Author name: Dr. Rathod Medical Foundation

When a foreign object gets swallowed or stuck in the GI tract, the endoscope is almost always the first and only intervention needed. A flexible camera goes in through the mouth or, in colonic cases, from below, locates the object under direct vision, and retrieves it using tools passed through the instrument channel without a single cut. Around 80 to 90% of swallowed foreign bodies pass spontaneously, but the ones that don’t, particularly sharp objects and batteries in the oesophagus, need prompt endoscopic attention. According to Dr. Vipulroy Rathod, Gastroenterologist in Mumbai, “Button batteries are the ones that keep me up at night. They can cause severe oesophageal burns within two hours of impaction, and families often wait and watch before coming in. Everything else can usually wait until morning. A battery stuck in the oesophagus cannot.” How Is the Procedure Performed? The technique adapts to the object, and the endoscopist’s toolkit covers most situations the scope can reach. Rat-tooth forceps, snares, and retrieval nets are the standard tools, chosen based on the object’s shape and surface something smooth and round needs a net, something flat or fragmented needs forceps, something lodged in a narrow segment needs a snare. For sharp objects like fish bones or razor blades, an overtube is placed over the scope before insertion, so the sharp edge can be drawn into the tube during withdrawal and pulled out without tearing the oesophageal wall. Coins and food boluses sitting in the oesophagus are among the most common presentations and usually come out cleanly in a single pass, with the procedure over before the patient has fully woken from sedation. Button batteries need a different urgency entirely. Once confirmed on X-ray as sitting in the oesophagus, they go straight to emergency endoscopy, and the retrieval technique prioritises speed over everything else. Once the object is out and the mucosa inspected for damage, a specialist in foreign body removal assesses whether any secondary treatment is needed for burns, lacerations, or perforation risk before discharge. What Affects the Outcome? Most removals go smoothly, but a few variables shape how straightforward or complex the procedure turns out to be. Time matters for batteries and sharp objects. The longer a battery sits in the oesophagus, the more tissue damage accumulates, and a delayed presentation that might have been a clean removal becomes a mucosal repair case. Location changes the technical difficulty. Objects in the oesophagus are usually more accessible than those in the stomach or small bowel, and deeper objects that have passed the pylorus are monitored conservatively unless they’re sharp or causing symptoms. Object characteristics determine tool selection. A smooth marble and a jagged piece of bone require different retrieval approaches, and misjudging the grip means the object slips and has to be repositioned, adding time and procedural steps. Perforation risk rises with attempted passage of sharp objects through narrowed segments or around bends, which is why imaging before endoscopy helps map the position and decide the safest route of withdrawal. Understanding how endoscopy functions as both a diagnostic and treatment tool helps put foreign body removal in context alongside its other roles. Read more on role of endoscopy to see how the same flexible scope that retrieves foreign bodies also diagnoses and treats a wide range of GI conditions. Why Choose Dr. Vipulroy Rathod for Foreign Body Removal? Dr. Vipulroy Rathod has been performing therapeutic endoscopy at Fortis Hospital Mulund for over 30 years, including complex foreign body retrievals involving sharp objects, impacted dentures, batteries, and oesophageal food boluses. That experience means difficult cases, including those referred after failed attempts elsewhere, get handled with the technique and judgment the situation requires. Physicians from 35 countries have trained under his approach at Fortis. Book your consultation today with one of India’s most experienced specialists for endoscopic foreign body removal and therapeutic endoscopy. Book Appointment Call now Frequently Asked Questions How does endoscopic foreign body removal work? The endoscopist passes a flexible scope into the GI tract, locates the object under direct vision, and retrieves it using forceps, a snare, or a basket without any incision. Which foreign bodies need urgent removal? Button batteries and sharp objects in the oesophagus need removal within hours due to the risk of burns, perforation, and serious mucosal injury. Is endoscopic foreign body removal safe? Yes. It is minimally invasive, performed under sedation, and avoids surgery in the vast majority of cases, with complications being uncommon in experienced hands. What if the foreign body cannot be removed endoscopically? Surgical removal becomes necessary when the object is too large, too deeply embedded, or inaccessible, though this is needed in fewer than 5% of cases. Reference Overtube-Assisted Foreign Body Removal: A Review of Endoscopic Management — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707170/ Removal of Foreign Bodies in the Upper GI Tract: ESGE Clinical Guideline — Endoscopy/PubMed, https://pubmed.ncbi.nlm.nih.gov/26862844/

Colonoscopy reaches the colon and terminal ileum well, but a large stretch of small bowel between those two points stays largely invisible to it. The gap capsule endoscopy fills a camera the size of a pill that the patient swallows, which transmits images of the entire small bowel to a recorder worn around the waist. In IBD, particularly Crohn’s disease, it’s this segment that gets missed most often and investigated last, which is exactly where the capsule changes the clinical picture. According to Dr. Vipulroy Rathod, Gastroenterologist in Mumbai, “Capsule endoscopy picks up small bowel Crohn’s disease that colonoscopy and CT scans have both missed. Patients who’ve had unexplained anemia, weight loss, or abdominal pain for months with normal previous investigations often get a clear answer from a capsule study that nobody thought to do earlier.” When Is Capsule Endoscopy Used in IBD? Four situations in IBD practice consistently push the clinical decision toward