Dr. Subhash Agal

Dr. Subhash Agal

Head, Gastroenterology

MD, DNB (Gastro)

  • YEARS OF PRACTICE: 34 years
  • GENDER: Male
  • LANGUAGES SPOKEN: English, Hindi
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Biography

Dr Subhash Agal had done his DNB (Gastro) under able guidance of Late Dr H G Desai who was a doyen in the field of Gastroenterology. Subsequently he under acquired endoscopy skills from the best in the field. He has been practising gastroenterology for more than 29 years, and in the process alleviated the sufferings of lakhs of patients. His clinical acumen is equally admired by the doctors’ peer group. He figured in the list of 10 best gastroenterologists in Mumbai in the year 2009 as per the survey conducted among the peers by an independent journal.

My Mantra

I do my best in clinical practice, and leave the rest to the God

AREA(S) OF INTEREST:

All kinds of interventional gastro-intestinal endoscopies, capsule endoscopies, enteroscopies and fibroscan of liver. High level of skill in diagnosis and treatment of all kinds of gastrointestinal, gall bladder and biliary, pancreatic and liver disorders.

TREATMENTS/PROCEDURES OFFERED:

Management of GERD, Nonulcer Dyspepsia, IBS and other Functional Disorders of the gut., Management of all kinds of small bowel and colonic disorders., Evaluation and management of gastrointestinal cancers., Evaluation and management of pancreato-biliary cancers., Evaluation and management of all kinds of liver and hepatobiliary disorders like cirrhosis of liver, chronic hepatitis B and C, fatty liver, fulminant liver failure, gall stones etc., Evaluation and management of pancreatitis., Diagnostic and Interventional gastrointestinal endoscopies like variceal banding, glue injection into gastric varices, polypectomy, endoscopic mucosal resection, stricture dilatation, PEG insertion, esophageal, duodenal and colonic stenting etc., Fibroscan of liver to identify and prognosticate liver disorders., Interventional Biliary and Pancreatic endoscopies., Endoscopic Pancreatic Necrosectomy, Endoscopic Pancreatic Pseudocyst drainage

NAME OF INSTITUTE(S):

    • JLN medical college, Ajmer, Rajasthan
    • Jagjivan Ram Hospital, Mumbai
Dr Phani Dhar memorial oration 2019 – on Nonalcoholic Steatohepatitis

Dr. Subhash Agal has more than 29 years of clinical experience in Gastroenterology and GI Endoscopy. He was Head of Gastroenterology Centre and guide for post-doctoral course in superspeciality degree of Gastroenterology (DNB Gastro) at Jagjivan Ram Hospital, Mumbai Central for six years. His special field of interest is Interventional GI Endoscopy which includes Luminal as well as Biliary and Pancreatic Therapeutic Endoscopies. Endoscopic Pancreatic Necrosectomy for Infected Necrosis of Pancreas is one such complex therapeutic procedure with excellent outcomes  in his expert hands. Dr. Agal has routinely performed ERCP for very demanding procedures like CBD Stone Removal, CBD Stenting, Pancreatic Duct Stone Removal and Stenting, and for placement of self-expandable metallic stent in inoperable esophageal, pancreatobiliary and gall bladder malignancies. He is also dexterous at other intricate interventions related to upper GI endoscopy and colonoscopy like dilatations of strictures, polypectomies, variceal banding and glue injections, achalasia dilatation etc.

He is also very competent to do paediatric endoscopies – both diagnostic and therapeutic. He has done the maximum number of paediatric endoscopies in Western India. Variceal banding, sclerotherapy, foreign body retrievals, polypectomies are some of these procedures which are routinely performed by him with excellent outcomes. He has done numerous percutaneous endoscopic gastrostomies in infants and children who fail to thrive because of congenital abnormalities of oral cavity, congenital heart diseases, neurological defects etc. The PEG procedure has been done by him successfully on infants weighing as little as 3 kg.

Dr Agal has also been regularly doing Liver Fibroscan for detecting and prognosticating chronic liver diseases of various etiologies.

