Digestive disorders are undoubtedly common disorders. Many of us have had abdominal cramps, burns or transit disorders at least once in our lives. Therefore, Dr. Elena Ciuperca explains to the readers of Ziare.com what the gastroenterology consultation consists of and when it is necessary.
Here are the situations in which you should present yourself at a gastroenterological evaluation:
– Acute or chronic transit disorders (constipation / diarrhea)
– Severe or persistent acute abdominal pain
– Chronic abdominal pain that affects quality of life
– Swallowing disorders – pain or difficulty swallowing
– Vomiting, persistent nausea
– Digestive bleeding: vomiting with fresh or digested blood, stools with fresh or digested blood
– Evaluation of the patient with anemia
– Burns or regurgitations – when they are common and affect the quality of life
– Anal pain
– Yellow coloration of the skin and mucous membranes = jaundice
– Increasing the volume of the abdomen
– Bad breath
– When there are changes in liver tests (TGO, TGP, total and direct bilirubin, GGT, alkaline phosphatase).
In principle, control is required when there are severe or persistent digestive symptoms.
During the gastroenterology consultation, the specialist doctor analyzes the accusations, defines their characteristics and focuses on a list of possible causes. Also, the patient’s health problems and current medication are taken into account and risk factors are inventoried (family diseases with hereditary transmission potential, chronic family infections, work in a toxic environment, smoking, stress, alcohol consumption).
Clinical examination of the patient may provide additional information in the diagnostic orientation: discoloration of the skin and mucous membranes (pallor in patients with anemia, yellow staining in patients with jaundice), the presence of localized or diffuse sensitivity of the abdomen on palpation, vivid sensitivity or abdominal contraction palpation in patients with acute abdomen, palpable abdominal tumor masses, enlarged organs, localized or generalized enlargement of the abdomen, etc.
If the patient has recent investigations, they may be helpful in speeding up the diagnostic process. Therefore, it is important to consult all recent medical documents, the specialist doctor will select the relevant information.
Also, if he has a chronic medication, it is good to bring a list of the medications he takes so as not to omit any under the rule of emotions; this is important because many medications can have digestive side effects or there may be interactions with medication prescribed by the gastroenterologist.
If the patient does not have recent investigations, following the discussion and clinical examination the doctor will make an investigation plan that may include blood and / or stool tests, abdominal ultrasound (for examination of the liver, gallbladder, pancreas and other extradigestive abdominal organs – kidneys, spleen, uterus and ovaries / prostate, bladder), upper digestive endoscopy (for exploration of the esophagus, stomach and the first segments of the duodenum) or lower. (for exploring the large intestine).
If the patient has the necessary preparation for the investigation (usually to have an empty stomach) and if time is available, abdominal ultrasound and upper digestive endoscopy can be performed even during the consultation.
Depending on the situation, imaging explorations such as computed tomography or MRI may be necessary (eg for the characterization of ultrasound-detected liver / pancreatic formations or for the staging of stomach or colorectal tumors diagnosed endoscopically), barium transit (eg in the evaluation of digestive tract narrowing that cannot be overcome endoscopically, diagnosis and characterization of transhiatal gastric hernia), echoendoscopy (evaluation that uses an endoscope that has an ultrasound transducer and that allows by combining the two methods to obtain high accuracy details on lesions digestive wall, surrounding lymph nodes, changes in the pancreas or distal bile ducts), endoscopic video capsule (a capsule that films with one or two ends and can bring information about changes in the mucosa of the small or large intestine) or highly specific explorations such as be esophageal or rectal manometry (car e measures pressure changes) and esophageal pH metry (which measures pH changes in the esophagus using a catheter and may be needed in the evaluation of patients with reflux disease).
After performing the investigation scheme, the gastroenterologist determines if it is the case of a diet to be followed by the patient and the prescription of drug treatment.
Which are common gastroenterological disorders:
- – Gastroesophageal reflux disease-characterized by the frequent presence of reflux-burn symptoms, regurgitation
- – Gastritis – inflammation of the stomach lining
- – Gastric and / or duodenal ulcer – means the appearance of a “wound” in the stomach or duodenum
- – Inflammatory bowel diseases – Crohn’s disease, ulcerative colitis – which are chronic inflammations that can affect different segments of the digestive tract triggered by an abnormal reaction of the immune system
- – Irritable bowel syndrome – defined by persistent or recurrent abdominal pain associated with transit disorders
- – Celiac disease – gluten intolerant
- – Colonic diverticulosis – the appearance of “bags” of mucosa in weak areas of the intestinal wall that can be complicated by inflammation, bleeding or narrowing of the colon
- – Gallstones – the presence of stones in the gallbladder and / or bile ducts that can trigger biliary colic and complications such as cholecystitis or acute pancreatitis
- – Acute and chronic pancreatitis – acute or chronic inflammation of the pancreas
- – Chronic liver diseases – viral, toxic, drug, autoimmune, etc.
- – Anorectal pathology – hemorrhoidal disease, anal fissures, etc.
- – Digestive cancers (esophagus, stomach, colon, rectum, pancreas, liver, gallbladder, bile ducts) -are among the most common neoplasms, colon cancer being on the 2nd place in women and on the 3rd place in men as frequency and gastric cancer ranks second as cancer mortality. Digestive cancers usually appear after the 4th decade of life, those that affect the esophagus or gallbladder and bile ducts even after the 6th decade of life; their appearance in young people is rare.
In conclusion, gastroenterology consultation is necessary when severe or persistent digestive charges occur; most of the time these accusations are nonspecific and can occur in many diseases with different prognosis and treatment. For example, bloody stools can occur in hemorrhoids and colorectal cancer, but obviously the same investigations are not necessary, nor is the treatment the same. The specialist doctor establishes the investigation and monitoring plan as well as the treatment correlating all the medical information he obtains.
Sometimes a digestive disorder cannot be diagnosed in a single consultation and requires several investigations arising from each other. There are also conditions to which the treatment must be adjusted in time depending on the response as well as conditions that require chronic treatment (eg inflammatory bowel disease, decompensated liver cirrhosis).
Within the consultations necessary to establish the diagnosis and treatment in the foreground are the establishment of a relationship of respect and trust between doctor and patient as well as a good communication.
Dr. Elena Ciuperca
If you have any questions for the collaborating specialists of Ziare.com, we invite you to address them by a comment or by email at [email protected].
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