Definition and Overview
A gastroenterology follow-up refers to an after-care appointment or a series of appointments that are scheduled after the treatment plan has been completed.
Gastroenterology is a medical field that deals with the many parts of the digestive system as well as the conditions or diseases that affect them. The digestive or gastrointestinal tract (GI tract) is broken up into two sections: upper and lower.
The upper digestive tract starts from the mouth to the duodenum, which is the uppermost end of the small intestine. The lower tract, on the other hand, is composed of the majority of small intestines as well as the colon (lower intestine), rectum and anus. A gastrointestinal disease can affect only an organ or a small section of the GI tract or a huge part of it, as in the case of Crohn’s disease.
To a certain extent, however, gastroenterology includes the liver and the gallbladder since they secrete and store bile, which is necessary for the breakdown of fats found in food.
A doctor who specialises in this field is referred to as gastroenterologist. Aside from providing a diagnosis, he can also evaluate the progress of the disease or the treatment through tests and exams like endoscopy, treat conditions, manage symptoms and even counsel patients in relation to GI issues. Some of these medical professionals also subspecialize in other related fields such as surgery.
Who Should Undergo and Expected Results
A gastroenterology follow-up may be recommended for people who have:
Developed complications after treatment or test – Certain GI tests have risks or complications. For example, a colonoscopy may lead to dizziness, nausea, or rectal bleeding while an endoscopy may hurt vessels that can also lead to bleeding. Infections may also occur. The follow-up can be helpful in detecting and managing complications as well as to determining whether treatments against them are working.
Progressive or chronic disease – Some GI conditions like ulcerative colitis or Crohn’s disease are chronic and are thus more likely to progress over time even if treatments are available. The follow-up is necessary to carefully track their progress, manage the symptoms and effects as soon as possible, and discover ways to delay their progress.
Possibility of recurrence – People with colon cancer, for example, may experience recurrence or spread. A follow-up can be useful in detecting recurrence while it’s still early.
High risk of developing a GI illness – Many factors can contribute to the possibility of developing a GI condition. These include genetics, diet, overall health condition, age, environment and lifestyle. Depending on the degree of exposure to these risks, the doctor may conduct follow-up after consultations or screening to control these risks or manage the disease as soon as they are caught.
How Does the Procedure Work?
Initial discussions about the follow-up are conducted (1) during the formulation of the treatment plan, (2) immediately after consultation, and (3) after tests.
Follow-up appointments have different time intervals or frequency and this is based on the condition being treated, treatment or test conducted, the health of the patient and his age as well as symptoms and their severity. For example, patients who have been treated for colon cancer may require follow-up visits and tests every three to six months during the first five years to monitor recurrence or spread. Common tests conducted include physical examination, CT scan, rectosigmoidoscopy and CEA testing.
In other cases, one follow-up may be enough, especially if the symptoms have completely cleared up, the condition is mild, or the patient has a rather strong immune system.
Usually, the follow-up takes around 30 to 45 minutes. The first follow-up sessions are also normally the longest. Unless the condition has turned for the worse or the patient is considered in an emergency situation, the patient is expected to set up an appointment with a gastroenterologist in a clinic or hospital setting. An appropriate schedule is provided while a staff is responsible for reminding the patient if the appointment is nearing.
Upon arrival, the patient goes through preliminary examinations and interviews. The staff also prepares the medical records and other health information, which will then be forwarded to the doctor.
During the meeting, the gastroenterologist will conduct a medical evaluation through a physical exam (or other tests), compare previous and present results and make recommendations based on these factors. The doctor may also conduct counseling to improve treatment, management and survival outcomes.
Possible Risks and Complications
Some of the tests may not only be time-consuming but may also be painful or uncomfortable for the patient. They may also not want to deal with minor complications anymore. This may then encourage them to skip follow-up and avoid retaking exams.
- American Gastroenterology Association