GASTROENTEROLOGY

In the Gastroenterology department, the diagnosis and treatment of diseases involving the esophagus, stomach, intestines, liver, pancreas, and gallbladder are carried out. Gastroenterology units not only provide medical treatment for diseases related to the digestive system organs but also perform endoscopic procedures for the purpose of diagnosing diseases. Imaging procedures of the bile ducts, pancreas, stomach, small intestine, and large intestine are frequently conducted for the diagnosis of diseases. Biopsy procedures, particularly for liver-related cancers and similar diseases, are also performed in collaboration with surgical specialists in gastroenterology units. Specialized gastroenterologists in advanced units have completed 6 years of medical education, followed by a 5-year internal medicine residency program, and at least 3 years of specialization in gastrointestinal system diseases, endoscopic diagnosis, and treatment for these diseases, to earn this title.

The Gastroenterology department provides treatment procedures for both acute and chronic gastrointestinal system diseases. Some of the main procedures performed for the treatment of these diseases include:

• Emergency treatment for gastrointestinal bleeding to stop the bleeding.
• Sclerotherapy treatment for conditions such as variceal bleeding.
• Gastroscopy and colonoscopy for diagnostic and therapeutic purposes.
• Treatment of chronic pancreatitis using the ERCP method.
• Treatment of gallstones and strictures in the bile ducts, including procedures for stone removal.
• Polypectomy, which involves removing polyps in the stomach and intestines.
• Treatment of gastric ulcers.
• Treatment of gastroesophageal reflux disease.
• Management of chronic intestinal diseases such as Crohn’s disease and ulcerative colitis.
• Placement of stents in patients with strictures or blockages in the bile ducts or esophagus.

These procedures are performed meticulously by expert teams in the Gastroenterology department for both diagnosis and treatment purposes.

The main procedures performed within the scope of the Gastroenterology department include both the diagnosis and treatment of diseases.

Endoscopy

One of the units where endoscopy, a procedure widely applied with success in many medical fields, is most commonly used is gastroenterology clinics. Endoscopy is the process of visually examining the internal parts of various organs, primarily the stomach, using advanced optical devices. This procedure is performed with the help of an instrument called an endoscope, which has a light source that allows clear visualization of the area. By using this device, the esophagus, stomach, duodenum, small intestine, and large intestine can be visualized clearly, enabling accurate diagnosis of gastrointestinal system diseases. Additionally, during endoscopy, samples (biopsies) can be taken from the diseased tissues for pathological examination. It is also possible to collect samples from tumors and polyps observed during the procedure to investigate whether they are benign or malignant, or to examine the presence of Helicobacter pylori, a bacterium that particularly causes gastritis and ulcers in the stomach. While all imaging procedures performed with the assistance of an endoscope are referred to as endoscopy, there are different types within the field of gastroenterology, such as gastroscopy and colonoscopy, which are specific to the examined organs. The name of the endoscopic procedure may vary depending on the organ being examined, and the sizes and types of endoscopes and other instruments used can vary according to the region.

Endoscopy Procedure: Who is it Applied to?

Endoscopy is applied to individuals who present with the following symptoms and conditions:

• Individuals who seek medical attention from internal medicine and other clinics due to complaints of stomach pain.
• Patients who experience symptoms such as heartburn, acid reflux, sour taste in the mouth, chest burning, nausea, persistent vomiting, fever, and fatigue.
• Patients who complain of difficulty swallowing (dysphagia) and a sensation of food getting stuck while swallowing.
• Individuals experiencing unexplained significant weight loss.
• People who have anemia despite having a sufficient and balanced diet.
• Individuals who have complaints of brown or bloody vomit, bloody diarrhea, and black-colored stools.
• Patients who have previously undergone surgical operations related to the gastrointestinal system and require follow-up examinations.
• Cases of long-standing, persistent, and unresponsive constipation.
• Patients who have suspicious lesions detected during imaging procedures such as ultrasound and computed tomography (CT) and require biopsy of these lesions.
• Use of endoscopy procedures for catheter placement and monitoring in patients who cannot be orally fed and require tube feeding through practices such as percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic jejunostomy (PEJ).

Colonoscopy

Colonoscopy, a subfield of endoscopy, is one of the most commonly performed endoscopic procedures in gastroenterology clinics. This procedure involves the visualization of the entire large intestine and the adjacent portion of the small intestine using a thin and flexible device with a camera at its tip. It is considered the most reliable method for the diagnosis of colorectal cancer. Additionally, this procedure allows for the diagnosis and treatment of diseases in the region from the end of the small intestine to the large intestine, rectum, and anus. During diagnostic colonoscopy, if an inflamed area, ulcer, polyp, or suspicious lesion is encountered, a biopsy can be taken from the area and sent to pathology laboratories for examination. Moreover, common colorectal polyps can be removed during colonoscopy if deemed necessary. Even in the absence of any symptoms, it is recommended by the Ministry of Health and the World Health Organization for individuals aged 50 and above to undergo colonoscopy for routine screening purposes.

Who is the Colonoscopy Procedure Applied to?

• In cases of black-colored stools, rectal bleeding, and blood in the stool.
• When there are unexplained abdominal pain, diarrhea, and constipation.
• For the diagnosis and treatment of intestinal polyps.
• In patients with a family history of colorectal cancer for regular check-ups.
• In cases of unexplained anemia.
• When fecal tests detect blood in the stool.
• For the diagnosis, treatment, and surgical procedures in patients with colon cancer.
• To investigate the underlying causes of unexplained weight loss.
• For the diagnosis and treatment of hemorrhoids.
• When suspicious lesions are found during imaging procedures related to the intestine.
• In cases where the stool consistency remains abnormal for an extended period.
• For the control and surgical treatment interventions in patients with chronic intestinal diseases such as ulcerative colitis and Crohn’s disease.
• Routine screenings for older patients for both diagnosis and, if necessary, treatment stages may involve colonoscopy.