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Gastroenterology

Gastroenterology In Nashik

The primary aim of our Institutes of Medical and Surgical Gastroenterology is to diagnose, prevent and treat disorders of the digestive tract, liver and pancreatico-biliary system in both children and adults.

The department offers superior care and with modern state-of-art facilities. The Centres offer the latest Endoscopic procedures for Gastrointestinal bleed, Gastrointestinal cancers, foreign body removal etc.

Our Gastrointestinal Surgeons provides minimal access surgery to treat major gastrointestinal surgical problems of the intestines, pancreas and hepatobiliary tract, including cancers

Overview

The Department of Gastroenterology& Hepatology at Apollo Hospitals, Nashik provides excellent facilities for the diagnosis, treatment and prevention of diseases of the digestive tract and liver. Patients having gastric, small bowel, colon, liver, pancreatic & biliary tract diseases undergo evaluation and management by skilled and experienced gastroenterologists here.

The department has most modern state of art equipment backed by modern intensive care units to carry out evaluation of patients including various endoscopies, endosonography and capsule endoscopy also.

Diagnostic Services

  • Upper GI Endoscopy
    In this, a flexible endoscope is used to visualize the upper GI tract. The oesophagus, stomach, and duodenum – the first part of the small intestine make up the upper GI tract.
  • Capsule Endoscopy
    This test helps in visualizing and evaluating the lining of the middle part of the gastrointestinal tract, consisting of the three portions of the small intestine (duodenum, jejunum and ileum).
  • Enteroscopy
    In Enteroscopy, which is a test used to examine the small intestine (small bowel), a thin, flexible tube (endoscope) is passed through the mouth or nose and into the upper gastrointestinal tract.
  • Colonoscopy
    Colonoscopy is a diagnostic procedure performed to look inside the colon and rectum. Colonoscopy is used to find inflamed tissue, ulcers, and abnormal growths. It is also used to look for early signs of colorectal cancer.
  • E R C P
    ERCP is a procedure that allows the doctors to diagnose diseases in the gallbladder, bile ducts, and pancreas.

Treatments

Details Of Surgeries Performed

  • Surgeries for benign and malignant conditions of oesophagus, stomach, intestines, liver and pancreas
  • Cholecystectomy, Appendectomy, Splenectomy and Intestinal Resections including Minimally Invasive options for diseases of these organs
  • Hiatus Hernia Surgery is a commonly performed procedure.
  • Complex Biliary reconstruction surgery for bile duct strictures with very good outcomes
  • The Minimally Invasive Surgery Division is one of the highlights of the Centre and performs the large number of laparoscopic procedures in the region. The team routinely performs basic laparoscopic procedures as well as complex procedures such as laparoscopic oesophageal surgery, gastric resections, colorectal surgery, pancreatic surgery, small bowel surgery, etc.

Diagnostic And Therapeutic Endoscopies

The department of gastroenterology provides various diagnostic and therapeutic endoscopies of different kinds as mentioned below.

Diagnostic Endoscopy

  • Upper Gastro Intestinal Endoscopy
  • Sigmoidoscopy/Left Limited colonoscopy
  • Full length colonoscopy
  • Colo-Ileoscopy
  • ERCP (Endoscopic Retrograde Cholangio Pancreatography)

Therapeutic UGI Endoscopy

  • Dilatation of oesophageal strictures/webs
  • EVL(Endoscopic Variceal Ligation (Oesophageal varices)
  • EST(Endoscopic Sclero Therapy) (Oesophageal varices)
  • Glue Injection for Gastric varices
  • Injection Sclerotherapy
  • Oesophageal stenting
  • Entero duodeno stenting
  • Percutaneous endoscopic gastrostomy(PEG)
  • Endoscopic placement of feeding tubes (NGFT)
  • Foreign Body Removal
  • Gastric duodeno polypectomy

Capsule Endoscopy

The Department has been using capsule endoscopy for last several years for the evaluation of patients with small bowel diseases like obscure gastro intestinal bleed, Crohns disease, Tuberculosis & chronic dirrhoea with very encouraging results.

