Evidence-Based Medical Treatments
Targeted treatment plans for chronic gastrointestinal, liver, and metabolic conditions built around what the evidence actually supports.
Conditions We Treat
Click any condition below to explore detailed treatment information, or scroll to read comprehensive care protocols.
Acid Reflux & GERD
Gastroesophageal Reflux Disease
Overview
Stomach acid repeatedly pushes into the food pipe, causing chest burning, throat irritation, and discomfort when swallowing. We go beyond antacids. Diagnostic checks on esophageal sphincter function, identifying daily triggers, and targeted acid-suppression protocols give the tissue a real chance to heal.
Signs & Symptoms
- Persistent heartburn and chest burning
- Throat irritation and hoarseness
- Discomfort when swallowing
- Regurgitation of sour or bitter-tasting acid
- Symptoms worsening when lying down
- Chronic cough, especially at night
Diagnostic Methods
- Upper GI Endoscopy (EGD) to assess esophageal damage
- Esophageal manometry to evaluate sphincter function
- 24-hour pH monitoring to quantify acid exposure
- Barium swallow for structural evaluation
Treatment Options
Targeted Acid-Suppression Therapy
Proton Pump Inhibitors (PPIs) and H2 blockers tailored to severity, allowing esophageal mucosa to heal while identifying the minimum effective dose.
Trigger Identification & Lifestyle Modification
Systematic identification of dietary and positional triggers with personalized avoidance strategies and meal timing protocols.
Sphincter Function Assessment
Manometry-based evaluation of lower esophageal sphincter competence to guide procedural decisions when medication alone is insufficient.
Endoscopic & Surgical Options
Fundoplication or TIF for refractory cases where structural deficiency requires mechanical reinforcement beyond pharmacological management.
Lifestyle & Diet
- Avoid meals within 3 hours of bedtime
- Elevate head of bed 6-8 inches
- Identify and eliminate personal trigger foods
- Maintain healthy weight to reduce abdominal pressure
- Eat smaller, more frequent meals
- Avoid lying down immediately after eating
Why Choose Our Care
- Diagnostic checks on esophageal sphincter function
- Beyond antacids — targeted protocols that heal tissue
- Evidence-based step-up and step-down therapy
- Access to endoscopic and surgical interventions when needed
Frequently Asked Questions
Q1.Can GERD be completely cured?
While GERD is typically chronic, many patients achieve long-term remission through targeted therapy. In select cases with clear anatomical defects, surgical intervention can provide permanent resolution.
Q2.How long does it take for the esophagus to heal?
With appropriate acid suppression, mild esophagitis heals within 4-8 weeks. We monitor progress endoscopically and adjust therapy to ensure complete mucosal healing.
Q3.Is long-term medication safe?
When medically indicated, long-term therapy is monitored for safety. We regularly assess bone health, B12 levels, and kidney function, always aiming for the lowest effective dose.
Fatty Liver Disease
NAFLD / NASH
Overview
Fat builds up in liver cells, triggering silent inflammation that slowly breaks down healthy tissue if nothing changes. Structured metabolic adjustments, nutritional changes, and close monitoring of liver enzyme trends actively reverse early-stage fatty changes before permanent scarring sets in.
Signs & Symptoms
- Often asymptomatic in early stages
- Fatigue and general malaise
- Discomfort in upper right abdomen
- Elevated liver enzymes on routine blood work
- Unexplained weight gain or difficulty losing weight
Diagnostic Methods
- Liver function tests (AST, ALT, GGT)
- Abdominal ultrasound for fatty infiltration
- FibroScan / transient elastography for liver stiffness
- MRI-PDFF for precise fat quantification
- Exclusion of other liver diseases (viral, alcoholic, autoimmune)
Treatment Options
Structured Metabolic Adjustment
Personalized plans targeting insulin resistance, dyslipidemia, and metabolic syndrome — the root drivers of fatty liver progression.
Nutritional Intervention
Evidence-based dietary protocols focusing on reducing hepatic de novo lipogenesis while preserving muscle mass and metabolic rate.
Liver Enzyme Trend Monitoring
Serial ALT/AST tracking with FibroScan surveillance to confirm fat reduction and rule out advancing fibrosis.
Pharmacological Support
Where indicated, vitamin E, pioglitazone, or GLP-1 receptor agonists to accelerate metabolic recovery and liver fat reduction.
