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Gastroenterology is. a branch of medicine concerned with the structure, functions, diseases, and pathology of the stomach and intestines .Gastroenterology is the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. It involves a detailed understanding of the normal action (physiology) of the gastrointestinal organs including the movement of material through the stomach and intestine (motility), the digestion and absorption of nutrients into the body, removal of waste from the system, and the function of the liver as a digestive organ. It includes common and important conditions such as colon polyps and cancer, hepatitis, gastroesophageal reflux (heartburn), peptic ulcer disease, colitis, gallbladder and biliary tract disease, nutritional problems, Irritable Bowel Syndrome (IBS), and pancreatitis. In essence, all normal activity and disease of the digestive organs are part of the study of Gastroenterology.

Who should consider Gastroenterology Surgery ?

Weight loss and change in bowel habit are the alarming symptoms for gastroenterology. Apart from these, there are some conditions where the patient is required to consult a specialist –

  • Constipation
  • Abdominal Pain
  • Diarrhea
  • Blood in the stool
  • Gastroesophageal Reflux Disease or Acid Reflux

Gastroenterology Disorders

  • Bowel and colon cancers
  • Biliary tract disease
  • Cholecystitis
  • Gastric cancers
  • Hepatitis
  • Pancreatitis
  • Colon polyps
  • Esophageal cancers
  • Cancer and gall bladder stones
  • Achalasia
  • Pancreatic Cancer
  • Malabsorption and nutritional problems

Symptons

Types of general GI symptoms include the following:

Types of Gastrointestinal Surgery

Different types of gastrointestinal surgery can treat the following conditions that can improve quality of life of for many patients. Some of these conditions include –

  • Mediastinal masses
  • Achalasia
  • Laryngopharyngeal reflux disease (LPR)
  • Paraesophageal hernias, hiatal hernias and ventral hernias
  • Gastrointestinal reflux disease (GERD) or severe heartburn
  • GIST and other stomach tumors
  • Esophageal disease
  • Anorectal disease including rectal prolapse, incontinence
  • Gallbladder disease
  • Ulcerative colitis and Crohn’s disease
  • Enterocutaneous fistula and short bowel syndrome

The extent and type of GI (Gastrointestinal Surgery) largely depend upon the location and the size of the cancer. Gastrointestinal surgery could be the only treatment and can also be performed along with radiation therapy and chemotherapy.

Gallbladder Cancer : Surgery is used for treating the early stages of gallbladder cancers.

Stomach Cancer : Gastrectomy is the procedure by which the stomach cancer is treated. Partial gastrectomy is used for removing a part of the stomach. The remaining part of the stomach is connected with esophagus to the small intestine.

Liver Cancer : Hepatectomy is the surgical procedure for removing the parts of liver. 80% of the liver can be removed if the rest liver tissue is healthy. The left part of the liver helps in proper functioning of the liver.

Pancreatic Cancer : Whipple procedure is used for treating pancreatic cancer in order to remove the first part of the small intestine, head of the pancreas, part of the stomach and the bile duct. The tail and body of the spleen and the pancreas can be removed with the help of a distal pancreatectomy procedure.

Esophageal Cancer : A part or the entire esophagus can be removed with the help of esophagectomy procedure. This is done for treating the esophageal cancer.

Colorectal Cancer : The removal of the rectum or a segment of the colon and the 2 remaining ends are reconnected for the purpose of treating the colorectal cancer. The colostomy is the rare procedure by which a new path is created for taking out the waste products. An opening is made in the abdomen for connecting the opening with the intestine. A bag is then fitted in the opening in order to collect the waste.

Gastroenterology Diseases and Treatments

Diseases of the Small Intestine

  • Celiac Disease
  • Dysmotility
  • Infections of the Small Intestine
  • Inflammatory Bowel Disease (IBD)
  • Intestinal Lymphangiectasia
  • Intestinal Lymphoma
  • Lactose Intolerance
  • Small Bowel Obstruction
  • Tropical Sprue
  • Tumors of the Small Intestine
  • Whipple’s Disease

Diseases of the Duodenum and Stomach

  • Fungal Infections
  • Ulcers
  • Cancer

Diseases of the Gall Bladder

  • Gallstones
  • Cholecystitis
  • Choledocholithiasis
  • Acalculous Gallbladder Disease
  • Sclerosing Cholangitis
  • Gallbladder Cancer
  • Gallbladder Polyps
  • Gangrene of the Gallbladder
  • Abscess of the Gallbladder

Diseases of the Colon

Diseases of the Pancreas

Diseases of the Esophagus

  • Achalasia
  • Barrett’s Esophagus
  • Esophageal Cancer
  • Gastroesophageal Reflux Disease (GERD)
  • Peptic Stricture
  • Webs, Rings and Diverticula

Diseases of the Liver

  • Cirrhosis
  • Acute Hepatitis
  • Amoebic Abscess
  • Chronic Hepatitis
  • Liver Cancer

Gastroenterology Surgery Procedures

Endoscopic Retrograde Cholangiopancreatography (ERCP): During an endoscopic retrograde cholangiopancreatography, or ERCP, the gastroenterologist uses an endoscope, a long, thin, flexible tube with a light and camera at the end, through the esophagus, the stomach, and the first part of the small intestine, called the duodenum. Once the endoscope reaches the papilla, which is the opening of the common bile duct, the physician injects dye through these ducts, enabling x-rays to be taken. The procedure is meant for those who develops jaundice or experience abdominal pain. Scar tissue that is blocking the bile duct, tumors or gallstones can be easily identified through this procedure.

