Diagnosis

To make a diagnosis, the doctor must first determine the localization of the pain and the disease. To do this, he first conducts a patient interview, the anamnesis. During this interview, the patient can, for example, provide information about the exact location and intensity of the pain. The doctor will then palpate the patient.If the diagnosis is unclear, blood can be taken to see whether any inflammation parameters have increased, or an ultrasound or CT scan can be performed. In particularly unclear cases, it can also help if the patient takes contrast medium to find the exact cause of the gastrointestinal disease in the X-ray image.

Frequency distribution

Gastrointestinal diseases are among the most common diseases in Germany. Appendicitis alone is operated on 127,000 times per year in Germany. The probability to get a diverticulum and to fall ill with it increases with age and is already at 30% for the 60 year old. Thus, diseases of the gastrointestinal tract are among the most popular diseases.

Symptoms

Depending on which gastrointestinal disease is present, the symptoms can be very different:

Malignant tumors, no matter in which area of the gastrointestinal tract, usually become noticeable very late because they do not cause pain.
The reflux esophagitis usually manifests itself as pain after belching, compared to heartburn.
A stomach ulcer or a stomach tumor is often noticed when the patient no longer feels like drinking alcohol or when he strongly rejects high-fat food, especially meat. In addition, nausea and vomiting often occur.
Inflammatory diseases of the small or large intestine are usually manifested by an altered stool, usually alternating between diarrhea (diarrhea) and constipation. In addition, there is sometimes severe pain in the abdominal area (abdomen).
A diverticulum also makes itself felt in a similar way, although the pain here is characterized by an acute abdomen, i.e. it occurs quickly and very intensively.
Diseases of the rectum are quite common.
Hemorrhoids in particular affect more and more patients. Patients usually complain of increasing itching in the area of the anus.
The symptoms of an abscess are often more unspecific. However, since it is a purulent inflammation, fever and chills usually occur.
In the case of an externally visible abscess on the buttocks, the patient often has pain when sitting.
A fistula is also usually accompanied by inflammation and can be difficult to diagnose under certain circumstances. However, if the fistula is located in the anal canal area, it usually causes pain and the discharge of blood and/or pus, which then gets trapped in the underwear.

All gastrointestinal diseases mentioned here require surgical intervention. In addition, however, they usually require drug treatment as well:

In the case of a malignant tumor (carcinoma), it must be removed and possibly followed by chemotherapy.
In the early stages of reflux esophagitis, conservative therapy is sufficient, but later a fundus cuff is applied to the upper part of the stomach to prevent the backflow of gastric acid.
Even in the case of a peptic ulcer, drug therapy is often sufficient in the beginning, but in more severe cases the ulcer must be surgically removed.
In Crohn’s disease, it is possible that the only treatment option is surgical removal of the inflamed section of the bowel.
In ulcerative colitis, conservative therapy is also attempted for as long as possible. However, if complications occur, either parts of the bowel, sometimes even the entire colon must be removed.
A diverticulum is always removed only when it causes problems, which may not always be the case.
Abscesses, fistulas and haemorrhoids are always removed surgically, as patients are usually free of complaints afterwards. However, anti-inflammatory drugs can also be administered.