What Gastroenterologists Do?


Last updated Feb. 10, 2018


When our doctor sends us to see a Gastroenterologist, the visit can seem a little intimidating. Just the name of the doctor’s field of expertise is a little daunting and hard to say. We go to them when there is something wrong with one of the most private part of ourselves.

These doctors take away that discomfort in a tactful and clinical way that also eases not only our physical discomfort but our embarrassment, as well.

Gastroenterology is the study of the digestive system. This system is also called the gastrointestinal tract, or GI tract. This tract includes the tongue, salivary glands, pharynx, esophagus, stomach, small and large intestines, epiglottis, gallbladder, liver, pancreas, rectum and anus.

A Gastroenterologist is a specialized doctor that treats conditions along this tract. These doctors have specialized internal training and can diagnose any conditions or illnesses related to these organs.

They treat men, women, and children. Patients with problems in the GI tract will be sent to a gastroenterologist by referral from their regular doctor or they will be seen by one in a hospital setting.

These doctors pay close attention to how food moves through the body’s GI tract, and how the body digests the food intake. This includes how effectively the nutrients are absorbed and how thoroughly waste is removed.

The Gastroenterologist will diagnose any problems throughout this whole system. The mouth is also included along with this path but the Gastroenterologist does not oversee the health of the mouth. That is left for professionals in the dental field.

Gastroenterologists usually see patients in their clinic or in the hospital. They will consult with other doctors and work in research. The Gastroenterologist will evaluate his patients and diagnose a problem then set and execute a treatment plan.

These doctors will perform endoscopic procedures. To do this they use a flexible instrument that is inserted into the mouth or rectum. This instrument is called an endoscope.

It uses an included strobe light and video chip to then investigate the GI tract. This information is displayed on a video monitor so the doctor can see the entire inner organ being examined.

The Gastroenterologist will not perform surgery. They do work closely with a GI surgeon should one be needed.

Symptoms and Problems of Concern:

Patients who are sent to a GI specialist are usually experiencing one or more of the following symptoms:

  • Unexplained blood in the stool
  • Abdominal pain
  • Unexplained difficulties when swallowing

Gastroenterologists will see and treat patients who suffer from:

  • Abdominal discomfort and/or pain
  • Constipation and/or diarrhoea
  • Bleeding in the digestive tract
  • Heartburn
  • (GERD) Gastroesophageal Reflux Disease
  • Gallbladder problems and/or disease
  • Difficulty swallowing
  • Hiatal Hernias
  • Liver Disease including Hepatitis and Jaundice
  • Hemorrhoids
  • Diseases of the colon including polyps, Irritable Bowel Syndrome, Crohn’s disease and Colitis
  • Ulcers
  • Malabsorption disorders such as Celiac disease and lactose intolerance
  • Unusual weight loss
  • Inflammation of the digestive tract
  • Cancers: gastric (stomach), colorectal, pancreatic, liver
  • Bloody stool

Two of the most common diseases seen by a gastroenterologist in South Africa is hepatitis, which is inflammation in the liver caused by taking medication or by a viral infection, and liver cirrhosis which is caused by alcohol abuse.

Hepatitis is found in three forms: A, B, and C. All three can be treated, however, if they are not they can cause permanent scarring along the liver.


Gastroenterology Procedures

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Patients who are sent to a gastroenterologist need one of these possible procedures done for a problem along their GI tract:


Endoscopic Ultrasound: This scan is performed to view the upper and lower GI tract. It is used to diagnose digestive and lung diseases.

A special endoscope is used that utilizes high-frequency sound waves to produce detailed images for the doctor to read. Images are taken of the lining or walls of the digestive tract and chest as well as nearby organs.


Colonoscopy: These routine tests are recommended for every adult. They will be given to patients past a certain age or if they are experiencing problems that need examination.

This test is performed to diagnose polyps in the colon or cancer. This procedure is also done as preventative care. It is a scan of the lower digestive tract.


Liver Biopsy: These are taken to examine pain or blood loss in the bowel. A liver biopsy is performed with a minuscule needle that is inserted into the liver to collect a tissue sample. This is an outpatient procedure or during surgery. The removed tissue is then examined in a lab to help the doctor diagnose diseases and disorders of the liver.


Endoscopic Retrograde Cholangiopancreatography: This procedure is performed to help identify gallstones, scar tissue along the bile duct, or tumours.


Sigmoidoscopy: Patients will have the procedure done when they are enduring pain or blood loss in the bowel. This procedure is used to allow the doctor to see within the sigmoid colon, which is the part of the large intestine near the rectum, and the rectum itself.


Double Balloon Endoscopy: These tests are done to examine along the small intestine. This is a new technique to allow the doctor to see the entire small bowel.


Capsule Endoscopy: This new procedure is also used to examine the small intestines. It involves a tiny camera that is inside a pill. This pill is swallowed and the camera then follows along the digestive tract where it will take pictures on the way down.

Those images are then sent to the gastroenterologist via computer. When done, the bowel will dispose of the tiny camera through regular waste.


Gastroenterologists Education & Training

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Gastroenterologist’s need to be careful and to put their patients at ease. They need to be calm and patient, accurate and respectful. They need to be ethical and have great communication with their patients.

Each gastroenterologist needs to have a Senior Certificate which meets degree requirements for the degree course. Each university will have its own qualifying requirements to accomplish.

It is highly competitive to enter into this course of study and many applicants will apply but only those with excellent grades will be given preference.

A Gastroenterologist must have extensive training including:

  • An MBChB degree from a reliable university such as UCT, UFS, UKZN, UL, UP, US, or Wits
  • 6 years of Theoretical training
  • 1 year of student internship
  • 1 year of practical work at a hospital
  • 4 years of post-graduate specialization studies as a gastroenterologist after completing all MBChB degree requirements and be registered as a medical doctor with the Interim Medical and Dental Council (IMDC) of South Arica for 1 year.
    To register for the IMDC as a gastroenterologist the candidate must successfully complete the exam to qualify as a specialist in the field.

A Gastroenterologist works in a demanding field. They are employed in South Africa in private practices, in hospitals and other care facilities, in clinics and medical schools.

The demand is great both physically and mentally but the work is thoroughly rewarding when so many lives are saved by the work that they do. When we are sick with something along our digestive tract, it is scary and it is unpleasant.

It can be embarrassing to be examined in such a private way. The Gastroenterologist makes it his duty to put the patient at ease and take away the unpleasantness as he examines what is wrong.

If you feel that you need one of the above examinations or procedures, talk to your doctor right away or seek out emergency medical help.



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