What is gastroenterology?
Gastroenterology is the branch of medicine that has to do with the digestive system. The digestive system involves the gastrointestinal (GI) tract, comprising the esophagus, stomach, and small and large intestines. A gastroenterologist also deals with problems in the pancreas, liver, and gallbladder.
Gastroenterology is a subspecialty of internal medicine. A doctor who trains in gastroenterology is known as a gastroenterologist. Gastroenterologists do not perform surgeries. They often coordinate the best approach for a patient and any post-surgery care with surgeons.
Education of a gastroenterologist
Becoming a gastroenterologist is a lengthy and challenging process requiring over a decade of education and training. It begins with earning a Bachelor of Science degree, which typically takes four years. During this time, students complete coursework in physics, biology, chemistry, anatomy, and psychology, among other subjects. Along with these foundational courses, students are required to take classes in organic chemistry, biochemistry, and physiology to prepare for the next steps.
After completing their undergraduate studies, students must take the Medical College Admission Test (MCAT), a required exam for medical school admission. The MCAT is a rigorous, seven-hour test that evaluates knowledge in various scientific and analytical areas. Success on this exam opens the door to medical school, where the first two years focus on classroom learning, covering topics like medical ethics, pharmacology, and pathology. The last two years involve hands-on clinical rotations, offering exposure to different medical fields.
Graduating from medical school earns a student either a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO) degree, but the path continues beyond there. Next comes the United States Medical Licensing Exam (USMLE), which assesses practical skills and clinical knowledge. After passing the first two parts, aspiring gastroenterologists enter a three-year residency program, gaining supervised experience with actual patients. Following this, they must pass part three of the USMLE to become licensed physicians.
For those specializing in gastroenterology, additional training is required through a fellowship. This in-depth program, lasting several years, focuses on gastrointestinal disorders and prepares doctors to manage complex cases. Finally, certification from the American Board of Internal Medicine is obtained, first in internal medicine and then in gastroenterology, marking the culmination of their training.
Common gastrointestinal conditions
Gastroenterologists can diagnose and treat conditions affecting your digestive system, including the intestines, stomach, esophagus, liver, pancreas, biliary, and gallbladder. These may include:
- Inflammatory bowel syndrome
- Stomach ulcers
- Appendicitis
- Hemorrhoids
- Irritable bowel syndrome
- Food intolerances and allergies
- Small intestinal bacterial overgrowth
- Celiac disease
- Colorectal polyps
- Diverticulitis
- Hiatal hernias
- Esophagitis
- Gastroesophageal reflux disease
- Swallowing difficulties
- Cirrhosis
- Toxic hepatitis
- Viral hepatitis
- Fatty liver disease
- Pancreatitis
- Cholecystitis
- Gallstones
What is endoscopy?
A common procedure gastroenterologists perform is endoscopy diagnostics when they need more information about the internal digestive organs. In this procedure, a thin, long, flexible tube with a tiny video camera attached, called an endoscope, is inserted into the body. Endoscopy provides a detailed view of the digestive organs from inside the body.
Gastroenterologists can see how the organs work and identify the abnormalities causing the symptoms. They can also take tissue samples and perform minor surgical interventions using small medical tools that pass through the endoscope.
Endoscopy is a practical intermediate step to treat gastrointestinal conditions before surgery. Gastroenterologists can treat blockages, stop bleeding, remove tumors, and open narrowed channels with the help of an endoscope.
Different types of endoscopic procedures include the following:
- Endoscopic ultrasound: It is a lower or upper endoscopy wherein an ultrasound wand is attached to the endoscope. It helps visualize the biliary system.
- Enteroscopy: It examines the small intestine.
- EGD or upper endoscopy: It examines the upper GI tract from the throat through the stomach and upper small intestine.
- Polypectomy: It removes polyps from the intestines or stomach during endoscopy.
- Colonoscopy: It examines the large intestine and lower GI tract.
- ERCP or endoscopic retrograde cholangiopancreatography: An upper endoscopy extends to the bile ducts and takes video X-rays of the biliary system.
Can gastroenterologists treat cancer?
