The division of Digestive Diseases and Clinical Nutrition offers a variety of services for patients and doctors. Over 2,000 new patients with digestive cancers are managed by the division every year. Patient-oriented services including endoscopy, nutrition therapy, cancer chemotherapy, cancer surveillance and screening and cancer education are offered either on a day-care basis or by distance consultation.

During the last three years over 6,000 upper endoscopies, 1,000 sigmoidoscopies and colonoscopies and 600 ERCPs were performed. All types of therapeutic endocsopy for palliation of cancer such as endoscopic gastronomy, dilatation of strictures, esophageal prosthesis (plastic and metal), colonoscopy, polypectomy, endoscopic laser therapy, ERCP, sphincteroctomy and biliary endoprosthesis placement are performed routinely.

Adjuvant and palliative chemotherapy is offered to patients with digestive cancers. For enteral nutrition therapy, nasogastric/duodenal tube placements and PEG are performed. Total parenteral nutrition therapy consultations and TPN formulations are manufactured as per the clinical requirements are also provided for in-patients and out-patients. A comprehensive clinical nutrition team comprising of gastroenterologists, endoscopist, nutrition nurse and dietician is available on all working days.

Screening of high-risk individuals such as those with Barrett's esophagus, gastric intestinal metaplasia and hereditary colorectal cancers are regularly undertaken. The Division also has a registry to provide various services to registered patients with family history of cancer. These services are free-of cost and include counselling, information materials, follow-up reminders and placements for surgery or regular endoscopic screening.

The Division is very active in the areas of research and education. Case presentations, reviews, as well as journal club, pathology and radiology meetings are held every week. Clinical, epidemiological and basic research is carried out regularly. Indigenous, low-cost endoscopic accessories such as the PEG tube, silicone rubber esophageal prosthesis, biliary stents and other devices and new techniques have been developed and tested in the Division. Some of the studies that are under way include epidemiological studies of Barrett's esophagus, hereditary colorectal cancer and Heliobacter pylori infection in MALT lymphoma and gastric cancer, molecular epidemiological study of human papilloma virus infection in esophageal cancer, evaluation of a bile cytology device in the diagnosis of malignant obstructive jaundice, evaluation of metallic stents for palliation of digestive cancers as well as several phase II cancer chemotherapy clinical trials. Development of a clinical epidemiology unit for Digestive Cancers is in progress. The faculty members have participated in many national conferences, workshops, international symposia and have contributed chapters to many national and international books.