Gastroenterology

Conditions and diseases diagnosed and treated by a gastroenterologist

An expert gastroenterological examination, even the one which excludes ultrasound imaging,  may reveal a series of gastrointestinal conditions thanks to the combination of a detailed medical history, a physical examination and different non-invasive or minimally invasive tests. Typically, the following can be detected: 

• Gastroesophageal reflux disease (GERD) – on the basis of symptoms, such as heartburn, acid reflux or chest pain, which may also indicate the changed condition of oesophagus which is called Barrett’s oesophagus, in which the normal cellular tissue in the lining of oesophagus is changed in such as a way that it resembles the tissue in the lining of intestines.
• Peptic ulcers – identification of typical symptoms such as abdominal pain which worsens or improves depending on food may indicate a stomach or duodenum ulcer.
• Infections – symptoms, such as diarrhoea, nausea, vomiting or abdominal pain may indicate infectious gastroenteritis or specific infections such as an infection caused by  Helicobacter pylori.
• Inflammatory bowel diseases – symptoms such as chronic diarrhoea, abdominal pain, fatigue or inexplicable loss of weight may suggest conditions such as Crohn’s disease or ulcerative colitis.
• Irritable bowel syndrome (IBS) – identification of symptoms such as abdominal pain, bloating, changes in the bowel rhythm (diarrhoea, constipation or both), which improve with defecation.
• Haemorrhoids – based on the symptoms such as anal itching, pain, tenderness or bleeding during or after defecation, or based on a visual examination of the anal region, the doctor may detect external haemorrhoids, abnormalities might also be felt in the rectum by a manual examination, while a more detailed examination with the help of an anoscope will provide a clear view of the internal region of the anus and lower rectum, which is useful for the confirmation of the presence of internal haemorrhoids, which can often display symptoms similar to those of graver conditions, such as polyps or colon cancer. 
• Diverticulitis – based on the combination of symptoms, such as a sudden pain in the lower abdomen, especially on the left side, which may be quite intense and usually increases when pressed, together with fever, nausea, vomiting, changes in bowel movement and abdominal tenderness, divericulitis or a pouch which has formed on the colon and which is inflamed can be suspected.
• Functional diseases – such as functional dyspepsia or indigestion causing pain and discomfort in the upper abdomen without obvious organic cause.
• Coeliac disease – can be suspected on the basis of symptoms, such as diarrhoea, bloating and fatigue, especially if there is a reaction to gluten in diet.
• Nutrient deficiency – identification of symptoms which indicate deficiency in nutrients may indicate different gastrointestinal problems which impede absorption.
• Anaemia – detection through clinical signs and symptoms as well as through simple laboratory tests which indicate low haemoglobin levels, which may be the consequence of hidden gastrointestinal bleeding.

The ultrasonography of abdomen is a useful diagnostic method which is often utilised in gastroenterology for the detection and assessment of various conditions and diseases of the digestive system and the surrounding organs. These are a few conditions which may be detected using an ultrasound: 

• Liver diseases – an ultrasound may reveal cirrhosis, fatty liver, hepatitis as well as other abnormalities, such as liver tumours and cysts.
• Gallbladder diseases – conditions such as gall stones, gallbladder polyps or gallbladder inflammation are often diagnosed by an ultrasound.
• Diseases of the pancreas – an ultrasound may identify changes on the pancreas, such as pancreatitis, pancreatic cysts and tumours.
• Diseases of the kidneys – an ultrasound is useful for the detection of kidney stones, kidney cysts and other diseases of the kidneys.
• Splenomegaly – the enlarged spleen may be visible in an ultrasound and it may indicate various primary diseases, such as infections, anaemia or malignancy.
• Abdominal aortic aneurysms – an ultrasound may help in detecting abdominal aortic aneurysms, which is important for the prevention of potentially dangerous conditions.
• Inflammatory bowel diseases – although other methods, such as CT scanning or MRI are often used for more thorough evaluation, an ultrasound can always help in the identification of certain aspects of inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis.
• Ascites – the presence of free fluid in the abdomen, often connected with cirrhosis or carcinoma, can also be detected by an ultrasound exam.