Narayana Hospital, Guwahati
State-of-the-Art Interventional Gastroenterology

Procedures We Offer

From routine painless diagnostic checks to complex therapeutic interventions like ERCP, foreign body retrieval, polyp removal, and variceal banding — all performed with cutting-edge medical scopes under conscious sedation for zero patient discomfort.

Diagnostic Procedure
1-2 mins diagnostic (5-10 mins with sampling)

Upper GI Endoscopy

Advanced Endoscopic Evaluation of the Upper Digestive Tract

Anesthesia: Local throat anaesthetic spray ± Light conscious sedation
Setting: Day-care / Outpatient Endoscopy Suite

Upper GI Endoscopy (also known as Gastroscopy or Upper Gastrointestinal Endoscopy) is a safe, accurate, and minimally invasive procedure used to examine the oesophagus (food pipe), stomach, and duodenum (first part of the small intestine).

Using a thin, flexible tube fitted with a high-definition camera, the procedure allows direct visualization of the upper digestive tract to diagnose the cause of symptoms, obtain tissue samples (biopsy), and perform certain treatments during the same procedure when required.

Upper GI Endoscopy is considered the gold standard investigation for many diseases affecting the upper digestive system and plays a crucial role in the early diagnosis of ulcers, infections, inflammation, bleeding, and gastrointestinal cancers.

Clinical Highlights

Gold standard diagnostic tool for upper GI complaints
Visualizes esophagus, stomach, and duodenum in ultra-high definition
Painless tissue biopsies and immediate therapeutic interventions possible in same session
Fast recovery - patients usually return home within 1-2 hours

When is Upper GI Endoscopy Recommended?

  • Persistent acidity or heartburn (GERD)
  • Upper abdominal pain or discomfort
  • Difficulty or pain while swallowing (Dysphagia/Odynophagia)
  • Persistent nausea or vomiting
  • Vomiting blood (Haematemesis)
  • Black stools (Melena)
  • Unexplained anaemia
  • Unexplained weight loss
  • Loss of appetite
  • Recurrent indigestion or dyspepsia
  • Suspected stomach or oesophageal ulcer
  • Suspected gastrointestinal bleeding
  • Long-standing acid reflux requiring evaluation
  • Follow-up of previously diagnosed ulcers or Barrett's oesophagus
  • Surveillance for selected gastrointestinal conditions

What Conditions Can Be Diagnosed?

Oesophageal Disorders
  • Acid Reflux (GERD)
  • Oesophagitis
  • Barrett's Oesophagus
  • Oesophageal Strictures
  • Achalasia
  • Oesophageal Varices
  • Oesophageal Cancer
Stomach Disorders
  • Gastritis
  • Helicobacter pylori Infection
  • Gastric Ulcers
  • Gastric Polyps
  • Stomach Cancer
  • Gastric Outlet Obstruction
Duodenal Disorders
  • Duodenitis
  • Duodenal Ulcers
  • Coeliac Disease
Gastrointestinal Bleeding
  • Upper Gastrointestinal Bleeding from ulcers, varices, or vascular malformations

Treatments Performed During Procedure

Tissue biopsy for pathology and rapid urease test (H. pylori)
Removal of small foreign bodies
Control of active gastrointestinal bleeding (hemoclipping, injection, heat probes)
Variceal band ligation (EVL)
Endoscopic injection therapy
Oesophageal dilatation (balloon / bougie)
Stent placement for obstruction
Removal of selected polyps (polypectomy)
Feeding tube (PEG) placement in selected patients

How Should I Prepare?

Before the Procedure
  • Do not eat or drink anything for 6–8 hours before the procedure to ensure stomach is completely empty.
  • Inform your doctor about all medications you are taking, especially blood thinners, diabetes medications, or insulin.
  • Inform your doctor if you have heart disease, lung disease, kidney disease, liver disease, or allergies.
  • Remove dentures, spectacles, and removable dental appliances before the procedure.
  • If sedation is planned, arrange for a responsible adult to accompany you home.

What Happens During the Procedure?

  1. 1After arriving at the endoscopy unit, your medical history will be thoroughly reviewed.
  2. 2Your blood pressure, pulse, and oxygen levels will be continuously monitored.
  3. 3A local anaesthetic spray is applied to numb the throat and suppress the gag reflex.
  4. 4Sedation may be administered when appropriate to improve patient comfort.
  5. 5You will be asked to lie comfortably on your left side.
  6. 6The endoscope is gently passed through the mouth into the oesophagus, stomach, and duodenum.
  7. 7Air or carbon dioxide is gently introduced to expand the digestive tract for clear visualization.
  8. 8Photographs, videos, or painless biopsies may be taken if necessary.
  9. 9The diagnostic examination usually takes only 1-2 minutes (5-10 minutes if therapeutic interventions are performed).
Is the Procedure Painful?

Most patients tolerate Upper GI Endoscopy very well. You may experience mild throat numbness, temporary gagging during insertion, and a feeling of fullness due to air introduced into the stomach. The procedure is generally not painful, and sedation can be used when appropriate to improve comfort.

Is Sedation Necessary?

Many patients undergo Upper GI Endoscopy comfortably using only local throat anaesthesia. However, conscious sedation may be recommended for anxious patients, previous difficulty tolerating endoscopy, therapeutic procedures, or selected medical conditions. Your doctor will discuss the most appropriate option based on your individual needs.

Is it Safe?

Upper GI Endoscopy is considered a very safe procedure when performed by experienced gastroenterologists using modern equipment. Serious complications are uncommon.

  • Bleeding (usually minor, following therapeutic procedures or biopsy)
  • Perforation (very rare)
  • Sedation-related complications
  • Temporary sore throat
  • Temporary bloating

Frequently Asked Questions

Doctor's Clinical Advice

"Persistent acidity, difficulty swallowing, unexplained weight loss, recurrent vomiting, vomiting blood, black stools, or long-standing indigestion should never be ignored. Upper GI Endoscopy is one of the safest and most effective investigations for identifying the underlying cause and allowing early treatment before serious complications develop."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Diagnostic & Therapeutic
20 - 30 Minutes

Colonoscopy

Comprehensive Examination of the Large Intestine for Accurate Diagnosis & Early Disease Detection

Anesthesia: Conscious Sedation / Monitored Anesthesia Care (MAC)
Setting: Day-care / Outpatient Endoscopy Suite

Colonoscopy is a safe, highly accurate, and minimally invasive procedure that allows direct examination of the entire large intestine (colon) and the terminal ileum (the last part of the small intestine) using a thin, flexible tube equipped with a high-definition camera.

