GASTROENTEROLOGY & HEPATOLOGY

Reflux
It is a disease that is caused by reflux of gastric acid into esophagus and characterized by complaints such as epigastric burn, esophageal reflux, hoarseness or cough. Gastroesophageal reflux is one of the most common chronic diseases in adults at our country. While changes in eating habits and optimal body weight may help treatment of this disease, which affects quality of life adversely, medical treatments are also crucial.

Ulcer
Ulcer is the tissue loss secondary to damage to the stomach or the duodenum by gastric acid and digestive juices. Ulcer may cause severe complications such as hemorrhage. The most important risk factors include a bacterium called H. Pylori, non-steroidal anti-inflammatory drugs and smoking. Pain is a prominent complaint in patients with ulcer. Medications are used to decrease production of gastric acid. Since a certain bacterium, called H. Pylori that resides in the stomach, contributes to the onset of peptic ulcer, antibiotherapy is required for the patients with this condition.

Dyspepsia
Dyspepsia is characterized by complaints such as sensation of postprandial fullness, pain/burn in upper abdomen or distention. These signs can be manifested alone or in combination. Dyspepsia is a fairly common health problem. Treatment should be planned after certain tests are carried out by gastroenterologist.

Diarrhea
Diarrhea is addressed in two clinical conditions depending on its duration; acute and chronic diarrhea. Diarrhea may be caused by a number of reasons. Acute diarrhea lasts less than 4 weeks and is usually caused by an infection. Diarrhea lasting more than 4 weeks is called chronic diarrhea and patients with chronic diarrhea should absolutely visit a gastroenterologist for further examination. Irritable bowel syndrome, celiac disease, inflammatory bowel disease (ulcerative colitis-Crohn’s disease), excessive bacterial growth in the intestine, parasitic infestations and gastrointestinal cancer are among numerous causes for chronic diarrhea.

Constipation
It is a common health problem that affects quality of life adversely. There are many possible causes. One should visit a gastroenterologist if there are changes in defecation habits, weight loss, abdominal pain and/or blood in stool. These may be cautionary signs for colon cancer and colonoscopy should be performed by a gastroenterologist.

Hemorrhoids
Hemorrhoids are dilated veins in the anal canal. Dilatation of the said veins may cause symptoms such as bleeding, itching or pain. It develops more easily in cases where intra-abdominal pressure increases such as long standing constipation or pregnancy. Although medication treatment may help the early-stage hemorrhoids, various treatments can be employed by gastroenterologists in rectosigmoidoscopy for advanced stage condition. Surgery may be required in more advanced stages.

GASTRIC BOTOX

Botulinum toxin is a substance used in various medical disciplines and recently, it is used effectively to manage the obesity. After an appropriate amount is administered to the pre-determined gastric regions with endoscopic technique; weight loss is facilitated by slowing down the gastric emptying, decreasing secretion of the hunger hormone and alleviating the nervous stimulation. Fullness is prolonged since food remains in the stomach longer and fullness is promoted with less amount of food.

The patients should strictly follow dietary advices following the Botox procedure. The intended weight loss may fail in patients with poor compliance to the diet.

Gastric Botox is recommended, after body mass index is calculated. Endoscopic procedure is carried out under sedation and lasts approximately 15 minutes. The patient doesn’t feel pain during procedure

Stomach and duodenum are carefully evaluated before the procedure. The procedure is performed after peptic ulcer is duly treated. It is a safe method.

The patient may be discharged on the same day after the procedure. Loss of appetite starts two days after the procedure. It may be repeated 6 months after the first procedure, if required. Although it does not have a major side effect, dyspepsia, nausea or distention are rare complications.

It is not recommended for people with morbid obesity, pregnant women or lactating mothers.

MİDE BOTOKS

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Colon cancer

Colon cancer is among the most common cancers. Colon polyps play a crucial role in development of colon cancer, which becomes a more common problem at advanced age. A part of the colon polyps show structural changes that may transform into a cancerous condition. Most colon polyps do not cause clinically significant symptoms, and therefore, further tests should be performed to detect them.

Risk factors of colon cancers are listed below:

  • Being overweight or obese
  • Being physically inactive
  • Excessive consumption of processed food or red meat.
  • Alcohol consumption
  • Smoking
  • Advanced age
  • A family member with same cancer
  • Certain Genetic Disorders:
    • Alterations in certain genes increase the risk of colorectal cancer. Hereditary non-polyposis colon cancer (HNPCC) is the most common type of hereditary colorectal cancers.
    • Familial adenomatous polyposis (FAP) is a rare condition characterized by hereditary polyps in colon and rectum. It occurs due to change in a specific gene, called APC.
    • Past history of colorectal cancer: Colorectal cancer may relapse in people with past history of colorectal cancer.
    • Ulcerative colitis and Crohn’s Disease: The risk of colorectal cancer is higher in people with the aforementioned inflammatory disease.

Colonoscopy and occult fecal blood play an important role in colon cancer screening. Colonoscopy at 5-year intervals and annual occult fecal blood are recommended for individuals at 50 years of age with negative family history. For patients with family history significant for the cancer, screening tests should be started 10 years before the age of the first case in the family. Colonoscopy evaluates the terminal part of the small intestine, called terminal ileum, and the colon with endoscopic technique. Patients do not feel any discomfort since sedation is administered during the procedure. The patients may be discharged when deemed appropriate by the doctor following the procedure. Polyps detected in colonoscopy are removed in the same session and the risk of cancer is eliminated.

 

CAPSULE ENDOSCOPY

Capsule endoscopy is a state-of-the-art technique based on assessment of images acquire while a capsule equipped by a mini camera recorder is inserted into the mouth cavity and advanced into the digestive system. This easy and safe technique ensured significant breakthrough in diagnosis of the diseases that involve the gastrointestinal tract, especially the small intestines. Capsule endoscopy method is carried out at our healthcare center.