The advent of endoscopy has revolutionized the practice of Gastroenterology in the country, achieving advances not only in the diagnosis but treatment of potentially life-threatening gastrointestinal disorders
By LYKA MAE P. CHIANG | Photo By RAMIR G. CAMBIADO
For the past 42 years, the Philippine Society of Digestive Endoscopy (PSDE) has been intently focused on its vision to becoming the foremost organization championing the science of Gastrointestinal (GI) Endoscopy through world-class clinical practice, research and public service.
The Society is composed of certified gastroenterologists devoted to learning the dynamic development of endoscopic technology and how it could contribute to the nation’s improved quality of healthcare.
Introduced around half a century ago, GI endoscopy was regarded as an off-the-mainstream procedure in the evaluation of patients with GI diseases during its growing up years. Hence, there was a lack of practitioners and instruments in the country at the time. But in the 1970s when the Japanese developed the flexible types of scopes, the country’s gastroenterologists became more encouraged in keeping up with the technology advancement and invested in instruments to conduct endoscopic procedures here.
After the advent of the endoscopy revolution, the Philippines started learning this innovative procedure. Dr. Gabriel Carreon, then PGH director, encouraged gastroenterologists practicing endoscopy to promote the discipline as a distinct subspecialty. He inducted its first set of officers with 21 founding members. Such was the birth of the PSDE.
The Society has since then grown by leaps and bounds, with 29 presidents taking its helm. Through their leadership, these men and women have steered the Society and its members to attain its objectives of academic and professional excellence, research and service. It has consistently adhered to its core principles and values.
Through the years, the Society has walked the proverbial extra mile in pursuing its advocacy to obtain and convey extensive knowledge on GI endoscopy and embarked on continuing medical education (CME) for its members and field experts through its annual joint symposia with their sister societies, the Philippine Society of Gastroenterology and the Hepatology Society of the Philippines.
This CME activity gathers distinguished local and international faculties to discuss the latest issues and advancement on the field of gastroenterology including endoscopic technology, offering post-graduate courses to members and non-members, residents, fellows, and nurses.
The Society likewise conducts live endoscopic workshops, its keynote annual activity, which allow members to learn heuristic endoscopic techniques through clinical lectures and demonstrations.
Last year’s workshop, headed by Dr. Dennis Ona, highlighted the important role of the various endoscopic approaches in the management of several GI diseases. It was graced by foreign faculties who dealt with several cases such as peroral endoscopic myotomy (POEM) for achalasia, metal stenting for difficult biliary strictures, submucosal resection of rectal adenomas, enhanced imaging of the different endoscopic lesions, ampullectomy, among others.
The Endo Forum is an open case discussion activity held by the Society, wherein only fellows and consultants interested to learn about endoscopic techniques are invited in the event. It was a brainchild of Dr. Evan Ong, which was revived by the current PSDE Board with Dr. Julius Co Soriano as Chair. Last year, the Society conducted a series of fora which tackled various topics including biliary complications and GI bleeding, a well-anticipated activity by the participants.
Training conferences, workshops
Among the other activities hosted by the Society are training conferences for fellows-in-training—such as the monthly Endoscopic Radiologic Conference which is an inter-hospital activity that allows fellows to present intriguing cases involving thematic presentations focused on popular games or shows. This event paves the way for fruitful discussions on innovative ways to put solutions to those cases that increase the participants’ knowledge in GI diseases and endoscopic procedures.
Another activity for fellows-in-training is the Ex-Vivo Workshop, which allows them to conduct hands-on endoscopic procedures, from basic to advanced, and aims to strengthen one’s desire in training and help carry out the direction they want to pursue after their fellowship.
Expert gap in provinces
Although GI endoscopy is now considered an established modality in gastroenterology, there are still a limited number of physicians practicing it in the country, especially in remote rural areas. “Right now, we only have one chapter because we only have 407 members,” says Dr. Dennis Ona, current president of PSDE, explaining the expert gap in the provincial areas.
It is therefore the Society’s advocacy to encourage fresh training program graduates to spend their practicum in their respective areas, with GI endoscopy as their specialty.
