Gastroenterology Hepatology & Endoscopy Division

Division of

Gastroenterology / Hepatology & Endoscopy

1- GI-Endoscopy Unit:

A well-recognized Unit by most physicians in the Kingdom and Middle East with its state of the art equipment blended with vast skillful experience in the field of therapeutic endoscopy, to which patients are referred from almost all cities of Kingdom, neighboring countries and various hospitals in Jeddah.

The unit has just been renovated, expanded into three endoscopic procedure rooms, private recovery rooms & two large recovery rooms. Each holds up to 5 patients and supplied with all safety monitors and comfort facilities and supplied with the newest generation of endoscopy instruments (electronic video). This was complimented with 6mm/video endoscope for transnasal ultrathin endoscopy and for scoping infants whose weight is less than 10 Kgs, and 230 cm enteroscope for small bowel endoscopy and capsule endoscopy.

Our unit is famous in its capabilities to handle the most challenging therapeutic endoscopic procedures (ERCP, none variceal and variceal bleeding, strictures dilation and stenting, polypectomy, foreign body removal, etc.), and we are one of the few referral centers in the Kingdom with high experience in the use of Cyanoacrylate injection therapy for massive Gastroesophageal variceal bleeding, and one of the few centers which uses various expandable metal stents for the esophageal, pyloric, dudenal, colonic & biliary tumor palliation. Furthermore, all therapeutic endoscopic procedures mentioned above have also been performed in pediatric population beginning with infancy.

We were the first center in the Middle East Certified by the ASGE (American Society for Gastrointestinal Endoscopy) to perform endoscopic anti reflux therapy for the management of GERD.

In 2005 Argon plasma coagulator was added to our various therapeutic endoscopic modalities for the management of various GI bleeding lesion and for tumor ablation.

We have also started utilizing Endoscopic Ultrasonography (EUS) service will be soon available with all its spectrum including radial imaging, linear array for interventional EUS (FNA, drainage of pancreatic pseudocys, nerve plexus ablation,...etc.) and mini probe together with colored doppler imaging for evaluating adjacent vascular supplies.

We will also be the first center in the kingdom to use the capsule technique to take live images of the small bowels by using a small capsule swallowed by the patient which sends its images wirelessly to a remote receiver held by the patient.

2- GI physiology Lab:

The GI physiology lab. is a non invasive laboratory dedicated to the evaluation of gastroesophageal reflux as well as other gastrointestinal motility disorders.

This state-of-the-art diagnostic facility offers comprehensive motility and pH testing and features a specialized team responsible for the evaluation and interpretation of all studies.

The GI Physiology Lab strives to provide technically accurate tests with a clinically relevant interpretation. Interpretations are given directly to the referring physician and to the patient as well.

We offer the following GI tests:

Esophageal Manometry

a.) Esophageal manometry analyzes the amplite and propagation of peristalsis during dry and wet swallowing, as well as the pressure of the lower esophageal sphincter before and during swallowing. During this procedure, pressure measurements are obtained simultaneously from multiple locations in the esophagus.

Esophageal manometry is one of the most commonly used in the evaluation of dysphagia, chest pain and in the preoperative assessment of motility before anti-reflux procedures.

In general, non-cardiac pain should not be considered unless a cardiac cause if first excluded.

Pharyngeal_Manometry

There are many methods used to evaluate the oropharyngeal swallow. The most commonly used radiographic method is the modified barium swallow, or videofluoroscopic swallowing study. Occasionally, these studies cannot distinguish impaired UES opening from poor UES relaxation. Pharyngeal and upper sphincter manometry can detect failure of UES relaxation and the relative coordination of the pharyngeal contraction with cricopharyngeal relaxation.

b.) Conventional 24-hour Esophageal and Gastric pH Monitoring and wireless 48 hours study of the esophageal PH

This test is most commonly used to evaluate patients with reflux symptoms refractory to therapy. Also, it is useful to demonstrate an association between reflux and pulmonary symptoms; ENT symptoms or chest pains; to document reflux prior to anti-reflux surgery; to evaluate patients after surgery who are suspected of having ongoing abnormal reflux.

Conventional Technique:
Esophageal manometry must first be done to locate the lower esophageal sphincter. A thin catheter is then placed through the nose into the esophagus and taped in place. The patient resumes normal activity for 24 hours while the amount of acid in the esophagus is measured in 2-3 different locations. The patient returns the next day to have the data analyzed.

Wireless Technique (BRAVO System):

This state of the art device, the 1st set to be brought to the middle east, is done by implanting a small capsule at the distal esophagus endoscopically, then the patient carries the receiver on the belt or in the pocket. This electronic capsule transmit the data it gets from the esophageal PH into the receiver wirelessly and for 48 hours. Then patient returns the receiver for analysis of the data. the capsule will spontaneously be expelled with the stool. the advantages of this modern technique: a) convenient with no wire getting out of the nose. b) does not intervene with life activity & business. c) it records data for 48 hours instead of 24 hours which increases its accuracy.

This test can be done either while off acid suppressive medication or it may be performed on medication to document the degree of acid suppression of a patient who is unresponsive to typical drug doses.

Esophageal pH recording is not recommended in the presence of esophagitis, esophageal strictures, esophageal varices or active bleeding.

3- Hepatology Section:

Thanks to our advanced and modern laboratory that performs all virological (including PCR for HCV RNA and HBV DNA), serological and auto-immune tests, all acute and Chronic liver diseases are taken care in our section, for the last ten years, hundreds of patients with types & stages of hepatitis and with their various presentations and complications have been treated successfully. Besides, with the help of our interventional Radiology service radio frequency tumor ablation is done for primary hepatocellular carcinoma or metastatic lesions of limited number & sizes.

4- Academic Achievement:

Since 1985, more than 29 papers and clinical studies have been completed and presented in well known domestic and international meetings [e.g. SGA (Saudi Arabia); ACG, AGA & ASGE (USA)] on various clinical and endoscopic subjects (e.g. GERD, H. Pylori, UGI bleeding (both variceal and nonvariceal bleeding), large biliary stones, biliary stenting, Hepatitis C, etc.