The functioning of the digestive organs at an early age has its own specific characteristics and therefore not every specialist who treats adult patients can accurately diagnose and choose the best method of treating gastrointestinal tract diseases in a child. Detects and treats diseases of the digestive system in children pediatric gastroenterologist. A highly qualified gastroenterologist can promptly recognize and prescribe a course of treatment for diseases of the gastrointestinal tract in a child, such as gastritis, sigmoiditis, esophagitis, hepatitis, peptic ulcers (ulcers). duodenum, stomach), duodenitis, colitis and others.
The slightest concern about burning and pain in the gastrointestinal tract in a child should alert you - effective treatment without possible complications diseases of the digestive system depends on the timely detection of the disease at an early stage of development.
Pediatric gastroenterologist You should definitely examine your child if the following symptoms appear:
1. Vomiting, nausea, belching, heartburn
2. Disturbance in the process of defecation
3. Chronic abdominal pain
4. Decreased appetite
5. Bleeding from the digestive organs
6. Bad breath
7. Abnormal stool (diarrhea, constipation, unstable stool)
8. Weight loss
Pediatric gastroenterologist will examine the child, listen to complaints and collect an anamnesis about the child’s development, find out the features of possible previous treatment of diseases and features of the diet. Then the gastroenterologist will prescribe additional examinations and diagnostics: stool tests for scatology, dysbacteriosis, carbohydrates,
general blood analysis,
Ultrasound examination (ultrasound) of organs digestive system,
If necessary, refer the child for examination by other specialists for a more accurate diagnosis.
Below is information about the main diseases of the digestive system in children, which are detected pediatric gastroenterologist and then prescribes a course of treatment:
How to recognize the symptoms of gastrointestinal diseases in an infant?
Baby's tummy pain infancy manifested by twisting legs, frequent restlessness, bending of legs towards the stomach, and strong crying. The baby's tummy may be dense, noticeably swollen, and make specific sounds: transfusion and rumbling. At the same time, the baby strains, blushes heavily, and groans.
Pain in the baby's tummy can appear due to the accumulation of gases, severe colic (spontaneous intestinal spasms), which leads to sleep disturbances and loss of appetite.
An experienced pediatric gastroenterologist will determine the causes of symptoms of digestive diseases in an infant. The reasons can be very different:
1. General immaturity of the digestive system in an infant, characteristic of any infant at an early age (frequent colic and accumulation of gases are quite normal for completely healthy children under 4 months of age)
2. Intestinal dysbiosis
3. Lactase deficiency due to imperfect enzymatic systems in the child’s body
Lactose intolerance is a fairly common phenomenon for children under 1 year of age. Lactose (or milk sugar) is found in fermented milk products, breast milk, cow's milk and infant formula. A deficiency of the enzyme that breaks down lactose (lactase) in the baby’s body leads to poor tolerance to dairy foods and poor absorption of lactose (lactose intolerance).
Lactase deficiency in an infant can develop both due to a hereditary predisposition and against the background of intestinal dysbiosis or general enzymatic immaturity. Symptoms of lactose intolerance in an infant: tummy pain during or after feeding, frequent loose (and even foamy) stools (more than 10 times a day), bloating and weight loss. After examining the baby, the pediatric gastroenterologist may give a referral for a stool test for carbohydrates to confirm the diagnosis.
When the balance of intestinal microflora is disturbed with the developing dominance of pathogenic bacteria in the gastrointestinal tract, the functioning of the digestive system is disrupted and dysbiosis begins in children. Analysis of stool for dysbacteriosis (study of intestinal microflora) allows you to accurately establish a diagnosis and prescribe appropriate treatment to correct the intestinal microflora and restore the functionality of the child’s digestive system.
Often see a pediatric gastroenterologist They bring children with periodically occurring acute abdominal pain that is not associated with diseases of the digestive system. The child complains of abdominal pain after suffering shocks and psycho-emotional stress. These are so-called neurotic pains in children. After the examination, the gastroenterologist may advise you to consult with a pediatric neurologist, a child psychologist, and also a cardiologist - abdominal pain may be part of vegetative-vascular dystonia.
Why does my child have a stomach ache? The most common causes of digestive system dysfunction in children encountered pediatric gastroenterologist in your medical practice:
1. Overeating
Often found in very young children. Do you never deny your child a supplement? Do not be surprised if, some time after overeating, the child begins to complain of pain in the tummy, he develops lethargy, apathy, and mild nausea.
If this happens, put the baby to bed and if he vomits, give him some water to drink. Enzyme preparations can significantly alleviate the condition, but they can only be given after consultation with a pediatrician!
And most importantly, try to teach your child to eat in moderation!
2. Colic (spontaneous intestinal spasms)
If the child is very small (several months old), then colic is usually provoked by air collecting in the intestines.
Manifestations of colic in a child - the baby cries a lot for a long time after eating.
What you need to do - if you are breastfeeding your baby, make sure that he grasps not only the nipple with his mouth, but also the areola around it. Try to use only easily digestible foods. And if your baby is on artificial nutrition, then consult your pediatrician to choose the appropriate option. baby food(mixtures) for the baby.
Prevention: Hold the baby upright for some time after feeding, until excess air is released from the intestines.
3. Constipation
You should be wary of your child having bowel movements that are too infrequent (only a few times a week), as well as the appearance of periodic abdominal pain and frequent flatulence.
What you need to do: Be sure to take your child for examination see a pediatric gastroenterologist. Constipation can be a consequence of functional disorders of the pancreas or thyroid gland, as well as the liver. But similar reasons do not occur often and in most cases it is enough to change the child’s lifestyle and diet. Give your child more foods that perfectly activate the intestines, maintaining the balance of microflora - acidophilus milk, yogurt with bifidobacteria, kefir, as well as dried fruits (dried apricots, prunes, raisins) and raw and cooked vegetables (carrots, beets, apples, tomatoes) .
Constipation in a child can also be a consequence of dehydration - give the baby as much liquid as possible (juices, fruit drinks, compote).
The best way to combat constipation in a child is to eat a nutritious diet, drink as much fluid as possible and walk more in the fresh air.
4. Pathogenic bacteria
Some of the most common bacteria that cause diseases of the digestive system are salmonella and shigella.
Symptoms of salmonellosis in a child are high fever, diarrhea, diarrhea, vomiting, abdominal pain.
What to do? Be sure to show the child pediatrician to clarify the diagnosis. A course of antibiotic treatment is usually prescribed. Treatment begins with the use of sorbents - activated carbon, sillard, smecta.
With shigellosis (dysentery) in a child, the child’s body temperature rises to 38-39 degrees, watery stools mixed with mucus and blood, and a painful urge to defecate appear.
What to do? Be sure to take your child to the pediatrician for examination. For dysentery, treatment with antibacterial drugs is usually prescribed. It is imperative to give a glucose-saline solution, and when the baby gets better, replace it with a weak solution of unsweetened tea. Diet for dysentery - steamed cutlets, porridge, baked apples. Give more fruits, berries and vegetables (wash them thoroughly).
5. Viral diseases
A fairly diverse group of pathogenic microorganisms - enteroviruses lead to stomach upset in a child.
Enteroviral diarrhea. Absolutely any child can get sick by putting a dirty toy in their mouth or interacting with an infected peer. Typically, enteroviral diarrhea affects children under 4 years of age. Symptoms: fever up to 38 degrees, cough, stuffy nose, sore throat. If you have symptoms of diarrhea, check with your pediatrician about the dosage of cold medications and treatment regimen. Let your child drink as much fluid as possible. Build your child's immunity.
Another disease caused by a certain type of enterovirus is Hepatitis A in a child. The infection is transmitted through personal hygiene items, infected dishes, and tap water (if the child drank raw water). Symptoms: the temperature rises sharply, the child suffers from nausea and sharp pains in a stomach. The stool becomes discolored and the urine turns dark yellow. Yellowness of the whites of the eyes appears, then the face and then the whole body (signs of infectious jaundice).
With hepatitis A, the child will have to stay in the hospital for some time. Diet for hepatitis A - vegetable soups, dietary meat (rabbit, turkey, chicken), dishes from stewed, boiled and raw vegetables.
