Gastroenterology

 

Gastroenterology is a branch of science that aims to prevent diseases of the digestive system (esophagus, stomach, small intestine, large intestine, gall bladder, pancreas) and liver before they occur, and deals with diagnosis and treatment after they occur. The specialist physician working in this branch of science is called a gastroenterologist. Gastroenterology specialists first specialize in Internal Medicine and then undertake a minor in gastroenterology. 

In Emsey Hospital Gastroenterology Clinic, specialized physicians and competent health professionals work in order to establish the correct diagnosis and to organize the most effective treatment in the light of scientific data. The center is also equipped with modern technological equipment and technical infrastructure in order to ensure that invasive procedures can be performed in the least invasive manner.
 
Treatments and Operations in Gastroenterology Department;

  • Diagnosis and treatment of esophagus diseases
  • Diagnosis and treatment of stomach and intestinal diseases
  • Diagnosis and treatment of gall bladder and tract diseases
  • Diagnosis and treatment of liver diseases (Hepatit, Cirrhosis etc.)
  • Diagnosis and treatment of pancreatic diseases
  • Gastroscopy, Colonoscopy, Rectoscopy (Endoscopy procedures) applications
  • Non-surgical removal of polyps (Polypectomy, mucosal resection)
  • Opening and widening esophagus and stomach strictures with balloon or bougie
  • Band therapy in esophageal varicose veins
  • Sclerotherapy, argon plasma coagulation, clip therapy in bleeding ulcers
  • Stenting of the esophagus, stomach, large intestine to provide nutrition or prevent obstruction in esophagus, stomach, large intestine cancers
  • Diagnostic imaging of bile ducts and pancreatic ducts with ERCP
  • Calculus removal from the biliary tract (non-surgical) with ERCP
  • Stent insertion in bile duct strictures with ERCP
  • Endoscopic (non-surgical) feeding tube insertion into the stomach
  • 24-hour pH measurement for the diagnosis of reflux
  • Capsule Endoscopy
  • Performing Endoscopic Ultrasonography (EUS)
  • Application of gastric balloon to assist diet in cases where failure to lose weight with diet alone in obese

Endoscopy; It is the general expression of the procedures of examining hollow organs such as stomach, intestine, lung, bladder, bile duct and pancreatic ducts with an illuminated camera device. Diagnostic sensitivity of endoscopy procedures is over 90 percent.

Gastroscopy (Esophagogastroduodenoscopy); It is a form of endoscopy. It is the examination of the esophagus, stomach and the twelve intestines with a light-attached camera device, biopsy or treatment if necessary.

Who Should undergo Gastroscopy?

  • Anyone over the age of 45 with stomach problems
  • Complaints of stomach discomfort under the age of 45
  • Those with alarm signs such as nausea, vomiting, weight loss
  • Those whose stomach discomfort persisting despite medication
  • Those with upper digestive system bleeding
  • Those with suspicious images in the stomach radiogram
  • Those with a history of stomach cancer
  • Unidentified cause of abdominal pain
  • Long-term reflux complaints, especially in patients over 50 years of age
  • For follow-up purposes in patients with Barret esophagus
  • Those with vitamin B12 deficiency whose cause cannot be revealed
  • In cases of unexplained iron deficiency and low deposit iron
  • In patients with gastric ulcer, after 6-8 weeks, for re-evaluation purposes
  • Gastroscopy should be performed in cirrhosis patients.


Colonoscopy, on the other hand, is the examination of the large intestine and the last part of the small intestine with a light-attached camera device, if necessary, biopsy or treatment procedures. 

 

Who Should Undergo Colonoscopy?

  • Screening for early diagnosis of bowel cancer to anyone aged 50 and over
  • Those with suspicious appearance in intestinal radiograms
  • Those who have rectal bleeding or have occult blood in their stool
  • To investigate anemia due to iron deficiency
  • Those with a history of bowel cancer or polyps
  • Those with low deposit iron
  • Those with first-degree relatives with colon cancer
  • in the follow-up of Crohn's disease, Ulcerative colitis
  • In patients with suspicion in the history
  • Colonoscopy should be performed in patients with prolonged diarrhea.


 
ERCP (Endoscopic Retrograde Cholangiopancreaticography);


It is the procedure in which the bile ducts, which are entered through the orifice, come up to the opening of the duodenum, and are passed through the camera tubing system, to view the bile ducts, gall bladder, pancreatic ducts and therapeutic applications when necessary. (removal of stones in the bile duct without surgery, stenting in strictures, etc.)

 

When ERCP is done?

