Gastroenterology

Last updated date: 30-Aug-2023

Originally Written in English

Overview

Occasionally, nearly everyone experiences digestive disorders ranging from mild to chronic cases. Such conditions come with varying symptoms and can as well cause pain and discomfort. It also hinders the normal functions of the digestive system, triggering additional health issues. 

Gastroenterology is thus a scientific specialty that can help you with such issues. It focuses on diagnosing, treating, and evaluating all conditions regardless of the severity, affected organ, and the patient’s age. 

 

What is Gastroenterology?

gastrointestinal (GI) tract

Gastroenterology is a medical branch that deals with the digestive system or the gastrointestinal (GI) tract. It’s also concerned with the functions and the disorders that affect the GI tract. Basically, it comprises of stomach, esophagus, small intestine, gallbladder, liver, bile ducts, pancreas, colon, and rectum. 

The digestive system plays significant roles in the body, including; 

  • Breaking down food into several important nutrients like fats, proteins, and carbohydrates. 
  • Facilitating absorption of the nutrients into the bloodstream for the body to use for growth, energy, and repair purposes. 
  • Getting rid of the waste products and excess fluids in the body

 

What is a Gastroenterologist?

Gastroenterologist

Gastroenterologists are internists who specialize in the diagnosis and treatment of digestive organ diseases such as the esophagus, stomach, intestines, pancreas, liver, and gallbladder.

These expert tackles diseases such as stomach discomfort, ulcers, diarrhea, cancer, liver illness, and jaundice, and uses endoscopes to see interior organs during sophisticated diagnostic and therapeutic operations. Gastroenterologists work in a variety of places.

When gastroenterologists are on call, they may anticipate to be busy in most practice settings. The number and type of call are determined by the sort of practice. In gastroenterology, situations such as gastrointestinal hemorrhage must be addressed swiftly, even overnight.

The gastroenterologist sees patients who have digestive system illnesses. Patients experiencing symptoms such trouble swallowing, heartburn, stomach discomfort, nausea and vomiting, jaundice, diarrhea, and constipation are included.

Gastroenterologists commonly treat gastrointestinal bleeding, esophageal reflux, celiac disease, bile duct stones, pancreatitis, inflammatory bowel disease, hepatitis, obesity, and nutrition issues. Many patients with complex liver illness are treated by a hepatologist, who is a gastroenterologist who specializes in treating liver problems.

 

Gastroenterology Diseases

Gastroenterology Diseases

The digestive system is prone to a range of conditions and illnesses. Some are minor and can be treated with simple treatment forms. However, others require advanced treatment options and a professional gastroenterology specialist who is skilled and utilizes state-of-the-art equipment. 

Gastroenterologists treat a wide range of disorders affecting the digestive system. These are some examples:

  • Acid reflux is a frequent digestive problem that generates a burning sensation (often described as heartburn). This sensation in the lower chest is caused by stomach acids going back into the esophagus. GERD (gastroesophageal reflux disease) is diagnosed when this occurs three or more times per week.
  • Gastric ulcers are ulcers that can form on the stomach lining.
  • IBS (irritable bowel syndrome) is a prevalent colon illness (large intestine)
  • Hepatitis C is a contagious liver disease that can cause mild to severe liver damage.
  • Polyps are growths that commonly occur in the large intestine.
  • Jaundice is a yellowing of the skin caused by an excess of bilirubin (a byproduct of the liver) in the blood.
  • Haemorrhoids are swollen veins that occur in the anal region.
  • Bloody stools may be innocuous or an indication of a serious sickness.
  • Pancreatitis is an uncommon illness that causes pancreatic inflammation.
  • Colon cancer, often known as bowel cancer or colorectal cancer, is any cancer that affects the colon or rectum.

 

Common Causes of Gastroenterology Disorders

Causes of Gastroenterology Disorders

Sometimes, gastroenterology diseases are congenital, while some are acquired with time. Some of the general factors that might trigger digestive system disorders include; 

  • Food intolerance:

It’s sometimes difficult to tolerate certain types of food. It can be a result of a particular environmental factor or genetic predisposition. This could impact the GI system, causing celiac conditions or non-celiac gluten sensitivity. 

