Gastroenterologist
A gastroenterologist is a doctor who specializes in the treatment and diagnosis of diseases of the digestive tract. The gastroenterologist is in charge of such organs as the esophagus, stomach, small and large intestines, liver and bile ducts, pancreas.
As a rule, patients come to an appointment with a gastroenterologist on the recommendation and direction of a therapist. Sometimes people with complaints of digestive problems independently seek advice from a gastroenterologist. Many people, before going to a specialist, read reviews about gastroenterologists.
There is continuity and stages in the treatment of the digestive tract. Medical care can be obtained on an outpatient basis at a polyclinic at the reception of a gastroenterologist, and if necessary, patients are hospitalized in a specialized gastroenterology department. The gastroenterologist helps to rule out life-threatening conditions, such as ulcer perforation or obstruction.
Features of gastroenterological examination
Before engaging in therapy, the gastroenterologist gets acquainted with the patient's life history and the history of his illness. For this, the gastroenterologist asks the patient about living and working conditions, heredity, possible harmful factors at work and eating habits that can provoke digestive disorders. For example, stomach ulcer and duodenal ulcer has a distinct hereditary predisposition, and can also be triggered by constant stress at work.
It is important for a gastroenterologist to know the chronology of the development of the disease - the age of its occurrence, the frequency and seasonality of exacerbations, the nature of the pain, the symptoms that manifest the disease and the ways to alleviate the patient's condition.
When consulting a gastroenterologist, patients most often complain about:
- Stomach ache;
- Appetite disorders, weight loss;
- Dyspepsia (nausea, vomiting, heartburn, belching);
- Disturbances in the nature and frequency of stool;
- Bleeding from the digestive tract.
The next step in the diagnosis of diseases of the digestive tract will be a laboratory examination.
The results of a general and biochemical blood test (enzymes, bilirubin, total protein and its fractions, PTV), markers of viral hepatitis and antibodies to mycoplasmas, chlamydia, protozoa, lamblia can help a gastroenterologist in making the correct diagnosis. In the analysis of feces, pathogens of intestinal infections, worm eggs or protozoa can be detected.
Instrumental diagnostics by a gastroenterologist
The following instrumental diagnostic methods help to identify the localization and nature of the disease of the digestive tract:
- Endoscopy;
- Intragastric pH-metry;
- Digestive tract manometry;
- Ultrasound examination;
- Biopsy;
- X-ray with contrast, etc.
Endoscopy using a flexible fiber endoscope is performed by an endoscopist. With its help, you can examine the surface of the hollow digestive organs, as well as take material for biopsy (microscopic examination of tissues). Endoscopy detects erosions and ulcers, polyps, tumors or bleeding.
Intragastric pH-metry is performed during endoscopy or using a special pH probe in the form of a capsule that the patient swallows. Acidity is measured at different levels of the digestive tract from the esophagus to the intestines. This method of examination, according to reviews of gastroenterologists, is the most reliable in identifying gastroesophageal reflux (reflux of gastric contents into the esophagus). It is also an auxiliary for the gastroenterologist in the diagnosis of hyperacid gastritis (they are accompanied by increased acidity of gastric juice) and anacid conditions (when the acidity, on the contrary, is reduced).
Gastrointestinal manometry allows you to study the contractile activity of the esophagus, stomach and intestines. It is indicated for disorders of esophageal motility (achalasia of the cardia, diffuse spasm of the esophagus, etc.), for constipation that does not respond to standard therapy and suspicion of intestinal obstruction, and for disorders of colon motility.
Ultrasound examination of the digestive tract is most informative in the diagnosis of lesions of the liver, its ducts and pancreas - that is, parenchymal, and not tubular organs. Ultrasound of the abdominal organs helps the gastroenterologist to detect abnormalities in the structure of these organs, an increase in their size, stones or tumor inclusions.
X-ray diagnostic method with contrast agents is used to detect ulcers, strictures, tumors, disorders of the patency of the biliary tract and intestines. According to the reviews of gastroenterologists, despite the radiation exposure to the patient, in some cases it cannot be done without it, for example, if there is a suspicion of perforation of a hollow organ or intestinal obstruction.
Based on the complete picture of the examination, the gastroenterologist at the reception makes a diagnosis and prescribes treatment. For some chronic diseases, patients are constantly monitored by a gastroenterologist.
Pediatric gastroenterologist
Due to the fact that the body of a small child is distinguished by its structural and functional features, a separate specialist, a pediatric gastroenterologist, deals with the health of his digestive tract.
The peculiarities of the work of a pediatric gastroenterologist include the difficulty of collecting complaints and anamnesis of the disease, as well as difficulties in conducting instrumental diagnostics. The disease profile in children is also somewhat different from that of adults, and the dosage of drugs is based on the weight of the child, and the pediatric gastroenterologist takes this into account in his work.
The pediatric gastroenterologist faces an important task - not only to cure the disease, but also to prevent its transition to a chronic form, which negatively affects the development and growth of the child.
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