a capsule study. Suspected small bowel Crohn’s with negative colonoscopy is the clearest indication. Up to 30% of Crohn’s patients have disease limited to the small bowel, and the capsule reaches those segments with a diagnostic yield that beats both CT and barium studies. Monitoring mucosal healing after treatment matters more now that deep remission is the target in Crohn’s management, and the capsule gives a direct mucosal view of segments that no external imaging assesses with enough resolution to count. Obscure GI bleeding in a patient with known IBD often points toward small bowel involvement, and when upper and lower endoscopy come back clean, the capsule is the next logical step rather than another round of cross-sectional imaging. Assessing post-operative recurrence after bowel resection in Crohn’s disease, particularly at the neo-terminal ileum, is a setting where the capsule adds detail that colonoscopy alone doesn’t provide for segments proximal to the anastomosis. These decisions sit within the broader framework of endoscopic IBD management, and a specialist in IBD management weighs which investigation fits the patient’s specific presentation. What Are the Limitations and Risks? Capsule endoscopy is powerful but not without conditions that limit its use. Capsule retention is the main risk. If the bowel is narrowed by a stricture, the capsule can get stuck, and a patency capsule or cross-sectional imaging beforehand checks whether the passage is clear enough to proceed safely. The capsule cannot take biopsies or treat what it finds, so any suspicious lesion it identifies still needs a follow-up procedure to sample tissue or deliver therapy. Bowel preparation affects image quality, and an inadequately prepared small bowel produces images that are harder to read and easier to misinterpret, making patient adherence to the prep protocol essential. Not every patient swallows it easily. Those with known oesophageal strictures or severe dysphagia sometimes need the capsule placed endoscopically rather than swallowed, which adds a step but doesn’t change the imaging itself. Understanding how colonoscopy fits alongside the capsule for IBD diagnosis helps clarify which tool does what. Read more on Crohn’s detection to understand what colonoscopy finds in Crohn’s disease and where it hands over to the capsule. Why Choose Dr. Vipulroy Rathod for Capsule Endoscopy? Dr. Vipulroy Rathod has been using capsule endoscopy as part of his IBD and small bowel practice at Fortis Hospital Mulund for over two decades, and the patients who reach him have often already had colonoscopy and CT without a clear answer. That experience means the clinical picture gets read correctly, the right preparatory steps are taken, and the capsule findings are interpreted in context rather than in isolation. Physicians from 35 countries have trained under his approach at Fortis. Book your consultation today with one of India’s most experienced specialists for capsule endoscopy and IBD assessment. Book Appointment Call now Frequently Asked Questions What is capsule endoscopy? A pill-sized camera swallowed by the patient that travels through the digestive tract and transmits small bowel images to a recorder worn around the waist. When is capsule endoscopy used for IBD? It is used when colonoscopy cannot reach suspected small bowel Crohn’s, when monitoring mucosal healing, or when obscure bleeding points to small bowel involvement. Can capsule endoscopy diagnose Crohn’s disease? Yes. It detects ulcers, erosions, and inflammatory changes in the small bowel that colonoscopy cannot reach, making it valuable for diagnosing and monitoring small bowel Crohn’s. What are the risks of capsule endoscopy? The main risk is capsule retention in a narrowed bowel segment, so patients with suspected strictures are assessed with a patency capsule or imaging first. Reference Capsule Endoscopy for Crohn’s Disease: Current Status of Diagnosis and Management — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706954/ Capsule Endoscopy Findings for the Diagnosis of Crohn’s Disease — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394710/

Jaundice, the yellowing of the skin and eyes, signals a build-up of bilirubin that the body isn’t clearing properly. The causes range from harmless and short-lived to genuinely dangerous, spanning bile duct stones, hepatitis, cirrhosis, and cancers of the pancreas or bile duct. What determines how worried to be is rarely the yellowing itself but what comes with it, particularly pain, fever, weight loss, or a change in the colour of urine and stool. According to Dr. Vipulroy Rathod, Gastroenterologist in Mumbai, “Jaundice always needs a cause identified, never just observation. Sometimes it’s a bile duct stone we can clear endoscopically in an afternoon, and sometimes it’s the first sign of pancreatic or bile duct cancer. The difference between those matters enormously, which is why painless jaundice in particular should never be waited out.” What Causes Jaundice in Adults? Jaundice in adults sits in one of three categories, and getting the right one matters because the investigation and treatment differ entirely. A stone sitting in the bile duct backs up into the bloodstream, turns the skin and eyes yellow, darkens the urine, and drains colour from the stool — and unlike most other causes, it can be cleared endoscopically in a single session once identified. What liver disease does to bilirubin depends on how badly the liver is damaged. Hepatitis, cirrhosis, and alcohol injury all reduce how efficiently the liver processes bilirubin, and the jaundice here often comes alongside fatigue, bruising, and other signs that the organ is struggling. Not every jaundice patient has a blocked duct or a damaged liver. Some have increased red cell breakdown, as seen in certain anaemias, which floods the system with more bilirubin than even a healthy liver can clear in time. Pancreatic, bile duct, or gallbladder cancers need naming separately because they block the bile duct silently, and painless jaundice accompanied by weight loss in someone over 50 is a cancer workup until a scan says otherwise. Sorting out which mechanism is behind the jaundice is where a biliary stone extraction specialist runs the right investigation rather than