About Gastroenterologist Speciality

Gastroenterology is a medical branch that studies the gastrointestinal tract and the diseases related to it. A gastroenterologist diagnoses and treats severe digestive conditions such as colon polyps, colon cancer, colonitis, hepatitis, gallbladder disease, irritable bowel syndrome, pancreatitis, peptic ulcer disease, etc. A gastroenterologist uses various techniques to cure these diseases, the most prominent of which is endoscopy. This involves entering a small camera with a light through a long thin tube, which helps to examine the problem so that a diagnosis can be done.
Gastroenterologists are intensely trained by recognised experts in the field and develop a detailed understanding of gastrointestinal diseases. Gastroenterologists also learn how to perform advanced endoscopic procedures such as polypectomy (removal of colon polyps), oesophageal and intestinal dilation (stretching of narrowed areas), and haemostasis (injection or cautery to stop bleeding). Some Gastroenterologists also receive directed training in advanced procedures using endoscopes such as endoscopic biliary examination, removal of tumours without surgery etc.

A gastroenterologist is trained medical professional who diagnoses and treats diseases of the gastrointestinal tract in both men and women.

The medical field of gastroenterology involves the study, research, diagnosis, and management of health conditions that may affect the digestive system or the gastrointestinal (GI) tract. A GI tract includes the mouth, pharynx, oesophagus, stomach, small intestine, large intestine, liver, gallbladder, pancreas, salivary glands, tongue, epiglottis, rectum and anus. 

In order to become a gastroenterologist, one must complete seven or more years of medical school and post-graduate training and become board certified in Internal Medicine. After that, two to three years of study related to gastrointestinal tract to be certified in the subspecialty is necessary. A gastroenterologist may work in private practice or within a team setting at a gastroenterology clinic or a hospital. 

When to see a gastroenterologist? 
When you cross the age barrier of 50, you must meet with a gastroenterologist for preventive care. Men and women over the age of 50 are at an increased risk for colon cancer. Your general physician may refer you to a gastroenterologist, if you:
  • Are experiencing blood in your stool
  • Are having swallowing problems
  • Are suffering from persistent abdominal pain

What conditions does a gastroenterologist normally treat?

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD) is a chronic digestive disease in which stomach acid flows back into your food pipe. This activity irritates the lining of your oesophagus and causes GERD. 

Symptoms of Gastroesophageal Reflux Disease (GERD)
Symptoms include burning sensation in your chest, chest pain, difficulty swallowing, sore throat, acid reflux. 

Treatment of Gastroesophageal Reflux Disease (GERD)
A gastroenterologist may prescribe antacids, H-2-receptor blockers or proton pump inhibitors to treat GERD. In some cases, surgery may be required to fix the oesophagus.   

Peptic Ulcers

Peptic ulcers are sores that develop in the lining of the stomach, lower oesophagus, or small intestine. Gastric ulcers, oesophageal ulcers and duodenal ulcers are some of the types of peptic ulcers. 

Symptoms of Peptic ulcers
Symptoms include burning abdominal pain that extends from the navel to the chest. 

Treatment of Peptic ulcers
A gastroenterologist may prescribe antibiotics to help kill infections, and proton pump inhibitors to help reduce stomach acid.

Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome is a condition that affects the large intestine. 

Symptoms of Irritable Bowel Syndrome
Symptoms include cramping, abdominal pain, bloating, gas, diarrhoea and constipation. Food allergy, stress, hormones and illnesses such as gastroenteritis are known to cause IBS. 

Treatment of Irritable Bowel Syndrome
A gastroenterologist may prescribe fibre supplements, over-the-counter medications to control diarrhoea, antispasmodic medications or tricyclic antidepressant to treat IBS. 

Hepatitis C

Hepatitis C is a viral infection that causes liver inflammation and if left untreated can lead to liver damage. Hepatitis C virus spreads through contaminated blood. 

Symptoms of Hepatitis C
Symptoms include bruising and bleeding, weight loss, swelling in the legs, poor appetite etc.
 
Treatment of Hepatitis C
A gastroenterologist may prescribe antiviral medications intended to clear the virus from your body. But in severe cases, a liver transplantation becomes necessary. 

Colon Polyps

A colon polyp is a small clump of cells that forms on the lining of the colon. If left untreated, a colon polyp can develop into colon cancer. 

Symptoms of colon polyps
Symptoms include rectal bleeding, changes in stool colour, irregular bowel habits, vomiting, and iron deficiency. 

Treatment of colon polyps
A gastroenterologist in coordination with a gastrointestinal surgeon may opt for polyp removal through minimally invasive surgery or complete colon and rectum removal. 

Jaundice

Jaundice is a yellowish discoloration of the skin, mucous membranes and of the white of the eyes caused by increased levels of the chemical bilirubin in the blood. 

