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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 organs of the gastrointestinal system increases by 10-15% per year. This is due to various factors, but the main ones are: 

  • non-observance of the rules of rational nutrition, 
  • extremely low quality of drinking water and consumed products, 
  • ecological problems, 
  • stress 
  • sedentary lifestyle.

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

Who is a gastroenterologist?

A specialist who diagnoses, diagnoses, treats diseases of the gastrointestinal system, is a gastroenterologist. In this way it would be necessary to formulate the direction of this specialization according to the Greek sources - gaster, enteron, logos, which literally means the stomach, gut and teaching. However, every year information on pathologies in various parts of the digestive tract is added, the diseases are studied more deeply, so changes began in the specialization - adding supervised organs and dividing into narrow areas: 

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

Therefore, answering the question, who is a gastroenterologist, you need to consider all possible specializations of this doctor. Accordingly, in addition to basic training in a higher medical institution, a gastroenterologist must undergo advanced postgraduate training in clinical residency and, as a result, acquire such 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 provisions for the treatment and prevention of digestive tract diseases.
  • Examination, palpation, auscultation, percussion, abdominal puncture.
  • Preparation of the patient for examination (X-ray of the stomach, intestines, gallbladder).
  • Conducting or supervising the process of endoscopic examinations - FGDS, colonoscopy, laparoscopy, sigmoidoscopy, as well as an adequate evaluation of the results.
  • Ability to correctly assess the results of ultrasound studies of the liver, pancreas.
  • Ability to evaluate the results of computed tomography of all organs of the abdominal region.
  • Ability to correctly analyze and evaluate the results of laboratory studies - biochemical blood test, coprogram, PH-metry, fractional study of gastric juice.
  • Knowledge of the criteria of indications or contraindications to surgical intervention.
  • Ability to determine the tactics and strategy of treatment of the revealed pathology.
  • Knowledge of the basics of physiotherapy, massage, exercise therapy.
  • Knowledge of the bases of therapeutic nutrition, dietotherapy.
  • Basic criteria for determining the need for sanatorium treatment.
  • General issues of preventing diseases of the digestive tract.
  • Ability to correctly prepare the relevant medical documentation.

Summarizing, you can say who is a gastroenterologist. He is a highly educated specialist with deep, extensive knowledge and practical skills in the diagnosis, therapy and prevention of almost all diseases related to digestion.

When should I go to a gastroenterologist?

Problems of diseases of the gastrointestinal tract, the organs of the digestive system have the same ancient history as the first food taken by our ancestors. Unfortunately, today the pathologies of the digestive system are the second most numerous among all the diseases of mankind. Therefore, the question of when to contact a gastroenterologist is extremely important and relevant. Any discomfort or pain, such as heartburn, colic, constipation, spasms, or flatulence, should be the reason to get counseling or to undergo examination.

Within the framework of the problem of digestive system diseases, the most important task, directly relating to the patient himself, is not to allow the pathological process to pass into a chronic form. Many doctors are convinced that most GI diseases can be treated fairly quickly and successfully if they are detected at the earliest stages. And chronic pathologies are extremely difficult to supervise and often lead to exacerbations, up to those that need surgery.

So, when, at what signs, symptoms should you go to a gastroenterologist? 

  • If the pain in the abdomen is not individual, last more than a day, or repeated regularly.
  • If discomfort in the digestive system disrupts the overall rhythm of life, interferes with work.
  • If you lose your appetite.
  • If the weight begins to decrease or increase.
  • With any symptoms accompanied by nausea or vomiting. Indomitable vomiting requires urgent care.
  • If the pain in the abdomen is accompanied by an increase in temperature.
  • With indomitable diarrhea (emergency treatment).
  • Constipation.
  • Constant heartburn.
  • If the pain in the abdomen occurs at night, is acute, intolerable.
  • If the history already has a disease associated with the gastrointestinal tract.
  • If you have suffered a catarrhal operation.
  • If the pain in the digestive organs occurs after taking certain medications.
  • If you have a history of diabetes.

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

What tests should I take when I contact a gastroenterologist?

The first visit to the doctor may be accompanied by certain rules and requirements. Most often the patient gets to the gastroenterologist in the direction of the therapist, which indicates the list of the most necessary laboratory tests, the further diagnostic measures are determined by a narrow specialist.

