Gastroenterology deals with study of normal functions and diseases associated with the esophagus, stomach, small intestine, colon and rectum.
A gastroenterologist studies the physiological functions of these organs, including the movement of material through the stomach, intestines and colon.
“Motility” examines the digestion of food and the absorption of nutrients, as well as waste material that is eventually expelled. A gastroenterologist specialist studies the entire digestive system, recommending treatments when necessary. Gastroenterologist physicians are also hepatologists, because gastroenterology also deals with associated digestive organs, including the liver, gall bladder, bile ducts and pancreas.
One of a gastroenterologist’s most important responsibilities is to detect cancers. Cancers within the esophagus, stomach, colon, rectum and liver can all be successfully treated with early detection.
Endoscopy is one of the most reliable methods for detecting gastrointestinal diseases. The endoscope is a thin, flexible tube fitted with a camera and light inserted into the gastrointestinal tract to provide an inside picture of the esophagus, stomach, duodenum and colon.
Examination of the upper digestive tract, including the esophagus, stomach and duodenum, is normally done by gastroscopy. The large intestine, or colon, is examined by colonoscopy.
A great advantage of endoscopy is that special instruments can be passed through the endoscope to take biopsies, removing growths such as polyps (polypectomy), without surgery. Polypectomy can also stop bleeding lesions by either injection or cautery (haemostasis), and can stretch narrowed areas through dilatation, placing stents through blocked tubes and removing gallstones from bile ducts through a special procedure called endoscopic retrograde Cholangio-Pancreatography.
Endoscopic laser or argon-plasma beam therapy can also be applied to burn away cancers and arrest internal bleeding. The small intestine, previously inaccessible, can now be examined with a new technology called capsule endoscopy, developed by Balloon Endoscopes. Endoscopic ultrasound is a technique that examines the walls of the digestive tract, and associated organs including the pancreas and bile ducts.
Gastroenterologists are different from general practitioners, internal medicine specialists and surgeons, all of which also deal with digestive tract diseases. The highly focused training of a gastroenterologist allows for the provision of comprehensive care for a wide range of gastrointestinal ailments, especially in endoscopy.
Gastroenterologists perform the bulk of their research on gastrointestinal diseases, endoscopy and the interpretation of endoscopic findings. Because of the prevalence of “functional diseases” like non-ulcer dyspepsia, irritable bowel syndrome or “invisible” diseases such as malabsorption syndrome, gastroenterologists are specially trained to evaluate patients who have no endoscopic signs to explain significant symptoms. These disease categories are often the most difficult to evaluate and treat.
So who needs a gastroenterologist? There are many bothersome and persistent digestive-related symptoms that might compel a gastroenterologist’s opinion. Here are some symptoms — either alone or in combination — that may require further examination:
Heartburn; reflux of acid or stomach contents into the throat; bloated or distended sensations in the abdomen; difficulty swallowing; constipation; diarrhea; any significant change in bowel movements; vomiting; fresh or altered blood passing from the rectum; loss of appetite or weight; lethargy or lack of wellness; jaundice; yellowing of the skin and whites of eyes; dark-colored urine, or pale-colored stools.
In addition, it may be appropriate for some asymptomatic patients to seek non-cancer screening. Some people have a family history of cancer (especially colorectal cancer) or polyps, while others could have significant blood test abnormalities from general health screens.
Given the high prevalence of colorectal cancer, anyone around the age of 50 who have never been screened before should consider a check-up, especially since the risks increase sharply among those over the age of 50.
Dr. Tan Chi Chiu
MBBS (S’pore), MMed (Internal Medicine), MRCP (Ireland), MRCP (UK), FRCP (Edinburgh), FRCP (London), FAMS
consultant gastroenterologist & physician at
Gastroenterology & Medicine International Pte Ltd
6 Napier Road, 10-08 Gleneagles Medical Centre, Singapore 258499