Colonoscopy : A colonoscope is used to examine the colon in a procedure known as a colonoscopy. A colonoscope is a long, thin, flexible tube with a miniature video camera and light at its end. The gastroenterologist will put a little bit of air into the colon as he/she inserts the scope. The camera on the end helps the physician both guide the colonoscope throughout the length of the colon and take pictures of the colon.

This procedure also allows other instruments to be passed through the colonoscope. For example, forceps may be used to painlessly remove a suspicious looking growth for analysis. During the colonoscopy, the gastroenterologist can remove polyps with a procedure called “polypectomy”. In this way, a colonoscopy may help to avoid surgery or better determine what kind of surgery needs to be performed.

Endoscopic ultrasonography  (EUS)

Endoscopic ultrasonography, or EUS, is used to examine the upper or lower part of the gastrointestinal tract. The upper GI tract includes the esophagus, stomach and first part of the small intestine, called the duodenum; the lower GI tract includes the colon, anus and rectum. EUS can also be used to examine other internal organs, such as the pancreas and gallbladder.

EUS involves the use of an endoscope or colonoscope, long, thin, flexible tubes with a light and camera at the end, to help guide the scope throughout the duration of the procedure. However, these scopes are different than those used in colonscopy and ERCP: they emit sound waves that create visual images of the digestive tract that a normal endoscope cannot detect.

Flexible Sigmoidoscopy : This procedure enables the physician to study the sigmoid colon from inside. The colon (the large bowel) is gastrointestinal tracts’s last portion. The section of the colon closest to the anus and rectum is known as the sigmoid. The sigmoid colon is 20 inches of the colon which is 4 feet in length. The basic function of the colon is to store the byproducts of the food till they get eliminated. The purpose of flexible sigmoidoscopies is to assess  the changes in bowel habits, blood loss and pain.
Liver Biopsy  : A liver biopsy is used to determine the presence of inflammation, fibrosis and to help diagnose various liver diseases.
During this procedure, the patient is fully conscious. A physician numbs the area around the liver using a local anesthetic (similar to that used by a dentist), and then using a long, narrow needle obtains a tiny piece of liver tissue.
Upper GI Endoscopy : An upper GI endoscopy looks at the upper part of the gastrointestinal tract including the esophagus, the stomach and the first part of the small intestine, called the duodenum. The esophagus is a hollow tube that carries the food to the stomach and small intestine for digestion.

The gastroenterologist uses an endoscope, a long, thin, flexible tube with a light and camera at the end to help guide the scope throughout the duration of the procedure. The camera on the end helps the physician both guide the endoscope throughout the length of the upper GI tract, and take pictures.

Gastroenterologists commonly perform this procedure as a way to evaluate and diagnose various problems, such as chronic heartburn (acid reflux), difficulty swallowing, stomach or abdominal pain, bleeding, ulcers and tumors.

Capsule Endoscopy

Capsule endoscopy allows examination of the entire small intestine by ingesting a vitamin-pill sized video capsule with its own camera and light source. During the eight-hour exam, the patient is free to move about. While the video capsule travels through the body, it sends images to a data recorder on a waist belt worn by the patient. Afterwards the doctor will view the images on a video monitor.

Capsule endoscopy helps determine the cause for recurrent or persistent symptoms such as abdominal pain, diarrhea, bleeding or anemia undiagnosed by other techniques including endoscopy, colonoscopy and x-rays. In certain chronic gastrointestinal diseases, this method can also help to evaluate the extent to which the small intestine is involved or monitor the effect of therapy.
Double Balloon Enteroscopy: Double balloon enteroscopy is a new method of examining the small intestine that previous techniques could not reach. Double balloon enteroscopy employs a high- resolution video endoscope with latex balloons attached at the tips that can be inflated and deflated with air from a pressure-controlled pump system. A sequence of inflation/deflation cycles allow the scope to be advanced further into the small intestine. This technique can be performed using either an oral or anal route.
Indications for double balloon enteroscopy include obscure gastrointestinal bleeding, Crohn’s disease, unexplained diarrhea, but also pancreaticobiliary disease in patients with altered anatomy such as Roux-en-Y, access to the excluded stomach after bariatric surgery and incomplete colonoscopy.

Cost of Gastroenterology Surgery

The gastroenterology surgery in India is very cost-effective and all hospitals in India possesses state of art endoscopic procedures that are basically performed for a gastrointestinal bleed.