Department of Surgical Gastroenterology

Department Overview

Surgical Gastroenterology is a progressive and specialised department that encompasses the surgical treatment of digestive ailments of the oesophagus, liver, pancreas, gall bladder, stomach, small intestines, large intestines, rectum, and anal region.

The Department of Surgical Gastroenterology provides expert medical treatment and surgical interventions for the management and prevention of clinical issues related to the digestive tract. Our world class surgeons and cutting-edge surgical procedures combine to provide patients the best possible outcomes. With dedicated, skilled and experienced staffs that are trained in the treatment of abdominal issues, we provide the best health care facilities and a multi-disciplinary approach to treat a spectrum of gastroenterological ailments.

Best Surgical Gastroenterology Hospital in Chennai

World-class surgical treatments with superior care and visible effective results are provided at affordable costs in Gleneagles Global Health City. With highly qualified surgeons and expert health care providers, every patient is ensured a safe and healthy recovery.

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Providing those who come to us for treatment receive the best possible care in every respect and ensuring that the recovery is as swift and comfortable as possible are the cornerstones of our patient care philosophy.

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Surgical Gasterentology Diseases and Treatments

Foregut and Midgut

GERD (Gastro-Oesophageal Reflux Disease)

GERD Overview

GERD is a highly prevalent chronic digestive disease in which the stomach acid or bile frequently backwashes into the food pipe connecting the stomach and the mouth – a condition known as acid reflux, resulting in the irritation of the oesophagus or the food pipe. In mild cases, this typically occurs a few times a week. If diagnosed in the initial stages, it should get better with lifestyle changes; otherwise medical intervention helps to treat the condition.

Signs and symptoms of GERD

People suffering from GERD often experience heartburn, especially after eating. As the stomach acid is pushed up the taste of food or digestive acid is felt in the mouth. There would be also a discomfort felt in the area behind the chest bone; other symptoms include heaviness, a lumpy feeling in the throat, nausea, difficulty while swallowing, hoarseness in the throat and pain in the chest.

Causes and risk factors of GERD

Most often untimely meals, heavy late-night meals, obesity, irregular bowel movement, smoking and passive smoking lead to Acid reflux or heartburn. Depression, bloating of the upper stomach known as hiatal hernia, lack of physical exercise, slow body metabolism and increased stress are some of the risk factors of GERD.

Complications of GERD

If neglected, GERD could lead to a host of other issues like Oesophagitis, Barret’s Oesophagus, Asthma, Chronic cough, Laryngitis and several other complications. It could also lead to Ineffective Oesophageal Motility in many cases.

Diagnosis of GERD

Patients experiencing symptoms of GERD should consult Gastroenterologists for an accurate diagnosis. At Gleneagles Global Health City both inpatient and outpatient diagnosis is provided. Multiple procedures are adopted for diagnosis including Upper GI Endoscopy, Upper GI series, Oesophageal manometry, Upper digestive system X-ray and Ambulatory acid pH tests.

Surgery of GERD

Surgical intervention is needed if the symptoms of GERD do not subside with suggested lifestyle changes or medications. The suggested surgical treatment is Fundoplication or Laparoscopic anti-reflux surgery, where pressure is created on the lower end of the Oesophagus by stitching the oesophagus with the upper end of the stomach, to stop reflux. Endoscopic procedures are also adopted in some cases.

Prevention of GERD

Since there are numerous causes for GERD, common preventive measures that could be considered are to avoid eating heavy meals, eating slowly and concentrating on chewing the food. Limiting or avoiding alcohol intake, smoking, lying down after eating, etc. are aspects that must be considered. Self-medication should be completely avoided and any symptoms of GERD should be discussed with specialist doctors immediately.

Oesophageal Motility Disorder

Oesophageal Motility Disorder Overview

This is one condition wherein the patient finds it difficult to swallow food, either due to inflammation of the oesophagus or allergic reactions. When the oesophagus contractions become irregular or are completely absent, then the condition is identified as Oesophageal Motility Disorder.

Signs and symptoms of Oesophageal Motility Disorder

Patients experience mild to severe chest pain, difficulty while swallowing and regurgitation. Symptoms vary from case to case but they can be largely identified as dysphagia or difficulty in swallowing and a burning sensation in the chest. A feeling that food is stuck in the throat often prevails. Some experience malnutrition and weight-loss.

Causes and risk factors of Oesophageal Motility Disorder

The oesophagus is the main pathway for the food to travel from the mouth to the stomach. Any disruption in this pathway creates the risk of the food getting pushed back into the throat, thus leading to OMD.

Complications of Oesophageal Motility Disorder

If left untreated symptoms can worsen. Often when a Motility disorder is neglected it leads to sudden weight loss, pneumonia and weakened lungs. Achalasia is a condition of severe motility disorder which occurs when the oesophagus nerves get damaged causing further complications.

Diagnosis of Oesophageal Motility Disorder

Based on the symptoms of OMD, the diagnosis normally includes acid reflux tests, barium swallow, and high-resolution manometry. The latest technological treatment for evaluating the condition of the oesophagus is Impedance Planimetry under which the internal sensory and motor functioning of the oesophagus are measured in relation to the pressure exerted by the lumen.

Surgery of Oesophageal Motility Disorder

Surgical treatment for Oesophageal Motility Disorder is essential in case of a distorted oesophagus or when there is a malignancy. Only after a complete preoperative inspection of the oesophagus further treatment is advised.

Prevention of Oesophageal Motility Disorder

Eating certain foods like meat, rice, etc. can worsen OMD.

Oesophageal Stricture Following Corrosive Poisoning

Oesophageal Stricture Following Corrosive Poisoning Overview

This is a condition caused by corrosive poisoning due to the consumption of corrosive agents like alkalis or acids that damage the GI tract. The extent of damage and perforations depends upon the concentration of the acid or alkali. Corrosive poisoning has a devastating effect on the GI tract which comprises of larynx, oesophagus and the stomach.

Signs and symptoms of Oesophageal Stricture Following Corrosive Poisoning

There are chances of massive bleeding from the stomach due to haemorrhage after ingestion of corrosive agents. Abdominal pain or chest pains are some of the initial symptoms that occur in such cases and they should be further investigated for diagnosing Oesophageal Strictures.

