Gastroenterologist

The type of therapeutic care for diseases of the digestive tract is called gastroenterology.

According to statistics, the number of diagnosed pathologies of the gastrointestinal system is growing by 10-15% annually. This is due to various factors, but the main ones are considered to be the following:

• failure to comply with the rules of rational nutrition,
• extremely low quality of drinking water and consumed food,
• environmental issues,
• stress
• sedentary lifestyle.

In this sense, timely access to the right specialist significantly reduces the risk of possible complications, ensures the restoration of digestive function, and, therefore, the quality of life in general. If a person discovers signs and symptoms of malaise in the stomach, intestines, liver, gallbladder or pancreas, most often he seeks help from a therapist, who, after a preliminary examination and examination, gives a referral to a specialist, a gastroenterologist.

Who is a gastroenterologist?

A specialist who identifies, diagnoses, and treats diseases of the gastrointestinal system is a gastroenterologist. This is how the direction of this specialization should be formulated according to Greek sources - gaster, enteron, logos, which literally means stomach, intestine, and teaching. However, every year information about pathologies in various parts of the digestive tract is added, diseases are studied more deeply, so changes have begun to occur in the specialization - the addition of supervised organs and division into narrow areas:

• Hepatologists.
• Pancreatologists.
• Abdominal surgeons.
• Proctologists.

Therefore, when answering the question of who a gastroenterologist is, it is necessary to take into account all possible specializations of this doctor. Accordingly, in addition to basic training at a higher medical educational institution, a gastroenterologist must undergo in-depth postgraduate training in clinical residency and as a result acquire the following knowledge and skills:

• Clinical symptoms, pathogenesis of development and prognosis of the main pathologies of the digestive system.
• Semiotics, diagnostics of diseases of all organs of the digestive tract.
• Basic principles for the treatment and prevention of diseases of the digestive tract.
• Examination, palpation, auscultation, percussion, puncture of the abdominal cavity.
• Preparing the patient for examinations (X-ray of the stomach, intestines, gallbladder).
• Conducting or supervising the process of endoscopic examinations - FGDS, colonoscopy, laparoscopy, rectoscopy, as well as adequate assessment of the results obtained.
• Ability to correctly evaluate the results of ultrasound examinations of the liver and pancreas.
• Ability to evaluate the results of computed tomography of all abdominal organs.
• Ability to correctly analyze and evaluate the results of laboratory tests - biochemical blood analysis, coprogram, pH-metry, fractional analysis of gastric juice.
• Knowledge of the criteria for indication or contraindication for surgical intervention.
• Ability to determine tactics and strategy for treating the identified pathology.
• Knowledge of the basics of physiotherapy procedures, massage, and exercise therapy.
• Knowledge of the basics of therapeutic nutrition and diet therapy.
• Basic criteria for determining the need for spa treatment.
• General issues of prevention of diseases of the digestive tract.
• Ability to correctly complete relevant medical documentation.

To summarize, we can say who a gastroenterologist is. This is a highly educated specialist with deep, extensive knowledge and practical skills in matters of diagnostics, therapy and prevention of almost all diseases related to digestion.

When should you see a gastroenterologist?

Problems of diseases of the gastrointestinal tract, organs of the digestive system have the same ancient history as the first food taken by our ancestors. Unfortunately, today pathologies of the digestive system occupy the second place in number among all diseases of mankind. Therefore, the question - when to contact a gastroenterologist, is extremely important and relevant. The reason for receiving advisory assistance or undergoing an examination should be any discomfort or pain, be it heartburn, colic, constipation, spasms or flatulence.

In the context of the issue of digestive diseases, the most important task, directly concerning the patient himself, is to prevent the pathological process from becoming chronic. Many doctors are convinced that most gastrointestinal diseases can be treated quite quickly and successfully if they are detected at the earliest stages. And chronic pathologies are extremely difficult to treat and often lead to exacerbations, up to those that require surgery.

So, when, at what signs and symptoms should you contact a gastroenterologist?

