Medical Gastroenterology
The Department of Medical Gastroenterology at Kauvery Hospital, Radial Road, Chennai, provides comprehensive treatment to improve the health of the digestive system. The department uses cutting-edge facilities to diagnose gastrointestinal disorders.
Our gastrointestinal expert team will diagnose your condition more efficiently and will provide both surgical and non-surgical treatment options with the least complications. Modern flexible endoscopes for diagnostic and interventional procedures like gastroscopy, colonoscopy, ERCP, EUS, Third Space Endoscopy are available as part of diagnostics and treatment facilities.
Services Offered
- Diagnostic Gastroscopy, colonoscopy and Duodenoscopy (with ME and NBI)
- Gastrointestinal bleed management (banding, sclerotherapy, APC etc)
- ERCP for biliary and pancreatic diseases
- EUS- therapeutic and diagnostic
- Third space endoscopy
- Luminal stricture and fistula management by endoscopy
- Capsule endoscopy
- Endo bariatrics ( Balloon placement, Endoscopic sleeve gastropexy)
- GERDX for GERD
- Advanced pancreatic disease management
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Speciality Clinics
This clinic provides patients with chronic liver disease and liver cancers a one-stop solution. These patients are worked up based on standard protocols to get the accurate diagnosis and management of their condition. They are also given long-term care for chronic liver disease. Medical management of cirrhosis and pre transplant care. Also, Ascites management and diagnostic liver biopsy are done on day care basis.
People with inflammatory bowel disease (IBD) receive excellent care at IBD Clinic. Our expert IBD specialists use a multidisciplinary approach and collaborate with numerous other specialists to develop a tailored care plan that is best for you. We have a regular daycare setup for biological administration and fecal microbiota transplantation.
Reduction of body fat in a sustainable way is highly recommended for all obese diabetic patients, people with fatty liver disease and obstructive sleep apnoea syndrome. Along with diet and exercise counseling, we offer endoscopic balloon placement, endoscopic sleeve gastropexy (reduction of stomach capacity) and pharmacotherapy.
We provide diagnosis & treatment of a large cohort of adults and children with inflammatory bowel disease. Patients with IBD frequently require long-term monitoring, so we collaborate with you to identify the most effective therapy options for controlling your symptoms.
We have state of the art facilities like Esophageal high resolution manometry and anorectal manometry to treat gastrointestinal problems.
Special Services
Presentation – Dysphagia for solids and liquids, chest pain, nocturnal regurgitation, weight loss, nocturnal cough. This is due to defective relaxation of lower oesophageal sphincter during swallowing, likely due to neuro degeneration.
Diagnostic tests – Upper GI Endoscopy ( showing oesophageal stasis, tight gastroesophageal junction) , Oesophageal Manometry (shows tight lower oesophageal sphincter and absent peristalsis of oesophagus, Barium swallow (optional), CT thorax (optional)
Treatment: POEM – Per Oral Endoscopic Myotomy. Under GA, a tunnel is created in sub-mucosal space using an endoscope and cautery knife. After exposing a length of muscle layer in distal esophagus, GE junction and gastric side, myotomy is done. Incision wound in the mucosal side is closed with clips. Patients will be started on an oral diet after 24 to 48 hours. Follow up after one month is advised, for oesophageal manometry to establish the success of the procedure. Duration of hospital stay is 48 hours. Special diet will be suggested for one month. After one month from the date of procedure, patients can follow a normal diet.
Any mucosal lateral spreading tumours and early stage cancers in oesophagus, stomach or colon can be removed using an electrocautery knife. The mucosal layer involving the tumour and surrounding normal margins is removed en bloc.
Presentation: incidentally picked up in routine endoscopy or colonoscopy or by active screening endoscopy program.
Presentation – Oesophageal GIST or Leiomyoma may present with dysphagia or GERD symptoms. Gastric lesions may present as indigestion, haemetemesis, malena, weight loss or most often asymptomatic.
Diagnosis: Endoscopy, CT thorax, EUS (layer of origin of the mass can be located within the oesophageal or gastric wall. Mass may be subjected to EUS guided fine needle biopsy for histopathological confirmation prior to removal.
Treatment: Under GA, similar to POEM procedure, submucosal tunnelling is done in the oesophagus, starting the incision proximal to the tumour. Tissue around the tumour is dissected, tumour removed en bloc and entry wound closed with clips. Patient is usually started on oral diet 24-48 hours after the procedure. Duration of hospital stay is 3-4 days. Very minimally invasive procedure, where recovery is very fast.
Presentation – Patients with gastric outlet obstruction may be due a peptic ulcer of disease or gastric or pancreatic malignancy. Patients present with vomiting, weight loss with or without abdominal pain.
Diagnosis: Endoscopy and CT abdomen
Treatment: Gastric bypass anastomosing stomach with jejunum is the standard of care. It was done by open or laparoscopy in the past. Now it can be done completely by endoscopy using a cautery based lumen apposing metal stent (LAMS). Under GA, the jejunal loop is identified by endoscopic ultrasound from the gastric station; the jejunal loop will be filled with blue dyed water, directly punctured from the stomach using the metal stent delivery device. After deploying the dumbbell shaped LAMS across the jejunal loop and stomach, a 2 cm opening is created. Patients can be started on a liquid diet the very next day. Pain-free procedure compared to surgery, but offers the same benefit of surgery.
Pancreatitis can result in peri pancreatic fluid collection, which can organize after a few days to form Pseudocyst or Walled off pancreatic necrosis (WOPN).
Presentation: Pain, vomiting, weight loss, fever.
Diagnosis: CECT Abdomen, EUS, MRCP, USG abdomen.
Treatment: Usually, laparoscopic necrosectomy is done for WOPN. Now Endoscopic metal stents can be placed between stomach and lesser sac (fluid collection). Subsequently endoscopes can be passed into the cavity of necrosis for debridement of the necrotic material.
Presentation: Pain due to advanced pancreatic or gastric malignancy, refractory to medical management. Pain due to chronic pancreatitis
Treatment: Celiac ganglion or plexus neurolysis is done via EUS. Absolute alcohol and bupivacaine is injected into the celiac ganglion. Post procedure maximum pain relief is achieved after 48 hours. In case of chronic pancreatitis with pain, steroid is injected into the celiac plexus, offering a good pain relief for at least 3 months.
