Gastroenterology

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Gastroenterology, medical specialty that focuses on the human digestive system and the diseases that affect it. Specialists in the field, called gastroenterologists, study and treat disorders of the esophagus, stomach, small and large intestines, and colon—collectively called the gastrointestinal tract—as well as disorders of the liver, gallbladder, and other organs involved in digestion.

Among the most common conditions that gastroenterologists care for are disorders of the stomach, the organ that receives, stores, and partially digests food in the early steps of human digestion. Gastritis, for example, is an inflammation of the stomach lining that often results in abdominal pain, nausea, and vomiting. Gastritis may be caused by the bacterium Helicobacter pylori, viral infections, stress, allergies, and reactions to alcohol, aspirin, or other substances. A gastroenterologist must identify the causative agent in order to treat this inflammation.

Gastroenterologists also specialize in treating peptic ulcers, sores or erosions in the lining of the stomach or the first portion of the small intestine, called the duodenum. Superficial ulcers cause indigestion and other pain; ulcers causing deeper erosion may lead to abdominal bleeding and, if untreated, death. In recent years, researchers have found a definitive link between Heliobacter pylori and chronic ulcers. Gastroenterologists prescribe antibiotics that kill this bacterium, as well as medications that buffer the acidity in the stomach or slow the stomach’s secretion of digestive acids.

Gastroenterologists treat many diseases related to other organs involved in digestion. The esophagus, for example, can become inflamed from the presence of gastric acid from the stomach, causing heartburn. This condition, known as acid reflux, may be treated with weight loss, drugs that limit the secretion and acidity of gastric acid, and surgical procedures. In the liver, common disorders include hepatitis, an inflammation caused by infection or toxic agents, and cirrhosis, a condition frequently caused by alcohol damage that can ultimately lead to liver failure. Gastroenterologists also treat gallstones, lumps of solid matter found in the gallbladder; inflammation of the pancreas, called pancreatitis; and inflammation of the colon, called colitis.

Gastroenterologists use a variety of highly specialized tools to examine, diagnose, and treat disorders of the gastrointestinal tract. In a procedure called endoscopy, physicians use a long, flexible tube with magnifying lenses and a light source, called an endoscope, to examine internal body cavities. Endoscopes are fitted with specialized attachments, such as grasping forceps or brushes, that enable the physician to remove small tissue samples for laboratory analysis, in a procedure called a biopsy. Endoscopes are also equipped with lasers that enable gastroenterologists to treat disorders without performing more invasive surgery. For example, gastroenterologists cauterize, or burn, peptic ulcers with laser-equipped endoscopes.

Those seeking a career in gastroenterology must first earn a medical degree, then complete a three-year in-hospital training program called a residency, followed by two years of specialized training in gastroenterology and a certification exam.

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