Medical Gastroenterology

Gastroenterology

Overview

Department of Medical Gastroenterology at Ramkrishna CARE Hospitals is dedicated to excellence in patient care, advancement in research and innovation and a holistic approach to healthcare. The institute provides patients advanced care in the prevention, diagnosis and treatment of diseases of the gastrointestinal system. Medical gastroenterology primarily involves the diagnosis and management of patients using medicines and minimally invasive interventions. Medical gastroenterology is often considered a less specialized area, but has the opportunity to develop a subspecialty in liver disease, dyspepsia, inflammatory bowel disease, functional disturbances of the gut, cancer and endoscopy. The institute has the complete range of the latest endoscopic facilities, including endoscopic retrograde cholangiopancreatogram (ERCP) and allied interventions. Ramkrishna CARE Hospitals offers round-the-clock service in gastrointestinal emergencies like vomiting of blood, foreign body ingestion and hepatic coma.

Subspecialties

Services & Procedures

Advanced Endoscopy

Endoscopy is a minimally invasive diagnostic medical procedure in which a long, thin, flexible tube with a light and a video camera takes images of the inside parts of the body. These images can be seen on a screen. The entire endoscopy is recorded for the doctors to enable them to check it again, if required. This minimally invasive procedure is usually performed to find out the level/degree of the problem.

Upper GI Procedures

Upper gastrointestinal (GI) endoscopy is a procedure that helps view the interior lining of the esophagus, stomach and the first part of the small intestine through a thin, flexible viewing instrument called an endoscope. The tip of the endoscope is inserted through the mouth and then gently moved down the throat into the esophagus, stomach and duodenum (upper gastrointestinal tract).

The upper GI procedures performed include:

• Diagnostic upper GI scopy
• Narrow band imaging for diagnosing early GI malignancies
• Endoscopic therapy for variceal & non-variceal bleed
• Banding sclerotherapy, argon plasma coagulation (APC), bipolar coag, clips, loops, spray coagulation
• Polypectomy & submucosal resections
• Oesophageal stricture balloon dilatations
• Pyloric stricture balloon dilatations
• Foreign body removal
• Self-expanding metallic stents for benign & malignant cases
• Percutaneous Endoscopic Gastrostomy (PEG)
• Endoscopic jejunostomy

Colonoscopic Procedures

A colonoscopy is an outpatient procedure in which the inner lining of the large intestine (colon and rectum) is examined. The doctor uses a thin, flexible tube called a colonoscope to look at the colon. A colonoscopy helps find ulcers, colon polyps, tumors and areas of inflammation or bleeding. A colonoscopy can also be used as a screening test to check for cancer or precancerous growths in the colon or the rectum.

The colonoscopic procedures performed include:

• Diagnostic colonoscopy
• Narrow band imaging for diagnosing early GI malignancies
• Endoscopic therapy for colonic bleeds (sclerotherapy, argon plasma coagulation (APC), bipolar coag, clips)
• Polypectomy & submucosal resections
• Clip/loop application for post polypectomy bleeds
• Colonic stricture balloon dilatations
• Foreign body removal
• Self-expanding metallic stents for malignant colonic disorders
• Colonic decompression
• Hemorrhoidal banding

Enteroscopic Procedures

Enteroscopy is a procedure in which the small bowel (small intestine) is examined. In enteroscopy, one or two balloons are attached to the tube. These can be inflated to help in the diagnosis or treatment. Depending on the type of problem, the scope is inserted either into the mouth (upper endoscopy) or the rectum (lower endoscopy). The inflated balloons hold onto the sides of the bowel and a tube slides over the scope. This pleating action helps move the scope through the bowel.

The enteroscopic procedures performed include:

• Endoscopic therapy for small bowel bleeds (sclerotherapy, APC, bipolar coag, clips)
• Polypectomy
• Small bowel stricture balloon dilatations
• Foreign body removal
• Self-expanding metallic stents for malignant small bowel disorders

ERCP

Endoscopic retrograde cholangiopancreatography (ERCP) is a non-invasive procedure that combines upper gastrointestinal endoscopy and X-rays to treat problems of the bile and pancreatic ducts, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery) and cancer. ERCP is also used to diagnose problems. However, the availability of non-invasive tests such as magnetic resonance cholangiography has allowed ERCP to be used primarily for cases where the treatment is expected to be delivered during the procedure.

The procedures offered are:

• Diagnostic ERCP
• Common bile duct (CBD) stone removal
• Mechanical lithotripsy, extracorporeal shock wave lithotripsy (ESWL), papillary balloon dilatation for large CBD stones
• Stent placements for benign & malignant biliary stricture
• Pancreatic pseudocyst drainage
• Pancreatic duct stenting for chronic pancreatitis & pancreatic duct leaks

Endoscopic Ultrasonography Procedures

An endoscopic ultrasound (EUS) is a procedure in which the doctor examines the esophagus, stomach and small intestine by using a small, flexible tube which has an ultrasound device at the end. The ultrasound enables your doctor to examine the walls of the intestinal tract, as well as adjacent organs such as the liver, pancreas and gall bladder.

• Diagnostic EUS
• Mediastinal EUS & fine-needle aspiration (FNA) from mediastinal nodes & masses
• FNA of pancreatic drainage
• Celiac ganglion block & neurolysis
• Pelvic abscess drainage

Outpatient Ascitic Fluid Paracentesis

Paracentesis is an outpatient endoscopic procedure performed to remove the fluid accumulated in the abdominal cavity. The accumulation of fluid is called ascites. Ascites may be caused by infection, inflammation, abdominal injury or other conditions like cirrhosis or cancer. The fluid extracted is sent to the lab to determine the cause of the fluid build-up. Paracentesis may also be done to take the fluid out to relieve belly pressure or pain in people with cancer or cirrhosis.

Interventional Radiology Services

Radiology interventional procedures for GI bleeds, intra abdominal collections, biliary disorders, pancreatic collections done by senior interventional radiologists

Liver Clinic

The Liver Clinic at Ramkrishna CARE Hospitalsprovides comprehensive diagnosis and treatment for all types of liver diseases in adults and children. It has the required acumen to deal with any acute and chronic liver disease in both adult and pediatric patients. The clinic is equipped with state-of-the-art technology and has a highly qualified staff.

Technology

• Advanced endoscopic retrograde cholangiopancreatography (ERCP) to diagnose and treat conditions of the gall bladder, bile ducts, pancreas and liver
• Advanced endoscopic ultrasound with fine needle aspiration for diagnosis and staging of tumors of the GI tract and lung
• State-of-the-art digital high definition imaging system
• Full range of accessories, including advanced instruments
• High-resolution recording unit for documentation of procedures
• International standard maintenance & sterilization
• Advanced procedures to diagnose and stage cancers of the gastrointestinal tract

Doctors