Gastroenterology treatments range from advanced medications to minimally invasive endoscopy. LIV Hospital offers expert care for digestive recovery.

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Healing from Within

For decades, a diagnosis of a large colon polyp, a bile duct stone, or early-stage stomach cancer meant one thing: major open surgery. It meant large incisions, long hospital stays, and weeks of recovery.

At Liv Hospital, we have pioneered a different path. We specialize in Interventional Gastroenterology, a field that bridges the gap between medicine and surgery. Using high-tech endoscopes and microscopic tools, we can now perform complex procedures entirely through the body’s natural openings (the mouth or rectum). We can peel away tumors, crush stones, and widen narrowed passages without making a single cut on your skin.

Our Treatment and Management philosophy focuses on Organ Preservation. Why remove a stomach if you can just remove the cancer? Why remove a colon if effective medication can heal the inflammation? Whether managing a chronic condition like Crohn’s Disease or performing a life-saving ERCP, our goal is to restore your digestive health with the absolute minimum disruption to your life.

Endoscopic Resection

Finding a polyp or early tumor is only the first step. Removing it safely and completely is the cure.

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Polypectomy (The Standard)

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  • The Procedure: For small polyps (<1cm), we use a “snare”—a tiny wire loop that lassoes the polyp.
  • The Cut: We pass an electric current through the wire (electrocautery) to cut the polyp off and seal the blood vessel simultaneously. It is painless.
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EMR (Endoscopic Mucosal Resection)

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For larger or flat polyps (1–2cm) that sit deeper in the lining.

  • The Lift: We inject a blue liquid cushion under the polyp to lift it away from the muscle wall.
  • The Cut: We remove it in pieces (piecemeal) or one block using a larger snare.

ESD (Endoscopic Submucosal Dissection)

This is the pinnacle of endoscopic skill, pioneered in Japan and performed by experts at Liv Hospital.

  • The Candidate: Patients with Early Gastric Cancer, Esophageal Cancer, or giant flat colon polyps (>2cm) that would otherwise require organ removal.
  • The Technique: Using a specialized electrosurgical knife, the doctor carefully dissects (peels) the tumor off the muscle layer in one single piece, like filleting a fish.
  • The Benefit: Because it is removed in one piece, the pathologist can confirm the margins are clear (R0 resection). The recurrence rate is extremely low, and the patient keeps their organ.
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ERCP: Clearing the Bile Ducts

When a gallstone escapes the gallbladder and blocks the main bile duct, it causes jaundice, severe pain, and life-threatening infection (Cholangitis).

  • The Procedure: We guide a side-viewing endoscope down to the duodenum. We insert a cannula into the papilla (the opening of the bile duct).
  • Sphincterotomy: We make a tiny cut in the muscle of the papilla to widen the opening.
  • Stone Extraction: We use a balloon or basket to pull the stones out into the intestine, where they pass naturally.
  • Mechanical Lithotripsy: If the stone is huge, we use a metalcrusher to break it into pieces first.
  • Stenting: If a tumor (pancreatic or biliary) is blocking the flow, we place a plastic or metal stent (tube) to bypass the blockage and drain the bile. This instantly relieves jaundice and itching.

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Prof. MD. Reskan Altun Prof. MD. Reskan Altun Gastroenterology Overview and Definition
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POEM (Peroral Endoscopic Myotomy)

For patients with Achalasia, a rare condition where the swallowing muscle (LES) is too tight, preventing food from entering the stomach.

  • The Old Way: Laparoscopic surgery (Heller Myotomy).
  • The Liv Way (POEM): We tunnel inside the wall of the esophagus using an endoscope. Once we reach the tight muscle, we cut it from the inside.
  • The Result: The valve relaxes, and patients can eat normally the next day. No external scars.

Managing Inflammatory Bowel Disease (IBD)

Crohn’s Disease and Ulcerative Colitis are lifelong autoimmune conditions. The goal is not just symptom relief, but “Mucosal Healing”—making the gut look normal again to prevent surgery.

Biologic Therapies (The New Era)

We move beyond simple steroids to targeted “Smart Drugs” that block specific inflammatory pathways.

  • Anti-TNF Agents (Infliximab/Adalimumab): Powerful antibodies that stop inflammation systemically.
  • Gut-Selective Integrin Blockers (Vedolizumab): These target only the gut immune system, leaving the rest of the body’s defenses intact (fewer side effects).
  • JAK Inhibitors: Oral pills for patients who prefer not to have injections.

Stricture Dilation

In Crohn’s disease, scar tissue can narrow the intestine (stricture), causing blockages.

  • Balloon Dilation: Instead of surgery to remove the narrowed segment, we pass a balloon through the stricture and inflate it to stretch the scar tissue open.

