Gastroenterology

Gastroenterology Services at Da Medika Polyclinic

Specialized diagnostics and treatment of liver, pancreas, bile duct diseases, as well as lesions of the intestines and stomach using the most advanced methods. The Gastroenterology Center is led by Prof. Dr. Dragan Tomić, an internist-gastroenterologist and hepatologist with extensive clinical experience and one of the founders of the endoscopic ultrasonography and Doppler ultrasonography unit, as well as the Department of Interventional Ultrasonography at KCS.

What is gastroenterology and what does it focus on?

Gastroenterology is a discipline of medicine which focuses on studying, diagnosing and treating diseases and disorders of the gastrointestinal system. This system comprises the organs which are responsible for food digestion and nutrient absorption, such as oesophagus, stomach, small and large intestine as well as the associated organs, such as liver, pancreas and gall bladder.

Gastroenterologists are devoted to a wide range of conditions – from indigestion and irritable bowel syndrome to more severe conditions, such as the inflammatory bowel disease, liver cirrhosis and digestive system cancers.

This medical specialty involves various diagnostic and treatment procedures, such as endoscopy, colonoscopy and ultrasound so that the causes of symptoms would be identified and efficient treatment plans for patients developed.

The symptoms which necessitate a visit to a gastroenterologist

There is a number of symptoms which indicate the need for an examination by a gatroenterologist, especially if they have been present for a long time or have been aggravating. A specialist in this branch of medicine will assess your symptoms, and, if necessary, he or she will perform appropriate diagnostic procedures for establishing the cause of the problem and then recommend adequate treatment.

These are some of the common symptoms which may require an examination by a gastroenterologist:

  • Abdominal pain – pain which is persistent or intense may point to various gastrointestinal problems, which will be detected by further examination.
  • Changes in a routine bowel movement – including chronic constipation or diarrhoea, which may by the symptoms of different conditions, such as irritable bowel syndrome or an inflammatory bowel disease.
  • Gastrointestinal bleeding – the presence of traces of blood in stool, black or red stool or vomiting blood may indicate internal bleeding in the gastrointestinal tract.
  • Heartburn or acid reflux – frequent or severe episodes of heartburn may be a sign of gastroesophageal reflux disease (GERD).
  • Difficulties with swallowing – difficulty swallowing or dysphagia may be a symptom of the problem with oesophagus.
  • Inexplicable loss of weight – loss of weight without previous change of diet or exercise may be a sign of a more severe health problem. 
  • Nausea and vomiting – constant nausea or vomiting may be symptoms which require further examination.

Gastroenterological examinations and methods offered by Da Medika Polyclinic

There are several different types of gatroenterological examinations which are performed for the assessment and diagnosing different gastrointestinal conditions. At Da Medika Polyclinic, it is possible to have an expert gastroenterological examination done by a professor, including ultrasound examination of the abdomen.

An expert examination by a gastroenterologist includes a detailed physical examination which may involve palpation of the abdomen for establishing tender areas and checking whether liver or spleen are enlarged as well as listening to the bowel sounds, which may give additional information of the intestinal motility and the presence of obstruction.

An abdominal ultrasound is a non-invasive method which provides important information on the structure, the size and the contour of internal organs, which may be essential for early detection and correct management of various medical conditions.

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.

What does an examination by a gastroenterologist involve?

An examination by a gastroenterologist is a thorough process which enables profound understanding of your digestive health and leads to efficient solving of a problems. It comprises several steps, from preparation to the completion of the examination. This is how this process usually looks like:

Making an appointment and preparation

After you make an appointment, you should prepare all the previous medical documentation if you possess it. If the ultrasonography of the abdomen has also been arranged, special preparation is required, which involves instructions about avoiding food 6-12 hours prior to the examination, the choice of food that does not cause bloating a day before the examination, increased water intake as well as temporary discontinuation of taking certain medications, which the staff of the clinic will advise you of.

Information gathering

At the very beginning of the visit, a gastroenterologist will talk with you about your current symptoms, medical history as well as your family medical history. This helps in understanding possible causes of your problems.

Physical examination

A gastroenterologist will conduct a physical examination, which may involve palpation of the abdomen so that any abnormalities in the size and structure of internal organs would be felt as well as the presence of bloating, pain or other problems checked.

 

Diagnostic procedures

If necessary, a gastroenterologist may order different diagnostic tests, such as:

– Laboratory blood or stool tests for checking whether infections, inflammation or other irregularities are present.

– An ultrasound of the abdomen for the visualization of internal organs.

– Endoscopic imaging for the direct inspection of the inside of the oesophagus, the stomach and the small intestine.

– Colonoscopic imaging for the inspection of the large intestine. 

 

Interview about the results

After all the examination and test results have been processed, the doctor will talk with you during the check-up about the results and the diagnosis and recommend treatment or further tests, if required.

 

Treatment plan

If a diagnosis has been established,  a gastroenterologist will develoop a treatment plan, which may involve changes in the diet and medications and, in certain cases, recommendations concerning operations or other procedures.

 

Monitoring

Depending on your condition, additional visits may be scheduled so that the efficaciousness of the treatment and the progress of the recovery would be monitored.  

 

Patient education

A gastroenterologist will provide you with information and advice on how you should  manage your condition, including the changes in your lifestyle and diet, which can help in managing symptoms and the prevention of future problems.

Experts who perform gastroenterological examinations at Da Medika Polyclinic

Da Medika Polyclinic boasts a top-tier team of specialists, and in the field of gastroenterology, patients have access to Prof. Dr. Dragan Tomić, a specialist in internal medicine, gastroenterologist, and hepatologist. He is a renowned expert in the diagnosis and treatment of liver, pancreas, and bile duct diseases, as well as the diagnosis of intestinal and stomach lesions. He carefully analyzes his patients’ symptoms and conducts thorough clinical and ultrasound examinations, providing a comprehensive analysis of your condition, diagnosis, and appropriate treatment.

Our Team of Gastroenterologists

Specialist in Internal Medicine

Impressions of our patients

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