It is considered the gold standard for diagnosing diseases of the colon and rectum, detecting colorectal cancer at an early stage, removing precancerous polyps, investigating chronic bowel symptoms, and monitoring inflammatory bowel disease. In many cases, diagnosis and treatment can be performed during the same procedure, avoiding the need for additional interventions.

Clinical Highlights

Gold standard investigation for the large intestine, rectum, and terminal ileum
Proven to prevent colorectal cancer by snaring and removing precancerous polyps
Painless procedure carried out under gentle conscious sedation
Same-day discharge with rapid resumption of daily life

When is Colonoscopy Recommended?

  • Blood in the stool or rectal bleeding
  • Persistent diarrhoea lasting more than four weeks
  • Chronic constipation
  • Unexplained abdominal pain
  • A persistent change in bowel habits
  • Unexplained iron deficiency anaemia
  • Unexplained weight loss
  • Positive stool occult blood or FIT test
  • Suspected Inflammatory Bowel Disease (Crohn's Disease or Ulcerative Colitis)
  • Suspected intestinal tuberculosis
  • Colorectal polyps detected on imaging
  • Surveillance after previous polyp removal
  • Family history of colorectal cancer
  • Screening for colorectal cancer in eligible individuals (age 45+)

What Conditions Can Be Diagnosed?

Inflammatory Disorders
  • Ulcerative Colitis
  • Crohn's Disease
  • Microscopic Colitis
  • Infectious Colitis
  • Intestinal Tuberculosis
Structural Disorders
  • Colorectal Polyps
  • Diverticular Disease
  • Colorectal Cancer
  • Colonic Strictures
  • Rectal Disorders
Functional & Other Conditions
  • Chronic diarrhoea evaluation
  • Chronic constipation workup
  • Unexplained gastrointestinal bleeding
  • Iron deficiency anaemia
  • Terminal ileal diseases

Treatments Performed During Procedure

Removal of colorectal polyps (Polypectomy)
Tissue biopsy for pathology
Control of lower intestinal bleeding (clips, injection, thermal coagulation)
Dilatation of selected strictures
Removal of selected foreign bodies
Tattooing of lesions before laparoscopic surgery
Decompression of selected colonic obstruction

How Should I Prepare?

Proper Bowel Preparation
  • Proper bowel preparation is essential because even small amounts of stool may hide important abnormalities.
  • Follow a low-residue diet as advised 1-2 days before the procedure.
  • Take only clear liquids during the bowel preparation period as instructed.
  • Drink the prescribed bowel-cleansing solution (e.g. PEG solution) exactly as directed.
  • Inform your doctor about all medications, especially blood thinners, diabetes medications, or iron supplements.
  • Arrange for someone to accompany you home after sedation.

What Happens During the Procedure?

  1. 1Your medical history and previous reports are thoroughly reviewed upon arrival.
  2. 2Blood pressure, pulse, and oxygen levels are continuously monitored.
  3. 3Sedation is administered to ensure comfort throughout.
  4. 4You will lie comfortably on your left side.
  5. 5The colonoscope is gently passed through the rectum and advanced to examine the entire colon up to the terminal ileum.
  6. 6Carbon dioxide or air is introduced to inflate the lumen for optimal visualization.
  7. 7Photographs, biopsies, or polyp removals are performed where necessary.
  8. 8A routine diagnostic colonoscopy usually takes 20–30 minutes.
Is the Procedure Painful?

Most patients tolerate colonoscopy very well. You may experience mild abdominal pressure, temporary cramping, or a feeling of bloating. Sedation is commonly used to ensure complete comfort, and many patients remember little or nothing about the procedure.

Is it Safe?

Colonoscopy is considered a very safe procedure when performed by experienced gastroenterologists. Serious complications are uncommon and every precaution is taken.

  • Bleeding (usually minor, following polyp removal)
  • Perforation of the bowel wall (rare, < 1 in 1,000 cases)
  • Sedation-related complications
  • Temporary abdominal discomfort and bloating

Frequently Asked Questions

Doctor's Clinical Advice

"Blood in the stool, persistent diarrhoea, chronic constipation, unexplained weight loss, iron deficiency anaemia, or a lasting change in bowel habits should never be ignored. Colonoscopy remains the most accurate investigation for diagnosing diseases of the colon and rectum and plays a vital role in the prevention and early detection of colorectal cancer."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Diagnostic Procedure
Approximately 10 Minutes

Flexible Sigmoidoscopy

Targeted Examination of the Rectum & Lower Colon

Anesthesia: Usually none required (or light sedation if requested)
Setting: Day-care / Clinic Suite

Flexible Sigmoidoscopy is a safe, minimally invasive endoscopic procedure used to examine the rectum and sigmoid colon (the lower part of the large intestine) using a thin, flexible tube fitted with a high-definition camera.

It is commonly performed to investigate rectal bleeding, persistent diarrhoea, inflammatory bowel disease, rectal pain, and changes in bowel habits. Unlike a full colonoscopy, Flexible Sigmoidoscopy examines only the lower part of the colon and usually requires less bowel preparation.

The procedure provides an accurate diagnosis of diseases affecting the rectum and lower colon and allows biopsies or selected treatments to be performed during the same examination.

Clinical Highlights

Quick 10-minute examination of the lower third of the large bowel
Requires minimal bowel preparation (often just a simple enema)
Generally performed without sedation, allowing immediate return to work
Painless tissue biopsies and small polyp removal

When is Flexible Sigmoidoscopy Recommended?

  • Rectal bleeding or bright red blood in stool
  • Blood or mucus in stool
  • Persistent diarrhoea
  • Suspected Ulcerative Colitis or Proctitis
  • Rectal pain or tenesmus
  • Persistent change in bowel habits
  • Follow-up of inflammatory bowel disease response to therapy
  • Surveillance of selected rectal conditions
  • Abnormal findings on pelvic imaging requiring direct endoscopic evaluation

What Conditions Can Be Diagnosed?