To see a specialist, you need to go with the card and the results of previous studies, if they were conducted. Before the consultation it will be necessary to "refresh"

Biochemical blood test (studies of ALT, AST, alkaline phosphatase, bilirubin, lipase, pancreatic amylase, GGTP), also coprogram and analysis of feces for dysbiosis. Often, the therapist prescribes and ultrasound of the abdominal cavity, as well as EGD

A more detailed list of indicators that will help a doctor to more accurately establish a diagnosis of a digestive system: 

  • ALAT - alanine aminotransferase.
  • Amylase.
  • Lipase.
  • Cholinesterase.
  • Alkaline phosphatase.
  • The protease inhibitor is alpha 1-antitrypsin.
  • Reactive protein of acute phase, AGP - alpha 1 glycoprotein.
  • Cellular enzyme of AST - aspartate aminotransferase.
  • Bilirubin is a common, direct, as well as albumin, a common protein.
  • Amino acid enzyme, GGT - gamma glutamyltransferase.
  • Markers of hepatitis viruses.
  • PTV - prothrombin time and PTI - prothrombin index.
  • Protein fractions - proteinogram.
  • Coprogram on the definition of latent bleeding.
  • Analysis of feces for helminthiasis.
  • The test for Helicobacter, blood for antibodies to Helycobacter.
  • FED-test for food intolerance.
  • X-ray contrast study of the gastrointestinal tract.
  • Colonoscopy.
  • Enteroscopy.
  • Determination of pH of gastric juice.

What diagnostic methods does the gastroenterologist use?

Modern gastroenterological diagnostics presupposes the use of all the latest achievements in this field, but the already well-known types of examinations - ultrasound, FGD, laparoscopy, sigmoidoscopy and various radiological methods of research - remain important and relevant. All this in combination with traditional laboratory analyzes allows you to quickly and accurately determine the etiology and pathogenetic mechanisms of disease development.

In addition, there is also a classical scheme, which includes such stages of the survey: 

  • Conversation with the patient and clarification of anamnestic information, especially symptoms, clinical manifestations of the disease.
  • Examination of the patient - examination of the tongue, palpation and percussion of the abdomen.
  • If necessary, rectal examination is possible.

Further, instrumental types of examination come into play, which play an important role in an integrated diagnostic strategy. The main methods of diagnosis of diseases of the digestive system: 

  1. X-ray is a contrast study of the state of the esophagus, stomach, small and large intestine, duodenum.
  2. Endoscopy - examination using a probe of the esophagus, stomach, duodenum and large intestine.
  3. Ultrasound is sonography, which determines the size, shape, structure and localization of the 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 makes it possible to evaluate the functions of the digestive system: 

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

In addition, recently a fairly widely used computed tomography, which allows you to obtain a visual image of tissues at virtually any depth, and layerwise, multidimensional. Thus, the doctor has the opportunity to evaluate tissue structures, their density, integrity and other characteristics of the organs. CT is assigned to study the condition of the liver, spleen, gall bladder, vascular system of the abdominal region.

The choice of the type of diagnosis is associated with the characteristics of the disease, the nature of its course, each method has its own limits of informativeness and can not be used as an independent, mono test.

What does a gastroenterologist do?

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

What does a gastroenterologist do? The answer is both simple and complex - all diseases related to digestion. Digestion is a complex, interrelated process that processes the incoming food in the body to obtain much-needed energy for man. All food passes a multi-stage processing process, under the influence of enzymes it splits into necessary and unnecessary categories, then absorbed into the blood and lymph. From the state of the esophagus, mucous membrane of the stomach, duodenum, gallbladder and bile ducts, virtually all human health depends on the functioning of the pancreas. In addition, liver function is important, which purifies blood from intoxication products and participates in many other metabolic processes. Therefore, it is rather difficult to answer specifically what the gastroenterologist is doing, it all depends on which organ, system, the failure occurred. Modern gastroenterology has a long way of development, since the time of Hippocrates and Galen, it continues to develop intensively, therefore the scope of the gastroenterologist is very wide. In this regard, the division of specialization into narrower areas that make the doctor's work more urgent and timely became important: 

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

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

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

What diseases does the gastroenterologist treat?

Most often the primary method is performed by a gastroenterologist, if it turns out that a narrowly targeted diagnosis and therapy is needed, the patient may be referred to a hepatologist or proctologist, acute, urgent conditions require surgical treatment with the help of abdominal surgery.