Lifestyle & Diet
- Gradual weight loss (5-10% of body weight)
- Reduce refined carbohydrates and added sugars
- Increase physical activity (150+ min/week)
- Limit fructose-sweetened beverages
- Prioritize whole foods and adequate protein
- Regular follow-up for enzyme trend monitoring
Why Choose Our Care
- Metabolic-angle approach, not just liver-focused
- Close monitoring of liver enzyme trends
- Structured nutritional changes with measurable outcomes
- Early intervention before permanent scarring
Frequently Asked Questions
Q1.Can fatty liver be reversed?
Yes. Early-stage NAFLD can be fully reversed with sustained weight loss and metabolic improvement. Even NASH with fibrosis can show significant regression with dedicated intervention.
Q2.How is this different from just losing weight?
Fatty liver requires targeted metabolic correction beyond general weight loss. We address insulin resistance, specific macronutrient ratios, and liver-specific markers to ensure the liver itself recovers, not just the scale.
Q3.How often should I be monitored?
Every 3-6 months initially, with liver enzymes and FibroScan. Once stable, annual surveillance is usually sufficient unless metabolic parameters shift.
Viral Hepatitis
Hepatitis B & C
Overview
Persistent viral infections quietly strain liver function and raise long-term risk of organ failure or liver cancer. Customized antiviral regimens, regular PCR-based viral load monitoring, and scheduled liver imaging keep the virus suppressed and catch any changes early.
Signs & Symptoms
- Often asymptomatic for years
- Fatigue and weakness
- Jaundice in acute or advanced cases
- Dark urine and pale stools
- Abdominal discomfort
- Unexplained nausea or poor appetite
Diagnostic Methods
- Serological testing: HBsAg, anti-HBc, anti-HCV
- PCR-based viral load quantification
- Liver function tests and fibrosis assessment
- Hepatitis genotyping for treatment selection
- Ultrasound and AFP for HCC surveillance
Treatment Options
Customized Antiviral Regimens
Direct-Acting Antivirals (DAAs) for Hepatitis C achieving >95% cure rates, and potent nucleos(t)ide analogues for Hepatitis B suppression.
PCR-Based Viral Load Monitoring
Quantitative PCR at defined intervals to confirm virologic response, detect breakthrough, and guide treatment duration.
Scheduled Liver Imaging
Biannual ultrasound plus AFP monitoring for at-risk patients, enabling early detection of hepatocellular carcinoma.
HCC Surveillance Program
Structured screening for cirrhotic and high-risk chronic HBV patients with multidisciplinary tumor board coordination when needed.
Lifestyle & Diet
- Complete alcohol abstinence
- Avoid hepatotoxic medications and supplements
- Maintain healthy weight
- Regular monitoring appointments
- Vaccination against Hepatitis A if non-immune
- Family screening and safe practices to prevent transmission
Why Choose Our Care
- Customized antiviral regimens based on genotype and resistance
- Regular PCR-based viral load monitoring
- Scheduled liver imaging for early change detection
- HCC surveillance with multidisciplinary coordination
Frequently Asked Questions
Q1.Is Hepatitis C curable?
Yes. Modern DAAs cure over 95% of patients after 8-12 weeks of treatment with minimal side effects.
Q2.Can Hepatitis B be cured?
Complete eradication is rare, but long-term antiviral suppression effectively prevents cirrhosis, liver failure, and cancer. Functional cure research is advancing.
Q3.How often do I need monitoring?
Every 3-6 months for liver function and viral load, with biannual ultrasound for HCC surveillance in cirrhotic or high-risk patients.
Peptic Ulcer Disease
H. Pylori & Stomach Ulcers
Overview
Painful sores develop in the stomach lining, commonly driven by a stubborn H. pylori bacterial infection. Validated multi-drug eradication cycles fully clear the bacteria, combined with conditions that allow the stomach lining to repair itself properly.
Signs & Symptoms
- Burning stomach pain, worse between meals or at night
- Nausea and vomiting
- Bloating and early satiety
- Unexplained weight loss
- Dark or tarry stools (melena)
- Vomiting blood (hematemesis)
Diagnostic Methods
- Upper GI Endoscopy with biopsy
- Rapid urease test (CLO test) for H. pylori
- Stool antigen test for H. pylori
- Urea breath test for active infection
- Histopathological examination of biopsy samples
Treatment Options
Validated Eradication Therapy
Bismuth quadruple therapy or concomitant therapy based on local resistance patterns, with confirmation of eradication via urea breath test.
Acid Suppression for Healing
High-dose PPI therapy to create an intragastric environment conducive to mucosal repair while eradication therapy works.