treating on assumption. When Is Jaundice Serious? The yellow skin is rarely what makes jaundice dangerous. It’s what else is happening at the same time. Painless jaundice with weight loss is the most important red flag in GI medicine. No pain does not mean no problem, and this combination belongs in a cancer workup immediately, not in a wait-and-watch queue. Cholangitis is what fever and severe pain alongside jaundice means until proven otherwise, and it’s an infected, obstructed bile duct that can turn life-threatening within hours without emergency drainage. If the urine has gone dark and the stools have turned pale, bile isn’t reaching the gut and something is blocking its passage, which needs urgent imaging rather than observation over a few days. Confusion or drowsiness coming on with the jaundice means bilirubin may be high enough to affect the brain or that liver failure is progressing, and this belongs in emergency care rather than an outpatient queue. Most obstructive causes can now be relieved endoscopically without surgery, often in the same procedure that diagnoses them. Read more on ERCP procedure to understand how bile duct obstruction causing jaundice is cleared endoscopically. Why Choose Dr. Vipulroy Rathod for Jaundice? Dr. Vipulroy Rathod has been diagnosing and treating the causes of jaundice at Fortis Hospital Mulund for over 30 years, with more than 20,000 EUS procedures and extensive ERCP experience behind him. That combination means an obstructing stone or tumour gets identified accurately and, in most cases, relieved endoscopically in the same session rather than through open surgery. Physicians from 35 countries have trained under his approach at Fortis. Book your consultation today with one of India’s most experienced specialists for jaundice assessment and endoscopic biliary treatment. Book Appointment Call now Frequently Asked Questions What causes jaundice in adults? Jaundice comes from raised bilirubin, caused by bile duct obstruction from stones or tumours, liver disease like hepatitis or cirrhosis, or increased red cell breakdown. When is jaundice serious? It is serious with fever, severe abdominal pain, weight loss, or dark urine and pale stools, as these can indicate obstruction, infection, or cancer. Can jaundice be a sign of cancer? Yes. Painless jaundice with weight loss can signal pancreatic, bile duct, or gallbladder cancer blocking the bile duct, which needs prompt investigation. How is jaundice treated? Treatment depends on the cause. Bile duct obstruction is often relieved endoscopically through ERCP, while liver-related jaundice is treated medically. Reference Endoscopic Retrograde Cholangiopancreatography for Choledocholithiasis and Obstructive Jaundice — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665873/ Evaluation of Jaundice in Adults — American Family Physician/NCBI, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5228380/

Difficulty swallowing, known medically as dysphagia, ranges from a harmless occasional sensation to an early warning of something serious. It can stem from acid reflux scarring, a muscle disorder like achalasia, inflammation, or in the cases that matter most, oesophageal cancer. What separates a benign cause from a dangerous one is often the pattern, particularly whether the difficulty is getting steadily worse and whether solid food is starting to stick. According to Dr. Vipulroy Rathod, Gastroenterologist in Mumbai, “Most patients treat swallowing difficulty as an inconvenience and wait it out, which is exactly the wrong instinct. Food sticking on the way down is never normal, and while the cause is often something treatable like a reflux stricture, it can also be the first sign of an oesophageal cancer that we’d much rather catch early.” What Causes Difficulty Swallowing? The cause behind dysphagia sets both how urgent it is and how it gets treated, and four stand out in clinical practice. Reflux strictures are the most common cause seen in the clinic. Years of acid exposure scar the lower oesophagus into a narrowing, and solid food begins catching where it never used to. Achalasia works differently. The lower oesophageal sphincter stops relaxing, food banks up above it, and patients describe a sensation of something lodged in the chest after nearly every meal. In younger patients with no reflux history, oesophageal inflammation from eosinophilic oesophagitis or infection is often the culprit, making swallowing both painful and difficult. The cause nobody can afford to miss is oesophageal cancer. A tumour narrowing the food pipe produces dysphagia that begins with solids and worsens steadily over weeks, which is exactly why progressive symptoms need a scope. Telling these apart is where an oesophageal cancer specialist directs the right investigation instead of treating on assumption. When Is Swallowing Difficulty Serious? Some patterns shift dysphagia from a nuisance into a red flag, and recognising them early is what changes the outcome. Progressive difficulty is the clearest warning sign. Trouble that starts with solids and marches on to soft foods and then liquids over a few weeks points hard toward a structural cause needing urgent evaluation. Weight loss alongside it changes everything. Dysphagia paired with unintended weight loss is one of the strongest signals of oesophageal cancer, and it should never be managed at home. Food genuinely getting stuck, not just moving slowly, is a mechanical sign of real narrowing, and whether the cause is a benign stricture or a tumour, only direct visualisation separates the two. Bleeding, anaemia, or new chest pain appearing with swallowing difficulty pushes the urgency higher still, and these belong in a timeline measured in days. Serious causes like achalasia now have minimally invasive endoscopic solutions that once required major surgery. Read more on POEM procedure to understand how achalasia and other swallowing disorders are treated endoscopically without open surgery. Why Choose Dr. Vipulroy Rathod for Swallowing Difficulty? Dr. Vipulroy Rathod has been evaluating and treating dysphagia at Fortis Hospital Mulund for over 30 years, across the full range of causes from reflux strictures and achalasia to early oesophageal cancer. His endoscopy and EUS practice means the cause is