We believe that the ambience of the hospital does a lot to improve a patient’s condition
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We have Mrs. Vibha Palshetkar, M.Sc., Dip. Nutrition & Dietetics Diet Counsellor who is a clinical nutritionist.
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Stoma Clinic
While operating on the intestines, many a time surgeons have to create on alternative pathway or outlet or faeces or intestinal effluents. This outlet may be temporary i.e. till the general condition of the patient becomes normal, or permanent. If the outlet drains small intestine, it is called as an “Enterostomy or lleostomy. If it drains the large intestine it is called as “colostomy”.
Lleostomy effluents are more fluid and copious, whereas, colostomy effluents are thicker and well formed semisolids.
The social issues are
» It is a psychological shock to the patient who could not have imagined passing the stools through such outlet on the anterior abdominal wall instead of anus.
» Tremendous inconvenience can be caused if it is not managed properly especially at social functions and work places.
» Social stigma.
» Lack of knowledge about its management.
We, at Gastrocare Hospital guide such patient in our Stoma Clinic program.
» Pre-operative surgery and assessment of the exact and convenient site for the stoma.
» Pre-operative trial of various prostheses and bags
» Patients training for stoma irrigation and managed by themselves independently.
» Assurance for almost normal activities and behavior.
» Monthly ostomate's meet : We invite all our members once in a month (every third Saturday at 4-00 pm) over a tea. In such meetings the trained ostomates share their experiences which can guide and inspire the new ones. This creates the “self help group'”
» We make the ostomy bags and other accessories at a very concessional rate for the patients. E.g. bags, irrigation sets, kidney trays, and Duoderm wafers, Stomahesive paste, caraya gum.



Constipation clinic
About 20% population suffers from unsatisfactory defaecation some or other time.
We define constipation as a disorder of defaecation when patient passes fewer than 3 bowel movements per week. Chronic sever constipation means bowel movements less frequent than once in 5 days with symptoms persisting for more than 18 months.
Due to the lack of knowledge and awareness. Usually patients land up. Taking self medications fur prolongs time which leads to severe colonic disfunction.
Causes of Constipation:
» Dietary
» Functional
» Medications
» Endocrine/ Metabolic
» Neuromuscular disorders including diabetes mellitus
Our Constipation c1inic aims at defining exact causes of patient's constipation and locating exactly where we want to medicate. We do this by:
» Detailed history about patient's eating habits, work pattern psychosocial factors, etc.
» Though clinical examinations.
» Certain peculiar investigations like Defecating proctography, Anorectal mannometry.
Patient is offered treatment and the counselling afterwards.



Laparoscopy
Laparo (Latin) = abdomen and scopy view
It is one of the minimal accesses, modality for surgery.
It is primarily diagnostic since the peritoneal organs can be directly viewed on the monitor. This is especially very useful in exploring the intestines where minor pathologies can be missed on other modalities.
A space is created between the abdominal organs and the abdominal wall for operation by implanting it with carbon dioxide.
A gasless method by laparolift technique is also available. But for some reasons itís not really popular.
Commonly done Laparoscopic procedures in Gastrocare Hospital
» Cholecystectomy
» Umbilical or Incisional hernia repair
» Appendisectomy
» Duodenal Ulcer perforation repair
» Vagotomy & Gastrojejunostomy
» Right Hemicolectomy
» Resection of Meckel's diverticulam
» Resection of small bowel segments
» Splenectomy



Gastrointestinal Endoscopy
It is primarily a diagnostic modality and many therapeutic procedures can be performed through it.
Three main types of Endoscopes are
» Upper G. I. Endoscope or Gastroscope - It explore the GI tract from oral cavity larynx, pharynx, oesophagus, stomach up to second part of duodenum
» Duodenoscope or ERCP Scope - it is a side viewing scope which reaches the second part of duodenul and locates the 'Ampulla of Vater'. It is the site where pancreatic duct and common bile duct open together. For Endoscopists it is the site for access hepetobiliary system
» Colonoscope - It is passed through the anus and the large bowel is explored.


Therapeutic Endoscopic Procedure
Bleeding duodenal / Gastric Ulcer- when ulcer in the duodenum erodes the blood vessels, the spurt of bleeding is endoscopically located.
Adrenalin injection at the site constricts the blood vessel and stops the bleeding temporarily A glue (Nectacryl Glue) is spread over the ulcer which prevents further bleeding.



Bleeding Oesophageal Verices
This condition occurs when patient suffers from liver pathology commonly cirhosis of liver which causes portal hypertension and dilated venous plaxus around the oesophago-gastric junction. Notwithstanding the increased prassure within the blood vessel ruptures and bleeds heavily
Such patient is started on somatostatin or its derivatives to lower the splanchnic blood pressure.
Endoscopy is then performed to locate the bleeding varices. Banding or injection of sclerosing agent such as 1 % sodium tetradecyl sulphate obliterates the verix and prevents further bleed. The same procedure is repeated number of times in followup visits.



Oesophageal Strictures
Serial oesophageal dilators are passed over the guild wire passed endoscopically across the stricture to dilate the stricture.
Self expandable metal stents also can be passed across the stricture, which prevents the current narrowing of the Lumen



Oesophageal Foreign bodies
Coins in children and dentures in elderly are the common foreign bodies found in the oesophagus. They can be retrieved endoscopically by using appropriate forceps or baskets.



ERCP
Endoscopy retrograde cholangiopanoreaticography
Common bile duct stones with obstructive jaundice CBD strictures
Obstructive jaundice due to cancer growth
Conic pancreatitis with pancreatic duct stones and strictures
Colonic Ploypectomy by Snaring