Dr.Dilaram Khan Gastroenterologist/Hepatologist

26/04/2026

Spontaneous Bacterial Peritonitis

26/04/2026

25/04/2026

Therapeutic modality only..no more diagnostic role

24/04/2026

DIAGNOSTIC APPROACH TO PATIENT WITH DYSPHAGIA
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STEP 1: Differentiate Type
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Oropharyngeal? → Difficulty initiating swallow,
choking, nasal regurgitation
Esophageal? → Food “sticking” after swallowing

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STEP 2A: If OROPHARYNGEAL
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→ Neurological evaluation
→ Videofluoroscopic swallow study (VFSS)
→ Consider ENT referral
→ MRI brain if indicated

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STEP 2B: If ESOPHAGEAL
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→ Solids only? → Mechanical obstruction likely
→ Solids + liquids? → Motility disorder likely

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STEP 3: Look for RED FLAGS 🚨
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Weight loss, anemia, bleeding, progressive symptoms
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├── YES → Urgent Upper GI Endoscopy (OGD)
└── NO → Proceed routinely

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STEP 4: Initial Investigation
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→ Upper GI Endoscopy (OGD) = FIRST LINE
• Detect cancer, stricture, esophagitis
• Biopsy if needed

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STEP 5: If Endoscopy NORMAL
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→ Barium swallow
→ Esophageal manometry (gold standard for motility)

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STEP 6: Special Tests (if needed)
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→ pH monitoring (for GERD)
→ CT scan (external compression/malignancy)
→ EUS (staging tumors)

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FINAL DIAGNOSIS → Targeted Management

22/04/2026

"Your Digestive Health Matters"!
■Dr Dilaram Khan
Consultant Gastroenterologist & Hepatologist
Lady Reading Hospital, Peshawar
●If you’re facing issues like acidity/GERD, abdominal pain, hepatitis,Cirrhosis Liver, fatty liver, IBS,IBD,Pancreatic diseases,Biliary diseases, expert care is now easily accessible.
Get professional consultation and personalized treatment for all gastrointestinal and liver diseases.
📍 Clinic Location: Room 13, OPD / IBP Block
🕓 Timings: 4:30 PM – 8:30 PM
Take the first step toward better health today.
Your liver and digestive system deserve the best care!

19/04/2026

Causes of Re**al bleeding

19/04/2026

Management of Triglycerides induced Pancreatitis

18/04/2026

LFTs: evaluation

18/04/2026

Constipation:Causes &Management