Fiber is a part of the food plants that the body cannot digest. Instead, it goes through the body and keeps the digestive system healthy. It also eases bowel movements and gets rid of cholesterol and other harmful carcinogens. Therefore, a low fiber in the system can limit certain digestive activities, causing various GI disorders. 

Stress and anxiety mainly alter a person’s mental health. However, it can also impact the general digestive system health and functions. Also, there is an established connection between the brain and the digestive system; hence they always function and communicate together. This, thus, indicates that stress can trigger various digestive disorders. For instance, inflammation, cramping, bloating, changes in gut bacteria, and loss of appetite. 

  • Drinking insufficient water 

Water is generally essential when it comes to food digestions and absorption of nutrients. It also helps clean the digestive tract and softens the stools. This prevents constipation and other disorders. Therefore, insufficient water in the body can cause various digestive disorders. 

  • Genetic issues

Most of the immune and autoimmune digestive system disorders are caused by genetic factors in the family. For example, you can be genetically predisposed to developing disorders, such as ulcer colitis, Crohn’s disease, cystic fibrosis, celiac disease, liver disorders, or diabetes.

  • Infections 

Digestive infection is also referred to as the stomach flu. It develops when the gut or the digestive system is exposed to a virus, bacterial or parasitic infections. This could cause minor and severe digestive disorders, including ulcers and acute diarrhea. 

  • Consuming too much dairy food 

Dairy foods consist of proteins and fats that are not easy to digest. Therefore, consuming too much dairy foods or products can result in digestive disorders, such as constipation, abdominal cramps, bloating, or gas. 

  • Lifestyle aspects 

Lack of enough physical exercise and consuming unhealthy food can affect digestive health. To prevent this, medical practitioners recommend exercising regularly and opting for a balanced diet as an effective alternative for addressing GI issues. 

 

Gastroenterology subspecialties

There are two primary subspecialties within the area of gastroenterology:

 

Hepatology

Hepatology

Hepatology is the field of medicine that studies and treats illnesses of the liver, gallbladder, biliary tree, and pancreas. Although usually considered a sub-specialty of gastroenterology, fast growth in several countries has resulted in doctors specializing completely in this field, known as hepatologists.

 

What conditions does a hepatologist treat?

A hepatologist is a doctor who specializes in treating GI diseases and has specialized training in treating a number of liver and associated ailments, such as:

  • Ascites are fluid accumulation in the belly that can cause edema.
  • Bile duct disorders and injuries are a group of ailments that affect the tiny tubes that transport bile from the liver and gallbladder to the small intestine.
  • Cirrhosis of the liver is characterized by scarring of liver tissue induced by infection or excessive alcohol intake.
  • Fatty liver disease and nonalcoholic steatohepatitis (NASH), both of which cause an accumulation of excess fat in the liver.
  • Small, hard calcium deposits that can occur in the bile ducts are known as gallstones.
  • Gallbladder disease can manifest as inflammation, infection, obstruction, or gallbladder stones.
  • Cysts, or growths that form in areas of your GI system.
  • Hepatitis, an infection that causes liver inflammation. There are five types (A, B, C, D, and E), each with a different cause.
  • Liver cysts and tumors, which can be noncancerous or cancerous.
  • Liver cancer, cancer that originates in the cells in your liver.
  • Liver failure, which can be chronic or acute. When the liver is damaged, it can begin to shut down.
  • Varices, or enlarged veins in the esophagus.

 

How is liver disease diagnosed?

We provide screening tests that employ cutting-edge technology to detect liver disease in its early stages, when it is most curable. Your doctor may do the following diagnostic tests on your liver:

  • Liver function test – A test that evaluates how your liver is functioning.
  • FibroScan – A noninvasive ultrasound procedure that can identify changes in your liver.
  • Liver biopsy – A tiny sample of tissue is removed by your doctor using a fine needle or during a surgical procedure. A microscope is used to check the tissue for malignant cells.
  • Endoscopy – Your doctor will put a tiny scope via your mouth to inspect the hard-to-see regions of your GI system, such as your liver, pancreas, and gallbladder, during this minimally invasive operation.
  • Blood tests – These tests can rule out problems with your liver, gallbladder, or other organs.
  • Imaging tests – MRIs, CT scans, and PET scans are examples of diagnostic imaging techniques that give comprehensive images of your GI system.