Inflammatory Disorders
  • Ulcerative Colitis
  • Proctitis
  • Infectious Colitis
  • Radiation Proctitis
Structural Disorders
  • Rectal Polyps
  • Colorectal Polyps (Lower Colon)
  • Rectal Cancer
  • Sigmoid Colon Cancer
  • Diverticular Disease
Other Conditions
  • Lower gastrointestinal bleeding
  • Solitary Rectal Ulcer Syndrome (SRUS)
  • Unexplained chronic diarrhoea

Treatments Performed During Procedure

Painless tissue biopsy
Removal of small polyps (polypectomy)
Control of selected bleeding lesions
Assessment of mucosal healing in inflammatory bowel disease
Tattooing of lesions before surgery in selected patients

How Should I Prepare?

Preparation Guidelines
  • Follow the bowel preparation instructions provided by your doctor.
  • A simple rectal enema is commonly administered 1-2 hours before the examination to clear the rectum and sigmoid colon.
  • In some cases, mild oral laxatives may be advised.
  • Inform your doctor about blood-thinning medications, diabetes medicines, allergies, or significant medical conditions.

What Happens During the Procedure?

  1. 1You will lie comfortably on your left side on the examination couch.
  2. 2The flexible sigmoidoscope is gently inserted through the rectum.
  3. 3The rectum and sigmoid colon are carefully examined up to approximately 60 cm.
  4. 4Air or carbon dioxide is introduced to expand folds for clear visualization.
  5. 5Photographs, biopsies, or polyp removal may be performed if required.
  6. 6The examination usually takes approximately 10 minutes.
Is the Procedure Painful?

Most patients tolerate the procedure very well. You may experience mild pressure, temporary cramping, or a feeling of gas/bloating. Sedation is usually not required because the procedure is brief and well tolerated.

Is it Safe?

Flexible Sigmoidoscopy is a very safe procedure when performed by an experienced gastroenterologist. Complications are extremely rare.

  • Minor bleeding (especially after biopsy or polyp removal)
  • Perforation (very rare, < 1 in 10,000 cases)
  • Temporary abdominal discomfort

Frequently Asked Questions

Doctor's Clinical Advice

"Rectal bleeding, persistent diarrhoea, blood or mucus in the stool, rectal pain, or a lasting change in bowel habits should not be ignored. Flexible Sigmoidoscopy is a quick, safe, and effective procedure for diagnosing diseases affecting the rectum and lower colon, allowing early treatment when needed."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Diagnostic Procedure
8 - 12 Hours recording time

Capsule Endoscopy

A Non-Invasive Examination of the Small Intestine

Anesthesia: None required (completely non-invasive)
Setting: Outpatient / At-home wireless recording

Capsule Endoscopy is an advanced diagnostic procedure that uses a small, swallowable capsule containing a miniature camera to examine the small intestine, an area that cannot be fully evaluated by routine Upper GI Endoscopy or Colonoscopy.

It is particularly useful in patients with unexplained gastrointestinal bleeding, iron deficiency anaemia, suspected Crohn's disease, small bowel tumours, or persistent symptoms despite normal endoscopy and colonoscopy.

The capsule naturally travels through the digestive tract while capturing thousands of high-definition images, which are transmitted wirelessly to a small recorder worn around your waist and later reviewed by the gastroenterologist. The procedure is painless, does not require sedation or hospital admission, and the capsule is passed naturally in the stool.

Clinical Highlights

Painless swallowable pill camera size of a vitamin capsule
Visualizes the entire 6-meter small intestine in high resolution
No sedation, no radiation, no hospital stay required
Expelled naturally in normal bowel movement

When is Capsule Endoscopy Recommended?

  • Unexplained or obscure gastrointestinal bleeding
  • Persistent iron deficiency anaemia despite normal endoscopy and colonoscopy
  • Suspected Crohn's disease involving the small intestine
  • Investigation of small intestinal tumours or polyps
  • Surveillance in hereditary polyposis syndromes (Peutz-Jeghers, FAP)
  • Unexplained chronic abdominal pain or chronic diarrhoea
  • Assessment of refractory Coeliac disease

What Conditions Can Be Diagnosed?

Small Bowel Disorders
  • Small bowel bleeding (angiodysplasias, vascular ectasias)
  • Crohn's disease of the jejunum and ileum
  • Small intestinal ulcers and strictures
  • Small bowel polyps and tumours (neuroendocrine tumours, adenocarcinoma, GIST)
  • Coeliac disease refractory changes
  • NSAID-induced enteropathy

How Should I Prepare?

Patient Preparation
  • Fast for 10–12 hours prior to swallowing the capsule.
  • A mild bowel preparation liquid may be advised the evening before to ensure small bowel clarity.
  • Do not take medications within 2 hours of swallowing the capsule.
  • You can resume clear liquids 2 hours after ingestion and a light snack after 4 hours.
Is the Procedure Painful?

Completely painless. You swallow the smooth pill capsule with a glass of water just like an ordinary vitamin tablet.

Is it Safe?

Capsule Endoscopy is exceptionally safe. The primary rare risk is capsule retention in patients with known severe intestinal strictures or blockages.

  • Capsule retention in severe narrowings (evaluated beforehand if suspected)

Frequently Asked Questions

Doctor's Clinical Advice

"When upper endoscopy and colonoscopy both return normal but bleeding, anaemia, or abdominal pain continues, Capsule Endoscopy is the premier diagnostic breakthrough to illuminate the hidden small intestine."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Diagnostic Procedure
5 - 10 Minutes

FibroScan® (Transient Elastography)

Non-Invasive Assessment of Liver Fat & Liver Fibrosis

Anesthesia: None required (completely non-invasive & painless)
Setting: OPD Consultation Room / Clinic

FibroScan® is a quick, painless, and non-invasive test used to assess the health of the liver. It measures liver stiffness (fibrosis) and liver fat (steatosis) without the need for needles, injections, or surgery.

Unlike a routine ultrasound, FibroScan® provides quantitative numerical measurements about the amount of liver scarring and fat accumulation, making it an important tool for diagnosing and monitoring chronic liver diseases such as fatty liver disease, hepatitis B, hepatitis C, alcohol-related liver disease, and cirrhosis.

The procedure is performed in just a few minutes and allows your gastroenterologist to make informed decisions regarding treatment, lifestyle changes, and long-term follow-up.

Clinical Highlights

Painless numerical quantification of liver fat (CAP) and stiffness (LSM)
Eliminates the need for painful liver needle biopsy in over 90% of patients
No radiation, no injections, no recovery downtime
Results delivered immediately at consultation

When is FibroScan® (Transient Elastography) Recommended?