So, what diseases does the gastroenterologist treat? The list of them is very large, we give the main conditions, pathologies that require diagnosis and therapy: 

  • All types of gastritis, regardless of the nature of the course of the disease, acute or chronic: 
    • Haemorrhagic gastritis with bleeding erosions.
    • Atrophic gastritis.
    • Superficial gastritis.
    • Gastritis - increased acidity.
    • Gastritis - reduced acidity.
    • Hypertrophic gastritis.
  • Diaphragmatic hernia: 
    • Sliding hernia.
    • Paraesophageal hernia.
  • Achalasia of the cardia.
  • YABZH - peptic ulcer of the stomach and duodenum.
  • Stenosis of the gatekeeper.
  • All types of diverticulosis: 
    • Congenital diverticula - Meckel's diverticulum (ileum) or localized in another zone.
    • Acquired diverticulosis of the intestine - pathology of the intestine, intestinal injuries, false diverticula, true diverticula.
  • IBS is irritable bowel syndrome.
  • Crohn's disease of different localization.
  • Dysbacteriosis.
  • Reflux esophagitis.
  • Cancer of the stomach - all kinds.
  • Postoperative conditions (operated stomach).
  • Agangliosis is Hirschsprung's disease.
  • Neoplasms (cysts), pancreas stones.
  • Syphilitic lesions of the intestine.
  • Tuberculosis of the intestine.
  • Hypoglycemic syndrome.
  • Progressive enteritis, celiac disease (gluten disease), sprue, Whipple's disease.
  • Dyskinesia of the intestine of various etiologies.
  • Syndrome of functional malabsorption.
  • Carcinoid of the gastrointestinal tract.
  • Aspergillosis of the gastrointestinal tract.
  • Mycosis of the digestive tract.
  • All kinds of pancreatitis.
  • Cystic fibrosis.
  • Clinical conditions of the acute abdomen - inflammation of the appendix, peritonitis, perforation of the ulcer and so on.
  • Infectious mononucleosis, toxoplasmosis.

What heals a hepatologist?

  • All kinds of hepatitis.
  • Fatty degeneration of the liver.
  • Cirrhosis.
  • Liver cancer.
  • Cholelithiasis.
  • Vascular diseases of the biliary system and liver, including metabolic changes.
  • All kinds of cholecystitis.
  • All kinds of cholangitis.
  • Oncology of the biliary system.
  • Biliary dyskinesia.
  • Ascites.

What diseases are treated by the gastroenterologist-proctologist? 

  • Constipation is spastic, atonic.
  • Hemorrhoids.
  • All kinds of proctitis, including paraproctitis.
  • Cracks in the anal passage.
  • Condylomatosis of the rectum and anorectal area.
  • Cryptite.
  • Colitis.
  • Fistulas - rectovaginal, fistula of the rectum.
  • Polyps.
  • Epithelial coccygeal passage.
  • Tumors.

Obviously, the list of diseases that enter the field of gastroenterology is great, and it is impossible to provide it in full within the framework of this article. This once again underscores the importance and multi-vector nature of the work of a gastroenterologist.

Advices of a gastroenterologist

The first thing that gastroenterologists advise almost to all patients is to adjust the diet and diet. From what enters the body in the form of food, not only the state of the stomach and intestines depends, but also the normal functioning of the liver and the entire biliary system (the gallbladder, its ducts).

If a person continues to consume fatty, spicy, high-calorie foods, treatment, however complex it may be, will not produce the proper result. Therefore, the basic advice of a gastroenterologist is concerned, first of all, with such moments: 

  • Assortment and diet. Exclude heavy food, eat fractional, perhaps according to the prescribed diet (dietary rations for Pevzner).
  • Control of body weight. Both obesity and malnutrition significantly reduce the activity of the digestive system. Body weight must comply with generally accepted medical standards. (BMI).
  • Rejection of bad habits. Neither excessive craving for alcoholic drinks, nor smoking does not contribute to the normal functioning of the digestive tract. About 85% of liver pathologies are associated with alcohol consumption, smoking - a direct path to the YaBZ (peptic ulcer disease).
  • Refusal from uncontrolled reception of medicines, from self-treatment. Over-the-counter vacation of many drugs, so-called "folk" remedies often leads to either a chronic pathological process, or to menacing complications. Especially it concerns such popular method as liver cleaning. More than 45% of people who risked cleaning the liver without a preliminary examination and consulting a doctor, get on the operating table in connection with the obstruction of the bile duct.
  • Compliance with all medical recommendations even in the period when acute pains, exacerbations are stopped. Treatment should be brought to the end, then there is the opportunity to reduce the risk of relapse, and also completely get rid of the disease.
  • Pass regular check-ups, which should be comprehensive and include a visit to the gastroenterologist.

Diseases of the digestive system are diseases that are familiar to every second person, most often such conditions pass into a chronic form and are combined with other pathologies. To prevent and prevent dysfunction of the digestive system is a common task, both for the doctor and for the patient. A gastroenterologist can help in a qualitative and high-grade manner, if a person consults him in a timely manner, with the first symptoms. Then the diagnosis will be accurate, treatment effective, and restoring the functions of the digestive system will help to fully experience the taste of a healthy lifestyle.

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Medical expert editor

Portnov Alexey Alexandrovich

Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"

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