Gastroenterology

Gastroenterology

Endoscopic services provided by GI unit at ESH

  • Upper GI Endoscopy ( Esophago-Gastro-Duodenoscopy), with detailed and thorough examination of upper GI tract ( esophagus , stomach and duodenum),high level expertise in using NBI ( narrow band imaging ) to detect early pre-malignant and malignant lesions
  • Colonoscopy, detailed and through examination with extensive experience in detecting, pre cancers and cancerous lesion
  • Advanced therapeutic endoscopic procedures including;
  • 1-EMR ( Endoscopic Mucosal Resection) of large polyploidy lesions, pre-cancerous and cancerous lesions ( early stages), in the colon, Esophagus, and stomach, avoiding patients to undergo major surgical intervention and large operations
  • 2-Placement of esophageal, duodenal and colonic metal stents, to relieve obstruction.
  • 3-CRE Balloon dilatation of strictures in esophagus, stomach, duodenum and colon.
  • 4- Endoscopic management of gastrointestinal tract bleeding, both upper and lower GI tract ( esophagus, gastric, small intestine and colon), including ; adrenaline injection, APC ( Argon Plasma Coagulation), Gold Probe treatment, Endoscopic clips, , Esophageal varices banding, Histo-Acryle Glue injection to gastric varices.
  • Diagnostic and Interventional EUS ( Endoscopic Ultrasound)
  • obtaining samples ( FNA) from lesion in pancreases, liver, Para esophageal and intra-abdominal lymph nodes, submucosal benign and malignant lesion in esophagus, stomach, duodenum and distal colon.
  • Detailed and accurate assessment of pancreatic and biliary system
  • Staging of esophageal, gastric , pancreatic and rectal tumors
  • Advanced Therapeutic ERCP;
  • Extraction of multiple and large common bile duct stones (CBD) stones ( gall stones fallen into the biliary system) using balloon and lithotripsy
  • Plastic and Metal biliary stent insertion to relieve biliary strictures
  • CRE balloon dilation and cytology brushing of biliary strictures
  • Single and Double balloon Enteroscopy for assessment of small intestinal
  • Both diagnostic and Therapeutic
  • Capsule Endoscopy for assessment of small intestine
  • Gastric Baloon for weight reduction
Gastroenterology

Services Provided at ESH

  • Investigations and management of weight loss, diarrhea, rectal bleeding, un-explained and vague abdominal symptoms
  • Diagnosis and management of Gastro-Esophageal Reflux Disease (GERD), including medical, endoscopic and surgical management
  • Diagnosis and management of esophageal dysmotitly ( e.g diffuse esophageal spasm, achalasia)
  • Medial and surgical treatment for Barrett’s esophagus
  • Diagnosis and management of Peptic Ulcer Disease.
  • Treatment Helico-bacter infection, persistent or recurrent
  • Diagnosis and management of non ulcer dyspepsia
  • diagnosis and management of celiac disease
  • Diagnosis and management of inflammatory bowel disease ( ulcerative colitis, Crohn’s disease), with extensive experience in the use of immunomodulators and biologic therapy
  • Diagnosis and management of function bowel disorders ( e.g Irritable bowel syndrome)
  • Diagnosis and management of acute and chronic liver diseases, including Viral hepatitis ( hepatitis A, hepatitis B, hepatitis C, hepatitis E and hepatitis D), Haemochromatosis, Fatty Liver Disease, NASH ( Non Alcoholic SteatoHepatitis), AIH ( Autoimmune hepatitis), PBC ( Primary Biliary Cirrhosis), Wilson’s disease, alfa-1 antitrypsin deficiency,
  • Management of pre- and post liver transplant care ( UK experience, Queen Elizabeth Liver Transplant Centre)
  • Diagnosis and management of solid and cystic pancreatic lesions, including benign,
  • pre-malignant and malignant lesions, ( IPMN, intrapapillary mucinous neoplasm, serous cyst adenoma, mucinous cyst adenoma, pancreatic neuroendoscrine tumours, pancreatic adenocarcinoma)
  • Assessment , diagnosis and management of biliary diseases, including medical, endoscopic and surgical management ( Gallstones, CBD stones ( choledocholithisis), benign and malignant biliary strictures, PSC ( primary sclerosing cholangitis, cholangicarcinoma, anastomotic biliary strictures)
  • Weight reduction clinics, including medical management, gastric balloon placement, gastric sleeve and gastric bypass surgery

Appropriate Indications for Gastroenterology Referrals

  • Reflux symptoms ( heart burn) ;
  • Uncontrolled with medical therapy ( 4 weeks of PPI therapy)
  • Controlled with PPI therapy, but more than 5 years , plus any two of the following critera
  • BMI > 30
  • male patient
  • white
  • hiatus hernia
  • > 50 years old
  • positive Fhx for esophageal cancer
  • Persistent or recurrent Helicobacter infection
  • New onset dyspepsia in any patient > 50 years old
  • Dysphagia at any age, all types, new onset, progressive, intermittent
  • Non cardiac chest pain
  • chronic cough ( respiratory causes excluded)
  • Abdominal pain, new onset, chronic , intermittent
  • Weight loss
  • patient > 40 year old, with change in bowel habit, shape, caliber, consistency, frequency
  • Diarrhea > 4 weeks ( chronic ), persistent or intermittent
  • fecal consistence
  • Constipation
  • Rectal bleeding ( any), melena
  • positive Fhx for colon cancer
  • positive Fhx for Gastric cancer
  • Anemia
  • Iron deficiency in male patient > 50 years old
  • Vitamin B12 deficiency
  • positive FIT test
  • Overweight
  • Abnormal Liver function test
  • Abnormal pancreatic function test
  • Liver, pancreatic or biliary abnormalities on imaging ( Ultrasound / CT scan)
  • Colon cancer screening candidates
  • Any patient > 40 years old
  • positive Fhx for colo-rectal cancer
  • Hx of IBD ( inflammatory bowel disease, i.e Ulcerative colitis or Crohn’s disease)
  • History of colonic polyps
  • Gastric cancer screening
  • Atrophic gastritis
  • pernicious anemia
  • Hx of gastric polyps
  • positive Fhx for gastric cancer
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