Gastroenterologist
Physicians who specialize in the diagnosis and treatment of the digestive system or gastrointestinal tract are gastroenterologists. When they specialize to treat children in the same area, they are termed as pediatric gastroenterologist. They treat conditions such hepatitis, colon or rectal cancer, ulcerative colitis and Crohn's disease. A gastroenterologist must complete four years of degree, four years of medical school, three years residency in internal medicines and later specialize in gastroenterology for a period of two to three years. Certification from a recognized board is necessary.
Role of gastroenterologist
Diagnose and offer medical treatment for any kind of disorder in the gastrointestinal tract.
Order for blood tests, x-rays, endoscope checks of the stomach called gastroscopy or for the large intestine called colonoscopy depending on the patient's illness.
Assist a surgeon in exactly locating the area of problem that needs treatment in the gastrointestinal section.
They follow up digestive system disorders that include esophagus, small and large intestine, stomach, pancreas and the liver. They also follow up on symptoms of heartburn, indigestion, ulcers etc following an operation.
Modern techniques and gastroenterologist
Use of ultra high frequency in endosonography gives better understanding of any lesions formed.
Measuring of myoelectric and contractile activity in the gastrointestinal tract, esophageal and anal manometry to understand constipation, nausea, abdominal pain etc better in any patient.
Electrogastrography and few other modern techniques have made it easier to understand the esophageal transit in patients easier.
Hiatal Hernia
A hernia is a condition where a part of the body protrudes through an opening into another part of the body. Most hernias are found in the abdominal area. A hiatal hernia is usually located at the opening of the diaphragm and is an anatomical abnormality of the esophagus. Then the hiatal hernia displaces the muscle band at the lower end of the esophagus (lower esophageal sphincter) and leads to gastroesophageal reflux. As a result, stomach acid flows into the esophagus leading to esophagitis. Hiatal hernia is noticed among obese persons and those who have sustained an injury to that part of the body. Women are at increased risk and so are smokers.
Heartburn is the primary complaint of patients suffering from hiatual hernia. There is belching and feeling of vomiting. Many patients feel that there is something lodged in their chest. Coughing, vomiting or physical exertion can worsen the symptoms of hiatal hernia. The symptoms worsen during pregnancy, lying down or lifting heavy objects. In some cases, a hiatal hernia may go unnoticed. Lifestyle changes like eliminating coffee, alcohol and smoking can help relieve some of the symptoms associated with hiatus hernia. Sleeping with the head at a mild elevation can help prevent stomach acid reflux at night.
A barium x-ray can help in examining the upper digestive tract and checking for any backlash of stomach contents into the esophagus. An endoscopy helps diagnose a hiatal hernia and check for any inflammation of the esophagus. Antacids can help in neutralizing stomach acid. Drugs such as ranitidine, omeprazole or cimetidine are prescribed to reduce the secretion of stomach acid. Surgery is resorted to when there is a possibility of reduced or obstructed blood supply. This is done through laparoscopy to reduce pain, scarring and chances of infection.
Esophagitis
Esophagitis is a condition where there is inflammation and swelling of the esophagus. Esophagitis is caused by stomach acid reflux, fungal or viral infection of the esophagus, certain medications and weakened immune system. If esophagitis is left untreated, it can lead to ulcers and difficulty in swallowing. This can lead to scarring of the esophagus and a situation where food may stick in the area (dysphagia). Often Hiatus Hernia causes Esophagitis since the distension of the stomach through the diaphragm muscle hampers the draining of food and stomach acid. This results in the damage of the esophagal tissue. Candida yeast infection can develop in the esophagus and lead to esophagitis. It attacks when the immune system is weakened and is treated with anti-fungal drugs.
A person suffering from esophagitis has difficulty in swallowing and nausea and vomiting. There are mouth sores. Heartburn involves acid reflux into the esophagus as a burning sensation with a bitter-tasting liquid that may regurgitate into the mouth. A patient can reduce the symptoms of esophagitis by eating smaller meals and avoiding eating for 2 hours before going to bed. Avoid too much spices and acidic food and beverages. Take small bites and chew food thoroughly before swallowing. Place your head at an elevation while sleeping to prevent regurgitation and stomach acid reflux. Smoking, alcohol, caffeine, chocolate, peppermint and fatty foods can aggravate the condition.
The physician can view the esophagus with an endoscope to look for scarring and inflammation. A biopsy can be taken for diagnosis. A Barium swallow involves use of a special dye to facilitate x-ray of the esophagus and check for abnormalities. Antacids can help in reducing stomach acid reflux. Medication to improve the strength of the LES muscle can help in treating esophagitis. Antibiotics or anti-fungal drugs may be prescribed to treat the infection. Inflammation can be reduced with the help of corticosteroid medication. Surgery is resorted to in cases where there is a hiatus hernia or to remove the damaged part of the esophagus.
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