  • Fatty Liver Disease (MASLD / NAFLD)
  • Elevated liver enzymes (SGOT, SGPT, GGT on LFT)
  • Chronic Hepatitis B infection
  • Chronic Hepatitis C infection
  • Alcohol-related liver disease
  • Autoimmune liver disease
  • Obesity or metabolic syndrome
  • Type 2 Diabetes mellitus
  • Long-term liver disease requiring regular follow-up
  • Suspected liver fibrosis or early cirrhosis

What Does FibroScan Measure?

Liver Stiffness Measurement (LSM)

Measures the amount of fibrosis (scarring) in the liver in kiloPascals (kPa). Higher values indicate stiffer tissue and advanced scarring.

F0 - F1: Mild or No Fibrosis
F2: Moderate Fibrosis
F3: Advanced Fibrosis
F4: Cirrhosis
Controlled Attenuation Parameter (CAP)

Quantifies the percentage of fat stored within liver cells in decibels per meter (dB/m).

S1: Mild Fatty Liver (< 33% fat)
S2: Moderate Fatty Liver (33% - 66% fat)
S3: Severe Fatty Liver (> 66% fat)

How Should I Prepare?

Simple Preparation
  • Avoid eating or drinking for at least 3–4 hours before the test.
  • Wear comfortable, loose clothing that allows easy access to the right upper abdomen.
  • Continue your regular medications unless advised otherwise.
  • No injections, bowel preparation, or hospital admission are required.

What Happens During the Procedure?

  1. 1You lie comfortably on your back with your right arm placed behind your head.
  2. 2A water-based gel is applied to the right side of your ribcage.
  3. 3The doctor places the FibroScan probe against your skin between the ribs.
  4. 4Gentle painless acoustic wave pulses are transmitted into the liver.
  5. 5You feel a slight flick or tap on your skin with each pulse.
  6. 6At least 10 validated measurements are recorded automatically within 5 to 10 minutes.
Is the Procedure Painful?

No. FibroScan is completely non-invasive and painless. There are no needles, no injections, no radiation, no sedation, and no recovery period. Most patients describe the examination as similar to an ultrasound.

Is it Safe?

Yes. FibroScan has been used worldwide for over two decades and is exceptionally safe. Because it uses harmless mechanical shear waves rather than radiation, it can be repeated regularly.

Frequently Asked Questions

Doctor's Clinical Advice

"Fatty liver disease often causes no symptoms until significant liver damage has occurred. FibroScan allows early detection of liver fat and fibrosis, enabling timely lifestyle changes and treatment before irreversible complications develop."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Diagnostic Procedure
Adds 1 - 2 minutes to routine endoscopy

Endoscopic Biopsy

Safe & Accurate Tissue Sampling During Endoscopy

Anesthesia: Included under the routine endoscopy spray / sedation
Setting: Endoscopy Suite

An Endoscopic Biopsy is a simple, safe, and painless procedure performed during an Upper GI Endoscopy or Colonoscopy to obtain small tissue samples from the digestive tract for microscopic examination. It is one of the most important tools for accurately diagnosing inflammation, infections, ulcers, precancerous changes, and cancers of the digestive system.

A biopsy does not mean cancer is suspected. In fact, most biopsies are performed to diagnose common conditions such as gastritis, Helicobacter pylori infection, inflammatory bowel disease, coeliac disease, or to confirm the cause of persistent digestive symptoms.

Clinical Highlights

Painless micro-tissue sampling with sterile micro-forceps
Essential for detecting H. pylori, coeliac sprue, microscopic colitis, and dysplasia
Does not prolong procedure duration or recovery time
Definitive histopathological diagnosis guided by experienced pathologists

When is Endoscopic Biopsy Recommended?

  • Persistent gastritis or stomach ulcers
  • Suspected Helicobacter pylori infection
  • Chronic diarrhoea evaluation
  • Suspected Coeliac disease (duodenal biopsy)
  • Inflammatory Bowel Disease (Crohn's disease or Ulcerative Colitis)
  • Abnormal growths or polyps
  • Difficulty swallowing
  • Barrett's oesophagus surveillance
  • Unexplained weight loss or anaemia
  • Suspicious ulcers or mucosal irregularities
  • Evaluation of gastrointestinal cancers

What Conditions Can Be Diagnosed?

Oesophagus
  • Oesophagitis
  • Barrett's oesophagus
  • Eosinophilic oesophagitis
  • Oesophageal cancer
Stomach
  • Gastritis
  • Helicobacter pylori infection
  • Gastric ulcers
  • Atrophic gastritis
  • Intestinal metaplasia
  • Stomach cancer
Small Intestine
  • Coeliac disease
  • Malabsorption disorders
  • Infections
  • Small intestinal inflammation
Colon & Rectum
  • Ulcerative Colitis
  • Crohn's Disease
  • Microscopic Colitis
  • Intestinal Tuberculosis
  • Colorectal Polyps
  • Colorectal Cancer
Is the Procedure Painful?

No. The lining of the digestive tract does not have sensory pain receptors for cut or pinch sensations. As a result, tissue samples are taken completely painlessly. Most patients are unaware that a biopsy was even performed.

Is it Safe?

Yes. Endoscopic biopsy is a routine, highly standardized procedure performed worldwide with an exceptional safety record.

  • Minor self-limiting oozing (stops spontaneously within seconds)
  • Extremely rare perforation (< 1 in 10,000)

Myths vs. Facts

MythMedical Fact
A biopsy means I have cancer.Most biopsies are performed to diagnose benign, non-cancerous conditions like gastritis or coeliac disease.
A biopsy is painful.The digestive tract lining lacks pain receptors; the procedure is completely painless.
A biopsy spreads cancer.There is no evidence that routine endoscopic biopsy spreads cancer.
One biopsy is always enough.Multiple micro-samples are often collected to increase diagnostic accuracy.

Frequently Asked Questions

Doctor's Clinical Advice

"An endoscopic biopsy is one of the most valuable tools for reaching an accurate diagnosis. It helps distinguish inflammation, infection, precancerous changes, and cancer, allowing the right treatment to begin as early as possible. In most patients, the procedure is quick, painless, and extremely safe."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Therapeutic Intervention
30 - 90 Minutes

ERCP (Endoscopic Retrograde Cholangiopancreatography)

Advanced Endoscopic Treatment for Bile Duct & Pancreatic Disorders

Anesthesia: Deep Conscious Sedation or Monitored Anesthesia Care (MAC)
Setting: Advanced Endoscopy Suite with Fluoroscopy (X-Ray)

ERCP (Endoscopic Retrograde Cholangiopancreatography) is a highly specialized endoscopic procedure used to diagnose and, more importantly, treat diseases affecting the bile ducts, gallbladder, and pancreas. Unlike routine endoscopy, ERCP is primarily a therapeutic procedure, allowing many conditions to be treated without major surgery.

