All you need to know about Gastroenterology

What is gastroenterology meaning?

Originally, the term ‘gastroenterology’ comprises three words from Ancient Greek origins – ‘gaster,’ meaning ‘stomach,’ ‘enteron’ meaning ‘intestine,’ and ‘logos’ meaning ‘reason.’

It is a sub-branch of medicine that deals with the study of function and disease of the digestive system and liver. The organs studied and investigated include the esophagus, stomach, small and large intestine, pancreas, rectum, colon, and liver. [1] 

What is a gastroenterologist?

A physician who has obtained a specialized degree in gastroenterology is known as a gastroenterologist. A gastroenterologist thus specializes in the management and treatment of the diseases covered under gastroenterology.  

What are the super specializations in gastroenterology?

Super-specializations can be done post-specialization of gastroenterologists (M.D. in Gastroenterology) in different departments under gastroenterology. Some of the prominent fields of super-specialization include – nutrition specialist, gastrointestinal oncologist, clinical trialist, general gastroenterologist, laboratory scientist, hepatologist, proctologist, and advance endoscopists

What is the scope of gastroenterology? What are the different types of disorders in gastroenterology? 

The digestive tract is one of the major systems that go through different types of stresses. The problems may arise due to drugs, improperly cooked food, and contaminated water. There lies a significant chance of gut dysbiosis (attack of harmful bacteria on the digestive tract), creating complications. Additionally, the cases of cancers of the stomach, pancreas, colon, and intestine are becoming common these days. 

Thus the scope of gastroenterology is massive, and it encompasses a wide array of disorders, starting from the mouth to the colon, including the liver. 

Which diseases are covered under gastroenterology?

Some of the diseases encountered by gastroenterologists include – 

1. Diseases of the mouth and salivary glands – aphthous ulceration (superficial and painful ulcers in the mouth), candidiasis (oral thrush caused by yeast), parotitis (inflammation of parotid gland due to bacterial/viral infections), oral cancers (tumors) 
2. Diseases of the esophagus
   1. Gastro-esophageal reflux disease – upward movement of acid into the esophagus 
   2. Motility disorders – an improper movement of esophageal muscles
   3. Tumors of esophagus
   4. Perforation of esophagus 
3. Diseases of the stomach and duodenum
   1. Gastritis 
   2. Peptic ulcer disease
   3. Functional disorders 
   4. Tumors of the stomach 
4. Diseases of the small intestine
   1. Disease-causing malabsorption 
   2. Motility disorders
   3. General disorders of the small intestine
   4. Adverse food reactions
   5. Infections of the small intestine
   6. Tumors of the small intestine 
5. Diseases of the pancreas
   1. Acute pancreatitis 
   2. Chronic pancreatitis
   3. Congenital abnormalities affecting the pancreas
   4. Tumors of pancreas  
6. Inflammatory bowel disease – inflammation in the rectal region (ulcerative colitis), terminal ileum, colon, and jejunum (Crohn’s disease)
7. Irritable bowel syndrome – recurrent abdominal pain and abnormal defecation in the absence of the gut’s structural abnormality. 
8. Ischemic gut injury –is the result of arterial occlusion in the gut. Different blood vessels are involved; sometimes, severe hypotension and venous insufficiency are reported. The diagnosis is difficult.
9. Disorders of colon and rectum
   1. Tumors of the colon and rectum 
   2. Diverticulosis
   3. Constipation and disorders of defecation
   4. Anorectal disorders 
   5. Diseases of the peritoneal cavity

Which are the complications studied under Gastroenterology?

What are the comorbidities, complications, organs affected, signs, and symptoms of gastroenterological problems?

Doctors can clinically examine comorbidities associated with gastroenterological problems. 

Some of the common findings include – 

1. Head and neck region – clinical findings of jaundice, mouth ulcers, and enlargement of parotid glands. 
2. Clubbing (change in the shape and structure) of hands and fingers 
3. Dehydrated skin, discoloration, muscle bulk, and signs of weight loss
4. Bowel sounds in the abdominal region
5. Skin tags, hemorrhoids, and masses in the rectal region

The organs affected in patients with gastroenteric problems include – esophagus, stomach, small intestine, pancreas, colon, and liver.

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Common signs and symptoms of gastroenterological diseases – 

1. Dysphagia – difficulty, and trouble in swallowing. It very often co-exists with heartburn and vomiting.
2. Dyspepsia – symptoms of discomfort, nausea, and bloating that arise mainly from the upper GI tract
3. Heartburn & Regurgitation – a burning sensation in the chest, very often co-existing with the back movement of acidic fluid (regurgitation) in the throat
4. Vomiting – a complex anti-peristaltic movement involving the dysfunction in the autonomic and somatic nervous system 
5. GI bleeding – bleeding in the stomach 
6. Diarrhea – passage of more than 200g of watery stools daily. The condition may be acute/chronic, often accompanied by electrolyte imbalance and body weakness.
7. Malabsorption – failure of the body to absorb the nutrients from the food correctly.
8. Unexplained Weight Loss 
9. Constipation – inconsistency to pass stools
10. Abdominal pain – local pain in the abdomen region

What are the different Diagnostic Tests?

Gastroenterologists perform a wide variety of diagnostic tests for the investigation of disease symptoms. 

Some of the most commonly used tests are – 

• Imaging tests 
  • Plain X-rays – helpful to detect abnormalities in the organ structures. 
  • Contrast studies – helpful to understand motility and structural abnormalities
  • Ultrasound, computed tomography (CT-Scan), and magnetic resonance imaging (MRI) – these tests are essential for non-invasive evaluation of intra-abdominal diseases.
  • Endoscopy – these are invasive devices used for therapeutic and diagnostic procedures. There are different types of endoscopies used – double-balloon endoscopy, capsule endoscopy, upper gastrointestinal endoscopy, magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP) 
  • Histology – test and investigation of extracted tissues of affected organs.
• Tests for infections 
  • Bacterial cultures of stool
  • Serology to detect antibodies against H. pylori, Salmonella sp., Entamoeba histolyticaBreath tests to detect H. pylori infections.
• Functional tests
  • Esophageal motility – used to investigate non-acid or gas reflux events using barium swallow and videofluoroscopy. 
  • Gastric emptying – to study the delay in emptying of the stomach (gastroparesis)
  • Colonic and anorectal motility – used to investigate the causes of chronic constipation.. 
• Radioisotope tests – these tests use radioisotopes of different elements to check for infections/ diseases.
  • Urea breath test 
  • Meckel’s scan
  • Somatostatin receptor scan
  • Gastric emptying study

What is the consultation cost for a gastroenterologist?

The average cost for consulting a gastroenterologist in India ranges between INR 500-1000. The cost of consultation in major cities of India are as follows – 

• New Delhi – INR 500-1000
• Mumbai – INR 1500-3000
• Chennai – INR 500-800
• Bengaluru – INR 500-900
• Hyderabad – INR 500-1000