Clinic in Hepatology and Gastroenterology

Clinic in hepatology and gastroenterology is a part of Charité in Berlin.The clinic is specialized in the treatment of liver diseases. Particular attention is paid to the treatment of Hepatitis B and C, liver cirrhosis caused by infection, alcohol abuse or diseases arising from other complications.Clinic in hepatology has a unique experience in radiofrequency ablation for liver carcinoma treatment and treatment of bile duct diseases. The clinic is specialized in the treatment of gastrointestinal diseases such as pancreatic and colorectal cancers.

Clinics in Hepatology in Germany

A professional Check –up program is offered for a gastrointestinal endoscopy and gastrointestinal functional diagnostics.

Clinic in hepatology and gastroenterology provides medical services to patients in functional endocrinology diagnosis, diagnosis and treatment of diabetes, thyroid gland disorders, and held special consultations with osteoporosis, diet and obesity for patients with diabetes.

Gastroenterology services:

• Advanced diagnostic and therapeutic gastrointestinal endoscopy services:
• Esophagogastroduodenoscopy
• Colonoscopy with polyp removal
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Percutaneous transhepaticcholangioscopy
• Stent implantation for gastrointestinal tract (esophagus, stomach and duodenum)
• Endoscopic drainage for pancreatic pseudocyst
• Functional gastrointestinal diagnosis for:
• Helicobacter pylori Urea Breath Test
• Lactose and glucose tolerance test
• Endosonography (EUS)
• Manometry
• Special consultations in Crohn’s disease
• Special consultations in nonspecific ulcerative colitis

 

Helicobacter pylori Urea Breath Test

A bacterium Helicobacter Pylori can cause many gastrointestinal diseases.

Helicobacter, a gram-negative bacterium, shows a high urease activity. Consumption of alcohol or medicaments, but also stress offer favourable conditions for penetration of bacterium into the stomach walls and duodenum.

Helicobacter Pylori infection most often occurs in childhood and can be confused with mild clinical symptoms of food poisoning.In the future, the infection becomes chronic and causes under certain conditions, gastritis and gastroduodenitis.Not excluded is the role of H. pylori in the development of erosive and ulcerative lesions of the gastric mucosa and duodenum.

It is possible to find Helicobacter Pylori by biopsy of the gastric mucosa done during the endoscopy.Sometimes the indirect diagnostic method is used to determine antibodies against H. pylori.

The test cannot be done if the patient takes antibiotics, antisecretory, anti-inflammatory drugs, antacids and analgesics. The examination can be done after 2 weeks break without antisecretory drugs and antibiotics.After receiving these drugs the break must be at least 5 days.

The test procedure is as follows: the patient has to breathe into the plastic respiration tube.The tube is to be held deep into the mouth.The breathing should be normal with an open mouth.In case of temporary discomfort the pipe can be removed from the mouth. The examination can continue 6 minutes later after the patient takes a substance of urea.For the next 6 minutes he has to breathe into the tube.It is necessary at this stage to eliminate saliva inside the tube.Otherwise, the study can be repeated no sooner than in 40-60 minutes.Next, the tube can be given to the doctor and he can analyse the activity of H. pylori.

Hepatology

• Sonography, Duplex sonography
• Various types of liver biopsy
• Laparoscopy
• Percutaneous ethanol (alcohol) injection for hepatocellular carcinoma (less than 3)
• Portal venous stent placement for portal hypertension treatment
• Endoscopic sclerotherapy and ligation for bleeding esophageal varices
• Special consultation for our patients on viral hepatitis
• Special consultation on hepatocellular carcinoma
• Percutaneous radiofrequency thermal ablation for hepatocellular carcinoma
• Special consultation on liver transplantation

Endocrinology / Diabetology

• Diagnostics of endocrine function
• Diseases of hormone imbalance
• Diabetes: diagnosis and treatment
• Diagnosis of thyroid disease
• Special Tipps on osteoporosis treatment and diagnosis
• Special Diet Counselling
• Obesity
• Health consultation

Crohn’s Disease treatment in Germany

Crohn’s disease is an inflammatory disease affecting mainly the large intestine and sometimes also other parts of the gastrointestinal tract.The etiology of Crohn’s disease has not yet been studied completely therefore the disease considered incurable. The treatment with special drugs allows in 60% of all cases to achieve complete remission.In general, this disease is characterized by inflammation of the colon sections (and its mucosal muscle layer), and subsequently the development of local and systemic symptoms.

Treatment of Crohn’s Disease in Germany

Crohn’s disease symptoms are frequent and prolonged abdominal pain and cramping (sometimes more than 2 months), right iliac fossa pain. The pain is often combined with severe intoxication and body weight loss (due to reduced appetite, ability to digest and absorb food). You may have fever due to inflammation and feel tiered.The disease is accompanied by nausea, vomiting, blood in your stool (or hidden bleeding), and mouth sores, perianal lesions (cracks, abscesses, fistulas).Crohn’s disease most commonly affects the oral cavity, esophagus, gastric mucosa, small intestine.The mucosa and muscle layer of the colon are commonly infected.

Complications of Crohn’s disease can be scarring and narrowing (stenosis) and bowel obstruction. The intestinal wall can thicken and prevent digestive contents flow. The surgery may be necessary to remove the affected part of the bowel. Chronic inflammation can cause ulcers – open sores in the mouth, around the anus and also inside the genital area. Crohn’s disease can lead also to fistulas, abnormal connection growing between different parts of the body. The most common fistulas arise around the anal area. Fistulas can become life-threatening in form of infected abscess and have to be treated.

Further complications caused by Crohn’s disease are anal fissure (small tissue or skin tear around the anus), malnutrition due to diarrhoea (anaemia due to low iron or vitamin B-12).

Also colon cancer is occurring from this disease. People suffering from Crohn’s disease have to make colonoscopy every 10 years or more frequently. Crohn’s disease can also lead to other health problems like, osteoporosis, anaemia, and gallbladder and liver diseases.

 Video about the treatment of Crohn’s disease:

Conservative treatment of Crohn’s disease in Germany uses therapies with following medications: mesalazine, prednisone, and methotrexate.Antibiotics and medicines are prescribed to suppress the immune response during attacks.

Sometimes there is a destruction not only of the large intestine, but also of the small intestine, often diagnosed through bowel obstruction. Bowel obstruction is accompanied by cicatricle stenosis which is caused by peptic ulcer disease. Direct indications for operative treatment are gastrointestinal fistula resection and bowel obstruction surgical treatment. Intestinal anastomosis and gastric bypass surgery are suitable in this case.

The colonic form of the disease leads to local lesions of muscle and mucosa. The hepatology and gastroenterology clinic in Germany applies segmental resection (removal of the affected part) in the presence of strictures – strictureplasty and coloprotectomy.