The best cure for hepatitis A is vaccination. Teach your child to eat only washed fruits and to wash their hands thoroughly before eating.
6. Acetonomic crisis
The causes are poor nutrition, frequent overwork, long trips - severe stress for the child’s body, leading to excess production. ketone bodies in the blood (acetoneacetic acid and acetone).
Symptoms - the child often vomits undigested food mixed with bile. The temperature rises and severe abdominal pain appears. The child's breath smells like acetone.
Be sure to take your child for examination see a pediatric gastroenterologist to clarify the diagnosis. Every five minutes, give your child a teaspoon of a solution of rehydron or alkaline mineral water without gas. Do an enema to cleanse the intestines (2 teaspoons of soda per 200 grams of water). Give your child a sorbent (polysorb, smecta, sillard). Diet - for several days, give your baby porridge, crackers, pureed vegetable soups.
A nutritious diet and the elimination of stressful situations will prevent a recurrence of the child’s acetone crisis.
Tests and diagnostics prescribed pediatric gastroenterologist :
1. Stool tests for carbohydrates, dysbacteriosis, scatology
2. Biochemical blood test
3. Diagnosis of the pancreas and liver
4. Gamma-glutamyltransferase, aspartate aminotransferase, proteinogram (protein fractions), alpha-1-acid glycoprotein, total bilirubin, antitrypsin, cholinesterase, etc.
5. Ultrasound examination (ultrasound) abdominal cavity
In our modern world Many people's lives are in a hurry. Everyone knows this picture: snacking on the go, eating junk food, eating dry food. It would seem nothing special, but this diet can lead to gastritis and other gastrointestinal diseases. And therefore, today a gastroenterologist is one of the most frequently visited specialists among young people and adults.
Just a few years ago, such a profession was completely unclaimed, and there were even clinics where there was no such doctor. Today there is a gastroenterologist in every clinic and hospital; meds.ru can advise you on the best specialist, but let’s figure out what kind of doctor he is and what is his approach to treating your illness?
Today, a gastroenterologist may have different specializations. The most common are considered to be:
- A pediatric gastroenterologist works with patients from birth to 18 years of age. Often the reason for visiting this doctor is an anomaly in the development of the gastrointestinal tract.
- A gastroenterologist surgeon works with patients of all ages. They turn to it in advanced stages when surgical intervention is required. Most often he performs the following operations: removal of the gallbladder, stopping internal bleeding, resection of the walls of the digestive tube.
However, in gastroenterology there are other sections that concern individual organs. These include the following narrow areas:
- A hepatologist works with diseases of the liver, gallbladder and biliary tract. One of the frequent diagnoses with which he is approached is hepatitis (A, B, C).
- A proctologist deals with diseases of the rectum (hemorrhoids, oncology, coccygeal whales, paraproctitis). This specialty appeared only a few years ago due to frequent requests from patients. Until recently, these problems were dealt with by coloproctologists.
- A coloproctologist works with changes of any kind in the intestines and rectum. The main way to diagnose this specialization is to take tests.
If you don’t know which doctor to contact with certain complaints, you need to contact a therapist, who, after an examination, will write a referral to a specialist.
What organs does a gastroenterologist treat?
When a person starts to have a stomach ache, the first thing he asks himself is: which doctor should he see? You need to seek help from a gastroenterologist, who will listen to the patient and determine his diagnosis. Thus, we can say that a doctor of this profile treats all organs that take part in digestion. The gastroenterologist also treats those digestive organs that absorb nutrients that come with food.
You should contact this doctor if the functioning of the following organs is disrupted:
- stomach;
- liver;
- esophagus;
- pancreas;
- intestines;
- biliary tract;
- duodenum;
- gallbladder.
Depending on the specialization of the gastroenterologist, what the doctor treats depends on the diagnoses with which patients often turn to him.
Reasons for visiting a gastroenterologist
The reasons why patients seek help from this specialist can be very different. But the most common are the following:
- stomach diseases (ulcers, polyps, gastritis, pulpitis, oncology);
- spleen diagnoses (abscesses, tumor cysts);
- gallbladder diseases (cholecystitis, biliary dyskinesia);
- hepatitis;
- diseases of the esophagus (hernia, varicose veins veins, esophagitis, diverticulum, reflex disease);
- diagnoses of the pancreas (cystic fibrosis, pancreatitis).
In addition to all this, a gastroenterologist works with any intestinal pathologies, these include colitis, Crohn's disease, irritable bowel syndrome. If you ignore the reasons described above and do not contact a gastroenterologist, then complications are unlikely to be avoided. The most serious consequence An untreated diagnosis can be called a tumor.
Very often, patients ask the following question: “which doctor treats gastritis?”, since this diagnosis is one of the most common today. A gastroenterologist deals with the recovery of this disease.
How does a gastroenterologist treat
This doctor's treatment methods mainly depend on the type of disease. Initially, the attending physician conducts an initial examination and listens to the patient’s complaints in order to predict his diagnosis. No less important in its formulation is the patient’s medical history. Then the specialist gives directions for various tests to confirm or refute the preliminary diagnosis.
To determine an accurate diagnosis, the following diagnostic measures may be required:
- Ultrasound of the abdominal cavity;
- gastroscopy;
- DNA - diagnostics;
- FGDS;
- analysis of blood, urine, feces, gastric juice;
- urography.
Only after this can the doctor use different techniques to treat the patient. The most common methods of recovery include the following:
- drug treatment;
- phytotherapy;
- ethnoscience;
- changing the daily routine.
When it comes to advanced cases, all these methods will be useless - surgical intervention is necessary. Sometimes surgery is the only chance for recovery. But finding a good specialist is not easy.
If children turn to this specialist, then most often the cause is dysbacteriosis. In this case, the doctor may write a referral for blood, urine and stool donation. In some cases, an x-ray or ultrasound is required.
When to visit a gastroenterologist
Since gastrointestinal diseases are very common today, there is always a demand for this specialist. According to statistics, 1/3 of patients in medical institutions turn to a specialist in this profile. Moreover, at his reception there can be people of different ages and genders. Sometimes problems also affect newborn babies who have problems due to early complementary feeding or non-compliance with the diet by the mother.
And even if a person is completely healthy and does not feel any problems in the digestive tract, it is necessary to visit a gastroenterologist once a year for consultation and examination. This is the only way to prevent the early development of diseases. The most appropriate time to visit a doctor is the appearance of symptoms of gastrointestinal diseases. The most common ones include:
- discomfort and pain in the abdomen;
- skin problems for no obvious reason;
- frequent belching after eating;
- heartburn;
- nausea;
- bitterness in the mouth;
- loose stools;
- vomit;
- smell from the mouth;
- feeling of heaviness;
- change in color of stool and urine;
- bloating.
All these signs of the disease indicate patients with gastric or duodenal ulcers. As practice shows, very often the symptoms described above are addressed to a local pediatrician or therapist, who then refers the patient to a specialist. But, however, there are patients who are “frequent guests” in the gastroenterologist’s office. These include people with the following diseases and symptoms:
- cirrhosis of the liver;
- nonspecific colitis;
- chronic hepatitis of any group;
- complex course of reflux disease;
- patients who have undergone surgery.
One of the symptoms of problems with the gastrointestinal tract includes dry skin, cracking, and peeling. This sign may also be one of the alarming ones that requires immediate consultation with a doctor.
What does a gastroenterologist's office look like?
A specialist’s office should have everything necessary equipment for examining patients. These include the following:
- medical scales;
- bactericidal lamp;
- obstetric chair;
- couch;
- phonendoscope;
- screen;
- a set of tools for providing emergency assistance;
- tonometer;
- centimeter;
- negatoscope;
- height meter
In addition, the doctor and nurse must have desks with the necessary documentation and a computer. Some doctors have special equipment in their offices to conduct tests.
In conclusion, I would like to say that a gastroenterologist is a common specialist whom people turn to with different problems. After the first symptoms of gastrointestinal diseases appear, you must consult a doctor for timely treatment and elimination of the diagnosis.
Chronic duodenitis
the duodenum is the initial section small intestine. Inflammation of the duodenum can be an independent disease ( primary duodenitis), and develop as a complication of a number of other diseases ( secondary duodenitis).
