Frequently Asked Questions
What does a liver biopsy mean?
Liver biopsy is a medical test that is done to aid diagnosis of liver disease, to assess the severity of known liver disease, and to monitor the progress of treatment.
What is the most common cause of cirrhosis of the liver?
The most common causes of Cirrhosis are Hepatitis C, Alcohol-related Liver Disease, Non-Alcoholic Fatty Liver Disease, and Hepatitis B. Many people with Cirrhosis have no symptoms in the early stages of the disease. Alcohol remains the second most common cause of liver Cirrhosis after hepatitis C virus.
Does a liver biopsy hurt?
Because of the local anaesthetic, you should not feel any pain. However, you may feel some mild discomfort or pressure as the doctor pushes on the needle.
What is the common causes of liver cirrhosis
Liver cirrhosis is a condition where is irreversible liver damage ( advanced liver fibrosis ) by various causes . Among the common causes of liver cirrhosis is alcohol related liver damage and liver infection caused by Hepatitis B virus is common .
Other cause are Hepatitis C Infection , Obesity and Diabetes related liver damage (NAFLD), Wilson disease, Hemochromatosis and unknown cause .
Many patient with liver cirrhosis have no symptoms in early stages of diseases.
In advanced stage of liver cirrhosis patient presented as abdominal distension (Ascites), Yellowish discoloration of eye and urine ( Jaundice) , Blood in vomiting (Hemetemesis), Altered sensorium (Hepatic Encephalopathy) and liver cancers
Liver cirrhosis diagnosed by blood investigations, USG abdomen, Fibroscan and UGI Endoscopy
Stage of liver cirrhosis also assessed and managed according the cirrhosis stage.
In advanced stage of liver cirrhosis where complications cannot managed by medically then liver transplantation should be done
How to know if I am suffering from Jaundice?
Jaundice is a condition in which the skin, whites of the eyes and mucous membranes turn yellow because of a high level of bilirubin, a yellow-orange bile pigment.
What happens to your body when you have gastroenteritis?
When gastroenteritis causes you to vomit or have diarrhea, your body loses fluids and electrolytes. If you don’t replace those fluids and electrolytes, you may become dehydrated. When you are dehydrated, your body doesn’t have enough fluids and electrolytes to work properly.
What is the treatment for Hematemesis?
Following treatments are available:
- Medicine may be given to reduce the amount of acid your stomach produces.
- Endoscopy may be used to treat the cause of your bleeding.
- A blood transfusion may be needed if you lose a large amount of blood.
- An angiogram is done to look for and stop bleeding from an artery.
Q) Which Diseases Managed in the Department of Gastroenterology & Hepatology :
Diseases which cover under Medical Gastroenterology broadly divided into three categories
1. Liver Related Diseases
- Jaundice, Liver Infections (HAV, HBV, HCV, HEV)
- Alcohol-related liver disease
- Liver Cirrhosis
- Obesity and DM related liver diseases (NAFLD)
- Liver abscess
- Bile Duct stones
- Bile duct obstruction by stones/cancer/mass/lymph nodes/extrinsic compression
- Drug-Induced liver injury
- Liver Failure, Liver Cancers
2. GUT Related Diseases
- Acidity, retrosternal burning, esophageal cancers, swallowing difficulty
- Gastritis/Gas/Stomach ulcers/Stomach cancers
- Recurrent vomiting, Gastric Outlet Obstruction
- Gluten sensitivity (Celiac disease), Diarrhea, IBS
- Abdominal Pain, Intestinal TB, Fluid in the abdomen (Ascites)
- Constipation, Bleeding PR, Piles , IBD , Abdominal Cancers
3. Pancreas Related Disease
- Acute pancreatitis
- Chronic pancreatitis
- Alcohol-related pancreatic diseases
- Pancreatic Cancers
Q) What are Different Procedures done in the Gastroenterology Department
- Upper GI Endoscopy- Both Diagnostic & Therapeutic
- Esophageal Stricture dilatation
- Esophageal Stenting in esophageal cancers
- Sigmoidoscopy, Pile Injection & Piles Banding
- Colonoscopic Polypectomy (Removal of polyp mass in large intestine)
- Side Viewing Endoscopy
- Bile duct stone removal
- Bile Duct Stenting
- Pancreatic duct stones removal and Pancreatic Duct Stenting
- Esophageal Manometry
- Esophageal PH Metry
- Anorectal Manometry
Q) What is Endoscopy and Indication of Endoscopy
Upper GI Endoscopy also known as oesophago-gastroscopy is a visualization of upper GI tract which includes esophagus, stomach and small intestines by video-endoscope. UGI endoscopy usually performed on outpatient basis . UGIE done for diagnosis of various diseases and in certain cases therapy can be done through endoscopes
Indications of UGI Endoscopy :
1) Esophagus Related Diseases
- Esophageal ulcers
- Swallowing Difficulty
- Retrosternal Burning/GERD
- Esopahgeal Cancers
- Recurrent Vomiting
- Blood In Vomitus
2) Stomach Related Disease
- Gastritis, Acidity , Dyspepsia
- Stomach Ulcers
- Stomach Cancers
- Gastric Outlet Obstruction
3) Small Intestine Related Diseases
- Chronic Diarrhea
- Gluten Sensitivity (Celiac disease)
- Small Intestine TB/Male-absorption syndrome
Q) What is Lower GI Endoscopy ( Sigmoidoscopy & Colonoscopy) and Uses