Using a specialized side-viewing endoscope (duodenoscope) and real-time X-ray guidance, the bile duct and pancreatic duct can be accessed to remove stones, relieve blockages, place stents, widen narrowed ducts, treat bile leaks, and obtain tissue samples for diagnosis.

ERCP has revolutionized the treatment of biliary and pancreatic diseases, helping patients recover faster while avoiding surgery in many cases.

Clinical Highlights

Clears common bile duct stones without the need for open surgery
Relieves obstructive jaundice and treats life-threatening cholangitis
Fluoroscopic real-time X-ray guidance with plastic and metal (SEMS) stenting
Saves patients from major abdominal operations

When is ERCP (Endoscopic Retrograde Cholangiopancreatography) Recommended?

  • Common bile duct (CBD) stones
  • Obstructive jaundice
  • Acute cholangitis (bile duct infection)
  • Benign bile duct strictures
  • Malignant bile duct obstruction (cholangiocarcinoma / pancreatic cancer)
  • Bile leaks following gallbladder surgery or liver injury
  • Pancreatic duct strictures
  • Selected pancreatic duct stones
  • Blocked biliary or pancreatic stents
  • Evaluation and tissue sampling of selected biliary strictures

What Conditions Can Be Treated?

Biliary Disorders
  • Common bile duct stones (Choledocholithiasis)
  • Acute cholangitis
  • Benign bile duct strictures
  • Bile duct injury
  • Bile leaks
  • Primary sclerosing cholangitis (selected patients)
Malignant Disorders
  • Cholangiocarcinoma (Bile Duct Cancer)
  • Pancreatic Cancer causing jaundice
  • Ampullary Tumours
  • Gallbladder Cancer with biliary obstruction
  • Metastatic disease causing bile duct blockage
Pancreatic Disorders
  • Selected pancreatic duct stones
  • Pancreatic duct strictures
  • Chronic pancreatitis
  • Pancreatic duct leaks (selected patients)

Treatments Performed During Procedure

Endoscopic sphincterotomy (widening the papilla of Vater)
Removal of bile duct stones with retrieval balloons or baskets
Mechanical lithotripsy for large or impacted stones
Plastic biliary stent placement
Self-expanding metal stent (SEMS) placement
Balloon dilatation of bile duct strictures
Nasobiliary drainage (in severe sepsis)
Tissue sampling (Brush cytology / Biopsy)
Stent replacement or removal

How Should I Prepare?

Before the Procedure
  • Do not eat or drink for 6–8 hours before the procedure.
  • Inform your doctor about all medications, especially blood thinners, diabetes medicines, or insulin.
  • Inform your doctor if you have heart disease, kidney disease, liver disease, allergies, or previous reactions to sedation.
  • Blood investigations (LFT, INR, Amylase) and imaging such as ultrasound, CT scan, or MRCP are completed before ERCP.
  • Hospital admission (daycare or overnight observation) is routinely planned.

What Happens During the Procedure?

  1. 1You are monitored continuously by the clinical and anaesthesia team.
  2. 2Sedation or anaesthesia is administered to ensure total comfort.
  3. 3A specialized side-viewing endoscope is passed through the mouth into the duodenum.
  4. 4A fine catheter (cannula) is introduced into the opening of the bile or pancreatic duct.
  5. 5Contrast dye is gently injected to visualize the duct architecture under real-time X-ray fluoroscopy.
  6. 6Stones are removed using balloons/baskets after a small incision (sphincterotomy).
  7. 7A stent (plastic or metal) may be placed to ensure continuous bile drainage.
  8. 8The procedure usually takes 30–90 minutes depending on complexity.
Is the Procedure Painful?

Patients are comfortable throughout ERCP because it is performed under sedation or anaesthesia. Afterwards, some patients may experience mild throat soreness or abdominal bloating, which quickly subsides.

Is it Safe?

ERCP is a well-established, highly effective procedure performed by experienced endoscopists. Every precaution is taken to prevent complications.

  • Post-ERCP pancreatitis (preventive medication or pancreatic stenting used in high-risk cases)
  • Bleeding at sphincterotomy site
  • Infection (cholangitis)
  • Perforation (rare)

Frequently Asked Questions

Doctor's Clinical Advice

"Persistent jaundice, fever with chills, severe upper abdominal pain, dark urine, pale stools, or abnormal liver function tests may indicate bile duct obstruction. Early evaluation and timely ERCP can relieve the obstruction, control infection, and prevent serious complications such as liver damage, pancreatitis, or sepsis."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Therapeutic Intervention
Adds 5 - 15 Minutes to colonoscopy

Polyp Removal (Endoscopic Polypectomy)

Minimally Invasive Removal of Precancerous Polyps During Endoscopy

Anesthesia: Covered under colonoscopy conscious sedation
Setting: Endoscopy Suite

Endoscopic Polypectomy is an advanced therapeutic endoscopic procedure used to remove abnormal growths called polyps from the lining of the digestive tract. It is commonly performed during Colonoscopy and, in selected cases, during Upper GI Endoscopy.

Most polyps are benign (non-cancerous). However, some types have the potential to develop into cancer over time. Removing these polyps early is one of the most effective ways to prevent colorectal cancer and other gastrointestinal cancers, often avoiding the need for surgery.

Clinical Highlights

Proven colorectal cancer prevention by eliminating precancerous adenomas
Immediate snare excision during routine screening colonoscopy
Completely painless tissue removal
All excised polyps retrieved and sent for microscopic analysis

When is Polyp Removal (Endoscopic Polypectomy) Recommended?

  • Colorectal polyp detected during screening or diagnostic Colonoscopy
  • Stomach or duodenal polyp identified during Upper GI Endoscopy
  • Polyp causing gastrointestinal bleeding or iron deficiency anaemia
  • Large or suspicious polyps requiring definitive histological evaluation
  • History of previous polyps requiring surveillance
  • Patients with hereditary polyposis syndromes

Treatments Performed During Procedure

Cold snare polypectomy for small polyps (< 5 mm)
Electrocautery snare polypectomy for larger stalked (pedunculated) polyps
Endoscopic Mucosal Resection (EMR) for flat, sessile polyps
Prophylactic hemoclip placement to prevent delayed bleeding
Is the Procedure Painful?