Chronic enteritis is an inflammatory disease of the small intestine that gradually leads to profound changes in its mucous membrane ( degeneration) with disruption of all functions of the small intestine ( especially absorption and digestive).
The group of chronic enteritis includes:
- enteritis after acute intestinal infection;
- enteritis due to food poisoning;
- enteritis in case of poisoning with toxic and medicinal substances;
- allergic enteritis;
- radiation enteritis;
- ischemic enteritis;
- enteritis in Whipple's disease;
- chronic granulomatous enteritis ( Crohn's disease).
Ischemic enteritis and colitis
Ischemic enteritis and colitis develop when the mesenteric arteries supplying the intestinal wall are blocked, resulting in damage ( reversible state) or necrosis ( irreversible condition, necrosis) intestinal wall. In this case, the process can be limited only to the mucous membrane, or it can spread to the entire wall. The larger the caliber of the blocked artery, the larger the affected area.
Whipple's disease
Whipple's disease is a disease of the whole body, which necessarily affects the small intestine, as well as joints, adrenal glands, heart, central nervous system and skin. The cause of the disease is actinomycetes, which cause allergization of the body and immune inflammation.
Crohn's disease
Crohn's disease can affect various parts of the gastrointestinal tract, but the small intestine is most commonly affected ( its end part) and large intestine. It is believed that the disease develops with a hereditary predisposition to the formation of IgG antibodies to the cells of the gastrointestinal tract, which leads to allergic inflammation and the formation of granulomas ( dense nodules consisting of immune cells), ulcerations of the mucous membrane and enlarged lymph nodes.
Celiac disease
Celiac disease ( synonyms - flour disease, celiac enteropathy) is a non-inflammatory disease of the small intestine that develops due to the absence or deficiency of an enzyme that breaks down gluten - a component of the gluten protein of cereals ( barley, millet, rye, wheat). The mucous membrane of the small intestine in celiac disease atrophies due to immune inflammation, but this process is reversible.
Lactase deficiency
Lactase deficiency ( lactase enteropathy) is an insufficient production of the lactase enzyme in the mucous membrane of the small intestine, as a result of which the process of breaking down milk sugar into glucose and galactose is disrupted. Undigested lactose ( milk sugar) comes to colon, where bacteria begin to decompose it, producing substances such as carbon dioxide and hydrogen.
Chronic colitis
Chronic colitis is an inflammation of the large intestine.
Among chronic colitis there are the following types:
- Ulcerative colitis is a disease of the colon including direct) of an unspecified nature, in which ulcers form in the mucous membrane and complications such as bleeding, narrowing of the intestinal lumen, and intestinal rupture develop. The cause of such changes in the mucosa is immune inflammation. Unlike Crohn's disease, the ulcers do not penetrate deeper than the submucosal layer, while in Crohn's disease all layers of the intestinal wall are affected.
- Non-ulcerative colitis is an inflammatory disease of the large intestine, which over time leads to atrophy of its mucous membrane.
Irritable bowel syndrome
Irritable bowel syndrome is pain or discomfort in the abdomen accompanied by changes in bowel movements ( diarrhea or constipation), which pass after defecation ( bowel movements), while no changes in the intestinal structure are detected.
Chronic hepatitis
Chronic hepatitis is an inflammation of the liver tissue that continues for more than 6 months without improvement in the patient's condition.
The following types of chronic hepatitis exist:
- chronic viral hepatitis ( type B, C, D);
- autoimmune chronic hepatitis;
- drug-induced chronic hepatitis;
- hepatitis of unknown origin ( cryptogenic hepatitis).
Cirrhosis of the liver
Liver cirrhosis is a severe chronic liver injury with a progressive course, in which the liver tissue is destroyed and replaced with scar connective tissue ( fibrosis). All this leads to a restructuring of the liver tissue and its vascular system with impairment of all liver functions.
The main causes of cirrhosis are:
- chronic alcohol abuse ( alcoholism);
- all types of chronic hepatitis;
- primary biliary cirrhosis;
- secondary biliary cirrhosis.
Primary biliary cirrhosis is an autoimmune disease that affects the intrahepatic bile ducts, causing them to become inflamed ( cholangitis), gradual destruction, which leads to stagnation of bile ( cholestasis) and the proliferation of connective tissue in the liver.
Secondary biliary cirrhosis is a complication of diseases of the biliary tract due to their compression or blockage of the lumen.
Hepatoses
Hepatoses are a group of non-inflammatory liver diseases that develop due to metabolic disorders in the liver itself and lead to its degeneration.
Unlike cirrhosis, with hepatosis there is no restructuring of the liver tissue and hepatic vessels.
There are the following types of hepatosis:
- Hereditary ( pigment) hepatosis- develop due to genetic disorders regulation of the exchange of bilirubin pigment ( Gilbert's syndrome, Crigler-Najjar syndrome, Rotor syndrome), which lead to the development of jaundice.
- Acquired hepatoses- dystrophic changes in the liver that occur during acute or chronic liver poisoning ( toxic hepatoses) or with alcoholism and fat metabolism disorders ( fatty liver or steatosis).
Hepatolienal syndrome
Gastroenterologists also treat the spleen in case of development of hepatolienal ( hepatosplenic) syndrome. This syndrome is characterized by simultaneous enlargement of the liver and spleen with disruption of their functions. Both these organs are connected by the portal vein ( the splenic vein drains into the portal vein, and the portal vein drains into the liver). If severe liver disease causes compression small branches portal vein, then portal hypertension develops ( increased portal vein pressure). This high pressure transmitted to the splenic vein, disrupts the outflow process venous blood from the spleen and causes its enlargement, and with prolonged flow, degenerative processes develop in the spleen.
Other causes of spleen enlargement are dealt with by hematologists, since the spleen is, first of all, a hematopoietic organ. If the cause of portal hypertension is a thrombus in the portal vein, then treatment is carried out by vascular surgeons.
Cholecystitis
Cholecystitis is an inflammation of the gallbladder.
Cholelithiasis
Cholelithiasis ( cholelithiasis) is a disease in which cholesterol or pigment stones form in the gallbladder and/or bile ducts.
The causes of cholelithiasis can be:
- inflammation of the biliary tract- promote stagnation of bile;
- metabolic disorder- disturbance of the exchange of bilirubin and cholesterol ( both components of bile) for obesity, diabetes, atherosclerosis, gout, as well as hereditary hepatosis.
Biliary dyskinesia
Biliary dyskinesia is a violation of the motor function of the gallbladder or bile ducts, which leads to impaired bile secretion. The reasons may be structural changes in the biliary tract ( malformations, inflammation, tumors) or diseases of other organs of the gastrointestinal tract.
Impaired motor function may manifest itself as increased or decreased contraction of the muscular wall of the gallbladder and bile ducts.
Pancreatitis
Pancreatitis is a disease of the pancreas in which the patency of its ducts is disrupted and “self-digestion” occurs ( autolysis) gland tissue with its own enzymes. Pancreatitis can be acute or chronic. They appear the same. The difference is that with chronic pancreatitis full recovery the structure and function of the pancreas is not observed.
The causes of pancreatitis may be:
- damage to the gland itself- alcohol abuse, fatty foods, the influence of certain medicines, viral infection;
- diseases of neighboring organs- duodenum, biliary tract, liver, in which the normal outflow of pancreatic juice into the duodenum is disrupted.
Tumors of the digestive organs
Tumors of the gastrointestinal tract can be benign or malignant.
Examination of feces for occult blood;
X-ray examination of the stomach and duodenum;
Study of the secretory function of the stomach;
Electrogastrography;
Esophagomanometry;
pH monitoring of the stomach;
Endoscopic examination of the stomach and duodenum ( gastroscopy, duodenoscopy);
Tests that detect Helicobacter pylori infection;
CT scan;
Gastritis;
Functional stomach disorders.
(disappears after eating)
After gastric digestion and evacuation ( movements) food from the stomach, the remaining hydrochloric acid begins to corrode the mucous membrane of the stomach and/or duodenum;
Increased production of hydrochloric acid at night due to increased tone of the vagus nerve ( parasympathetic division of the autonomic nervous system).
Stretching of the walls of the esophagus when gastric contents are thrown back into the esophagus;
Spasm in the area of the lower esophageal sphincter;
Spasm of the gastric sphincter ( gatekeeper).