KDAH Experience

Dr Agal has performed more than 23000 endoscopic procedures of all kinds (age group 2 months to 98 years) during his tenure at Kokilaben hospital since the year 2009. These also include some of the most complex endoscopic procedures like pancreatic necrosectomy, pseudocyst drainage, minor papilla PD stenting for pancreas divisum, removal of giant polyps etc.

Dr. Agal has more than 50 scientific papers in reputed International and National Journals.

Publications

  • Agal S , Kulshrestha PP. Endoscopic removal of coins with “w-shapa” forceps in children. Indian J Gastroenterol 1994; 13(1): A 38.
  • Kulshrestha  PP,  Agal S , Halder  PJ, Maydeo A. Preliminary observations on therapeutic endoscopic procedures. Indian J Gastroenterol 1993; 12(2): A 129 (Best Paper award).
  • Maydeo  A, Kulshrestha  PP, Vadeyar H,  Agal S. Role of esophageal endoprosthesis in cancer esophagus. Indian J Gastroenterol 1994; 13(1): A 105 (Best Paper award).
  • Kulshrestha  PP, Vadeyar H, Agal S, Maydeo A. Therapeutic ERCP using indigenous accessories in 122 patients. Indian J Gastroenterol 1994; 13(1): A 38.
  • Maydeo A, Kulshrestha PP, Agal S. Endoscopic pancreatic duct drainage in chronic pancreatitis. Indian J Gastroenterol 1995; 14(1): A 110.
  • Agal S, Kulshrestha  PP. Fibreoptic colonoscopy in children. 1st International Congress on Pediatric Gastroenterology and Nutrition, Jaipur, Dec. 1995.
  • DN Amarapurkar, S Chauhan, S Agal, R Baijal, PP Kulshrestha. Combination therapy of low dose interferon and lamivudine for chronic Hepatitis B. Hepatology 1998; 28: 215 A.
  • DN Amarapurkar, R Baijal, S Agal, PP  Kulshrestha. Comparison of natural history of hepatitis B and hepatitis C. Indian J Gastroenterol 1998; 17: S 4.
  • S Seth, DN Amarapurkar, PP Kulshrestha, R Baijal, S Agal, A Deo, S Mani, K Chopra, S Bichile, P Mehta. A simple investigative model for non-cirrhotic portal hypertension. Indian J Gastroenterol 1998; 17: S 10.
  • Baijal R, Agal S, Kulshrestha PP, Amarapurkar DN, Desai HG. Primary biliary cirrhosis : a report of  five cases. Indian J Gastroenterol 1998; 17: S 13.
  • Amarapurkar DN, Kulshrestha PP, Agal S, Baijal R. A comparative study of endoscopic variceal ligation (EVL), endoscopic sclerotherapy (EST) and combination therapy in the management of esophageal varices.  Indian  J  Gastroenterol  1998; 17: S 82.
  • Deepak Amarapurkar, Sangita Chouhan, S Agal, P  Kulshrestha, R Baijal. Role of colonoscopy in the management of lower GI bleeding. Indian J Gastroenterol 1998; 17: S 82.
  • R Baijal , S Agal , R Kumar, Harshwardhan, PP Kulshrestha, D N Amarapurkar, A Choksi, H G Desai. Hepatic artery aneurysm presenting as pain and mass in the epigastrium. J Assoc Phys India 1998; 26: 823. 
  • DN Amarapurkar, R Baijal, S Agal , PP Kulshrestha. Tuberculosis of the Esophagus: A report of four cases. Bombay Hosp J 1999; 41: 572-3.
  • Deepak Amarapurkar, Baijal Rajiv, Agal Subhash, Kulshrestha Pramod, Nilay Mehta, HG Desai. Primary Biliary Cirrhosis: A report of six cases. Bombay Hosp J 1999; 41: 582-85.
  • R Baijal, S Agal, PP Kulshrestha, DN Amarapurkar, MR Chakraborty, SS Pramanik.  Site-specific incidence of abdominal tuberculosis : a retrospective study. Indian J Gastroenterol 2000; 19: A 44-45.
  • MR Chakraborty, PP Kulshrestha, S Agal, R Baijal, PJ Haldar. Oesophageal malignancy : a retrospective analysis of experience in a tertiary care center. Indian J Gastroenterol 2000; 19: A 56.
