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Medical Gastroentrology Procedures

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Service offered at VGM Endoscopy Centre

Diagnostic Procedures- High definition Endoscopy
    The endoscope is a tube which is passed into the food pipe, stomach and the starting portion of the small intestine. Gastritis, esophagitis, ulcers, cancers, bleeding spots, hiatus hernia, lax sphincter etc can be diagnosed. The patient has to be on empty stomach (clear fluids like water or glucose water are allowed). The procedure is painless. Duration is 2-5 min. It can be done with or without sedation. During the procedure, biopsy may be done to detect Helicobacter pylori, the bacteria which causes ulcer and cancers (by rapid urease test or RUT).
    The colonoscope is passed via the anus, visualises the large intestine and reaches upto the last portion of the small intestine. Ulcers, cancers, polyps, inflammation of the regions can be detected and treated. The patient will undergo preparation before the procedure, wherein he will pass stools till the bowel is cleared. The procedure is generally done under sedation. The duration is 15-45 minutes.
    The scope is passed via the anus, and visualises the final half of the large intestine. Ulcers, cancers, polyps and inflammation of the regions can be detected and treated. The patient will be given enema/ suppository before the test. The procedure is generally done without sedation. The duration is 5 minutes.
    The enteroscope is longer than the endoscope and is used to visualise the small intestine. It can be done under sedation. Cancers, strictures, polyps, bleeding spots, inflammation, etc, can be detected and treated.
    The procedure is done by swallowing a capsule. The capsule contains cameras, light source, transmitting device etc. It shows the entire digestive tract from mouth to anus. It can detect ulcers, inflammation, cancers, polyps, bleeding spots etc. The patient needs to undergo preparation before the procedure. The duration is approximately 24 hours. Real time imaging is possible with HD clarity. The procedure is over when the capsule passes out in the stool. The data is seen by the doctor and reported.
    The manometry detects any abnormal motility of the food pipe. The symptoms of dysmotility are difficulty swallowing food, chest pain, cough, excessive heart burn etc. The patient has to be on empty stomach. A thin tube is passed through the nose. The recording is done while the patient is asked to swallow water. The duration is 15 minutes. VGM houses state-of-the art high resolution video manometry.
    Lactose breath test detects lactose (milk) intolerance. Glucose breath test detects bacterial overgrowth causing bloating and discomfort. Both tests are breath tests (no needle prick!), They are done on empty stomach.
    It is also a breath test done to detect Helicobacter pylori, the bacteria responsible for causing stomach cancer and ulcer. It is non invasive (no needle pricks). It is done on empty stomach.
    Detects the hardness of the liver (due to fibrosis). When liver gets fibrosed, the liver function deteriorates and the liver fails. Alcohol abuse, hepatitis B, hepatitis C and fatty liver are at risk of liver fibrosis. The test is non invasive (no needle prick). Duration is 2 minutes. It is done on empty stomach. It gives an accurate measure of liver stiffness. VGM hospital is the first centre in South India to use the fibroscan.
    It helps to detect any abnormality of the esophagus, stomach, and the first portion of small intestine. The patient has to swallow barium and the X ray is taken.
    It is done for long standing constipation. The patient has to swallow certain markers and the progress of the markers in the gut is monitored by serial X rays over 2 days.
    This is the thinnest endoscope (6mm) in the world. It is generally used in children and can be used in adults with any obstruction in the GI tract. The endoscope can be used to do trans nasal endoscopy.
    Manometry can also be used to check the motility of the anorectal region. The thin tube is inserted via the anal canal. The basal pressures are recorded and the pressures are recorded while the patient strains. The test duration is 20 minutes.
    This endoscope is a side viewing scope, designed to study the opening of the bile duct and pancreatic duct into the duodenum. It specifically looks for cancers or abnormalities of that area. It can be done with or without sedation.
    Reflux disease is a common problem. However only those patients with significant reflux are at risk of certain problems. pH study is done for 24 hours. It quantifies the acid reflux, non acid reflux (by a combination of impedance study) and the relation to food, posture, sleep etc. It guides in treating the patient effectively. It signifies if the patient requires surgery to correct the reflux disease. A thin tube is passed into the nose and the patient records his symptoms on the data recorder provided.
    This is the smallest endoscope in the world (6 mm). It is usually used in children and in those patients who have a narrowing which does not allow the regular scope to pass through. This scope can be passed through the nose (instead of mouth), which improves patient tolerance.

    Therapeutic Procedures


    Patients with cirrhosis (fibrosed liver), portal vein obstruction (EHPVO) are prone to develop bleeding through the vessels in the food pipe. EVBL or banding is used to treat the vessels prone to bleeding, by applying bands to the vessels. It is usually done under sedation. It is a day care procedure.
    Patients with cirrhosis or EHPVO, can develop bleeding through vessels in the food pipe. Sclerotherapy involves injecting the sclerosant into the vessel and preventing the bleeding. It is usually done under sedation.
    Patients with cirrhosis or EHPVO, can develop bleeding through vessels in the stomach also. Glue injection is done to control or prevent the bleeding. This procedure is done under sedation.
    Bleeding ulcer manifests as dark stools, blood in stools or blood vomiting. Endoscopy can localise the area of bleed. The bleed is arrested by injecting epinephrine, special clip placement or thermal coagulation, based on the intesity and location of bleed. By these techniques, surgery can be avoided.
    Collagen powder is sprayed using VGM hemoseal spray. It helps in stopping bleeding and also speedens ulcer healing. It is a daycare procedure and does not require sedation.
    Endoscopically any narrowing in the food pipe can be dilated. Patients who have difficulty in swallowing (such as after intake of corrosives) will require this therapy. It is done under sedation. It is generally a day care procedure.
    Esophageal cancer Colonic cancer-enteral stent Enteral stent for gastric outlet obstruction Metallic stents can be placed as a part of palliative care for cancers of the food pipe, stomach and colon: especially for 1. patients who cannot undergo surgery for cancer due to medical reasons or old age, or for 2. those patients who are not willing to undergo cancer surgery, 3. patients whose cancer has advanced so much that surgery cannot be done. The stent holds back the cancer tissue and hence allows the patient to eat food.

    Therapeutic Procedures

    • Adrenaline injection therapy for ulcer bleed
    • Thermal coagulation therapy
    • Hemoclip placement for ulcer bleed
    • Endoscopic Mucosal resection
    • Endoscopic Submucosal dissection
    • Pneumatic dilation for achalasia cardia
    • POEM for Achalasia cardia
    • ERCP's with Billary stents
    • EUS / Endosonography
    • RF ablation for Barret's Esophagitis(Metaplasia)
    • Spy glass cholangioscoy for bile duct and pancreatic duct disease
    • Formalin Gauze therapy for radiation proctitis
    • Endoscopic and colonoscopic Polypectomy
    • Foreign body removal from G.I tract
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