Gastroenterology – Manhattan Specialty Care

Gastroenterology

Gastroenterology is a subspecialty of internal medicine. A gastroenterologist is a doctor trained to treat the diseases of the gastrointestinal (GI) tract, which is made up of two different kinds of organs. There is the hollow set of organs linked as a tube from your mouth to your anus. These include your:

• Mouth
• Esophagus
• Stomach
• Small intestine
• Large intestine
• Colon

Your GI tract also consists of your bile ducts and three solid organs:

1. Liver
2. Pancreas
3. Gallbladder

Types of Conditions Treated

Your family doctor may refer you to a gastroenterologist if you’re suffering from a specific GI problem. These specialists possess an intimate knowledge of the physiology and correct functioning of both the hollow and solid organs that comprise your GI tract. Specialists in internal medicine (internists) understand how ingested food flows through your system — absorbing nutrients and removing waste — that involves your liver and kidneys, among other systems.

Gastroenterologists treat conditions such as:

• Colitis: This is an inflamed condition of the lining of your colon, often caused by an infection or an allergic reaction. The most common causes are Crohn’s disease, ulcerative colitis and pseudomembranous colitis.
• Colon polyps: These are clusters of cells that develop on the lining of your colon. While not harmful in and of themselves, they can be a precursor to cancer. In fact, if left untreated, they can eventually become cancerous themselves. Adenomatous, serrated, and inflammatory are the three most common forms of polyps.
• Colon cancer: This is a cancer of your large intestine. The disease begins with adenomatous polyps that gradually turn into cancer.
• Hepatitis C: This is a virus that can cause liver disease. It can be a mild condition lasting only a few weeks or a chronic and debilitating one that lasts a lifetime.
• Peptic ulcer disease: This is a condition where painful sores develop on the lining of your stomach or at the beginning of your small intestine. Bacteria called helicobacter pylori are the culprits.
• Gallbladder disease: This disease encompasses several conditions that affect your gallbladder, such as the familiar gallstones, the most common cholecystitis and the acute cholecystitis.
• Biliary tract disease: The biliary tract refers to the liver, gallbladder, and bile ducts. Bile duct cancer (cholangiocarcinoma), sphincter of oddi dysfunction (SOD) and gallstone disease are all considered biliary tract diseases.
• Nutritional problems: Poor eating habits can lead to nutritional deficiencies.
• Gastroesophageal reflux: Heartburn is a common affliction. It occurs when stomach acid creeps into your esophagus, causing irritation.
• Irritable Bowel Syndrome (IBS): A long-term, but not critical, condition, IBS can manifest as cramping, constipation, diarrhea, abdominal pain or bloating.
• Pancreatitis: This refers to the inflammation of your pancreas. It can either be acute (temporary) or chronic (long-term).

Any malady that affects any part of your gastrointestinal tract falls under the purview of a gastroenterologist. Your family doctor or general practitioner likely refers you to a gastroenterology specialist if you’re suffering from one of the conditions listed above.

Training and Education for a Gastroenterologist

The educational path for a gastroenterologist is similar to that of general medical practitioner until the specialization. The first step is to earn a four-year college degree and then get accepted into medical school. A typical medical school program requires four years of study before becoming an intern. Interns are doctors in their first year of a three-year internal medicine residency program.

After the residency program, the gastroenterologist can undergo even more specialized instruction and practice in gastroenterology. This specialized two-to-three-year period of study is referred to as a fellowship. Fellowships are rigorous programs that require intensive training and study under the direction of seasoned experts.

The fellowship program not only increases the doctors’ knowledge of the GI tract, but it also acclimates them to many of the typical symptoms they can encounter. Furthermore, the residents gain valuable experience treating patients in real-world settings. During this contact with patients, doctors also hone their communication skills to instruct patients on staying as healthy as possible — thereby helping patients avoid inadvertently worsening their disease or encouraging its reappearance.

Typical Gastroenterology Procedures

Due to the increased risk of colon cancer for men and women over the age of 50, anyone in this age group is encouraged to ask their general practitioner for a referral to an internist with specialization in gastroenterology for preventive care. If you are over 50, you should receive a regular colonoscopy. If a family member has had colon cancer, you should go even sooner.

Other reasons to visit — or be referred to — a gastroenterologist are mostly symptomatic. In other words, see your doctor if you’re exhibiting any of these symptoms:

• Acute or chronic abdominal pain
• Mysterious blood in your stool
• Trouble swallowing

Gastroenterologists can perform a vast scope of non-surgical procedures. The treatment depends on your condition and how early it’s caught. Non-surgical procedures include:

• Examining the loss of blood or sores in your bowel using a sigmoidoscopy procedure
• Assessing inflammation or fibrosis in your liver by collecting a biopsy
• Examining your small intestine through a double balloon enteroscopy procedure
• Searching for cancer or polyps using a colonoscopy
• Recognizing tumors or gallstones using endoscopic retrograde cholangiopancreatography
• Examining your entire GI tract with endoscopic ultrasounds

Gastroenterologist Professional Organizations

There are several groups that gastroenterologists can join to network, keep abreast of new research and cultivate a culture of lifelong learning:

• The American College of Gastroenterology (ACG) has a membership of more than 13,000 professionals worldwide. They offer a wide array of educational resources and keep their members abreast of the latest legislative developments in the interest of improving patient care.
• Founded in 1897, the American Society for Gastrointestinal Endoscopy (ASGE) boasts more than 14,000 members across the globe. It endeavors to promote standards for endoscopic training, encourage research and recognize the achievements in the field of gastroenterology.
• The World Gastroenterology Organization was founded in 1958, and its membership is an agglomeration of more than 100 member groups encompassing over 100,000 members worldwide. It has hosted the World Congress of Gastroenterology every four years to allow its members to make presentations and discuss research developments.

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