Gastroenterology

The division of Gastroenterology and hepatology provides comprehensive care to patients with gastrointestinal and liver disorders. These includes but not limited to:

• Gastro oesophageal reflux
• Peptic ulcers
• Swallowing difficulties.
• Constipation and Diarrhea
• Irritable bowel Syndrome or Irritable colon
• Oesophageal Stomach and Colon Cancer
• Halitosis or bad Breath
• Abdominal bloatedness and “Gases”
• Management of Hepatitis A,B & C
• Management of raised Liver enzymes
• Management of biliary (Bile Tubes) disease
• Management of Pancreatic diseases
• Management of Liver fibrosis and liver cirrhosis
• Management of Fatty Liver and steatohepatitis

The divisions have the facilities to perform the following Endoscopy Procedures also.

• Diagnostic and theraphic gastroscopy and colonoscopy
• ERCP & removal of biliary stones
• Dilatation of digestive tract strictures and stenting
• Variceal banding and glue injections
• Treatment of bleeding ulcers with clips, 
• cautery and injections
• Removal of digestive tract polyps
• Gastric Balloon Insertion and removal

Gastroenterology: Additional Expertise at ZHS

Capsule endoscopy

Capsule endoscopy is a technique designed to visualize the most inaccessible parts of gastrointestinal tract , the small capsule is an ingestible camera in a pill which passes through the patient's GI tract taking about 50,000-60,000 digital images for doctor's review .

The most frequent indication is to evaluation of obscure GI bleeding after upper and lower endoscopic procedures failed to find a bleeding source ,patients who have unexplained iron deficiency anemia or are losing blood from an unknown source in GI tact are first evaluated with a colonoscopy and gastroscopy.

Another common indication is to evaluate small bowel inflammation, ulceration, bleeding, polyps and tumors.

It is non-invasive, painless and disposable investigation .it can be used in an ambulatory or hospital setting, takes around 8 to 12 hours, but the patient can go to work or perform routine activities.

Fibroscan :

Liver diseases are important health problems world wide, Accurately diagnosed liver fibrosis is the most important factor for determining the stage of the disease, assessing the patient's prognosis, and predicting the treatment response.

There is true for a wide range of disorders, including viral hepatitis alcoholic and non-alcoholic fatty liver diseases, drug induced liver injury, primary biliary cholangitis and autoimmune hepatitis.

This is a sensitive, non-invasive method that will help the patient with an underlying liver disease for better and safe diagnosis within few minutes and can predict the prognosis and response of treatment without any complications.

Ultrasound - based elastography (Fibroscan) provides a noninvasive approach for assessing the degree of liver fibrosis that has largely replaced the previously used complicated invasive liver biopsy not accepted by a majority of patients.

We are introducing the fibroscan which is a sensitive, non- invasive method that will help the patient with underlying liver disease for better and safe diagnosis within few minutes and can predict the prognosis and response of treatment without any complications.

PH Monitoring:

Gastroesophageal reflux disease is a common disease that can cause troublesome symptoms and have a significant impact on quality of life.

Ambulatory 24-hour esophageal PHmonitoringis the best study for quantifying gastroesophageal reflux.

Ambulatory 24-hour esophageal ph monitoring helps to confirm reflux in patient with normal endoscopic findings , those whose symptom continue despite an acid suppression treatment , identifies candidates for anti reflux surgery and to evaluate the effectiveness of medical or surgical treatments

We are introducing Ambulatory 24-hour esophageal ph monitoring which had a sensitivity , specificity more than 96% and can be done when the patient is on or off proton pump inhibitors therapy .

EUS - endoscopic ultrasonography:

Endoscopy machine withultrasound probe at its end, 2 probes available radial and linear in majority of cases we use linear scope due to therapeutic potentiality and fin needle aspiration.

EUS consider a revolutionary device for diagnosis and treatment of different kind of intra-abdominal diseases this procedure to be done under sedation in the following situation.

Diagnosis : mucosal and sub mucosal lesions and cancer staging in the esophagus, stomach and duodenum along with surrounding organ disease like mediastinum ,pancreas ,Gallbladder , common bile duct , Liver spleen and adrenal gland by taken biopsy and fluid simples , EUS also can evaluate rectal lesions and anal sphincter disease .

• therapeutic procedure : EUS can be used for : pseudo cyst drainage, celiac plexus block , intra-abdominal abscess drainage , mediastinal abscess drainage , EUS guided intra-tumoral therapy , EUS guided biliary and pancreatic duct drainage ,gall bladder drainage and vascular intervention .

In conclusion this machine can help to get final and accurate diagnosis in specific inconclusive diseases along with less invasive therapeutic procedure for some of intra -abdominal disease which need surgery before.