Lower GI Endoscopy also known as Sigmoidoscopy and Full colonoscopy . Colonoscopy is the visual examination of the anal canal, Rectum and large Intestine (Colon) by using lighted, flexible video colonoscope
Lower GI endoscopy used for
1) Ano-Rectal Diseases
- Bleeding PR
- Piles diagnosis
- Piles Injection therapy and Piles Banding
- Anal Fissure
- Anal Fistula
- Anorectal Growth/Cancers
- Pain/Itching in anal canal
2) Large Intestine Diseases (Colon)
- Blood mixed stool
- Inflammatory Bowel Disease ( IBD-UC & CD)
- Chronic diarrhea
- Colon Cancers
- Colon Polyps Diagnosis and Removal
- Diverticulosis and Diverticulitis
- Intestinal TB
- Anemia cause
- Unexplained weight loss
- Chronic Constipation
Q) What is ERCP ( Diagnostic & Therapeutic ) and Uses of ERCP
ERCP means endoscopic retrograde cholangio pancreatography. ERCP helps in diagnosis and treatment of various diseases related to Gall bladder, Bile duct and Pancreas. The patient is sedated and a piece of plastic ( Mouth piece) placed into mouth to keep mouth open. A bendable, lighted tube (Side Viewing Endoscope) is placed through mouth and into stomach and first part of small intestine . An incision can be made using electrocautery to open the lower end of bile ducts. Then bile duct stones removed or stent placed into bile duct . ERCP takes about 20 to 60 minutes. ERCP useful in management of various diseases such as
- Bile Duct Stones
- Bile Duct Blockage
- Bile Duct Cancers
- Jaundice (Obstructive)
- Cancer of bile ducts, Gall Bladder and Pancreas
- Bile duct Infections
- Bile Duct and Pancreatic Duct Leak
Q) What is Manometry – Esophageal Manometry & Anorectal Manometry
Manometry is the recording of muscle pressures within an organ. So esophageal manometry measures the pressure/motility within the esophagus . And Ano-recal manometry measures the sphincter pressure and anorectal muscle pressure/motility which is useful in constipation evaluation and management. Manometry is a OPD basis procedure which usually takes 10-20 minutes
Indications of Esophageal Manometry
- Swallowing difficulty specially for liquids
- Non Cardiac Chest Pain
- Reflux disease ( GERD)
- Systemic disease ( Connective tissue disease)
- suspected Upper Esophageal sphincter dysfunction
Indications of Anorectal Manometry
- Chronic Constipation
- Fecal Incontinence
- Hirschsprung diseases
- Evaluation of ano-rectal pain
- Biofeedback Therapy for constipation
- Prior to surgery for rectal prolapse
Q) What is Peptic Ulcers and How to treat it
Peptic ulcers also known as peptic ulcer disease (PUD) is most common complications of chronic acidity. Long standing acidity can lead to ulcer formations in food pipes or in stomach. PUD patients usually presents as abdominal pain, burning, nausea , vomiting and in advanced stage patient can also presents as vomiting of blood and stomach cancers . PUD usually diagnosed by upper GI endoscopy and managed accordingly . If patient having alarm/red flag symptoms such as decreased appetite, weight loss, anemia, blood in vomitus, swallowing difficulty then patient should undergo upper GI endoscopy as early as possible to rule out esophageal cancer or stomach cancers .
Q) What is common causes of Blood in stool
Passage of blood per rectum is a common symptoms of various underlying diseases of ano-rectum and large intestine. Lower GI bleeding is a frequent cause of hospital admission . Causes of bleeding PR divided into two parts
1) Disease of ano-rectum
- Rectal Polyps
- Ano-Rectal cancers
- Radiation Proctitis
- Anal Fissure
- Rectal Ulcers
2) Diseases of Large Intestine
- Inflammatory bowel disease ( IBD-UC/CD)
- Colon Cancers
- Colon Polyps
- Colon ulcers
- Intestinal TB
- Ischemic colitis
Causes and source of GI bleeding identified by colonoscopy and treated according the cause of bleeding
Q) What is Pancreatitis
The pancreas is also called “hidden organ” because it is located deep in abdomen behind the stomach .The pancreas produces juices and enzymes that flow through these tubes into the intestine, where they mix with food. There are two types of pancreatitis
1) Acute pancreatitis
This condition occurs when the pancreas becomes quickly and severely inflamed . The common causes of acute pancreatitis are alcohol intake, gall stones/gall bladder disease, trauma, drugs and auto-immune diseases. The main symptoms of pancreatitis are acute, severe pain in the upper abdomen which is radiating to back, frequently accompanied by vomiting and abdominal distension. Most patients with mid and moderate pancreatitis recovers with conservative management . Severe pancreatitis requires prolonged ICU care and about 40% mortality with severe pancreatitis
2) Chronic Pancreatitis
In the chronic pancreatitis pancreatic gland shrunken with pancreatic duct dilatation and stones in pancreatic duct. Most patients with chronic pancreatitis presented with recurrent episodes of severe upper abdominal pain . Few patients of chronic pancreatitis presents with associated diabetes and chronic diarrhea. Most common cause of chronic pancreatitis is long standing alcohol intake
Patient of chronic pancreatitis treated by medications , ERCP & Pancreatic duct stenting and in advanced cases surgery is also done
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