Gastroenterology Services

What are the diseases that the Gastroenterology department deals with?

 When it comes to diseases of the digestive system, it can be summarized as the digestive tract, including the esophagus, stomach, small intestine, large intestine, anal diseases, and diseases related to organs outside the digestive tract such as the liver, pancreas, and gallbladder/ducts. Among these diseases are reflux disease, gastritis, stomach and duodenal ulcers, gallstones/polyps, hepatitis, cirrhosis, liver cancer, pancreatitis, Celiac Disease, Crohn's Disease, Ulcerative Colitis, other inflammatory bowel diseases, irritable bowel syndrome, diverticulosis coli, hemorrhoids, anal fissure, and cancers of the esophagus, stomach, pancreas, and intestines.

 What are the areas of expertise for Gastroenterology specialists?

 Gastroenterology specialists are physicians who specialize in diseases of the digestive system after completing their internal medicine specialization. They undergo 3-4 years of theoretical/practical subspecialty training. In this context, they are trained and experienced in the use of state-of-the-art devices and systems such as Endoscopy, Colonoscopy, Ultrasonography, Endoscopic Retrograde Cholangiopancreatography (ERCP), Endoscopic Ultrasonography, Manometry, Capsule Endoscopy, and advanced diagnostic/therapeutic procedures performed through these methods.

What are gastrointestinal tract diseases?

 Among gastrointestinal tract diseases are reflux disease, gastritis, stomach and duodenal ulcers, Celiac Disease, Crohn's Disease, Ulcerative Colitis, other inflammatory bowel diseases, irritable bowel syndrome, diverticulosis coli, hemorrhoids, anal fissure, and cancers of the esophagus, stomach, and intestines.

How are the diagnosis and treatment of gastrointestinal tract diseases conducted?

 In the diagnosis and treatment of gastrointestinal tract diseases, non-invasive diagnostic methods such as patient information, physical examination, and necessary laboratory tests, ultrasound, contrast studies, computed tomography, magnetic resonance, as well as interventional methods such as endoscopy, colonoscopy, endoscopic ultrasound, and ERCP may be used. These methods are employed by physicians not only for diagnostic purposes but also for therapeutic interventions.

If we are to give examples of therapeutic endoscopic interventions:

• Prevention of cancer development through the removal of polyps (benign tumors)

• Endoscopic removal of tumoral structures developing in the tissue of the digestive system using special blades (submucosal dissection, subepithelial dissection)

• Stopping bleeding in patients by injecting hemostatic drugs, cauterizing with laser, or applying internal stitches (clips) or bands to halt bleeding

• Implementation of dilation treatments for narrow channels using devices such as balloons, bougies, or stents

• Treatment of hemorrhoids by ligating with bands or using medication-laser therapy.

• Endoscopic stitching or repair with stents in cases of canal injuries or tears resulting from surgery or other causes

• Application of stents (tubes) in cases of narrowness in the digestive system.

What are stomach diseases?

 The main diseases of the stomach include gastritis, ulcers, reflux, polyps, and cancers. How are the diagnosis and treatments of stomach diseases carried out? In the diagnosis and treatment of stomach diseases, methods such as laboratory tests, imaging techniques, endoscopy, and endoscopic ultrasound are used. Helicobacter pylori infection, medications, and stress-related stomach complaints are frequently observed in our country and can pose a risk for serious problems such as cancer in some patients. Endoscopy plays a crucial role in the diagnosis and monitoring of these patients. Treatments applied in light of the latest diagnosis/treatment guidelines are highly effective and satisfactory.

What are small intestine diseases?

 The small intestine, starting immediately after the stomach, is divided into the duodenum (twelve-finger intestine), jejunum, and ileum in sequence. Its main functions include the digestion of nutrients, hormone secretion, and protection against pathogenic microbes. In this part, main diseases such as ulcers, Celiac disease, other absorption disorders, Crohn's disease, food poisoning (acute gastroenteritis), and some cancers can occur.

How are the diagnosis and treatments of small intestine diseases conducted?

 In the diagnosis and treatment of small intestine diseases, non-invasive diagnostic methods such as laboratory tests, ultrasound, contrast studies, computed tomography, magnetic resonance, as well as interventional methods like endoscopy, endoscopic ultrasound, capsule endoscopy may be utilized. These methods can be employed by physicians not only for diagnostic purposes but also for therapeutic interventions.