No. Because the inner lining of the colon has no nerve endings that sense heat or cuts, polyp removal is completely painless.

Is it Safe?

Yes. Endoscopic Polypectomy is exceptionally safe and widely performed worldwide.

  • Minor bleeding or delayed bleeding (manageable endoscopically)
  • Perforation of the bowel wall (rare, < 1 in 1,000)
  • Post-polypectomy syndrome (mild, localized inflammation treated conservatively)

Frequently Asked Questions

Doctor's Clinical Advice

"Most colorectal cancers develop slowly from precancerous polyps. Endoscopic Polypectomy allows these polyps to be removed safely before they become cancerous, making it one of the most effective procedures for colorectal cancer prevention. Regular surveillance, when recommended, plays a vital role in maintaining long-term bowel health."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Therapeutic Intervention
10 - 20 Minutes

Endoscopic Variceal Band Ligation (EVL)

A Life-Saving Endoscopic Treatment for Oesophageal Varices

Anesthesia: Local throat spray ± Conscious Sedation
Setting: Endoscopy Suite (Elective or Emergency)

Endoscopic Variceal Band Ligation (EVL), also known as Endoscopic Banding, is an advanced therapeutic endoscopic procedure used to treat oesophageal varices—enlarged veins in the food pipe that develop due to portal hypertension, most commonly in patients with liver cirrhosis.

These enlarged veins can rupture and cause severe or life-threatening bleeding. EVL works by placing small rubber bands around the varices, cutting off their blood supply so they gradually shrink and disappear. It is considered the treatment of choice for both controlling active variceal bleeding and preventing future bleeding episodes.

Clinical Highlights

Gold standard emergency and prophylactic therapy for bleeding esophageal veins
Substantially reduces mortality from portal hypertension bleeding in liver cirrhosis
Quick 15-minute procedure with rubber band ligation
Repeated in organized sessions every 2–4 weeks until variceal eradication

When is Endoscopic Variceal Band Ligation (EVL) Recommended?

  • Oesophageal varices due to liver cirrhosis
  • Acute bleeding from oesophageal varices (haematemesis or melena)
  • High-risk varices (with red wale marks or grade III/IV) detected on screening endoscopy
  • Secondary prevention to stop recurrent variceal hemorrhage in chronic liver disease

How is EVL Performed?

  1. 1A flexible endoscope is gently passed through the mouth into the oesophagus.
  2. 2The enlarged variceal cords are identified and mapped.
  3. 3A specialized multi-band ligator device attached to the endoscope tip is positioned over the varix.
  4. 4Suction draws the varix into the chamber, and a tiny rubber band is deployed around its base.
  5. 5The banded veins shrink and are gradually replaced by safe scar tissue within days.
  6. 6The procedure typically takes 10 to 20 minutes.
Is the Procedure Painful?

No. The procedure is performed under throat anesthesia and sedation. Mild chest heaviness, throat irritation, or slight difficulty swallowing may occur for 24–48 hours, which is easily managed with prescribed antacids and pain relief.

Is it Safe?

Yes. EVL is a well-established, life-saving therapeutic procedure that has dramatically reduced deaths from cirrhosis-related variceal bleeding.

  • Temporary retrosternal chest discomfort
  • Transient difficulty swallowing
  • Superficial banding ulcers (normal part of healing)
  • Minor delayed bleeding

Frequently Asked Questions

Doctor's Clinical Advice

"Bleeding from oesophageal varices is a medical emergency that requires immediate treatment. For patients with liver cirrhosis and portal hypertension, regular endoscopic surveillance and timely EVL can significantly reduce the risk of life-threatening bleeding and improve long-term outcomes."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Therapeutic Intervention
10 - 20 Minutes

Endoscopic Hemostasis

Advanced Endoscopic Treatment for Gastrointestinal Bleeding

Anesthesia: Sedation / Anesthesia tailored to clinical stability
Setting: Endoscopy Suite / Intensive Care Unit

Endoscopic Hemostasis is an advanced therapeutic procedure performed during Upper GI Endoscopy or Colonoscopy to control active bleeding within the digestive tract. It is the first-line treatment for many causes of gastrointestinal bleeding and can often stop bleeding without the need for surgery.

Depending on the source of bleeding, various techniques such as endoscopic clips, injection therapy, thermal coagulation, or haemostatic powders may be used to achieve effective bleeding control.

Clinical Highlights

First-line emergency treatment for acute GI bleeding
Arrests bleeding from peptic ulcers, Mallory-Weiss tears, and vascular malformations
Dual-modality combination therapy (clips + adrenaline injection) for maximum safety
Averts the need for emergency major open surgeries

When is Endoscopic Hemostasis Recommended?

  • Bleeding stomach or duodenal ulcers
  • Vomiting blood (Haematemesis)
  • Black tarry stools (Melena)
  • Severe lower gastrointestinal bleeding
  • Post-polypectomy bleeding
  • Bleeding from vascular lesions (Dieulafoy lesions, AVMs)
  • Selected tumour-related gastrointestinal bleeding

Treatments Performed During Procedure

Mechanical hemoclipping (metallic clips applied directly across bleeding vessels)
Injection therapy (dilute adrenaline solution to cause vasoconstriction)
Thermal coagulation (heater probe or bipolar electrocoagulation)
Topical haemostatic sprays / powders for diffuse oozing surfaces
Is the Procedure Painful?

No. Performed under sedation or anaesthesia with continuous vital monitoring.

Is it Safe?

Yes. It has dramatically reduced emergency surgeries and mortality from GI bleeding.

  • Recurrent bleeding (close monitoring in hospital for 24–48 hours is standard)
  • Perforation (rare)

Frequently Asked Questions

Doctor's Clinical Advice

"Vomiting blood, passing black stools, or significant rectal bleeding are medical emergencies and require immediate evaluation. Early endoscopic treatment can control bleeding, reduce complications, and save lives."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Therapeutic Intervention
15 - 30 Minutes

Esophageal Dilatation

Endoscopic Treatment for Narrowing of the Food Pipe

Anesthesia: Conscious Sedation
Setting: Endoscopy Suite

Esophageal Dilatation is a minimally invasive therapeutic endoscopic procedure used to widen narrowed areas (strictures) of the oesophagus (food pipe). Narrowing of the oesophagus can make swallowing difficult and may result from acid reflux, surgery, radiation therapy, corrosive injury, or other medical conditions.