• If abdominal pain is not isolated, lasts more than a day, or recurs regularly.
• If discomfort in the digestive system disrupts the general rhythm of life and interferes with work.
• If you have lost your appetite.
• If your weight starts to decrease or increase.
• For any symptoms accompanied by nausea or vomiting. Uncontrollable vomiting requires emergency care.
• If abdominal pain is accompanied by a rise in temperature.
• For uncontrollable diarrhea (emergency care).
• Constipation.
• Constant heartburn.
• If the abdominal pain occurs at night, is acute and unbearable.
• If there is already a history of a disease associated with the gastrointestinal tract.
• If you have had abdominal surgery.
• If pain in the digestive organs occurs after taking certain medications.
• If there is a history of diabetes.

In addition, the reason for receiving emergency medical care is the threatening conditions of "acute abdomen", when the pain is unbearable, accompanied by a drop in blood pressure, pulse, tachycardia, nausea, and fainting.

What tests should you take when visiting a gastroenterologist?

The first visit to the doctor may be accompanied by certain rules and requirements. Most often, the patient gets to the gastroenterologist by referral from the therapist, who specifies the list of the most necessary laboratory tests, further diagnostic measures are determined by a specialist.

When you go to see a specialist, you need to bring your card and the results of previous studies, if any. Before the consultation, you will need to “refresh”

Biochemical blood test (ALT, AST, alkaline phosphatase, bilirubin, lipase, pancreatic amylase, GGT), coprogram and stool analysis for dysbacteriosis will also not be superfluous. Often, the therapist prescribes an ultrasound of the abdominal organs, as well as FGDS

A more detailed list of indicators that will help the doctor more accurately diagnose a digestive system disease:

• ALaT – alanine aminotransferase.
• Amylase.
• Lipase.
• Cholinesterase.
• ALP – alkaline phosphatase.
• Protease inhibitor - alpha 1-antitrypsin.
• Acute phase reactive protein, APP – alpha 1 glycoprotein.
• The cellular enzyme AST is aspartate aminotransferase.
• Bilirubin - total, direct, as well as albumin, total protein.
• Amino acid enzyme, GGT – gamma-glutamyl transferase.
• Hepatitis virus markers.
• PT – prothrombin time and PTI – prothrombin index.
• Protein fractions - proteinogram.
• Coprogram to determine hidden bleeding.
• Fecal analysis for helminthiasis.
• Helicobacter test, blood for antibodies to Helicobacter.
• FED food intolerance test.
• X-ray contrast study of the gastrointestinal tract.
• Colonoscopy.
• Enteroscopy.
• Determination of pH of gastric juice.

What diagnostic methods does a gastroenterologist use?

Modern gastroenterological diagnostics involves the use of all the latest achievements in this area, but the already known, well-proven types of examinations remain important and relevant - ultrasound, FGDS, laparoscopy, rectoscopy and various radiological research methods. All this, together with traditional laboratory tests, allows you to quickly and accurately determine the etiology and pathogenetic mechanisms of disease development.

In addition, there is also a classic scheme, which includes the following stages of examination:

• Conversation with the patient and clarification of anamnestic information, especially symptoms and clinical manifestations of the disease.
• Examination of the patient – examination of the tongue, palpation and percussion of the abdomen.
• If necessary, a rectal examination may be performed.

Next, instrumental types of examination come into play, which play an important role in a comprehensive diagnostic strategy. The main methods for diagnosing diseases of the digestive system:

1. X-ray is a contrast study of the condition of the esophagus, stomach, small and large intestines, and duodenum.
2. Endoscopy is an examination of the esophagus, stomach, duodenum and colon using a probe.
3. Ultrasound is a sonography that determines the size, shape, structure and location of abdominal organs. In addition, ultrasound reveals neoplasms - cysts, tumors, stones, various vascular disorders, determines the condition of the ducts.
4. Electrographic methods.
5. Electrometric methods.