What are colon diseases?

 The colon (large intestine) is the final part of the digestive system that begins after the small intestine and ends in the anus region. Its main functions include contributing to digestion, maintaining the body's water balance, and providing protection against infections. Among its diseases are inflammatory bowel diseases (ulcerative colitis and Crohn's Disease), irritable bowel syndrome, diverticulosis coli, acute infectious colitis (some food poisonings), polyps (benign tumors), and cancers.

How are the diagnosis and treatments of colon diseases conducted?

 In the diagnosis and treatment of colon diseases, non-invasive diagnostic methods such as laboratory tests, ultrasound, contrast studies, computed tomography, magnetic resonance, as well as interventional methods like colonoscopy, endoscopic ultrasound may be utilized. These methods can be employed by physicians not only for diagnostic purposes but also for therapeutic interventions. Examples of therapeutic endoscopic interventions include:

• Prevention of cancer development through the removal of polyps (benign tumors)

• Stopping bleeding in patients by injecting hemostatic drugs, cauterizing with laser, or applying internal stitches (clips) or bands to halt bleeding

• Implementation of dilation treatments for narrow channels using devices such as balloons, bougies, or stents

• Treatment of hemorrhoids by ligating with bands or using medication-laser therapy

• Endoscopic stitching or repair with stents in cases of canal injuries or tears resulting from surgery or other causes.

What are liver and bile duct diseases?

The liver is an organ with essential functions such as digestion, storage, fighting infections, detoxification, and the synthesis of many vital proteins and substances. It is capable of self-repair/regeneration, especially in conjunction with our skin. For example, in donors who have two-thirds of their liver removed for liver transplantation purposes, it is observed that the missing part is significantly regenerated within one month. Among its main diseases are acute or chronic hepatitis (inflammation of the liver), jaundice, cirrhosis, cancer, benign cysts and tumors, and vascular obstructions.

Bile is essentially secreted and produced by the liver, stored in the gallbladder located just below the liver through bile ducts. When triggered by hormonal mechanisms during meals, the gallbladder contracts to release the stored bile into the duodenum (the first part of the small intestine) through channels. Among its main diseases are gallstones, gallbladder polyps, inflammation of the gallbladder known as cholecystitis, inflammation of the bile duct causing jaundice known as cholangitis, and tumors.

How are the diagnosis and treatments of liver and bile duct diseases conducted?

In the diagnosis and treatment of liver and bile duct diseases, non-invasive diagnostic methods such as laboratory tests, ultrasound, computed tomography, magnetic resonance, as well as interventional radiological methods (such as PTC), interventional endoscopic methods (such as Endoscopic Ultrasound or ERCP) can be used. These methods can be employed by physicians not only for diagnostic purposes but also for therapeutic interventions. For example, in a case where jaundice develops due to a stone-related obstruction in the bile duct, an endoscopic treatment called ERCP, performed under sedation (while the patient is asleep), is used to enter the bile duct, remove the stone, and treat the jaundice.

What are pancreatic diseases?

The pancreas, located behind the stomach, is our organ that plays a role in the digestion process with the secretion of digestive enzymes and regulates sugar metabolism and digestive functions through hormone secretion, primarily insulin. Its main diseases include acute and chronic inflammation (pancreatitis), cysts, tumors, and cancers.

How are the diagnosis and treatments of pancreatic diseases conducted?

 In the diagnosis and treatment of these cases, non-invasive diagnostic methods such as laboratory tests, ultrasound, computed tomography, magnetic resonance, as well as interventional radiological methods, interventional endoscopic methods such as Endoscopic Ultrasound or ERCP, can be used.

What is Endoscopy?          

Endoscopy is a procedure in which a flexible device with a illuminated camera system at its tip is used to examine the esophagus, stomach, and small intestine of patients. With advancements in camera technology, devices are continuously changing, improving, and being developed, allowing doctors to see, touch, and take biopsy samples of patients' internal organs in more detail. Since patients are sedated during this procedure, it ensures both safety and comfort. The authority to perform endoscopy is granted by laws to specialists in gastroenterology, gastrointestinal surgery, pediatric surgery, and pediatric gastroenterology. Routine diagnostic endoscopy takes approximately 10 minutes, and there is no need for any preparation other than fasting for 6-8 hours. Patients taking blood-thinning medications that pose a bleeding risk may need to stop them for the specified durations before the procedure. In high-risk individuals for cancer development in the community, it is the most reliable early diagnostic method within surveillance protocols. These methods can be employed by physicians not only for diagnostic purposes but also for therapeutic interventions.

