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Gastroenterology

Endoscopy is done by inserting a thin line instrument (endoscope), in the patients’ body to view the internal blood vessels. It does not require the surgeon to make incisions and despite that view the problems. 
Endoscopy is not a painful procedure but most people may experience a mild discomfort. In case the patient is still not comfortable, then the doctor gives a local anesthesia to numb the particular area or a sedative to help you relax more.
The colon is another term for the long intestine is the lowest part of the digestive system. Colon Cancer is when there is uncontrolled cell growth in the colon area. Most colon cancers originate from small non-cancerous tumors called adenomatous polyps that form the inner walls of the large intestine. It is the third most common cancer among men and second most common among women. Certain indviduals have genetic susceptibility to develop cancer. 
Yes it can be prevented. You can follow few measures to control the spread of cancer like:
• Get regular screening – Probably the best way to have an early detection of colon cancer is to get a colonoscopy done at regular intervals. This will help you in keeping track of your health.
• Don’t smoke –Smoking can have adverse effects on your body. It not only increases the risk of cancer but also lead to diseases of lungs, heart, and throat.
• Avoid consumption of red meat – Studies have found that eating too much red meat can increase the chance of colon cancer. Consuming processed meat doubles the risk of getting cancer as much as red meat.
• Maintaining a healthy weight is important to reduce the risk of cancer. Combine your diet plan with proper exercise to be fit. If you intend on losing weight, discuss the diet plan with the doctor and ensure that exercise is involved. Aim to reduce weight slowly by increasing the amount of exercise and reducing the calorie intake.
• Healthy consumption – Ensure that you eat a variety of fruits and vegetables regularly. 
The procedure involves the use of a colonoscope where the surgeon views the inner lining of large intestine in order to identify tumors, colon polyps, ulcers, internal bleeding or inflammation. The surgeon can also take samples of tissues for biopsy. 
After the colonoscopy, there is a possibility that you will hungry. The doctor will suggest you a diet to make you feel comfortable after the procedure. You need to have:
• A lot of fluids because you will be dehydrated post colonoscopy. Fluids can be energy drinks or other carbonated drinks that will make you feel hydrated and gain electrolytes.
• Light Foods- Foods which are light on the stomach, easy to chew should be consumed until the time the sedative wears off. If you consume heavy foods it will lead to vomiting or make you feel nauseated.
• Low residue diet – Your colorectal surgeon will advise you to have a low residue diet like a fibre diet that will not cause irritation in the colon area.  
Yes, colon cancer can be genetically inherited. About 5-10 percent of all colon cancers are inherited genetically. There are 2 major subtype of hereditary colon cancer.
• Familial Adenomatous Polyposis (FAP) – This type of cancer consists of many precancerous polyps.
• Lynch Syndrome or Hereditary Nonpolyposis Colorectal Cancer (HNPCC) – This is the most common form of colon cancer. Although not everyone who inherits the HNPCC gene will develop colorectal cancer. Moreover, they have a higher risk of developing other form of cancers such as kidney, ovarian, uterine, renal, pelvis, small intestine or stomach cancer. 
The treatment of colon varies based on the severity of the cancer its stage.
• Stage 1 cancer – This is the stage where the cancer has grown into the layers of the colon wall but has not spread outside the wall. The treatment for this can be done through colonoscopy itself or surgical intervention may be needed if the cancer in the polyp is high grade.
• Stage 2 cancer – This is the stage where the cancer has grown beyond the colon wall and into nearby tissues but not the lymph nodes. The best treatment in this stage is surgery and adjuvant chemotherapy.
• Stage 3 Cancer – This is the stage where the cancer has spread to the lymph nodes apart from the colon wall. The best treatment would be surgery to remove the affected area along with the lymph nodes followed by adjuvant chemotherapy. Radiation therapy may be an option available for people who aren’t fit for surgery.