Therapeutic colonoscopy

  • Colonoscopic polypectomy
  • Sclero therapy for bleeding lesions in colon and ileum
  • Colonic stents
  • Colonoscopic decompression in Pseudo obstruction
  • Therapeutic ERCP
  • Removal of CBD stones
  • Biliary stenting to relieve jaundice and cholangitis (plastic stents and metallic stents)
  • Bile duct stricture dilatation and stenting
  • Stenting of Pancreatic duct

Upper GI Endoscopy

Upper GI endoscopy is a procedure that uses a flexible endoscope to visualize the upper GI tract. The upper GI tract includes the oesophagus, stomach, and duodenum – the first part of the small intestine.

1. How is upper GI endoscopy performed ?

During the procedure, patients lie on their back or side on an examination table. An endoscope is carefully fed down the oesophagus and into the stomach and duodenum. A small camera mounted on the endoscope transmits a video image to a video monitor, allowing close examination of the intestinal lining. Air is pumped through the endoscope to inflate the stomach and duodenum, making them easier to see. Special tools that slide through the endoscope allow the doctor to perform biopsies, stop bleeding, and remove abnormal growths.

2. What problems can upper GI endoscopy detect ?

Upper GI endoscopy can be used to determine the cause of

  • Abdominal pain
  • Nausea
  • Vomiting
  • Swallowing difficulties
  • Gastric reflux
  • Unexplained weight loss
  • Anaemia
  • Bleeding in the upper GI tract

It is used for both diagnostic and therapeutic procedures.

Diagnostic upper GI endoscopy is done to detect

  • Ulcers
  • Abnormal growths
  • Obstruction
  • Inflammation
  • Hiatal hernia
    • – source of bleeding
    • – tissue samples (biopsy) are also taken during endoscopy and sent for pathological examination     to confirm the diagnosis.

The following therapeutic (treatment) procedures are also performed through upper GI endoscopy

  • Foreign body removal
  • Treat bleeding ulcers by
    • – Injection of medication (injection therapy) Application of heat (coagulation) or
    • – Application of clips (hemoclips) to the bleeding vessel
  • Treat bleeding varices (engorged veins in liver disease) by applying plastic rings (EVL)
  • Glue injection for gastric varix

Colonoscopy

Colonoscopy is a procedure used to see inside the colon and rectum which are parts of the large intestine for diagnoses and /or treatment.

1. What problems can colonoscopy detect?

Colonoscopy is a procedure used to see inside the colon and rectum.

Colonoscopy can help doctors diagnose the reasons for

  • Unexplained changes in bowel habits
  • Abdominal pain
  • Bleeding from the anus
  • Unexplained weight loss

Colonoscopy can also detect inflamed tissue, ulcers, and abnormal growths.

The procedure is used to look for early signs of colorectal cancer. The doctor can also take samples from abnormal-looking tissues during colonoscopy. The procedure, called a biopsy, allows the doctor to later look at the tissue with a microscope for signs of disease. The doctor removes polyps and takes biopsy tissue using tiny tools passed through the scope. If bleeding occurs, the doctor can usually stop it with an electrical probe or special medications passed through the scope. Tissue removal and the treatments to stop bleeding are usually painless.

2. Colonoscopy can be used to

  • Remove polyps (polypectomy)
  • Dilate narrowed segments (stricture dilation) of large intestine and place metallic stents across them (colonic stenting)
  • Banding for haemorrhoids (piles banding)

3. How is colonoscopy performed?

During colonoscopy, patients lie on their left side on an examination table. The doctor inserts a long, flexible, lighted tube called a colonoscope, into the anus and slowly guides it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. A small camera mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctor to carefully examine the intestinal lining. The doctor may ask the patient to move periodically so the scope can be adjusted for better viewing.

Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again. Bleeding and puncture of the large intestine are possible but they are uncommon complications during colonoscopy.

Dr. Dhaval Choksi

MD, DM (Gastro)

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