Gastroenterologist

The gastroenterologist – the doctor who specializes in treatment and diagnosis of diseases of a digestive tract. Such bodies as a gullet, a stomach, a small and large intestine, a liver and biliary tract, a pancreas are under authority of the gastroenterologist.

On reception to the gastroenterologist, as a rule, patients get according to the recommendation and the direction of the therapist. Sometimes people with complaints to problems with digestion independently address for consultation the gastroenterologist. Many people before addressing the specialist, read comments on gastroenterologists.

There is succession and staging in treatment of bodies of a GIT. The medical help can be received in out-patient conditions of policlinic on reception at the gastroenterologist, and in case of need patients are hospitalized in specialized gastroenterological department. The gastroenterologist helps to exclude life-threatening states, for example, a perforation of the ulcer or impassability.

Features of gastroenterological inspection

Before being engaged in therapy, the gastroenterologist gets acquainted with the anamnesis of life of the patient and the anamnesis of his disease. For this purpose the gastroenterologist asks the patient on living conditions and work, heredity, on possible harmful factors at work and eating habits which can provoke disturbances in digestion. For example, the peptic ulcer of a stomach and duodenum has pronounced genetic predisposition, and also can be provoked by constant stresses at work.

It is important to gastroenterologist to know chronology of development of a disease – prescription of its emergence, frequency and seasonality of aggravations, the nature of pains, symptoms which show the disease and ways facilitating a condition of the patient.

At the gastroenterologist patients most often complain of consultations on:

• Abdominal pains;
• Appetite disturbances, reduction of weight;
• Dyspepsia (nausea, vomiting, heartburn, eructation);
• Disturbances in character and frequency of a chair;
• Bleedings from a digestive tract.

Laboratory inspection will be the following stage in diagnosis of diseases of a digestive tract.

Directed by the right diagnosis the gastroenterologist can be helped by results of the general and biochemical analysis of blood (enzymes, bilirubin, crude protein and its fractions, PTV), markers of a viral hepatitis and an antibody to mycoplasmas, chlamydias, protozoa, lyambliya. In analyses a calla causative agents of intestinal infections, eggs a worm or protozoa can be found.

Tool diagnosis by the gastroenterologist

The following tool diagnostic methods help to reveal localization and the nature of a disease of bodies of a GIT:

• Endoscopy;
• Intragastric rn-metriya;
• Manometriya of a digestive tract;
• Ultrasonic inspection;
• Biopsy;
• X-ray analysis with contrast, etc.

Endoscopy by means of a flexible fibroendoskop is carried out by the endoscopist. With its help it is possible to examine a surface of hollow digestive organs, and also to take material on a biopsy (microscopic examination of fabrics). Endoscopy allows to find erosion and ulcers, polyps, tumoral changes or bleedings.

The intragastric rn-metriya is carried out to time of endoscopy or using the special rn-probe in the form of the capsule which the patient swallows. Measurement of acidity comes at the different levels of a digestive tract from a gullet to intestines. This method of inspection according to gastroenterologists is the most reliable in identification of a gastroesophageal reflux (throwing of gastric contents in a gullet). It also is auxiliary for the gastroenterologist in diagnosis of hyperacid gastritises (they are followed by a hyperoxemia of a gastric juice) and anacid states (when acidity on the contrary, is reduced).

The gastrointestinal manometriya allows to study sokratitelny activity of a gullet, stomach and intestines. It is shown at disturbances of motility of a gullet (a cardia achalasia, a diffusion esophagospasm, etc.), at locks, not giving in standard therapy and suspicion on impassability of intestines, at disturbances of motility of a large intestine.

Ultrasound examination of a digestive tract most informatively in diagnosis of damages of a liver, its channels and a pancreas – that is parenchymatous, but not tubular bodies. Ultrasonography of abdominal organs helps to find to the gastroenterologist of disturbance in structure of these bodies, increase in their sizes, stones or tumoral inclusions.

The radiological diagnostic method with contrast agents is used for detection of ulcers, strictures, tumors, disturbances of passability of biliary tract and intestines. According to gastroenterologists despite beam load of the patient in certain cases not to do without him, for example, at suspicion of a perforation of hollow body or intestinal impassability.

On the basis of a full picture of inspection the gastroenterologist on reception exposes the diagnosis and appoints treatment. At some chronic diseases patients are observed by the gastroenterologist constantly.

Children's gastroenterologist

Because the organism of the small child differs in features of a structure and functioning, the certain specialist – the children's gastroenterologist is engaged in health of his digestive tract.

Difficulty of collecting complaints and the anamnesis of a disease, and also difficulty in carrying out tool diagnosis belongs to features of work of the children's gastroenterologist. The profile of diseases at children also differs from adults a little, and dosages of drugs are expected the child's weight, and the children's gastroenterologist considers it in the work.

The children's gastroenterologist is faced by an important task – not only to cure a disease, but also not to allow its transition to a chronic form that has an adverse effect on development and growth of the child.