Gastroenterology

Background History

The Department of Gastroenterology was formally started in 1982, by the Late Prof. S R Naik. However, gastroenterology services were started in this hospital by the late Prof. Raghavan, two decades prior to this. After the unfortunate demise of Prof Raghavan, the tradition was continued by Prof. B. D. Pimparkar. Following Prof. Pimparkar’s retirement, Dr S R Naik took over; he moved to Lucknow in 1988. The department was then headed by Dr P Abraham. Dr. Shobna Bhatia was HOD from 2006 till 2019. Dr. Akash Shukla took over in December 2019 and is present HOD. This department started the DNB program in 1987 and DM course was recognized in 1990. The scientific program mainly included multi-disciplinary approach towards patients with gastrointestinal disorders. Gastroenterology in general, has grown very rapidly all over the world and has already started branching into further subspecialization such as hepatology, pancreatology, functional bowel disorders with motility studies, therapeutic endoscopy and endoscopic ultrasound. This department is well known for its profile as being amongst the few of the best ones in the country providing fine clinical services, high-quality academic program and highly qualified and committed doctors. This makes this department one of most sought after in India for post doctoral courses in Gastroenterology.
The Department is located on the 9th floor of the multi-storeyed building of the hospital along with two wards (ward 41 for male patients and ward 32 A for female patients). A separate endoscopy area having three endoscopy tables and a 6-bedded recovery area, located on the 11th floor, has been recently developed. The GI physiology laboratory is located on the 11th floor. Procedures performed here include Esophageal and anorectal manometry, ambulatory pHmetry and hydrogen-methane breath analysis.

Pioneering activities

The Liver Clinic was established in 2007. The Clinic is scheduled on Monday morning and Friday afternoon. The Liver transplant OPD was started in collaboration with GI surgery services; this OPD is on Friday morning.
The Liver ICU construction has been completed. This 6-bedded unit will cater to patients with liver failure due to various causes, and also for care during the post transplant period.
GI motility and functional bowel disease OPD was first started in Mumbai inthis department. The department is also the first to acquire solid state manometry, which is state-of-the-art equipment for esophageal, gastric and colonic motility disorders. The Department acquired a Hydrogen-Methane breath analyser for investigations in patients with small intestinal bacterial overgrowth, food intolerance and irritable bowel syndrome.
We conduct all advanced therapeutic endoscopic procedures including

Per oral endoscopic myotomy (POEM)
Zenker’s myotomy
Endo-bariatric procedures
Endoscopic submucosal dissection (ESD)
Endoscopic mucosal resection (EMR)
EUS guided biliary drainage procedures
EUS guided cystogastrostomy
Advanced endoscopic imaging modalities including NBI and Chromoendoscopy
Percutaneous gastrostomy (PEG) placement

Sr No	Name	Designation
1	Dr. Akash Shukla	Professor & Head Department of Gastroenterology MD, DM, Gastroenterology drakashshukla@yahoo.com
2	Dr. Biswa Patra	Assistant Professor Department of Gastroenterology MD, DM, Gastroenterology Biswarj23@gmail.com
3	Dr. Arun Vaidya	Assistant Professor Department of Gastroenterology MD, DM, Gastroenterology arunvaidyagastro@gmail.com
4	Dr. Sidharth Harindranath	Assistant Professor Department of Gastroenterology MD, DM, Gastroenterology h.sidharth@gmail.com
5	Dr. Ankita Singh	Assistant Professor Department of Gastroenterology MD, DM, Gastroenterology Sruhi_0501@rediffmail.com
6	Dr. Mohit Aggarwal	Assistant Professor Department of Gastroenterology MD, DM, Gastroenterology maggarwal36@gmail.com

Residents

Sr No	Name	Designation
1	Dr. Nitish Patwardhan	DM Sr. III yr Resident
2	Dr. Michael Kuruthukulangara	DM Sr. III yr Resident
3	Dr. Mayur Satai	DM Sr. III yr Resident
4	Dr. Love Garg	DM Sr. III yr Resident
5	Dr.Ansari Abu Aasim Akhtar	DM Sr. II yr Resident
6	Dr. Shashank Pujalwar	DM Sr. II yr Resident
7	Dr. Gautam Jain	DM Sr. II yr Resident
8	Dr.Tanmay Laxane	DM Sr. II yr Resident
9	Dr. Chetan Saner	DM Sr. I yr Resident
10	Dr. Vaibhav Padole	DM Sr. I yr Resident
11	Dr.Jitendra Yadav	DM Sr. I yr Resident
12	Dr. Shubham Gupta	DM Sr. I yr Resident
13	Dr. Komal Dhotre	House Officer