NSAID-Related Ulcer Management
For non-H. pylori ulcers, PPI healing plus risk stratification for ongoing NSAID need, with COX-2 selective agents or PPI co-therapy.
Bleeding Ulcer Intervention
Endoscopic hemostasis (clips, thermal coagulation, injection) for bleeding ulcers, with second-look endoscopy when indicated.
Lifestyle & Diet
- Complete H. pylori eradication confirmation
- Avoid NSAIDs unless absolutely necessary
- Limit alcohol and smoking cessation
- Regular meal timing, avoid prolonged fasting
- Stress management techniques
- Follow-up endoscopy to confirm ulcer healing
Why Choose Our Care
- Validated multi-drug eradication cycles
- Confirmation testing to ensure bacteria is fully cleared
- Endoscopic capability for diagnosis and bleeding control
- Structured follow-up to confirm mucosal healing
Frequently Asked Questions
Q1.How do I know if H. pylori is gone?
We confirm eradication with a urea breath test or stool antigen test at least 4 weeks after completing antibiotics and 2 weeks after stopping PPIs.
Q2.Can ulcers come back after treatment?
If H. pylori is successfully eradicated and NSAIDs are avoided, recurrence is rare. We verify eradication and address any ongoing risk factors.
Q3.Is endoscopy always needed?
For alarm features (bleeding, weight loss, persistent vomiting) or patients over 60 with new symptoms, endoscopy is essential. Younger patients with classic symptoms may be tested non-invasively first.
Inflammatory Bowel Disease
Crohn's & Ulcerative Colitis
Overview
Severe, long-term inflammation throughout the digestive tract causes intense cramping, frequent diarrhea, and poor nutrient absorption. Long-term maintenance plans using targeted anti-inflammatory and immune-balancing treatments help patients regain reliable digestive rhythm.
Signs & Symptoms
- Intense abdominal cramping and pain
- Frequent diarrhea, sometimes with blood
- Urgent need to defecate
- Fatigue and low energy
- Unintended weight loss
- Poor nutrient absorption and anemia
Diagnostic Methods
- Colonoscopy with ileoscopy and biopsies
- Fecal calprotectin to differentiate from IBS
- CT or MR enterography for small bowel assessment
- Complete blood count and inflammatory markers
- Celiac serology and infection exclusion
Treatment Options
Targeted Anti-Inflammatory Therapy
5-ASA compounds for mild-moderate ulcerative colitis; corticosteroid induction for flares with rapid taper to maintenance.
Immune-Balancing Treatments
Thiopurines, methotrexate, and biologics (anti-TNF, anti-integrin, anti-IL12/23) for moderate-severe disease and steroid-dependent cases.
Long-Term Maintenance Planning
Structured remission maintenance with scheduled biomarker monitoring, endoscopic surveillance, and dose optimization to prevent flares.
Nutritional Rehabilitation
Iron, B12, vitamin D replacement; exclusive enteral nutrition for Crohn's; dietitian-guided exclusion diets where evidence supports.
Lifestyle & Diet
- Strict medication adherence even in remission
- Identify and avoid personal dietary triggers
- Maintain adequate nutrition and hydration
- Regular exercise within tolerance
- Stress management and adequate sleep
- Scheduled surveillance colonoscopy per guidelines
Why Choose Our Care
- Long-term maintenance plans, not just flare management
- Targeted anti-inflammatory and immune-balancing treatments
- Endoscopic and biomarker-based disease monitoring
- Nutritional rehabilitation alongside medical therapy
Frequently Asked Questions
Q1.Can IBD be cured?
There is currently no cure for IBD, but with proper maintenance therapy, most patients achieve long-term remission and live normal, active lives.
Q2.Will I need biologics?
Not everyone does. We start with the least intensive effective therapy and escalate based on disease severity, location, and response. Biologics are reserved for moderate-severe or refractory cases.
Q3.How often do I need colonoscopy?
During active disease, more frequently to assess healing. In remission, surveillance intervals depend on disease duration and severity, typically every 1-3 years for colitis patients.
Experiencing Symptoms?
Early intervention leads to better outcomes. If you are experiencing any of the symptoms described above, schedule a consultation for prompt evaluation and personalized treatment.
Ready to Take Control of
Your Digestive Health?
Professor Dr. Asif Mehmood is widely respected for his clinical excellence, academic contributions, and commitment to comprehensive, patient-centered care. Schedule your appointment today.
Call Us
+92 303 4252501
Working Hours
Mon - Sat: 9AM - 8PM
Location
Lahore, Pakistan