Symptoms of Jaundice
Symptoms include pale-coloured stools, dark-coloured urine, skin itching, nausea and vomiting, rectal bleeding, weight loss, loss of appetite, swelling of the legs, etc. Treatment of jaundice depends on the type. 

Treatment of Jaundice
A gastroenterologist may order blood transfusion to replenish red blood cells in the body or a surgery if bile duct system is blocked. 

Haemorrhoids

Haemorrhoids are swollen veins located around the anus or in the lower rectum. They can either be internal or external. External haemorrhoids are the most common and worrying. 

Symptoms of Haemorrhoids
Symptoms include itching or pain around the anus, faecal leakage, painful bowel movements, swelling near your anus, bloody stool etc. 

Treatment of Haemorrhoids
A gastroenterologist may prescribe fibre supplements to help soften your stool. Over-the-counter topical creams can ease your discomfort from haemorrhoids. 

Pancreatitis
Pancreatitis is inflammation in the pancreas. It can either be acute or chronic. 

Symptoms of Pancreatitis
Symptoms include upper abdominal pain, nausea, vomiting, tenderness when touching the abdomen, abdominal pain that feels worse after eating etc. 

Treatment of Pancreatitis
A gastroenterologist may order fasting to control the inflammation in your pancreas, prescribe pain medications and intravenous fluids. In severe cases, surgery may be performed to remove bile duct obstructions.

Anal Fissure

An anal fissure is a small tear in the thin, moist tissue that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. 

Symptoms of anal fissure
Symptoms may include severe pain during bowel movements, pain after bowel movements, bloody stool, irritation around the anus, visible crack in the skin around the anus, small lump near the anal fissure. 

Treatment of anal fissure
A gastroenterologist may prescribe externally applied nitroglycerin, topical anaesthetic creams, botulinum toxin type A (Botox) injection, blood pressure medications for the treatment of anal fissure. Moreover, gastroenterologists may recommend lateral internal sphincterotomy (LIS) surgery to reduce spasm and pain and promote healing. 
 
Constipation

Constipation refers to as difficulty in passing of stools that persists for several weeks or longer. The condition is usually described as having fewer than three bowel movements a week. 

Symptoms of Constipation
Symptoms may include lumpy or hard stools, straining to have bowel movements, feeling of blockage in your rectum that prevents bowel movements, feeling that you can't completely empty the stool from your rectum etc.

Treatment of Constipation
A gastroenterologist may prescribe laxatives to soften your bowel movement such as fibre supplements, stimulants, osmotic laxatives, lubricants, stool softeners such as docusate sodium, enemas and suppositories. Other than these, a gastroenterologist may also suggest medications that draw water into your intestines like lubiprostone and linaclotide.  
   
Anal Fistula

Anal fistula is a medical condition referred to as an infected tunnel that develops between the skin and the muscular opening at the end of the digestive tract. Anal fistulas develop because of an infection that starts in an anal gland.

Symptoms of Anal fistula
Symptoms may include recurrent anal abscesses, pain and swelling around the anus, pain with bowel movements, foul-smelling drainage from an opening around the anus, general feeling of fatigue, irritation of the skin around the anus. 

Treatment of Anal fistula
A gastroenterologist may recommend surgery (fistulotomy) to manage an anal fistula. Following fistula surgery, he may prescribe stool softeners or laxatives for a week.   

Diverticulitis

Diverticulitis is a small, bulging pouch that can form in the lining of your digestive system. They are found most often in the lower part of the large intestine. In some cases, more than one pouch can become form inflamed or infected. 

Symptoms of Diverticulitis
Symptoms may include pain in the lower left side of the abdomen, nausea, vomiting, abdominal tenderness, constipation etc. 

Treatment of Diverticulitis
A gastroenterologist may prescribe antibiotics, a liquid diet or an over-the-counter pain reliever, such as acetaminophen for the treatment of diverticulitis. Additionally, primary bowel resection or bowel resection with colostomy are surgical procedures performed by a gastroenterologist to treat diverticulitis.  

Ulcerative Colitis

Ulcerative colitis is an inflammatory bowel disease that leads to long-lasting inflammation and ulcers in your digestive tract. Most commonly, ulcerative colitis affects the innermost lining of your large intestine and rectum. 

Symptoms of Ulcerative colitis
Symptoms include diarrhoea often with blood or pus, abdominal pain and cramping, rectal pain, rectal bleeding, urgency to defecate, weight loss, fatigue etc.
  