Gastroenterologists are the first medical professionals to detect cancer in any of the organs of the digestive system. Through biopsy and endoscopy, gastroenterologists can identify, locate, and remove cancerous tumors from the GI tract and biliary system. They can diagnose and treat various cancers, such as:
- Colorectal cancer
- Stomach cancer
- Small intestine cancer
- Duodenal cancer
- Gastrointestinal stromal cancer
- Liver cancer
- Esophageal cancer
- Bile duct cancer
- Gallbladder cancer
- Pancreatic cancer
Four signs you need a gastroenterologist
Unless you have been to a gastroenterologist, it can be challenging to recognize digestive issues that need specialized attention. The following are signs to watch out for that might warrant an appointment with a gastroenterologist near you.
Chronic diarrhea or constipation
An infection can cause chronic diarrhea or constipation, eating unclean food, or certain medications. It becomes a cause for concern when diarrhea or constipation is frequent or lasts for weeks. A gastroenterologist can evaluate your medical history and lifestyle and conduct tests to determine why these irregular bowel movements occur.
Intense bloating
Certain foods and a sedentary lifestyle can cause your body to produce excess gas. These habits lead to bloating, a feeling where the belly feels full or tight. When bloating is temporary, it usually resolves within a day or two. Bloating also occurs due to conditions such as lactose intolerance, irritable bowel syndrome (IBS), and small intestinal bacterial overgrowth (SIBO). Consult a gastroenterologist to get the appropriate treatment and medication to relieve the constant discomfort.
Heartburn
Often, one needs to take heartburn seriously more to consult a gastroenterologist; this would be the right approach in most circumstances. If heartburn is severe or frequent, it is time to seek professional medical help. Chronic heartburn often stems from Gastroesophageal Reflux Disease (GERD) and can be diagnosed only by a specialist.
Bloody stool
Hemorrhoids are the most prevalent cause of rectal bleeding and bloody stool. You should seek further treatment when hemorrhoids do not resolve with home treatments or over-the-counter (OTC) remedies. Your gastroenterologist can determine whether hemorrhoids or some other reason are causing the bleeding.
What causes constipation?
The colon, a vital digestive system component, is crucial in extracting water from residual food, forming stool, and propelling waste through the rectum for elimination. Prolonged stool retention in the colon can result in its solidification, causing difficulties in passage.
One of the primary contributors to constipation is an insufficient diet. Incorporating dietary fiber and ample water intake is essential for maintaining soft stools. Constipation can also be instigated by factors such as stress, changes in routine, and conditions affecting muscle contractions in the colon or delaying the urge to have a bowel movement. Common causes include a low-fiber diet high in meat, milk, or cheese, dehydration, insufficient physical activity, postponing bowel movements, travel, certain medications (such as antacids, pain medications, diuretics, and Parkinson's disease treatments), pregnancy, and advancing age. With constipation affecting around one-third of individuals aged 60 and over, it can be a leading cause of concern among older people.
How does a gastroenterologist treat constipation?
Gastroenterologists employ a tailored approach when addressing constipation, considering key factors to ensure effective management. The plan of action includes factors such as the patient's age, general health, and medical history, which are crucial in the treatment plan. The severity and extent of the condition are carefully assessed to formulate an appropriate course of action. The patient's tolerance for specific interventions, expectations for the condition's progression, and their opinions or preferences are integral considerations.
Treatment for constipation, often managed by gastroenterologists, commonly involves the
following:
- Diet modifications: A cornerstone of constipation management is adjusting the diet to include 20 to 35 grams of fiber daily. Fiber-rich foods like beans, whole grains, bran cereals, fresh fruits, and vegetables are emphasized. Conversely, limiting low-fiber foods like ice cream, cheeses, meats, and processed foods is recommended.
- Laxatives: If dietary and lifestyle changes prove ineffective, laxatives may be prescribed to facilitate bowel movements.
- Medication adjustment: Evaluating and, if necessary, adjusting or discontinuing medications that may contribute to constipation.
- Biofeedback: Biofeedback is employed in cases of chronic constipation arising from anorectal dysfunction. This therapeutic approach focuses on retraining the muscles responsible for controlling bowel movements.