Electrography and electrometry allow us to evaluate the functions of the digestive organs:

• Electrogastrography is the registration of biological potentials of the stomach.
• Electrointestinography – assessment of the biopotential of intestinal function.
• Rheography is the registration of tissue resistance to the effects of current.
• Radiotelemetry - assessment of the physiological activity of the gastrointestinal tract.
• Phonogastrography and phonointestinography – assessment of the motor-evacuation activity of the intestine (sounds are recorded).

In addition, computer tomography has been widely used recently, allowing to obtain a visual image of tissues at almost any depth, layer by layer, multidimensionally. Thus, the doctor has the opportunity to evaluate tissue structures, their density, integrity and other characteristics of organs. CT is prescribed to examine the condition of the liver, spleen, gallbladder, and vascular system of the abdominal region.

The choice of the type of diagnostics is related to the characteristics of the disease, the nature of its course, each method has its own information content limits and cannot be used as an independent, single-method examination.

What does a gastroenterologist do?

Sometimes a gastroenterologist is called a gastrologist, which is not entirely correct, because he treats not only stomach diseases - gastritis and other pathologies. This is just a part of the many tasks that fall within the competence of a gastroenterologist.

What does a gastroenterologist do? The answer is both simple and complex - all diseases related to digestion. Digestion is a complex, interconnected process that processes the food entering the body to obtain the energy that a person needs so much. All food goes through a multi-stage processing process, is broken down into necessary and unnecessary categories under the influence of enzymes, and is then absorbed into the blood and lymph. Almost all human health depends on the condition of the esophagus, the mucous membrane of the stomach, the duodenum, the gallbladder and bile ducts, and the work of the pancreas. In addition, the function of the liver is also important, which cleanses the blood of intoxication products and is involved in many other metabolic processes. Therefore, it is quite difficult to answer specifically what a gastroenterologist does, everything depends on which organ or system has failed. Modern gastroenterology has come a long way since the time of Hippocrates and Galen, it continues to develop intensively, so the scope of activity of a gastroenterologist is very broad. In this regard, the division of specialization into narrower areas that specify the work of a doctor has become extremely relevant and timely:

• Gastroenterologist – diseases of the gastrointestinal tract.
• Hepatologist – treatment of the liver and biliary system (gallbladder and ducts).
• Proctologist, coloproctologist – diseases of the rectum (large intestine) and anorectal area.
• Abdominal surgeon – surgical treatment of pathologies, traumatic injuries of all abdominal organs.

Thus, a gastroenterologist diagnoses and treats everything that is included in the list of organs of the digestive system:

• Esophagus.
• Stomach.
• Small intestine, duodenum.
• Large intestine.
• Gallbladder and bile ducts.
• Liver.
• Pancreas.

What diseases does a gastroenterologist treat?

Most often, the initial consultation is conducted by a gastroenterologist; if it turns out that a narrowly focused diagnosis and therapy is needed, the patient may be referred to a hepatologist or proctologist; acute, urgent conditions require surgical treatment using abdominal surgery.

So, what diseases does a gastroenterologist treat? The list is quite large, here are the main conditions, pathologies that require diagnostics and therapy:

