Colonscopia Robotica

Gastroenterology

What is gastroenterology?

Gastroenterology is a branch of medicine that deals with the study and treatment of pathologies regarding the stomach, the intestine, and more generally the entire digestive system. The organs that are studied by the gastroenterological specialist are the oesophagus, the stomach, the intestine both small and large, but also other organs which are not directly involved such as the liver, the gallbladder, or the pancreas.

Studied Pathologies

The pathologies dealt with by the gastroenterologist are numerous and can be very different. Here is a list of pathologies that are normally studied, based on the organ they involve:

Pathologies of the oesophagus

  • Acid reflux: it the passage of small quantities of gastric fluids back into the oesophagus from the stomach, provoking heartburn and regurgitate. Rarely reflux is without symptoms;
  • Tongue thrust: the most common form of atypical swallowing is caused by positioning the tongue and cheek between the teeth, it is usually a prolonging of an infantile behaviour, and is difficult to diagnose as it happens when the lips are closed impeding a visual examination, especially if it involves the back teeth rather than the front;
  • Oesophageal varices: manifest themselves as difficulty swallowing (dysphagia), but the most characteristic and dangerous symptom is bleeding, visible as blood in vomit or in faeces (melaen: the blood having been digested, is tar-like);
  • Oesophageal tumours: initial symptoms are almost always progressive weight loss, preceded by dysphagia, that is difficulty swallowing that normally appears in a gradual manner, first with solid foods and then progressively for liquids as well;

Pathologies of the stomach

  • Stomach tumour: is the fourth cause of death due to neoplasms in men, after tumours of the lungs, colon-rectum and prostate and the third cause in women after breast and colon-rectum. The difference in the incidence seem to be linked to genetic, environmental, an dietary factors, in various combinations;
  • Celiac disease: is a permanent intolerance to gluten, a protein substance present in oats, wheat, spelt, kamut, barely, rye, and triticale. The incidence of this intolerance worldwide is estimated at 1 in every 100 people;
  • Gastritis: gastritis is characterized by an inflammation of the walls of the stomach. Such an inflammation is gradually accompanied by gastric pain, cramps or excessive gas. Generally this pathology is caused by multiple factors and is actually very often a type of genetic predisposition in patients who in addition to an improper diet and bad lifestyle habits, give origin to these problems;
  • Ulcers: a gastric ulcer is a wound that is formed on the internal wall of the stomach. The ulcer is a problem that presents itself normally when the protective gastric structure is lacking;
  • Hiatal hernia: in the majority of patients hiatal hernias are not symptomatic; this is especially true for sliding hernias. If the symptoms do present themselves, then they are usually in the form of heartburn, regurgitate, that is to say reflux when the stomach acids reflux back into the oesophagus;
  • Helicobacter pylori: is the name of a bacteria able to colonize the mucous of the stomach; the resulting infection creates a local inflammatory state, that can progress, and less frequently can lead to more important pathologies such as gastritis, non-ulcerative dyspepsia, peptic ulcer and stomach cancer;

Pathologies of the intestine

  • Irritable bowel Syndrome: is a chronic condition which can even be present despite evident alterations of the structure (non organic symptoms). The only element which characterises it is a gradual chronic progression, thus non acute;
  • Constipation: constipation is a very common disturbance, especially in women and in people over the age of 65;
  • Colon cancer: is, unfortunately, a widespread pathology, about 7% of the population of wealthy countries has been struck by it. In some cases, colon cancer is incurable, however an early diagnosis can make the difference in the degeneration of the disease;
  • Intestinal Polyps: form on the mucous of the intestine, above all in the colon and rectum. The majority of these neoformations are benign, but regardless must be kept under close observation so as to avoid complications;
  • Diarrhoea: is considered a disruption in bowel movements in which the person affected produce a daily dose of faeces that can be more than 200 grams: the faeces are runny and the person affected will have repeated bowel movements in a day;
  • Haemorrhoids: are varicose dilatations of the haemorrhoidal veins in the rectum and anus. They are the most common disturbance of the last part of the intestinal canal and usually develop with age, weight gain, excessive force when having a bowel movement, hard faeces, pregnancy, or hereditary factors;
  • Meteorism: this word means a clinical condition referring to an accumulation of gas in excessive quantities in the digestive tract;

When to see a gastroenterologist

When is it necessary to have a medical visit with a gastroenterologist?

The symptoms or discomfort that should give a patient reason to request a specialised visit can be numerous, as well as very subjective. Here is a list of the most common symptoms:

  • Persistent heartburn, especially if it is strong;
  • Nausea;
  • Frequent and apparently unexplained stomach ache;
  • Repeated digestive difficulty over time;
  • Presence of dyspepsia, more commonly called “indigestion”;
  • Persistent diarrhoea without an apparent cause;
  • Presence of blood or mucous in the faeces;
  • Difficulty having bowel movements;
  • Pain in the stomach or intestine;
  • Unexplained weight loss;
  • Presence of anaemia;

 

Gastroenterological visit and medical exams

How does a visit with a specialist proceed?

During the medical visit the specialist makes a careful diagnostic evaluation in that multiple aspects of the patients are examined in a more detailed manner: all of the information about the patient clinical history is scrupulously collected, an evaluation is made of the existing gastroenterological problems which may involve various aspects and diseases such as the oesophagus, the stomach, the small intestine, the colon, the rectum, the anal canal, the pancreas, the liver, the gallbladder, biliary tract or the respiratory system.

A careful evaluation by the specialist needs further consideration regarding family history, lifestyle, the symptoms referred, pre-existing conditions, and finally a physical examination of the patient through palpating.

At the end of the specialized evaluation, an opinion can be formed regarding a provisional diagnosis. A gastroenterological evaluation can end with the prescription of a treatment or with a request for specialised tests.

Is pre-visit preparation needed?

No, there is no pre-visit preparation needed. The first appointment is the opportunity to collect of the known clinical information of the patient without instrumental or diagnostic tests.

Do I have to bring medical records?

If on hand, then it would be a good idea for the patient to bring all medical documentation. Remember that during the first appointment, the patient’s clinical history will also be reconstructed so as to have as clear and real a general view as possible. It’s obvious then that the gastroenterologist will have an advantage if they can evaluate medical records in the patient’s possession.

How long does a visit last?

It depends; duration may be different from patient to patient. Generally a visit lasts on average about 40 minutes, but there are situations in it can last for over an hour. It is therefore a good idea to arrive at the appointment with plenty of time available so that the specialist has all the time necessary to make all the evaluations of the case.

The main examinations

The gastroenterologist uses many exams as both diagnostic and therapeutic tools of which:

Where can I go to have a gastroenterological visit?

In all of the CertisMed centres it is possible to request a booking for a medical visit with a specialist. Anyone interested can contact the patient answering service to request more information about the centres closest to you and the relative costs.

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