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Gastroenterology

Gastroenterology is the branch of medicine that focuses on the structure, function, and diseases of the digestive system. The gastrointestinal tract breaks down food as it is digested to provide energy for the human body to function. During the digestive process, food and liquids travel from the mouth to the anus where elimination takes place. The digestive function is a complex process involving the esophagus, the stomach, the small and large intestines, the liver, the pancreas, and the gallbladder. If any part of this digestive process fails, it can lead to a host of gastric conditions that range from minor discomfort to potentially fatal malignancies.

The first signs of gastric problems may be discoloration or ulcers in the cheeks, hard and soft palates, and tongue. Gastric conditions include dyspepsia, gastric reflux, bowel-related conditions, malabsorption syndromes, ulcerative colitis, Crohn's disease, hepatitis, and malignancies of the gastric tract. Tools used in diagnosis include blood tests, gastroscopy, X-rays, and measurements of esophageal acidity and neuromuscular dysfunction. Treatments vary according to the condition and may include drugs, antacids or alginates, weight loss, elevation of the head when sleeping, and the elimination of smoking, alcohol, caffeinated beverages, fruit juices, and fatty and spicy foods. Surgery is used in more serious cases and may be followed by radiation and chemotherapy in the case of gastric cancers.

Dyspepsia

Gastric upsets are particularly common in Western countries because of nutritional and lifestyles. Approximately 10 percent of all visits to general practitioners involve gastric conditions, and 40 percent of the adult population in Western nations experience at least one serious gastrointestinal attack each year. Ninety percent of all gastric cases diagnosed by health-care professionals are identified as dyspepsia, which is an umbrella term for gastric conditions. Dyspepsia includes indigestion, reflux (heartburn), gastritis, and duodenal and gastric ulcers. It is impossible to estimate how many people self-medicate and never seek professional help for dyspepsia. Dyspepsia can be caused by eating too quickly or eating on the move so that food is not digested properly. Stress may also be a factor in gastric disorders. Particular medications such as aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), antacids containing magnesium, antibiotics, dioxin in large amounts, proton-pump inhibitors, and thiazide diuretics may also lead to dyspepsia.

Diagnosis is based on observation and patient reports of abdominal discomfort accompanied by belching, bloating, flatulence, feelings of fullness, and heartburn. It may be necessary to rule out peptic ulcers. Pain associated with common forms of dyspepsia tends to be aching or uncomfortable. Sharp and stabbing pains or pain that radiates to other body parts may be indicative of more serious conditions. Symptoms that call for professional consultation include persistent vomiting with or without blood and unintentional rapid weight loss. Discomfort alleviated by pain suggests peptic ulcers, while pain relieved by food is indicative of a duodenal ulcer.

Gastric Reflux

If the muscles at the lower end of the esophagus fail to close after contents are emptied into the stomach, gastric reflux may occur, causing partially digested food to back up. The result is heartburn, belching, and other gastric distress. The condition could also be indicative of a hiatal hernia. Virtually all human beings experience gastric reflux at some point in their lives. Infants are particularly prone to the condition. Between the ages of birth and three months, one-half of all infants suffer gastric reflux that causes them to “spit up” undigested milk or food. Between 4 and 6 months, two-thirds of all infants experience gastric reflux at least once a day. Incidences decline after eight months as the infant's digestive system matures. In some cases, reflux may require hospitalization. Warning signs include malnutrition due to inadequate caloric intake or loss of calories through continual regurgitation, and pain, inflammation, or bleeding in the esophageal tract. Gastric reflux may also affect the airways, leading to constant hoarseness, laryngitis, cough, apnea, exacerbation of asthma, or pneumonia.

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