pinned down accurately and, where possible, treated in the same session rather than referred onward. Physicians from 35 countries have trained under his approach at Fortis. Book your consultation today with one of India’s most experienced specialists for swallowing difficulty assessment and endoscopic treatment. Book Appointment Call now Frequently Asked Questions What causes difficulty swallowing? Reflux strictures, achalasia, oesophageal inflammation, neurological conditions, and in serious cases oesophageal cancer can all cause it, so persistent symptoms need evaluation. When is difficulty swallowing serious? It is serious when progressive, when solid food sticks, or when it comes with weight loss or bleeding, as these can indicate a stricture or cancer. Can acid reflux cause swallowing difficulty? Yes. Long-standing reflux can scar and narrow the lower oesophagus into a stricture, causing food to stick, and can lead to Barrett’s oesophagus over time. How is difficulty swallowing diagnosed? Upper GI endoscopy is the main test, allowing direct visualisation and biopsy, with manometry or barium swallow added to assess motility disorders like achalasia. Reference Dysphagia: Evaluation and Diagnosis — American Family Physician/NCBI, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233111/ Achalasia: Diagnosis and Management — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6182129/

Diet is one of the few colorectal cancer risk factors a person can actually change, and over the years it adds up. Red and processed meat, low fibre, excess weight, and alcohol all push risk upward across study after study. Fibre-rich eating and a healthy weight pull it back down. None of this guarantees prevention, but among the things within a patient’s control, diet carries real weight. According to Dr. Vipulroy Rathod, Gastroenterologist in Mumbai, “Colorectal cancer isn’t just a screening problem, it’s partly a lifestyle problem, and the dietary patterns that drive it are the same ones driving metabolic disease more broadly. Patients who ask what they can do beyond getting scoped regularly are asking exactly the right question, and diet is one of the most actionable answers.” Which Foods Raise Colorectal Cancer Risk? Few areas of cancer research produce evidence this consistent, and a handful of dietary patterns turn up as risk-raisers again and again. Eating red meat daily raises risk through haem iron and the compounds formed when meat is cooked at high heat, and the link holds across studies from India, Europe, and North America alike. Processed meat is the clearer culprit. Bacon, sausages, salami, and deli meats carry the strongest evidence of all, and even modest regular intake nudges risk upward measurably. Alcohol matters at any level, with the risk climbing steadily the more regularly someone drinks rather than needing heavy consumption to register. Refined carbohydrates and ultra-processed food feed obesity and low-grade inflammation in the colon, and both of those conditions raise cancer risk on their own, which makes this increasingly relevant as Indian diets urbanise. Several of these habits running together over years is what lifts individual risk to a level worth acting on, and a colorectal cancer specialist can weigh that against the rest of a patient’s clinical picture. Which Dietary Habits Lower Colorectal Cancer Risk? The protective side of the evidence is just as solid, and more useful because it’s something patients can act on directly. Eat more fibre. Vegetables, legumes, whole grains, and fruit speed bowel transit and cut the time carcinogens spend in contact with the colon lining, and the association with lower risk is remarkably consistent. If weight is the one thing you change, change that. Central obesity creates the inflammatory conditions that drive polyp formation, and reducing it lowers risk independently of any single food. Keeping red meat to two or three portions a week rather than daily brings the exposure down to a level where the risk link weakens sharply. Adequate calcium and dairy show a modest protective link in several large studies, and building enough calcium into the diet is straightforward within a broadly sensible eating pattern. Diet and gut health overlap well beyond cancer risk, shaping how chronic GI conditions behave day to day. Read more on IBD and diet to understand how dietary choices influence gut inflammation and long-term bowel health. Why Choose Dr. Vipulroy Rathod for Colorectal Cancer? Dr. Vipulroy Rathod has been managing colorectal cancer and its risk factors at Fortis Hospital Mulund for over 30 years, watching the dietary and metabolic patterns behind late diagnoses play out across his referred patients. His colonoscopy and EUS practice means that when dietary risk turns into an actual finding, assessment and treatment happen in the same workup. Physicians from 35 countries have trained under his approach at Fortis. Book your consultation today with one of India’s most experienced specialists for colorectal cancer risk assessment and endoscopic screening. Book Appointment Call now Frequently Asked Questions How does diet affect colorectal cancer risk? Diets high in red and processed meat, low in fibre, and high in refined sugars raise colorectal cancer risk, while fibre-rich plant-based diets and healthy weight lower it. Which foods increase colorectal cancer risk? Red meat, processed meat, alcohol, refined carbohydrates, and ultra-processed foods are consistently linked to higher colorectal cancer risk across large population studies. Can a healthy diet prevent colorectal cancer? Diet alone cannot guarantee prevention, but a fibre-rich diet with limited red meat and no processed meat substantially reduces risk alongside healthy weight and regular screening. Is obesity linked to colorectal cancer? Yes. Excess body weight, particularly central obesity, is an independent risk factor for colorectal cancer through the inflammation it creates in the colon over time. Reference Diet, Nutrition, Physical Activity and Colorectal Cancer — World Cancer Research Fund/NCBI, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326011/ Red Meat Consumption and Risk of Colorectal Cancer — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4698595/

