Best Gastroenterologist
Doctors in Rajshahi

Chronic Hepatitis B: Rajshahi carries a significant hepatitis B burden — a legacy of a period when blood transfusions, injections, and medical procedures were routinely performed without adequate infection control. Many patients in Rajshahi are living with chronic hepatitis B diagnosed incidentally on a blood test done for something entirely unrelated, with no idea what it means for their liver over the next decade. Gastroenterologists assess hepatitis B viral load through HBV DNA quantification, evaluate liver damage through fibroscan or biopsy, and initiate antiviral therapy — tenofovir or entecavir — for patients meeting treatment criteria. The majority of patients with chronic hepatitis B who are properly treated and monitored will never develop cirrhosis or liver cancer. Those who are not monitored have no such reassurance.

Peptic Ulcer Disease and H. pylori: Helicobacter pylori — a bacterium that colonizes the stomach lining — is extraordinarily prevalent in Bangladesh and is the underlying cause of the majority of peptic ulcers, chronic gastritis, and a significant proportion of stomach cancers. Patients in Rajshahi who present with burning epigastric pain that improves with eating then returns, nausea, and bloating — the classic ulcer pattern — are tested for H. pylori through urea breath test, stool antigen test, or rapid urease test during endoscopy. Eradication therapy — a combination of two antibiotics and a proton pump inhibitor for 14 days — cures the infection in most cases and heals the ulcer permanently. Without eradication, ulcers reliably recur.

Gastroesophageal Reflux Disease: GERD in Rajshahi is dramatically undertreated and dramatically overtreated simultaneously — undertreated in patients who have had significant acid reflux for years and never had an endoscopy to check for Barrett's esophagus, and overtreated in patients who are taking high-dose proton pump inhibitors indefinitely for symptoms that turn out to be functional rather than acid-related. Gastroenterologists distinguish true acid reflux from functional dyspepsia through endoscopy and pH monitoring, treat GERD appropriately with the minimum effective medication dose, and identify the minority of patients who develop Barrett's esophagus — a premalignant change in the esophageal lining — and require regular surveillance endoscopy.

Inflammatory Bowel Disease: Ulcerative colitis and Crohn's disease — chronic immune-mediated conditions causing inflammation of the gastrointestinal tract — are increasingly recognized in Rajshahi as gastroenterology expertise has grown in the city. Patients with ulcerative colitis present with bloody diarrhea, urgency, and cramping that has often been treated as infectious colitis for months before the correct diagnosis is established. Crohn's disease causes transmural inflammation that can affect any part of the gut from mouth to anus — presenting with abdominal pain, diarrhea, weight loss, and sometimes fistulas or abscesses. Gastroenterologists confirm diagnosis through colonoscopy with biopsy and manage with aminosalicylates, immunosuppressants, and biological therapy for refractory cases.

Fatty Liver Disease: Ultrasound reports describing hepatic steatosis — fatty liver — are among the most common investigation findings sitting in the files of patients walking into gastroenterology clinics in Rajshahi. The condition has two main forms: alcoholic fatty liver disease and non-alcoholic fatty liver disease associated with obesity, type 2 diabetes, and metabolic syndrome. Most patients with fatty liver are entirely asymptomatic and find out about it incidentally. Gastroenterologists stratify risk through fibroscan and liver enzymes — the majority have simple steatosis that does not progress to significant disease with lifestyle modification, but a proportion develop non-alcoholic steatohepatitis which can progress to cirrhosis over years without the patient ever touching alcohol.