Gastroenterology

Gastroenterology is the study of the various parts of the gastric system, including the esophagus, small intestine, stomach, colon, pancreas, gallbladder, rectum, liver and bile ducts.

A detailed understanding of the normal action of the gastrointestinal organs is required, as well as the movement of material through the stomach and intestines (motility), digestion, absorption, and removal of waste from the system, and the role of the liver in digestion. 

Among the common and important conditions are colon polyps and cancer, gastroesophageal reflux disease (heartburn), peptic ulcer disease, colitis, gallbladder disease, and Irritable Bowel Syndrome (IBS). 

Gastroenterology is the study of all normal and abnormal activity of the digestive organs.

Gastroenterologist Training

Gastroenterologists must first complete a three-year Internal Medicine residency and are then eligible for additional specialized training (fellowships) in Gastroenterology. 

Following medical school, gastroenterologists typically complete a 2- to 3-year fellowship, meaning that they have had at least five years of additional specialized education.

Fellowship training in gastroenterology is an intensive, rigorous program that enables future gastroenterologists to learn directly from national experts in the field and develop a detailed understanding of gastrointestinal diseases. 

Students learn how to evaluate and treat gastrointestinal complaints, provide recommendations for maintaining health and preventing disease. 

In the hospital as well as in the office, they learn how to care for patients.

Additionally, gastroenterologists receive dedicated training in endoscopy (upper endoscopy, sigmoidoscopy, and colonoscopy) from expert instructors. 

In endoscopy, small, flexible lighted tubes with built-in video cameras are used to visualize the inside of the intestines. 

Specialized training includes in-depth study of how and when to perform endoscopy, optimal methods for completing these tests safely and effectively, and the use of sedating medications to ensure patient comfort and safety. 

In addition to performing basic endoscopic procedures, gastroenterology trainees also learn about polypectomy (removal of colon polyps), intestinal and esophageal dilation (stretching of narrowed areas), and hemostasis (stiffening of bleeding). 

In order to make appropriate recommendations for the treatment of diseases and/or the prevention of cancer, gastroenterologists learn how to properly interpret these findings and biopsy results. 

The training of some gastroenterologists may also include advanced endoscopic procedures using endoscopes, such as endoscopic retrograde cholangiopancreatography (ERCP), endoscopic mucosal resection (EMR), stent placement, and endoscopic ultrasound (EUS). 

This provides them with the training necessary for non-surgically removing stones in the bile ducts, evaluating and treating tumors of the digestive tract and liver, and providing minimally invasive alternatives to surgery for some patients.

Gastrointestinal Endoscopy

Endoscopy is a procedure that enables a physician to view the lining of the digestive tract from the inside. 

An endoscope – a flexible fiberoptic tube with a tiny camera at the end – is used for the examination, allowing close-up, real-time viewing.

In addition to examining your digestive tract, the endoscope can be used for treating a variety of conditions within its reach. 

It is equipped with tiny instruments that can be used to treat many of the abnormalities that may be encountered. 

The physician can remove benign growths such as polyps, treat tears or ulcers, or stretch strictures (narrow areas). 

In addition, he or she can use it to collect small pieces of tissue for biopsy.

Colonoscopy

During a colonoscopy, a doctor uses a colonoscope or scope to inspect the rectum and colon. 

During a colonoscopy, it is possible to see ulcers, polyps, and cancerous tissue.

Colonoscopy is also used as a screening tool for colon polyps and cancer. 

Screening is testing for diseases when you are asymptomatic. 

Diseases can be detected at an early stage by screening, when doctors have a better chance of curing them.

If you don’t have any health problems or other risk factors that make you more likely to develop colon cancer, your doctor may recommend screening for colon and rectal cancer at age 45.

Doctors may recommend more frequent screening if you are at higher risk for colorectal cancer.

Colon Cancer

The large intestine (colon) is the site of colon cancer. 

It is the last section of the digestive tract.

Any part of the colon can develop colon cancer. 

Colonoscopy is a way to detect colon cancer and polyps by using a long, flexible tube equipped with a camera.

In most cases, colon cancer affects older adults, although it can affect anyone. 