1. Diagnostic ERCP;

  1. In the differential diagnosis of some jaundice whose cause cannot be revealed by laboratory tests and imaging techniques
  2. In cases where it is detected that the bile flow is blocked, but the cause cannot be revealed by laboratory tests and imaging techniques
  3. In the investigation of unexplained but recurrent pancreatitis (pancreatic inflammation) and pancreatic cysts
  4. Used for the diagnosis of bile duct and pancreatic cancers


 

2. ERCP for therapeutic purposes;

  1. In treatment of bile duct stones
  2. In cancer-related strictures requiring stenting in the bile duct
  3. To reduce the pressure by intervening in the bile duct mouth in bile duct fistulization
  4. In the treatment of pancreatic duct stenosis
  5. If surgical treatment cannot be performed in a short time in benign strictures of the biliary tract, to insert a stent

24 Hour pH Measurement;
This test is the most valuable test in the diagnosis of reflux disease. This examination is done by wired or wireless methods.

 

In wired pH measurement technique;

After stopping all stomach medications 5 days ago, a very thin capillary tube is placed from the nose to the upper part of the esophagus. The end of the tube, one end of which comes out of the nose, is attached to the small computer placed in the waist, and the recording is made in terms of ascite leakage for 24 hours, the patient continues his normal nutrition and activities. Then, by evaluating these computer records, it is determined by objective methods whether there is ascite leakage towards the esophagus.

 

Wireless pH Measurement Technique;


After stopping all stomach medications 5 days ago, the patient is put to sleep and a very small chip is placed in the lower part of the esophagus with the endoscope. In this method, there is no pipe cable to disturb the patient. Information from this chip is transferred to the small computer placed in the waist for 24-48 hours. Computer transcripts are then analyzed to determine whether there is reflux. There is no need for another procedure to get this chip, the chip inserted in the esophagus falls off spontaneously after a few days and is excreted with feces.

 

Band Application to Esophageal Varicose Veins


Varicose veins in the esophagus in cirrhosis patients; It is the process of strangling and deflating varicose veins with bands in the presence of a risk of bleeding that may occur in the near future, during bleeding or in the risk of re-bleeding, and it is a repeated procedure as varicose occurs again with periodic follow-ups. The procedure is the method in which the patient is put to sleep and applied by endoscopy.

 

Percutaneous Endoscopic Gastrostomy (PEG)


It is the process of attaching a feeding tube to the stomach by an endoscopic method without surgery to ensure nutrition in patients who cannot be fed orally, and ensuring that the appropriate food or ready-made nutritional solutions are given directly to the stomach through this tube with one end outside and the other end in the stomach.

 

Liver Biopsy


It is one of the diagnostic methods of liver diseases and it is the process of taking 1-2 cm pieces with a special needle to reach the diagnosis, to make staging, to diagnose suspicious lesions when a clear diagnosis cannot be reached with examination, laboratory findings. It can be performed under ultrasound or tomography or directly at the bedside.

 

Stent Insertion in Strictures
In the presence of cancer that causes or will cause obstruction of the esophagus, stomach and intestine, and in cases where the patient is not suitable for therapeutic surgery, it is the process of installing metallic, expanding cage structure apparatus that is less wearing for the patient in order to increase the quality of life, to contribute to the life span and to support chemotherapy. Metallic or plastic stents are also applied in bile ducts and pancreatic duct cancer or benign strictures.
Stents can also be placed in bowel cancer patients who cause complete obstruction but have a chance to be treated with surgery. In this way, it is possible to perform bowel surgery in one session.

 

Balloon Expansion of Strictures


It is the expansion process with balloons of various diameters and sizes in benign strictures in the esophagus, duodenum inlet and outlet, achalasia disease, some types of cancer and bile duct strictures.

 

Capsule Endoscopy


It is the process of diagnosing by examining the images taken from the small intestine with a capsule camera and transmitted to the small computer outside with the purpose of examining the small intestine in patients with obvious or hidden bleeding in the digestive system and whose location and cause cannot be determined by gastroscopy and colonoscopy.

 

Stomach Balloon
It is the process of placing a fluid-filled balloon into the stomach in order to help diet by providing a feeling of satiety in patients who are scientifically obese, whose hormonal cause cannot be determined and who cannot lose weight despite diet and physical exercise.

 

Double Balloon Enteroscopy


It is the process of examining the small intestine with the endoscope, thanks to the double balloon system, in cases where there are undetermined digestive system bleeding or suspicious conditions in the small intestine in capsule endoscopy examination.

 

Polypectomy-Mucosal Resection


There may be glandular formations called polyps that can be cancer precursors in the intestine and stomach. If these formations are not removed, it may turn into cancer in the future. These are the procedures of removing these formations by endoscopic method without surgery.

 

Endoscopic Ultrasonography (EUS)


It is used to identify undiagnosed or suspicious structures in the digestive system, gall bladder and pancreas by biopsy. With the ultrasonography device at the end of the endoscopy device, the patient is put to sleep and the oral esophagus, stomach and duodenum are entered and the digestive system is ultrasonographed from the inside.

 



Emsey Hospital
leventdemirtürkdamali.png Prof. Dr. Levent DEMİRTÜRK Gastroenterology Physician Info
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