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Date

10. - 13. March, 2018

Place

Hotel Antunović
Zagreb, Hrvatska

Congress organizer

Association of Teachers in General Practice/Family Medicine

WELCOME SPEECH

Dear fellow physicians and much appreciated other participants in health care,

On behalf of all members of ATGP/FM I cordially invite you to participate in the VII Congress of the Association of teachers of general / family medicine, which is dedicated to patients with gastrointestinal disorders in family medicine.

In their everyday work, family medicine physicians, dedicated to their patients, very often encounter problems related to diseases of the digestive system including diseases of the mouth, esophagus, stomach, pancreas, gall bladder, liver and intestines. Family medicine physicians assess patients’ problems comprehensively, in the context of their ways of life and work, which strongly affect the function of their digestive system, regardless of their age. Very often young children when they go to their kindergarten or school respond with stomach pain. This kind of functional disorders can be converted into organic disease due to their duration, and because the problems in the environment have not been addressed. We should highlight the irritable colon syndrome because of its prevalence and importance. Not only because of the unpleasant pain accompanying this disorder, but also because of the patient's concerns. Symptoms are persistent and do not respond well enough to pharmacological therapy. The psychological background of the problem leads us to the role of the family physician being "doctor as medicine" where supportive and advisory role of the physician is crucial.

Among the most common diseases of the digestive system, we should certainly emphasise disorders and diseases associated with the secretion of stomach acid (dyspepsia, GERD and peptic ulcer). The most common symptoms associated with these disorders are heartburn, hoarseness, burning, nausea, sleep disturbances and pain that does not necessarily have to be linked to the stomach, but may also occur in the chest, mimicking the pain associated with diseases of the heart or lungs. The importance of these changes is that they can be perceived as diseases of other mentioned organs. Besides pharmacological therapy, behaviour changes certainly have an impact on treatment (if necessary, smoking cessation, reduction or cessation of alcohol consumption, a change of diet with weight reduction). We need to mention that some medicines can often lead to the above mentioned disorders (acetyl salicylic acid and non-steroidal anti rheumatics). Today's pharmacological method of treatment has reduced the prevalence of ulcer disease and has significantly reduced symptoms. With medication, patients today live more easily and more safely.

With the modern life-style, inflammatory bowel diseases are gaining in significance due to their prevalence and the severity of clinical presentation. a growing importance by prevalence and the severity of the clinical presentation. The use of biological drugs has not yet come into being. Such patients endure severe mutilations through necessary surgical procedures.

Behavior changes (consumption of alcohol and fatty foods) are also related to diseases of the liver and pancreas, which can ultimately lead to lethal outcome. Therefore, knowledge about the patient's life-style is crucial in assisting the patient in his/her decision to change it. Physician's advice, given unobtrusively, but frequently (family physicians can do it in their frequent contacts with the patient) has been proven useful. Positive decisions are possible and more easily implemented when there is continual control and psychological help available.

In the end, due to the severity of problems they cause, we have to mention the importance 7 of malignant diseases of the gastrointestinal tract. Although today's surgical techniques do not mutilate the organism very much, the consequences of surgical procedures can be severe, such as the constant presence of a stoma. Permanent support is required together with oncological therapy. Here I have to highlight the importance of enteral nutrition not only for patients with malignant diseases but also for patients with malnutrition, which can be devastating in the elderly.

Although not very frequently, the increased use of non-steroidal antirheumatics is followed by an increased number of emergencies in family medicine as a consequence of diseases of the digestive system.

This altogether is a part of family medicine physician's everyday work. Family medicine physicians need to be enabled an easy and simple access to information about the latest news in medical science related to conditions and diseases of the digestive system. That is why this Congress is dedicated to this theme.

Prof. dr. sc. Biserka Bergman Marković