  • SS Pramanik, S Agal, R Baijal, MR Chakraborty, PP Kulshreshta. Clinical and endoscopic profile of lower GI malignancy in Western Railway Hospital, Mumbai. Indian J Gastroenterol 2000; 19: A 76.
  • DN Amarapurkar, R Baijal, PP Kulshrestha, S Agal, MR Chakraborty, SS Pramanik. Profile of hepatitis B e antigen negative chronic hepatitis B. Indian J Gastroenterol 2000; 19 : A 102-3.
  • MR Chakraborty, PP Kulshrestha, S Agal, R Baijal, SS Pramanik,DN Amarapurkar. A retrospective study of prevalence of esophagogastric varices in cirrhosis of liver: A retrospective study. Indian J Gastroenterol 2001; 20: C 20.
  • DN Amarapurkar, R Baijal, PP Kulshrestha, S Agal, MR Chakraborty, SS Pramanik. Spectrum of hepatic presentations of Wilson`s disease. Indian J Gastroenterol 2001; 20: C 18-19.
  • S Agal, PP Kulshrestha, R Baijal, MR Chakraborty, SS Pramanik, P Gupte. Clinical profile and endoscopic management of malignant obstructive jaundice. Indian J Gastroenterol 2001; 20: A 41.
  • SS Pramanik, PP Kulshrestha, S Agal, R Baijal, MR Chakraborty. Prevalence of HBV and HCV infection in alcoholic liver disease. Indian J Gastroenterol 2001; 20: C 20-21.
  • SS Pramanik, PP Kulshrestha, S Agal, R Baijal, MR Chakraborty, PA Gupte. A five years’ study of clinico-pathological profile of colonic polyps. Indian J Gastroenterol 2001; 20: A 70-71.
  • DN Amarapurkar, R Baijal, PP Kulshrestha, S Agal, MR Chakraborty, SS Pramanik. Profile of hepatitis B e antigen-negative chronic hepatitis B. Indian J Gastroenterol 2002; 21: 99-101.
  • N Patel, DN Amarapurkar, PP Kulshrestha, S Agal, R Baijal, SS Pramanik, P Gupte. Utility of serological markers in inflammatory bowel disease. Indian J Gastroenterol 2002; 21: A 37-38.
  • P Gupte, DN Amarapurkar, PP Kulshreshta, S Agal, R Baijal, SS Pramanik, ND Patel. Prevalence of nonalcoholic fatty liver disease in type 2 diabetes mellitus. Indian J Gastroenterol 2002; 21: A 58.   
  • ND Patel, R Baijal,  DN Amarapurkar, PP Kulshrestha, S Agal,  SS Pramanik, P Gupte. Gastrointestinal luminal tuberculosis- establishing the diagnosis. Indian J Gastroenterol 2002; 21: A 68.
  • A Amita, AK Sharma, PP Kulshrestha, S Agal, R Baijal, P Gupte, N Patel, Shobha, Aziz. Clinical profile of spontaneous bacterial peritonitis in cirrhosis of liver. Indian J Gastroenterol 2002; 21: A 105-6.
  • Subhash Agal. Endoscopic accesses for enteral nutrition. Bombay Hosp J 2002; 44:578-584.
  • Aziz K, RP Mathur, R Baijal, S Agal, P Gupte, N Patel, SS Pramanik, PP Kulshrestha. Acute renal failure associated with liver disease: etiology and outcome. Indian J Gastroenterol 2002; 21: A 107.
  • PM Kamani, DN Amarapurkar, S Agal, R Baijal, SS Pramanik, PA Gupte, ND Patel. Role of malnutrition as a risk factor for antitubercular drug-induced hepatotoxicity. Indian J Gastroenterol 2003, 22; A 101.
  • DN Amarapurkar, AD Amarapurkar, ND Patel, S Agal, R Baijal, P Gupte, SS Pramanik. Non-alcoholic steatohepatitis (NASH) with diabetes: predictors of liver fibrosis. Indian J Gastroenterol 2003; 22: C 14-15.
  • S Agal, R Baijal, D N Amarapurkar, P A Gupte. Prevalence of Hepatitis B and C viral markers in Western Railway population. Journal of Gastroenterology and hepatology 2004; 19: A 768.
  •  N D Patel, R Baijal, D N Amarapurkar, P P Kulshrestha, S Agal. Serological markers in differentiating IBD from various forms of infective colitis. Bombay Hosp J 2004; 46: 95-6.