Causes and risk factors of Oesophageal Stricture Following Corrosive Poisoning

Important factors that contribute to the severity of the condition are the time or duration of contact with the corrosive agent, the nature of the agent, the quantity of the intake etc.

Complications of Oesophageal Stricture Following Corrosive Poisoning

Dysphagia, malignant transformations, substernal pressure, are the main complications that generally arise in patients with corrosive poisoning. In most cases, it takes more than three weeks for the complications to appear as patients are asymptomatic for the first fifteen days after infection.

Diagnosis of Oesophageal Stricture Following Corrosive Poisoning

Barium swallow, Upper endoscopy (EGD) are the procedures used to diagnose and evaluate the Oesophageal Strictures.

Surgery of Oesophageal Stricture Following Corrosive Poisoning

Suggested treatment in cases of Oesophageal Strictures is the replacement of the damaged oesophagus. This is known as Oesophageal Resection or Oesophagectomy and the oesophagus may be removed fully or partially depending on the severity of the ailment. In the case of complications such as Gastric Necrosis, Total Gastrectomy is advised which involves removal of the stomach, nearby lymph nodes, part of the oesophagus and part of the small intestines.

Prevention of Oesophageal Stricture Following Corrosive Poisoning

Oesophageal damage happens when the corrosive substance ingested is either acidic or alkali in nature. Acid ingestion in cases of adults happens mostly due to suicidal efforts and in case of children due to accidental ingestion. Corrosive materials should be stored where access is limited.

Oesophageal Tumour/Cancer

Oesophageal Tumour/Cancer Overview

The oesophagus which is the main channel of food passage is a complicated network of lymphatic muscles, extending from the larynx to the stomach. Oesophageal cancer is the sixth most fatal cancer. It can attack any part of the Oesophagus.

Signs and symptoms of Oesophageal Cancer

Sudden, unexplainable weight loss, pain while swallowing food, chest pain or pressure, indigestion that worsens with food consumption and a hoarse cough are the typical symptoms exhibited by people affected with Oesophageal tumour or cancer. However, this condition can remain asymptomatic for an extended period.

Causes and risk factors of Oesophageal Cancer

If symptoms persist for long, medical attention is recommended. Barret’s oesophagus is a condition that could sometimes indicate the presence of tumors and should be discussed with medical experts. Exact causes of Oesophageal tumor are not known but observations reveal the abnormal growth of the cells in the oesophagus tend to accumulate as a tumour.

Complications of Oesophageal Cancer

Factors that aggravate the irritation of the oesophagus cells primarily contribute to the occurrence of oesophagus cancer. Habits like smoking and alcohol consumption trigger complications related to Oesophageal Cancer. If Oesophageal Cancer is left untreated it could lead to a blockage in the oesophagus restricting the passage of food, and causing severe pain and bleeding in the food pipe.

Diagnosis of Oesophageal Cancer

The procedures followed to diagnose Oesophageal Cancer are a barium swallow followed by an X-ray, endoscopy to discover cancer-prone areas and a biopsy to test for cancerous cells. Based on the results of these diagnosis further tests to locate any cancerous lymph nodes are often advised.

Surgery of Oesophageal Cancer

Oesophageal Cancer poses a major threat of post-surgery complications and infections. Global Health City’s experienced team of surgeons is dedicated to the health and recovery of the patient. Depending upon the patient’s condition and the stage of cancer, appropriate surgical treatment is suggested. Endoscopic surgery is advised for the removal of minor tumors in the upper layers of the oesophagus. Oesophagectomy is the surgical process under which the cancerous portion of the oesophagus, the upper stomach and the surrounding lymph nodes are removed and the rest of the oesophagus is then connected with the stomach. Oesophagogastrectomy is the surgical process in which the upper part of the oesophagus and a larger part of the stomach and the surrounding lymph nodes are removed and the balance stomach is attached with the oesophagus with the help of colon if needed.

Prevention of Oesophageal Cancer

The exact causes of Oesophageal cancer are not known. But healthy habits like regular exercise, quitting alcohol, quitting smoking, observing a healthy weight will help prevent the occurrence of oesophageal cancer.

Stomach (gastric) Stricture Following Corrosive Poisoning

Stomach (gastric) Stricture Following Corrosive Poisoning Overview

Gastric stricture due to ingestion of corrosive substances is rare, risky and the injuries vary. The chances of the upper gastrointestinal tract being damaged are high. The extent of damage in case of gastric injury due to corrosive poisoning, varies from partial to severe, like partial gastric mucosa or total gastric mucosa, transmural necrosis, prepyloric strictures or chronic gastric injuries. If a large volume of corrosive liquid has been ingested it scars the stomach completely and results in diffusely contracted stomach.

Signs and symptoms of Stomach (gastric) Stricture

Gastric obstruction is indicated by nausea, a feeling of fullness, bloating, immense abdominal pain and continuous vomiting. Burning sensations, extreme pain while swallowing, and blood in the vomit – are often early signs of the existence of the condition.

Causes and risk factors of Stomach (gastric) Stricture

The corrosive capacity, the viscosity and the quantity of intake determine the intensity of the damage to the inner lining of the stomach. Accidental ingestion of corrosive poisons is common among children and the extent of the damage sustained depends on the strength of their bodies.

Complications of Stomach (gastric) Stricture

Severe post corrosive injuries and oesophageal perforations may be fatal complications in certain cases, especially acid based poisoning. Oesophageal stenosis and gastric stenosis are also experienced.

Diagnosis of Stomach (gastric) Stricture

Clinical examination, endoscopic and exploratory laparoscopic examinations and radiological testing are among the main diagnostic tools that are used.

Surgery of Stomach (gastric) Stricture

In case of stomach strictures due to ingestion of corrosive poisons there could be a part of the pylorus (the opening in the stomach that connects to the duodenum) damaged and this requires Stricturoplasty that involves removal of scar tissues. Gastrojejunostomy is the surgical treatment advised in cases of long-segment strictures. This is the surgical process that creates a direct connect between the stomach and the middle part of the small intestine.

Prevention of Stomach (gastric) Stricture

Ingestion of corrosive substances generally occurs when persons have suicidal thoughts. It is important to increase social interactions and develop healthy lifestyle habits to build a happy mind and strong personality that would shun depression and negative thinking.

