Gastroenterology

Gastroenterology aims to preserve the normal functions, motility, digestion and absorption processes of the digestive system organs and to treat disorders affecting these organs.

Digestive system health has a direct impact on the body’s overall energy balance and immune system. Gastroenterology specialists (gastroenterologists) diagnose diseases by directly visualizing the organs through endoscopic and colonoscopic procedures.

What is Gastroenterology?

Gastroenterology is an advanced medical specialty that thoroughly examines the biochemistry, physiology and pathology of the digestive system and related organs. Physicians working in this field complete a specialization in Internal Medicine after six years of medical education and then further specialize by completing an additional three-year subspecialty training in Gastroenterology

The gastroenterology clinic is concerned not only with the treatment of diseases but also with maintaining the healthy functioning of the digestive system. Today, with advancing technology, diagnostic and treatment procedures have become much more comfortable due to camera-equipped devices inserted through the mouth or anus without the need for surgical intervention.

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What Organs Does Gastroenterology Department Deal With?

Gastroenterology examines the digestive tract, one of the longest systems in the body by dividing it into different sections. The main organ structures focused on by gastroenterology department are as follows:

Upper digestive tract: Esophagus and stomach.
Small and large intestine: Duodenum, jejunum, ileum and colon structures.
Hepatobiliary system: Liver, gallbladder and bile ducts.
Pancreas: Digestive enzymes and insulin-secreting glandular tissue.
Anorectal region: Diseases around rectum and anus.

What Diseases Does Gastroenterology Treat?

The gastroenterology department deals with the treatment of a wide range of diseases, from inflammatory conditions of the digestive system to tumor formations. These diseases can be classified according to severity of symptoms and affected organ.

Esophagus and Stomach Diseases

Stomach and esophageal complaints are among the most common gastroenterological problems in the society. Main disorders checked in this group are as follows:

Gastroesophageal reflux: It is the backflow of stomach acid to esophagus.
Gastritis and ulcer: Irritation or wounds in inner surface of stomach.
Hiatus Hernia (Stomach hernia): It is when a part of the stomach shifts to chest cavity.
Difficulty swallowing (dysphagia): Esophagus strictures or movement disorders.
Celiac Disease: It is the small intestine disorder related to gluten sensitivity.

Intestinal Diseases

Intestinal health is vital for the excretory system and absorption in the intestines. Intestinal diseases are listed below:

Irritable Bowel Syndrome (IBS): It is a functional digestive disorder (irritable bowel).
Inflammatory Bowel Diseases (IBD): Ulcerative colitis and Crohn’s disease are managed.
Colon Polyps: They are tissue growths that have a risk of developing into cancer in the future.
Diverticulitis: It is the inflammation of small pouches that develop in the intestinal wall.
Chronic diarrhea or constipation: They are excretion disorders that occur constantly.

Liver, Gallbladder and Pancreas Diseases

Also known as hepatology, this subspecialty aims to protect the body’s metabolic center. Hepatology diseases are listed below:

Hepatitis types: They are Hepatitis A, B, C and other viral infections.
Fatty liver disease: It is excessive fat accumulation in liver (steatosis).
Cirrhosis: It is the hardening of liver tissue and function loss.
Gallbladder stone and infection: They are cholelithiasis and cholecystitis conditions.
Pancreatitis: It is the acute or chronic inflammation of pancreas.

What Are The Diagnosis Methods Use In Gastroenterology Department?

Diagnostic devices used by gastroenterologists focus on directly visualizing the internal structures of digestive organs or measuring functional disorders. These methods are supported by laboratory tests and radiological imaging, providing a multidisciplinary approach. The most frequently used diagnosis methods in gastroenterology are as follows:

Endoscopic imaging: Gastroscopy (upper GIS) and Colonoscopy (lower GIS)
Imaging methods: Ultrasonography (US), Computed Tomography (BT) and MRI.
Functional tests: Urea breath test and pH meter measurements.
Interventional diagnosis devices: Endoscopic Ultrasonography (EUS) and ERCP.