- Analysis of urine;
- stool analysis;
- ultrasonography ( Ultrasound) liver, gallbladder and bile ducts;
- X-ray examination biliary tract;
- X-ray contrast examination of the colon;
- X-ray contrast angiography of the liver;
- fractional duodenal intubation and bile examination;
- endoscopic retrograde cholangiopancreatography;
- laparoscopy;
- liver biopsy;
- CT scan;
- Magnetic resonance imaging.
Cirrhosis of the liver;
Hepatoses;
Liver tumors;
Echinococcus liver;
Cholecystitis;
Cholangitis;
Cholelithiasis;
Tumors of the bile ducts;
Inflammation of the right half of the colon.
Stagnation of bile in the bile ducts.
Destruction of the pancreas by its own enzymes due to disruption of the secretion of pancreatic juice into the duodenum.
- blood chemistry;
- general urine analysis ;
- general stool analysis;
- ultrasound examination of the pancreas;
- CT scan;
- Magnetic resonance imaging.
Stretching of the wall of the small intestine;
Blockage of the lumen of the small intestine by a foreign body;
Inflammation of the diverticulum of the small intestine;
Blockage of the lumen of the mesenteric vessels supplying the small intestine with a thrombus.
- blood chemistry;
- stool analysis;
- Analysis of urine;
- study of absorption, excretory, digestive and motor functions of the intestine;
- plain fluoroscopy of the abdomen;
- X-ray examination of the small intestine;
- CT scan;
- Magnetic resonance imaging.
Lactase deficiency;
Celiac disease;
Whipple's disease;
Ischemic enteritis;
Crohn's disease;
Intestinal obstruction.
- blood chemistry;
- stool analysis;
- Analysis of urine;
- X-ray examination of the large intestine;
- colonoscopy;
- CT scan;
- Magnetic resonance imaging.
Ulcerative colitis;
Ischemic colitis;
Crohn's disease;
Intestinal tumors.
The presence of an obstruction in the path of feces causes intestinal distension;
The accumulation of gas in the intestines causes stretching of its walls.
- blood chemistry;
- general stool analysis;
- general urine analysis;
- ultrasound examination of the abdominal organs;
- plain fluoroscopy of the abdomen;
- X-ray examination of the stomach and intestines;
- laparoscopy;
- CT scan;
- Magnetic resonance imaging.
Chronic enteritis and colitis;
Intestinal obstruction.
Passive movement of gastric juice from the stomach into the esophagus when the lower esophageal sphincter is open, especially in a horizontal position.
- blood chemistry;
- survey fluoroscopy;
- fluoroscopy of the stomach;
- esophagogastroscopy;
- study of the acidity of the stomach and esophagus;
- esophagomanometry;
- esophageal pH-metry;
- fractional study of gastric juice;
- tests for Helicobacter pylori infection.
Gastroesophageal reflux disease;
Peptic ulcer of the stomach and duodenum;
Hernia hiatus diaphragm.
Chronic pancreatitis;
Duodenitis;
Chronic enteritis enteritis;
Biliary dyskinesia;
Crohn's disease;
Cholelithiasis;
Chronic cholecystitis.
Slowing down the absorption of fluid from the intestinal lumen;
Increased intestinal secretion ( secretion of intestinal juice) and mucus formation.
Blood chemistry;
Stool analysis;
Analysis of urine;
Stool analysis;
Small intestinal function study;
X-ray contrast examination of the gastrointestinal tract;
Determination of stomach acidity;
Gastroscopy;
Colonoscopy;
Ultrasound examination of the abdominal organs;
CT scan;
Magnetic resonance imaging.
- pancreatitis;
- hepatitis;
- cirrhosis of the liver;
- cholelithiasis;
- cholecystitis;
- biliary dyskinesia;
- chronic enteritis;
- celiac disease;
- lactase deficiency;
- dysbacteriosis;
- dysbacteriosis;
- irritable bowel syndrome;
- Crohn's disease;
- Whipple's disease;
- ischemic disease intestines.
- compression of the intestines from the outside;
- eating food that does not contain fiber, which has an irritating effect on the nerve endings in the intestinal wall, stimulating its contractions;
- loss of tone of the intestinal wall when exposed to various toxins;
- suppression of reflexes that cause defecation ( bowel movement);
- impaired flow of bile into the duodenum ( bile acids stimulate motor function intestines);
- intestinal spasm in a separate area, which disrupts the movement of feces;
- antiperistaltic contractions of the intestine ( contraction waves in the opposite direction);
- mechanical obstruction in the anus;
- violation nervous regulation intestinal peristalsis.
Irritable bowel syndrome;
Colon tumors;
Diverticulosis of the colon;
Cholelithiasis;
Biliary dyskinesia;
Chronic cholecystitis;
Pancreatitis;
Intestinal obstruction.
If the membrane is damaged ( cell wall) hepatocytes disrupt the process of releasing already bound bilirubin into bile, and it partially enters the blood, therefore the level of bound bilirubin in the blood increases;
IN severe cases in hepatocytes the binding process is disrupted ( conjugation) bilirubin with glucuronic acid, which also increases the level of free ( unconjugated) bilirubin in the blood;
Free bilirubin in jaundice can penetrate into the urine, causing it to darken;
Severe swelling of hepatocytes during their inflammation can compress the intrahepatic bile ducts, preventing bile from entering the duodenum.
Blood chemistry;
Stool analysis;
Analysis of urine;
Ultrasound examination of the liver;
Radioisotope liver scan;
Computed tomography of the liver;
Magnetic resonance imaging.
Cirrhosis of the liver;
Hepatoses;
Liver tumors.
- blood chemistry;
- stool analysis;
- Analysis of urine;
- ultrasound examination of the pancreas, gall bladder;
- X-ray contrast examination of the biliary tract;
- fractional duodenal intubation with bile examination;
- endoscopic retrograde cholangiopancreatography;
- scintigraphy of the biliary tract;
- radioisotope study of the pancreas;
- CT scan;
- Magnetic resonance imaging.
Pancreatitis;
Cholecystitis;
Cholangitis.
What kind of research does a gastroenterologist do?
Today, a gastroenterologist has a wide choice diagnostic methods to accurately identify the causes of the patient’s complaints and clarify the expected diagnosis. Diagnosis of diseases of the digestive system is carried out using instrumental and laboratory research methods. Some studies combine both methods. Sometimes a gastroenterologist can simultaneously use two instrumental methods if access to the organ is difficult. In all cases, in diagnosis there is a principle “from simple to complex”.
Instrumental methods for studying the digestive organs
| Research method | What diseases does it detect? | How is it carried out? | |
| Plain X-ray of the abdomen |
|
|
|
| X-ray of the esophagus, stomach and duodenum |
|
|
|
| X-ray of the small intestine |
|
|
|
| X-ray of the large intestine |
|
|
|
| X-ray of the biliary tract | Oral cholecystography |
|
|
| Intravenous cholegraphy |
|
||
| Percutaneous transhepatic cholangiography |
|
||
| X-ray angiography (study of blood vessels) of the liver |
|
|
|
| Splenoportography |
|
|
|
| Ultrasound examination of the biliary tract |
|
|
|
| Ultrasound examination of the liver |
|
|
|
| Ultrasound examination of the pancreas |
|
|
|
| Esophagogastroduodenoscopy |
|
|
|
| Colonoscopy |
|
|
|
| Endoscopic retrograde cholangiopancreatography |
|
|
|
| Diagnostic laparoscopy |
|
|
|
| Targeted liver biopsy (lifetime sampling of liver tissue) |
|
|
|
| Radioisotope liver scan |
|
|
|
| Scintigraphy of the gallbladder |
|
|
|
| Radioisotope scan of the pancreas |
|
|
|
| Radioisotope study of the small intestine |
|
|
|
| CT scan |
|
|
|
| Magnetic resonance imaging |
|
|
|
| Intragastric and esophageal pH-metry (stomach acidity test) |
|
|
|
| Determination of stomach acidity using probeless methods |
|
|
|
| Assessment of the digestive function of the stomach (desmoid test) |
|
||
| Assessment of the absorption capacity of the small intestine |
|
|
|
| Fractional study of gastric juice |
|
|
|
| Fractional duodenal intubation |
|
|
|
| Electrogastrography |
|
|
|
| Esophagomanometry |
|
|
|
Laboratory methods for studying the digestive organs
| Analysis | What is being determined? | When is it appointed? | How is the test taken and carried out? | |||
| General blood analysis | - number of leukocytes; Leukocyte formula; The number of red blood cells and the hemoglobin content in them; Albumin; C-reactive protein ( SRB). | - gastritis; - peptic ulcer of the stomach and duodenum; - stomach tumors; - pancreatitis; - pancreatic tumors; - hepatitis; - cirrhosis of the liver; - hepatosis; - liver tumors; - enteritis; - celiac disease; - chronic ulcerative colitis; - Crohn's disease. |
||||
| Enzymes | - liver transaminases or transferases ( ALT, AST); Gamma glutamyl transferase; Lactate dehydrogenase ( LDH); Alpha amylase; Pancreatic amylase; Lipase; Trypsin; Alkaline phosphatase. | - cholelithiasis; - chronic cholecystitis; - cholangitis; - hepatitis; - cirrhosis of the liver; - liver tumors; - hepatosis; - liver echinococcosis; - pancreatitis; |
||||
| Lipids | - total cholesterol; Triglycerides. | - hepatitis; - cirrhosis of the liver; - fatty hepatosis; - liver fibrosis; - liver tumors; - alcoholic liver damage; - pancreatitis; - pancreatic tumors. |
||||
| Carbohydrates | - blood glucose. | - hepatitis; - cirrhosis of the liver; - hepatosis; - liver tumors; - chronic pancreatitis; - celiac disease; - pancreatic tumors; - dumping syndrome. |
||||
| Pigments | - total bilirubin; Direct bilirubin ( connected, conjugated); Indirect bilirubin ( free, unbound). | - cholelithiasis; - chronic cholecystitis; - cholangitis; - tumors of the bile ducts and gallbladder; - pancreatitis; - pancreatic tumor; - hepatitis; - cirrhosis; - liver tumors; - hepatosis; - liver echinococcosis; - intestinal obstruction. |
||||
| Nitrogenous substances | - urea. | - hepatitis; - cirrhosis of the liver; - liver tumors; - hepatosis. |
||||
| Blood clotting index | - prothrombin ( prothrombin time). | |||||
| Hormones that regulate the function of the gastrointestinal tract | - gastrin. | - gastritis; - peptic ulcer of the stomach and duodenum; - stomach tumor; - Zollinger-Ellison syndrome; - pyloric stenosis; - chronic enteritis. |
||||
| General stool analysis | Study physical properties feces | - consistency; Leftover undigested food. | - chronic gastritis; Peptic ulcer of the stomach and duodenum; | - feces are collected after spontaneous bowel movement ( do not use laxatives or enemas); To collect stool, use a special sterile container with a spoon; Feces collected no later than 8 to 12 hours after defecation are submitted to the laboratory; For persistent constipation, you should perform an intestinal massage, or, as a last resort, give an enema and collect the densest part of the stool. |
||
| Biochemical study of stool | - pH ( acid-base reaction) feces; Reaction to occult blood; Reaction to stercobilin; Reaction to bilirubin; Reaction to protein. | - gastritis; - peptic ulcer of the stomach and duodenum; - stomach tumors; - duodenitis; - tumors of the small intestine; - hepatitis; - cirrhosis of the liver; - cholelithiasis; - cholecystitis; - cholangitis; - tumors of the biliary tract; - pancreatitis; - pancreatic tumor; - enteritis; - celiac disease; - chronic non-ulcerative colitis; - nonspecific ulcerative colitis; - Crohn's disease; - dysbacteriosis; - intestinal obstruction. |
||||
| Microscopic examination feces | - cellular elements of blood ( leukocytes, erythrocytes, macrophages); Intestinal epithelium; Tumor cells; Muscle fibers ( with and without striations); Connective tissue; Fat and its breakdown products ( neutral fat, fatty acids, soaps); Plant fiber ( digestible and indigestible); Starch; Crystalline formations; Slime. | - gastritis; - hepatitis; - cirrhosis of the liver; - hepatosis; - liver tumors; - echinococcus liver; - pancreatitis; - pancreatic tumors; - cholelithiasis; - cholecystitis; - cholangitis; - biliary dyskinesia; - pancreatic tumors; - duodenitis; - pancreatic tumors; - enteritis; - celiac disease; - tumors of the small intestine; - non-ulcerative colitis; - ulcerative colitis; - Crohn's disease; - Whipple's disease; - tumors of the large intestine; - ischemic colitis. |
||||
| Bacteriological research feces | Disturbance of intestinal microflora ( dysbacteriosis) - increase in the number of potentially pathogenic ( opportunistic bacteria) and a decrease in the number of “good” bacteria involved in the process of intestinal digestion. | - duodenitis; - chronic enteritis; - celiac disease; - lactase deficiency; - diverticula of the duodenum and small intestine; - Crohn's disease; - tumors of the small intestine; - cholecystitis; - cholangitis; - biliary dyskinesia; - cholelithiasis; - tumors of the biliary tract. |
||||
| General urine analysis | - bilirubin; Lactate dehydrogenase ( LDH). | - hepatitis; - hepatosis; - liver tumors; - echinococcus liver; - cholelithiasis; - cholecystitis; - cholangitis; - biliary dyskinesia; - pancreatitis; - tumors of the biliary tract; - pancreatic tumors; - chronic enteritis; - non-ulcerative colitis; - ulcerative colitis; - Crohn's disease; - intestinal obstruction; - intestinal tumors. | - before taking the analysis, the external genitalia are toileted ( Urine tests are not collected during menstruation); You need to collect urine in a sterile jar, which you buy at the pharmacy; Collect the morning urine sample; The first portion of urine is drained past the container, the rest into the container; The amount of urine should be 50 - 100 ml; On the eve of the test, you should not eat foods that change the color of urine ( beets, carrots, candies with food coloring and so on). |
|||
| Immunological blood tests | - alpha-fetoprotein. | - liver tumor; - hepatitis; - cirrhosis of the liver. | - detected using enzyme immunoassay in blood ( ELISA) . | |||
| - markers of viral hepatitis ( virus antigens and antibodies to them). | - chronic viral hepatitis ( B, A, C). | |||||
| - antinuclear antibodies; - antibodies to smooth muscle cells. | - chronic autoimmune hepatitis. | |||||
| - antimitochondrial antibodies. | - cirrhosis of the liver ( primary biliary). | |||||
| - antibodies to gastromucoprotein; Antibodies to stomach cells that produce hydrochloric acid. | - autoimmune gastritis. | |||||
| - antibodies to gliadin. | - celiac disease. | |||||
| Histological examination of biopsy specimens of the stomach and duodenum | - severity of inflammation of the mucous membrane- assessed by the number of inflammatory cells ( leukocytes, eosinophils); - mucosal inflammation activity- assessed by the number of neutrophils; - atrophy of the mucous membrane- shortening of villi and reduction of glandular cells of the mucous membrane; - intestinal or gastric metaplasia- transformation of mucosal tissue ( for example, the gastric mucosa transforms into intestinal mucosa), which in some cases ( not always) is regarded as a precancerous condition; - degree of contamination of the mucous membrane with Helicobacter bacteria- the number of Helicobacter pylori bacteria. | - gastritis; - peptic ulcer of the stomach and duodenum; - tumors of the stomach and duodenum. | Collection of material from the mucous membrane ( biopsy) taken during endoscopic examination of the stomach and duodenum ( gastroscopy). Then it is sent to the laboratory, where it is stained in a strictly defined way and examined under a microscope. | |||
| Detection of Helicobacter pylori infection (Helicobacter pylori) | Urease test | The test detects ammonium ions or carbon dioxide ( CO2), which are formed during the decomposition of urea under the influence of the enzyme urease secreted by Helicobacter. Ammonium ions are acidic. | - gastritis; - peptic ulcer of the stomach and duodenum. | For research, a biopsy of the mucous membrane obtained during gastroscopy is taken and placed in a medium with a pH level indicator. If Helicobacter is present in the biopsy specimen, the medium becomes crimson in color. The more bacteria in the medium, the faster the medium becomes colored. | ||
| C-urease breath test | The patient ingests urea labeled with radioactive carbon. Helicobacter bacteria destroy urea, producing ammonia and carbon dioxide ( CO2). The latter is determined in exhaled air. | |||||
| Micro-biological method | The method allows you to determine the sensitivity of Helicobacter to antibacterial drugs, which is very important for choosing the right drug for therapy. | A culture of the mucous membrane of the stomach and duodenum is inoculated with a biopsy obtained during gastroscopy and a culture of Helicobacter is grown. | ||||
| Immunological method | Using this method, antibodies to Helicobacter in the blood and secretory ( local) immunoglobulins in saliva and gastric juice, which are formed 3 to 4 weeks after infection. The test may remain positive for a month after successful eradication of Helicobacter. | Blood, saliva or gastric juice are examined using an enzyme immunoassay ( ELISA) with determination of the level of IgG, IgA and IgM. | ||||
What diseases does a gastroenterologist treat?