Gastric Ulcer Complications

Gastric Ulcer Overview

Ulcers are painful sores or holes on the mucosa (inner lining) of the stomach, areas of the small intestine or in the lower end of the oesophagus due to various causes like bacterial infection, smoking, alcohol consumption, intake of drugs and harsh substances. Barring neonatal gastric ulcers, Gastric ulcers are uncommon in young children; whereas the chances of relapse are high in elderly patients.

Signs and symptoms of Gastric Ulcer

Symptoms may vary from mild to severe. Common symptoms include burning sensations in the stomach or sharp pain in the upper abdomen (that gets temporarily eased with the intake of antacids), nausea, feeling bloated, blood in the vomit, fainting, dark blood in the stools, stomach pain between meals and appetite changes.

Causes and risk factors of Gastric Ulcer

When there is excess acid production in the stomach, it depletes the protective mucous layer in the stomach which triggers the occurrence of gastric sores. Helicobacter pylori bacteria (H. Pylori) which is found in the mucous layer of the stomach inner walls, causes inflammation, at times leading to ulcers. The bacteria enters the body through food, water or when in close contact with infected persons. Factors that can worsen the condition of the ulcer are smoking, drinking alcohol, consuming spicy foods and leading a stressful life.

Complications of Gastric Ulcer

If left untreated, gastric ulcers can cause deep perforations in the stomach walls or intestines, and increase the risk to the abdominal cavity (peritonitis). Also, the obstruction in the passage of food through the digestive tract can cause bloating and fullness leading to weight loss. In certain cases, severe ulcers that do not receive medical care can lead to internal bleeding and gastric cancer.

Diagnosis of Gastric Ulcer

Upper GI imaging using barium swallow and CT gastroscopy are used to locate ulcers. Based on the medical history of the patient, initial tests are done for H. Pylori bacterium through blood, breath or stool test. Endoscopic procedures are also adopted in elderly patients. A biopsy is also used to diagnose ulcers.

Surgery of Gastric Ulcer

Resection of gastric ulcers is essential. Critical ulcer surgery as vagotomy pyloroplasty and proximal gastric vagotomy based on the condition of the patient is often suggested. In cases of recurrent ulceration, tracking the actual cause is a pre-requisite. During cases of excessive bleeding, total gastrectomy is advised.

Prevention of Gastric Ulcer

Controlling stress and mental strain by adopting healthy habits will have a positive impact on health. Reducing the use of painkillers, smoking and alcohol intake will reduce the chances of ulcers. Maintaining a healthy diet, physical hygiene and eating cooked food will help in avoiding H. Pylori bacterium.

Gastric Cancer

Gastric Cancer Overview

Often referred to as Stomach Cancer, in this condition cancerous cells are generated in the mucous producing cells of the stomach’s inner lining. Stomach Adenocarcinoma, Lymphoma, Carcinoid Cancer, Gastrointestinal Stromal Tumour are the different types of gastric cancers; the most common being Stomach Adenocarcinoma.

Signs and symptoms of Gastric Cancer

The symptoms of Gastric Cancer include sudden weight loss, difficulty while swallowing, bloated feeling after consuming food, continual heartburn, difficulty while swallowing, acid reflux, frequent abdominal pain and nausea.

Causes and risk factors of Gastric Cancer

The reasons behind the continuous modification of the stomach DNA cells which accumulate to form a tumour are not yet known. In certain cases, the cells spread or metastasize increasing the risk factor. Other risk factors include a family history of cancer, intake of excessive salt, Helicobacter pylori infection and low intake of fresh fruits and vegetables.

Complications of Gastric Cancer

Complications could arise if the cancer spreads to the liver. It may lead to jaundice, obstructed gastric outlet and anaemia.

Diagnosis of Gastric Cancer

The procedures to diagnose Gastric Cancer and assess the progression involve several tests including upper endoscopy, biopsy, CT scan and barium swallow. Tests to evaluate the stage of the cancer include blood tests to measure the organ function, Positron Emission Tomography, endoscopic ultrasound and laparoscopic exploratory surgery.

Surgery of Gastric Cancer

Depending on the stage of cancer, surgical procedures may be adopted. For minor and early-stage tumours, endoscopic mucosal resection and endoscopic submucosal resection are the advised surgical treatments. If the cancer is in the part of the stomach closest to the small intestines, then Subtotal Gastrectomy is done where the affected portion is surgically removed. If the body of the stomach is affected then Total Gastrectomy is performed in which the stomach is removed and the oesophagus is connected to the small intestines.

Prevention of Gastric Cancer

The ways to mitigate the risk of gastric cancer are unclear. But certain precautionary methods can be adopted like ensuring healthy body weight, healthy dietary intake especially of citrus fruits, zero intakes of alcohol, quitting smoking and genetic testing in cases of hereditary gastric cancer syndrome.



Appendicitis Overview

The Appendix is the finger-shaped vestigial organ, in the lower right side of the abdomen. Appendicitis is the condition where the appendix gets inflamed causing pain. If neglected, this condition can worsen and will then require surgery to remove the appendix. This condition can occur in any age group but is most common among people aged between 10 to 30 years.

Signs and symptoms of Appendicitis

The symptoms include sharp severe pain around the navel extending to the lower right side of the abdomen, high fever, flatulence, nausea, bloating in the abdominal area and discomfort that worsens with coughing, sneezing or walking. When there is extreme unbearable pain in the abdomen immediate surgical intervention could be essential.

Causes and risk factors of Appendicitis

The exact cause of Appendicitis is unknown but there could be certain triggering reasons like any blockage in the appendix, bacteria, or an injury. The genetic risk of inheriting the condition is one of the risk factors that could complicate the condition. The use of steroids, having diabetes and pulmonary diseases all increase the risk of developing appendicitis.

Complications of Appendicitis

Appendicitis poses a risk of bacterial infection of the inner walls of the appendix, which can lead to the inflammation. If this condition is left untreated, it can further lead to pus accumulation in the organ, which may cause a rupture and increase the chances of the bacteria spreading across the abdomen.

Diagnosis of Appendicitis

Patients affected with Appendicitis will be first physically examined for abdominal pain, abdominal rigidity, or stiffened abdominal muscles, which are signs of pressure of an inflamed appendix. Due to the variations in the size of the appendix, its location and the proximity of other organs pelvic and abdominal aches can be confused with Appendicitis pain. The other methods of testing adopted by doctors are white blood cell count, urinalysis, barium enema, laparoscopy, ultrasonography and CT scan.

