A Gastroenterologist is a physician with dedicated training and unique experience in the management of diseases of the gastrointestinal tract and liver.

Gastroenterologists are well trained in the evaluation, diagnosis, management, and treatment of the following symptoms and conditions:

  • Abdominal pain and discomfort
  • Bleeding in the digestive tract
  • Cancer (e.g., colorectal cancer, stomach [gastric] cancer, pancreatic cancer, liver cancer)
  • Constipation and diarrhea
  • Difficulty swallowing food substances
  • Diverticular disease and other diseases of the colon (e.g., polyps, irritable bowel syndrome [IBS], colitis, Crohn’s disease)
  • Gallbladder disease
  • Heartburn and gastroesophageal reflux disease (GERD)
  • Hemorrhoids
  • Hiatal hernias
  • Inflammation in the digestive tract (e.g., gastritis)
  • Liver disease (e.g., hepatitis, jaundice)
  • Malabsorption disorders (e.g., celiac disease, lactose intolerance)
  • Stomach upset, nausea, vomiting
  • Gastrointestinal ulcers
  • Unexplained weight loss.

You should see a gastroenterologist if you’re experiencing any of these common symptoms:

Persistent heartburn (Acid reflux)

Heartburn is a sharp, burning sensation just below the ribs or breastbone. It is a fairly common symptom; almost everyone has heartburn once in a while. It is usually accompanied by regurgitation of food, an acidic taste in the mouth or burning in the throat. However, frequent and consistent heartburn for six months or longer, and is not relieved by a proton pump inhibitor may signal a more precarious condition like gastro-esophageal reflux disease, Barrett’s esophagus, and esophageal cancer.

Constipation

Constipation occurs when the muscles in the colon are contracting slowly or poorly, causing unabsorbed digested food to move too slowly and lose more water. The rule of thumb is that less than three bowel movements a week indicate constipation.

Constipation mostly affects older people, people who are dehydrated or have diets that are low in fiber. It could also be a symptom of an underlying disease or conditions such as inflammatory bowel disease, endocrine disorders (diabetes, hypercalcemia, and hypothyroidism) and cancer

Constipation on its own can be uncomfortable but not life-threatening. However, severe constipation can develop into more severe conditions, including:

  • Rectal bleeding after continually straining to pass stools.
  • Swollen or inflamed blood vessels of veins in the rectum (hemorrhoids)
  • Anal fissure, or a small tear around the anus.

Blood in Stool.

Blood in the stool is often a serious sign that something isn’t right. Blood in the stool can be bright red, maroon in color, black, and tarry, or occult (not visible to the naked eye). It can be caused by benign, irritating conditions of the gastrointestinal tract such as hemorrhoids and anal tear (anal fissures) resulting from straining against hard stools with constipation to life-threatening conditions such as colorectal or anal cancer.

If you notice any rectal bleeding or blood in your stool, seek out a gastroenterologist immediately to rule out any cancer

Cancer Screenings.

This is by far the most important reason why you should visit a gastroenterologist. Some people have a higher risk of developing cancer (like colorectal cancer). People at risk may need to be tested more often and at an earlier age than people with average risk. You are at a higher risk if you meet any of these criteria:

  • Have a personal history of colon or rectal cancer
  • Have a parent, sibling or child with intestinal cancer
  • A personal history of benign or pre-cancerous polyps in the colon or rectum
  • Showing signs and symptoms of intestinal or colorectal cancer
  • Inflammatory bowel disease (ulcerative colitis or Crohn’s disease).
  • Inherited conditions, such as familial adenomatous polyposis (FAP) or Lynch syndrome (also called hereditary non-polyposis colorectal cancer, or HNPCC)

Your gastroenterologist will assess your risk and may recommend any of the following plans for testing. This may include.

  • Colonoscopy
  • Flexible sigmoidoscopy
  • Double-contrast barium enema
  • guaiac fecal occult blood test (gFOBT) or fecal immunochemical test (FIT)

Gallstones

Gallstones are tiny, solid nuggets that form in the gallbladder, a small organ in the belly. A gallstone can be as small as a grain of sand or as large as a golf ball. Some people have one large stone while others develop multiple stones of different calibers. Most people with gallstones have no presenting symptoms. But as complications develop, the pain presents in the right upper part of the abdomen and occurs in episodes in the form of an attack. The pain is usually severe, dull and constant and can last from thirty minutes to five hours. If this pain is consistently severe, you should seek a gastroenterologist, who might need to remove your gallbladder to prevent further complications surgically.

Unexplained Weight Loss

The well-accepted clinical definition of unexplained weight loss is a loss of 5% of body weight over a period of 6-12 month or loss of 10 pounds (4.5kg). Possible cause of unexplained weight loss includes:

  • Cancer (Lung, pancreas, breast, and prostate cancer)
  • Endocrine causes such as diabetes mellitus, thyroid disorder,
  • Idiopathic (Cause unknown)

Abdominal Pain or Bloating

Abdominal bloating occurs when the abdomen fills with air or gas. This may cause the abdomen to appear larger or swollen and may feel hard to the touch. Consult your gastroenterologist if you or your child have persistent abdominal bloating. If you are consistently feeling bloated after eating, it could be caused by your diet. Other possible causes of abdominal bloating include: ovarian cancer, ectopic pregnancy, irritable bowel syndrome, colitis, peritonitis

Diarrhea

Diarrhea is the exact opposite of constipation. It means an increase in the frequency of bowel movements, an increase in the looseness of stool or both. Most cases of diarrhea are caused by bacteria, viral or parasitic infections Having regularly-occurring diarrhea could spell a more serious underlying condition, like Irritable Bowel Syndrome, Celiac disease, endocrine causes or cancer.

Hemorrhoids

Hemorrhoids are swollen or bulging veins in the anus. They can be caused by excessive straining during defecation, from sitting too long or conditions such as liver disease, obesity or pregnancy. They are common especially among people ages 45 to 75.

Most hemorrhoid symptoms can usually be treated with home and over-the-counter remedies. A painful, bleeding or chronic hemorrhoid may signal its time to visit gastroenterology.

Pale-colored stools

Pale or clay-colored stools are abnormal. They are often caused by problems with the biliary system which consists of the liver, gallbladder, and pancreas. The absence of bile causes the stool to lose its normal brownish color and leaves it appearing pale.

Consult your physician to carry out necessary tests and rule out any liver diseases, pancreatic cancer or blockage of biliary duct.

 

 

References

Gordon, D. (1999). When does heartburn warrant more concern?. Gastroenterology117(2), 293. doi: 10.1053/gast.1999.0029900293a

Screening for colorectal cancer – Canadian Cancer Society. (2018). Retrieved from http://www.cancer.ca/en/cancer-information/cancer-type/colorectal/screening/?region=qc

What Is a Gastroenterologist? – General GI Symptoms – HealthCommunities.com. (2018). Retrieved from http://www.healthcommunities.com/general-gi-symptoms/what-is-a-gastroenterologist.shtml