 1–3 the latter include discovery of the rotavirus and subsequent vaccine development 4 …”