Surgery of Appendicitis

As the appendix is an organ that does not impact any other body function, the typical treatment is to remove the infected organ to avoid further complications. There are very rare cases of Appendicitis getting cured without surgery. Laparoscopic surgery is an option which involves the removal of the appendix with a very small incision, resulting in less blood loss and a quicker recovery.

Prevention of Appendicitis

The cause of Appendicitis is unknown but it can be prevented by maintaining a healthy diet rich in fiber like whole wheat, fresh fruits, brown rice. Fried foods, sugary foods, alcohol, red meat that are difficult to digest and can upset the digestive system should be avoided.


Hernia Overview

The word “Hernia” means “coming through”. Hernia is the condition wherein an organ projects through a weak spot in the surrounding muscle. When the organ protrudes through a weak area in the connecting tissue it leads to pain, and if this is neglected it can cause serious complications. A hernia can occur in different areas and the most commonly found hernias are Inguinal hernia- in the area above the groin; Incisional hernia – in scar tissues; Femoral hernia – in the upper area of the thigh; Umbilical hernia – in the area near the navel; Epigastric hernia – in the gaps of the abdominal wall between breastbone and navel and those that cannot be observed externally are known as Diaphragmatic hernias. Hernias do not generally go on their own.

Signs and symptoms of Hernia

Hernias are often seen as bulges without much pain and discomfort but still carry a threat with their presence. The common symptoms include vomiting, nausea, trouble while breathing, swallowing, muscle tensions, fever and belching.

Causes and risk factors of Hernia

Hernia syndrome is caused when the abdominal muscles or connecting tissues are weak by birth, due to surgery or illness, heavy-weights are lifted in the incorrect postures and continuous heavy coughing and sneezing.

Complications of Hernia

Hernia, when left undiagnosed or untreated can get bigger over time and lead to constriction like blockage of the bowel passage, etc. If the blood vessels in the hernia sac are dead, it can lead to inflammation of the sac, which can pierce through the skin.

Diagnosis of Hernia

Diagnosis is done by studying the patient’s medical history and examining the symptoms being displayed.

Surgery of Hernia

Surgical treatment is the best option to treat a Hernia. Hernioplasty is the surgical treatment which involves tissue repair. The safest option is Laparoscopic or keyhole surgery where minimal invasion is required. The hernia is removed by inserting special surgical instruments which involves reduced blood loss and quicker healing. Open surgery is the other option where the hernia sac is removed or pushed into the abdomen, and a fine synthetic mesh is placed around the area for support.

Prevention of Hernia

Depending on the type of hernia, its occurrence can be prevented. The preventive measures include avoiding certain physical activities like lifting heavy weights, reducing alcohol intake, avoiding smoking, maintaining good body weight, etc.

Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease Overview

Inflammatory bowel disease is a condition when there is chronic inflammation in the GI tract. The good bacteria in the gut gets attacked by the immune system of the body causing injury. The two types of IBD are – Ulcerative Colitis that affects the colon or large intestine and Crohn’s disease that impacts the inner layers of the gastrointestinal tract.

Signs and symptoms of Inflammatory Bowel Disease

The symptoms of Inflammatory bowel disease vary from mild to severe based on the intensity of the condition and range from diarrhoea, abdominal cramps, blood in stools, sudden weight loss to unexplained fatigue.

Causes and risk factors of Inflammatory Bowel Disease

Though the exact cause for IBD is not known, hereditary factors, inflammatory reactions in the intestinal tract due to attacks on the body’s immune system by antigens, virus or bacteria, dietary habits and stress are all suspected to trigger IBD. Certain non-steroidal medications which are anti-inflammatory may worsen the condition of IBD.

Complications of Inflammatory Bowel Disease

Ulcerative Colitis and Crohn’s disease each have complications of their own based on the severity of the condition. Major complications that are associated with IBD are malnutrition, bowel rupture, intestinal bleeding from the ulcers, development of blood clots in the arteries or veins and inflammation of the joints, eyes and the skin.

Diagnosis of Inflammatory Bowel Disease

Irritable Bowel Disease is diagnosed through various tests and procedures like stool tests, CB (Complete Blood Count), Barium X-rays, other blood tests like CRP (C-Reactive Protein), radiological tests, Colonoscopy where a long flexible tube (colonoscope) is used to examine the colon and upper endoscopy. Imaging procedures such as MRI, CT scan and X-ray are also methods of diagnosis in some cases.

Surgery of Inflammatory Bowel Disease

Surgery in the case of Ulcerative Colitis involves the removal of the entire colon and rectum. For Crohn’s disease, surgery involves removal of the damaged part of the digestive tract and reconnecting it to the healthier parts. Along with surgery, constant medication is needed for containing Crohn’s disease.

Prevention of Inflammatory Bowel Disease

Irritable Bowel Disorder can be prevented by following a stress-free lifestyle supplemented with a nutritious diet that involves controlled intake of dairy products, small meals, sufficient hydration and exercising regularly.


Diverticulitis Overview

The condition in which smallpouch-like projections are developed in the inner lining of the lower part of the large intestine. These pouches are called diverticula. When these pouches get inflamed or infected, they pose a threat to health and the condition is called Diverticulitis. Diverticulitis happens when bacteria get caught in these pouches.

Signs and symptoms of Diverticulitis

Though some cases of Diverticulitis display no symptoms, there are certain observed symptoms of this condition such as pain in the lower left abdomen, change in bowel habits (constipation, diarrhoea), vomiting, high fever, fatigue and bladder infection.

Causes and risk factors of Diverticulitis

Diverticulitis is predominantly found in the age group of above 60, equally affecting both men and women. There is a high risk of developing Diverticulitis with growing age, with the increased use of laxatives, a sedentary lifestyle with no exercise, genetically inherited conditions, obesity and smoking.

Complications of Diverticulitis

There could be two major complications – colon bleeding and colon constriction. Since Diverticulitis can be asymptomatic for a few cases, there is a scope of pus formation, infection or an obstructed colon.

Diagnosis of Diverticulitis

Diverticular diseases are diagnosed by using barium enema test in which the liquid barium is injected into the colon through the rectum to identify polyps. Colonoscopy is another diagnostic procedure to identify any extra growths in the colon.

