Gastroenterology

The gastroenterology department provides prevention, diagnosis and treatment of various gastrointestinal disorders. It includes disorders of the esophagus, stomach, small and large intestines, gall bladder, pancreas and liver, which may be simple like jaundice to complex like IBD or cancer. The gastroenterology section has been ranked amongst the top 10 departments in the country consistently.

A. Medical Gastroenterology and Hepatology
The department deals with various medical problems in gastroenterology in the outpatient, inpatient, and emergency settings. The doctors have expertise in the management of the full spectrum of gastrointestinal, liver and pancreaticobiliary diseases. This includes, but is not restricted to, disorders like inflammatory bowel disease, irritable bowel syndrome, malabsorption syndrome, gastrointestinal bleed, chronic diarrhea, constipation, peptic ulcer, reflux disease, acute liver failure, chronic liver disease (viral, alcoholic and others), portal hypertension, biliopancreatic disorders and malignancies, Crohn's diseases, pancreatitis, ulcerative colitis, celiac diseases, gastrointestinal bleeding, hepatitis, chronic and acute liver diseases, peptic ulcers etc.

B. Pediatric Gastroenterology
This is a subspecialty in medical gastroenterology that deals with children suffering from various disorders like chronic constipation, Hirschsprung's disease, malabsorption syndrome, acute viral hepatitis, inborn errors of metabolism, Wilson's disease, and paediatric inflammatory bowel diseases.

C. Liver Transplantation
In addition to the various liver disorders listed above, we run a liver transplant program along with the surgical and intensive care transplant team; this service is registered with the state Zonal Transplant Coordination Committee.

D. Interventional Gastroenterology
We have a well-equipped endoscopy department where diagnostic, therapeutic as well as emergency procedures in gastroenterology are performed. We also perform procedures like percutaneous and transjugular liver biopsy, HVPG monitoring and TIPSS placement.

UGI Endoscopy: Examination of the upper gastrointestinal tract using a flexible video endoscope. Diagnostic – for disorders like acid-peptic disease, H. pylori infection, gastroesophageal reflux disease, and cancers of the esophagus and stomach.

Therapeutic – for management of emergencies like variceal bleeding (procedures like sclerotherapy, variceal banding), endoscopic therapy for bleeding peptic ulcer by injection, application of hemoclips or thermal current, placement of percutaneous endoscopic gastrostomy (PEG) tube or jejunostomy as a feeding device for neurologically impaired individuals or those who are unable to swallow. We also perform endotherapy for early cancers and place stents for palliation of obstructive malignant lesions.

Colonoscopy: Examination of the lower gastrointestinal tract using a flexible video-endoscope. Diagnostic – for disorders like polyps, cancers, strictures, bleeding sites, diverticuli.

Therapeutic – for management of colonic obstruction with stenting, endotherapy for lower gastrointestinal bleeding, and polypectomy.

ERCP (Endoscopic retrograde cholangiopancreatography): This procedure involves treating various biliopancreatic disorders. These include obstructive jaundice caused by common bile duct stones (extraction of the stones) or relieving obstruction in bilio-pancreatic cancers by the placement of plastic or metal stents. ERCP also aids in obtaining tumour tissue cytology/biopsy from the bile duct to confirm the diagnosis in suspected cases of malignancy. We also treat chronic pancreatitis and perform pseudocyst drainage in acute or chronic pancreatitis by placing plastic stents

EUS (Endoscopic ultrasonography): This procedure involves performing an ultrasound examination with a probe attached at the tip of an endoscope. It allows detailed visualization of the walls of the esophagus, stomach, and duodenum, as well as the pancreas, bile duct, other adjacent organs, lymph nodes and blood vessels. This allows quicker and definitive diagnosis of various diseases, and staging of cancers, and thus aids in management. EUS is also helpful in procuring tissue for examination. It aids in difficult biliary and pancreatic therapeutic endoscopic procedures.

Capsule Endoscopy: This is a painless procedure in which the patient swallows a capsule with an inbuilt camera that takes and transmits photographs of the intestine, helping in diagnosis and planning treatment of various conditions, e.g., localizing the site and cause of intestinal bleeding, chronic diarrhoea, polyps and tumours in the small intestine.

Manometry: In this procedure, pressures in the esophagus, stomach, duodenum and anorectal region are measured, aiding in the diagnosis of disorders like achalasia cardia, pelvic floor dysfunction, Hirschsprung's disease, chronic constipation and incontinence.

Hydrogen Breath Test: This is a non-invasive test that measures hydrogen exhaled in the breath, to diagnose disorders like malabsorption, small intestinal bacterial overgrowth syndrome and short bowel syndrome.

Urea Breath Test: This is a modality for non-invasive diagnosis of Helicobacter pylori infection without performing an endoscopy, in patients with dyspepsia; it also confirms eradication after treatment of H. pylori infection.

GI Radiology

We have a well-equipped department of interventional radiology that performs procedures like

• Transjugular liver biopsy
• Measurement of hepatic venous pressure in cirrhosis of the liver by HVPG
• Liver cancer treatment procedures like
• Chemoembolization: injection of chemotherapeutic agents into blood vessels supplying the liver tumour.
• Radiofrequency ablation: ablating tumour tissue by radiofrequency waves.
• Thermosphere - injection of the radioactive agent into liver tumours.
• CT scan-guided / Ultrasonography-guided procedures like
  • Liver biopsy
  • Liver lesion biopsy
  • Pancreatic biopsy
  • Abdominal lymph node biopsy
  • Abscess drainage
  • Percutaneous transhepatic biliary drainage for relieving jaundice due to obstruction of bile duct - Bile duct stenting for cancers
  • Angiography – Diagnostic and treatment of gastrointestinal bleeding, treatment of aneurysms