  •  Parijat Gupte, Deepak Amarapurkar, Subhash Agal, Rajiv Baijal, Pramod Kulshrestha, Nikhil Patel, Aruna Madan, Anjali Amarapurkar, Hafeezunnisa. Non-alcoholic steatohepatitis in type 2 diabetes mellitus. Journal of Gastroenterology and Hepatology 2004; 19: 854-58.
  • S Agal, R Baijal, DN Amarapurkar, HRP Kumar, PA Gupte, ND Patel, PM Kamani. Prevalence of fatty liver in western railway population. Journal of  Gastroenterology and Hepatology 2004: 19.
  • S Agal, R Baijal, DN Amarapurkar, PA Gupte, ND Patel, PM Kamani, HRP Kumar. Prevalence of hepatitis B and C markers in western railway population. Journal of Gastroenterology and Hepatology 2004; 19: A 768.
  • Nikhil Patel, Deepak Amarapurkar, Subhash Agal,  Rajiv Baijal, Pramod Kulshrestha, Snehansu Pramanik, Parijat Gupte. Gastrointestinal luminal tuberculosis: Establishing the diagnosis. Journal of Gastroenterology and Hepatology 2004;19: 1240-46.
  • R Baijal, S Agal, DN Amarapurkar, PM Kamani, PA Gupte, ND Patel, HRP Kumar. Prevalence of gall stone disease in western railway population. Journal of Gastroenterology and Hepatology 2004; 19:  A 810.
  •  DN Amarapurkar, ND Patel, AD Amarapurkar, S Agal, R Baijal, P Gupte. Tissue Polymerase Chain Reaction in Diagnosis of Intestinal Tuberculosis and Crohn`s Disease. J Assoc Phys India 2004; 52: 863-67.
  • R Baijal, Praveen Kumar H R, Praful K Kamani, P Bhagwat, S Agal. Bedside Diagnosis  of  Spontaneous Bacterial Peritonitis  by using Reagent Strips. Indian J Gastroenterol 2005.
  • Praful Kamani, Rajiv Baijal, Deepak Amarapurkar, Subhash Agal. Guillain-Barre syndrome associated with acute hepatitis E. Indian J Gastroenterol 2005; 24: 216.
  • S.Agal, R.Baijal, P.Gupte, N.Patel, P.Kamani, Praveenkumar H.R. R.Chavda.
  • Non-surgical management of Infected Pancreatic Necrosis. Indian J Gastroenterol    2005; 24: A 67.
  • Subhash Agal, Rajiv Baijal, Snehanshu Pramanik. Monitoring and Management of antituberculosis drug induced  hepatotoxicity. Journal of Gastroenterology and hepatology 2005; 20: 1745-52.
  • R Baijal, Praveen Kumar HR, Praful Kamani, Ruchir Chavda, A Madan, Indranil Bhattacharya, S Agal. Bedside diagnosis of spontaneous bacterial peritonitis by using Reagent Strips. Indian J Gastroenterol 2005; 24: A 92-3.
  •  S Agal,  R Baijal, Mehul Choksi, Praveen Kumar H R. Hepatic Overlap and sequential syndromes – a report of three cases. Indian J Gastroenterol 2006; 25: A 154.
  •  R Baijal, Praveen Kumar H R, Mehul Choksi,  S Agal.  Randomized controlled trial to assess the effect of Rabeprazole on post-esophageal variceal ligation (EVL) ulcers. Indian J Gastroenterol 2006; 25: A 156.
  • S Agal, R Baijal, D N Amarapurkar et al. A series of 13 cases of Esophageal tuberculosis. Journal of Gastroenterology and Hepatplogy 2008; 23 (suppl 5) A 80.
  • Deepak A, Subhash A, Rajeev B et al. Epidemiology of Hepatitis E virus infection in Western India. Hepatitis monthly 2008; 8(4) 258-262.
  • R Baijal, S Agal, Praveen Kumar et al. Clinical spectrum of esophageal ulcers. Journal of Gastroenterology and Hepatplogy 2008; 23 (suppl 5) A 79.
  • S Agal, R Baijal, Praveen Kumar et al. Non- surgical management of pancreatic fluid collections. Journal of Gastroenterology and Hepatplogy 2008; 23 (suppl 5) A 22.
  • Rajiv Baijal, Subhash Agal, Deepak Narayan Amarapurkar et al. Esophageal Tuberculosis : An analysis of fourteen cases. Journal of Digestive Endoscopy 2009;1:14 – 18.
  • Nusrat Nazli, Bangladesh