- Lifestyle changes: A fundamental aspect of constipation management is encouraging lifestyle modifications, such as increased water and juice intake, regular exercise, and allocating sufficient time for daily bowel movements.
Ensuring gastrointestinal health
Seeking medical help is necessary for health concerns such as gastrointestinal issues. Irrespective of your GI problems, you can adopt some simple steps to improve your gut and digestive health.
- Managing what you put into your mouth can go a long way toward easing GI problems. Aim to include five to seven servings of vegetables and fruits of different colors in your daily diet. These foods contain a spectrum of nutrients to promote better digestive health.
- Include a healthy serving or two of fiber every day. Whole grains, nuts, beans, and cherries are readily available fiber-rich foods. Fiber helps with digestion and prevents constipation.
- Cut down on the amount of processed food in your diet. Eliminate or, at the least, drastically limit the consumption of bacon, salami, and hot dogs.
- Turn to healthier cooking by avoiding frying, grilling, or using too much oil and choosing to steam, broil, or stew your food. Cook meat thoroughly to prevent the risk of gut infections such as salmonella.
- Lose any extra weight you have, especially around the belly. Develop an exercise and diet plan to help you achieve your body weight goals.
- Reduce the size of portions and choose to have smaller, more frequent meals instead. Smaller portions help your body digest the food faster and help prevent heartburn, bloating, and other issues.
- Stay physically active by pursuing activities such as running, walking, swimming, and bicycling. Exercise helps speed up your body's metabolism and curbs stress, which can cause many digestive problems.
- Include probiotics in your diet if you still need to do it. Yogurt, juices, and specific snacks contain probiotics full of the good bacteria necessary for gut health.
Finding the right gastroenterologist in Seattle
If you are looking for a gastroenterologist near you, it is natural that you are worried about making the right choice. Digestive diseases can be challenging to diagnose and treat, so they need the expertise of an experienced and qualified specialist.
It would be best if you sought a board-certified gastroenterologist. Board certification means that the doctor has undergone all the necessary training and passed the board exam over the stipulated period. The profiles listed on Zocdoc provide information on the practitioner's educational qualifications and professional credentials to help you with this.
Previously, you would have had to contact friends, family members, and co-workers to get referrals to gastroenterologists before setting up an appointment. With Zocdoc, you get all this information and more with just the click of a button. You can also use the filters to check their insurance coverage. If you prefer to keep your insurance details private from your provider while booking an appointment on Zocdoc, you can acknowledge that you plan to pay out-of-pocket. While some providers may require insurance information to secure an appointment, you can easily find alternative providers on Zocdoc who accommodate your preference for self-pay. You can visit Zocdoc's patient help center for more insurance-related questions.
Check the reviews by actual patients to understand the doctor's bedside manner and approach. Patient reviews will likely mention their satisfaction or dissatisfaction with the appointment and treatment. Only when you are satisfied should you book an appointment with a gastroenterologist near you. All bookings made on Zocdoc are secure, safe, and free.
Statistics on gastrointestinal diseases in Washington
Gastrointestinal problems are widespread across the world and can manifest as different diseases. About 10-15% of adults in the United States suffer from irritable bowel syndrome (IBS), but only half get diagnosed. Pain is a frequently observed symptom; 20 to 40% of gastroenterologist visits are IBS-related. Similarly, about 20% of the population experiences gastroesophageal reflux disease (GERD) weekly symptoms.
In Washington, colorectal cancer is the second most common cancer. About 38 people in 100,000 are detected with this form of cancer annually. The state is trying to bring down this number and is seeing success. Nearly 38% of colorectal cancer cases across the state were in the early stage. Mortality rates have declined over the years and stand at approximately 14 per 100,000.
The statewide outbreak of Hepatitis A ended in September 2021, and King County, where Seattle lies, also experienced a reduction in cases simultaneously. The years from 2010 to 2019 saw only a maximum of 16 cases of Hepatitis A annually in King County. This figure was nearly 199 from January 2019 to September 2021.
Sources
Houston Methodist
WebMD[1]
WebMD[2]
WebMD[3]
Cleveland Clinic
National Institute of Diabetes and Digestive and Kidney Diseases
American College of Gastroenterology
Healthline
Johns Hopkins Medicine
GastroMD
