Gastroenterology

The Gastroenterology is a branch of internal medicine that deals with diseases of the gastrointestinal tract and the surrounding organs. It uses a number of diagnostic and examination procedures, among which endoscopy, ultrasound and functional tests are considered to be predominant.

What is gastroenterology?

As a technical term, gastroenterology is derived from the Greek words γαστήρ, gastēr, German "stomach" and έντερον, enteron, German "intestine". It is dedicated to the prevention, diagnosis and conservative therapy of diseases of the gastrointestinal tract with the help of medication and / or physical measures.

The range of treatments in gastroenterology also includes the surrounding organs, liver, gallbladder and pancreas. As a sub-area of ​​internal medicine, gastroenterology can be further subdivided into a number of specialist areas. There are e.g. hepatology, proctology and gastrointestinal oncology. Hepatology deals with both the physiology and pathology of the liver and biliary tract and is responsible for the diagnosis and treatment of diseases in these organs.

Proctology (also known as coloproctology or coloproctology), on the other hand, focuses on diseases of the rectum. The focus of non-surgical (e.g. drug) treatment in this specialty area is the colon, rectum and anal canal. The last-mentioned gastrointestinal oncology deals with multidisciplinary curative and palliative therapy and is used for sonographic and endoscopic preventive examinations in people with an increased risk.

Treatments & therapies

A wide range of gastroenterological treatments allows various diseases of the gastrointestinal tract and the surrounding organs to be identified and treated at an early stage. The diagnosis and treatment of tumors is an important part of the gastroenterological task.

These include e.g. Malignant tumors of the esophagus (esophageal carcinoma) that develop from the cells of the glands in the lining (adenocarcinoma) or surface cells (squamous cell carcinoma). Malignant tumors in the area of ​​the large intestine (colon carcinoma) are also worth mentioning. They occur primarily in the lining of the colon and arise from the intestinal polyps. In Germany they come in second place after breast cancer in women and lung cancer in men and thus represent one of the greatest threats to human health.

In addition to various tumors of the gastrointestinal tract, gastroenterology also deals with chronic inflammation. This includes e.g. Appendicitis, which can occur suddenly at any age and is accompanied by severe pain in the lower abdomen. The inflammation of the gastrointestinal mucous membrane, also known as gastritis (formerly gastric catarrh), is also well known. A distinction is made between three types. Type A can be traced back to autoimmune processes. The most common type B is the result of a bacterial infection of the stomach with the germ Helicobacter pylori.

Type 3, on the other hand, is affected by external stress factors such as Alcohol abuse or caused by the use of certain medications. With regard to diseases of the gastrointestinal tract, the intestinal obstruction (ileus), which is due to mechanical and / or functional causes, should not be neglected because it can be life-threatening without early therapy and often surgery. Cirrhosis of the liver, which in Germany is primarily caused by increased alcohol consumption and chronic hepatitis C, can also have serious health consequences.

A large group of diseases that are treated within gastroenterology also form the so-called functional disorders. Irritable bowel syndrome and functional dyspepsia serve as examples of this. For some years now, gastroenterology has also increasingly devoted itself to coughing with shortness of breath, which can refer to the backflow of stomach acid into the esophagus (reflux).

Diagnosis & examination methods

Gastroenterology uses various diagnostic and examination methods to identify and treat diseases of the gastrointestinal tract and the surrounding organs. Gastroscopy (gastroscopy) and colonoscopy (colonoscopy) are predominant.

The first takes about 10 to 15 minutes and enables gastroenterologists to take a close look at the stomach, esophagus and duodenum using a special gastroscope. The second, on the other hand, takes about 20 to 30 minutes and, thanks to a video colonoscope with variable flexibility, allows the entire large intestine and the confluence of the small intestine to be examined. Both endoscopic examination methods are perceived as painless, if somewhat uncomfortable.

While a local anesthetic is sprayed into the throat or, in acute cases, a sedative injection (sedoanalgesia) is given to the patient before the gastroscopy, the colonoscopy requires a thorough colon cleansing with an intestinal cleansing agent and the mandatory administration of sedoanalgesia. Another endoscopic method is the so-called endoscopic retrograde cholangiopancreatography (ERCP), which examines the bile duct or pancreatic duct and can be used to remove stones or smash them. In this context, the so-called NOTES methods are also gaining increasing interest among patients.

These are endoscopic operations through natural openings, which are to be regarded as an advance in laparoscopic surgery. In addition, ultrasound is of great importance, and today, in addition to conventional sonography, very modern contrast medium sonography is also used. This ensures a very precise representation of the blood flow to the organs, which can be recorded and analyzed with the aid of a computer. Similar to gastroscopy and colonoscopy, the ultrasound examination is painless. Nor does it cause any consequential inconvenience.

Function tests, including a complex series of C13 and H2 breath tests, are further diagnostic and examination procedures in the field of gastroenterology. Thanks to this, e.g. Helicobacter pylori can be detected. Capsule pH-metry, which is used to measure acidity in the esophagus over a period of 48 hours and can confirm or rule out reflux disease (heartburn), may be known. High-resolution manometry (HRM), which serves as an example of a new method for measuring pressures in the gastrointestinal tract, also makes a significant contribution today.

Typical & common diseases of the digestive tract

• Gastric ulcer
• Inflammation of the lining of the stomach (gastritis)
• Abdominal influenza
• Irritable stomach
• Stomach cancer
• Crohn's disease (chronic bowel inflammation)
• Appendicitis