    All doctors team work is very excellent. Our co-ordinator is very helpful (Ms. Moumita). All sisters are very active. Overall everything is very nice. Atlast I think this is the best hospital in the world.

  • Sunil Gupta

    Respected Smt Kokilabenji,

    I want to inform you the excellent hospital you have opened. Yesterday, Dr Subhash Agal did my endoscopy. I was tended of camera to be inserted. He made me sleep, woke me up, I asked him when camera w...

  • Pradeep Pandey

    Dear Mrs. Ambani,
    I am writing this mail to thank you for setting up a world class hospital like Kokilaben Dhirubhai Ambani Hopsital at Four Bunglows in Andheri (W). I stay in Lokhandwala and have visit...

Conditions/Procedures No. of Cases Treated
Endoscopic Procedures >12000

Dr. Subhash Agal | Gastroenterology

Dr. Subhash Agal

A 36 yrs old women presented to Kokilaben Hospital on 23rd March 2009 with history of Recurrent Cholangitis for last six months.

She was seen by Dr.Subash Agal, Consultant Gastroenterologist at KDAH.

She gave history of episodic epigastric pain and fever lasting for 2 - 3 days each time.

An ultrsasound done 6 months earlier was reported as liver abscess and she was treated with antibiotics without any relief.

An MRI with MRC was performed on her. MRI showed heterogenous lesions in right as well as left lobe of liver each measuring approximately 3 - 5 cm in size. The lesions showed cystic ( with septae) and solid components. Magnetic Resonance Cholangiography showed dilatation of left hepatic duct, normal caliber common bile duct and irregular filling defect in distal CBD.

Her liver profile was normal except mild increase in enzyme gamma glectamyl transferase. Her CBC and EXR were within normal limits.

An ERCP was performed on her by Dr. Subash Agal on 25/03/09. Cholangiogram showed irregular filling defect in mid and distal CBD. After biliary sphincterotomy, basketing of CBD revealed a live leaf like reddish brown worm was identified as liver fluke or fasciola hepatica. The patient showed remarkable improvement after the procedure.

Fasciola hepatica also known as sheep liver fluke, is an uncommon worm infestation. Eggs from infected animal's feces hatch into miracidia. The latter enter the snails and develop into cercaviae which attach to the aquatic plants. Man becomes infected by consuming plants containing encysted metacercariae. They bore through intestinal wall to enter into peritoneal cavity and then penetrate the liver capsule and finally come to lie into the bile ducts where they eventually develop into adult forms.

Symptoms due to this worm could be initially due to migration of worms through the intestine, peritoneal cavity and liver.
The patient presents with fever, pain in right hypochondrium and urticaria.
Recurrent biliary colic and cholangitis are late features when worm lies in biliary ductis.
Liver pathology includes necrosis,granuloma with eosinophilic infiltrates & Charcot - Leyden crystals.

The medical treatment consists of administration of triclabendajole.

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