Gastroscopy (Upper Gastrointestinal Endoscopy)

Gastroscopy is a procedure in which the esophagus, stomach and duodenum are examined using a thin, flexible tube with a light and camera at its tip. This method allows direct visualization of lesions, ulcers or tumoral formations on the inner surfaces of the organs.

During the procedure, the physician may take biopsies from suspicious areas or intervene in bleeding foci. The gastroscopy procedure typically takes 5-10 minutes and is performed under local anesthesia or sedation to prevent the patient’s gag reflex.

Colonoscopy and Sigmoidoscopy

Colonoscopy is an essential diagnostic method used for detailed visualization of the entire large intestine and the last part of the small intestine. It is vital in the diagnosis of intestinal polyps, diverticulitis, inflammatory bowel diseases (Crohn’s disease and ulcerative colitis) and colon cancer.

Bowel preparation (diet and use of laxatives) is required before the procedure. During colonoscopy, polyps that are detected can be removed in the same session using polypectomy, helping to prevent the development of cancer. Sigmoidoscopy is the examination of only the last 60 cm of the large intestine (the sigmoid colon and rectum).

Endoscopic Ultrasonography (EUS)

EUS is the imaging of the walls of the digestive tract and nearby organs (pancreas and bile ducts) using a miniature ultrasound device attached to the tip of an endoscope. It provides high-resolution data from deep tissues that cannot be reached by standard ultrasound.

This technology is particularly used in staging cancers of the stomach and esophagus, evaluating pancreatic masses and obtaining needle biopsies from deeply located lymph nodes. EUS helps diagnose the deep tissue without needing invasive surgery.

ERCP (Endoscopic Retrograde Cholangiopancreatography)

ERCP is an advanced gastroenterology procedure that combines endoscopy and radiology (X-ray) and has both diagnostic and therapeutic applications. It is used to identify blockages, stones or strictures in the bile ducts and pancreatic ducts.

During the procedure, a contrast agent is injected through the opening of the bile duct in the duodenum and images are obtained under fluoroscopy. After diagnosis, procedures such as stent placement in the duct or removal of bile duct stones can be performed simultaneously.

Liver Biopsy

It is a procedure used in the diagnosis and follow-up of liver diseases such as hepatitis B and hepatitis C which are commonly seen in our country. It is a procedure in which a small sample is taken from the liver without surgery using a special needle inserted through the right side of the abdomen, while the patient is lightly sedated and the biopsy site is numbed. This sample is then examined under a microscope by pathology, providing important information about the disease.

24-Hour Esophageal pH Monitoring

It is a procedure used especially in patients with reflux symptoms to assess whether stomach acid flows back into the esophagus and if there is, how much it had. It is one of the most reliable methods currently used in the diagnosis of gastroesophageal reflux disease (the backflow of stomach contents into the esophagus). For the test, a catheter (a flexible tube about 2 mm in diameter) with a sensor for pH (acid) changes at its tip is inserted through the nose and positioned at the lower end of the esophagus. The end of the catheter that was left outside, is connected to a small computer. pH (acid) changes at the lower end of the esophagus are transmitted and recorded by the computer system every 4-8 seconds. At the end of the recording, the catheter is removed and the data stored in the small device is transferred to another computer to determine whether there is clinically significant reflux. Nowadays, this procedure can also be performed with wireless sensors.

C13 and C14 Urea Breath Test

It is a simple and reliable test used to detect the presence of Helicobacter pylori, a bacteria that causes gastritis and ulcers in the stomach. The test takes approximately 30 minutes and samples of exhaled breath are collected at the beginning and end of the test to detect the presence of this bacteria in the stomach. C13 breath test does not contain radioactive materials.

Capsule Endoscopy

The small intestine, where some gastrointestinal (stomach-intestinal tract) diseases occur, is a region that is very difficult to examine due to its anatomy. For this reason, the small intestine has been considered the “black box” of the gastrointestinal system. Considering that about 10 percent of unexplained bleeding cases are thought to originate from the small intestine, the importance of its evaluation becomes clear