Treatment of Ulcerative colitis
A gastroenterologist may prescribe a number of medicines to treat ulcerative colitis including anti-inflammatory drugs such as sulfasalazine, corticosteroids, immunosuppressant drugs such as azathioprine, cyclosporine, infliximab, vedolizumab, antibiotics, anti-diarrheal medications, pain relievers and iron supplements. Alternatively, a gastroenterologist may recommend removing your entire colon and rectum via a surgical procedure known as proctocolectomy.     
 
Crohn's Disease

Crohn's disease is an inflammatory bowel disease which causes inflammation of the lining of your digestive tract. The swelling may appear in different areas of the digestive tract and may be different in different people. Crohn's disease can be extremely painful and sometimes lead to life-threatening complications. 

Symptoms of Crohn's disease
Symptoms may include diarrhoea, feeling tired or low energy, abdominal pain and cramping, bloody stool, mouth sores, reduced appetite and weight loss, pain or drainage near or around the anus due to inflammation. 

Treatment of Crohn's disease
A gastroenterologist may prescribe a number of medicines to treat Crohn's disease including anti-inflammatory drugs such as sulfasalazine, corticosteroids, immunosuppressant drugs such as azathioprine, cyclosporine, infliximab, vedolizumab, antibiotics such as metronidazole and ciprofloxacin, fibre supplements, pain relievers, iron supplements, calcium and vitamin D supplements. Occasionally, a surgery may be required to remove a damaged portion of your digestive tract and then reconnect the healthy sections.   
  
Gallstones

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Gallstones are of different sizes- from a sand grain to a golf ball. People may develop one or multiple gallstones. 

Symptoms of Gallstones
Symptoms include intense pain in the upper right portion of your abdomen, intense pain in the centre of your abdomen, back pain, pain in the right shoulder, nausea or vomiting.
 
Treatment of Gallstones
A gastroenterologist may recommend surgery to remove your gallbladder (Laparoscopic cholecystectomy), since gallstones frequently recur. Alternatively, he may prescribe medicines to dissolve gallstones.   
 
Celiac Disease

Celiac disease is an immune reaction to eating gluten, a protein found in wheat, barley and rye. This reaction destroys your small intestine's lining and leads to malabsorption. In children, malabsorption can affect growth and development. 

Symptoms of Celiac disease
Symptoms include iron deficiency, Loss of bone density, softening of bone, blistery skin rash, damage to dental enamel, mouth ulcers, headaches and fatigue, nervous system injury, joint pain, reduced functioning of the spleen or heartburn. 

Treatment of Celiac disease
In addition to eating gluten-free diet, a gastroenterologist may prescribe calcium supplements, folate supplements, Iron supplements, vitamin B-12, vitamin D, vitamin K supplements and zinc supplements to treat celiac disease.  

Gastroenteritis

Gastroenteritis is a viral intestinal infection caused due to contact with an infected person or by ingesting contaminated food or water. 

Symptoms of Gastroenteritis
Symptoms include watery diarrhoea, abdominal cramps and pain, nausea, vomiting or both, occasional muscle aches or headache, low-grade fever. 

Treatment of Gastroenteritis
There’s no medication for gastroenteritis as antibiotics have no effect on viruses. Consult a gastroenterologist before applying self-care measures. 

Diarrhoea

Diarrhoea is referred to as a condition in which a person experiences loose, watery and possibly more-frequent bowel movements. Diarrhoea lasts a couple of days but when it stretches, it may turn into a serious disorder. 

Symptoms of Diarrhoea
Symptoms include loose, watery stools, abdominal pain and cramps, fever, bloody stool, bloating, nausea and urgent need to have a bowel movement.

Treatment of Diarrhoea
A gastroenterologist may prescribe antibiotics for diarrhoea caused by bacteria or parasites. Antibiotics won’t help if the reason behind diarrhoea is a virus. He may advice you to take fluids rich in salts and electrolytes. 

Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease (IBD) involves chronic inflammation of all or part of your digestive tract. This medical condition can lead to life-threatening complications if not managed properly. 

Symptoms of Inflammatory Bowel Disease (IBD)
Symptoms include diarrhoea, weight loss, abdominal pain and cramps, bloody stool, lack of appetite, etc.

Treatment of Inflammatory Bowel Disease (IBD)
A gastroenterologist may prescribe anti-inflammatory drugs such as aminosalicylates and corticosteroids for the treatment of inflammatory bowel disease. Additionally, to reduce inflammation, he may prescribe immunosuppressant drugs such as azathioprine, cyclosporine, infliximab, methotrexate or natalizumab.      

Gastroenterologists also perform a range of diagnostic procedures as well including:
  • Endoscopic Ultrasounds
  • Colonoscopies
Endoscopic Retrograde Cholangiopancreatography
  • Sigmoidoscopies
  • Liver Biopsies
  • Capsule Endoscopies
  • Double Balloon Enteroscopies

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