On the inside of the colon, small, noncancerous (benign) clumps of cells called polyps commonly form. 

Some of these polyps can eventually turn into colon cancer.

Many treatment options are available to control colon cancer, including surgery, radiation therapy, and drug treatments, including chemotherapy, targeted therapy, and immunotherapy.

Rectal Cancer

Several inches of the large intestine make up the rectum. 

Rectal cancer begins in the mucosa lining the rectum.

Cancer in the rectum (rectal cancer) and cancer in the colon (colon cancer) are often referred to as “colorectal cancer.”

Ulcers

Peptic ulcers are sores on the stomach, small intestine, or esophagus. 

Gastric ulcers are peptic ulcers in the stomach. 

Duodenal ulcers are peptic ulcers that form in the first part of the small intestine (duodenum). 

Lower down in your esophagus is where an esophageal ulcer occurs.

Peptic ulcers are open sores that develop on the inner lining of the stomach as well as the upper portion of the small intestine. 

Stomach pain is the most common symptom of a peptic ulcer.

Ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), which are nonsteroidal anti-inflammatory drugs (NSAIDs), are often responsible for peptic ulcers. 

Peptic ulcers are not caused by stress or spicy foods. 

However, they can worsen your symptoms.

Swollen Tissue

A swelling caused by fluid trapped in your body’s tissues is called edema. 

The most common sites of edema are the feet, ankles, and legs, but it can also occur on the face, hands, and abdomen. 

In some cases, edema affects the entire body.

Your doctor will ask you questions, examine you thoroughly, and may order tests to determine why you have edema.

Depending on its cause, edema can be temporary or permanent. 

Depending on the condition that causes it, edema will be treated accordingly.

Esophagogastroduodenoscopy (EGD)

EGD (Esophagogastroduodenoscopy) is a procedure for examining the linings of the stomach, esophagus, and first part of the small intestine (the duodenum).

EGD is performed in a hospital or medical center. 

The procedure is performed with an endoscope. 

At the end of the flexible tube is a light and a camera.

Once the test has been completed, you will be unable to eat or drink anything until your gag reflex returns (to prevent choking).

Before the test, you will not be allowed to eat anything for 6 to 12 hours. 

Before the test, stop taking aspirin and other blood-thinning medications.

Anesthetic spray makes it difficult to swallow. 

A couple of hours after the procedure, it wears off. You might gag from the scope.

The scope may move in your abdomen and cause you to feel gas. 

There won’t be any pain from the biopsy. 

There is a possibility that you won’t feel any discomfort and won’t remember the test due to the sedation.

Gastroenterology Frequently Asked Questions

Gastroenterologists typically complete four years of college, four years of medical school, and a three-year residency program in internal medicine. 

Residents work alongside experienced gastroenterologists and receive mentoring from mentors.

Frequently, gastroenterologists assist surgeons in selecting the best operation for a particular patient.

You will be asked to insert a long, flexible tube (endoscope) into your esophagus and down your throat. 

Your doctor uses an endoscope to examine your esophagus, stomach, and the beginning of your small intestine (duodenum) with a tiny camera.

The colonoscopy procedure is safe. 

Occasionally, however, it can cause heavy bleeding, tears in the colon, inflammation or infection of pouches in the colon, severe abdominal pain, and problems in people with heart or blood vessel problems.

Upper endoscopy is a procedure that examines the upper part of the digestive tract. 

Also known as EGD, esophagogastroduodenoscopy is a procedure to examine the intestines. 

An endoscope is the tool used by gastrointestinal (GI) doctors. 

Video camera and a light are mounted on the scope’s narrow, flexible tube.

The doctor may perform this procedure to diagnose and treat certain disorders of the upper GI tract when possible. 

It is often used to diagnose symptoms such as abdominal pain, difficulty swallowing, prolonged nausea & vomiting, heartburn, unexplained weight loss, anemia, or blood in the stools.

After the procedure, your throat may feel scratchy or sore, but this feeling disappears quickly. 

Your physician will then explain how likely it is that you will experience complications based on your exam results. 

Patients may feel a bit woozy after an EGD, which requires some anesthesia.