A gastroenterologist treats diseases that cause disruption of the digestive process.
These are inflammatory and non-inflammatory diseases of the gastrointestinal tract, as well as the liver, gall bladder, bile ducts and pancreas.
Gastroenterologists treat tumors of these organs together with oncologists.
Treatment of diseases of the gastrointestinal tract
| Disease | Basic treatment methods | Approximate duration of treatment | Forecast | ||
| Diseases of the esophagus | |||||
| Achalasia cardia | - therapeutic nutrition- frequent, in fractional portions, no later than 3 hours before bedtime; - drug therapy - nitroglycerin, no-spa, nifedipine, verapamil, atropine, motilium; - antibacterial therapy- when food gets into the respiratory tract; - balloon cardiodilation- instrumental expansion of the esophagus or lower esophageal sphincter using balloons inserted into the esophagus; - endoscopic injection of botulinum toxin- chemical denervation ( destruction of nerve fibers) esophagus or lower esophageal sphincter; - plastic surgery of the lower esophageal sphincter - treatment with surgery ( laparoscopic or open esophageal surgery). |
|
|
||
| Diffuse spasm of the esophagus (esophagospasm) |
|
|
|||
| Gastroesophageal reflux disease (reflux esophagitis) | - lifestyle changes- stop smoking, adhere to a therapeutic diet, avoid work associated with lifting heavy objects and bending the body; - drug therapy - antacids (Maalox, phosphalugel, gaviscon and others), H2-histamine blockers ( ranitidine, quamatelomeprazole, pantoprazole), prokinetics ( domperidone); - endoscopic treatment- radiofrequency ablation, endoscopic plication, surgery with a special Esophyx endoscope; - laparoscopic treatment- fundoplication ( creation of a cuff from the fundus of the stomach enveloping the esophagus) and crurorrhaphy ( suturing the legs of the diaphragm); - surgery- Nissen fundoplication. |
|
|
||
| Hiatal hernia |
|
|
|||
| Barrett's esophagus | - therapeutic nutrition- frequent split meals; spicy, too hot or too cold foods are excluded from the diet; - drug therapy- antacids ( Maalox, Gaviscon), proton pump inhibitors ( omeprazole, pantoprazole) prokinetics ( domperidone); - endoscopic treatment- endoscopic resection ( excision of altered mucosa), radiofrequency ablation, cryoablation, thermal ablation, laser therapy; - surgery- removal of the lower third of the esophagus and elimination of the cause of the development of Barrett's esophagus - reflux esophagitis ( Nissen fundoplication). |
|
- drugs that normalize stomach acidity- Maalox, ranitidine, omeprazole and others; - gastroprotectors de-nol, sucralfate, solcoseryl, enprostil, cytotec); - symptomatic treatment - antispasmodics ( no-shpa) and antiemetics ( cerucal); - endoscopic treatment- removal of ulcers, stopping bleeding, local administration of drugs, applications to the mucous membrane, blockade of nerve endings, stretching of narrowed areas; - surgery- resection of the stomach, intersection of the trunks of the vagus nerve ( vagotomy). |
|
|
| Chronic gastritis | - therapeutic nutrition- small, frequent meals, excluding spicy, rough, too hot or cold foods; - elimination of Helicobacter pylori infection - antibiotics, bismuth preparations; - correction of gastric secretion- drugs used for high acidity ( omeprazole, maalox, ranitidine) or with low stomach acidity ( proserin, pentagastrin, pepsin, gastric juice, Creon and other drugs); - gastroprotectors- drugs that restore the protective properties of the gastric mucosa ( de-nol, sucralfate, solcoseryl, enprostil, cytotec); - symptomatic treatment- spasm relief ( no-shpa), eliminating vomiting ( cerucal), prokinetics ( domperidone). |
|
|
||
| Duodenitis |
|
|
|||
| Functional stomach disorders | - elimination of neuropsychic factors; Frequent small meals with the exclusion of hard-to-digest foods; Stop smoking, drinking alcohol, and non-steroidal anti-inflammatory drugs; The use of drugs that reduce stomach acidity ( Maalox, ranitidine, omeprazole and others); For Helicobacter pylori infection, a course of antibiotics is prescribed; Treatment with prokinetics that improve the motor function of the digestive tract ( domperidone). |
|
|||
| Dumping syndrome | - diet therapy- fractional meals with increased amount protein and low carbohydrates; - drug therapy - acarbose, octreotide; - surgery- repeated surgery to restore the function of the pylorus. |
|
|
||
| Diseases of the small intestine | |||||
| Chronic enteritis | - therapeutic nutrition- mechanically, thermally and chemically gentle diet, “hungry” days; - anti-inflammatory treatment- sulfasalazine, prednisolone, budesonide; - immunosuppressants- azathioprine, methotrexate; |
||||
| Celiac disease | - diet therapy- exclusion of products containing gluten ( bread, pasta, dumplings, cakes and so on); - drug treatment- glucocorticoid therapy, enzyme replacement therapy, protein preparations, calcium, vitamin D and more. |
|
|
||
| Lactase deficiency | - diet therapy- exclusion of dairy products; - replacement therapy- preparations containing lactase ( lactaid, lactrase); - symptomatic treatment- elimination of diarrhea ( Imodium); - normalization of microflora- probiotics, prebiotics, antibiotics; - detoxification - intravenous administration solutions; - endoscopic treatment- expansion of narrowed areas using a balloon; - surgery- in case of gangrene of the intestinal wall, removes the affected area. |
|
|
||
| Liver diseases | |||||
| Chronic hepatitis | - treatment regimen
- exclusion of alcohol, rest, bed rest during an exacerbation, exclusion of contact with toxic substances; - therapeutic nutrition- plenty of fluids, enough protein, limited fat; - antiviral treatment - interferons, nucleoside analogues; - immunosuppressants- glucocorticoids and cytostatics; - metabolic and enzyme therapy- multivitamin complexes, Essentiale, lipoic acid and other drugs; - detoxification- administration of solutions of hemodesis, glucose, saline intravenously by drip. |
|
|
||
| Cirrhosis of the liver | - treatment of the underlying disease- treatment of the cause that led to liver cirrhosis ( antiviral drugs, glucocorticosteroids, immunosuppressants, allohol); - treatment regimen- light work schedule, bed rest during exacerbation; - therapeutic nutrition- 4 - 5 meals a day, more protein, less fat; - improvement of hepatocyte metabolism- vitamin therapy, lipoic acid, essentiale; - slowing down the pathological process in the liver- inhibition of fibrosis ( colchicine); - treatment of complications- decongestants ( diuretics), elimination of anemia ( introduction of blood substitutes), prevention of bleeding from the esophagus ( propranolol, monosorb); - surgical treatment of symptoms- placement of a shunt for ascites, endoscopic treatment of varicose veins of the esophagus. |
|
|
||
| Hepatoses | - non-drug treatment- therapeutic nutrition, exclusion of contact with the causative factor ( poisons, drugs, alcohol) and physical exercise ( weight loss); - drug treatment- improvement of liver metabolism, restoration of lipid metabolism, inhibition of connective tissue growth. |
|
|
||
| Inflammation of the gallbladder and bile ducts | |||||
| Cholecystitis | - diet therapy- frequent and small meals with the exclusion of fatty, fried, spicy, spicy foods from the diet; - relieve spasm and pain- no-shpa; - antibiotics- amoxicillin, ciprofloxacin and others; - enzyme preparations- festal, mezim, creon; - detoxification of the body- hemodesis or polydesis solution; - choleretic drugs - allohol, cholenzim, sea buckthorn oil, magnesium sulfate and others; - dissolution of stones- medicinal ( Chenotherapy using Ursofalk), ultrasonic, shock wave, laser dissolution, duodenal lavage, probeless tubage; - surgery- removal of the gallbladder using laparoscopic or open surgery, facilitating the spontaneous passage of stones from the bile ducts during endoscopy ( plasty of the sphincter of Oddi, duodenal intubation) or open surgery. |
|
|
||
| Cholangitis |
|
|
|||
| Cholelithiasis |
|
|
|||
| Biliary dyskinesia |
|
|
|||
