The main purpose of gastroenterological examination is to examine and diagnose various gastrointestinal disorders and diseases such as gastroesophageal reflux disease (GERD), peptic ulcer, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), irritable bowel syndrome (IBS), gastrointestinal bleeding, liver disease and pancreatic disorders, and others.
The examination involves a variety of techniques, which depend on the symptoms and suspected disorders. Common gastroenterological examination includes taking a medical history, physical examination of the abdomen, ultrasound, endoscopy and colonoscopy, as well as various laboratory tests.
Types of gastroenterological examinations
There are several different types of gastroenterological examinations that, in addition to abdominal palpation and anamnesis, are usually performed to assess and diagnose various gastrointestinal conditions.
X-ray
Native abdominal imaging assesses the structure and integrity of the digestive system and identifies obstructions and abnormalities such as enlargement of the intestine. In addition to ordinary X-ray imaging, a barium contrast agent can be used to visualize the upper digestive tract (the patient swallows barium) or the lower digestive tract (barium enema). Barium examination helps identify structural abnormalities or functional disorders.
Upper endoscopy (Esophagogastroduodenoscopy – EGD, gastroscopy)
This procedure involves inserting a thin, flexible tube with a camera (endoscope) through the mouth to examine the esophagus, stomach and upper part of the small intestine.
Colonoscopy
A procedure in which a long, flexible tube with a camera (colonoscope) is inserted through the rectum to visualize the colon and rectum. It is commonly used to detect polyps, colorectal cancer and other abnormalities.
Endoscopic capsule
In this procedure, the patient swallows a small capsule containing a camera that captures images as it passes through the digestive tract. It is mainly used for visualization of the small intestine, which is not easily accessible by other methods.
Endoscopic retrograde cholangiopancreatography (ERCP)
ERCP combines endoscopy and X-rays to diagnose and treat diseases of the liver, gallbladder, bile ducts and pancreas. It is especially useful for diagnosing conditions such as gallbladder stones, pancreatitis and bile duct obstruction.
Endoscopic ultrasound (EUS)
The EUS involves the use of an endoscope with an ultrasonic probe attached to it. It allows the gastroenterologist to obtain detailed images of the digestive tract and surrounding organs, such as the pancreas, liver and lymph nodes. EUS is useful for diagnosing and evaluating stages of gastrointestinal cancer, as well as for assessing conditions such as pancreatic cysts and bile duct abnormalities.
Flexible sigmoidoscopy
This examination involves inserting a flexible tube with a camera (sigmoidoscope) into the rectum and lower part of the colon. It is primarily used to examine the rectum and the left side of the colon for conditions such as polyps, inflammation and bleeding.
During endoscopic examinations, a gastroenterologist may take biopsies (small tissue samples) for further analysis or perform therapeutic procedures such as polyp removal, extension of strictures, or placement of stents to eliminate obstructions.
In addition to these tests, certain conditions will require additional examinations such as stool tests, blood tests, CT (computed tomography), MRI – magnetic resonance imaging or urease exhalation test (for Helicobacter pylori).
The specific type of examination recommended will depend on the patient’s symptoms and medical history. Each examination has its advantages and limitations, and the choice of procedure will be determined by a gastroenterologist in collaboration with the patient.
Symptoms indicating the required gastroenterological examination
Several symptoms may indicate the need for a gastroenterological examination. Although these symptoms are not definitive evidence of a gastrointestinal condition, they require further diagnostic by a gastroenterologist. Here are some common symptoms that may require a gastroenterological examination:
Abdominal pain
Persistent or recurrent abdominal pain that is severe, inexplicable, or interferes with daily activities.
Gastrointestinal bleeding
Any sign of bleeding, such as blood in the stool (hematohesia) or black, tar stool (melena).
Difficulty swallowing
If you have persistent difficulty swallowing (dysphagia) or have a feeling that food is stuck in your throat or chest, this may indicate a problem with the esophagus or upper part of the digestive tract.
Chronic heartburn or acid reflux
Frequent or severe heartburn, acid reflux symptoms (such as regurgitation) or gastroesophageal reflux disease (GERD) that does not respond to over-the-counter medications may require further evaluation.
Persistent nausea or vomiting
Frequent or prolonged nausea or vomiting, especially if they are accompanied by other symptoms such as abdominal pain or weight loss.
Change of bowel habits
Sudden changes in bowel habits, such as persistent diarrhea, constipation or significant changes in the appearance of the stool.
Unexplained weight loss
If you are experiencing unexplained weight loss without any obvious cause or significant changes in your diet or exercise routine, this may indicate an underlying gastrointestinal problem.
Chronic diarrhea or constipation
Persistent diarrhea or constipation that persists for a long period or is accompanied by other symptoms should be evaluated by a gastroenterologist.
Bloating or gases in the stomach
If you frequently experience bloating, excessive gas, or abdominal bloating, it may indicate an underlying gastrointestinal issue.
Family history of gastrointestinal disorders
If you have a family history of gastrointestinal conditions such as colon cancer, inflammatory bowel disease (IBD), or celiac disease, you may benefit from screening and preventive examinations.
It is important to note that these symptoms can be caused by various conditions, and a gastroenterological examination helps in accurately diagnosing the underlying cause. If you have any of these symptoms, it is advisable to consult a healthcare professional or a gastroenterologist for appropriate evaluation and guidance.