Hepatology Treatments: Saving the Liver

The liver has an amazing capacity to regenerate, but it needs help to fight viruses and toxins.

Hepatitis B and C Cure

  • Hepatitis C: We use Direct-Acting Antivirals (DAAs) for 8–12 weeks. The cure rate is over 95%. This is one of the greatest medical achievements of the century.
  • Hepatitis B: While rarely “cured,” it is completely controlled with a daily pill (Tenofovir/Entecavir) that suppresses the virus to undetectable levels, preventing cirrhosis and cancer.

Variceal Band Ligation (EVL)

For patients with Cirrhosis, the veins in the esophagus can swell (varices) and burst.

  • The Preventive Fix: During endoscopy, we suck the swollen vein into a cap and fire a rubber band around its base. This cuts off the blood flow, causing the varix to scar over and disappear. It saves lives by preventing massive bleeding.

Fatty Liver (NASH) Management

There is no “magic pill” yet, but we offer a structured program:

  • Weight Loss: 10% weight loss reverses fibrosis.
  • Diabetes Control: Using GLP-1 agonists (like Semaglutide) to improve insulin resistance and reduce liver fat.
  • Vitamin E & Pioglitazone: Specific medical therapies for select patients.

Reflux (GERD) and Barrett’s Esophagus

Chronic acid reflux is dangerous. It changes the lining of the esophagus (Barrett’s Esophagus), which can turn into cancer.

Radiofrequency Ablation (RFA – HALO)

If you have Barrett’s Esophagus with dysplasia (precancerous cells).

  • The Treatment: We insert a balloon catheter that delivers heat energy to the esophageal lining.
  • The Effect: It burns away the bad “Barrett’s” cells. New, healthy squamous cells grow back in their place. It eliminates the cancer risk.

Anti-Reflux Mucosectomy (ARMS)

A newer endoscopic technique where we tighten the valve between the stomach and esophagus by creating a controlled scar, reducing reflux without surgery.

Non-Surgical Weight Loss

Obesity is a major cause of GI disease. We offer endoscopic solutions for patients who do not want Bariatric Surgery.

Intragastric Balloon (Allurion / Orbera)

  • The Concept: We place a saline-filled silicone balloon in the stomach. It takes up space, making you feel full faster.
  • The Swallowable Balloon (Allurion): You swallow a capsule. Once in the stomach, we inflate it. No endoscopy, no anesthesia needed. It naturally deflates and passes after 4 months.
  • Weight Loss: Typically 10–15% of total body weight.

Endoscopic Sleeve Gastroplasty (ESG)

  • The “Accordion” Procedure: We use an endoscopic sewing machine (Apollo OverStitch) to suture the stomach from the inside, reducing its volume by 70%.
  • The Result: It mimics a Surgical Sleeve gastrectomy but without cutting the stomach out. Recovery is 1–2 days.
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Managing Pancreatic Diseases

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The pancreas is unforgiving. We treat its complications gently.

  • Pseudocyst Drainage: After acute pancreatitis, a fluid collection (cyst) can form. Instead of surgery, we place a stent from the stomach into the cyst (Cystogastrostomy) using EUS guidance. The fluid drains internally into the stomach.
  • Pancreatic Enzyme Replacement (PERT): For patients with Chronic Pancreatitis who cannot digest food. We prescribe precise doses of enzymes to be taken with every meal to prevent malnutrition.

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With patients from across the globe, we bring over three decades of medical

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FREQUENTLY ASKED QUESTIONS

Is removing a large polyp dangerous?

The main risks are bleeding (1–2%) and perforation (<0.5%). At Liv Hospital, we use preventative clips to close the defect immediately after removal, significantly reducing these risks. If a complication occurs, we can almost always fix it endoscopically during the same procedure.

Yes, usually the next morning. You may have a sore throat from the scope. If you had a sphincterotomy (cut), we advise a soft diet for 24 hours. If you have Pancreatitis after ERCP (a known risk), you may need to fast for a few days.

No. Once you achieve “Sustained Virologic Response” (SVR) at 12 weeks post-treatment, the virus is gone from your body forever. However, you can get reinfected if you are exposed to infected blood again. It does not provide immunity.

  • Allurion (Swallowable): ~4 months.

Orbera (Endoscopic): 6 months or 12 months (depending on the model). It must be removed (or pass) because the acid in the stomach eventually weakens the balloon material.

Because they suppress the immune system, there is a slightly increased risk of infections (like TB or pneumonia). We screen you thoroughly for latent infections before starting. However, the risk of untreated Crohn’s disease (surgery, cancer, malnutrition) is far higher than the risk of the medication.

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