| Pancreatitis | - non-drug treatment- hungry days ( 2 - 4 days), pumping out gastric juice, cold on the stomach; - correction of pancreatic enzyme secretion- during exacerbation of the disease, secretion is suppressed ( sandostatin, contrical), and outside of exacerbation - stimulate ( secretin, pancreozymin, calcium gluconate); - replacement therapy- with a lack of enzymes ( creon, festal); - antibacterial therapy- amoxicillin, cephalosporins; - symptomatic treatment- no-shpa ( antispasmodic), promedol ( narcotic pain reliever) tserukal ( antiemetic), insulin ( with increased blood glucose); - endoscopic treatment- stenting of the pancreatic duct, removal or destruction of stones, drainage; - surgery- removal of part of the pancreas, creating a bypass between the pancreas and the small intestine. |
|
|
||
| Tumors of the digestive organs | |||||
| Polyps | - endoscopic destruction of the polyp; Surgical removal of part of an organ ( resection) for large or multiple polyps. | - |
|
||
| Cysts | - endoscopic removal cysts of the esophagus, stomach or intestines; Puncture of a liver cyst with removal of fluid and introduction of healing substances; Surgical treatment of the tumor. |
|
|
||
| Cancer | - chemotherapy; Surgical removal of the tumor ( usually together with part of the organ); Surgeries to relieve symptoms caused by malignant tumors. |
|
|
||
What does a gastroenterologist treat and what diseases does he help get rid of? This question interests people who came to see this doctor for the first time. Gastroenterology, as a branch of medicine, has several subsections. All of them, one way or another, are related to the structure and functioning of the human gastrointestinal tract. A specialist in this field has jurisdiction over all digestive organs.
What is gastroenterology?
Treatment digestive organs Individual doctors practiced this in ancient times, but gastroenterology as a separate medical discipline was formed recently, at the beginning of the 19th century. The name of the concept consists of three ancient Greek words: “stomach”, “intestines” and “teaching”. Gastroenterology is a scientific branch of medicine that studies the gastrointestinal tract and the pathological processes that occur in it. Depending on the organs affected, there are separate specialists who advise on certain issues:
- Hepatologist– the same gastroenterologist specializing in diseases of the liver and biliary tract.
- Proctologist examines the anus and rectum.
- All sections of the large intestine are subject to coloproctologist. Often these two specialties are combined into one.
- Gastrologer(sometimes abbreviated as a gastroenterologist) deals with stomach problems.
Gastroenterologist – who is he and what does he treat?
A therapist (pediatrician), gynecologist or nutritionist can refer you to a doctor of this specialty for advice on a matter in which they are not competent. But patients still have an open question: who is a gastroenterologist and what does he treat? Today this profession is in demand. According to statistics, the prevalence of digestive diseases is increasing, up to 95% of the world's population needs medical supervision, both children and adults from young to old. What does a gastroenterologist treat? These are diseases associated with:
- stomach (peptic ulcer, etc.);
- gallbladder, including;
- spleen (tumors and cysts);
- intestines (dysbacteriosis, invasions, etc.);
- pancreas ().
When to contact a gastroenterologist?
Most digestive problems are diagnosed at an appointment with a therapist in a clinic. But knowing what a gastroenterologist treats, a generalist doctor can refer a patient who complains of dysfunction of the gastrointestinal tract to see him. Long-term difficulties, discomfort, pain associated with digestive processes are the case when you need to contact a gastroenterologist. Warning symptoms include:
- pain in the stomach and intestines;
- bowel dysfunction;
- vomit;
- nausea;
- skin rashes;
- frequent heartburn, etc.
Appointment with a gastroenterologist
Gastrointestinal diseases are common among people of all ages, so a gastroenterologist can be both an adult (general specialist) and a pediatrician - he helps to cope with dysbiosis and spasms in infants, and digestive pathologies in older children. You don’t need to take any tests first; a specialist will find out everything you need and give you a referral for testing. necessary examinations. The doctor approaches each patient individually. A standard gastroenterologist appointment consists of:
- oral questioning of the patient (collecting anamnesis);
- inspection;
- subsequent diagnostics.
Appointment with a gastroenterologist - preparation
As a rule, there is no need to prepare for your initial appointment with a gastroenterologist. But some clinics require you to follow some recommendations: if possible, refrain from eating and drinking water, and do not clean off the white coating from your tongue, as it may be taken by the doctor for analysis. If you plan to conduct an examination of the stomach, colon or duodenum, doctors will personally and in advance tell you how to prepare for the examination: whether to go on a diet beforehand, take a laxative or do an enema. Otherwise, the gastroenterologist accepts clients according to the general rules.
How is an examination by a gastroenterologist performed?
At the first meeting, the doctor listens to the main complaints, finds out the causes of the ailment and tries to find out the provocateurs of the phenomenon. To diagnose pathologies, physical examination methods are used, the main of which is palpation, palpation of the abdomen in order to find the source of pain. When localization is found, the doctor may prescribe a set of additional studies that will either confirm or refute the diagnosis. Other methods included in the examination by a gastroenterologist: percussion (tapping) and auscultation (using a stethoscope).
What tests does a gastroenterologist prescribe during an examination?
Diseases diagnosed and treated by a gastroenterologist may require additional research. To identify various pathologies they are used
- ultrasound;
- sigmoidoscopy;
- fibrogastroduodenoscopy.
What tests does a gastroenterologist prescribe besides this? The most common, prescribed to both adults and children: urine and stool tests, general and biochemical blood tests. In addition, an enzyme-linked immunosorbent blood test (to detect Helicobacter pylori) may be required.
Consultation with a gastroenterologist
A gastroenterologist is a specialist in the functioning of the gastrointestinal tract, but his consultation may be required even for a healthy person who is at risk of certain ailments. Digestive problems are caused by poor environmental conditions, abuse of fast food, long-term use of medications, and undergoing courses of radiotherapy and chemotherapy. As a preventative measure, it is recommended to visit this doctor once every 2-3 years.
A gastroenterologist understands how metabolic processes occur in the body, how the gastrointestinal tract functions and what actions cause pathologies. If the patient has such diseases, following certain rules will help to avoid exacerbations. About healthy and proper nutrition and the elimination of popular ailments will be told by the recommendations of a gastroenterologist. They are listened to by people who monitor their health and those who are trying to avoid the deterioration of their condition due to gastrointestinal problems.
The main advice of a doctor in this specialty concerns proper nutrition.
- Do not abuse alcohol. It catalyzes 80% of liver diseases.
- Choose fresh foods. The diet should be varied with vegetables, fruits, meat, fish, etc.
- Limit consumption of fatty, sweet foods. Advice from a pediatric gastroenterologist may also include prohibitions on citrus fruits, sparkling water, and chocolate.
- Take dietary supplements and home remedies with caution.
- Any diet should be discussed with your doctor. Some types of fasting can cause kidney stones.
- It is advisable to stick to fractional meals, eat little but often (4-5 times a day is ideal).
A gastroenterologist will help you cope with gastritis, a common disease of young and active people. An inappropriate lifestyle (irregular rhythm, food that does not run) and poor nutrition become provocateurs of gastritis. The doctor recommends completely eliminating bad habits: overeating, alcohol, frequent visits to fast food establishments. If you treat gastritis with medication and at the same time continue to behave incorrectly, the problem will not be solved.