Diagnoses that can be determined using gastroenterological examinations
During the gastroenterological examination, different diagnoses can be made depending on the findings and specific tests. Here are some common diagnoses that can be made during or as a result of a gastroenterological examination:
Gastroesophageal reflux disease (GERD)
The diagnosis of GERD can be made on the basis of the presence of erosive esophagitis, esophageal structures or evidence of acid reflux during upper endoscopy.
Peptic ulcer
The presence of stomach ulcers or duodenal ulcers can be detected by upper endoscopy or other imaging techniques.
Inflammatory bowel disease (IBD)
Conditions such as Crohn’s disease and ulcerative colitis can be diagnosed through a combination of symptom assessment, imaging tests (such as colonoscopy or capsule endoscopy) and biopsy results.
Irritable Bowel Syndrome (IBS)
IBS is diagnosed on the basis of a combination of symptom assessment and absence of structural abnormalities during diagnostic tests. Other conditions with similar symptoms should be excluded beforehand.
Gastrointestinal bleeding
The source and cause of gastrointestinal bleeding can often be identified by a combination of procedures, such as upper or lower endoscopy or an endoscopic capsule.
Tumors of the gastrointestinal tract
Various types of tumors of the gastrointestinal tract, including cancers of the esophagus, stomach, colorectal, pancreas and liver, can be detected and diagnosed through imaging tests (such as endoscopy or ultrasound) and are confirmed by biopsy.
Disorders of the gallbladder and bile ducts
Conditions such as gallstones, cholecystitis and bile duct obstruction can be diagnosed using imaging techniques such as ultrasound, CT scanning or ERCP.
Pancreatic disorders
Pancreatitis, pancreatic cysts, and pancreatic cancer can be diagnosed using a combination of symptom assessment, imaging tests (such as CT scans or endoscopic ultrasound) and biopsy results.
Celiac disease
The diagnosis of celiac disease involves a combination of blood tests to detect specific antibodies and upper endoscopy with small intestinal biopsies to confirm damage to the intestinal mucosa.
Liver diseases
Various liver conditions, such as hepatitis, cirrhosis, fatty liver disease and liver tumors, can be diagnosed with blood tests, imaging (ultrasound or MRI), and sometimes liver biopsy. It is important to note that the specific diagnosis will depend on the symptoms of the individual patient, the history of the disease and the findings of the gastroenterological examination. A gastroenterologist will interpret the results and make a diagnosis based on the best available evidence.
Conducting gastroenterological examinations
Upper endoscopy (EGD)
Preparation: The patient will usually be asked to fast for a certain period before the procedure, usually overnight. You may also need to stop taking certain medications.
Procedure: The patient will be given a sedative that will help him relax. A thin, flexible tube with a camera (endoscope) will be inserted through the mouth into the esophagus, stomach and upper part of the small intestine. The gastroenterologist will carefully maneuver the endoscope while examining the mucous membrane of the digestive tract and taking pictures.
Duration: The procedure usually takes about 10 to 20 minutes.
Colonoscopy
Preparation: The patient will be given special instructions for cleaning the large intestine before the procedure. This usually involves a liquid diet and taking laxatives or bowel-emptying medications.
Procedure: The patient will be given a sedative for relaxation. A long, flexible tube with a camera (colonoscope) will be inserted through the rectum and gradually carried further through the entire colon. A gastroenterologist examines the mucous membrane of the colon, looks for abnormalities, and can take a biopsy or remove polyps if necessary.
Duration: The procedure usually takes about 30 minutes to an hour.
Endoscopic capsule
Preparation: The patient will usually be asked to fast for a certain period before the procedure.
Procedure: The patient swallows a small capsule containing a camera. As the capsule passes through the digestive tract, it captures images of the intestinal mucosa. The patient wears a data recorder on the belt, which receives and captures images for later examination by a gastroenterologist.
Duration: The capsule takes about 8 hours to pass through the entire digestive tract. It is important to note that the procedures of tests may vary depending on the patient, the purpose of the examination and the practice of the medical institution or gastroenterologist performing the procedure.
Results and monitoring
After a gastroenterological examination, the results obtained by various tests and procedures will be examined by a gastroenterologist. He will make a diagnosis or will recommend additional examinations. When a diagnosis is made, the gastroenterologist will make a treatment plan tailored to the specific condition. This may include changes in lifestyle habits and diet, medication or other interventions, depending on the underlying cause and severity of the condition.
A gastroenterologist can schedule check-ups to monitor progress, evaluate the effectiveness of treatment, and make all necessary adjustments to the treatment plan. The frequency of control visits will depend on the specific condition and individual needs of the patient.
It is important for patients to actively participate and to inform their gastroenterologist of any changes or concerns during the control examinations. Regular monitoring and constant communication with the health care team help ensure optimal management of gastrointestinal conditions and promote long-term digestive tract health.
When should you schedule a gastroenterological examination?
If you have persistent gastrointestinal symptoms or have a family history of digestive disorders, it is crucial that you take measures and schedule a gastroenterological examination. Do not ignore the symptoms or assume that they will resolve themselves.
Contact a gastroenterologist to discuss your symptoms and determine if a gastroenterological examination is necessary. Remember, early detection and intervention can lead to more effective treatment outcomes and a better quality of life. Therefore, do not delay, be proactive about the health of your digestive system. Schedule a gastroenterological examination today and take a key step towards understanding and improving your health.
