Gastroenterology is a branch of internal medicine that deals with diseases of the gastrointestinal tract as well as the surrounding organs. It uses a number of diagnostic and investigative procedures, among which endoscopy, ultrasound and functional tests are considered predominant.
What is gastroenterology?
Gastroenterologist deals with diseases of the gastrointestinal tract as well as the surrounding organs. As a technical term, gastroenterology is derived from the Greek words γαστήρ, gastēr, meaning “stomach” and έντερον, enteron, meaning “intestine.” It is dedicated to the prevention, diagnosis and conservative therapy of diseases of the gastrointestinal tract with the help of medications and/or physical measures. The treatment spectrum of gastroenterology also includes the surrounding organs of the liver, gallbladder and pancreas. As a subspecialty of internal medicine, gastroenterology can be further subdivided into several specialties. They are, for example, hepatology, proctology and gastrointestinal oncology. Hepatology deals with both physiology and pathology of the liver and bile ducts and is responsible for the diagnosis as well as therapy of diseases of these organs. Proctology (also known as coloproctology or coloproctology), on the other hand, focuses on diseases of the rectum. The focus of non-surgical (e.g. medicinal) treatment in this specialty is on the colon, rectum and anal canal. The latter gastrointestinal oncology deals with multidisciplinary curative and palliative therapy and is used for sonographic and endoscopic preventive examinations in individuals at increased risk.
Treatments and therapies
A wide range of treatments in gastroenterology allows early detection and treatment of various diseases of the gastrointestinal tract and surrounding organs. An important part of the task for gastroenterology is the diagnosis and therapy of tumors. These include, for example, malignant tumors of the esophagus (esophageal carcinoma), which develop from the glandular cells of the mucosa (adenocarcinomas) or surface cells (squamous cell carcinomas). Furthermore, malignant tumors in the area of the large intestine (colon carcinoma) are worth mentioning. They occur predominantly in the mucous membrane of the large intestine and arise from intestinal polyps. In Germany, they occur in second place after breast cancer in women and lung cancer in men, and thus represent one of the greatest dangers to human health. In addition to various tumors of the gastrointestinal tract, gastroenterology also deals with chronic inflammations. These include, for example, appendicitis, which can occur suddenly at any age and is accompanied by severe pain in the lower abdomen. Also generally known is the inflammation of the gastrointestinal mucosa, which is also called gastritis (formerly gastric catarrh). Three types are distinguished here. Type A can be attributed to autoimmune processes. The most common type B is the result of a bacterial infection of the stomach with the germ Helicobacter pylori. Type 3, on the other hand, is caused by external stress factors such as alcohol abuse or by taking certain medications. Furthermore, with regard to diseases of the gastrointestinal tract, intestinal obstruction (ileus), which is due to mechanical and/or functional causes, should not be neglected because it can be life-threatening without early therapy and often surgical intervention. Liver cirrhosis, which in Germany is primarily caused by increased alcohol consumption as well as chronic hepatitis C, can also have severe health consequences. A large group of diseases that are treated within gastroenterology are also the so-called functional disorders. Examples of these are irritable bowel syndrome and functional dyspepsia. For several years, gastroenterology has also been increasingly devoted to cough with shortness of breath, which may refer to the reflux of gastric acid into the esophagus (reflux).
Diagnosis and examination methods
Gastroenterology uses various diagnostic and examination methods to detect and treat diseases of the gastrointestinal tract and surrounding organs. Gastroscopy (gastroscopy) and colonoscopy (colonoscopy) are considered predominant.The first takes about 10 to 15 minutes and allows the gastroenterologist to see the stomach, esophagus and duodenum with the help of a special gastroscope. The second, on the other hand, takes about 20 to 30 minutes and, thanks to a video colonoscope with variable flexibility, allows the entire large intestine and the junction of the small intestine with the large intestine to be examined. Both endoscopic examination methods are considered painless, although somewhat uncomfortable. While patients are sprayed with a local anesthetic in the throat prior to gastroscopy or given a sedative injection (sedoanalgesia) in acute cases, colonoscopy requires thorough bowel cleansing using a bowel cleanser as well as the forced administration of sedoanalgesia. Another endoscopic procedure method is the so-called endoscopic retrograde cholangiopancreaticography (ERCP), which allows the bile duct or pancreatic duct to be examined and can be used for stone removal or disintegration. In this context, the so-called NOTES methods are gaining more and more interest among patients. These are endoscopic operations through natural openings, which can be seen as an advance within laparoscopic surgery. Furthermore, a significant importance is attached to ultrasound, where today, in addition to conventional sonography, a very modern contrast agent sonography is also used. This ensures a very precise representation of the blood flow to the organs, which can be recorded and analyzed by computer. Similar to gastroscopy and colonoscopy, ultrasound examination is painless. It also does not cause any follow-up discomfort. Other diagnostic and examination procedures in the field of gastroenterology include functional tests, including complex series of C13 and H2 breath tests. Thanks to these, e.g. Helicobacter pylori can be detected. Capsule pH-metry, which is used to measure acidity in the esophagus over 48 hours and can confirm or exclude reflux disease (heartburn), is also known. High-resolution manometry (HRM) also makes a significant contribution today, serving as an example of a new method for measuring pressures in the gastrointestinal tract.
Typical and common diseases of the digestive tract.
- Gastric ulcer
- Inflammation of the gastric mucosa (gastritis)
- Stomach flu
- Irritable stomach
- Stomach cancer
- Crohn’s disease (chronic inflammation of the intestine)
- Appendicitis