• Stage 4 Cancer – This is the stage where the cancer has spread to distant organ and tissues. It usually spreads to the liver but it can also spread to other areas. Surgical intervention may not help, however, if there are few areas where the cancer has spread then surgery may help increase chances of survival or even cure. In this stage, if surgery does not help then chemotherapy is the best alternative. 
Celiac disease refers to a situation where a person is permanently intolerant to gluten. Gluten is a protein mainly found in wheat, barley, oat and rye. If a person suffering from celiac disease consumes gluten food then it will damage the small bowel, leading to reduced absorption of nutrients, and thereby causing weight loss, anaemia and fatigue. There is no permanent cure but the best way to reduce the chances of the disease would be consume gluten free products.
Peptic Ulcers are open sores that develop on the lining of the stomach or upper portion of the intestine. The most common symptom would be the stomach pain. However, there are other ways of determining this disease.
• Tests for H. Pylori – Helicobacter Pylori bacteria(H. Pylori) is the most common source for the cause of ulcers. The doctor tests for the level of the bacteria present in your body. The best way to test this is by taking a breath test where the surgeon will ask you to consume items containing radioactive carbon. Then you will be required to blow into a bag which is sealed. If you’re infected with H.Pylori then your breath will contain radioactive carbon in the form of carbon dioxide.
• Endoscopy – During endoscopy, the doctor will pass a thin, flexible pipe through the throat to search for ulcers. If ulcers are detected then tissue samples maybe collected and action will be taken accordingly. 
There are various tests used to diagnose esophageal cancer.
• Barium swallow – Also called esophagram, the patient swallows liquid containing barium and then conducts an X – Ray. The barium covers the affected area which is visible through an X-ray and then an endoscopy is done to check whether it is cancerous or not.
• Upper endoscopy – Also called esophagus gastric duodenoscopy, where a thin flexible tube is passed through the throat while the patient is sedated. If there is any suspicious growth of cells, a biopsy is done to check whether it is cancerous or not.
• Endoscopic Ultrasound – It is often done at the time of endoscopy. The sound waves is used to determine how deep the cancer has grown and whether it has grown into nearby lymph nodes or tissues.
• Bronchoscopy – similar to endoscopy, this is done if the cancer is located in the upper part of the esophagus or if the tumor is growing in the person’s windpipe.
• CT Scan – A CT scan helps gives a 3D picture of the inside of the body by providing a cross section computerized view of the affected area. This method also helps in determining the size of the tumor as well. 
The treatment for esophageal cancer depends on the several factors, from the severity of the cancer (type and stage), possible side effects, and patients’ preference and overall health. For cancers which have not spread, doctors advise to combine multiple treatments like radiation therapy, chemotherapy and surgery. The order of treatment varies and several factors are considered, including type of esophageal cancer.
There are no particular long term side effects as such for esophageal cancer. The affected area might be permanently tanned but this is not harmful. You will experience fatigue and breathing problems in the early stages but that will improve eventually.
Yes, there will be change in diet and the exact diet plan will depend from person to person. A basic diet plan can be:
• Consuming soft/moist food
• Small, nutrient dense meals and snacks regularly throughout the day
• 6-8 glasses of fluids daily
• Daily multivitamins consumption 
Inflammatory bowel disease can be diagnosed from the following tests
• Blood tests
• Colonoscopy
• Endoscopy
• X-Ray
• CT Scan
• MRI 
It is not necessary that you are required to undergo an operation to cure IBD. Most of the cases can be treated without any operation and with the help of medicines. However, if the case is severe or critical then operation may be required. So treatment through an operation cannot be completely ruled out.
IBD cannot be 100% treated naturally but it can delay or control the symptoms leading to inflammation of the bowel area. you need to have a:
• Controlled diet – Healthy fruits, vegetables, limited dairy products, low fat food and fibre
• Avoid Smoking
• Exercise Properly
• Destressing and regular relaxation 
Yes, post surgery follow up is very important, which is decided by your surgeon  

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