The procedure helps restore normal swallowing, relieve symptoms, and improve quality of life without the need for major surgery.

Clinical Highlights

Widens benign and peptic strictures to restore comfortable swallowing
Performed using specialized balloon dilators or wire-guided bougies
Rapid relief from dysphagia without open surgical incisions
Same-day discharge with customized dietary progression

When is Esophageal Dilatation Recommended?

  • Difficulty swallowing (Dysphagia) with solid foods or liquids
  • Benign oesophageal strictures
  • Peptic strictures secondary to long-standing acid reflux (GERD)
  • Post-surgical anastomotic narrowing
  • Radiation-induced oesophageal strictures
  • Corrosive or chemical injury to the food pipe
  • Achalasia Cardia (pneumatic balloon dilatation)

Treatments Performed During Procedure

Controlled Radial Expansion (CRE) balloon dilatation under endoscopic vision
Savary-Gilliard wire-guided bougie dilatation
Pneumatic dilatation for achalasia cardia
Intralesional steroid injection to prevent recurrent stricturing
Is the Procedure Painful?

No. Performed under sedation. Mild throat discomfort or chest soreness may occur for 24 hours afterwards.

Is it Safe?

Yes. Safe and effective when performed by experienced hands with gradual step-wise sizing.

  • Minor bleeding
  • Temporary chest discomfort
  • Perforation (rare, minimized by gradual dilatation protocols)

Frequently Asked Questions

Doctor's Clinical Advice

"Persistent difficulty swallowing should never be ignored. Early evaluation with Upper GI Endoscopy and timely Esophageal Dilatation, when indicated, can relieve symptoms, improve nutrition, and help identify the underlying cause before complications develop."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Emergency Therapeutic Procedure
10 - 30 Minutes

Endoscopic Foreign Body Removal

Emergency Endoscopic Removal of Swallowed Objects

Anesthesia: Sedation / General Anaesthesia with airway protection
Setting: Emergency Endoscopy Suite

Endoscopic Foreign Body Removal is an emergency endoscopic procedure used to safely remove swallowed objects from the oesophagus, stomach, or upper digestive tract without the need for surgery. Prompt removal helps prevent complications such as obstruction, perforation, bleeding, or infection.

Using specialised endoscopic instruments, most foreign bodies can be removed safely and effectively during a single procedure.

Clinical Highlights

Urgent endoscopic extraction of impacted bones, coins, batteries, or food
Protects against esophageal perforation, pressure necrosis, and airway compromise
Utilizes specialized retrieval nets (Roth nets), snares, and alligator forceps
Eliminates the need for emergency open thoracic or gastric surgery

When is Endoscopic Foreign Body Removal Recommended?

  • Food bolus impaction (meat stuck in esophagus)
  • Sharp fish bones or chicken bones
  • Swallowed coins
  • Dentures or dental appliances
  • Button batteries (high emergency requiring removal within 2 hours)
  • Magnets
  • Sharp objects such as pins, needles, or razor blades
  • Accidentally swallowed foreign objects in children or adults
Is the Procedure Painful?

No. Performed under sedation or anaesthesia to ensure comfort and patient safety.

Is it Safe?

Yes. Emergency endoscopy safely retrieves over 99% of swallowed objects without surgical incisions.

  • Minor mucosal abrasion
  • Transient sore throat

Frequently Asked Questions

Doctor's Clinical Advice

"If you or your child develops difficulty swallowing, severe throat or chest pain, persistent vomiting, or has swallowed a button battery, magnet, or sharp object, seek emergency medical care immediately. Early endoscopic removal significantly reduces the risk of serious complications."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Therapeutic Intervention
20 - 45 Minutes

Endoscopic Stent Placement

Minimally Invasive Treatment for Digestive Tract & Bile Duct Obstruction

Anesthesia: Sedation or Monitored Anesthesia Care (MAC)
Setting: Endoscopy & Fluoroscopy Suite

Endoscopic Stent Placement is an advanced therapeutic procedure used to relieve narrowing or blockage of the oesophagus, stomach, bile ducts, pancreas, or colon without major surgery. A specialised expandable tube (stent) is placed using endoscopic guidance to restore the normal passage of food, bile, or digestive secretions.

Stent placement provides rapid symptom relief and may be used as a temporary or long-term treatment, depending on the underlying condition.

Clinical Highlights

Self-expanding metal stents (SEMS) and plastic stents
Relieves malignant bile duct and digestive blockages immediately
Restores the ability to eat solid foods in esophageal or gastric obstruction
Provides palliative comfort and restores bile flow without major bypass surgery

When is Endoscopic Stent Placement Recommended?

  • Malignant bile duct obstruction (Pancreatic cancer, Cholangiocarcinoma)
  • Benign bile duct strictures
  • Oesophageal cancer causing severe difficulty swallowing
  • Gastric outlet obstruction (duodenal stenting)
  • Pancreatic cancer with obstructive jaundice
  • Colonic obstruction (bridge to surgery or palliation)
  • Post-operative bile leaks

Treatments Performed During Procedure

Biliary metal and plastic stent placement
Esophageal SEMS placement for dysphagia
Enteral duodenal stent placement for gastric emptying
Colonic self-expanding stent placement for acute bowel obstruction
Available at Narayana Hospital, Amingaon & outreach centres.
Therapeutic Intervention
15 - 30 Minutes

Argon Plasma Coagulation (APC)

Advanced Endoscopic Treatment for Gastrointestinal Bleeding & Abnormal Tissue

Anesthesia: Sedation / Endoscopy anaesthesia
Setting: Endoscopy Suite

Argon Plasma Coagulation (APC) is an advanced therapeutic endoscopic procedure that uses ionized argon gas and high-frequency electrical energy to stop bleeding and treat abnormal tissue within the digestive tract. As a non-contact technique, APC allows precise treatment while minimizing damage to surrounding healthy tissue.

It is widely used to control gastrointestinal bleeding, treat abnormal blood vessels, remove residual polyp tissue, and manage selected precancerous conditions—often avoiding the need for surgery.

Clinical Highlights

Non-contact thermal coagulation using ionized argon gas jet
Controls diffuse bleeding from radiation proctitis and vascular malformations
Ablates residual polyp margins and Barrett's esophagus tissue safely
Minimizes perforation risk due to controlled, uniform shallow depth

When is Argon Plasma Coagulation (APC) Recommended?