• All types of gastritis, regardless of the nature of the disease, acute or chronic:
  • Hemorrhagic gastritis with bleeding erosions.
  • Atrophic gastritis.
  • Superficial gastritis.
  • Gastritis is high acidity.
  • Gastritis – low acidity.
  • Hypertrophic gastritis.
• Diaphragmatic hernias:
  • Sliding hernias.
  • Paraesophageal hernias.
• Achalasia of the cardia.
• GU – gastric ulcer and duodenal ulcer.
• Pyloric stenosis.
• All types of diverticulosis:
  • Congenital diverticula - Meckel's diverticulum (ileum) or localized in another area.
  • Acquired intestinal diverticulosis – intestinal pathologies, intestinal injuries, false diverticula, true diverticula.
• IBS – irritable bowel syndrome.
• Crohn's disease of various localizations.
• Dysbacteriosis.
• Reflux esophagitis.
• Stomach cancer - all types.
• Postoperative conditions (operated stomach).
• Aganglionosis is Hirschsprung's disease.
• Neoplasms (cysts), stones of the pancreas.
• Syphilitic lesions of the intestine.
• Intestinal tuberculosis.
• Hypoglycemic syndrome.
• Progressive enteritis, celiac disease, sprue, Whipple's disease.
• Intestinal dyskinesia of various etiologies.
• Functional malabsorption syndrome.
• Gastrointestinal carcinoid.
• Aspergillosis of the gastrointestinal tract.
• Mycosis of the digestive tract.
• All types of pancreatitis.
• Cystic fibrosis.
• Clinical conditions of acute abdomen include appendicitis, peritonitis, ulcer perforation, and so on.
• Infectious mononucleosis, toxoplasmosis.

What does a hepatologist treat?

• All types of hepatitis.
• Fatty liver disease.
• Cirrhosis.
• Liver cancer.
• Gallstone disease.
• Vascular diseases of the biliary system and liver, including metabolic changes.
• All types of cholecystitis.
• All types of cholangitis.
• Oncology of the biliary system.
• Dyskinesia of the biliary tract.
• Ascites.

What diseases does a gastroenterologist-proctologist treat?

• Constipation - spastic, atonic.
• Haemorrhoids.
• All types of proctitis, including paraproctitis.
• Anal fissures.
• Condylomatosis of the rectum and anorectal region.
• Cryptite.
• Colitis.
• Fistulas - rectovaginal, rectal fistula.
• Polyps.
• Epithelial coccygeal passage.
• Tumors.

It is obvious that the list of diseases that fall under the scope of gastroenterology is large, and it is impossible to provide it in full within the framework of this article. This once again emphasizes the importance and multi-vector nature of the work of a gastroenterologist.

Advice from a gastroenterologist

The first thing that gastroenterologists advise almost all patients is to adjust their diet and eating regimen. Not only the condition of the stomach and intestines, but also the normal functioning of the liver and the entire biliary system (the gallbladder and its ducts) depend on what enters the body in the form of food.

If a person continues to consume fatty, spicy, high-calorie food, treatment, no matter how complex, will not bring the desired result. Therefore, the basic advice of a gastroenterologist concerns, first of all, the following points:

• Range and diet. Eliminate heavy food, eat fractionally, possibly according to the prescribed diet (dietary rations according to Pevzner).
• Body weight control. Both obesity and exhaustion significantly reduce the activity of the digestive organs. Body weight should correspond to generally accepted medical norms. (BMI).
• Giving up bad habits. Neither excessive alcohol consumption nor smoking contribute to normal functioning of the digestive tract. About 85% of liver pathologies are associated with alcohol consumption, smoking is a direct path to gastric ulcer.
• Refusal of uncontrolled medication intake, self-medication. Over-the-counter sale of many drugs, so-called "folk" remedies, often leads to either chronicity of the pathological process or threatening complications. This is especially true for such a popular method as liver cleansing. More than 45% of people who risked liver cleansing without a preliminary examination and consultation with a doctor end up on the operating table due to obstruction of the bile ducts.
• Compliance with all medical recommendations even during the period when acute pains and exacerbations have been stopped. Treatment should be completed, then there is a possibility to reduce the risk of relapses, as well as to get rid of the disease altogether.
• Undergoing regular medical examinations, which should be comprehensive and include a visit to a gastroenterologist.

Digestive system diseases are diseases familiar to every second person, most often such conditions become chronic and are combined with other pathologies. Preventing and preventing dysfunction of the gastrointestinal tract is a common task for both the doctor and the patient. A gastroenterologist can help qualitatively and fully if a person contacts him in a timely manner, at the first symptoms. Then the diagnosis will be accurate, the treatment will be effective, and the restoration of the functions of the digestive system will help to fully experience the taste of a healthy lifestyle.