Surgery of Diverticulitis

For mild cases of Diverticulitis, oral medication, rest, a liquid diet with low fibre foods introduced after a few days of treatment, are the suggested treatments. However, in cases of severe symptoms or complications like colon inflammation, Colostomy for bowel resection is done by creating a gap in the abdominal wall. In some cases, the affected part of the intestine is removed.

Prevention of Diverticulitis

A diet rich in fibre and fruits will help to maintain a healthy gut, regular exercising, drinking plenty of fluids, andactive and stress-free lifestyle and reduced use of laxatives can help to prevent the onset of Diverticulitis.

Colorectal Cancer

Colorectal Cancer Overview

A growth of cancerous cells in the large intestine or the lower part of the rectum is called colorectal cancer. Colon cancer and rectal cancer both cause similar symptoms due to which they are grouped as Colorectal Cancer. The non-cancerous tissues that grow in these regions over time turns into cancerous polyps due to genetical modifications.

Signs and symptoms of Colorectal Cancer

Colorectal cancer often goes without symptoms in the initial days. But the observed symptoms are a change in bowel habits, blood in the stools, anaemia, sudden weight loss, vomiting.

Causes and risk factors of Colorectal Cancer

Genetic mutation plays a major role in the growth of Colorectal cancer but the exact reasons for its cause are unknown. The risk factors of developing Colorectal cancer are obesity, regular intake of alcohol, excessive consumption of deep-fried foods and red meat, smoking and an inactive lifestyle.

Complications of Colorectal Cancer

As Colorectal cancer is asymptomatic in the initial stages complications like colon blockage and spread of cancerous cells to other organs are some complications that can emerge due to delayed diagnosis.

Diagnosis of Colorectal Cancer

If symptoms are displayed, colonoscopy is performed in which a long tube is used to examine the rectum and colon, and also extract polyps, if any ,for further diagnosis. Barium Enema, X-ray, Flexible Sigmoidoscopy in which an “S” shaped tube is inserted into the anus for examining the colon, complete blood count tests, imaging tests like X-rays, MRI, and CT scans are some other tests used to diagnose Colorectal Cancer.

Surgery of Colorectal Cancer

Surgery is the best treatment for Colorectal cancer. For the initial stages of cancer, using Colonoscopic Polypectomy the cancerous tissues are removed through a local incision; for advanced stages of cancer, the removal of affected portions of the colon is done through an open surgery called Laparoscopic Colectomy. The other surgical option is Colostomy when an opening(stoma) is created in the abdominal wall to connect one end of the large intestine, creating a new passage for waste materials. Colostomy is a temporary or a permanent process. Proctectomy is the surgical option advised when a part of the rectum or the entire rectum has to be removed.

Prevention of Colorectal Cancer

In the case of a family history of polyps, getting regularly screened for colorectal cancer is recommended. The other effective ways to lower the risk of Colorectal cancer is to maintain a healthy diet rich in whole wheat and grains, fruits and vegetable, reduced meat and alcohol, exercising regularly and maintaining a balanced vitamin and mineral intake.

Haemorrhoids (piles)

Haemorrhoids (Piles) Overview

Haemorrhoids(piles) is a condition similar to varicose veins, where the veins in the anus or rectal area are swollen and cause pain. If the swollen veins are found towards the edge of the anus it is called external haemorrhoids, if found in the inside of the rectum they are internal haemorrhoids, and in some cases, the swollen veins project out of the anus and are called as prolapsed haemorrhoids.

Signs and symptoms of Haemorrhoids (Piles)

Depending upon the types of haemorrhoids, the symptoms may vary from swelling in the anus, bleeding, irritation in the anal region to slight blood in stools. In case there are clots formed it could cause pain and inflammation.

Causes and risk factors of Haemorrhoids (Piles)

When the pressure on the rectal area increases due to strained bowel movements like constipation or diarrhoea, sitting for long hours in the toilet, pregnancy, being overweight, standing for long hours etc., it can cause haemorrhoids. There is a risk of developing haemorrhoids with age is high as the muscles in the rectal and anal regions become weaker.

Complications of Haemorrhoids (Piles)

Haemorrhoids cause complications like formation of blood clots, painful strangulated haemorrhoids or chronic blood loss.

Diagnosis of Haemorrhoids (Piles)

Haemorrhoids are usually diagnosed in different ways. External haemorrhoids are visible but for internal haemorrhoids, an examination of the anus is done wherein the doctor inserts a gloved finger into the rectal area to identify any growths. Other methods include examining the lower rectum and colon using a sigmoidoscope, an anoscope or a proctoscope; a colonoscopy is also performed in some cases.

Surgery of Haemorrhoids (Piles)

In case of mildly uncomfortable haemorrhoids oral medication and creams would be advised. For blood clots in external haemorrhoids, minimally invasive methods are used to remove the haemorrhage like rubber band ligation where bands are placed on the haemorrhage, sclerotherapy where chemical injections are given to shrink the haemorrhage or the coagulative method that uses a laser or infrared radiations to shrink and harden the haemorrhage. Hemorrhoidectomy is the surgery performed to remove bleeding tissues.

Prevention of Haemorrhoids (Piles)

Haemorrhoids can be prevented by maintaining a regular bowel movement for which one needs to ensure a daily intake of plenty of fresh fruits, fibre rich foods, lots of water and including more physical activity in the daily routine. Physical strain while using the toilet should be avoided as it creates more stress on the veins in the anal region

Anal Fissure/Fistula

Anal Fissure Overview

Fissure implies a tear whereas fistula is an opening in the outer anal skin to the rectum. Due to strain while passing stools, the sphincter muscles stretch and tend to tear. This generally heals over time. But in certain cases, due to excessive pressure, the condition gets worse leading to a tube-like opening which is more complex to treat.

Signs and symptoms of Anal Fissure

Anal fistulas or fissures often cause pain during bowel movement, urination, swelling around the anus, pus discharge from the sphincter muscle, pain and redness.

Causes and risk factors of Anal Fissure

When the fluids in the anal glands get accumulated, there are chances of bacteria build-up into small pockets called as abscess which cause a hole in the skin and the tunnel that connects the gland to the opening. The other risk factors that aid the formation of a fistula are trauma, inflammatory bowel disease, radiation therapies and systemic diseases like TB, HIV.