Balloon dilation widens a narrowed segment of the GI tract by inflating a balloon across the stricture through an endoscope, restoring normal passage without any incision. It’s used in the oesophagus, the small bowel, and the colon depending on where the narrowing sits, and in most cases the patient goes home the same day. What the procedure feels like, how many sessions it takes, and how durable the result is all depend on what caused the stricture in the first place. According to Dr. Vipulroy Rathod, Gastroenterologist in Mumbai, “Balloon dilation is one of those procedures that patients worry about far more than they need to. Done under sedation, it’s usually over in a few minutes and the improvement in swallowing or bowel passage is often immediate. The real clinical question isn’t the procedure itself but how often it needs repeating and whether the underlying cause is being addressed at the same time.” What Conditions Does Balloon Dilation Treat? The technique applies across several GI sites, with the balloon adapted in size to the stricture and the organ being treated. Peptic oesophageal strictures from years of acid reflux scarring the lower oesophageal lining are among the most common indications, and patients who’ve been managing progressive swallowing difficulty often notice improvement within days of the first dilation. In Crohn’s disease, short fibrotic strictures of the small bowel or colon that are causing obstructive symptoms respond well, and the procedure delays or avoids the bowel resection that would otherwise be the only alternative. After bowel or oesophageal surgery, anastomotic strictures at the joint site are a common complication and often need one or more dilation sessions before the narrowing stabilises and swallowing or passage returns to normal. Achalasia-related narrowing at the lower oesophageal sphincter can be opened with balloon dilation, though larger balloons and a slightly different technique apply here compared to a standard peptic stricture. Deciding which stricture needs dilation, how large the balloon should be, and whether the underlying condition needs addressing alongside it is where a specialist in IBD management shapes the whole approach. What Happens During and After the Procedure? Patients often arrive expecting something more uncomfortable than it turns out to be. Under sedation, the endoscope goes in first to visualise the stricture directly, and the balloon catheter is then passed through the scope and positioned across the narrowed segment. Inflating the balloon gradually opens the stricture by stretching it outward, held at target pressure for around a minute before deflation, with the degree of opening assessed through the scope immediately after. Most patients go home within a few hours, feeling mild discomfort or throat soreness after an oesophageal dilation that settles the same day, with diet restricted to liquids for 24 hours as a precaution. Follow-up depends on the cause. Some strictures hold well after one session; Crohn’s-related narrowings and refractory oesophageal strictures often need repeat dilation at planned intervals to maintain the result. Strictures from acid reflux are one of the clearest signs that GERD has gone beyond what medication alone can manage. Read more on GERD and endoscopy to understand when reflux complications like strictures need a scope rather than a prescription change. Why Choose Dr. Vipulroy Rathod for Balloon Dilation? Dr. Vipulroy Rathod has been performing balloon dilation for oesophageal, intestinal, and anastomotic strictures at Fortis Hospital Mulund for over 30 years, across the full range of causes including Crohn’s, peptic disease, post-surgical narrowing, and achalasia. That breadth means the balloon size, technique, and follow-up interval all get matched to the specific stricture rather than applied by rote. Physicians from 35 countries have trained under his approach at Fortis. Book your consultation today with one of India’s most experienced specialists for GI stricture assessment and balloon dilation. Book Appointment Call now Frequently Asked Questions What is balloon dilation for strictures? Balloon dilation widens a narrowed GI segment by inflating a balloon across it through an endoscope, restoring normal passage without surgery. What conditions require balloon dilation? It treats oesophageal strictures from reflux or surgery, Crohn’s intestinal strictures, anastomotic narrowing after bowel operations, and achalasia. How many sessions of balloon dilation are needed? Some patients need one session; others with Crohn’s or refractory strictures need repeat dilations at planned intervals over time. Is balloon dilation painful? Done under sedation, so no pain during the procedure. Mild throat discomfort after oesophageal dilation typically settles within a day. Reference Endoscopic Balloon Dilation for Crohn’s Disease-Associated Strictures — Korean Society of Gastrointestinal Endoscopy, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642359/ Complex Refractory Oesophageal Stricture and Balloon Dilation — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305297/

TIPS, transjugular intrahepatic portosystemic shunt, creates a channel inside the liver between the portal and hepatic veins to lower the pressure that builds up in portal hypertension. It’s performed through the jugular vein under imaging guidance, with no open surgery and a recovery considerably shorter than a surgical shunt. The procedure is used when cirrhosis complications, most often variceal bleeding or refractory ascites, stop responding to medical treatment and need a more direct pressure-reduction approach. According to Dr. Vipulroy Rathod, Gastroenterologist in Mumbai, “TIPS isn’t a first-line treatment, but for patients where medical options have run out, it buys meaningful time. The key is selecting the right patient carefully, because TIPS can genuinely worsen liver function in someone whose hepatic reserve is already compromised, and that selection decision matters more than the procedure itself.” What Conditions Are TIPS Used For? TIPS targets the complications of portal hypertension that won’t settle with drugs or endoscopic management. Variceal bleeding that keeps recurring despite band ligation and pharmacotherapy is the clearest indication, where