What is gastrointestinal intervention?

Gastrointestinal intervention refers to a range of minimally invasive procedures used to diagnose, treat, and manage diseases and conditions affecting the gastrointestinal (GI) tract.

Purpose of Gastrointestinal Interventions

• Diagnosis: To obtain biopsies, detect abnormalities, and diagnose conditions such as tumors, ulcers, strictures, and bleeding.
• Treatment: To manage conditions like gastrointestinal bleeding, blockages, cancers, and infections.
• Palliation: To relieve symptoms and improve quality of life in patients with incurable diseases.
• Nutritional Support: To place feeding tubes in patients who cannot eat by mouth.

What are the common gastrointestinal interventions?

1. Endoscopic Procedures:
Endoscopy involves the use of a flexible tube with a camera (endoscope) to visualize the GI tract and perform various therapeutic interventions.

• Esophagogastroduodenoscopy (EGD): Examines the esophagus, stomach, and duodenum. Used for biopsies, treating bleeding ulcers, and removing foreign bodies.
• Colonoscopy: Examines the colon and rectum. Used for polyp removal, biopsy, and treatment of bleeding lesions.
• Endoscopic Retrograde Cholangiopancreatography (ERCP): Combines endoscopy and fluoroscopy to diagnose and treat conditions of the bile ducts and pancreas, such as removing bile duct stones and placing stents.

2. Percutaneous Procedures:
Percutaneous procedures are performed through the skin using needles and imaging guidance (such as ultrasound or CT) to access the GI tract.

• Percutaneous Endoscopic Gastrostomy (PEG): A feeding tube is placed into the stomach through the abdominal wall, guided by endoscopy. Used for patients who need long-term nutritional support.
• Percutaneous Transhepatic Cholangiography (PTC): Involves inserting a needle through the liver to access the bile ducts, often used for drainage or stent placement in obstructed bile ducts.

3. Image-Guided Interventions:
These procedures use imaging techniques to guide the intervention accurately.

• Balloon Dilation: Using fluoroscopy or endoscopy, a balloon is inflated to dilate strictures (narrowed areas) in the GI tract, such as esophageal strictures.
• Stent Placement: Metal or plastic stents are placed to keep narrowed or blocked sections of the GI tract open, such as esophageal, biliary, or colonic stents.
• Gastrostomy and Jejunostomy: Tube placements for feeding or drainage, often done using endoscopic or radiologic guidance.

4. Embolization:
Embolization involves blocking blood vessels to control bleeding or reduce blood flow to certain areas.

• Transarterial Embolization (TAE): Used to control GI bleeding from conditions like ulcers, tumors, or varices by injecting materials to block the bleeding vessels.
• Selective Internal Radiation Therapy (SIRT): Involves injecting radioactive microspheres into the hepatic artery to treat liver tumors.

What are the benefits of gastrointestinal interventions?

• Minimally Invasive: Reduced recovery time, less pain, and fewer complications compared to open surgery.
• Targeted Treatment: Directly addresses the affected area, providing effective management of symptoms and conditions.
• Diagnostic Accuracy: Allows for direct visualization and biopsy of suspicious areas, leading to accurate diagnosis.
• Palliative Care: Helps manage symptoms and improve quality of life in patients with advanced or incurable GI diseases.