 

Proctology

Proctology

Proctology specialists are concerned with the prevention, identification, and treatment of rectum and anus illnesses. Proctoscopy (viewing of the anal canal) and rectoscopy are diagnostic procedures used by proctologists (viewing of the rectum). Tissue samples may be collected as part of these tests, and polyps and haemorrhoids may be treated. Both investigations are extremely low risk and cause little or no discomfort. An analgesic/sedative injection may be requested by the patient.

A proctologist is a surgeon who specializes in problems of the lower digestive tract, which includes the colon, rectum, and anus. Proctologists are now known as "colorectal surgeons" or "colon and rectal surgeons."

Proctologists collaborate closely with gastrointestinal (GI) doctors, commonly known as Gastroenterologists, who provide comprehensive care for digestive system diseases. A gastroenterologist is qualified to do colonoscopies but not surgery, whereas all proctologists are surgical experts.

 

When do I need to see a Proctologist?

When you have a health problem, the first thing you should do is see your primary care physician. If you have any of the following symptoms in the anal and rectal region, you should see a proctologist.

  • Itching or burning in the anus
  • Pain in the anus or rectum
  • Bleeding or other discharge from the anus
  • Warts or bumps in the anal region
  • Foreign objects in the rectum
  • Change in bowel habits or changes in the stool
  • Bowel incontinence

 

What do proctologists treat?

Proctologists usually treat the following conditions:

  • Hemorrhoids: inflamed and swollen veins in the lower rectum and anus that can cause itching, discomfort, and bleeding.
  • Anal fissures: microscopic tears in the anal lining.
  • Abscesses: pus-filled collections caused by an infection.
  • Anal fistulas are small irregular channels in the tissue that can develop as a result of surgery or infection.
  • Anal skin tags: harmless and painless skin growths.
  • Diverticulitis: a disorder in which tiny pouches (diverticula) grow in areas of the digestive tract that are weak.
  • Rectal prolapse: When the rectum slides out through the anal orifice.
  • IBS (irritable bowel syndrome): A chronic disorder characterized by bloating, discomfort, constipation, and diarrhea.
  • Inflammatory bowel disease (IBD): A collection of chronic diseases that cause inflammation in the intestinal lining, such as Crohn's disease and ulcerative colitis.
  • Small, benign aggregates of growths in the colon that have the potential to become malignant.
  • Cancers of the colon, rectal, and anal regions: These are cancers that begin in these areas.
  • STIs (sexually transmitted infections): Genital and anal infections include the following:
    1. Chlamydia
    2. Syphilis
    3. Gonorrhea
    4. Genital herpes

 

Signs and Symptoms of Gastroenterology Diseases 

Gastroenterology Diseases 

The signs and symptoms of digestive disorders often vary in intensity; it can be mild or severe. If you have persistent symptoms that occasionally cause pain and discomfort, it could indicate a digestive condition. 

These are thus the most common signs and symptoms you need to watch out for;

  • Constipation: This is when you have less than three bowel movements in a week or pass a dry and hard stool. It is one of the most common signs of digestive system disease. 
  • Bloating and excessive gas: This where gas builds up in the intestines or the stomach. Bloating or excessive gas can indicate digestive system disorder, including irritable bowel syndrome and celiac disease. 
  • Frequent heartburn: Chronic heartburn that lasts for more than a week can signify gastroesophageal reflux disease (GERD). If not addressed on time, stomach acid can destroy the esophagus, resulting in other health complications. 
  • Diarrhea: Prolonged diarrhea that lasts for one or more days could be an indication of digestive problems. For instance, it can be inflammatory bowel disease and lactose intolerance. 
  • Abdominal pain: At times, severe abdominal pain could be a sign of GI disorders, including ulcers, irritable bowel syndrome, or diverticulitis. 
  • Nausea and vomiting: This signifies a serious infection in the digestive system or the gallbladder. It could sometimes indicate health issues like pancreatitis, diverticulitis, irritable bowel syndrome, intestinal blockage, or appendicitis. 

