By Tara Narayan

THE historical Goa Medical College & Hospital has been moving from strength to strength in super-speciality departments – and even has a brand new super-speciality hospital near the old hospital complex now. There is a full-fledged cardiac facility, departments for neurology, nephrology, burns, even a geriatrics ward, but no gastroenterology department!
Which is surprising because health issues to do with the alimentary or gastroenterology tract (or digestive tract), some 30 feet long from mouth to anus in an adult – present with innumerable health issues. Most of us sooner or later struggle to manage our GI tract which also attach to key organs playing a role in digestion. Count the mouth, pharynx, esophagus, stomach, small and large intestines , rectum and anus and the organs of pancreas, gallbladder, liver, which play key roles in the digestion.
GI health issues may range from the simple stomach ache to more complicated abdominal pain, cramping, bloating, change in bowel habits, constipation and diarrhoea which are huge problems…there is irritable bowel syndrome which so many suffer form and which few can get to the bottom of. Mysterious are out eating and drinking habits which if ignore initially sooner or later to ulcers and cancers of the GI tract.

A gastroenterology department or ward for patients where all their alimentary or GI system health issues may be sorted out by doctors or specialists is an important branch of healthcare. However, currently all gastroenterology health issues are dealt with by the GMC’s Medicine department; also come to think of it there’re few gastroenterologists in Goa! Few doctors want to specialize in the myriad health issues of the GI tract. The Goa Medical & GMC has something like 1,160 beds for patients and treats 1,70,000 outpatients daily. Also count 16 operation theatres, 12 major OTs and four minor OTs. Surgeons do about 28 major operations and 12 major operations per day.
But to stay with the absence of a gastroenterology department, do you that the world gastroenterology comes to us from the Greek “baster” or belli, “enteron” or “intestine” and “logia” as in study of…gastroenterology referring to that branch of medicine to do with the digestive system and its disorders. The food we put in our mouth where digestion of carbohydrates begins moves on to the stomach which said to be the only acidic place in the body where proteins and other complex foods are broken down in the presence of hydrochloric acid…before it moves in to the small intestines for absorption of nutrients which make body beautiful work on oiled wheels or so to speak. Peristalsis moves the digested food along and after absorption the waste gathers in the colon and finally moves out of the rectum and anus and is called defecation.
Gastroenterology is a huge and important segment of healthcare. Therefore one wonders why there is no department devoted exclusively to this subject at the GMC! Health Minister Vishwajit Rane has been saying for some time that there is going to be a Gastroenterology department and ward and last year there was some talk that Margao-based consultant, medical gastroenterologist and surgeon Dr Jose Philip Alvares would be starting the department but it has not happened. Others names which come to mind are Dr Sanjay Altekar, Dr Amit Kalangutkar, Dr Rohan Badwe, Dr Harish Peshwe…and it to them that patients with gastro health issues go to.

A gastroenterologist is a specialist in gastrointestinal diseases and would treat all issues of the digestive system. Gastro issues may range from gastroesophegal reflux disease, gastrointestinal bleeding, irritable bowel syndrome, inflammatory bowel disease which includes Crohn’s disease and ulcerative colitis, peptic ulcer disease, gallbladder disease. Peptic ulcer disease is to do with breaks in the inner lining of the stomach, the first part of the small intestine, or sometimes lower oesophagus. An ulcer in the stomach is called a gastric ulcer, while in the first part of the intestines is called a duodenal ulcer. Most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain, and upper abdominal pain which improves with eating. Gastric ulcer pain worsens with eating. Pain burning or dull ache with belching, vomiting, weight loss, poor appetite are symptoms you need to check out and be treated for. Sometimes the elderly patients have no symptoms but they have digestive issues which sorting out.
Truly, Goa’s premier people’s public hospital, the old is gold Goa Medical College and Hospital is in dire need of a gastroenterology department and ward where patients with small or big GI tract health issues may get treated for quickly and exclusively, without the tedium of depending on Medicine department doctors who attention is diverted with so many other issues!

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