TIPS reduces the portal pressure driving the varices rather than repeatedly treating the varices themselves. Refractory ascites that require repeated paracentesis every few weeks is another strong indication, and TIPS relieves the pressure causing fluid accumulation and reduces the paracentesis burden substantially in suitable patients. Hepatic hydrothorax, fluid accumulating in the chest from portal hypertension, responds to TIPS in selected cases where thoracentesis has become the only management option. Hepatorenal syndrome can sometimes be reversed through TIPS when the pressure reduction restores enough renal perfusion, though this is reserved for carefully selected patients with sufficient residual liver function. Understanding how portal hypertension and liver decompensation interact is where a liver cirrhosis specialist decides whether TIPS is the right intervention or whether another route makes more clinical sense. What Are the Risks and Who Should Not Have TIPS? Patient selection is what separates a good TIPS outcome from a poor one, and the risks are real enough to make that selection non-negotiable. Hepatic encephalopathy is the most common complication, because TIPS diverts blood away from the liver and allows ammonia and other toxins to reach the brain rather than being cleared, which is why existing encephalopathy is a relative contraindication. Shunt stenosis or occlusion can develop over months and needs surveillance imaging to catch early, with covered stents now substantially reducing this problem compared to older bare metal designs. Patients with severe liver dysfunction are poor candidates because TIPS further reduces what little hepatic blood flow remains and can tip them into decompensation they can’t recover from. Heart failure and pulmonary hypertension push a significant volume of blood suddenly into the systemic circulation after TIPS, and an adequate cardiac workup before the procedure is essential in patients with any cardiac history. Managing the complications that lead patients to TIPS in the first place often involves a combination of endoscopic and medical treatment that endoscopy handles directly. Read more on pancreatic necrosis treatment to see how minimally invasive endoscopic approaches tackle other complex GI and hepatic complications without surgery. Why Choose Dr. Vipulroy Rathod for Liver Disease? Dr. Vipulroy Rathod has been managing cirrhosis complications and portal hypertension at Fortis Hospital Mulund for over 30 years, with endoscopic variceal management and EUS-guided assessment forming a core part of his practice. Patients approaching TIPS candidacy benefit from that depth of experience in identifying which complications can still be managed endoscopically and which genuinely need a shunt. Physicians from 35 countries have trained under his approach at Fortis. Book your consultation today with one of India’s most experienced specialists for liver cirrhosis and portal hypertension management. Book Appointment Call now Frequently Asked Questions What is the TIPS procedure? TIPS, or transjugular intrahepatic portosystemic shunt, is a procedure that creates a channel inside the liver between the portal and hepatic veins to reduce portal hypertension and its complications. What is TIPS used to treat? TIPS is used to treat portal hypertension complications including refractory variceal bleeding, recurrent ascites, hepatic hydrothorax, and in selected cases hepatorenal syndrome. Is TIPS a surgical procedure? No. TIPS is a minimally invasive interventional procedure performed through the jugular vein under imaging guidance, without open surgery and with significantly lower risk than a surgical shunt. What are the risks of the TIPS procedure? The main risks include hepatic encephalopathy, shunt stenosis or occlusion, and worsening liver function in patients with already compromised hepatic reserve, which is why careful patient selection is essential. Reference The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408669/ Effects of TIPS Treatment in Patients with Liver Cirrhosis and Portal Hypertension — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270572/

Gallbladder cancer is hard to catch early because it gives no reliable symptoms until it’s advanced, and standard ultrasound often misses the subtle wall changes that mark an early tumour. Endoscopic ultrasound narrows that gap by placing the probe directly against the gallbladder from inside the gut. For high-risk patients, that closer view is frequently what separates an early, treatable diagnosis from a late one. According to Dr. Vipulroy Rathod, Gastroenterologist in Mumbai, “The problem with gallbladder cancer is that by the time it causes symptoms, it’s usually advanced. EUS lets us look far more closely at a suspicious gallbladder wall than an ultrasound can, and in the right patient that closer look is exactly what picks up disease at a stage where we can still do something about it.” How Does Endoscopy Detect Gallbladder Cancer? Proximity is what gives endoscopy its edge here, reaching detail external imaging routinely misses. Sitting the EUS probe against the gallbladder from inside the stomach or duodenum gives a high-resolution view of the wall, and early thickening or a small mass that ordinary ultrasound overlooks becomes visible. Tumour depth is where EUS genuinely outperforms other imaging. It shows how far a cancer has grown through the gallbladder wall, and that single measurement often decides whether early treatment is still possible. Regional lymph nodes come into view in the same session, letting the endoscopist judge local spread without waiting on separate scans that only add delay. Once a lesion looks suspicious, EUS-guided fine needle aspiration samples it on the spot and confirms or rules out cancer when imaging alone can’t give a clear answer. Judging whether a gallbladder finding deserves this closer look is where a gallbladder cancer specialist turns scattered imaging into a single clear assessment. Who Benefits Most from Endoscopic Assessment? Not every gallbladder complaint needs EUS, and matching it to the right patient is what makes it worthwhile. If someone has large gallstones, their baseline cancer risk is already higher, and a suspicious wall change on their ultrasound