Complications of Anal Fissure

The common complications of Anal fistula/fissure are infections in the tract, bowel incontinence where the sphincter muscles lose control and lead to leakage of faeces.

Diagnosis of Anal Fissure

Anal fissures automatically heal by themselves over a few days but fistulas need medical intervention. Anal fistulas are easy to diagnose through physical examination and by identifying the presence of fluids or blood in the anal region. Further, a colon specialist will perform colonoscopy of the anal region, or use imaging of the rectal regions to examine the sphincter muscles and surrounding area.

Surgery of Anal Fissure

The location of the fistulas can create a threat of incontinence if any surgical complications arise. The treatment options include Fistulotomy which is done in two stages, where the fistula is cut open then cleaned, flattened and restitched; Rectal flap advancement where some tissues of the rectal wall are used to create a flap to cover the repair while the fistula is opened; Seton placement which uses a latex string to drain the fluids from the fistula and Fibrin glue (made fibrous protein) and collagen plugs which are used to fill in and seal the opening. Ligation of the inter-sphincteric fistula tract (LIFT) is the other treatment advised in which the fistula is artificially widened using a seton, later treated and sealed. More invasive surgical options like muscle flap, stoma and ostomy are available if needed.

Prevention of Anal Fissure

Anal fistulas can recur even after surgical treatment if proper care is not taken. The basic steps to prevent onset include maintaining a high fibre diet, drinking a lot of fluids, maintaining body hygiene, regular exercising and lifestyle management.


Gall Stone Disease

Gall Stone Disease Overview

The gall bladder is a pear-shaped sac located under the liver, on the right-hand side of the body. Due to chemical imbalance, the digestive fluids get hardened like stones causing Gall stone disease. Sometimes these stones do not cause any pain and go unnoticed for extended periods.

Signs and symptoms of Gall Stone

Gall stone disease causes a sharp sudden pain beneath the ribs on the right-hand side, pain in the right shoulder, back pain near the right-side shoulder blades, nausea, restlessness, sweating.

Causes and risk factors of Gall Stone

The reasons why chemical imbalance occurs in few people leading to gall stone formation is not clear. There are two types of Gall stones, one condition where the excess cholesterol in the bile leads to imbalance and stone formation; the other when the bile production is in excess due to other underlying conditions like infected bile tubes, liver infections or anaemia. Obesity and visceral fat growth lead to higher chances of gallstone formation, especially in women.

Complications of Gall Stone

Gall stone disease has serious complications in the case of people with a family history of the disease, or who have conditions of liver disease, are diabetic, are obese and experience sudden weight loss. Gall stones can also cause blockage of the bile duct that can lead to jaundice. It is important to seek medical attention with the onset of the early symptoms.

Diagnosis of Gall Stone

For diagnosing infections, blood tests are done; Abdominal ultrasound is done using a transducer on the stomach, Endoscopic ultrasound is done where a thin tube is sent through the mouth; imaging tests like Cholangiography where a chemical dye is injected into the blood for diagnosing through ERCP or X-rays, non-invasive CT scan and Cholscintigraphy where safe radio-active materials are injected into the gall bladder to identify any blocks of the bile ducts or abnormal contractions.

Surgery of Gall Stone

Removal of the gall bladder surgically is known as cholecystectomy, either through less invasive keyhole surgery or through an open surgery, where a large incision is made under the abdomen; dissolution of cholesterol-based gallstones is done using ursodeoxycholic acid; Endoscopic retrograde cholangiopancreatography is the treatment where an endoscope is inserted, and the bile duct is widened using heated wires to enable the passage of gall stones.

Prevention of Gall Stone

Gall stones disease depends on several unavoidable factors like age and ethnicity. Controlling body weight without adopting drastic weight changing diets; maintaining a vegetarian diet with high dietary fibres, and a balanced lifestyle all help to prevent gall stone disease.

Bile Duct Injury/Stricture

Bile Duct Injury/Stricture Overview

The bile duct is a group of tubes that are connected from the liver to the small intestines. They carry the digestive fluid “bile” from the liver to the gall bladder from where it carried to the small intestines. Bile Duct Stricture or Biliary stricture is when this duct is narrowed and obstructs the passage of the bile to the small intestines, making it difficult for food to digest and also causing the accumulation of the excess bile.

Signs and symptoms of Bile Duct Injury/Stricture

Symptoms of Bile duct injury/stricture can sometimes appear over years and include fatigue, weight loss, greasy grey coloured stools, fever, night sweats, reduced appetite, pain in the abdomen especially towards the right side of the rib cage; and excess bilirubin causing dark urine and itching anywhere on the skin.

Causes and risk factors of Bile Duct Injury/Stricture

The main causes that could trigger Biliary stricture are intestinal injuries especially small bowel injuries, presence of gall stones in the bile duct, damage to bile duct especially during gall bladder surgery, bile duct infection and cancerous bile duct and pancreatic cancer.

Complications of Bile Duct Injury/Stricture

If left untreated bile duct strictures can cause an increase of gall stones in the area close to the stricture causing abscess in the liver leading to infections and various diseases of the liver and sepsis.

Diagnosis of Bile Duct Injury/Stricture

Blood tests and imaging are used to decide if there is bile duct injury. Imaging tests that help to diagnose Biliary strictures are Ultra-sound of the Liver, CTI & MRI scans.

Surgery of Bile Duct Injury/Stricture

ERCP (Endoscopic retrograde cholangiopancreatography) in which the doctor uses a special endoscope and contrast fluid that is injected through a catheter to identify bile duct strictures which are opened using a bile stent. Percutaneous Transhepatic Cholangiography (PTHC) is the other process in which a catheter is inserted through the abdominal wall to keep the stricture open and help drain the excess bile. In some cases, the stricture is surgically removed and then the healthy duct is reconnected.

Prevention of Bile Duct Injury/Stricture

Bile duct strictures can be prevented by maintaining a healthy diet, losing weight gradually and maintaining a healthy weight and the reduced intake of sugars and fatty foods.