  • Bleeding from angiodysplasia (abnormal fragile blood vessels)
  • Gastric Antral Vascular Ectasia (GAVE / Watermelon Stomach)
  • Radiation proctitis following pelvic radiation therapy
  • Persistent or recurrent gastrointestinal bleeding
  • Bleeding after polyp removal
  • Residual or recurrent polyp tissue after EMR
  • Bleeding from selected gastrointestinal tumours
  • Selected early or precancerous gastrointestinal lesions

How is APC Performed?

  1. 1The procedure is performed during an Upper GI Endoscopy or Colonoscopy.
  2. 2The abnormal bleeding area is identified.
  3. 3A specialised flexible APC catheter is passed through the endoscope channel.
  4. 4Controlled argon plasma is applied to coagulate bleeding vessels without direct tissue contact.
  5. 5The treated area is carefully inspected for complete hemostasis before completing.
  6. 6The procedure usually takes 15 to 30 minutes.
Is the Procedure Painful?

No. APC is performed under sedation during endoscopy, ensuring complete patient comfort.

Is it Safe?

Yes. APC is exceptionally safe because energy penetration is automatically limited to 2–3 mm depth.

  • Mild temporary bloating or abdominal discomfort
  • Minor self-limiting bleeding
  • Superficial ulceration that heals normally

Frequently Asked Questions

Doctor's Clinical Advice

"Recurrent gastrointestinal bleeding or unexplained iron deficiency anaemia should never be ignored. Argon Plasma Coagulation (APC) is a safe and effective endoscopic treatment that can control bleeding, treat abnormal tissue, and often eliminate the need for more invasive surgery."

— Dr. Dipankar Das (DM Gastroenterology, IMS BHU Varanasi)
Available at Narayana Hospital, Amingaon & outreach centres.
Therapeutic Intervention
15 - 25 Minutes

PEG Tube Placement & Endoscopic Injection Therapy

Enteral Nutritional Access & Targeted Endoscopic Lesion Injections

Anesthesia: Local anaesthesia + Intravenous Conscious Sedation
Setting: Endoscopy Suite

Percutaneous Endoscopic Gastrostomy (PEG) is an endoscopic procedure to place a feeding tube directly into the stomach for patients who cannot swallow or maintain adequate oral nutrition (such as after neurological stroke, head/neck cancer, or severe neurological disorders).

Endoscopic Injection Therapy is also performed during endoscopy to inject therapeutic agents such as adrenaline for bleeding ulcers, sclerosants for varices, botulinum toxin for achalasia, or steroids for strictures.

Both procedures provide targeted, minimally invasive therapeutic solutions without requiring open surgical laparotomy.

Clinical Highlights

Direct stomach feeding tube placement without open surgery
Provides safe long-term nutrition for patients with severe swallowing impairment
Targeted local drug injection directly into gastrointestinal pathology
Comfortable recovery with family care training provided

When is PEG Tube Placement & Endoscopic Injection Therapy Recommended?

  • Patients unable to swallow safely (dysphagia after stroke, ALS, head/neck oncology)
  • Need for long-term nutritional support (> 4 weeks)
  • Aspiration pneumonia risk with oral intake
  • Bleeding ulcers requiring adrenaline injection therapy
  • Achalasia Cardia treated with botulinum toxin injection
  • Refractory strictures requiring steroid injections
Available at Narayana Hospital, Amingaon & outreach centres.
Clinical Reference Matrix

Diagnostic Checks vs. Therapeutic Interventions

Medical scopes serve two vital functions: visually detecting diseases (diagnostic) and repairing, clearing, or removing pathology (therapeutic).

Clinical ProcedureTypeCore IndicationAnesthesia LevelSetting
Upper GI Endoscopy (EGD)DiagnosticUlcers, gastritis, H. pylori, cancersThroat spray / light sedationDaycare Outpatient
Colonoscopy & PolypectomyDual-RoleScreening, bleeding, snare polyp removalConscious Sedation (IV)Daycare Outpatient
Flexible SigmoidoscopyDiagnosticLower colon, proctitis, rectal bleedingNone / MinimalClinic / Daycare
ERCP (Bile Duct & Pancreas)TherapeuticClear bile duct stones, jaundice, stentingDeep Sedation / GeneralDaycare / 24h Admit
EVL Banding (Varices Ligation)TherapeuticLigate bleeding veins in liver cirrhosisThroat spray + IV SedationEmergency or Daycare
Endoscopic HemostasisTherapeuticClips & injection for active ulcer bleedingSedation / AnaesthesiaEmergency / Inpatient
Esophageal DilatationTherapeuticCRE balloon dilatation for food pipe stricturesConscious SedationDaycare Suite
Foreign Body RemovalTherapeuticExtract bones, coins, batteries, food bolusSedation / GAEmergency Daycare
FibroScan® Liver ElastographyDiagnosticQuantify liver scarring (LSM) & fat (CAP)None (Non-invasive)OPD Consultation Room
Capsule EndoscopyDiagnosticSmall bowel bleeding, obscure anaemiaNone (Swallowable pill)At-Home Wireless
Preparation Guidelines

The Patient Preparation Journey

Proper preparation ensures high-definition diagnostic clarity and complete patient safety. Follow these clinical steps before your appointment.

01

24 Hours Prior

Begin clear liquid diet if undergoing colonoscopy. Take bowel preparation solution (PEG) as prescribed to thoroughly cleanse the colon. For upper GI procedures, eat a light, non-fat dinner.

02

6-8 Hours Prior

Start strict fasting (NPO). No solid food, tea, coffee, or milk. Water should be withheld completely for 4-6 hours prior to sedation.

03

Arrival & Prep

Arrive at the clinic/hospital 1 hour before your slot with an adult attendant. An intravenous cannula is placed for sedation. Vital signs (BP, Pulse, Oxygen) are clinically mapped.

04

The Procedure

You lie comfortably on your left side. Local throat spray or conscious sedation is administered. High-definition endoscopy or intervention is performed gently.

05

Recovery & Report

Rest in recovery for 30–60 minutes. Dr. Dipankar Das reviews the findings with you and your family, explains preliminary reports, and prescribes any necessary medications.

Book an Expert Evaluation

Consult Dr. Dipankar Das for Advanced Endoscopy & GI Care

Available for clinical consultations and specialized procedures across Guwahati (Narayana Superspeciality Hospital), Hojai (HAMM Hospital), and regional outreach centres.

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