Dr. Ona notes that few areas in the country already have the equipments, but there are no gastroenterologists to conduct the procedure.
“The problem underlies in the DOH deploying endoscopy machines without even knowing if there are gastroenterologists in the area, and we don’t even know where they are,” explains Dr. Ona. That’s why if we can identify those areas, we can encourage gastroenterologists to practice there,” he adds.
Education on digestive health
While many hospitals around the country are yet to offer endoscopic services, the Society has made gallant efforts in order to contribute its fair share of service to the marginalized sectors of society.
Many individuals, particularly those belonging to the less fortunate sectors with limited access to quality healthcare, do not recognize the significance of digestive health. This is the primary cause of the pressing health concerns related to chronic gut diseases—such as stomach cancer, hiatal hernia, stomach ulcers, among others.
One mission of the Society is to increase public awareness on the importance of digestive health and open one’s eyes to the available resources that can help address various digestive concerns.
Pursuing its commitment to this mission, the Society conducts activities extended to the grassroot level, especially those living in far-flung areas. The substandard quality of healthcare services in these communities, in addition to the lack of knowledge on digestive health, really calls for an urgent action to address pressing GI concerns.
The civic duties of the Society started with medical missions which provide free diagnostic and therapeutic endoscopy to those patients in need. Last year, headed by Dr. Karl Kim Yu Teng, chair of Committee on Civic Action of PSDE, the Society held three endoscopy clinic services in Davao City, Lucena City, and Tacloban City, where prescreened indigent patients were provided free gastroscopy and colonoscopy services.
Furthermore, the Society conducted a lay forum on colorectal cancer awareness in Cainta, Rizal and Naga City, which aimed to educate the lay on the risks and prevention of the killer disease, which is acknowledged as one of the deadliest cancers. It was then followed by another lecture on the utilization of GI endoscopy in common GI diseases.
Gastroscopy and colonoscopy were performed by board-certified gastroenterologists. and a total of 80 at-risk patients benefited from the endoscopy. The findings included colonic masses, gastric ulcers, and colonic polyps. Detected colonic polyps, which are generally precancerous, were excised. Those with suspicious colonic masses were biopsied and referred to secondary or tertiary hospitals.
Another civic service that the Society performs is the Pamaskong Handog, an annual Christmas observance for patients suffering from GI complaints. The event gives as gifts advanced diagnostic and therapeutic procedures that are not readily available and accessible by those patients, such as polypectomy or endoscopic removal of large pre-malignant polyps, endoscopic retrograde cholangiopancreatography (ERCP) or the removal of bile duct stones, and the latest technologies like endoscopic ultrasonography.
In 2016, the Society conducted a successful Pamaskong Handog at the Rizal Medical Center, offering all of the aforementioned procedures to the participating members of the community at no cost.
In its bid to reach and engage with the general public, the Society takes advantage of the advancement of the Internet technology and has established its own website and social media pages accessible not only to fellow healthcare professionals but also to the laymen.
These Internet pages provide useful and up-to-date information on the Society and its upcoming activities, as well as general knowledge on the subspecialty to make more people aware of the use of endoscopy and make it as the conventional choice in the diagnosis and treatment of GI diseases.
Today, the Society continues to embark on education and civic action programs and pursue its commitment to work hand-inhand with the medical community in the promotion of digestive health.
The primary goal of PSDE is to give service to its countrymen and provide the utmost endoscopic services to them. The doctors are the conduits to achieve this goal. The Society therefore ensures that its gastroenterologist-members are equipped with the right training and skills so that quality and safe endoscopy can be extended to the public.
It is the dream of the Society to make endoscopy available in all parts of the country and to bring the newest endoscopic procedures and technology to the Philippines. In this manner, it hopes to contribute its share in improving, hopefully saving the lives of millions of Filipinos with various GI disorders.
“It is the dream of the Society to make endoscopy available in all parts of the country and to bring the newest endoscopic procedures and technology to the Philippines”
March 2018 Health and Lifestyle