Biliary Cancer

Biliary Cancer Overview

When the slender bile ducts are infected with cancerous cells it is known as cholangiocarcinoma which generally occurs in the age group of above 50. The type of cancer depends on where it is located. Biliary Cancer is identified as Intraphetic Cholangiocarcinoma if it the bile ducts within the liver are affected; Hilar Cholangiocarcinoma if the bile ducts just outside the liver are affected and Distal Cholangiocarcinoma if the cancer is found in the bile ducts near the small intestine. Biliary Cancer is a rare type of cancer.

Signs and symptoms of Biliary Cancer

If there is persistent tiredness, dullness in the eyes, yellowish eyes, pale or whitish stool colour, uncontrollable itchy skin and abdominal pain, then it is better to consult the doctor for further diagnosis.

Causes and risk factors of Biliary Cancer

Though not very clear, studies have shown that the changes in the DNA of the bile duct cells cause the growth of cancerous cells resulting in tumour formation. The predominant risk factors associated with Biliary Cancer are when the person has Primary Sclerosing Cholangitis (PSC) – an inflammatory condition of the bile duct, by birth abnormalities like – Choledochal cyst, Caroli syndrome, Cirrhosis and in some cases the presence of a parasite called liver flukes, old age and excessive exposure to chemicals like nitrosamines, dioxins, etc.

Complications of Biliary Cancer

In Biliary Cancer the blockage of bile duct leads to further complications like cirrhosis, where the functioning of liver cells gets affected irreversibly and sclerosing cholangitis where the bile ducts become narrow and infected, obstructing the flow of the fluid.

Diagnosis of Biliary Cancer

Biliary Cancer is diagnosed through liver function tests, tumour markers in which the level of Cancer antigen in the blood is checked; ERCP, imaging tests such as CT scan, Computerised Tomography, MRI, MRCP – Magnetic Resonance Cholangiopancreatography which is a non-invasive imaging procedure, and biopsies.

Surgery of Biliary Cancer

Being a rare form of cancer that mainly affects the aged, surgery is challenging. Treatments include chemotherapy, radiation therapy, photodynamic therapy where the tumours are shrunk to control symptoms and radioembolization where radioactive materials are injected in measured portions to shrink the tumours.

Prevention of Biliary Cancer

There are no specific preventive methods that can be adopted but avoiding habits that could lead to liver inflammation or liver cirrhosis may help prevent the onset of Biliary cancer.

Gall Bladder Cancer

Gall Bladder Cancer Overview

The gall bladder is the pear-shaped organ beneath the liver that stores the digestive juice bile. In cases of Gall bladder cancer, there will be growths of abnormal cells in the gall bladder.

Signs and symptoms of Gall Bladder Cancer

Gall bladder cancer causes abdominal bloating and pain, sudden weight loss, yellowing of the skin and eyes. The extremely recessed position of the gall bladder makes it easy for the undetected growth of cancerous cells to occur.

Causes and risk factors of Gall Bladder Cancer

The changes in the DNA of the cells of the gall bladder causes tumour formation leading to Gall Bladder Cancer. The potential risk factors that increase the chances of developing Gall Bladder Cancer are presence of gall stones, presence of gall bladder polyps, old age, a family history of gall bladder cancer condition and smoking tobacco.

Complications of Gall Bladder Cancer

Complications of Gall Bladder Cancer include tumour recurrence, jaundice and intra-abdominal pain.

Diagnosis of Gall Bladder Cancer

Blood tests are used to diagnose the Gall Bladder Cancer. Ultrasound, Computerised Tomography, and Magnetic Resonance Imaging (MRI) are used to understand the stage of cancer if blood tests are positive.

Surgery of Gall Bladder Cancer

Depending on the stage of cancer, a surgical option is chosen; for the early stage cholecystectomy is performed in which gall bladder is removed; in case the liver is infected then the along with the gall bladder, the affected liver portion also would be removed. Chemotherapy, radiation therapy and targeted drug therapy would be used to restrict the growth of the cancerous cells.

Prevention of Gall Bladder Cancer

As Gall Bladder Cancer is challenging to treat due to its critical location, prevention is the safest option. But the role of factors like age, sex, ethnicity, etc. in developing Gall Bladder Cancer cannot be controlled, so maintaining a healthy diet and lifestyle and seeking medical consultation when in doubt advisable.

Chronic Pancreatitis

Chronic Pancreatitis Overview

The pancreas produces digestive enzymes and glucose regulating hormones. Inflammation of the pancreas is called as Pancreatitis or Chronic Pancreatitis. It can vary from a chronic condition that lasts for years to an acute condition that could last for a few days.

Signs and symptoms of Chronic Pancreatitis

Symptoms of Chronic Pancreatitis are sudden weight loss, pain in the upper abdominal area and a condition of smelly oily stools known as steatorrhea.

Causes and risk factors of Chronic Pancreatitis

When the digestive enzymes are activated while in the pancreas, they cause inflammation cause damage. A family history of Pancreatitis, obesity, excessive smoking and alcohol consumption are high-risk factors for triggering Pancreatitis.

Complications of Chronic Pancreatitis

Chronic Pancreatitis is a life-threatening condition if left untreated. Waste fluids get accumulated in the pancreas, that cause internal bleeding or damage. Further, it can lead to pancreatic infections, diabetes, kidney failure, malnutrition or severe complications like pancreatic cancer.

Diagnosis of Chronic Pancreatitis

To diagnose Pancreatitis, blood tests, stool tests, imaging tests like MRI, CT scan, and Endoscopic Ultrasound are performed.

Surgery of Chronic Pancreatitis

Pancreatitis treatment depends on its cause. Cholecystectomy or removal of the gall bladder is one surgical treatment, in case of gall bladder stones are causing it. Another surgery advised is to remove the infected tissues of the pancreas. ERCP – endoscopic retrograde cholangiopancreatography, a process in which blocked bile duct is opened using a tube is also advised for some cases.

Prevention of Chronic Pancreatitis

The risk of Pancreatitis can be reduced by limiting alcoholic intake, increased intake of water and fresh fruits and low- sugar and low- fat foods.

Pancreatic Tumour/Cancer

Pancreatic Tumour/Cancer Overview

Pancreatic cancer is the condition when there is a cancerous growth in the lining walls of the pancreatic ducts that carry the digestive enzymes.

Signs and symptoms of Pancreatic Tumour/Cancer

Symptoms of Pancreatic tumour are blood clots, sudden weight loss, dark-coloured urine, itchy skin, skin becoming pale and yellow, abdominal pain that is felt in the back, and fatigue.

