By Amy Tilara, MD, and Kunal Gupta, MD, MBA
As the medical field advances, our goal is to provide care that is more effective at diagnosing and treating problems, yet less invasive for patients.
The growing field of interventional gastroenterology (GI) is one of the areas in which we’ve made major progress in providing minimally invasive care. Interventional GI uses non-surgical endoscopic techniques to evaluate and treat conditions ranging from gastroesophageal reflux disease (GERD) and gallstones to cancers of the digestive tract.
These interventional treatments can help diagnose, treat and even prevent a wide range of conditions affecting the digestive tract. They can provide new options and an improved quality of life for patients who are struggling with pain and other symptoms related to GI cancers.
In the past, patients had to travel out of the area for these types of treatments. Now, CentraState Medical Center has the technology and the expertise to provide these procedures close to home for patients in our area.
For example, our program recently treated a man in his 80s who was admitted to the hospital with abdominal pain, nausea and vomiting. Using an interventional GI technique known as endoscopic ultrasound (EUS), we determined he had an obstruction of his bowel caused by a mass in the duodenum, the first part of the small intestine.
We were able to reopen the obstruction by inserting a small tube (stent) in the duodenum as well as in a blockage in his bile duct. These treatments resolved his symptoms, allowing him to eat again and go home until he could be scheduled for further treatment of the original mass, which we determined was caused by a treatable form of pancreatic cancer.
Treating Problems Without Surgery
Interventional gastroenterology procedures are done via endoscopy. Endoscopy uses a thin, flexible tube (endoscope) with a light and camera that allows your doctor to examine the upper or lower parts of the digestive tract. Special endoscopy equipment allows us to not only evaluate a condition but also provide therapy.
At CentraState, some of the more common interventional GI procedures include:
- Endoscopic ultrasound (EUS), which can be used to view and biopsy abnormalities of the pancreas and upper gastrointestinal tract and drain pancreatic pseudocysts.
- Endoscopic mucosal resection (EMR), a procedure to remove abnormal tissues (lesions) in the esophagus, stomach and upper part of the small intestine.
- Endoscopic retrograde cholangiopancreatography (ERCP), which can treat blocked or narrowed bile and pancreatic ducts.
- Stent placement, a procedure that uses a metal mesh or plastic tube to reopen a blocked section of the esophagus, biliary tree or intestinal tract.
- Electrohydraulic lithotripsy (EHL) to break up large bile duct stones so they can be more easily removed.
- Nerve blocks to treat pain in patients with advanced GI cancer.
- Closures of fistulas, which are abnormal connections between two organs in the GI tract.
These endoscopic procedures are done under sedation, allowing patients to return home and resume most normal activities the same day. They are performed in CentraState’s state-of-art endoscopy suite, giving patients the peace of mind of having their procedure in a hospital setting.
Preventing Cancer
Colonoscopy (lower endoscopy) has long been the gold standard for helping detect and prevent colon cancer, the third leading cause in the U.S. of cancer-related deaths in women and the second leading cause in men. During the procedure, doctors can remove precancerous colon polyps before they become malignant.
Now, we’re offering a procedure called radiofrequency ablation, which has the potential to prevent esophageal cancer in patients with advanced GERD. Radiofrequency ablation uses heat energy to destroy (ablate) diseased tissue in the superficial lining of the esophagus caused by Barrett’s esophagus, a complication of GERD.
An endoscope is inserted into the esophagus, allowing your doctor to view and measure the abnormal tissue that needs to be treated. The ablation device is then inserted to precisely deliver heat energy to only the diseased tissue. The tissue is destroyed and healthy tissue eventually grows back as it heals.
The treatment has been shown to be more than 90 percent effective in removing precancerous tissue from the esophagus. Our hope is that as the field of interventional GI continues to expand, more and more of these types of preventive treatments will become available.
An Experienced Team
The board-certified gastroenterologists with CentraState’s Interventional Gastroenterology Program have advanced training and extensive experience in endoscopic techniques. CentraState Medical Center’s endoscopy team was also recently named an EndoNurse All-Star Team by EndoNurse magazine, a nationally acclaimed publication for endoscopy. For more information about CentraState’s services, call 866-CENTRA7 (866-236-8727).
Dr. Amy Tilara is a board-certified gastroenterologist at Advanced Gastroenterology Associates and co-director of interventional endoscopy at CentraState Medical Center.
Dr. Kunal Gupta is a board-certified gastroenterologist and chief of gastroenterology at CentraState Medical Center and co-director of the interventional endoscopy at CentraState Medical Center. Drs. Tilara and Gupta can be reached by calling 866-CENTRA7.