To provide examples of therapeutic endoscopic interventions:

• Prevention of cancer development through the removal of polyps (benign tumors)

• Stopping bleeding in patients by injecting hemostatic drugs, cauterizing with laser, or applying internal stitches (clips) or bands to halt bleeding

• Implementation of dilation treatments for narrow channels using devices such as balloons, bougies, or stents

• Endoscopic stitching or repair with stents in cases of canal injuries or tears resulting from surgery or other causes

After the procedure, the patient is usually awakened in the recovery unit and discharged home. The risk of complications related to endoscopy is less than 1/1000, and most are mild problems that do not require hospitalization. The risk of complications related to sedation is around 1/1000, and most are mild problems that do not require hospitalization.

For whom is the endoscopy procedure applied?

Endoscopy must be performed in patients with chronic (long-term) and considered alarm symptoms such as weight loss, nausea, bleeding, anemia, difficulty swallowing, and those with a clinical history such as a family history of stomach cancer. Additionally, endoscopy is necessary in cases of medication-resistant heartburn or indigestion, suspicion of underlying Celiac disease, cancer screening and surveillance, and monitoring of cases with symptoms that increase the risk of cancer. In most of these situations, alternative non-invasive methods are either ineffective or not safe.

What is Colonoscopy?

Colonoscopy is a procedure in which a flexible device with an illuminated camera system at its tip is used to examine the thick and thin intestines of patients. With advancements in camera technology, devices are continuously changing, improving, and being developed, allowing doctors to see, touch, and take biopsy samples of patients' internal organs in more detail. Since patients are sedated during this procedure, it ensures both safety and comfort. The authority to perform colonoscopy is granted by laws to specialists in gastroenterology, gastrointestinal surgery, pediatric surgery, and pediatric gastroenterology. Routine diagnostic colonoscopy takes about 20-30 minutes. Prior to the procedure, strong medications are used for bowel cleansing one day in advance, except for a 15-hour fasting period. Patients may also need to follow a low-residue diet for 1-3 days. Patients taking blood-thinning medications that pose a bleeding risk may need to stop them for the specified durations before the procedure. These methods can be employed by physicians not only for diagnostic purposes but also for therapeutic interventions.

To provide examples of therapeutic endoscopic interventions:

• Prevention of cancer development through the removal of polyps (benign tumors)

• Stopping bleeding in patients by injecting hemostatic drugs, cauterizing with laser, or applying internal stitches (clips) or bands to halt bleeding

• Implementation of dilation treatments for narrow channels using devices such as balloons, bougies, or stents

• Treatment of hemorrhoids by ligating with bands or using medication-laser therapy

• Endoscopic stitching or repair with stents in cases of canal injuries or tears resulting from surgery or other causes

The patient is usually awakened in the recovery unit after the procedure and discharged home. The risk of complications related to colonoscopy is less than 1/10,000, with most being mild problems that do not require hospitalization. The risk of complications related to sedation is around 1/1000, and most are mild problems that do not require hospitalization.

For whom is the colonoscopy procedure applied?

Colonoscopy should be performed in patients with chronic (long-term) and recognized alarm symptoms such as weight loss, nausea, bleeding, anemia, and those with clinical features such as a family history of colon cancer or polyps. Additionally, colonoscopy is necessary in cases of changes in bowel habits unresponsive to medication, suspicion of underlying inflammatory bowel disease, cancer screening and surveillance, and monitoring of cases with symptoms that increase the risk of cancer. Colon cancer screening is clearly outlined in the guidelines of the World Health Organization and gastroenterology associations. Colonoscopy is recommended for the early diagnosis of cancer and, more importantly, for the destruction of structures that could lead to cancer. In patients with a family history, screening should be performed every 5 years starting from the age of 40 or 5 years earlier than the age of the cancer patient, while in those without a family history, screening should be done every 10 years after the age of 45. In most of these situations, alternative non-invasive methods are either ineffective or not safe. Due to the increasing frequency of polyps (benign intestinal tumors) with age, these screenings are crucial. Polyps detected during the procedure are removed in the same session using appropriate methods, and a screening program is initiated based on their number, size, and type.