Causes and risk factors of Pancreatic Tumour/Cancer

The exact reasons for the occurrence of Pancreatic Cancer are not known. Without an appropriate medical diagnosis, the cancerous cells can be spread across the other organs. Any genetic history of syndromes or Pancreatitis will increase the risk of Pancreatic tumour. Other factors are diabetes, being overweight and smoking.

Complications of Pancreatic Tumour/Cancer

Pancreatic Cancer brings complications of weight loss, jaundice, and bowel obstruction where cancer affects the small intestine.

Diagnosis of Pancreatic Tumour/Cancer

Diagnosis of Pancreatic Cancer involves Imaging techniques like MRI, CT Scan, PET scan; endoscopic ultrasound, biopsy where a part of the tissue is extracted for testing, and blood tests where tumour markers are used to diagnose the presence of Pancreatic Cancer cells.

Surgery of Pancreatic Tumour/Cancer

When the Pancreatic Cancer causing tumour is located at the head of the pancreas, pancreaticoduodenectomy is the procedure used to remove the infected area of the pancreas, liver, part of the bile duct and reattach the healthy parts. Distal pancreatectomy is the surgery performed to remove the cancer-affected part of the head and tail of the pancreas; Total pancretectomy wherein the entire pancreas is surgically removed; if blood cells are affected, then there are certain specific options of surgery to treat the cancerous cells.

Prevention of Pancreatic Tumour/Cancer

Pancreatic Cancer is caused by uncontrollable factors like genetics, family history.

Liver Tumour/Cancer

Liver Tumour/Cancer Overview

Because the liver is the main organ that filters the blood circulating through the body, there are high chances of it being prone to all kinds of cancerous cells. In most cases, liver cancer indicates cancer elsewhere, but there is a condition where cancer begins in the liver itself, known as hepatocellular carcinoma. The other uncommon forms of liver cancer are intrahepatic cholangiocarcinoma and hepatoblastoma.

Signs and symptoms of Liver Tumour/Cancer

Symptoms of liver cancer are chalky white stools, nausea, vomiting, loss of appetite, upper abdominal pain, sudden weight loss and eye discolouration.

Causes and risk factors of Liver Tumour/Cancer

The changes in the DNA may stimulate the uncontrollable growth of cells that turn into cancerous cells. Hepatitis Infections can also cause liver tumours. Factors that may increase the risk of developing liver tumour are cirrhosis where scar tissues are developed in the liver; inherited diseases of the liver; being diabetic; excess alcohol consumption and fat accumulation in the liver.

Complications of Liver Tumour/Cancer

Liver Cancer comes with the complications of bile duct constriction, bleeding, metastases or spreading of the tumour.

Diagnosis of Liver Tumour/Cancer

Recommended tests are imaging tests like MRI, CT scan, biopsy and blood tests to diagnose the extent of the tumour.

Surgery of Liver Tumour/Cancer

Depending on the functioning condition of the liver and the location of the tumour, surgery is suggested to remove the tumour affected portion of the liver. In certain cases a liver transplant may be required.

Prevention of Liver Tumour/Cancer

Taking steps to avoid Cirrhosis, and Hepatitis vaccinations could reduce the risk of developing liver tumours.


Basic and Advanced Laparoscopic Procedures

Our specialist surgeons are adept in performing the basic and advanced laparoscopic surgeries with precision. Laparoscope is a surgical instrument that aids in the diagnosis and medical intervention of abdominal organs. Laparoscopic procedures involve minimal blood loss, reduced post-surgery discomfort and quick recovery. The procedures under Basic Laparoscopy are Diagnostic laparoscopy, Laparoscopic Appendectomy and Laparoscopic Cholecystectomy. Advanced Laparoscopic Procedures require comprehensive training and special skill sets like proficiency in laparoscopic sutures, tissue extraction and knowledge of handling the energy devices and apparatus that are involved in the procedures. Advanced laparoscopic procedures include Laparoscopic Gastrectomy, Laparoscopic Gastrostomy, Laparoscopic Colostomy, and Laparoscopic Colectomy.

Precise GI Oncologic (Cancer) Procedures

GI oncologic procedures are administered with the utmost care and precision to treat all kinds of GI cancers. Our well-trained surgical gastroenterologists perform advanced diagnostic procedures and the latest medical oncology procedures using sophisticated technologies to deliver world class health care to our patients. Precision procedures are used to provide treatments designed to suit the specific needs of each patient based on the specifics of the ailment. Precise GI Oncologic (Cancer) procedures have been successful in providing molecular targeted specific treatments for the malignancy.

Bariatric (Weight Loss) Procedures

Bariatric procedures or Bariatric surgery is the umbrella term given to weight-loss surgeries. These procedures are performed to create weight loss by restricting the stomach’s capacity to hold food. Bariatric procedures are advised when the person’s body weight is creating major health hazards and the person’s weight is not responding to exercise regimes. There are 3 types of Bariatric procedures for weight loss –

  • Laparoscopic Sleeve Gastrectomy is a restrictive procedure without the mal-absorptive component. This involves removing two thirds of the left side of stomach containing the hormones for appetite and diabetes and leaving behind the pyloric valve to continue allowing the passage of food to the small intestines.
  • Gastric bypass or Roux-En-Y, where a small pouch is created that connects the stomach to the small intestine, so that food swallowed passes directly from this pouch to the intestine.
  • Mini Gastric bypass (MGBP) is a simplified modification of gastric bypass surgery in which the size of the stomach is reduced restricting the amount you can eat and also reduces absorption of food by bypassing up to 6 feet of intestine.

Best Gastroentrologists in Chennai

The Gastro Sciences Institute at Gleneagles Global Health City is one of the best hospitals for gastroenterology in Asia, located in Chennai which has one of the best teams of gastroenterology doctors and surgeons in Chennai to deliver the best treatment and care. Access to a team of highly experienced and well-trained surgeons and consultants, ensure that our patients always have access to the best medical minds, who are ably supported by a world-class team of nurses & paramedical staff.

Best Gastroenterologist Chennai DrBalashanmugamTS
Dr T S Bala Shanmugam

MS (General Surgery) FMAS

Senior Consultant & Head of Department - Minimally Invasive Bariatric & GI Surgery

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