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- Dubai Health Care City, Dubai, UAE
Digestive Health & Endoscopy Consultants in Dubai Health Care City
Wael Dahhan, MD, FACG
American Board Certified in Gastroenterology
Dr. Dahhan is American Board Certified in Gastroenterology. He has extensive clinical experience both from USA and UAE over the past 15 years.
He completed his Gastroenterology Fellowship at Yale University, New Haven, CT, USA. He pursued further Fellowship training in Advanced & Interventional Endoscopy at BIDMC, Harvard University, Boston, MA, USA.
After finishing his specialty fellowships in prestigious US universities and Hospitals, he joined one of the largest gastroenterology groups in South East Michigan where he had engaged in a Consultancy GI/ Hepatology busy practice for five years before moving to Dubai, He built an excellent professional reputation in his field in UAE over the past 10 years.
Dr. Dahhan provides care for common digestive diseases as well as in depth investigations for difficult GI conditions. He is one of the few Consultants in the Middle East who had formal fellowship training and expertise in liver diseases. His high quality performance of routine and advanced endoscopic procedures is well known in the region, including upper endoscopy, colonoscopy, ERCP, capsule endoscopy, esophageal PH and motility studies, Enteroscopy and liver biopsy.
He is a Fellow member in ACG, and member in ASGE, AGA. He is a regular speaker in national and international medical conferences.
A unique Gastroenterology Center providing a specialized care and services in the diagnosis and management of Digestive and Liver Diseases coupled with state of the art Endoscopy suite, all in one place.
Digestive Health & Endoscopy Consultants
Digestive health and endoscopy consultants specialize in treating various gastrointestinal conditions.
The website specially designed for their patients and provides comprehensive information on gastrointestinal conditions and treatments treated by the doctors. In addition to this, the site provides information on various Endoscopy procedures, appointments, driving directions, contact details and much more.
At Digestive Health and Endoscopy Consultants we provide diagnosis and treatment for gastrointestinal conditions associated with the esophagus, stomach, pancreas, colon, rectum, liver and gall bladder. Our comprehensive and focused approach to our patients along with the state-of-the-art-facility ensures that each of our patients gets the best possible outcome.
Upper GI Endoscopy
Understanding Upper Endoscopy
What is upper endoscopy?
Upper endoscopy lets your doctor examine the lining of the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). Your doctor will use a thin, flexible tube called an endoscope, which has its own lens and light source, and will view the images on a video monitor. You might hear your doctor or other medical staff refer to upper endoscopy as upper GI endoscopy, esophagogastroduodenoscopy (EGD) or panendoscopy.
Why is upper endoscopy done?
Upper endoscopy helps your doctor evaluate symptoms of persistent upper abdominal pain, nausea, vomiting or difficulty swallowing. It’s the best test for finding the cause of bleeding from the upper gastrointestinal tract. It’s also more accurate than X-ray films for detecting inflammation, ulcers and tumors of the esophagus, stomach and duodenum.
Your doctor might use upper endoscopy to obtain a biopsy (small tissue samples). A biopsy helps your doctor distinguish between benign and malignant (cancerous) tissues. Remember, biopsies are taken for many reasons, and your doctor might order one even if he or she does not suspect cancer. For example, your doctor might use a biopsy to test for Helicobacter pylori, the bacterium that causes ulcers.
Your doctor might also use upper endoscopy to perform a cytology test, where he or she will introduce a small brush to collect cells for analysis.
Upper endoscopy is also used to treat conditions of the upper gastrointestinal tract. Your doctor can pass instruments through the endoscope to directly treat many abnormalities – this will cause you little or no discomfort. For example, your doctor might stretch (dilate) a narrowed area, remove polyps (usually benign growths) or treat bleeding.
What preparations are required?
An empty stomach allows for the best and safest examination, so you should have nothing to eat or drink, including water, for approximately six hours before the examination. Your doctor will tell you when to start fasting as the timing can vary.
Tell your doctor in advance about any medications you take; you might need to adjust your usual dose for the examination. Discuss any allergies to medications as well as medical conditions, such as heart or lung disease.
Can I take my current medications?
Most medications can be continued as usual, but some medications can interfere with the preparation or the examination. Inform your doctor about medications you’re taking, particularly aspirin products or antiplatelet agents, arthritis medications, anticoagulants (blood thinners such as warfarin or heparin), clopidogrel, insulin or iron products. Also, be sure to mention any allergies you have to medications.
What happens during upper endoscopy?
Your doctor might start by spraying your throat with a local anesthetic or by giving you a sedative to help you relax. You’ll then lie on your side, and your doctor will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope doesn’t interfere with your breathing, Most patients consider the test only slightly uncomfortable, and many patients fall asleep during the procedure.
What happens after upper endoscopy?
You will be monitored until most of the effects of the medication have worn off. Your throat might be a little sore, and you might feel bloated because of the air introduced into your stomach during the test. You will be able to eat after you leave unless your doctor instructs you otherwise.
