Definition and Overview
Gastroenterology is a branch of medicine that involves with the normal function as well as diseases of the entire digestive system that include the oesophagus, stomach, gallbladder, pancreas, liver, bile ducts, small intestine, large intestine (colon) and rectum. A gastroenterologist, a doctor specializing in this field, has detailed knowledge and understanding of the normal physiology of the aforementioned organs as well as the proper motility of the gastrointestinal tract. In addition, he must also be able to advice patients the importance of maintaining healthy digestion and metabolism, absorption function of nutrients from food and the prompt removal of metabolic waste.
Diseases and diagnosis in Gastroenterology
Diseases that affect the organs of the gastrointestinal system are the following:
- Celiac disease and intolerances in food
- Chronic gastroparesis
- Colorectal cancer, colitis and cholecystisis
- Diseases of the liver including cirrhosis and fatty liver
- Diverticulitis, ischemic bowel disease and diverticulosis
- Esophageal Cancers
- Functional gastrointestinal illnesses including vomiting, diarrhea, belching, flatulence and constipation
- Gallbladder diseases such as stones and cancer
- Gastrointestinal tract infections caused by bacteria, virus or fungi
- Heartburn and GERD (gastroesophageal reflux disease)
- Inflammatory bowel disease (IBD) including ulcerative colitis and Crohn's disease
- Irritable bowel syndrome (IBS)
- Obesity, nutritional deficiencies, and malabsorption
- Pancreatitis (acute or chronic)
- Peptic ulcer and Helicobacter pylori
- Colorectal polyps
- Stomach cancer
- Viral hepatitis
To be eligible for training or fellowship in gastroenterology, a medical doctor must first complete residency training in Internal Medicine for three years. Gastroenterology training lasts another 2 to 3 years. During training, doctors go through an intensive program to gain in-depth, full understanding of gastrointestinal problems. They are trained in the proper evaluation, as well as properly interpreting symptoms, findings and biopsy results in order to recommend the most appropriate treatment.
Gastroenterologists are also given training in endoscopy (including upper endoscopy, sigmoidoscopy and colonoscopy), which is a very thin, narrow tube with light and built-in cameras used to visualize the inside linings of the gastrointestinal tract. Aside from their extensive training in performing endoscopy, they also receive training in using and administering sedating medicines to ensure the comfort of patients. Moreover, they are given further advanced training in advanced endoscopic procedures such as esophageal and intestinal dilation, hemostasis for stopping bleeding, and polypectomy (removal of abnormal growths or polyps).
Most gastroenterologists are also armed with advanced knowledge on modern procedures in endoscopy including endoscopic biliary examination, endoscopic ultrasound, placement of internal stents, and non-surgical removal of tumours through endoscopic mucosal resection. This advanced training allows them to evaluate and treat tumours using minimally invasive non-surgical options when available.
After a comprehensive training, gastroenterologists then start to incorporate their knowledge into practice to provide high-quality consultative and endoscopy services. Many gastroenterologists bear the suffixes FACG and FACP to indicate that they have been properly trained as fellows and fulfilled the educational and occupational requirements of the American College of Gastroenterology and American College of Physicians, two institutions which oversee quality education in medicine or their equivalent in the doctor's home country.
Some gastroenterologists go through a sub-specialization (additional training) in hepatology or hepatobiliary medicine to treat and manage advanced diseases of the pancreas, liver and biliary tree.
When to see a Gastroenterologist
Gastroenterologists are known for short as "GI" or Gastro-Intestinal doctors. Patients who have problems in digestive health can most benefit from the care and treatment of these medical professionals. Although some general practitioners can evaluate common digestive ailments, patients with advanced symptoms are almost always referred to a GI doctor for proper evaluation. A gastroenterologist can fully evaluate your symptoms, perform tests to make a diagnosis, and prescribe the most appropriate treatment.
What to expect in your visit
In your gastroenterologist visit, you will usually be welcomed by a staff member who will confirm your personal and insurance information, review allergies and medications, and check vital signs (blood pressure and heart rate), before you are led to see the physician. The GI doctor will then ask detailed questions about current symptoms, past medical history and other pertinent information related to your condition. Depending on the symptoms, the doctor may recommend further tests such as blood tests, gastrointestinal procedures, motility tests or an endoscopy. The doctor will discuss the proper care and instructions for preparation of these tests. Once the diagnosis is confirmed, appropriate treatment will be suggested. The amount of time required for your visit will depend on your gastrointestinal problem, but usually last about 30 to 60 minutes, however it can be varied depending on the diagnosis.
- American Gastroenterological Association. “About Gastroenterology” Available: http://www.gastro.org/patient-center/about-gastroenterology
- University of North Carolina Chapel Hill School of Medicine. “General Gastroenterology Clinic: What to Expect” Available: http://www.med.unc.edu/gi/for-patients/clinical-services/general-gastroenterology-clinic/what-to-expect-and-frequently-asked-questions