It is worth listening to the following tips:
- Change your diet. Eat a little, 3-4 times a day.
- Food should be made from simple ingredients that are better digestible. It is important to combine them correctly (lean meat with vegetables).
- It is advisable to warm up food before eating. It should be warm and soft; you can grind some dishes in a blender.
- Avoid canned, fried foods, chewing gum, spicy dishes.
- Monitor water balance (1-2 liters per day).
- Don't forget about vitamins.
Problems with bowel movements bother people of all ages. Sometimes constipation occurs due to medical and other problems. These include infrequent bowel movements, too little bowel movement, and intestinal obstruction. A diet for intestinal disease will help correct the situation; the advice of a gastroenterologist often concerns it.
- Increase your intake of high fiber foods.
- Drink more fluids (plain water, soups, juices).
- Eat regularly.
- Chew food thoroughly.
- Avoid stress and overexertion.
Many people are interested in the question: what does a gastroenterologist treat? This specialist is useful when many gastrointestinal problems arise; he knows not only how to diagnose them, but also quickly cure them. The gastroenterologist gives useful advice regarding the prevention of diseases, the most common of which are constipation and gastritis. People of all ages go to the doctor with these problems, and the professional tries to help everyone after the examination and tests.
What does a gastroenterologist treat? A gastroenterologist is a treating specialist who deals with diseases of the digestive system. His level of qualification allows him to diagnose, prevent and prescribe treatment for patients suffering from gastrointestinal pathologies. As a rule, before an appointment with a gastroenterologist, patients visit specialists with a broader profile. If the therapist or Family doctor turned out to be powerless in the face of the disease, then a gastroenterologist comes to their aid. Most diseases of the digestive tract can be diagnosed during an outpatient visit. When describing their own complaints, the patient must be attentive to details so that the gastroenterologist can make the correct diagnosis.
General diagram of the structure of the gastrointestinal tract
Gastroenterology
This branch of medicine specializes in the function of the gastrointestinal tract, as well as the pathological processes that occur in it. Literally, gastroenterology is translated as the science that studies the functioning of the stomach and intestines.
Since each organ of the digestive system performs a number of functions, to facilitate their study, subsections have been developed that specialize in one thing (hepatology, gastrology, proctology, etc.). For example, a hepatologist is a gastroenterologist who deals with liver diseases, a gastrologist deals with stomach pathology.
Who is a gastroenterologist?
Gastroenterologist, who is he and what does he treat? If we summarize all of the above, we can say that a gastroenterologist deals with the organs involved in the digestion process. To become a gastroenterologist, you must first complete an internship in the specialty “internal diseases”, and only then obtain a narrow specialization. In large hospitals, consultation with a gastroenterologist is often required if patients experience pain in the abdominal area and if there is a problem with stool passage.
Due to the increasing number of patients suffering from, a gastroenterologist is in demand more than ever. The relevance of a gastroenterologist is due to the changing pace of life. A modern working person fails to pay due attention to his own nutrition, which is why we are seeing an increase in cases of gastritis, colitis, irritable bowel syndrome, etc. in young active people.
Symptoms
Depending on the affected organ, the nature of the course and the prevalence of the pathological process, diseases of the digestive system can manifest themselves in different ways. The main reason patients turn to a gastroenterologist is pain. The anterior abdominal wall can be roughly divided into 9 sections and in each of them one or another organ is projected.
Abdominal areas
When localizing painful sensations as a rule, stomach diseases (gastritis, ulcers) are suspected. suggests a pathology of the liver and gall bladder. Options may arise if they arise. Many patients suffering from leukemia or portal hypertension experience an enlargement of the spleen, located precisely in this area. Splenomegaly is painless in most cases, however, it all depends on the individual characteristics of the patient. In addition, left-sided ones often occur or with the development of pancreatitis.
The small parts of the intestine are projected into. The left iliac is, as a rule, and the right is appendicitis. The remaining zones are informative only in combination with other symptoms. In addition, they can be involved in pathological processes of other organs and systems (immune, urinary, reproductive).
The second symptom, which has great importance in the diagnosis of gastrointestinal diseases, this is the passage of stool. The nature of the bowel movements can tell a lot about the disease. Frequent, unformed stools are typical for:
- Crohn's disease;
- Nonspecific ulcerative colitis;
- Pancreatitis;
- Cholecystitis;
- Dysbacteriosis;
- Irritable bowel syndrome.
There are also a number of diseases that belong to the group of food toxic infections, but they are dealt with by infectious disease doctors. Long-term constipation is typical for functional and organic intestinal obstruction, for megacolon and for oncological lesions of the digestive tract.
Nausea, vomiting and heartburn are symptoms characteristic of gastroesophageal reflux disease. The pathogenesis of this disease lies in the weakness of the cardiac sphincter, which limits the esophagus from the stomach. If it fails, the contents of the stomach flow back into the esophagus. With regular contact with gastric juice, the epithelium of the esophagus can change, thereby causing another pathology called Barrett's esophagus. This disease is precancerous and requires immediate treatment.
Diagnostics
During examination, the gastroenterologist pays attention to the color skin patient. Pallor may indicate anemia caused by chronic bleeding. Yellowness of the skin and mucous membranes speaks in favor of hepatitis, calculous cholecystitis and other pathologies of the liver and gall bladder.
The position in which the patient is located also speaks volumes. Acute pancreatitis is characterized by severe pain attacks that can cause loss of consciousness and even death from shock. Patients with this diagnosis are usually forced to take a specific position (fetal position) to reduce the intensity of pain.
Physical examination methods
They allow the gastroenterologist to suspect the presence of a particular pathology. This includes palpation, percussion and auscultation. By palpation it is possible to assess the localization and nature of pain. There are specific points on the front abdominal wall, which are a projection of the affected organs.
Abdominal palpation technique
Ker's point - located at the intersection of the right costal arch and the outer edge of the rectus abdominis muscle. Pain in this area is characteristic of acute or exacerbation of chronic cholecystitis.
If you roughly draw a line between the right armpit and the navel, then at a distance of 3-5 cm from the latter there will be a Desjardins point. If they appear painful sensations when pressing at this point, this indicates the development of inflammatory processes in the head of the pancreas.
If a line is drawn between the navel and the middle of the left costal arch, then the Mayo-Robson point will be located on the border of its middle and outer third. Indicates inflammation of the tail of the pancreas. There are other specific symptoms and points, but they are more characteristic of surgical pathology.
Percussion makes it possible to approximately determine the size of organs. The method is very good when there is a large flow of patients and it is necessary to determine who needs additional instrumental examination.
Auscultation can assess the peristalsis of the digestive tract. For intestinal obstruction organic origin Above the site of obstruction, it is possible to listen to the “falling drop” symptom.
Lab tests
At the beginning of the diagnostic study, the gastroenterologist prescribes a series of standard tests. A general blood test shows the quantitative and qualitative characteristics of the formed elements. A decrease in red blood cells and hemoglobin indicates a bleeding ulcer, ulcerative colitis or Crohn's disease. An increase in white blood cells indicates the presence of an inflammatory response. Increased ESR suggests the systemic origin of the pathological process.
The information given in the text is not a guide to action. To obtain more detailed information about your disease, you should consult a specialist.
Thanks to biochemical analyzes You can evaluate the condition of the pancreas, liver and kidneys. With the development of pancreatitis in patients, a specific enzyme amylase is detected in the blood. This compound increases in plasma when inflammatory processes occur in the pancreas. An increase in specific enzymes, such as alanine aminotransferase and aspartate aminotransferase, indicates the death of hepatocytes. An increase in the concentration of bilirubin, alkaline phosphatase and cholesterol speaks in favor of cholestatic syndrome.
Instrumental methods
Ultrasound examination. Mainly used to assess the condition of parenchymal organs. When prescribing an ultrasound of the abdominal organs, the size and condition of the parenchyma of the liver and pancreas are determined. In addition, you can look at the thickness of the gallbladder wall and detect stones in it.
Fibrogastroduodenoscopy. This is an endoscopic examination method used to assess the condition of mucous membranes upper sections digestive tract. Using this method, you can look at the esophagus, stomach and duodenum.
Loading...