Gastroenterology

Gastroenterology

Gastroenterology is the branch of science that deals with diseases of the digestive system. 

Areas of Interest of Gastroenterology

Gastric Reflux Disease

Coming up of stomach contents into the esophagus is called gastric reflux disease. This condition can also be seen in smaller amounts in healthy people after meals.  However, if complaints progress and affect the quality of life of a person, then you can talk about gastric reflux disease. Symptoms of Reflux Disease

The most common symptom is heartburn. Especially after meals, a burning sensation is felt upward from an upper part of the stomach. Another common symptom is that food in the stomach comes up to the mouth. 

It is a chronic disease that usually continues for life. Therefore, patients with reflux should avoid conditions that increase reflux and, if possible, learn to control their symptoms using  simple measures

Currently, the most effective medications used to treat reflux disease are drugs called proton pump inhibitors ( PPI).  

Nowadays surgical treatments based on tightening of the stomach entrance by laparoscopy method are also available. By this treatment, called fundoplication, complaints of heartburn and coming up of water to mouth can be prevented by up to 90%. 

Ulcer

It is described as lesions greater than 0.5 cm developing in the stomach and duodenum.  It causes symptoms including abdominal pain, pain in stomach region, heartburn, abdominal fullness, and nausea-vomiting. 

The most reliable method for its diagnosis is gastroscopy. 

The aim of ulcer treatment is to ensure closure of active ulcer and prevent new ulcers. 

The first thing to do to ensure closure of ulcer is to create an appropriate dietary regime. This dietary regime is based on eating in small portions at short intervals and avoiding eating foods that stimulate gastric secretion.

During medication treatment, effects of vagus nerve running the stomach and gastric acid are reduced.  Moreover, lesions are also treated by antibiotics. 

Stomach Cancer

Stomach cancer is the second most common type of cancer after lung cancer. 1 in every 10 cancer patients is stomach cancer. 

Your eating habits is important in the incidence of stomach cancer. Among the most common causes of cancer are over-consuming salty foods and not consuming enough vegetables and fruits. Additionally, hereditary factors are among causative factors in the development of gastric cancer.

The most effective method of diagnosis in stomach cancer is endoscopy. 

Surgical methods are used in the treatment of gastric cancer; stomach is removed by surgery.  According to the state of cancer, radiation therapy and drug therapy are applied after the surgery. 

Pancreatic Cancer

The pancreatic cancer is a disease which is quite severe and difficult to treat .  The risk of developing pancreatic cancer is much higher in men than in women .   At the same time, people who smoke, consume alcohol and have an irregular life are more likely to develop pancreatic cancer compared to other people.

Treatment process changes according to the stage of the cancer in the patient. Treatment methods of pancreatic cancer include surgery, radiation therapy or chemotherapy.

Gallbladder Diseases

Gallbladder’s job is to store bile produced by liver. Bile, which is accummulated in the gallbladder usually in the fasting state, becomes more concentrated and is stored in there. During digestion, the gallbladder contracts and releases its contents  into the duodenum and hence fats are absorbed.

Gallbladder Polyp

Gallbladder polyps are benign tumors of the gallbladder. There are different types of gallbladder polyps.

In the case of gallbladder polyp surgery, there is no such technique as removing polyp; the whole gallbladder should be removed.

Gallstone

It is caused by disturbance of ratios of gallbladder contents.  

For this reason, surgery is recommended to people having a gallstone with a diameter above  2 cm regardless of whether it causes symptoms or not. During gallstone surgery, the whole gallbladder organ should be removed.

Pancreatitis

Pancreatitis can simply be described as inflammation of the pancreas.   

While treatment of pancreatitis was mainly surgical in the past, nowadays it is mostly medical treatment, intensive care support and surgical intervention, where necessary. Treatment is associated with severity of pancreatitis attack. 

Colon Cancer

Large intestine, which we call colon, is the section coming after small intestine of digestive system, which is approximately 2 meters long. Incidence of colon cancer is equal in men and women and its incidence is in 3rd place among all cancers.  Exact cause of colon cancer is unknown but there are some environmental and genetic factors affecting its development.  Nutrition has an important place in colon cancer; consumption of animal fat was found to be effective through research studies.