Your physician will explain the results of the examination to you, although you’ll probably have to wait for the results of any biopsies performed.
If you have been given sedatives during the procedure, someone must drive you home and stay with you. Even if you feel alert after the procedure, your judgement and reflexes could be impaired for the rest of the day.
What are the possible complications of upper endoscopy?
Although complications can occur, they are rare when doctors who are specially trained and experienced in this procedure perform the test. Bleeding can occur at a biopsy site or where a polyp was removed, but it’s usually minimal and rarely requires follow-up. Perforation (a hole or tear in the gastrointestinal tract lining) may require surgery but this is a very uncommon complication. Some patients might have a reaction to the sedatives or complications from heart or lung disease.
Although complications after upper endoscopy are very uncommon, it’s important to recognize early signs of possible complications. Contact your doctor immediately if you have a fever after the test or if you notice trouble swallowing or increasing throat, chest or abdominal pain, or bleeding, including black stools. Note that bleeding can occur several days after the procedure.
If you have any concerns about a possible complication, it is always best to contact your doctor right away.
What is a Liver Biopsy?
A liver biopsy is a procedure whereby small pieces of liver tissue are removed in order to be sent to a laboratory for examination. It is very helpful in the diagnosis of diseases that affect the liver. The three main types of liver biopsy are percutaneous, transvenous, and laparoscopic. Other techniques for obtaining liver biopsies are with fine needle aspiration as well as open surgery.
This learning module will concentrate on the percutaneous liver biopsy with a brief overview of the other types of liver biopsies.
Types of Liver Biopsy
Alternatives to the percutaneous liver biopsy include transvenous, laparoscopic, open surgery, and fine-needle aspiration liver biopsy.
Transvenous Liver Biopsy:
Transvenous liver biopsy is used when a person’s blood clots slowly or when excess fluid is present in the abdomen, a condition called ascites.
During the procedure, patients lie on their back on an X-ray table and a local anesthetic is applied to one side of the neck. If needed, an IV tube is used to give sedatives and pain medication.
Transvenous Liver Biopsy:
A small incision is made in the neck and a specially designed hollow tube called a sheath is inserted into the jugular vein. The doctor threads the sheath down the jugular vein, along the side of the heart, and into one of the hepatic veins, which are located in the liver. To see the veins, the doctor injects liquid contrast material into the sheath. The contrast material lights up when x rayed, highlighting the blood vessels and showing the location of the sheath. The doctor threads a biopsy needle through the sheath and into the liver and a liver sample is quickly withdrawn. Several samples may be collected, requiring multiple needle insertions. The sheath is carefully withdrawn and the incision is closed with a bandage.
Transvenous Liver Biopsy:
The main drawback to this type of liver biopsy is that the tissue samples are generally small which could affect the analysis of the grading of liver inflammation scarring. The other disadvantage is the cost which can be twice the amount of a percutaneous liver biopsy.
Patients are monitored for 4 to 6 hours for signs of bleeding.
Laparoscopic Liver Biopsy:
Doctors use laparoscopic liver biopsy to obtain a tissue sample from a specific area or from multiple areas of the liver or when the risk of spreading cancer or infection exists. Laparoscopic surgery is a technique that avoids making a large incision by instead making one or a few smaller incisions. The doctor works with special tools, including a small lighted video camera passed through the tiny incisions.
A doctor may take a liver sample during laparoscopic surgery performed for other reasons, including liver surgery. A biopsy needle is inserted through the cannula and into the abdomen. The needle is inserted into the liver and a tissue sample is quickly withdrawn. Several samples may be collected, requiring multiple needle insertions. Any excessive bleeding because of the surgery is easily spotted with the camera and treated using an electric probe. After liver samples are collected, the cannula is removed and the incision is closed with dissolvable stitches.
Patients will need to remain at the hospital or outpatient center for a few hours while the sedatives wear off.
Open Surgical Liver Biopsy:
This procedure is rarely performed unless there is already an operation being performed in the general area of the liver. A small piece of liver tissue is extracted by needle or a surgical knife.
Fine-Needle Aspiration Biopsy:
A fine-needle aspiration biopsy is usually performed on patients to examine liver lesions or cancer. The procedure is performed percutaneously or endoscopically and has a very high accuracy rate since the needle is longer and can be guided to the exact location of the lesion that needs to be examined.
When is a Liver Biopsy Performed?
A liver biopsy is performed when a liver problem is difficult to diagnose with blood tests or imaging techniques, such as ultrasound and X-ray.
More often, a liver biopsy is performed to estimate the degree of liver damage, a process called staging. Staging helps guide treatment for liver disease.
How to Prepare for a Liver Biopsy
At least 1 week before a scheduled liver biopsy, patients should inform their doctor of all medications they are taking. Patients may be asked to temporarily stop taking medications that affect blood clotting or interact with sedatives, which are sometimes given during a liver biopsy.