Other rare but severe symptoms that could indicate a GI condition include; 

  • Immediate changes in bowel habits 
  • Traces of blood in the stool
  • Unexplainable weight loss
  • Chronic abdominal pain 

 

Diagnostic Procedures of Gastroenterology Disorders 

Endoscopic procedures

Mostly, the gastroenterology healthcare provider begins by thoroughly accessing your medical history. This is to examine a digestive condition and identify the root cause accurately. The gastroenterology doctor also notes the symptoms you are experiencing and other relevant information that might be helpful.  

Besides, the doctor can conduct a physical examination to assess the condition more accurately. However, if the situation is intense, you may be required to go through a more extensive diagnostic assessment. It can include any or a combination of these procedures; 

 

Laboratory tests 

  • Fecal occult blood test: This is a test to assess any hidden blood traces in the fecal matter thoroughly. Medical providers perform a fecal occult blood test by applying a small sample of the stool on a small card designed for testing purposes. The stool sample is then brought to the lab for further testing and assessment. 
  • Stool culture: Doctors perform this test to determine the fungal or bacteria causing diarrhea and other digestive system disorders. Your stool sample is taken and brought to the lab for thorough testing. This is done to check if any bacteria or fungi are causing the disorder. 

 

Imaging tests 

  • CT scan (computed tomography scan): This imaging procedure involves using computer technology and x-ray equipment to portray images of the digestive system. CT scan produces clear and detailed pictures of the organs, making it easy for the doctor to identify the problem.  
  • Ultrasound: Utilizes computer technology and high-frequency sound waves to display images of the inner digestive system and the organs. It allows the doctor to see how the GI organs function and evaluate how food travels within these organs. 
  • MRI (magnetic resonance imaging): MRI utilizes a combination of radio frequencies, computers, and large magnets. It creates detailed images of the digestive system structure and organs. During the procedure, the doctor will ask you to lie on the bed of the MRI machine. The machine will then take several pictures of the internal digestive organs using radio waves and magnetic fields. On the other hand, the computer is used to display the images captured. 
  • Magnetic resonance cholangiopancreatography (MRCP): This procedure uses MRI to view and assess the bile ducts. It also utilizes high-frequency radio waves and magnets to scan the internal organs and tissues thoroughly. 

 

Endoscopic procedures 

  • Colonoscopy: This procedure enables the doctor to see the whole length of the colon or large intestine. It helps identify the inflamed tissues, abnormal growth, bleeding, and ulcers. 
  • Endoscopic retrograde cholangiopancreatography (ERCP): This diagnostic test enables the doctor to evaluate and treat disorders of the pancreas, gallbladder, liver, and bile ducts. 

 

Other laboratory, imaging, and endoscopic tests include;

  • Colorectal transit study 
  • Barium beefsteak meal 
  • Defecography 
  • Lower GI series and upper GI series
  • Oropharyngeal motility study 
  • Radioisotope gastric emptying scan 
  • Sigmoidoscopy 
  • Upper endoscopy 
  • Esophageal, gastric, and anorectal manometry 

 

Therapeutic range of services of Gastroenterology

Services of gastroenterology

The therapeutic range of services of gastroenterology includes for the most part

  • Oesophago-gastro-duodenoscopy (gastroscopy)
  • Laparoscopy and tissue removal
  • Percutaneous transhepatic cholangiography (PTC) (biliary viewing through the skin)
  • Minimally invasive surgery
  • Manometry
  • 24-hour pH monitoring (long-term acid measurement) of the oesophagus and/or stomach
  • Provocation tests in the oesophagus (Bernstein test, balloon distension test)
  • H2-breath tests
  • Transit time measurements in the colon ( Hinton test)
  • Defecography
  • Barostatic measurements in the rectum
  • Anorectal endosonography
  • Liver transplantation

 

Conclusion 

Gastroenterology is all about the study of the GI tract or digestive system. It also involves diagnosis, treatment, and management of disorders affecting or altering the digestive system functions. 

Gastroenterologists are thus the medical providers you should always consult if you suspect any digestive issue.