is worth examining with EUS rather than repeating the same scan. Polyps above 1 cm need proper characterisation. EUS reads their features far better than a follow-up ultrasound that only tracks whether they’ve grown. An unclear incidental finding on CT or ultrasound is exactly where EUS earns its place, separating harmless thickening from something that needs sampling and staging. Women over 50 from northern India sit in the highest-risk group globally, and a lower threshold for detailed endoscopic assessment makes sense whenever their imaging looks off. Seeing how EUS extends into other specialised diagnostic and treatment roles helps put its value here in context. Read more on EUS-guided drainage to see how EUS handles complex diagnostic and treatment tasks that routine imaging cannot. Why Choose Dr. Vipulroy Rathod for Gallbladder Cancer? Dr. Vipulroy Rathod has performed over 20,000 EUS procedures across more than 30 years at Fortis Hospital Mulund, in a region where gallbladder cancer runs far above global averages. That depth of EUS experience is what lets a suspicious gallbladder wall be assessed accurately and staged in a single workup rather than through scattered scans. Physicians from 35 countries have trained under his approach at Fortis. Book your consultation today with one of India’s most experienced specialists for gallbladder cancer detection and endoscopic staging. Book Appointment Call now Frequently Asked Questions Can endoscopy detect gallbladder cancer early? Endoscopic ultrasound can detect early gallbladder cancer by assessing wall thickening and tumour depth with greater accuracy than surface imaging, and allows tissue sampling when a lesion looks suspicious. What is the role of EUS in gallbladder cancer? EUS assesses how deeply a gallbladder tumour has grown and whether nearby lymph nodes are involved, providing local staging detail that ultrasound and CT cannot match, along with fine needle aspiration for diagnosis. Is ultrasound or EUS better for gallbladder cancer? Ultrasound is the first-line screening test, but EUS is more accurate for assessing tumour depth and local spread, making it valuable when a suspicious lesion needs closer evaluation. Why is gallbladder cancer hard to detect early? Gallbladder cancer rarely causes specific early symptoms, so it is often found incidentally after gallbladder removal or on imaging done for another reason, which makes targeted endoscopic assessment valuable in high-risk patients. Reference Gallbladder Cancer Treatment (PDQ) — National Cancer Institute, https://www.cancer.gov/types/gallbladder/hp/gallbladder-treatment-pdq Role of Endoscopic Ultrasound in the Diagnosis of Gallbladder Lesions — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134300/

Colorectal cancer is appearing earlier than it used to, and in India it’s too often caught at an advanced stage that screening could have prevented. Average-risk adults are advised to start at 45, yet a meaningful share of patients carry risk factors that bring that age down to 40 or below. Working out which group you belong to matters far more than treating 45 as a fixed rule for everyone. According to Dr. Vipulroy Rathod, Gastroenterologist in Mumbai, “Colorectal cancer in India is being diagnosed at younger ages and more advanced stages than it should be. The age cutoff is a starting point, not a finish line, because plenty of patients in their 30s and 40s walk in with findings everyone assumed were nothing. Screening timing should follow personal risk, not just a calendar.” Who Should Start Screening at 40 or Earlier? Personal risk, not age alone, decides when screening should begin, and several factors move it forward. If a parent or sibling has had colorectal cancer, your screening starts 10 years before their diagnosis age or by 40, whichever lands first. Long-standing IBD changes the picture entirely. Once Crohn’s or ulcerative colitis has been active in the colon for 8 years or more, surveillance colonoscopy every 1 to 3 years becomes part of routine management. Inherited syndromes such as Lynch or FAP move screening into the teens or twenties with much tighter intervals, placing these patients on a completely separate track. Symptoms override age. Rectal bleeding, a persistent shift in bowel habits, or unexplained weight loss warrants investigation immediately, whether or not someone has reached 40. Pinning down exactly where you sit on this spectrum is where a colorectal cancer specialist sets the right screening age and interval for you. Why Does Screening After 40 Matter So Much in India? Catching this cancer early transforms the outlook, and the Indian context makes that timing especially important. Cases in younger adults keep climbing. Colorectal cancer is turning up under 50 more often in India, which quietly undermines the old assumption that it belongs to older age groups alone. Most patients present late after months of blaming symptoms on piles or acidity, so screening catches disease before treatment becomes far harder and far more invasive. Colonoscopy prevents cancer rather than just finding it, because polyps get removed during the same session, stopping many tumours from ever forming. Nobody schedules it for you here. Without an organised screening programme, the initiative rests with the individual, which makes knowing your own risk and acting on it the deciding factor. Knowing precisely when to book that first scope comes down to your individual risk profile. Read more on first colonoscopy age to work out the right age for your first colonoscopy based on your personal risk factors. Why Choose Dr. Vipulroy Rathod for Colorectal Screening? Dr. Vipulroy Rathod has spent over 30 years performing advanced endoscopy at Fortis Hospital Mulund, with more than 80,000 procedures including thousands of colonoscopies. That volume translates into a careful reading of subtle findings, the kind that matters when a small polyp or unusual patch shows up during an otherwise routine screening scope. Physicians from 35 countries have trained under his approach at Fortis.  