Working Schedule of department

Out Patient Clinic	Days	Timings
New patients OPD	Wednesday	8:30 am to 1: 30 pm
Liver OPD	Monday	8:30 am to 1: 30 pm
Functional GI OPD	Monday	1:30 pm to 4:00 pm
Inflammatory Bowel disease OPD	Tuesday	1:30 pm to 4:00 pm
Special Liver OPD (Budd Chiari syndrome, Wilson, Autoimmune hepatitis and Hepatitis C)	Friday	1:30 pm to 4:00 pm
Liver transplant and pancreatology OPD	Friday	11:30 am to 1:30 pm
Follow up OPD	Monday	1:30 pm to 4:00 pm

Indoor

Department has 30 beds (15 for male and 15 for female ) located on 9th floor for indoor patients.
Liver ICU has 6 beds for critically ill liver and post-transplant patients

Workload

The average OPD attendance patients-visits per year are as follows

New patient- 10,000 patients per year
Liver OPD- 35,000 patient-visits per year
Functional Bowel Disease OPD- 15,000 patients visits per year
IBD OPD- 3000 patient-visits per year
Special liver OPD-3000 patient-visits per year.
Pancreatology OPD - 2000 patient visits per year.

Out Patient Clinic	Days	Timings
New Patients OPD	Wednesday	8.30 am to 1.30 pm
Liver OPD	Monday	8.30 pm to 1.30 pm
Follow-up OPD	Monday	9.30pm to 11.30 pm
Inflammatory Bowel Disease and Functional Bowel Disease OPD	Thursday	9.00 am to 11.30 am
Special Liver OPD (Budd Chiari syndrome Wilson, Autoimmune,Hepatitis C)	Friday	1.30pm to 4.00pm
Liver Transplant OPD and Pancreatology OPD	Friday	11.30am to 1.30 pm
Follow up OPD (Old cases)	Monday	1.30 am to 4.00 pm

Department has 30 beds (15 for male and 15 for female ) located on 9th floor for indoor patients.
Liver ICU has 6 beds for critically ill liver patients

The average OPD attendance patients-visits per year are as follows</p>

New patient- 9,000 patients per year
Liver OPD- 32,000 patient-visits per year
Functional Bowel Disease OPD- 10,000 patients visits per year
IBD OPD- 2600 patient-visits per year
Special liver OPD-3000 patient-visits per year.
Pancreatology OPD started 2 years back caters to approximately 900 patient visits per year.

Around 13000 endoscopies done per year which include

Diagnostic and Therapeutic Gastroscopy procedures
Diagnostic and Therapeutic Colonoscopy procedures
ERCPs
Endoscopic Ultrasound (EUS)- Diagnostic and therapeutic
Esophageal and Anorectal Manometry
24 hour pH ambulatory studies
Impedence Manometry
Biofeedback therapy for Dysenergic Defecatory disorder
Liver Biopsy and Interventional Hepatology procedures (TIPSS,TJLB,PTBD) with help of interventional radiology department.
EUS guided liver biopsy
Paediatric Endoscopy
Emergency endoscopy services are available for 24 hours.
Therapeutic ERCPs and endoscopies requiring radiology support is performed daily and emergency ERCP done everyday.
EUS performed daily.
Pediatric and under anaesthesia endoscopic procedures are done on Tuesday/ Thursday and Saturday.
Manometry lab
Facilities provided: everyday morning by appointment

Course provided

Three years DM Gastroenterology
Participation in national multi-center research projects.
Undertakes many multi-disciplinary clinical projects
Structured academic program with periodic evaluationprojects

Courses offered For Student

DM (Gastroenterology) Course- 4 students per year are taken.
PhD – 4 students / year
MSc (Applied Biology)- 2 students per year
Fellowship in Hepatology( 6 month course)- 2 students /year

Academics

Wednesday afternoon at 2.30 pm: Combined GI medicine-GI Surgery-Radiology meeting

Saturday 10 am to 11 am: GI- pathology meeting

Thursday 1.30 pm: GI- Pharmacology meeting

Intradepartmental academic activities:

Tuesday and Friday morning: Journal club and case discussion

Thursday morning: Clinical case discussion

Thursday afternoon: Research review

Saturday 11 am to 12.30 pm: Topic Review

Working schedule

OPD schedule as above.

Endoscopy

The types of Endoscopy done include:

Diagnostic and therapeutic gastroscopy procedures
Diagnostic and therapeutic colonoscopy procedures
Therapeutic ERCPs
Endosonography

Endoscopy procedures are done by appointment on all days of the week. Emergency endoscopy services are available for 24 hours.
Therapeutic ERCPs and endoscopies requiring radiology support are done daily . Procedures that require anesthesia are done on Tuesday, Thursday and Saturday morning.

GI physiology Laboratory

Facilities provided:

Esophageal manometry (solid state and water perfusion)
Anorectal manometry (solid state and water perfusion)
24 hour pH / Impedance ambulatory studies
Biofeedback Therapy
Hydrogen-Methane breath analyser

Colonic transit studies