In the initial stages of colon cancer , feeling of fullness in the abdomen, mild pain, loss of appetite , weight loss , fatigue , and diarrhea or constipation occur. These symptoms are not specific to just the colon cancer , but when these symptoms occur, they need to be checked .  In further stages, first constipation begins and it is followed by attacks of pain. Then, fatigue, loss of appetite and weight become significant. Anemia occurs.  If the bowel is completely closed due to the cancer, the patient’s condition gets severe and passage of toxic substances into the blood starts. 

Treatment of colon cancer is surgery. The part with tumor is removed by surgical methods. Then, upper and lower sides of the part of bowel which has been removed are bonded to each other. Radiation therapy is not used in colon cancer.  But chemotherapy (drug treatment) can be applied to patients after surgery.

Ulcerative Colitis

It is an inflammatory disease of the large intestine. It causes formation of ulcers and bleeding in the large intestine.

Ulcerative colitis can be controlled with medication.  However, it is usually not possible to heal the disease with a treatment that lasts for a certain period of time. The disease continues for life. It usually goes on along with exacerbations and relief periods. Therefore, it is recommended that the treatment lasts for life. 

In the case of ulcerative colitis, where the disease cannot be fully controlled despite intensive therapy, medication side effects cannot be controlled, perforation or risk of cancer arises, surgery is employed.   But in the case of such an operation, not only the affected area of the large intestine but the whole organ should be removed. 

Hemorrhoids

Hemorrhoids or piles, in other words, are described as the expansion or varix of the veins in the rectum.

Primarily non-surgical treatments should be tried in the case of hemorrhoids. If non- surgical methods don’t help make progress, surgical methods are applied.  

Diagnostic Methods In Use

Colonoscopy

It is the most reliable method for large bowel cancer scan in healthy people aged 50 or older. The procedure involves an examination by entering the large bowel using a device with an extremely soft tip. This effective method can provide diagnosis, removal, biopsy of polyps. During the implementation of the method, very small doses of anesthesia are given to the patient to anesthetize him.

Gastroscopy

Gastroscopy is an examination of esophagus, stomach and duodenum using a gastroscopy device with a miniature illuminated camera on its tip. This system allows biopsy, where necessary, and diagnosis of stomach diseases and cancers. During gastroscopy, very small doses of anesthesia are given to the patient to anesthetize him. 

ERCP

ERCP is a successful method in diagnosis and treatment of stones and tumors causing inflammation of bile ducts or pancreatic duct and it can be defined as a procedure involving imaging of bile ducts and pancreatic duct using a special endoscope.

Computed tomography

Computed tomography is a special imaging technique that gives a cross-sectional image of the tissues and organs of the body using x-rays.   In comparison to ordinary plain radiographs, CT provides more detailed information about head injuries, brain tumors and other brain disorders. Bone , soft tissues and blood vessels can also be displayed by CT.

Magnetic resonance (MR)

MR is a painless procedure that can display internal organs and tissues in a clear and detailed manner. MR uses radio waves and a strong magnetic field, instead of X-rays.

Ultrasound

Ultrasound uses sound waves to view internal organs of the body.  Frequency of the sound waves used is so high that a human ear cannot hear. The amount of sound reflected by each tissue will be different so the image perceived will be different. Thus, tissues and organs will be seen on the screen of ultrasound device. By this method, different images can be detected for tissues like a cyst or tumor.

Biopsy

Biopsy is a procedure involving removal of a tiny portion of body tissue for examination. Then the tissue removed is examined under a microscope. Before biopsy material is examined, it  may undergo certain procedures and dying in such a way as to allow a series of microbiological and molecular biological investigations. Biopsies are usually done upon a suspicion of disease .  For example, if a patient has an unexplained swelling, mass, or suspected tumor, the best diagnostic method is to collect samples from the mass and examine them to make a diagnosis. 

PET/ CT

One of today’s most effective imaging technique, PET CT ( Positron Emission Tomography ) is utilized for diagnosis, staging , treatment response assessment and radiotherapy planning of  many cancers, including particularly lung , colon, head – neck cancers and lymphomas.  PET CT is also informative about the distribution of cancerous cells and allows determination of whether a cancer is benign or malignant.

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