Book your consultation today with one of India’s most experienced specialists for colorectal cancer screening and colonoscopy. Book Appointment Call now Frequently Asked Questions At what age should Indians start colorectal cancer screening? Average-risk adults should begin colorectal cancer screening at 45, but those with a family history, IBD, or genetic syndromes often need to start at 40 or earlier depending on individual risk. Why is colorectal cancer screening important after 40 in India? Colorectal cancer is rising in younger Indian adults and is often diagnosed late. Screening after 40, especially for higher-risk individuals, catches disease early when it is far more treatable. What is the best colorectal cancer screening test? Colonoscopy is the most thorough screening test as it examines the entire colon and allows removal of polyps in the same session, unlike stool tests or sigmoidoscopy which are more limited. Who should start screening before 45? People with a first-degree relative who had colorectal cancer, those with inflammatory bowel disease for over 8 years, and anyone with genetic syndromes like Lynch or FAP should start screening earlier. References Colorectal Cancer Screening (PDQ) — National Cancer Institute, https://www.cancer.gov/types/colorectal/patient/colorectal-screening-pdq Colorectal Cancer Screening Guideline Update — American Cancer Society, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943635/

Argon plasma coagulation is a non-contact endoscopic technique that stops bleeding in the gastrointestinal tract without the probe ever touching the tissue. It works by delivering ionised argon gas, energised into plasma, that coagulates bleeding vessels and abnormal mucosa at a controlled depth through the endoscope. What makes it valuable is its ability to treat wide areas of diffuse bleeding evenly, the kind of bleeding where clipping a single vessel or injecting a spot simply isn’t practical, which is exactly where many patients would otherwise face repeat transfusions or surgery. According to Dr. Vipulroy Rathod, Gastroenterologist in Mumbai, “APC has changed how we handle diffuse GI bleeding. When someone has bleeding spread across a wide area of mucosa, you can’t clip your way out of it. APC lets us treat that whole surface precisely, in the same session as the diagnosis, and most patients avoid both surgery and repeated transfusions as a result.” How Does APC Work and What Does It Treat? The technique combines precision with reach, treating sources that other methods struggle with. Passing a probe through the endoscope, APC releases argon gas that’s energised by high-frequency current into plasma, coagulating the target tissue at a controlled depth without any contact. Angiodysplasia and GAVE, the vascular lesions that cause slow chronic bleeding and anemia, respond particularly well because APC treats their scattered surface pattern evenly. In radiation proctitis, where the rectal lining bleeds diffusely after pelvic radiotherapy, APC ablates the fragile mucosa across a broad area that no single clip could address. For bleeding or obstructing tumours, APC offers palliative control, sealing the bleeding surface and easing symptoms in patients who aren’t surgical candidates. Deciding whether APC fits a given bleed needs endoscopic assessment of its source and pattern, which is where an APC bleeding control specialist matches the technique to the lesion. When Is APC the Right Choice for GI Bleeding? APC suits specific bleeding patterns, and knowing where it fits is what separates a controlled bleed from a surgical referral. Diffuse mucosal bleeding across a wide surface is APC’s clearest indication, since it treats the whole area evenly where clipping or injection would only address isolated points. When bleeding comes from vascular lesions, particularly angiodysplasia and GAVE, APC delivers reliable control that reduces the transfusion dependence these conditions often cause. In non-variceal upper GI bleeds such as certain ulcers, APC can supplement injection therapy to improve the durability of hemostasis at high-risk sites. Where surgery carries high risk, APC offers a same-day endoscopic alternative that controls the bleed without an incision or general anaesthetic in most cases. Understanding how APC fits within the wider range of endoscopic bleeding techniques helps put it in context. Read more on GI bleeding treatment to see how APC sits alongside clipping, injection, and band ligation in controlling GI bleeding without surgery. Why Choose Dr. Vipulroy Rathod for GI Bleeding? Dr. Vipulroy Rathod has been controlling acute and chronic GI bleeding at Fortis Hospital Mulund for over 30 years, using APC alongside clipping, injection, and variceal band ligation across a case volume few centres match. Patients arriving in active bleeding referred for a surgical opinion most often leave having had the source controlled endoscopically the same day, without ever meeting a surgeon. Physicians from 35 countries have trained under his approach at Fortis. Book your consultation today with one of India’s most experienced specialists for GI bleeding assessment and endoscopic bleeding control. Book Appointment Call now Frequently Asked Questions What is APC for GI bleeding? APC, or argon plasma coagulation, is a non-contact endoscopic technique that uses ionised argon gas to deliver controlled thermal energy, sealing bleeding vessels and abnormal tissue in the GI tract without touching them. What conditions is APC used to treat? APC treats angiodysplasia, gastric antral vascular ectasia, radiation proctitis, bleeding tumours, and diffuse mucosal bleeding across wide areas where clipping or injection is impractical. Is APC safe for GI bleeding? Yes. APC is minimally invasive, controls bleeding precisely without contact, avoids surgery in most cases, and allows same-day recovery, making it a safe alternative to repeat transfusion or operation. How does APC stop bleeding? APC releases ionised argon gas energised by high-frequency current, forming plasma that coagulates tissue at a controlled depth, sealing bleeding vessels evenly across the affected surface. References Improvement of Short-Term Outcomes for High-Risk Bleeding Peptic Ulcers With Addition of Argon Plasma Coagulation — NCBI/PMC, https://pubmed.ncbi.nlm.nih.gov/26266385/ Comparison of Argon Plasma Coagulation in Management of Upper GI Angiodysplasia and GAVE Hemorrhage — NCBI/PMC, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3439282/