Gastroenterology is the study of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver.
A gastroenterologist needs to have a detailed understanding of the normal physiology of all the above mentioned organs as well as motility through the intestines and gastrointestinal tract in order to maintain a healthy digestion, absorption of nutrients, removal of waste and metabolic processes.
Diagnosis of digestive disorders involves an evaluation of organ function, Only a comprehensive approach to diagnosis can provide appropriate treatment results.
Patient Complaints. Based on the nature of the patient’s complaints the doctor will ask the patient a number of questions dealing with his lifestyle, symptom onset and diet.
Case History. Next, the doctor will probe a patient’s case history, including patient family members.
Examination. The doctor conducts a physical examination using touch (palpation), listening to your internal organs (auscultation), and also tap and listen (percussion). These simple steps give a doctor basic information about your organs; their size, location, and a partial assessment of their functioning.
To obtain full information about the functioning of the internal organs, certain diagnostic procedures and tests employed, including:
Gastric intubation (or drainage) implies the introduction of a tube (probe) into the stomach for diagnostic or therapeutic purposes. It is used to examine gastric content if any diseases of the stomach or duodenum are suspected, as well as in some other pathological conditions associated with impaired gastric secretion. Gastric intubation is the main method to determine the most vital functions of the stomach: secretory, acid-forming and enzyme-forming functions.
Contrast X-ray examination is performed to reveal the structure of the gastrointestinal tract and its parts. The patient drink a barium contrast liquid which provides a radiopaque white shadow on the screen, reflecting the structure of the digestive tract and indicating the contours and mucous membrane of the esophagus, stomach and small intestine. Barium accumulates in the areas where there are any pathological changes, thus, making it possible to detect ulcers, tumors, erosions and esophageal varices.
Intragastric pH measurement is a diagnostic procedure during which the measurement of the acidity level in the stomach, esophagus or duodenum is performed. This method is widely adopted because most common inflammatory diseases of the gastrointestinal tract are based on the changes in its acidity. In case of such conditions this procedure helps choose adequate tactics of therapy and control the course of treatment.
Electrogastroenterogram is a method used to study gastrointestinal motility in the same way which it is employed in cardiac electrocardiography (cardiac ECG test). Electric signals produced by the stomach or intestine are recorded from the skin electrodes placed either on the patient’s extremities or abdomen. These signals are processed by computer using modern mathematical methods, such as band-pass filtering, wavelet analysis, and spectral analysis.
Ultrasound examination implies study of the internal organs and their movement with the help of ultrasound. The organ under test is being exposed to the ultrasound waves, the reflected signal is caught and processed, and after that the image of the organ is shown on the screen, and the image is in motion.
Computed tomography (CT) of the abdomen is a procedure that employs computer-processed X-rays to create section images of the abdominal organs - liver, spleen, pancreas, lymph nodes and blood vessels.
CT of the gastrointestinal tract gives an idea of the structural peculiarities of the parenchymal organs and indicates any inflammatory processes, necrosis, perifocal (around the area) inflammation, as well as the sizes, position and shape of the organ.
This method is based on the examination of the internal organs from the inside using a special optical device called an endoscope. This instrument is usually inserted into the patient through his natural ways, for example, into the stomach through the mouth, into the straight intestine (rectum) – through the anus. However, sometimes punctures in the abdominal wall can be used for this purpose.
Before the start of these diagnostic procedures, (scintigraphy) the patient eats a radiolabeled food for the radioactive isotope to concentrate in the organ under examination. The character of the movement of the substance in the tested organ is tracked and studied, helping doctors detect any disorders of this organ.
Stool test is a diagnostic method aimed at the evaluation of the digestion process. The test of stool includes the analysis of its physical (amount, shape, color, blood, mucus, parasites, etc.) and chemical (acid-base reaction, the presence and the amount of the hemoglobin degradation products – bilirubin, stercobilin, and soluble protein) characteristics.
Blood tests are one of the important laboratory methods for gastrointestinal diseases diagnosis; it helps evaluate the general condition (resistance) of the body, characterize functional state of certain organs and the level of structural lesion.
Blood tests can be divided into: