1. What is the task of gastroenterology?
Gastroenterology is a part of internal medicine, a discipline, dealing with the diseases of the intestinal tract. Diseases of the oesophagus, the stomach, the small and the large intestines, the functional disorders of the liver and the pancreas belong here.
Complaints in connection with these conditions are frequent and quite diverse. Is there anyone who has never experienced heartburn or felt nausea? Besides these, diarrhoea, constipation and inflation can also be frequent problems.
A big part of population is exposed to stress, coffee consumption, smoking or taking analgesics. These all are risk factors ulcer diseases. Several, so called civilization diseases also belong to the sphere of action of gastroenterology, like obesity and diabetes. This discipline has shown dynamic growth in recent years both in the field of diagnostics and therapy. Very significant development can be seen among others in endoscopic diagnostics. In the courses of gastroscopy and colonoscopy, (ez ide jó szó? Ugyanis ez vastagbéltükrözést jelent; nem találtam megfelelő szót az általános béltükrözésre. – A következő egyik alcímben már vastagbéltükrözés szerepel! A ford.) the whole gastrointestinal tract can be looked over without surgical intervention, which is not so burdening for the patient. During these procedures, histological sampling and even therapeutic intervention can be possible /e.g. removal of polyp(s)/.2. How does an examination take place?
It is possible to register to the examinations and treatments preliminarily at the receptions desk of our clinic personally, by phone or e-mail. At first personal visit, the patient is registered at the receptions desk and then he or she is directed to the specialist by our colleagues.
In the course of the gastroenterological examination, the specialist questions the patient about his or her complaints in detail. The first part of the questions is directed mainly towards general complaints.
It is followed by questions concerning the function of the digestive organs and the medicaments took by the patient. Some questions can be inconvenient or too intimate for the patient (questions concerning digestion), but they are unconditionally important for the physician to establish a reliable diagnosis.
Questioning is followed by a detailed physical examination. This is mostly general medical examination comprising all the body. During the first visit, the specialist examines the patient in detail, and later, in the follow-up visits, he or she has to concentrate rather on the changes of condition. This is why the follow-up visits are shorter.
Depending on the results of the examinations and on the complaints, the physician can order further exams (e.g. laboratory tests or gastroscopy).
Payment is done at the receptions desk after the examination, the consultation or the treatment.
What is a laboratory test?
Substances in the blood can provide valuable information for the physician. The aim ( céljak hiba: célja) of medical treatments in many cases is keeping values of substances in the blood in their normal range (e.g. blood sugar, blood lipids). Levels of certain enzymes can provide information about the function of the liver and the pancreas. In many cases, physical examination and laboratory test together are enough to establish the diagnose.
What is gastroscopy?
This is an examination method of the oesophagus, the stomach or the duodenum. It is simple, quick and provides with a large scale of information. During the examination, we look over the indicated digestive tract with a flexible device having a tiny camera on one end. In the course of the examination, histological sampling or therapeutic intervention can be possible. The intervention is not painful at all, but unfortunately, it is unpleasant. It lasts about 3-5 minutes. It can be done under local anaesthesia (generally accepted), or under surface or general anaesthesia. Of course this is not accompanied by any unpleasant consequences. During local anaesthesia, Lidocain is sprayed on to the mucous membrane of the throat and the pharynx, but, unfortunately, it can never produce total anaesthesia. The intervention is done in left lateral position of the patient. After the patient swallowed the device, it is forwarded by the examiner towards the oesophagus and into the stomach as well as into the duodenum. Inner cavities can be correctly checked with some added air. Pain cannot be felt, but some regurgitation can generally occur. Histological sampling cannot be felt by the patient. The procedure is worth to be done if there is a suspicion of any diseases in the upper intestinal tract. Complications can be observed very rarely, and they can be avoided quickly. Gastroscopy can be performed both in young or old age.
What is colonoscopy?
Examination to check the rectum and the colon. The lower digestive system can be checked with a flexible device having a tiny camera on one end lead through the rectum till the end of the small intestine. Besides this, less interventions can also be performed. The examination is burdening to a moderate extent. In order the physician could see the possible abnormalities clearly, the colon must be cleared. Practically, it means purging or if necessary, rectal lavages. Today evacuants and cleansing fluids are available expressly for this purpose. The examination can also be performed under local, surface or general anaesthesia. Way of anaesthesia is worth to decide depending on the body stature of the patient and on the planned length of the colon to be examined. The examination lasts generally 10-20 minutes. It is done in lateral or supine position of the patient. Sometimes the position of the patient is worth to be changed during the exam. Insufflation and aspiration of some air can occur, but a slight inflatedness, unpleasant fullness can always be felt. Sometimes it can cause more intense pain, that is why surface or general anaesthesia can be necessary. The examination is worth to perform in all cases when there is suspicion of any diseases in the final part of the small intestine or in the colon. It has a leading role in screening for colon cancer. This is expressly the most efficacious solution to screen for tumours and to remove benign ones. It has a few complications. Bleeding after removal of benign tumours (polyps) or perforation of the colon can occur.3. With what kinds of complaints, diseases should we call upon a gastroenterologist?
Gastroenterological examination can be reasonable in cases of any complaints in connection with digestion or digestive organs. Examination is recommended even in case of slight symptoms like heartburn, nausea, diarrhoea, constipation, inflation, slight abdominal pain, excessive feeling of satiation, halitosis, increased bowl sounds. In case of more serious complaints or warning symptoms like not desired weight loss, vomiting, strong abdominal pain, dysphagia, abnormal stool, or fever which can be connected to problems of digestive organs; it is a must to visit a specialist.
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